IMPLEMENTATION OF STUNTING REDUCTION ACCELERATION POLICY IN PONOROGO REGENCY

Stunting remains a critical public health concern globally, with severe consequences for child development and long-term well-being. This abstract highlights the implementation of the Stunting Reduction Acceleration Policy in Ponorogo Regency, Indonesia. The policy aims to address the high prevalence of stunting among children under five years old by employing a multifaceted approach, including nutrition intervention, healthcare access, and community engagement. This research provides an overview of the policy's key components, its implementation process, and the challenges encountered during execution. Data from government reports, interviews with policymakers, healthcare professionals, and community members, as well as field observations, were used to assess the effectiveness and sustainability of the policy. Preliminary findings indicate progress in reducing stunting rates, improved awareness, and community participation. However, persistent challenges, such as limited resources and infrastructure, require ongoing attention to achieve sustainable stunting reduction. This study underscores the importance of continued collaboration between government agencies, healthcare providers, and communities to successfully address the stunting crisis in Ponorogo Regency and beyond.


INTRODUCTION
One of Indonesia's main problems today is stunting.According to WHO data, there are 178 million children under five stunted.Africa and Asia (including Indonesia) are the 2 (two) continents with the highest percentage of stunting toddlers in the world, namely 40% and 36% (DPR RI, 2020), with this background President Jokowi has scheduled stunting handling to become one of the national priority programs (Organization, 2014).
The government has launched a National Action Plan for Stunting Handling which is contained in Presidential Regulation Number 72 of 2021 concerning the Acceleration of Stunting Reduction which emphasizes convergence activities at the national, regional, and village levels to prioritize specific intervention activities and sensitive interventions in the First 1000 Days of Life (HPK) up to the age of 6 years.Specific interventions are aimed at pregnant women and children in 1000 HPK with a contribution of 30% reduction in stunting and are generally carried out by the health sector (Rajpal, Joe, Kim, Kumar, & Subramanian, 2020).Meanwhile, sensitive interventions are aimed at various development activities outside the health sector with a contribution of 70% to reducing stunting rates targeting the general public and not specifically for pregnant women and toddlers in 1000 HPK (Presidential Regulation  Purbaningrum, 2022).
In conducting an annual evaluation of the success of accelerating stunting reduction, the Ministry of Health conducts a nutritional status survey (SSGI) (Pramono, 2020).SSGI is a survey conducted throughout Indonesia, with a survey method and is carried out to show representative results or represent conditions in Indonesia (Saputra, Suryoto, & Sutikno, 2022).The 2022 Indonesian Nutritional Status Survey (SSGI) provides an overview of the nutritional status of toddlers (stunting, wasting, underweight, overweight) and its determinants including indicators of specific nutritional interventions and nutrition-sensitive interventions using the 2stage stratified sampling method in a cross-sectional manner (Subramanian, Karlsson, & Kim, 2022).The implementation of SSGI 2022 involves the Vice President, Bappenas, BPS, Ministry of Agriculture, Poltekkes, Provincial Health Office, District/City Health Office, and experts from several universities (Zaleha & Idris, 2022).
A policy implementation must of course always be monitored and evaluated by the parties involved, in supporting and overseeing the policy, the Regent of Ponorogo establishes a team through the Regent Decree Number 188.45/563/405.12/2022concerning the Establishment of a Team to Accelerate Stunting Reduction in Ponorogo Regency for 2022 -2024, Regent Decree Number 188.45/1036/405.12/2022concerning the Formation of a District Stunting Reduction Acceleration Team (TPPS) in Ponorogo Regency (Wahyuningsih, Novianto, & Purwadi, 2017).
The policies contained in the Regent Regulation are one of the efforts to accelerate stunting reduction in Ponorogo through specific nutrition interventions aimed at addressing the direct causes of stunting in children through the health sector, nutrition-sensitive interventions to address indirect causes of stunting with cross-sector health cooperation targeting all communities (Rahmasari & Wicaksono, 2022), as stated in Regent Regulation Number 33 of 2022 article 6, the third part of the Pillars.These policies are made to improve the nutritional status of the community and the quality of human resources with strategies to be carried out in the form of education (Nutrition, 2013), training and counseling on health and nutrition through family independence, healthy living community movements, and strengthening the first thousand days of life (HPK) movement.Reducing stunting cases must involve collaboration between the health sector and the non-health sector in the form of