COLLABORATIVE GOVERNANCE IN THE HANDLING OF STUNTING PROGRAM IN EAST FLORES DISTRICT

Dominikus Fernandes, Jacoba Daud Niga, Rikhardus Seran Klau

Universitas Nusa Cendana, Indonesia

E-mail: [email protected], [email protected], [email protected]

KEYWORDS Collaborative governance, Handling Stunting

ABSTRACT Stunting management and prevention programs generally use specific nutrition intervention approaches and sensitive nutrition interventions. Several studies have shown that interventions that are effective in reducing the prevalence of stunting are still limited, although a lot of data captures and reveals the sub-focuses on nutrition, food security and WASH (water, sanitation and hygiene), PMT, multi-sectoral approaches and health promotion programs but so far this has not been enough. obtain definite information regarding the prevention and treatment of stunting. On the other hand, studies related to capacity implementation, especially those carried out by several government agencies in an integrated manner, have not shown a reduction in the prevalence of stunting. Efforts to reduce the prevalence of stunting in the form of collaborative governance are very strategic considering that the synergy (government, private sector and the community) is needed when a specific nutrition intervention approach or a nutrition-sensitive intervention is carried out. Organizationally, currently efforts to prevent and treat stunting in East Flores Regency are marked by the formation of the Task Force: Convergence, Synergy, Collaboration to Accelerate Stunting Reduction which is a Task Force (collaborative governance) consisting of bureaucratic and non-bureaucratic elements. The entire observation includes all agencies that are members of the Stunting Handling Convergence Task Force. Interviews were conducted using a structured interview list with designated OPD leaders and staff; interview with street level implementation. Furthermore, observations were made at the Posyandu activity location. The collected data are then categorized and analyzed according to the research objectives. The results showed that the collaborative governance model for the prevention and treatment of stunting showed significant results, namely a decrease in the number of stunting by 2% (previously it was 22% to 20%); This fact is mainly supported by the optimal performance of the Stunting Convergence Task Force.

INTRODUCTION

East Nusa Tenggara Province is one of the provinces with the highest stunting rate in 2013, with a stunting percentage of 51.7%. Through various handling and prevention efforts, in 2018 NTT experienced a decrease in stunting to 42.6%, but this decrease has made NTT still a region with high stunting rates (Binagwaho et al., 2020). In relation to this fact, the East Flores Regency Government has set a regional development vision, namely: Prosperous East Flores Within a Village Frame Building an Organizing City (Kim et al., 2020). This vision then sets out the missions: (1) save young people, (2) save infrastructure, (3) save people's crops, (4) save East Flores sea, (5) bureaucratic reform (Chris Ansell & Gash, 2008).

In East Flores Regency, handling and preventing stunting is one of the duties and responsibilities of several OPDs regulated in East Flores Regent Decree Number 59/2020 which includes Bappeda, Health Service, PP&KB Office, PP&PA, PKO Service, Public Works Service, Social Service, Department of Agriculture and Food Security (Christopher Ansell, Doberstein, Henderson, & Siddiki, n.d.).

Furthermore, by referring to the development vision of East Flores Regency, especially related to the first vision (save young people), the inter-OPD team is expected to work together to implement stunting prevention policies in this area. The following is stunting data in East Flores Regency (Emerson, Nabatchi, & Balogh, 2012). Even though it has been regulated through a district head's decree, efforts to reduce the prevalence of stunting in this district have not shown satisfactory results (Batory & Svensson, 2020).

In further developments; especially by looking at Presidential Regulation No. 72 of 2021 concerning the Acceleration of Reducing Stunting and the BKKBN Banding Number 12 of 2021 concerning the National Action Plan for Reducing Stunting (RAN PASTI), the East Flores Regency Government followed this up by establishing the East Flores Regency Stunting Handling Task Force (hereinafter referred to as the Convergence Handling Stunting Task Force) (Bentrup, 2001). which has a mission to reduce the prevalence of stunting in East Flores Regency by 2024 to 10% (below the national target of 2024 = 14%) (Connery et al., 2021). The Stunting Convergence Task Force is a collaborative governance task force consisting of local government bureaucratic agencies and non-bureaucratic agencies whose membership is as stated in the abstract section of this paper (Dhingra & Pingali, 2021).

Although this task force was formed in 2022, for the time being it has shown quite promising results towards achieving the goal of reducing the prevalence of stunting in this district, although as a collaborative governance it still needs to be improved and strengthened (Mutiarasari et al., 2021). Table 1 depicts stunting data in East Flores in numbers showing data from the work of the Convergence Handling Stunting Task Force in East Flores Regency (Harris, Frongillo, Nguyen, Kim, & Menon, 2017).

