Overcoming Implementation Barriers in a Qualitative Study of the Supplementary Feeding Program for Malnourished Toddlers in Rural Indonesia

Sri Wahyuni Nasution, Yerniyanti Lahagu, Chrismis Novalinda

Abstract


Nutritional problems among toddlers, particularly malnutrition, remain a significant public health concern in Indonesia. The Supplementary Feeding Program (PMT) is a key government initiative that utilizes local food resources to improve the nutritional status of children under five. However, the program continues to face several implementation challenges that must be addressed to ensure its effectiveness. This study aimed to identify the challenges and solutions associated with the implementation of the PMT in the Sei Mencirim Health Center area, Deli Serdang Regency. A qualitative case study design was employed, involving eight key informants comprising health workers, posyandu cadres, and parents of PMT recipients. Data were collected through in-depth interviews and analyzed thematically using the Miles and Huberman framework, which includes data reduction, data display, and verification. The findings revealed several key challenges: untimely distribution of PMT, declining food quality, budget constraints, low parental education levels, and limited parental involvement in program monitoring. To address these issues, a range of targeted solutions was implemented, including the formation of dedicated distribution teams, menu standardization, establishment of centralized food processing sites, improved data accuracy, continuous staff training, enhanced cross-sector coordination, and routine monitoring and evaluation. These interventions led to a 35% improvement in the timeliness of PMT distribution and a 50% increase in family participation, contributing positively to the nutritional outcomes of toddlers. In conclusion, targeted interventions and multisectoral collaboration significantly enhanced the effectiveness of PMT implementation in the study area.

 

Keyword: Supplementary Feeding Program, Toddlers, Implementation Challenges, Nutritional Status, Qualitative Study.


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Andriani, H., Friska, E., Arsyi, M., Sutrisno, A. E., Waits, A., & Rahmawati, N. D. (2023). A multilevel analysis of the triple burden of malnutrition in Indonesia: trends and determinants from repeated cross-sectional surveys. BMC Public Health, 23(1), 1–15. https://doi.org/10.1186/s12889-023-16728-y

Ariadi, S. (2023). Integrated handling to overcome stunting in rural areas in East Java, Indonesia. Masyarakat, Kebudayaan Dan Politik, 36(3), 436–450. https://doi.org/10.20473/mkp.v36i32023.436-450

Baskoro, A. (2023). Pemberian Makanan Tambahan pada Balita. Kemenkes RI.

Beal, T., Tumilowicz, A., Sutrisna, A., Izwardy, D., & Neufeld, L. M. (2018). A review of child stunting determinants in Indonesia. Maternal and Child Nutrition, 14(4), 1–10. https://doi.org/10.1111/mcn.12617

Corie, A. H., & Syakurah, R. A. (2024). Evaluation of the supplementary feeding programme targeted at malnourished toddlers in Prabumulih City, Indonesia. 07(4), 413–424.

Dinas Kesehatan Kabupaten Lima Puluh Kota. (2024). Monev Program Dan Monitoring pelaksanaan PMT lokal Puskesmas Baruah Gunung. Dinas Kesehatan Kabupaten Lima Puluh Kota.

Eko. (2022). 19 K/L Sepakat Ketahanan Pangan dan Percepatan Penurunan Stunting Tetap Menjadi Prioritas RPJM Hingga Tahun 2024. Paudpedia.

Ellora, W., Riang, E., Purba, T. H., Jl, A., Sumarsono, K., Lalang, K., Sunggal, K., & Serdang, K. D. (2025). Intervensi Gizi untuk Penanganan Terjadinya Gizi Kurang pada Balita Usia Dibawah Lima Tahun Institut Kesehatan Helvetia , Indonesia penelitian . Informasi desain penelitian , karakteristik sampel , intervensi yang diberikan , hasil. 3, 31–41.

Febriyati, T. S., Herawati, D. M. D., & Megawati, G. (2022). Implementation Supplementary Feeding Program and Infant and Young Child Feeding Counseling as a Stunting Prevention Program During Pandemic. Jurnal Kesehatan Prima, 16(1), 25–33.

Haryani, D. A., Amanda, Q., & Sabjan, N. (2024). Locally sourced supplementary feeding programs as a strategic intervention to address weight faltering in children : insights from a primary health center study. Sains Medika: Jurnal Kedokteran Dan Kesehatan, 15(2), 62–67.