promotive, preventive, curative, and rehabilitative efforts carried out by local governments and the entire community, as stated in Ponorogo Regent Regulation Number 33 of 2022 Chapter V "Implementation of Activities", articles 10 to 13.Each article is explained regarding the stages carried out in specific intervention activities, sensitive intervention activities, programs/activities that must be implemented by the village government as the target of the regent regulation, as well as the implementation of coordination of stunting reduction acceleration teams at the village level involving Human Development Cadres (KPM), health workers (midwives, nutrition workers and environmental health workers), PKK mobilization teams, family planning counselors, PAUD managers, village family planning guidance assistants (PPKBD), working groups and integrated service post cadres (Posyandu), village local assistants, as well as cadets and/or other community elements (Patton, 1999).
By Ponorogo Regent Regulation Number 33 of 2022, the Ponorogo Regency Government is committed to implementing efforts to reduce stunting in Ponorogo Regency by touching the smallest level of government, namely in village government.In addition to the village level, the implementation of coordination, integration, and collaboration are also carried out from the district to village levels.In addition, the village government synchronizes in planning and budgeting village development activities for stunting prevention (Prihatini, D., &;Subanda, 2020).Village governments should ensure that each priority target receives and utilizes a package of priority nutrition intervention services.The implementation of activities is carried out in collaboration with Human Development Cadres (KPM), Family Hope Program (PKH) assistants, Puskesmas officers, and village midwives, as well as Family Planning (KB) officers, village governments strengthen monitoring and evaluation of service implementation to all priority targets and coordinate target data collection and regular data updates.
The success of reducing stunting rates is certainly a commitment of cooperation and hard work from related parties.The Ponorogo Regency Government has made a policy, where every policy made must be continued with the policy implementation process."Implementation is considered the main form and decisive stage in the policy process" (Birklan, 2001: 177;Heineman et al., 1997: 60;Ripley and Franklin, 1986;Wibawa et al., 1994: 15).According to Edwards III (1984: 1) the implementation of policies that are said to be ineffective, can cause policymakers to make decisions that cause the policy cannot be implemented.
Looking at the phenomenon from previous studies conducted by several researchers in several regencies/cities in East Java, as well as stunting prevalence data in Ponorogo Regency, the data shows that Ponorogo Regency has exceeded the prevalence of Indonesia's stunting rate, there are still sub-districts in Ponorogo Regency that have increased stunting rates.For this reason, researchers decided to research on how the policy implementation process related to accelerating stunting reduction in Ponorogo Regency.
The implementation of the stunting reduction acceleration policy is an activity carried out to produce output for the community by the policy goals and objectives, In order for theForn of stunting reduction to be successful and on target, research on policy implementation is needed.From the background description that has been presented, researchers are interested in conducting research on thresearchinglicies to accelerate stunting reduction in Ponorogo Regency.Based on the initial study, researchers found that policymakers in Ponorogo Regency involved in this policy are committed and able to encourage the success of the stunting acceleration policy, so as to condition the community andtoments involved in this policy to comply with it.The implementation analysis that researchers use is a model initiated by Van Metter &;Carl Van Horn (1975).Van Metter & Van Horn (1975) said that "there are 6 variables analyzed, namely standards and policies, resources, communication between implementing organizations, characteristics of implementing organizations, attitudes of implementers and performance".The policy to accelerate stunting reduction is a top-down policy, the success or failure of this policy is determined by the implementing organizations, so the Van  Regency research offers a unique perspective by focusing on a specific geographic area in Indonesia.This study not only delves into the policy's outcomes but also investigates the intricacies of its implementation within a rural setting, shedding light on the contextual challenges and innovative strategies employed to combat stunting.Moreover, this research explores the interplay between local traditions, cultural practices, and policy implementation, providing valuable insights into the customization of anti-stunting interventions to fit the cultural fabric of the Ponorogo community.By examining these distinct aspects, the study contributes a fresh perspective to the broader discourse on stunting reduction policies and offers potential solutions that can be tailored to similar contexts worldwide.

