Public Health of Indonesia
E-ISSN: 2477-1570 | P-ISSN: 2528-1542
Original Research Strengthening the Role of Community Health Workers in High Stunting Prevalence Areas of Kendari City.
Southeast Sulawesi Province.
Indonesia: A Qualitative Study Hartati Bahar1*.
Devi Savitri Effendy2.
Hariati Lestari3 1 Department of Health Promotion.
Public Health Faculty.
Halu Oleo University.
Kendari.
Indonesia 2 Department of Nutrition.
Public Health Faculty.
Halu Oleo University.
Kendari.
Indonesia 3 Department of Epidemiology.
Public Health Faculty.
Halu Oleo University.
Kendari.
Indonesia *Corresponding author Hartati Bahar Department of Health Promotion.
Public Health Faculty.
Halu Oleo University.
Kampus Hijau Bumi Tridharma Anduonou Kendari.
Indonesia.
Email: hartati.
bahar@uho.
DOI: https://doi.
org/10.
36685/phi.
Copyright: A 2025 the Author.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium provided the original work is properly cited.
Article History:
Received 6 November 2024 Revised 15 January 2025 Accepted 6 November 2025 Abstract Background: The role of posyandu .
ntegrated health pos.
cadres constitutes a critical pillar in accelerating stunting reduction efforts in Indonesia.
Nevertheless, in practice, their contribution is often perceived as supplementary within primary healthcare services.
Objectives: This study aims to conduct an in-depth analysis of the strengths of posyandu cadres in assuming an active role in stunting reduction efforts in the stunting locus area of Dapu-dapura Village.
Methods: This qualitative study employed three data collection techniques: focus group discussions (FGD.
, in-depth interviews, and direct observations.
Two FGD sessions were conducted, and interview transcripts were analyzed using content analysis.
Informants included posyandu cadres, healthcare workers, mothers of stunted children, and local government A total of 16 participants aged 28 to 63 years were involved.
Results: The findings indicate that elderly cadres .
possess greater experience and employ interpersonal approaches that are more readily accepted by the community than younger These senior cadres have effectively shifted maternal perceptions related to stunting stigma, particularly among those hesitant to attend posyandu.
They serve as key intermediaries connecting healthcare workers responsible for program implementation with mothers as service Strategic efforts are needed to prepare younger cadres to gradually assume these roles as part of cadre regeneration.
Conclusion: Posyandu cadres in Dapu-dapura Village play an essential intermediary role in stunting prevention.
however, their performance is constrained by social stigma, limited maternal nutritional literacy, and geographic barriers.
Strengthening competencies in management, measurement accuracy, and counseling is necessary to enhance their effectiveness in contributing to stunting reduction at the community level.
Keywords: Social Stigma.
Primary Health Care.
Counseling.
Stunting.
Posyandu.
Indonesia Background Stunting is one of the major chronic nutritional problems characterized by a height-for-age Z-score (HAZ) below -2 standard deviations, according to the World Health Organization (WHO) growth standards.
This condition reflects prolonged nutritional deficiencies, particularly during the first 1.
000 days of life, from conception to the age of two years Volume 11.
Issue 4.
October Ae December 2025 (Mulyani.
Khairinisa.
Khatib, & Chaerunisaa, 2025.
Soliman et al.
, 2024.
World Health Organization, 2.
Early-life stunting has profound effects on brain development, cognitive function, growth, and metabolic processes.
In the long term, it increases susceptibility to diseases, reduces educational attainment and economic productivity, and contributes to decreased labor competitiveness (De Lucia Rolfe et al.
, 2018.
Dewey & Begum, 2011.
Effendi & Erawan, 2.
The most severe consequence of stunting is its contribution to child mortality, with an estimated one million deaths occurring annually, predominantly in developing countries (Togatorop.
Rahayuwati.
Susanti, & Tan, 2.
Globally, an estimated 154.
3 million children under the age of five experienced stunting in 2020, decreasing to 1 million in 2022.
The majority of these cases occurred in Asia .
%) and Africa .
%).
Indonesia is among the countries with a high burden of stunting, although national prevalence has shown a declining trend 24.
