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国家融合行动政策在印度尼西亚地方层面加速预防和减少发育迟缓的实施结果:一项定性研究。

Implementation Outcomes of National Convergence Action Policy to Accelerate Stunting Prevention and Reduction at the Local Level in Indonesia: A Qualitative Study.

机构信息

Department of Public Health, Faculty of Medicine Universitas Padjadjaran, Bandung 40161, Indonesia.

出版信息

Int J Environ Res Public Health. 2022 Oct 20;19(20):13591. doi: 10.3390/ijerph192013591.

DOI:10.3390/ijerph192013591
PMID:36294173
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9602846/
Abstract

The study aims to explore the implementation outcome variables of Indonesia's national policy convergence action in the stunting reduction intervention at district, sub-district, and village levels. The study design was qualitative with an implementation research approach at District Cirebon, Indonesia. Data were collected through in-depth interviews, focus group discussions, study documents, and 6 months of participant observation. We recruited 172 respondents. The assessment instrument used was formed on was implementation outcomes variables. Data were analyzed through coding, categorizing and thematic content analysis based on a predetermined theme. Comparative cross district activity-site analysis was applied between sub-districts and villages. The implementation outcome variables for the convergence action policy were performed well at the district level, in line with the central government's adequate regulation, control, and budget. Meanwhile, the sub-district and village levels only performed aspects of acceptability, appropriateness, and coverage for specific interventions. The acceptability level in the village was only partially running. The barriers at the sub-district and village levels were issues of commitment, staff capacity, and poor coordination. Superficial understanding and capacity weaknesses drove the convergence of the stunting reduction responsibility back into the burden of the health sector at the forefront. Local politics also colored the implementation in the village.

摘要

本研究旨在探讨印度尼西亚在减少发育迟缓干预方面的国家政策趋同行动的实施结果变量,该行动在区、分区和乡村各级实施。研究设计是定性的,采用实施研究方法在西冷区,印度尼西亚。数据通过深入访谈、焦点小组讨论、研究文件和 6 个月的参与观察收集。我们招募了 172 名受访者。使用的评估工具是根据预先确定的主题形成的实施结果变量。通过编码、分类和主题内容分析对数据进行分析。对分区活动现场进行了比较分析。在区级,趋同行动政策的实施结果变量表现良好,符合中央政府的充分监管、控制和预算。与此同时,分区和乡村层面仅对特定干预措施的可接受性、适当性和覆盖范围进行了执行。在乡村,可接受性水平仅部分运行。分区和乡村层面的障碍是承诺、员工能力和协调不善等问题。表面的理解和能力薄弱使得减少发育迟缓的责任趋同又回到了卫生部门的负担。地方政治也影响了乡村的实施。

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本文引用的文献

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Implement Res Pract. 2022 Jun 6;3:26334895221105585. doi: 10.1177/26334895221105585. eCollection 2022 Jan-Dec.
2
Reducing childhood stunting in India: Insights from four subnational success cases.减少印度儿童发育迟缓现象:来自四个邦级成功案例的见解
Food Secur. 2022;14(4):1085-1097. doi: 10.1007/s12571-021-01252-x. Epub 2022 Apr 1.
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The effect of convergent action on reducing stunting prevalence in under-five children in Banggai District, Central Sulawesi, Indonesia. convergent action 对减少印度尼西亚中苏拉威西省邦盖区五岁以下儿童发育迟缓患病率的影响。
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Reducing the quality risk of elderly care services in government procurement from market-oriented private providers through ex ante policy design: lessons from the principal-agent theory analysis.通过事前政策设计降低市场化私人养老服务供应商的质量风险:来自委托代理理论分析的经验教训。
BMC Health Serv Res. 2020 Dec 10;20(1):1135. doi: 10.1186/s12913-020-05994-w.
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Drivers of stunting reduction in Nepal: a country case study.尼泊尔减少发育迟缓的驱动因素:国家案例研究。
Am J Clin Nutr. 2020 Sep 14;112(Suppl 2):844S-859S. doi: 10.1093/ajcn/nqaa218.
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