METHOD
The method used in this study is a qualitative research method because researchers feel the need for an approach that can conduct a comprehensive and in-depth study of the policy to accelerate stunting reduction in Ponorogo Regency (Sharp, 2003).According to Asyifah (2021), qualitative research methods are research that investigates a social phenomenon and human problems.This research was conducted at the Ponorogo Regency Government, especially at the Regional Apparatus Organization (OPD) which is directly related to the policy of accelerating stunting reduction in Ponorogo Regency (Sugiyono, 2018).
In this study, researchers used data collection techniques from Cresswell, 2009.According to Cresswell, there are four models as a data collection system with qualitative research models (Creswell, 2009): a. Qualitative observation, where researchers went to the field to see the role of stakeholders and policyholders in the stunting bug forum and the stunting reduction acceleration team (Peterson, 2019).b.In-depth interviews are conducted directly with selected informants, guided by interview guides, and open-ended and unstructured frequently asked questions aimed at expressing participants' opinions and perspectives.c.Qualitative documents, Researchers also use qualitative documents, namely in the form of public documents related to research.Examples of qualitative documents are reports, regent regulations, regent decrees, newspapers, articles, and papers.d.Visual material, researchers also use several photo documents as support to show accelerated activities to reduce stunting.Coinciding with the 58th National Health Day on November 12, 2022, the "Ceting Beraksi" movement has been launched, which stands for "Prevent Stunting Together and Integrated".

RESULT AND DISCUSSION
Following up on the implementation of the Ceting Beraksi movement, the Ponorogo Regency Government carried out several activities related to accelerating stunting reduction activities as a continuation of Ceting Beraksi.The innovation implemented by the district government is the inauguration of the Chairman of the District PKK TP and the Head of the District PKK TP to become the Mother of Stunting Ponorogo.The inauguration of the chairman of TP PKK Regency and Sub-district as the mother of stunting is expected to further emphasize that the Chairman of TP PKK district and sub-district also has an important role in the movement to accelerate stunting reduction in Ponorogo Regency.The stunting mother was confirmed by the Regent of Ponorogo.

Policy Standards and Objectives
Policy standards and objectives are one component that influences how effectively policies are implemented.The success rate of policy implementation can be measured by knowing whether the scope and objectives of the policy are by the social culture at the executive level.a. Clear and Measurable b.Justice

Resources
The implementation of the policy to accelerate the stunting reduction in Ponorogo Regency will certainly not succeed without the ability to utilize the resources owned by the Regional Government.The existing resources are not only human resources but financial resources, time resources, and infrastructure.

Communication Between Implementing Organizations
The success of a policy implementation also depends on communication and coordination with other sectors.The better the communication and coordination between the parties involved, the greater the success rate of a policy.

Characteristics of the implementing organization
The performance of a policy will certainly show the characteristics and characteristics of the implementation team.This is related to the policy context, implementers must be appropriate by their fields so as to accelertosuccess of a policy.The scale of implementation

Implementation Of Stunting Reduction Acceleration Policy In Ponorogo Regency
619 https://joss.al-makkipublisher.com/index.php/js of a policy also affects the success, the greater the scale of implementation, the more implementing organizations are involved.
Bureaucracy is a unique type of organizational ownership that affects the services provided.The existence of a system used to assign responsibilities in an organization The smooth running of vertical delivery will be hampered if the bureaucratic structure of program management is too complex and the scope of control is too long.

Executive Attitude
The attitude of the implementer is the last variable expressed by Van Metter and Van Horn in the implementation or implementation of policies.The attitude of the implementer is defined as the desire of the parties involved to implement the policy.
The success or failure of public policy implementation is strongly influenced by the attitude of the implementing agent.Van Meter and Van Horn state that the disposition of the executing agent greatly influences the success of a policy, and the ability of the executing agent influences the disposition of the executing agent.If the implementor has a positive tendency towards the policy, it will increase the points in the success of the policy, but if the implementor has a negative tendency, the likelihood that the policy will fail is even greater.
Implementers must be competent in what they must know and the skills needed to implement the policy if the policy is to be effectively implemented.Researchers focus on three implementing elements that may influence the ability and desire for implementation of the policy, namely: the response of the implementer, knowledge and understanding, and consistency of attitude.

