Implementation of Regent Regulation Number 47 of 2020 Concerning Integrated Acceleration of Stunting Prevention in Suruh District, Trenggalek Regency

Dedy Wahyu Christanto¹, Mas Roro Lilik E², Sri Umiyati³

^1,2,3Master of Public Administration, Faculty of Social and Political Sciences Universitas Hang Tuah Surabaya, Indonesia

ABSTRACT: Stunting is a major nutritional problem that affects the social and economic life of the community. There is clear evidence that people with stunting have higher mortality rates and increased morbidity for several reasons: stunting impairs physical performance, and mental and intellectual functions are impaired. The form of commitment to reducing stunting in Trenggalek Regency has actually been stated in the Implementation of Trenggalek Regency Regent Regulation Number 47 of 2020 concerning the Acceleration of Integrated Stunting Prevention. One of the focuses of this study is Suruh District, where Suruh District has the highest Stunting rate in Trenggalek Regency.

The purpose of this study is to describe and analyze the Implementation of Trenggalek Regency Regent Regulation Number 47 of 2020 concerning the Acceleration of Integrated Stunting Prevention in Suruh District, Trenggalek Regency.

This qualitative research explores the Stunting Reduction Policy. Data collection in this study used interviews, documentation and observation. The results obtained were then collected, reduced, presented and conclusions were drawn.

The results of this study according to Van Metter Van Horn’s Theory and based on the results of the analysis of indicators and the findings of the discussion of the previous chapters, the researcher concluded that the implementation of Trenggalek Regency Regent Regulation Number 47 of 2020 concerning the Acceleration of Integrated Stunting Prevention in Suruh District has not been carried out optimally. However, in the variable of Communication between organizations and implementing activities in the Implementation of the Stunting Reduction Policy, the Trenggalek Regency Government only coordinates with related agency units and this is carried out together, it is indeed carried out, one of which is through the variable of communication between organizations, namely between Bappelitbangda, the Health Office and the Suruh District Health Center. But it is not carried out to the lowest level, namely the community.

KEYWORDS: implementation, policy, stunting, integrated

INTRODUCTION

Stunting is a form of growth and development failure that causes linear growth disorders in toddlers due to the accumulation of long-term nutritional deficiencies, starting from pregnancy to 24 months of age. AMalnutrition during early childhood growth and development will inhibit physical development, increase pain, inhibit children’s mental development, and even cause death. Toddlers who experience stunting nutritional problems are at risk of decreased intellectual ability, productivity, and the possible risk of experiencing degenerative diseases in the future. One of the causes of stunting is poor parenting practices, including the lack of maternal knowledge about health and nutrition before and during pregnancy, and after the mother gives birth (Health Data and Information Window Bulletin, 2018).

According to the World Health Organization (WHO) in 2017, there were 22.2 percent or around 150.8 million toddlers in the world experiencing stunting. More than half of the toddlers who experience stunting are in the Asian continent, namely 55 percent, and more than a third are in the African continent, namely 39 percent. Of the 83.6 million stunted toddlers in Asia, the largest proportion comes from South Asia at 58.7 percent and the smallest proportion in Central Asia at 0.9 percent. Meanwhile, Indonesia ranks third with the highest prevalence in the Southeast Asia Region (SEAR).

For this reason, the Indonesian Government has paid attention to preventing stunting. Several regulations have become the policies of the Indonesian Government to focus on this. namely Law No. 36 of 2009 concerning Health which is contained in articles 141, 142, and 143. This law explains that improving nutrition is directed at efforts to improve food consumption patterns in accordance with balanced nutrition, increasing awareness of nutritional behavior, carrying out physical and health activities, increasing the accessibility of facilities and quality of nutritional services, improving the food and nutrition alert system and efforts to increase cooperation between the government and the community in ensuring the availability of food supplies. Presidential Regulation No. 42 of 2013 concerning the National Movement for the Acceleration of Nutrition Improvement (Gernas PPG) also regulates efforts to prevent stunting as a joint prevention effort. Article 1 paragraph (1) states that efforts to accelerate nutritional improvement are carried out jointly between the government and the community through mobilizing the participation and concern of stakeholders in a planned and coordinated manner to accelerate nutritional improvement. From the laws and presidential regulations explained above, it can be seen that there is an emphasis on efforts to prevent stunting in Indonesia, but in its implementation it has not been optimally implemented. So that it has an impact on the prevalence rate of stunting in Indonesia which fluctuates from year to year.