4% in 2021, 21.
in 2022, and 21.
5% in 2023.
However, this reduction remains relatively slow and falls short of the national target of 14% by 2024 (East & Africa, 2021.
Jung.
Shin, & Lee, 2023.
Mehta et al.
, 2023.
World Health Organization, 2.
At the subnational level, the prevalence of stunting demonstrates considerable variation.
In Southeast Sulawesi Province, the prevalence was recorded at 30.
2% in 2021, decreased to 27.
7% in 2022, but rose again to 30.
0% in 2023 (Tim Percepatan Penurunan Stunting, 2.
A similar pattern was observed in Kendari City, where the prevalence declined from 24% in 2021 to 19.
5% in 2022, yet increased to 25.
7% in 2023 (Dinas Kesehatan Kota Kendari, 2.
These figures exceed the national average, indicating greater challenges in stunting prevention and control within the region.
addition to the high prevalence, the situation in Kendari City is further reflected in the coverage of child health services at community health posts .
Data from the Kendari City Health Office show that the proportion of under-five children weighed at posyandu increased from 61.
4% in 2021 to 82.
6% in 2022, before declining again to 71.
0% in 2023.
A similar fluctuation occurred in the Benu-Benua Community Health Center catchment area, where coverage dropped 1% in 2022 to 71.
4% in 2023 (Dinas Kesehatan Kota Kendari, 2.
These fluctuations suggest that a segment of children under five remains unreached by routine growth monitoring services, hindering the early detection and optimal management of stunting.
The Government of Indonesia has implemented a national strategy to accelerate the reduction of stunting through both specific and sensitive interventions (Tim Percepatan Penurunan Stunting, 2.
Specific interventions within the health sector rely heavily on the role of posyandu cadres, who serve as the frontline of community-based health services.
Their responsibilities include monitoring child growth, providing nutrition education, and facilitating maternal and child health referrals.
However, fluctuations in posyandu service coverage in Kendari City indicate persistent challenges in sustaining family participation, which may limit the effectiveness of early detection and intervention efforts for stunting.
Given these circumstances, strengthening the role of Community Health Workers (Cadre.
is crucial to reducing stunting prevalence, particularly in areas where the trend remains unstable.
This study aims to assess the effectiveness of posyandu cadres in preventing stunting within the service areas of community health centers .
in Kendari City.
Methods Study Setting and Design This study was conducted in Dapu-Dapura Subdistrict.
West Kendari District one of the priority areas for stunting reduction in Kendari City.
The location was selected due to its increasing stunting prevalence over the past three years.
qualitative approach was employed to explore the knowledge, understanding, and experiences of community health cadres in supporting the national stunting reduction program.
Data were collected through focus group discussions (FGD.
, in-depth interviews, and field observations.
Participants and Procedures Participants were purposively selected based on their involvement in the stunting reduction program.
A total of 16 informants participated, consisting of community health cadres, healthcare workers, mothers of stunted children, and key informants from city-level program implementers.
Recruitment began through the local cadre coordinator, who subsequently recommended other eligible participants.
Data Collection Data were gathered through two FGDs with cadres and healthcare workers, in-depth interviews with nutrition officers, midwives, and mothers of stunted children, as well as observations of cadre activities at posyandu .
ommunity health The interview and FGD guides were developed based on a review of the literature and discussions among the research team.
Each FGD session lasted between 45 and 120 minutes and was facilitated by the lead researcher as moderator, assisted by a research assistant as note-taker.
All sessions were audio-recorded with participantsAo consent.
Observations were conducted using a checklist based on the five-table posyandu model to assess cadre skills, particularly in anthropometric measurement.
Volume 11.
Issue 4.
October Ae December 2025 Data Analysis Audio recordings were transcribed verbatim and organized into a matrix format.
Key events that were not captured in the recordings were noted by the moderator and assistant, then integrated into the transcripts.
Once the matrices were completed, transcripts were reviewed and cross-checked against the recordings to ensure accuracy.
