Implementing Posyandu Cadre Empowerment Policy for Maternal and Child Health and Stunting Prevention: A Qualitative Study in South Papua, Indonesia

Abstract

Stunting is a multifactorial public health problem that requires strengthening community-based services through the involvement of Posyandu cadres. This study aims to analyze the implementation of the Posyandu cadre empowerment policy based on Merauke Regent Decree Number 100.3.3.2/396 of 2025 in maternal and child health services at Posyandu Wur, Mandala Village, Merauke Regency, South Papua Province, as well as identifying supporting and inhibiting factors and exploring their contribution to stunting prevention. The study used a descriptive qualitative approach with analysis based on George C. Edward III's four dimensions of implementation: communication, resources, disposition, and bureaucratic structure. Data were obtained through semi-structured interviews, observation, and documentation with seven purposively selected informants. The results show that policy implementation has generally been running and is supported by operational communication, availability of basic resources, implementer commitment, and a relatively clear service structure. However, obstacles remain, including suboptimal formal policy transmission, limited budget and cadre incentives, cross-sectoral coordination, partial community participation, and social and contextual challenges in service utilization. Empowering cadres contributes to strengthening maternal and child health services through education, growth monitoring, health communication, and target follow-up. There are indications of improvements in stunting, but this study cannot establish a direct causal relationship between policy implementation and reduced stunting prevalence. The findings underscore the importance of strengthening cadre capacity and providing ongoing institutional support.