To strengthen the guidelines for preventing stunting in Indonesia, the government has established the National Strategy for Accelerating Stunting (Stranas Stunting) document in 2018. One of the objectives of this National Strategy for Accelerating Stunting document is to regulate multi-sectoral involvement as an effort to accelerate the reduction of stunting (Ministry of Finance and Ministry of PPN, 2019:1). Because so far one of the causes of the hampered implementation of stunting prevention in Indonesia is the suboptimal coordination between government agencies (TNP2K, 2018:5). Coordination between government agencies is a strategic way to achieve the desired goals, considering that stunting is caused by various aspects. The multi-sectoral involvement consists of the health sector, food availability, education, clean water and sanitation, and social security (Ministry of Finance and Ministry of PPN, 2019:1).

The five pillars of the stunting handling strategy aim to increase awareness and change community behavior to prevent stunting in the First 1000 Days of Life (HPK) period, HPK is the period from when a child is in the womb until a child is two years old. This phase is called the Golden Period because during this period there is very rapid brain growth. Malnutrition in this period will result in damage or stunted growth that cannot be repaired in later life. Adequate nutrition during pregnancy will make the fetus grow and be born as a healthy, strong and perfect baby in every phase of its development and growth. The five pillars of the stunting handling strategy include: 1. Commitment to vision and leadership; 2. National campaign and communication of behavior change; 3. Convergence, coordination, and consolidation of central, regional, and village programs; 4. Nutrition and food security; 5. Evaluation and monitoring (Ministry of Health, 2019).

Since Stunting has been determined as a national priority in the 2019-2024 Medium-Term Development Plan (RPJMN) planning document which mandates strengthening commitment, monitoring and evaluation of improving community nutrition, developing a nutritional guarantee system and child growth and development by providing guaranteed nutritional intake since in the womb, improving family parenting patterns, and improving clean water facilities and environmental sanitation in supporting stunting management in Indonesia.

From determining stunting as a priority, it turns out that the prevalence of stunting has decreased but has not eliminated the prevalence of Stunting in Indonesia based on data from the Results of the Indonesian Nutritional Status Survey (SSGI).

Graph 1. National Stunting Prevalence 2018 – 2022

Source: SSGI, processed data, 2024

It can be seen from the data since stunting prevention was set as a national priority in the 2019-2024 Medium-Term Development Plan (RPJMN) planning document. The prevalence of stunting shows a significant decline seen in 2018. The prevalence of stunting was still 30.80 percent, dropping to 27.67 percent in 2019, dropping to 3.13 percent. Gradually decreasing in 2020, the Indonesian Nutritional Status Survey (SSGI). However, in 2021 to 2022, the National policy was still consistent, namely from 2021 by 24.40 percent to 21.60 percent. In 2021, seeing the condition of stunting which is still a concern, the Indonesian Government is paying great attention to stunting prevention, through Presidential Regulation of the Republic of Indonesia Number 72 of 2021 concerning the acceleration of stunting reduction which aims to increase the government’s commitment to accelerating stunting reduction. Acceleration of stunting reduction is implemented holistically, integratively and with quality through coordination, synergy and synchronization between ministries/institutions, provincial governments, and district/city governments. Based on these regulations, the role of the Regional Government is starting to be involved in efforts to reduce stunting. This can be seen in the data from the Results of the Indonesian Nutritional Status Survey (SSGI) East Java Province has a strong commitment to following up on Presidential Regulation of the Republic of Indonesia Number 72 of 2021 concerning the acceleration of stunting reduction by issuing East Java Governor Regulation Number 68 of 2021 concerning Integrated Acceleration of Stunting Reduction in 2021 – 2024, This regulation outlines Integrated Acceleration of Stunting Reduction, the Provincial Government is guided by the implementation of 5 (five) pillars in the National Strategy for Accelerating Stunting Reduction. Where East Java Province encourages 38 Regencies/Cities to take part in reducing Stunting as seen in the data from the Results of the Indonesian Nutritional Status Survey (SSGI).