Kementerian Kesehatan Republik Indonesia. (2023). Petunjuk Teknis Pemberian Makanan Tambahan (PMT) Berbahan Pangan Lokal untuk Balita dan Ibu Hamil.

Lisani, A. A. (2024). Review Of Maqashid Syariah On The Practice Of Child Labor As A Hawker At The Pawon Purwokerto Stop By Restaurant. In Proceeding of ICCoLaSS: International Collaboration Conference on Law, Sharia and Society.

Maryam, S., Arisona, W. L., & Nyeurmaha, S. Y. (2022). Evaluation of Supplementary Feeding (Pmt) From the Government To Stunting Toddlers. Journal for Quality in Women’s Health, 5(2), 201–212. https://doi.org/10.30994/jqwh.v5i2.171

Milwan, & Sunarya, A. (2023). Stunting Reduction in Indonesia: Challenges and Opportunities. International Journal of Sustainable Development and Planning, 18(7), 2223–2231. https://doi.org/10.18280/ijsdp.180727

Nadimin, N., Sirajuddin, S., Afifah, S. N., Hadju, V., & Bohari, B. (2025). The effect of nutritional assistance “Gammara’Na” on food acceptance and nutritional status of children in South Sulawesi, Indonesia. Nutricion Clinica y Dietetica Hospitalaria, 45(1), 38–46. https://doi.org/10.12873/451nadimin

Octasila, R., & Dariyani, S. (2021). Evaluation Of Supplementary Food (PMT) For Toddlers With Malnutrition In Pendemy Covid 19. Jurnal Stikes Al Insyirah, 2, 173–179.

Puskesmas Ajibarang. (2024). Sosialisasi Persiapan Penyaluran Bantuan PMT Lokal di wilayah kerja Puskesmas Ajibarang. Puskesmas Ajibarang (Pemerintah Kabupaten Banyumas).

Reza Nuur Wahyuningtias, & Latifah, N. (2025). Faktor-Faktor Yang Berhubungan Dengan Perilaku Higiene Sanitasi Pedagang Makanan Jajanan Di Kawasan Alun-Alun Pamulang. Jurnal Ilmu Kesehatan, 13(4), 1–6. https://doi.org/10.5455/mnj.v1i2.644xa

Sanggelorang, Y., Ari Anggraini Sebayang, F., Malonda, N. S. H., & Rumayar, A. A. (2024). Insights Into Childhood Malnutrition: an Analysis on Food Vulnerability and Stunting Using 2021 Indonesian Nutritional Status Survey Data. Media Gizi Indonesia, 19(3), 282–290. https://doi.org/10.20473/mgi.v19i3.282-290

Sarma, H., D’Este, C., Ahmed, T., Bossert, T. J., & Banwell, C. (2021). Developing a conceptual framework for implementation science to evaluate a nutrition intervention scaled-up in a real-world setting. Public Health Nutrition, 24(S1), S7–S22. https://doi.org/10.1017/S1368980019004415

Sebastian, A., Shivakumaran, S., Silwal, A. R., Newhouse, D., Walker, T., & Yoshida, N. (2018). A Proxy Means Test for Sri Lanka. In A Proxy Means Test for Sri Lanka (Issue October). https://doi.org/10.1596/30125

Simanjuntak, S., & Sinaga, H. T. (2023). Original Articel Journal Of Pharmaceutical And Sciences Electronic The Implementation Of Additional Feeding Additional Food Counseling (PMT-P) On Eating Pattern And Nutritional Status In Toddlers (12-59) Months At Bakaran Batu. Journal of Pharmaceutical and Sciences, 6(4), 1523–1533.

Warren, A. M., Frongillo, E. A., & Rawat, R. (2020). Building Implementation Science in Nutrition. Advances in Nutrition, 11(5), 1392–1398. https://doi.org/10.1093/advances/nmaa066

Wijeakumar, S., Forbes, S. H., Magnotta, V. A., Deoni, S., Jackson, K., Singh, V. P., Tiwari, M., Kumar, A., & Spencer, J. P. (2023). Stunting in infancy is associated with atypical activation of working memory and attention networks. Nature Human Behaviour, 7(12), 2199–2211. https://doi.org/10.1038/s41562-023-01725-3




DOI: http://dx.doi.org/10.30829/contagion.v7i1.24365

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Contagion: Scientific Periodical Journal of Public Health and Coastal Health by Program Studi Ilmu Kesehatan Masyarakat is licensed under Creative Commons Attribution-ShareAlike 4.0 International License.