Community Health Cadres as Community Mediators in Supporting Families at Risk of Stunting: A Qualitative Study within Maternal and Child Health Services in Indonesia

Abstract Background Stunting remains a major public health challenge shaped by socio cultural factors that influence caregiving practices, nutrition, and health-seeking behaviours. Although community health cadres play important roles in stunting prevention, limited evidence exists regarding their function as community mediators within maternal and child health services. This study explored how community health cadres function as community mediators in supporting families at risk of stunting within socio-cultural contexts. Methods A qualitative descriptive study was conducted in the Mandala Health Center service area, Lebak Regency, Banten Province, Indonesia. Thirty eight participants, including community health cadres, parents from families at risk of stunting, healthcare workers, community leaders, and a local government representative, were purposively recruited. Data were collected through in-depth interviews, focus group discussions, participant observation, and field notes and analysed using thematic analysis. Results Three themes were identified: community perceptions and engagement in family accompaniment, community health cadres as community mediators, and factors influencing accompaniment practices. Cadres acted as trusted community mediators who facilitated communication, strengthened family engagement, connected families with maternal and child health services, and adapted health messages to local socio-cultural contexts. The effectiveness of accompaniment was influenced by family participation, cultural beliefs, community support, and health system factors. Conclusion Community health cadres function as community mediators who bridge families, communities, and maternal and child health services through culturally responsive and relationship-centred accompaniment. Strengthening cadre capacity and supportive community systems may enhance community-based stunting prevention efforts.