Title : An exploratory analysis of the individual and environmental barriers faced by Posyandu cadres in child growth monitoring in Surabaya, Indonesia
Abstract:
Childhood stunting and malnutrition remain major challenges faced by low- and middle-income urban communities in Indonesia. To address such issues, the government established the Posyandu cadres, community-driven Integrated Health Posts that emphasize the role of community members as healthcare workers to improve the health status of women and children within their communities. Despite training support from local NGOs like Wahana Visi Indonesia (WVIN), cadres continue to face barriers in delivering child growth monitoring services in Surabaya’s urban villages. This study explored individual and environmental barriers faced by cadres, alongside mothers’ perspectives, in carrying out successful child growth monitoring. Focus Group Discussions were conducted with 10 cadres and 8 mothers from 5 sub-districts in Surabaya. From these discussions, key themes were identified such as training adequacy, occupational stress, community and familial support, and gaps in technical WASH knowledge. We further explored themes from mother participants including adherence to Posyandu advice, challenges to accessing nutritional resources, and perceptions of feeding practices. Further analysis revealed that cadres require longer, more interactive training (beyond the existing 3-day model), reduced occupational stress, and stronger support from the local government and WVIN. However, mothers did report having adequate access to nutritious foods and resources but lacked knowledge of correct feeding practices until guided by cadres, highlighting their reliance on the Posyandu. These responses emphasized the importance of cadres in the community for raising awareness for child feeding practices, and the importance of strengthening cadre training and streamlining Posyandu services. Recommendations were provided to WVIN to guide ongoing Posyandu training program support that prioritizes enhancing community education and improving child growth monitoring outcomes in Surabaya, Indonesia.