The analysis process involved several stages: repeated reading of transcripts to grasp the overall context.
open coding by marking words, phrases, or paragraphs of significance.
grouping codes into categories with similar meanings.
linking categories to identify emerging patterns.
and deriving overarching themes representing the studyAos findings.
Data analysis was performed manually and independently by the researchers, followed by team discussions to reach consensus on the final themes.
This process ensured the reliability and traceability of the analysis.
Representative participant quotations are presented in italic within the manuscript.
Credibility and Confirmability To ensure data credibility, all findings were reviewed by the research team, who examined the transcripts, audio recordings, and field observations to confirm their alignment with the studyAos objectives.
Data validity was maintained through several strategies.
First, source triangulation was achieved by involving diverse informants, including cadres, healthcare workers, mothers of stunted children, nutritionists, and local government officials.
Second, methodological triangulation was applied by combining FGDs, in-depth interviews, and observations.
Third, data triangulation was conducted by comparing primary and secondary data sources.
Furthermore, all findings were re-examined collaboratively by the research team to ensure consistency across transcripts, recordings, and observational data in relation to the research purpose.
Results The total number of informants in this study is 16 individuals aged between 29 to 63 years, consisting of 14 females and 2 males.
Of these, 6 have completed secondary education, and 10 have completed higher education.
INPUT Concept The cadres interviewed stated that they invite participants to the posyandu .
ommunity health pos.
through door-todoor visits.
WhatsApp groups, and by receiving reports from neighbors or local communities about pregnant women.
However, some residents visit posyandu locations that are not aligned with their residence areas.
Alternative one, the way to track them is through door-to-door visits.
The second way is because I have a good relationship with the community.
I always get news from them about posyandu targets.
(Interview with cadre T, 60 years ol.
Children and parents who cannot attend the posyandu, we visit them at their homes.
(Interview with Village Head of Dapu-dapura.
As, 41 years ol.
We announce it in the WhatsApp group, if they have never attended posyandu or have just moved here.
(Interview with cadre L, 33 years ol.
Usually, if we hear someone is pregnant, we visit them.
(Interview with cadre J, 46 years ol.
There is a resident from Dapu-dapura who moved to the posyandu in Jati Mekar, so when the child was diagnosed with being at risk of stunting and malnutrition, they refused to come to the posyandu here.
The public health center staff scolded me, asking why we didn't know? I answered that they never came to the posyandu again.
Finally, we visited them and encouraged them to attend regularly.
Now they are attending the Manggarai posyandu "(Interview with cadre T, 60 years ol.
Cadres mentioned that difficulties in encouraging people to attend the posyandu stem from a lack of awareness about the importance of measuring children's growth and development at posyandu.
Children over 9 months old are no longer brought to posyandu with the assumption that basic immunizations are complete.
Posyandu becomes busy again during the Vitamin A distribution months, which are February and August.
The hardest to invite to posyandu are the uneducated people.
Posyandu is busy again, especially during the Vitamin A distribution months (February and Augus.
"(Interview with cadre J, 46 years ol.
Here, residents, once their child's basic immunizations are done, no longer bring them to posyandu.
Especially regarding weighing their children, they donAot care.
Most are like that.
(Interview with cadre S, 34 years ol.
Volume 11.
Issue 4.
October Ae December 2025 Process Concept The cadres interviewed stated that communication channels with the village officials and health workers are functioning Midwives invite cadres to visit patients who have recently given birth, and the Village Head helps facilitate the posyandu's needs.
However, some posyandus in Dapu-dapura are located on the mountain.
Coordination with midwives is good.
We usually accompany the midwives to visit the homes of mothers who have recently given birth.
I accompany Midwife Yanti.
(Interview with cadre L, 33 years ol.
Oh, when I tell the Village Head I need a mattress for a pregnant woman who will be examined at the posyandu.
(Interview with cadre A, 63 years ol.
The government can provide posyandu facilities, because some village posyandus are in good locations, but some are located on the mountain.
(Interview with health worker UK, 28 years ol.
Cadres mentioned that some mothers do not want their children labeled as stunted.
They avoid discussions that might hurt the mother's feelings.
Some cadres cannot distinguish between stunting and wasting.