Graph 2. Prevalence of Stunting in East Java by Regency/City in 2022

Source: SSGI, processed data, 2024

The data shows that 18 regencies/cities have a Stunting Prevalence rate below the Prevalence Rate of East Java Province. Meanwhile, there are still 20 regencies/cities whose Stunting Prevalence rate is still above East Java Province. One of them is Trenggalek Regency at 19.50 percent, which is 0.30 percent behind East Java Province at 19.20 percent. This is quite concerning because according to media publications from (surya.co.id, 2019) In 2019, East Java Province held a competition between regencies/cities to assess the success of policies in handling stunting. This competition is entitled “Assessment of the Performance of Integrated Stunting Prevention and Reduction Efforts in Regencies/Cities in East Java Province in 2019”. The competition was won by Trenggalek Regency which was ranked first. Trenggalek Regency is one of the regencies in East Java Province that has the highest stunting prevalence rate (Jatim.idn times, 2019). In the competition above, Trenggalek Regency won first place because it succeeded in releasing 5 out of 10 villages that had a stunting prevalence rate of more than 20 percent to less than 20 percent (Surabaya.tribunnews, 2019). The success of Trenggalek Regency in reducing stunting rates within a period of 1 year cannot be left alone academically. The form of commitment to reducing stunting in Trenggalek Regency has actually been stated in the Implementation of Trenggalek Regency Regent Regulation Number 47 of 2020 concerning the Acceleration of Integrated Stunting Prevention, but in 2023 According to SSGI data in 2022 Trenggalek Regency was 19.50 percent which was 0.30 percent behind East Java Province which was 19.20 percent.

This is explained by the number of stunting in each sub-district through an online application initiated by the Ministry of Health through the e-PPGBM application (Community-Based Nutrition Reporting and Recording is a community-based recording and reporting with electronic technology). Data from the Trenggalek Regency Health Office, the results of e-PPGBM show that the prevalence of stunting in Trenggalek Regency is as follows:

Table: 1. Table of Stunting Prevalence in Trenggalek Regency Per Sub-district in 2022

Source: PPGBM, processed data

The table above shows that the highest prevalence rate is in Suruh District, which is 18.50 percent, which is only 1.1 percent below East Java, which is 19.20 percent. The effectiveness of the Implementation of Trenggalek Regency Regent Regulation Number 47 of 2020 concerning the Acceleration of Integrated Stunting Prevention in Suruh District, Trenggalek Regency needs to be reviewed again for its success. The success of implementing the stunting reduction policy cannot be separated from various elements, both from the government and non-governmental organizations. This is closely related to the Van Metter and Van Horn policy implementation model. Van Meter and Van Horn (1975), define policy implementation as an action used by individuals or groups of government or private officials, which is directed towards achieving a goal that has been outlined in a policy decision. Both views assume that policy implementation runs linearly from public policy, implementors and policy performance. Talking about stunting, stunting is not only the domain or business of the health sector but also the responsibility of all elements, including the planning and budgeting sector, education, community empowerment, agriculture and food, community organizations, professions, the business world and various other sectors.

Research in nine Sub-Saharan African countries shows that multi-sector interventions are needed to overcome stunting. The strategy used is to combine specific nutrition, a health-based approach with a livelihood-based intervention system. The results showed that within three years after the start of this program in 2005-2006, there was a consistent improvement in household food security and dietary diversity (Remans, 2011). The intervention carried out in order to accelerate the reduction of stunting in Southeast Asia is to increase the availability and access to nutritious food by collaborating between the private and public sectors. The Association of Southeast Asian Nations (ASEAN) can play a role as a facilitator. The private sector can produce and market nutritious food, while the public sector sets standards, promotes healthy and nutritious food, and ensures access to nutritious food for the poorest areas, for example through social safety net programs (Bloem, 2013). In Brazil, stunting reduction has been linked to increasing the purchasing power of low-income families, increasing maternal education levels, providing clean water and sewage systems, and virtual universalization of basic health care, including prenatal care. In Africa, programs have been carried out to improve household food security, dietary diversity, and increase interventions for child and disease care coverage (Unicef, 2013). Based on e-PPGBM data, the prevalence of stunting in Suruh District, which is 18.50 percent, is the highest in Trenggalek Regency, which is only 1.1 percent below East Java, which is 19.20 percent. Based on this, the researcher is interested in researching the writing of a thesis entitled “Implementation of Regent Regulation Noor 47 of 2020 concerning the Acceleration of Integrated Stunting Prevention in Suruh District, Trenggalek Regency”

