Implementation of The Stunting Prevention Policy Program In Cikawao Sub-District

The stunting problem in Indonesia has not been effectively addressed so far, due to policy implementers' inability to effectively actualize the policy. Addressing a significant national problem requires appropriate policies to accelerate problem-solving efforts. This study aims to determine the implementation of the stunting prevention program policy in Cikawao sub-district, Lengkong district, Bandung city. The research method used in this study is descriptive research with a qualitative approach. The data collection techniques used in this study are in-depth interviews, observation, and documentation. Meanwhile, the data analysis technique uses Milles et.al (2014) which consists of data reduction, data presentation, and conclusion drawing or verification. Based on the research results and discussion, it can be concluded that the implementation of the Stunting Prevention Program Policy in Cikawao sub-district, Lengkong district, Bandung city using the G. Edward III theory has been running quite well. However, some aspects need improvement, such as communication, which includes transmission factors, clarity, and consistency between implementers and the community, the resources, which include staff, information, facilities, and authority, also need to be improved. On the other hand, the disposition or behavior of policy implementers has been quite good.


INTRODUCTION
The Indonesian government has identified stunting as a national problem that must be resolved, and thus, in 2018, the National Strategy for Acceleration of Stunting Prevention was created. This was evidenced by Presidential Regulation Number 59 of 2017 on the Achievement of Sustainable Development Goals, in which improving nutrition is part of the sustainable development goals. In supporting this national strategy, during a limited meeting on April 5, 2018, the President instructed the Coordinating Minister for Human Development and Culture, the Minister of Health, and leaders of ministries/agencies to handle stunting issues in an integrated manner. This shows that the President also has a high commitment to stunting prevention in Indonesia. The follow-up to this commitment from the central government is the formulation of the National Strategy for Acceleration of Stunting Prevention Interventions for the 2018-2024 period by the Ministry of State Secretariat of the Republic of Indonesia in collaboration with 23 ministries/agencies in accelerating stunting prevention efforts, each playing their respective roles.
To prevent and reduce stunting, the government has established several policies and programs (Haris et al., 2018;Hung, 2017;Leviäkangas & Molarius, 2020;Rosenau et al., 1992;Suhardi et al., 2019). Policy is a set of alternative options that can be selected based on certain principles leading to the best alternative decisions (Limpo et al., 2015a(Limpo et al., , 2015a(Limpo et al., , 2015b. Policies are a series of principles that form the outline and basis of a plan in implementing a task, leadership, and action (about an organization or government); a statement of aspirations, goals, principles, or intentions as a guide for management in achieving specific objectives (Garcia-Sanchez et al., 2013;Nugroho, 2017;Treffgarne, 2019;Wonglimpiyarat, 2011).
One of the fundamental rights that everyone deserves is to have sufficient nutrition. Adequate nutrition in the body affects optimal growth and development from fetuses to sustain life thereafter. Indonesia is currently facing the challenge of double malnutrition, in which the Indonesian government still needs to work hard to overcome nutritional deficiencies, including stunting. Solving such significant national problems requires appropriate policies and measures to accelerate problem-solving efforts (Adebayo, 2021;Bezerra, 2021;Cheng, 2018;Dergiades et al., 2020;Ebrahimi et al., 2019;Hanifzadeh et al., 2018;John et al., 2022;Linder et al., 2017;Slaughter & Leslie, 1997). These policies also need to be implemented at the regional level, particularly in regions with high stunting rates.
Bandung is one of the cities selected among the 100 priority districts/cities in handling and preventing stunting problems in 2020. The location with the highest stunting rate in Bandung is in 15 sub-districts in 11 districts of Bandung. This location was established in Mayor's Decree Number: 050/Kep.607-Bappelitbang/2020 concerning the Designation of Village Locations for Stunting Reduction and Prevention Programs in Bandung City. In Bandung, the number of toddlers affected by stunting is spread across 11 districts and 15 sub-districts, with the highest number of cases found in Cibiru sub-district's Cipadung village, with 283 toddlers affected, and the lowest in Lengkong sub-district's Burarangrang village, with 94 toddlers affected due to malnutrition caused by economic failures resulting from the Covid-19 pandemic. According to the Bandung City Health Office in 2020, the increase in stunting cases is due to various factors, including insufficient food intake and poor nutritional intake during pregnancy.
The Bandung City Government is striving to reduce stunting rates by implementing innovative policies such as the Bandung Tanginas Program (Bandung Responsive to Stunting with Safe and Healthy Food). This program aims to accelerate the reduction of stunting rates in Bandung. Another program is the Non-Cash Assistance (BNT) which is budgeted from the Bandung City Regional Budget, provided to children under five years old (toddlers) and children under two years old (infants) in Bandung City. The implementation of these programs is due to the government's concern, especially the Bandung City Government, about the high number of toddlers and infants suffering from stunting, as well as the lack of knowledge among Bandung residents about the negative impact of stunting.
Based on Local Regulation Number 31 of 2006 Chapter 2 Article 2, sub-districts are formed to improve public services, carry out government functions, and empower communities to accelerate the achievement of community welfare. The Cikawao sub-district in Lengkong district, Bandung City is implementing the Stunting Prevention Program policy. A policy cannot be considered successful if, after the implementation of public policy, its impact is unable to solve the problems faced by the community. However, there are times when the results of public policy are not immediately effective in the short term, but after a certain process, it becomes effective. To determine whether the stunting program implementation has been effective, a certain process needs to be followed.
Cikawao sub-district is one of the sub-districts with a high stunting risk status in Bandung City. The number of short and very short toddlers in the sub-district is 106. The phenomena occurring in the implementation of stunting policy in Cikawao sub-district include the lack of socialization of the stunting program to the community, the ineffectiveness of stunting prevention programs, low literacy among the community related to stunting, low-income communities where most mothers work during the child's First 1000 Days, resulting in the child not receiving Exclusive Breastfeeding from the mother, leading to the child's inadequate nutrition. Moreover, community participation in weighing babies at Posyandu is also not effective, causing inaccurate data, which is a hindrance to the more effective implementation of stunting program