Mothers of children at risk of stunting may stop coming to posyandu.
There is a mother who does not want her child labeled as stunted.
She said, 'My child is just thin because they don't sleep enough, they don't want to eat.
(Interview with cadre A, 63 years ol.
There is a child over three years old who weighs only 10 kilograms.
I weighed them, and this child hasn't gained any weight.
It's for the child's good, but the mother doesn't want to be told her child is stunted or malnourished.
(Interview with cadre A, 63 years ol.
Yes, there is denial when their child is told to be stunted because they feel their child can speak, jump, and is active.
But stunting is a growth issue.
intelligence development can still progress.
(Interview with health worker UK, 28 years ol.
There was a nutritionist who visited a mother whose child was stunted, but the way it was said was too harsh.
After that, the mother refused to come to posyandu again.
During that visit, the cadre wasn't present.
(Interview with cadre T, 60 years ol.
There are many mothers who don't want their child to be labeled as stunted.
(Interview with cadre L, 33 years Here, the stigma surrounding stunting is that it is just a short child who isn't taken care of.
There is a lot of denial.
They say, 'My child isn't stunted, my child can jump, can talk.
' This needs to be understood stunting affects growth.
If a child is short but can learn and is smart, it means their development is improving, but their growth isn't.
"(Interview with health worker UK, 28 years ol.
We, the cadres, also try to be considerate of their feelings.
(Interview with cadre A, 63 years ol.
There is a resident from Dapu-dapura who moved to the posyandu in Jati Mekar, so when the child was diagnosed with being at risk of stunting and malnutrition, they refused to come to the posyandu here.
(Interview with cadre T, 60 years ol.
Cadres mentioned that many mothers do not understand the nutritional needs of their children during growth Both children and pregnant women often have insufficient protein intake.
Some parents give sweets or crackers to their children to stop them from crying.
My child is 11 months old.
He usually eats porridge and eggs.
This morning, he had porridge and eggs.
He doesn't eat at noon, only drinks milk and takes a nap.
So, before 8 pm, he doesn't eat.
(Interview with mother of a stunted child.
AU, 19 years ol.
Volume 11.
Issue 4.
October Ae December 2025 Nowadays, mothers don't know how to feed their children properly.
They don't know how much food a 1-year-old child should be given.
If we only give them one piece of cake in the morning, we would be starving by noon.
(Interview with nutritionist RW, 54 years ol.
Parents nowadays think children should eat a lot of vegetables to stay healthy, but for children who are still growing, their protein needs should be met first.
Vegetables are secondary.
The same goes for pregnant women.
their protein needs should be prioritized (Interview with health worker UK, 28 years ol.
Many mothers do this now, especially with snack kiosks.
They just give their children sweets or crackers to stop them from being fussy.
This actually goes against the recommendations for children's growth.
(Interview with cadre T, 60 years ol.
Output Concept Based on the interview results, it was found that mothers labeled as having stunted children are reluctant to bring their children back to posyandu.
Some cadres still struggle to provide health education to the community.
Some cadres do not fully understand the concept of stunting, and many are unaware of specific stunting prevention programs.
Furthermore, some cadres lack the skills to perform anthropometric measurements.
Older cadres present challenges in implementing the posyandu program.
I heard that once a mother was angry when she brought her child here because she didnAot want her child to be labeled as stunted, so she stopped bringing them here (Interview with cadre T, 60 years ol.
Health education is usually provided by the health center and delivered by the midwife.
(Interview with cadre L, 33 years ol.
The new posyandu system should empower cadres more.
Previously, health workers handled education, but now cadres should also be able to provide education.
Before, we only assisted, but now they are truly empowered (Interview with health worker UK, 28 years ol.
In some posyandus, the cadres are older.
They are assigned to record data, but usually, they rotate.
This month, they are at table 1, and next month, they may be assigned to weigh and measure children (Interview with health worker UK, 28 years ol.
Here, most people stop bringing their children to posyandu after their immunizations are done.
They think the immunizations are complete, and they donAot need to go anymore.
(Interview with cadre J, 46 years ol.
Some cadres still donAot know how to measure correctly.
