Analisis Perilaku Pencegahan dan Pengendalian Stunting dengan Pendekatan Health Action Model (HAM) di Kecamatan Seram Utara Kabupaten Maluku Tengah Provinsi Maluku

Dewi Syitra Rumadaul, Dr. Supriyati, S.Sos.,M.Kes.; Erlin Erlina.,S.Pi.,MA.,P.hD.

2024 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang: Indonesia menargetkan prevalensi stunting 14% pada tahun 2024. Berbagai program konvergensi telah diimplementasikan, namun prevalensi stunting di Provinsi Maluku masih cukup tinggi, yakni 26,1%. Salah satu kendala adalah perilaku masyarakat yang tidak sehat. Agar dapat mengoptimalkan perilaku sehat masyarakat, khususnya dalam mencegah dan mengendalikan stunting, dibutuhkan suatu analisis mendalam terkait perilaku tersebut, serta peran aktor kunci yang terlibat dalam pelaksanaan program di tingkat masyarakat.

Tujuan: Penelitian ini bertujuan untuk menganalisis perilaku pencegahan dan pengendalian stunting di Desa Sawai, Kecamatan Seram Utara, Provinsi Maluku dengan menggunakan pendekatan Health Action Model (HAM).

Metode: Penelitian kualitatif dengan pendekatan studi kasus ini dilakukan pada bulan April 2024. Pengumpulan data melalui observasi dan wawancara terhadap 25 partisipan yang dipilih secara purposive, meliputi 16 partisipan utama (ibu hamil, orang tua dan caregiver yang memiliki anak usia 0-2 tahun), dan 9 partisipan pendukung (petugas kesehatan, pemerintah desa, dan kader). Analisis data menggunakan framework analysis dan dibantu software Opencode versi 4.03.

Hasil: Perilaku pencegahan dan pengendalian stunting di Desa Sawai melibatkan berbagai pihak, termasuk petugas kesehatan, kader, pemerintah desa dan masyarakat. Petugas kesehatan memantau tumbuh kembang anak di posyandu dan PMT, sementara pemerintah desa fokus pada bantuan biaya persalinan dan PMT. Masyarakat menunjukkan perilaku yang mendukung upaya tersebut, meskipun lebih terfokus pada menjaga kesehatan secara umum. Sejalan dengan hal tersebut, sistem yang membentuk niat perilaku masyarakat berfokus pada kesehatan anak adalah prioritas. Sedangkan faktor pengetahuan, dan keterampilan dalam pencegahan stunting terbatas pada upaya pemenuhan nutrisi anak, serta terdapat pengaruh aspek sosial ekonomi, dan budaya yang menimbulkan stigma negatif tentang stunting di Desa Sawai.

Kesimpulan: Perilaku pencegahan dan pengendalian stunting di Desa Sawai menunjukkan keterlibatan berbagai pihak, namun belum optimal. Diperlukan model intervensi perubahan perilaku yang komprehensif sesuai kerangka HAM, dan revitalisasi posyandu oleh pemerintah desa untuk meningkatkan partisipasi aktif masyarakat dalam upaya tersebut.

Background: Indonesia targets a stunting prevalence of 14% by 2024. Various convergence programmes have been implemented, but the prevalence of stunting in Maluku Province is still quite high at 26.1%. One of the obstacles is the unhealthy behaviour of the community. In order to optimise healthy community behaviours, especially in preventing and controlling stunting, an in-depth analysis of these behaviours is needed, as well as the role of key actors involved in programme implementation at the community level.

Objectives: This study aims to analyze stunting prevention and control behavior in Sawai Village, North Seram District, Maluku Province, using the Health Action Model (HAM) approach.

Methods: This qualitative research study, using a case study approach, was conducted in April 2024. Data were collected through observation and interviews with 25 purposively selected participants, including 16 main participants (pregnant women, parents, and caregivers who have children aged 0-2 years) and 9 supporting participants (health workers, village government, and cadres). Data were analyzed using framework analysis and assisted by Opencode software version 4.03.

Results: Stunting prevention and control behaviours in Sawai Village involve various parties, including health workers, cadres, village government and the community. Health workers monitor children's growth and development at posyandu and providing supplementary food, while the village government focuses on assistance with maternity costs and providing supplementary food. The community exhibits behaviour that supports these efforts, although it is more focused on maintaining general health. In line with this, the systems that shape community behavioural intentions focus on children's health as a priority. Meanwhile, knowledge and skills factors in stunting prevention are limited to efforts to fulfil children's nutrition, and there is an influence of socio-economic and cultural aspects that cause negative stigma about stunting in Sawai Village.

Conclusion: The behavior of stunting prevention and control in Sawai Village shows the involvement of various parties, but not yet optimal. A comprehensive behavior change intervention model is needed according to the HAM framework, as well as the revitalization of posyandu by the village government to increase active community participation in these efforts.

Kata Kunci : Stunting Prevention and Control Behavior, Health Action Model (HAM)