RESEARCH METHOD

According to (Sugiyono, 2011), qualitative research methods are research methods based on post-positivism philosophy that can be used to research natural object conditions (as opposed to experiments) where researchers are key instruments in data source sampling carried out purposively and snowball, data collection techniques with triangulation (combination), data analysis is inductive or qualitative and the results of this study emphasize meaning rather than generalization. Qualitative research using documents or data, both primary and secondary data. The qualitative approach in this study was carried out by collecting related documents to obtain the required data. The data is then described and elaborated with the results of the interview so that valid results are obtained in accordance with what happened. This study uses an interactive model data analysis method (Matthew B. Miles, A. Michael Huberman, 2014) which puts forward 4 steps in qualitative data analysis, namely: 1). Data collection, is the stage of collecting data obtained from interviews, observations, documentation and secondary data that has been successfully obtained. 2). Data Condensation, refers to the process of selecting, focusing, simplifying, abstracting, and transforming data contained in the transcript field notes in the study. 3). Data presentation, is an activity after the data has been summarized. Data obtained from the results of observations, interviews and documentation are analyzed and presented in the form of CW (interview notes), CL (field notes), and CD (documentation notes). 4). Drawing conclusions, drawing conclusions from the analysis carried out by rechecking with evidence that has been found in the field. Drawing conclusions from the results of the study answers the focus of the study on the implementation of stunting reduction policies in Trenggalek Regency

RESULTS AND DISCUSSION

1. Policy standards and targets

     Policy Success Measures

In this study, the implementation of Trenggalek Regency Regent Regulation Number 47 of 2020 concerning the Acceleration of Integrated Stunting Prevention in Suruh District, Trenggalek Regency can be described using the policy analysis model from the Van Meter and Van Horn model, namely variables related to the basic measures and objectives of the policy made, policy sources in the form of human resources, resources in the form of budgets or other supporting resources, communication between organizations and implementation activities (communication) in implementing a policy, characteristics of policy implementing agencies, economic, social and political conditions that will affect the implementation of a policy in the field, and the Disposition (attitude of the implementers) between the policy implementer and the target group of a policy. The implementation of the policy that has been previously determined through the variables conveyed by Van Meter and Van Horn is expected to run according to the objectives that have been set, and achieve maximum success. The basic measurements of a policy program must be designed and clearly structured, both in terms of regulations or rules governing a policy program that have been set by decision makers and in the implementation of the policy program. In this study, researchers saw that the Integrated Stunting Prevention Acceleration policy has included basic measurement variables of the policy objectives that have been made. In addition to being stated in the Trenggalek Regency Regent Regulation Number 47 of 2020 concerning the Acceleration of Integrated Stunting Prevention. The Indonesian government also pays great attention to stunting prevention, through Presidential Regulation of the Republic of Indonesia Number 72 of 2021 concerning the acceleration of stunting reduction which aims to increase the government’s commitment to accelerating stunting reduction.

From the researcher’s observation, through the acceleration of stunting prevention as a national priority where the regulation is implemented holistically, integratively and with quality through coordination, synergy and synchronization between ministries/institutions, provincial governments, and district/city governments. Based on this regulation, it can be seen that the role of the Regional Government is starting to be involved in efforts to reduce stunting. The measure of success seen from the implementation of Regional Apparatus activities must be able to implement according to the action plan that has been stated in the regulation. What was conveyed by the Head of the Bappelitbangda Division of Trenggalek Regency, the measure of success in implementing policies related to Trenggalek Regency Regent Regulation Number 47 of 2020 concerning the Acceleration of Integrated Stunting Prevention in the form of achievements from the implementation of the Acceleration of Stunting Prevention. From the results of the research that have been presented above, the author interprets that the variable of the measure of policy success according to Meter and Horn in the research on the implementation of the Trenggalek Regency Regent Regulation Number 47 of 2020 concerning the Acceleration of Integrated Stunting Prevention has been implemented quite optimally. It can be seen that the measure of success is not only for reducing the prevalence of stunting but also becomes a guideline in implementing stakeholder policies including implementation in accordance with the action plan that has been established together with the Trenggalek Regency Stunting Reduction Acceleration Team, fulfillment and achievement of specific and sensitive indicators of stunting as well as in the RUK and RPK at the Health Center being implemented.

     Policy Objectives

The measure of policy success will run well if the objectives in the implementation of the policy. According to Van Metter and Van Horn, implementers may fail to implement policies because they reject or do not understand the objectives of a policy. When viewed from the theory of Van Metter and Van Horn, Regarding the objective aspect of Trenggalek Regency Regent Regulation Number 47 of 2020 concerning the Acceleration of Integrated Stunting Prevention, it was conveyed by the Head of the Trenggalek Regency Bappelitbangda Division. What was conveyed by the Head of the Trenggalek Regency Bappelitbangda Division, the objective of implementing the policy related to Trenggalek Regency Regent Regulation Number 47 of 2020 concerning the Acceleration of Integrated Stunting Prevention as the basis for stakeholder implementation. that in the policy objective variable according to Van Meter and Horn in the objective of the Implementation of Trenggalek Regency Regent Regulation Number 47 of 2020 concerning the Acceleration of Stunting Prevention is that in its implementation this regulation is used as a basis for Regional Apparatus related to District and Village/Sub-district Governments, Non-Governmental Institutions/Organizations and the Community in implementing integrated stunting prevention activities that are synergistic, integrated, targeted and sustainable in Trenggalek Regency in accordance with the field of work of each Regional Apparatus.

