Cadre Disposition as a Key Determinant of Local-Food Supplementary Feeding: A Mixed-Methods Study
Abstract
Introduction: Stunting remains a major public health concern in Indonesia. Local-food supplementary feeding (PMT berbasis pangan lokal) is prioritized in national strategies, yet implementation fidelity varies. This study aimed to assess determinants of PMT implementation in Donggala, Indonesia, a sequential explanatory mixed-methods approach among community health cadres and health workers, guided by Edwards III’s policy implementation framework.
Methodology: A sequential explanatory mixed-methods design was employedmixed-methods sequential explanatory design was applied. Quantitative data were collected via structured questionnaires from 54 cadres and health workers, while qualitative insights were derived from focus group discussions (FGDs). . Binary logistic regression examined the associations between communication, resources, disposition, and bureaucratic structure with PMT implementation, adjusting for education, occupation, and years of service. Results are presented as odds ratios (ORs), 95% confidence intervals (CIs), pseudo-R², and exact p-values. Qualitative data were derived from focus group discussions and analyzed thematically to contextualize quantitative findings.
Results: Disposition emerged as the only statistically significant determinant in the adjusted model (OR = 21.01; 95% CI: 3.02–146.18; p = 0.002), whereas communication, resources, and bureaucratic structure lost significance after adjustment. Qualitative findings reinforced these results, highlighting intrinsic motivation, peer solidarity, and willingness to serve as key drivers of implementation. Participants also identified systemic barriers, including unclear SOP dissemination, limited resources, and administrative burdens, which affected program continuity and cadre performance.
Conclusion: Cadre disposition plays a pivotal role in PMT implementation; however, its effectiveness depends on supportive structural and resource conditions. Motivation alone cannot compensate for weak communication systems, limited budgets, or burdensome administrative procedures. Strengthening supervision, improving communication channels, and ensuring adequate resource allocation are essential. Findings should be interpreted cautiously given the modest sample size and non-validated measurement instruments. Further research using larger samples and validated tools is recommended.
References
Hanifah I, Hidayati T. Implementation of Local Ingredient-Based Supplementary Feeding for Stunting Toddlers with Animation Media on Paiton Village. Int J Nurs MIDWIFERY Sci. 2024;8(2):180–9.
Syam DM, Sunuh HS. Hubungan kebiasaan cuci tangan, mengelola air minum dan makanan dengan stunting di sulawesi tengah. Gorontalo J Public Heal. 2020;3(1):15–22.
Kolomboy F, Adhyanti A, Arsyad G, Aminuddin A, Faisal TI, Ramadhan K, et al. Cross-Sectoral Collaboration in Stunting Prevention: Implementation in Donggala Regency, Central Sulawesi. J Public Heal Pharm. 2025;5(1):191–9.
Tibaka L, Malarangan K. The Rights Of Stunted Children to Health Services In Donggala District. Tadulako Soc Sci Hum J. 2024;4(2):34–40.
Masturina ML, Ilham M, Kurniawati L. Policy Implementation Handling Stunting In Bogor District West Java Province. Mutiara Multidiciplinary Sci J. 2025;3(6):601–22.
Daswati D, Ahsan SC. Implementasi kebijakan penurunan stunting di kabupaten Donggala. JPPI (Jurnal Penelit Pendidik Indones. 2024;10(4):529–52.
Indra J, Khoirunurrofik K. Understanding the role of village fund and administrative capacity in stunting reduction: Empirical evidence from Indonesia. PLoS One. 2022;17(1):e0262743.
Wahyudianto H, Prasetyo A. Addressing the Issue of Stunting in Papua Province: A Coordinated Effort for Child Well-being. In: 5th Borobudur International Symposium on Humanities and Social Science 2023. Atlantis Press; 2024. p. 74–82.
Suharsih S, Rahayu A. Relationship between budget policy, fiscal capacity and stunting prevalence in indonesia. Int J Adv Econ. 2023;5(7):187–98.
Murdhani LA. Empowering Village Communities Through Mutual Cooperation Mobilization Agents in Kalimontang Village in Overcoming Stunting. Int J Sci Res. 2024;1(01):1–6.