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Table 1

East Flores Stunting Data in Figures per Health Center

(August 2022 period)

Public health center	∑ target	The target is weighed	Total updated target toddler data	% data update divided by target number	%data update divided by the number of targets weighed	Not yet weighed	Which has not been entered yet
Boru	1008	1008	1006	99.8	99.8	-	2
Lewolaga	490	490	491	100.2	100.2	-	1
Lato	400	339	399	99.8	100	1	-
Ile Bura	446	446	446	100	100	-	-
Waiklibang	1,276	1,269	1,269	95.5	100	7	-
Lewolema	654	654	654	100	100	-	-
Nagi	1,791	1618	1625	90.7	100.4	173	7
Okay	904	900	900	99.6	100	4	-
Waimana	712	712	712	100	100	-	-
Demon Pagong	268	267	258	96.3	96.6	1	9
Rita Ebang	595	595	595	100	100	-	-
Kalike	401	401	401	100	100	-	-
win	1.118	1.118	1.118	100	100	-	-
Waiwadan	991	99	991	100	100	-	-
Baniona	797	797	797	100	100	-	-
Lite	822	822	822	100	100	-	-
Waiwerang	1,880	1,799	1,793	95.4	99.7	81	6
Ile Boleng	1,111	1,111	1,111	100	100	-	-
Witihama	1.168	1.168	1.168	100	100	-	-
Valley	772	772	772	100	100	-	-
Sago	848	848	848	100	100	-	-
Amount	18,446	18,177	18,176	98.5	100	269	17

Source: Secretariat of the Convergence Task Force for Handling Stunting, East Flores Regency, 2022

�� Based on the interviews of the research group with the Head of Family Planning, as well as the Head of Women's Empowerment in an outline it can be conveyed as follows: even though institutionally the government bureaucracy already has lines and descriptions as well as clear descriptions of tasks and responsibilities, but in the form of concrete actions especially related to cooperative relations and coordination with other relevant agencies is sometimes not matched, especially with regard to commitment, shared understanding of program goals and objectives, and building mutual trust, especially now that the Stunting Convergence Handling Task Force also has a non-bureaucratic institution. Sometimes it happens that the schedule of activities and the readiness of the field staff and the target group itself is still a separate problem; related to field extension staff, it seems to be concerned with issues of motivation, incentives, work culture and discipline, level of obedience, method and schedule of activities as well as other field administration. Meanwhile, directly related to the target group, the main issues revolve around mindsets regarding stunting, healthy living culture and behavior and parenting styles. The Head of Women's Empowerment further said that efforts to reduce the prevalence of stunting at this time seem to be getting optimal because there has been an integrated and integrated involvement of various public and non-public sector organizations so that their success or temporary achievements can be seen --- and these results can be used as a benchmark measurement and motivation in various stunting management efforts; it's just that it needs to be wisely regulated work systems and mechanisms so that they can build and form a strong commitment, one of which is by building open and trusted and consistent communication in the Stunting Handling Convergence Task Force (Botero-Tovar, Arocha Zuluaga, & Ram�rez Varela, 2020).

The results of the interview above show that even though collaborative governance has been formed in an effort to reduce the prevalence of stunting, such as the Stunting Reduction Convergence Task Force, it is still very open for failure to occur. For this reason, it is necessary to conduct studies related to the collaboration process model between bureaucracy and non-bureaucracy (Rivera Dommarco, Gonz�lez de Cos�o, Garc�a-Ch�vez, & Colchero, 2019). This model in the study of public administration studies is known as the collaborative governance model . As initiated by Ansell and Gash who offer a collaborative governance process model as follows: (a) face-to-face dialogue, (b) building trust, (c) commitment to the process, (d) shared understanding, (e) temporary impact (Weatherspoon, Miller, Ngabitsinze, Weatherspoon, & Oehmke, 2019).

These results are expected to make a scientific contribution to the development of public administration studies and to be practically useful for the East Flores District Government, specifically in the context of collaborative governance for handling stunting and in general in the context of optimizing collaborative governance in other fields/aspects of development (Rahayu, 2020).

RESEARCH METHODS

This research is a qualitative research which focuses on collaboration governance in the perspective of public administration. This research is also basically intended to explain the process and mechanism of the relationship (collaboration) in order to achieve the set goals.

regarding focus is the next collaborative governance will studied in sub focus: interface dialogue, build trust, commitment to the process, understanding together, impact while. Temporary that regarding with method study done with way: observation, study documents, and interviews structured.

The overall observation includes collaborating agencies/institutions and the overall collaboration process.