METHOD
This research uses a descriptive research method with a qualitative approach. This method is used to describe the phenomenon in detail and comprehensively. The data collection techniques used in this study are in-depth interviews, observations, and documentation. In-depth interviews are used to obtain detailed and comprehensive data from respondents related to the research topic.
Observations are conducted to obtain data on the behavior, actions, and social interactions of respondents that cannot be obtained through interviews. Meanwhile, documentation is used to obtain data from documents relevant to the research topic. For data analysis techniques, this research uses Miles, et.al (2014), namely data reduction, data presentation, and conclusion drawing or verification. Data reduction is done to reduce data into smaller units that can be processed effectively. Data presentation is done by organizing the reduced data for more systematic analysis. Conclusion drawing or verification is done to test hypotheses formulated based on data obtained from the study.

Result
Public policy is said to be a multidisciplinary science because formulating public policy involves many disciplines such as political science, social science, economics, psychology, statistics, mathematics, culture, law, and so on. Public policy is one of the studies in public administration. Every public policy has good goals that are oriented towards achieving goals or solving problems, or a combination of both. Policy implementation is a crucial stage in the public policy process. A policy or program must be implemented to have the desired impact or goal. Policy implementation is broadly viewed as a public administration tool where actors, organizations, procedures, techniques, and resources are organized together to carry out policies to achieve the desired impact or goal.
From the results of the interviews, it can be said that the constraints in human resources in implementing the Stunting Prevention Program policy in Cikawao Sub-district are the abilities of cadres in providing services which are still lacking, and there are often errors in inputting data. There are still many cadres who are elderly which results in slow service in the application of the ePPGBM (Electronic Recording and Reporting of Community-Based Nutrition). Here is the stunting data in Cikawao Sub-district, Lengkong District, Bandung City from the Bandung City Health Department.

c. Behavior (Disposition)
According to Edward III (1980), dispositional attitude is crucial because if policy implementers have a disposition that contradicts the direction of the policy, this perspective can also result in a mismatch between the actual policy objectives and policy implementation in the field. The aspect of behavior (disposition) in the implementation of the Stunting Prevention Program policy in Cikawao Subdistrict, Lengkong District, Bandung City is quite good. This is based on the fact that the informants received friendly and fair treatment from the officials. The obstacle to the disposition/behavior of policy implementation is that the stunting prevention policy implementers in Bandung City do not yet have the appropriate character and traits that can support the success of the policy.