Discussion
Based on the findings and facts that have been found in the research field and adjusted to the theory used as the main reference, a discussion of these findings and facts is carried out.The results found by the researcher are the performance of the implementation of Regent Regulation Number 33 of 2022 in Ponorogo Regency according to the theory established by Charles O. Jones (1996) through 3 stages, namely interpretation, organization, and application.
In the interpretation stage, Ponorogo Regent Regulation Number 33 of 2022 concerning the Acceleration of Stunting Reduction at the Village Level is a derivative of Presidential Regulation Number 72 of 2021 concerning the Acceleration of Stunting Reduction.The implementation of Ponorogo Regent Regulation Number 33 of 2022 has been followed up optimally by the implementation team which has been determined by the Regent Decree which is a follow-up to the regent regulation.In addition, Ponorogo Regent Regulation Number 33 of 2022 is also the legal basis for other regulations that support the implementation of the stunting reduction acceleration program.From the results of the research, it is known that the process of submitting Ponorogo Regent Regulation Number 33 of 2022 concerning the Acceleration of Stunting Reduction at the Village Level has run well and optimally, where it is known that the Regent Regulation is the legal basis for other provisions.
This statement is supported by variables that have been studied by researchers, namely policy goals and objectives.According to the variables of policy targets and objectives, it is found that the implementation of policies related to the acceleration of stunting reduction in Ponorogo Regency has been implemented clearly and measurably, according to the predetermined target and in its implementation has been structured and has clear levels at each stage that has been regulated.In the stunting reduction acceleration program, each region sets its target related to the extent to which stunting prevalence can be achieved by the region.
For the organizational stage, as a follow-up to Regent Regulation Number 33 of 2022, an implementation team was formed to accelerate the stunting reduction in the Ponorogo Regency.The implementation team was then determined by the Decree of the Regent of Ponorogo Number: 188.45/563/405.12/2022concerning the Establishment of a Team to Accelerate Stunting Reduction in Ponorogo Regency for 2022-2024.This organizational stage is supported by resource variables, consisting of human resources, financial resources, and facilities and infrastructure.From the results obtained by researchers, it is known that in accelerating stunting reduction there are sufficient human resources in the implementation of the policy, starting from the district level to the village level.Human resources ranging from the level of policymakers in OPD to implementers work by their respective tupoksi.
For financial resources, these financial resources are in the form of budget allocations either from the Ponorogo Regency Government, Province, or Financial Assistance from the Center to the budget at the village level from the Village Fund and Village APB.The budget is used to carry out planning, training, monitoring, and evaluation at the district and village levels.Financial resources to support the acceleration of stunting reduction are still lacking, because there are still several villages that are still lacking in allocating village funds to meet the program of accelerating stunting reduction activities.This can happen because there are still villages that are not the locus, feeling that the stunting program has not become a top priority.After all, they feel that their village is not the locus of stunting.But overall, financial resources to support the stunting reduction acceleration program have been said to be maximum and optimal.
In terms of resources, facilities, and infrastructure are attached to each party and use the existing budget, both specifically used for stunting reduction and integrated in other activities, for example, Village Healthy Houses (RDS).So that infrastructure facilities are determined to have become resources that optimally support the implementation of accelerating stunting reduction because they are directly attached to each OPD of the implementation team.
The next supporting variable is communication between implementing organizations.Based on the results of interviews and also a review of documents that have been conducted by researchers, researchers can draw conclusions, namely communication and coordination between parties involved in the implementation of policies to accelerate stunting reduction have been implemented both at the district and village scales, but it should be noted that activeness, commitment, and improvement efforts determine the success or failure of policy implementation.
The next variable that is supporting is the characteristics of the implementing organization.Researchers found that the characteristics of the implementation team were adjusted to the objectives of each work unit.So that the characteristics of the implementing organization can be said to be in accordanbyives specified in the stunting reduction acceleration team in the Decree of the Regent of Ponorogo Number 188.45/563/405.12/2022concerning the Establishment of the Ponorogo Regency Stunting Reduction Acceleration Team for 2022-2024.
The third stage is the application stage.At the application stage after the issuance of Regent Regulation Number 33 of 2022, the Ponorogo Regency Government launched the Creating Action Movement.Since the launching of the citing movement in action, agencies/agencies/institutions have also become more active in implementing programs related to accelerating stunting reduction, namely the inauguration of the Mother of Stunting and audits related to the implementation of the acceleration program for stunting reduction.The supporting variable of this application stage is the attitude of the implementer.From the results of research obtained by researchers, it can be said that the tendency of implementers varies, but all responses are the same because stunting reduction is a national priority program, All implementing parties accept and implement this policy, even though there are some dostand, causing efforts made to fulfill obligations to superiors.