     Policy Standards

There are still many deviations in policy implementation because in achieving goals and measures of success, people often do not know how to implement them. Implementation will run well if the measures and objectives are understood by the individuals responsible for policy performance in accordance with the theory put forward by Van Metter and Van Horn. Therefore, it is very important to pay more attention to the clarity of basic measures and policy objectives.

According to Van Metter and Van Horn, implementers may fail to implement policies because they reject or do not understand what the objectives of a policy are. From the results of the study, the author interprets that the target variable of the policy according to Meter and Horn in the study of the implementation of Trenggalek Regency Regent Regulation Number 47 of 2020 concerning the Acceleration of Integrated Stunting Prevention in Suruh District, Trenggalek Regency. The standardization of the success of the Trenggalek Regency Regent Regulation Number 47 of 2020 concerning the Acceleration of Integrated Stunting Prevention is the Standard for implementing policies related to the Trenggalek Regency Regent Regulation Number 47 of 2020 concerning the Acceleration of Integrated Stunting Prevention in the form of SOPs in each Regional Government according to their field of work.

2. Resources

Human Resources

Resources are the most influential thing in the implementation of a policy program, the success of the implementation of a policy program can be seen from the utilization of resources, both human resources in managing or implementing a policy program. At the stage of policy implementation, Trenggalek Regency Regent Regulation Number 47 of 2020 concerning the Acceleration of Integrated Stunting Prevention is implemented by the Regional Apparatus related to the Trenggalek Regency Integrated Stunting Prevention Acceleration Team.

From the results of the study, the author interprets that in the Human Resources variable according to Meter and Horn in the study of the implementation of Trenggalek Regency Regent Regulation Number 47 of 2020 concerning the Acceleration of Integrated Stunting Prevention in Suruh District, Trenggalek Regency. The Human Resources listed in the implementation of the policy include Regional Apparatus, 14 sub-district governments, Village/Kelurahan Governments, Health Facilities, Education Office through schools in Suruh District and Community Organization Institutions, from several stakeholders involved of course the Trenggalek Regency Integrated Stunting Prevention Acceleration Team.

Budget Resources

Budget Resources are a driving factor in implementing the Implementation of Public Service Policies in Handling Hazardous Goods Loads The amount of financial resource allocation for the implementation of Trenggalek Regency Regent Regulation Number 47 of 2020 concerning the Acceleration of Integrated Stunting Prevention. Every year, stakeholders involved must carry out budget planning, but in its implementation, the budget planning has not been able to meet the budget needs in Trenggalek Regency Stunting Prevention.

From the results of the study, the author interprets that in the Budget Resources variable according to Meter and Horn in the study of the implementation of Trenggalek Regency Regent Regulation Number 47 of 2020 concerning the Acceleration of Integrated Stunting Prevention in Suruh District, Trenggalek Regency. The Budget Resources listed in the implementation of the policy include the Village BKK for stunting locus villages, the Trenggalek Regency APBD listed in the regional apparatus related to the policy and other funding sources through CSR.

3. Organizational characteristics

Viewed from the perspective of the Van Meter and Van Horn implementation model, the competence of staff and support from implementing personnel in implementing a policy is one of the specific elements of the characteristics of the implementing organization that may affect an organization. In organizational characteristics, there are bureaucratic structures, norms and relationship patterns that occur in the bureaucracy, all of which will affect the implementation of a policy. In the implementation of the implementation of Trenggalek Regency Regent Regulation Number 47 of 2020 concerning the Acceleration of Integrated Stunting Prevention, the concern is the suitability of each organization in implementing the regulation, namely from the Trenggalek Regency Bappelitbangda which focuses on comprehensive planning regarding the Acceleration of Integrated Stunting Prevention, while the Health Office is the technical implementer of the implementation of Trenggalek Regency Regent Regulation Number 47 of 2020 concerning the Acceleration of Integrated Stunting Prevention, while the Suruh District Health Center itself is the technical implementer in the Suruh District area.