Alam S, Rusmin M, Aswadi A, Syafri M. the Role of Human Development Cadres in Efforts To Prevent Stunting. Homes J Hosp Manag Stud J. 2024;5(1):52–71.
Randani AI, Baliwati YF, Sukandar D, Tanziha I. Economic and consumption variables and their associations with stunting prevalence: A provincial analysis of the Indonesian child nutritional status survey 2019. J Gizi Dan Pangan. 2022;17(1):57–66.
Sipahutar T, Eryando T, Paulina Budhiharsana M. Spatial Analysis of Seven Islands in Indonesia to Determine Stunting Hotspots. 2022;
Yushananta P, Muslim A, Rusli Y. Specific Determinants of Stunting Toddlers in Lampung Province: Spatial Data Analysis. J Kesehat. 2023;14(3):462–74.
Fentiana N, L Achadi E, Besral B, Kamiza A, Sudiarti T. A stunting Prevention Risk factors pathway model for Indonesian Districts/Cities with a stunting prevalence of? 30%. 2022;
Soffiudin M, Putri W, Amanda R, Pratiwi D, Makrufardi F. Community Based Stunting Prevention: Learning from Blue Collar Workers’ Children in Indonesia. Indones J Community Occup Med. 2025;4(3):86–93.
Susyani S, Sartono S, Sadiq A, Telisa I, Terati T, Sary DK, et al. REFRESHING INTEGRATED SERVICES POST CADRES IN IMPROVING THE KNOWLEDGE AND SKILLS OF CADRES THROUGH ASSISTANCE METHODS IN PREVENTION AND ACCELERATION OF REDUCING STUNTING IN THE STUNTING LOCUS IN MUARA ENIM REGENCY. Abdi Dosen J Pengabdi Pada Masy. 2023;7(2):514–9.
Arief H, Ekoriano M, Rahadian AS, Widodo T. Good practices for reducing stunting in sumedang regency. Sci Environ J Postgrad. 2023;5(2):138–44.
Widiyaningrum A, Kholiq A, Pratiwi D. The Influence of Professional Competence, Workload, and Work Commitment on Teacher Performance through Job Satisfaction in Madrasah Tsanawiyah. Abjadia Int J Educ. 2024;9(2):433–48.
Suminar JR, Prasanti D, Fuady I, Arifin HS, Aisha S. The health communication for the acceleration of stunting reduction in Garut regency. J Kaji Komun. 2023;11(1):81–95.
Siswati T, Muchlasin A, Kristyanto RY, Gunawan DCD. Determinants and model for estimating the prevalence of stunting toddlers in Sleman Regency. Heal Dyn. 2024;1(6):191–8.
Ridwanah AA, Megatsari H, Laksono AD, Ibad M. Factors related to stunted in East Java Province in 2019: An ecological analysis. Medico-Legal Updat. 2021;21(2):230–5.
Riani EN, Margiana W. Hubungan Pola Asuh dengan Kejadian Stunting pada Balita. J Kebidanan Harapan Ibu Pekalongan. 2022;9(1):48–53.
Mahardhani AJ, Darmawan DA, Sunarto S, Mufanti R. Zero Stunting Villages: Analyzing the Challenges and Imperatives of Actor Collaboration. J Public Policy. 2025;11(2):133–40.
Marhaeni A, Yuliarmi NN, Primajana DJ, Pradnyadewi D, Yasa IGWM, Jayanthi NKE. The role of communication, information and education in preventing stunting among stakeholders in Abang Village, Karangasem Regency. Cent Community Dev J. 2024;4(1):1–13.
Ningsi NW, Mayangsari R, Abdullah AD. Water Sanitation and Stunting Incident in Banggae District, Majene Regency, West Sulawesi. J Ilm Kesehat. 2024;6(1):97–105.
Syukur D, Ganing A, Arsyad G, Mustaqim U. Analysis of Sanitation, Internal and External Factors Affecting Stunting Knowledge among At-Risk Communities in Central Sulawesi, Indonesia. J Kesehat Manarang. 2025;11(2):192–200.
Afrianto I, Yusuf H. The Relationship of Local Wisdom-Based Character Education on Young Females’ Reproductive Health in Parigi Moutong. Media Publ Promosi Kesehat Indones. 2024;7(12):2952–9.
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