They forget to remove the hairband from the child, or they forget to press the knees to keep the feet flat when measuring.
(Interview with health worker UK, 28 years ol.
Direct observations of anthropometric measurements conducted by posyandu cadres in the field revealed several procedural inaccuracies.
During the measurement of body length in infants and toddlers who were unable to stand, cadres did not remove shoes, socks, headbands, hats, or other accessories that could interfere with accurate measurement.
Additionally, cadres did not ensure that the childAos knees were fully extended or apply gentle pressure to position the feet flat against the measurement surface, which is essential for obtaining valid body length readings.
These deviations indicate the need for improved technical competency in anthropometric assessment.
The input stage reflects the initial mechanisms used by cadres to reach and engage the community.
Cadres conducted door-to-door visits, disseminated information through WhatsApp groups, and received reports from neighbors regarding newly pregnant women.
These strategies enabled early identification and outreach to target groups.
However, several residents were reported to seek services at posyandu outside their designated areas, which complicated coordination.
Additionally, cadres faced challenges in motivating community members to attend posyandu sessions due to limited awareness about the importance of growth monitoring for young children.
The process stage illustrates how cadres carry out their roles and interact with stakeholders.
Communication between cadres, village officials, and health workers was generally reported to be effective.
Midwives routinely involved cadres in home visits to new mothers, while village officials helped facilitate posyandu operations, particularly in mountainous locations.
Despite this, cadres encountered difficulties when addressing stunting due to social sensitivities.
Some mothers rejected the stunting label and avoided posyandu sessions after being informed of suspected growth issues.
Volume 11.
Issue 4.
October Ae December 2025 Cadres were hesitant to confront mothers directly for fear of offending them, opting instead for a persuasive and empathetic approach to encourage their return.
Furthermore, some cadres lacked the ability to differentiate between stunting and wasting, contributing to misinformation and weakened counseling effectiveness.
Mothers often assumed that a childAos normal development implied healthy growth, reflecting limited understanding of nutrition.
Feeding practices were also inadequate, with insufficient protein intake among children and pregnant women, and a common reliance on sweets or crackers to calm children.
These findings indicate gaps in knowledge and communication that affect the quality of posyandu service delivery.
The output stage reflects the outcomes of cadre performance and community response.
Mothers whose children were labeled as stunted frequently became reluctant to return to the posyandu, demonstrating the influence of stigma on health-seeking behavior.
Several cadres were not yet competent in providing health education, limiting their role to weighing and measuring toddlers without delivering essential counseling.
Some cadres continued to have an incomplete understanding of the stunting concept, and many were unfamiliar with specific stunting prevention programs.
Additionally, cadres lacked adequate skills in performing anthropometric measurements, which are crucial for accurate growth assessment.
The involvement of older cadres created further challenges, particularly in adapting to current program needs and technologies.
Although training opportunities were available, participation was conducted in shifts, preventing all cadres from receiving standardized capacity-building.
These limitations highlight the need for targeted training and program strengthening to improve posyandu performance.
Discussion Input Concept Posyandu cadres hold a central role in advancing stunting prevention efforts in Dapu-Dapura Subdistrict.
Their involvement in community health activities is highly significant, as they strengthen health promotion and preventive efforts while encouraging families to attend posyandu sessions.
Through their participation, regular monitoring of the nutritional status of toddlers and pregnant women becomes feasible, along with the early identification of stunting risk In Dapu-Dapura, cadre activities include home visits, while posyandu schedules and information are disseminated through neighborhood WhatsApp groups.
Cadres also receive direct notifications from residents regarding pregnancies, enabling them to invite and remind families to participate in posyandu activities.
Their contributions extend beyond routine services.
they motivate families, deliver health education, and foster community trust in local health facilities.
Previous research has emphasized the role of cadre motivation in improving posyandu attendance (Rahmawati & Sartika.
The present study supports these findings, demonstrating that cadres in Dapu-Dapura are proactive in conducting home visits, utilizing communication platforms such as WhatsApp, and responding promptly to reports of new Through these actions, cadres function as a direct link between the community and the health system.