d. Organizational Structure
Based on the above research results, it can be concluded that there is already a bureaucratic structure in stunting handling stated in SK

Efforts to overcome obstacles in the implementation of the Stunting Prevention Program policy
Basically, a policy established by the government is for the benefit of the community. Every policy made by the government will certainly not be separated from problems that may hinder the implementation of the existing policy. However, when the policy is established, the government has certainly considered the things that may happen. In other words, the implementation of a policy to be properly carried out to the target of the policy depends entirely on the ability of the policy implementers, which depends on the type of policy to be implemented, as well as the implementation of the Stunting Prevention Program policy. The Bandung City Government, in this case as the policy implementer, must be able to provide encouragement and education to the target groups of the policy. The efforts made are as follows: a. To overcome the mindset of the community that is still ignorant of stunting, the PKK of Cikawao Sub-district not only conducts program socialization once or twice, but also during every weighing at the integrated health post (posyandu). b. To overcome the problem of inaccurate recording and reporting by the human resources, training and strengthening is provided to the cadres. The Health Department also supervises the community health centers (puskesmas) in developing the cadres. c. To overcome the problem of data inaccuracy, where manual data and input data in the application differ, monitoring and evaluation are conducted to measure the validity of the data by re-measuring the height of the toddlers to ensure the data obtained is valid.
To overcome the problem of inadequate budget for the Supplementary Feeding Program, the PKK of Cikawao Sub-district selects nutritious menu options with a minimal budget, so that all toddlers can be covered. Additionally, some of the budget from the RT/RW Community Empowerment Fund (PIPPK) is allocated to the Supplementary Feeding Program.

Discussion
Public policy is considered a multidisciplinary science since it involves different disciplines such as political science, social science, economics, psychology, statistics, mathematics, culture, law, and more (Agustino, 2016;Yamin & Agustino, 2014). The policy-making process aims to achieve good goals that are oriented towards solving problems or achieving specific objectives. However, policy implementation is a crucial stage in the public policy process that involves different actors, organizations, procedures, techniques, and resources to carry out policies effectively (Agustino, 2020).
In the implementation of the Stunting Prevention Program policy in Cikawao Sub-district, Bandung City, there are several constraints in human resources. These include the lack of abilities of cadres to provide services and frequent errors in data inputting (Internal data from the Health Department of Bandung City, 2022). The Kelurahan Cikawao office provides training to improve the quality of human resources and cooperates with Talaga Bodas health center to provide training to PKK cadres to strengthen stunting prevention.
G. Edward III's Policy Implementation Model (Arwildayanto et al., 2018) includes communication, resources, behavior (disposition), and organizational structure as variables that determine the success of policy implementation. In terms of communication, the implementation of the Stunting Prevention Program policy in Kelurahan Cikawao has been good. However, some individuals still lack socialization regarding the policy, leading to a lack of understanding. The resource aspect of policy implementation, which includes staff, information, authority, and facilities, has not yet been fully achieved in Kelurahan Cikawao. The behavior (disposition) of policy implementation has been good, but the implementers still need to have the appropriate character and traits that can support the success of the policy. The organizational structure has a bureaucratic structure, but the implementation of the Stunting Prevention Program policy still lacks a written Standard Operating Procedure (SOP).
The efforts to overcome the constraints in implementing the Stunting Prevention Program policy in Cikawao Sub-district, Bandung City include conducting regular program socialization, providing training and strengthening to the cadres, monitoring and evaluating data accuracy, and selecting nutritious menu options with a minimal budget (Internal data from the Health Department of Bandung City, 2022).

CONCLUSION
The implementation of the Stunting Prevention Program policy in Cikawao Sub-district, Lengkong District, Bandung City using G. Edward III's theory has been implemented quite well, but there are still some aspects that need improvement. The communication aspect in implementing the Stunting Prevention Program policy, which includes transmission, clarity, and consistency between implementers and the community, is not running well. The resource aspect, which includes staff, information, facilities, and authority, has not been achieved as expected. The aspect of behavior or disposition in implementing the Stunting Prevention Program policy in Cikawao Sub-district has been quite good, as the informants received friendly and fair treatment from officials. The bureaucratic structure aspect, specifically the Standard Operating Procedure (SOP), has not been achieved as expected, as there is still no SOP in the implementation of the Stunting Prevention Program policy.