Implementation outcomes of convergence action policy to accelerate stunting reduction in Pidie district, Aceh province, Indonesia: a qualitative study

Objectives: The research aims to understand the challenges and opportunities in policy and programme convergence to accelerate interventions for reducing stunting at the district, subdistrict and the 10 focused villages.

Design: Data were collected through qualitative methods (in-depth interviews and document reviews), and then analysed using thematic processes with NVivo V.11 software, by QSR International The process included coding, categorising and linking to the eight implementation outcome variables (as determined themes), namely acceptability, adoption, appropriateness, feasibility, compliance, implementation cost, coverage and sustainability. The variables of convergence action policies were implemented differently by stakeholders at different layers of governance.

Setting: Pidie district, Aceh province, Indonesia.

Participants: 106 respondents from provincial to village levels were selected and interviewed, including leaders and policymakers (n=10); and convergence action implementers from the province to the villages (n=96).

Results: Stunting reduction policies were generally acceptable to local leaders and policymakers as a policy imperative. Implementation costs were considered sufficient by stakeholders, although focusing only on nutrition-specific interventions. However, in terms of adoption, feasibility, compliance, nutrition-sensitive intervention coverage and sustainability aspects were insufficiently implemented in all the focused villages due to inadequate collaboration between health and non-health sectors and limited experts.

Conclusions: This study offers key recommendations for policy and practice changes and considerations. The utilisation of methods and findings from this study in other areas in Indonesia or other low- and middle-income countries is important to explore more about the applicability, benefits and weaknesses of this study.