This study also identifies several substantial challenges in accelerating stunting reduction.
The stigma associated with the term stunting leads some mothers to feel reluctant to return to the posyandu.
In Dapu-Dapura, mothers who perceive their children as healthy often reject the stunting label and subsequently discontinue posyandu attendance.
The hilly topography further reduces accessibility, resulting in low participation except during specific events such as Vitamin A distribution.
Another impediment is the limited maternal knowledge regarding the importance of routine growth Children over 12 months of age are frequently no longer brought to the posyandu because parents assume that completing basic immunizations is adequate.
The availability of posyandu facilities and infrastructure is closely linked to attendance rates, as these factors directly influence service delivery.
The mountainous terrain in Dapu-Dapura creates additional barriers to increasing maternal participation.
Some posyandu sites are managed by the village government, while others operate within private homes located in elevated areas.
These findings align with previous studies indicating that the effectiveness of public service delivery depends on the adequacy of supporting facilities.
Local government authorities have acknowledged this need by providing resources to strengthen posyandu operations (Susanti & Marliana, 2.
A significant barrier faced by posyandu cadres in preventing stunting in Dapu-Dapura Village is the stigma associated with the condition, which discourages mothers from returning to the posyandu.
Social norms exert strong pressure on mothers to raise children according to idealized expectations, and when a child experiences nutritional problem, mothers are frequently perceived as being at fault.
Prior research has shown that mothers often face stereotypes regarding the notion of the Auideal motherAy and encounter difficulties in making autonomous childcare decisions (Hampson, 2020.
Johnston & Swanson, 2.
Negative stigma surrounding stunting has been shown to adversely affect mothersAo psychological well-being, reduce health-seeking behaviors such as attending posyandu, and ultimately Volume 11.
Issue 4.
October Ae December 2025 exacerbate children's nutritional and growth outcomes (Putri.
Kartasurya, & Musthofa, 2.
These barriers at the input stage have direct implications for the implementation of posyandu services.
Accordingly, it is essential to assess how cadres perform their roles during service delivery, including health education, documentation, and coordination with healthcare professionals.
Process Concept This study found that experienced posyandu cadres play a pivotal role in reshaping mothersAo perceptions related to stunting stigma.
Through emotionally attuned and personalized approaches, cadres were able to persuade hesitant mothers to return to the posyandu.
For example, a cadre with more than 20 years of experience successfully encouraged a mother to continue participating in growth monitoring despite her initial rejection of the stunting label.
This effectiveness stemmed from the cadreAos ability not only to convey health information but also to share personal parenting experiences, thereby fostering empathy and trust.
Thus, cadre experience is not solely a function of age but reflects their capacity to build meaningful emotional connections within the community.
These findings reinforce the argument that cadres should ideally be recruited from the local community, given their strategic role as intermediaries between health workers and the public.
The study also highlighted that the approaches used by health workers do not always align with community expectations, and cadres contribute to restoring trust in the available health services.
Previous studies have identified three essential roles of posyandu cadres prior to service sessions: motivating mothers to utilize posyandu services, fostering positive relationships between the community and health workers, and encouraging mothersAo willingness to attend posyandu (E.
Saragih.
Nababan, & Sihombing, 2019.
Saragih, 2.
All these roles were effectively demonstrated by cadres in Dapu-Dapura Subdistrict, contributing significantly to the success of child growth monitoring activities.
The study also found that older cadres face challenges in adapting to digital technologies, particularly in reporting and documentation processes, and frequently require assistance from younger cadres.
These findings indicate two key implications: first, cadre roles must be strengthened through capacity-building initiatives in posyandu management.
second, cadres should no longer be perceived merely as supplementary personnel within primary healthcare services.
The study further revealed that mothers of stunted children often exhibit inadequate feeding practices, such as skipping lunch and providing insufficient protein sources.
These practices are compounded by the tendency to offer sweets or crackers to prevent children from becoming fussy or crying.
Prior research by Syafei and Afriyani has documented a significant association between poor feeding practices and stunting, showing that inappropriate feeding behaviors increase the risk of growth failure (Syafei & Afriyani, 2.