CONCLUSION
Based on the formulation of the problem set by the researcher, it can be concluded as follows (Wahab, 2012): The Supporting factors in the successful implementation of the stunting reduction acceleration policy come from the standards and policy objectives, coordination, communication, commitment of implementing organizations, and responses from implementers who are ready to implement the policy, as well as implementing organizations appointed to implement policies by their respective tupoksi.
The inhibiting factor in policy implementation is the financial resources derived from village funds, it is felt that there are still some villages that are not optimal in their allocation.In addition, not all implementers understand and are competent in supporting the policy, and the evaluation of policies carried out monthly is considered ineffective.
//joss.al-makkipublisher.com/index.php/jsNumber 72 of 2021 concerning the Acceleration of) (Shauma, Udzu Nabila &; Implementation Process of Ponorogo Regent Regulation Number 33 of 2022 concerning the Acceleration of Stunting Reduction at the Village LevelIn examining the implementation process of Ponorogo Regent Regulation Number 33 of 2022, researchers use the policy implementation theory expressed by Charles O.Jones (1996), where the implementation of the policy is seen with three main things, namely interpretation, organization, and application.Researchers conducted research by these three indicators.a. InterpretationThe initiation process for the acceleration of stunting reduction began with the issuance of Presidential Regulation Number 72 of 2021 concerning the Acceleration of Stunting Reduction, which was immediately followed up by stunting rembug activities at the Pusdalop Building on September 28, 2021.b.Organization In the implementation of Ponorogo Regent Regulation Number 33 of 2022, rules have been established that contain the main duties of related parties, contained in the Ponorogo Regent Decree Number 188.45/563/405.12/2022concerning the Establishment of a Team for the Acceleration of Stunting Reduction in Ponorogo Regency for 2022-2024.The Decree certainly stipulates the details of the duties of each implementation team, by the tupoksi attached to each implementation team.c.Application After the issuance of Ponorogo Regent Regulation Number 33 of 2022 concerning the Acceleration of Stunting Reduction at the Village Level, the Regent of Ponorogo launched a movement to support the implementation of the stunting reduction acceleration policy.
implementation of policies related to the acceleration of stunting reduction in Ponorogo Regency is a derivative of Presidential Regulation Number 72 of 2021 concerning the Acceleration of Stunting Reduction, namely Ponorogo Regent Regulation Number 33 of 2022 concerning the Acceleration of Stunting Reduction at the Village Level.The implementation of the Regent Regulation which then became the basis for the implementation team in implementing the provisions for accelerating stunting reduction in Ponorogo Regency, began with the enactment of the Decree of the Regent of Ponorogo Number: 188.45/563/405.12/2022concerning the Establishment of a Team for the Acceleration of Stunting Reduction in Ponorogo Regency for 2022-2024, Decree of the Chief Executive of the Ponorogo Regency Stunting Reduction Acceleration Team Number: 188.4/1036/405.12/2022concerning the Formation of a Reduction Acceleration Team Stunting (TPPS) Sub-District in Ponorogo Regency in 2022, as well as the Issuance of the Decree of the Regent of Ponorogo Number: 188.45/472/405.27/2023concerning the Determination of Village Focus Locations for Integrated Stunting Reduction Interventions in Ponorogo Regency in 2023.

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Metter & Van Horn model is most suitable for this study.While many studies have explored the effectiveness of stunting reduction policies in various regions, the Implementation of Stunting Reduction Acceleration Policy in Ponorogo https://joss.al-makkipublisher.com/index.php/js