Multisectoral action to address child malnutrition at a district level in Aceh, Indonesia

Abstract

Child malnutrition remains a significant issue in many low-and -middle-income countries, including Indonesia, where stunting is prevalent. Multisectoral interventions combining nutrition-specific and nutrition-sensitive components are considered the most effective approach to addressing child malnutrition, though their success varies. There are still gaps in our understanding of the contextual factors influencing the effective implementation of these interventions.

To support efforts in improving child well-being in Aceh, UNICEF Indonesia implemented a three-year multisectoral systems strengthening intervention between 2019 and 2021 in eight districts in the province. The contents presented in this thesis utilised the data collected to evaluate this intervention.

The aim of this thesis is to understand how multisectoral systems strengthening interventions can drive changes in the prevention of child malnutrition at a district level in Aceh Province, Indonesia. It focuses on the contextual factors and experiences of stakeholders engaged in the intervention that shaped its implementation. This thesis employed quantitative and qualitative methods to explore this.

This thesis found that there was increased will and capacity at a local level to address child malnutrition in a multisectoral way, but that a number of contextual factors, such as human resourcing issues, and service delivery issues in village-level health services could have limited the potential of the intervention.

Multisectoral interventions for child malnutrition show considerable promise in Indonesia. The findings in this thesis extend our understanding of the diverse ways in which context can influence an intervention across several key stakeholder groups and strategies for how this might be managed to strengthen the intervention design and implementation.