POLICY BRIEF 

Beyond rurality: making Indonesia's stunting convergence policy work in 3T regions

Territorial difficulty should change how policy is financed, staffed, delivered and evaluated - not lower the right to an equivalent service.

Ahmad Nizar Hilmi | Department of Public Policy, Faculty of Social and Political Sciences, Universitas Negeri Surabaya, Surabaya, Indonesia

Email: [email protected] | ORCID iD: https://orcid.org/0009-0007-5494-4559

Why this matters now

Presidential Regulation No. 72/2021 established a national framework for accelerating stunting reduction through strategy, coordination, monitoring, evaluation, reporting, and financing. The convergence approach aligns planning, budgeting, implementation, monitoring, and control across sectors and levels of government so that priority households receive coordinated nutrition-specific and nutrition-sensitive interventions.

Evidence base

A Scopus search identified 132 records. After year, document-type, language and substantive screening, 45 English-language journal articles were included. The literature covers maternal and child factors, household food security, water and sanitation, infection, spatial disparities, service access, provider capacity, cadres, digital monitoring and policy implementation. Most studies identify risk factors; only a small subset directly examines convergence, coordination or administrative systems.

·         Remote and rural populations face overlapping food, WASH, infection and service-access disadvantages.

·         Rural providers report weaker capacity and greater implementation barriers than urban providers.

·         Formal acceptance of convergence can coexist with weak feasibility, coverage and sustainability.

·         Digital tools improve risk visibility but do not guarantee referral or material follow-up.

·         Cadres extend state reach but cannot substitute for infrastructure, professionals or stable finance.

The policy diagnosis: six territorial mismatches

Figure. Policy transition from uniform convergence and geographic targeting toward territorially differentiated implementation.

Six priority actions

1. Introduce territorial cost adjustment

Revise intergovernmental transfer and programme formulas using travel time, island geography, settlement dispersion, population density, transport dependence and infrastructure deficits.

2. Differentiate delivery and procurement

Permit mobile teams, rotating specialists, integrated outreach schedules, community-based logistics, offline-capable digital tools and procurement rules suited to remote supply chains.

3. Establish a remote-workforce package

Combine local recruitment, housing, professional networks, career progression, continuing support and retention incentives. Short training cannot compensate for persistent vacancies.

4. Separate administrative from substantive convergence

Report plans, meetings and data entry separately from household receipt of linked nutrition, WASH, health, food-security and social-protection services.

5. Connect data to decision rights and resources

A risk flag should trigger a named responsible agency, follow-up deadline, referral route, resource decision and auditable closure of the case.

6. Institutionalise cadres without informalising the state

Provide predictable remuneration, transport, occupational protection, simplified reporting, training and formal voice in local planning while maintaining professional public-service responsibility.

Implementation roadmap

Performance indicators that reveal real convergence

·         Percentage of priority households receiving the complete locally required intervention package.

·         Median travel time and cost from target settlements to functioning maternal-child services.

·         Vacancy, rotation and two-year retention rates for key rural and remote health personnel.

·         Share of expenditure directed to nutrition-sensitive infrastructure and social protection.

·         Median days from digital risk identification to verified follow-up and case closure.

·         Cadre workload, remuneration, transport support and participation in local planning.

·         Coverage and outcomes adjusted for territorial implementation difficulty.

Policy safeguard

Differentiation must not become a justification for lower rights or permanently inferior services. The principle is differentiated means for equivalent substantive access. National government should retain minimum rights and outcome standards while allowing financing, staffing, logistics and reporting arrangements to vary with territorial difficulty.

Method note

This brief is based on a systematic review of 45 Scopus-indexed English-language journal articles. The evidence strongly establishes territorial concentration of stunting risks and identifies recurring implementation barriers. Direct comparative evidence on unit costs, fiscal capacity, workforce retention and household receipt of convergent services remains limited. The recommendations therefore combine directly reported findings with a clearly identified conceptual synthesis: territorial mismatch.

About the author

Ahmad Nizar Hilmi is a public policy scholar at Universitas Negeri Surabaya whose research focuses on policy implementation, territorial inequality, state capacity, decentralisation, and stunting governance. Contact: [email protected].

Selected references

Barca, F., McCann, P., & Rodríguez-Pose, A. (2012). The case for regional development intervention: Place-based versus place-neutral approaches. Journal of Regional Science, 52(1), 134-152.

Government of Indonesia. (2021). Presidential Regulation No. 72 of 2021 on the acceleration of stunting reduction.

Rizkianti, A., et al. (2026). Local innovations and systemic barriers in stunting reduction. BMJ Open, 16(7).

Sufri, S., et al. (2024). Implementation outcomes of convergence action policy to accelerate stunting reduction in Pidie district. BMJ Open, 14(11).

Tim Percepatan Penurunan Stunting. (2026). Pillar 3: Strengthening convergence of specific and sensitive interventions.

Widyaningsih, V., et al. (2022). Determinants of socioeconomic and rural-urban disparities in stunting. Rural and Remote Health, 22(1), 1-9.