The findings related to cadre roles, technological adaptation challenges, and child feeding practices underscore that posyandu processes extend beyond routine service delivery and have direct implications for child growth and nutritional outcomes.
Output Concept This study found that in Dapu-Dapura Village, posyandu cadres did not provide counseling to mothers attending posyandu sessions.
According to the cadres, all educational and counseling activities were fully managed by health However, field observations showed that health workers were frequently unable to deliver education during posyandu activities due to heavy workloads.
Consequently, posyandu sessions proceeded without any educational component, despite the fact that posyandu cadres are community members specifically trained to assist in the provision of basic health services, particularly those related to maternal, child, and nutritional health.
Their responsibilities include registering and measuring children, recording anthropometric data, and providing health education at Table 5.
This role is essential because cadres serve as frontline personnel who directly interact with the community and are expected to help address the limited availability of health workers.
The success of the posyandu program particularly activities at Table 5 depends largely on the cadresAo ability not only to conduct early detection of stunting and malnutrition but also to deliver relevant health education.
For example, cadres can provide information on exclusive breastfeeding, balanced complementary feeding, anemia prevention among pregnant women, and parenting practices that support optimal child growth and development.
Strengthening cadre capacity to provide counseling and education at Table 5 is therefore a key component of posyandu revitalization.
However, in Dapu-Dapura, the effectiveness of this role is hindered by the areaAos mountainous terrain, which makes it difficult for pregnant women and parents of young children to attend posyandu sessions.
In such contexts, cadres are expected to adopt more proactive approaches such as conducting home visits to ensure that essential health messages reach families despite geographic barriers.
Volume 11.
Issue 4.
October Ae December 2025 Observations indicated that cadres in Dapu-Dapura possess limited skills in anthropometric measurement.
This represents a critical concern, as accurate measurements are fundamental to the early identification of childrenAos nutritional status.
Training in anthropometry including the measurement of length/height, weight, and head circumference, as well as the interpretation of growth charts is urgently required.
Adequate anthropometric competence has been shown to have a direct impact on accelerating stunting reduction.
A study by (Nurhidayah.
Hidayati, & Nuraeni, 2.
reported a 45% increase in cadre capacity following professional empowerment training.
In light of these findings, this study recommends two priority training programs for posyandu cadres: .
counseling and health education training, and .
anthropometric measurement training.
This study also has several limitations.
The research was conducted in a single village, which restricts the generalizability of the findings.
Additionally, data were collected through interviews and observations that may be influenced by informant and researcher subjectivity.
External factors such as family support, local government policies, and cross-sectoral interventions were not explored in depth.
Acknowledging these limitations is essential to ensure that the findings are interpreted appropriately and to provide a foundation for future research endeavors.
Conclusion This study demonstrates that Posyandu cadres in Dapu-dapura Village serve a critical intermediary function between communities and health professionals in stunting prevention through promotive, preventive, and early detection Despite fulfilling coordination and outreach roles, their performance is hindered by persistent social stigma surrounding stunting, limited maternal nutritional literacy, and geographic inaccessibility.
Experienced cadres, particularly those embedded within local communities, exhibit greater effectiveness in fostering trust and behavioral change through empathetic communication.
Nevertheless, deficiencies in technological literacy and anthropometric competence remain substantial barriers to optimal program implementation.
Capacity strengthening is therefore essential, focusing on management, measurement accuracy, and counseling skills.
Enhancing these competencies will enable cadres to transcend auxiliary functions and operate as integral actors in accelerating stunting reduction at the community level.
Declaration of conflicting interest We declare that there is no conflict interest Funding This study was funded by Faculty of Public Health.
Author contributions All authors contributed equally in all stages of the study and agreed with the final version of the article to be published and accountable in all phases of the work.
AuthorAos Biographies Hartati Bahar is a lecturer at the Faculty of Public Health.
Halu Oleo University.
Indonesia.
Devi Savitri Effendy is a lecturer at the Faculty of Public Health.
Halu Oleo University.
Indonesia.
Hariati Lestari is a lecturer at the Faculty of Public Health.
Halu Oleo University.
Indonesia.
References