The Role of Specific and Sensitive Interventions on the Human Development Index (HDI) and the Stunting Phenomenon in Regencies/Cities in Indonesia

Abstract

Stunting is a chronic nutritional problem that affects the quality of human capital and regional development. To address this issue, the government has implemented specific interventions, including iron supplementation (TTD) for pregnant women and adolescent girls, complementary feeding (MP-ASI), and complete basic immunization, as well as sensitive interventions such as pre-marital health screening, access to safe drinking water, proper sanitation, and Open Defecation Free (ODF) status. This study aims to analyze the effects of specific and sensitive interventions on the Human Development Index (HDI), examine their impact along with HDI on stunting prevalence, assess the mediating role of HDI, and formulate policy priorities for stunting reduction in regencies/cities in Bali Province. This study employs a mixed methods approach with an associative design. Quantitative analysis is conducted using path analysis to examine causal relationships among variables, while qualitative insights are obtained through in-depth interviews with key stakeholders. The study utilizes secondary data from 73 regencies/cities in Indonesia. The analysis is complemented by Importance Performance Analysis (IPA), focusing on Bali Province. The results indicate that iron supplementation for pregnant women, access to proper sanitation, and ODF status significantly affect HDI, while other intervention indicators are not statistically significant. Most interventions do not directly affect stunting prevalence, except for complete basic immunization, ODF status, and HDI, which significantly contribute to reducing stunting. HDI significantly mediates the effects of iron supplementation, sanitation access, and ODF status on stunting prevalence, whereas other variables are not mediated. IPA results identify complete basic immunization and sanitation access as priority areas for policy improvement in Bali. These findings highlight the importance of strengthening institutional capacity, improving implementation quality, and enhancing cross-sectoral integration to accelerate stunting reduction