Explaining the slow decline in child stunting: A multi-stakeholder qualitative case study from Sabang, Indonesia

Abstract

Stunting remains a major public health problem, particularly in Africa and Asia, including Indonesia. Sabang City recorded the slowest stunting reduction in Aceh Province (AARR: -5.20%). This qualitative case study examined factors underlying the slow decline in stunting prevalence in Sabang City. The study involved 21 informants consisting of policymakers, health workers, religious leaders, and traditional leaders. Data were collected through in-depth interviews, observations, and document reviews, while quantitative data on stunting prevalence trends were obtained from surveys conducted by the Indonesian Ministry of Health between 2013 and 2024. The findings indicate that the slow reduction in stunting prevalence in Sabang is influenced by migration-induced distortion of stunting indicators, fragmented accountability, and differences in data coverage across national survey instruments. The pattern of stunting in Sabang reflects contextual and structural dynamics. This study suggests that accelerating stunting reduction in Sabang requires migration-sensitive interventions, strengthened multisectoral collaboration, and harmonized data systems.