From the results of the study, the author interprets that the Organizational Characteristics in the research on the implementation of Trenggalek Regency Regent Regulation Number 47 of 2020 concerning the Acceleration of Integrated Stunting Prevention in Suruh District, Trenggalek Regency. That efforts to Accelerate Integrated Stunting Prevention according to the characteristics of its authority are seen in the Trenggalek Regency Bappelitbangda, namely the convergence and integration of activities in an effort to reduce the prevalence of stunting. Meanwhile, for the Suruh District Health Center, supervision of the implementation of the Regent’s Regulation is carried out at the District level every 3 months (4x in 1 year) through the Health Center mini-workshop. In addition, it is also carried out in the Convergence Action in AKsi 8, namely Review of the implementation of Convergence at the Village, District and Regency levels.

4. Inter-organizational communication

According to Van Meter and Van Horn (1974) what is the basis and purpose of the policy must be understood by the implementer who is responsible for achieving the targets and objectives of the policy. Therefore, the standards and objectives of the policy must be communicated to the implementers of the policy, if the sources of information are different then it will provide inconsistent interpretations of the standards and objectives of the policy or if the same source but provides conflicting interpretations, then the implementers face much greater difficulties in carrying out activities.

Based on the results of the study, it is known that the communication carried out by the Trenggalek Regency Government is only in the form of coordination with the relevant agency units and this is done together, it is indeed carried out, one of which is through inter-organizational communication variables, namely between Bappelitbangda, the Health Office and the Suruh District Health Center. But it is not carried out to the lowest level, namely the community.

5. The attitude of the implementers or disposition

Some reasons why the objectives of a policy are rejected by those responsible for implementing the policy, namely the previously set policy objectives may conflict with the personal value systems of the implementers, extra loyalty, feelings of self-interest, or because of existing and preferred relationships.

In a state of cognitive dissonance, individuals may try to balance the unsettling message with their perception of what the policy decision should be. The direction of the implementer’s tendencies towards the basic measures and objectives is also very important. Implementers may fail to implement the policy properly because they reject the objectives contained in the policy. And vice versa, acceptance of the basic measures and objectives of the policy that are widely accepted by policy implementers will be a driving force for successful policy implementation. In carrying out duties and responsibilities as policy implementers, it must be based on a good and consistent response. This is done because it can affect the success of the policy, each agency or institution implementing the policy must feel responsible for their respective duties based on the previously set plan.

6. Social, economic and political environment

The external environment is the environment outside the organization that also needs to be considered in order to assess the performance of public implementation, namely the extent to which the external environment contributes to the success of public policies that have been established. Economic, social and political environmental factors are one of the important factors in the implementation of a policy. If the environment is not supportive, it can be the core of the failure of a policy implementation. economic, social and political environment in the implementation of Trenggalek Regency Regent Regulation Number 47 of 2020 concerning the Acceleration of Integrated Stunting Prevention in Suruh District, Trenggalek Regency.

Based on the results of the interview, conducted by the researcher, it can be seen that the social, political and economic conditions in Trenggalek Regency can influence the implementation of the acceleration of integrated stunting prevention starting from the attitude of the regent, regional apparatus to the community if they collaborate in the implementation of Trenggalek Regency Regent Regulation Number 47 of 2020 concerning the Acceleration of Integrated Stunting Prevention, then the acceleration of stunting prevention can be carried out properly.

CONCLUSION

Based on the results of the research and analysis descriptions that the author has presented in the previous chapters, in this chapter the author will draw a conclusion based on the field research that has been conducted and provide suggestions related to the implementation of Trenggalek Regency Regent Regulation Number 47 of 2020 concerning the Acceleration of Integrated Stunting Prevention in Suruh District.

That the implementation of Trenggalek Regency Regent Regulation Number 47 of 2020 concerning the Acceleration of Integrated Stunting Prevention in Suruh District is measured using the Van Metter Van Horn Theory and based on the results of the indicator analysis including:

1. In the implementation of Trenggalek Regency Regent Regulation Number 47 of 2020 concerning the Acceleration of Integrated Stunting Prevention in Suruh District, the Trenggalek Regency Government in implementing the policy analysis model from the Van Meter and Van Horn models has been optimal, but in Communication with the Community The role of the Sub-district Health Center has not been maximized in overseeing the nutritional needs of toddlers in Suruh District has not been optimal because the Suruh District community often still cannot meet the nutritional needs of their toddlers properly;
2. There is still a lack of enthusiasm from the community in participating in the Stunting Prevention Counseling carried out by the Suruh District Health Center.

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