Health Service = 1 person	Universities: IKTL Larantuka = 1 person
Department of Agriculture = 1 person
Social Service = 1 person	Professional Organizations, IDI, IBI, PPNI, IAKMI, HAKLI = 1 person
Public Works Service = 1 1 person
Forest Service = 1 person	NGO/NGO, YPPS Larantuka Momentum = 1 person
Residential Area Housing and Land Agency = 1 person
Youth & Sports Education Office = 1 person	BKKBN, Technical Assistant (volunteers prepared by the province) = 1 person
Office of Communication & Informatics = 1 person
Dukcapil Service = 1 person	Print & Electronic Media = 1 person
Village Community Empowerment Service = 1 person
Ministry of Religion = 1 person
Bappeda = 1 person
DPP-KB, PP&PA = 1 person

DISTRICT LEVEL
1. Camat	2. Other Related Elements
3. Head of UPT Service

VILLAGE/SUB-DISTRICT LEVEL IMPLEMENTERS
1. Village head as Budget User/ Lurah as Budget User Authority	3. PL KB (BKB)
	4. Target Group 5. Group of teenage girls
2. PKH Facilitator, Service UPTD	6. Puskesmas/Posyandu

�

Interviews were conducted using a structured interview list with OPD leaders and non-governmental organization (NGo) leaders, interviews with street level implementation Furthermore, observations were made at the location of group activities and Posyandu. The collected data are then categorized and analyzed according to the research objectives.

RESULTS AND DISCUSSION

A. Description of Collaborative Governance for Handling Stunting in East Flores District

� 1) Purpose, Target and Organizing

There is awareness of the Regional Government of East Flores Regency regarding the link between poverty and stunting so that handling it requires systematic, integrated and comprehensive steps and approaches through just and sustainable development for the creation of community welfare. This concrete form of government awareness was subsequently stipulated in the Decree of the East Flores Regent, Number 159 of 2020 concerning the Determination of Stunting Locus Villages in East Flores Regency in 2021.

Objectives and Targets of the East Flores District Stunting Program

General purpose	Subfocus
a. reduce poverty	percentage of poor people
b. improve community welfare
Special purpose
the realization of healthy and intelligent human resources	stunting percentage
Target
management of stunting in a systematic, integrated and comprehensive manner in the village/kelurahan	families of couples of childbearing age, families of stunted children and youth groups

Stunting Villages/Kelurahan in East Flores Regency of 2021

Even though, an organization for handling and preventing stunting has been established in East Flores Regency which consists of related agencies within the scope of the East Flores Regional Government, based on reports and several studies it has been found that the number of stunting in this district continues to increase. Furthermore, paying attention to the development and progress of increasing stunting in East Flores Regency, the Regional Government of East Flores Regency in 2022 deems it necessary to form an organization (Satgas) whose membership consists of elements of the government bureaucracy and non-bureaucratic agencies (NGo). This Task Force is hereinafter known as the East Flores District Stunting Convergence Management Task Force (as in the following table)

Table: 4

CONVERGENCE, SYNERGITY, COLLABORATION TO ACCELERATE STUNTING REDUCTION 14% IN 2024
public health Office	College: IKTL Larantuka
Department of Agriculture
social services	Professional Organizations, IDI, IBI, PPNI, IAKMI, HAKLI
Public Works Department
forestry Service	NGO/NGo, YPPS Larantuka Momentum
Department of Housing, Residential Areas and Land Affairs
Youth & Sports Education Office	BKKBN, Technical Assistant
Office of Communication & Information
Civil Registry Service	Print & Electronic Media
Village Community Empowerment Service
Ministry of Religion
DPP-KB-PP&PA
Bappeda

Source: DPP-KB-PP&PA Office of East Flores district; 2022

The Convergence Task Force is a Task Force based in East Flores Regency with its secretariat located at the Office of Population Control for Family Planning, Women's Empowerment and Child Protection.

With regard to the tasks and functions of this Task Force, basically it refers to Presidential Regulation Number 72 of 2021 concerning the Acceleration of Reduction of Stunting and BKKBN Banking Number 12 of 2021 concerning RAN PASTI (National Action Plan to Accelerate Reduction of Stunting); the target to be achieved by the East Flores Regency Government by forming the Stunting Convergence Handling Task Force is to accelerate the reduction of stunting by 10% in 2024. This team's main task is in accordance with Ran Pasti priority activities, namely: a) providing data on families at risk of stunting, b) facilitation for families at risk of stunting, c) assistance to all prospective brides/prospective couples of childbearing age, d) surveillance of families at risk of stunting, e) audits of stunting cases, f) planning and budgeting, g) monitoring and fostering accountability for the implementation of activities to accelerate stunting reduction, h) monitoring, evaluation and reporting.

B. Results Analysis and Discussion of Collaborative Governance

a) Face to face dialogue ( face to face dialogue )

Every form of cooperation certainly requires face-to-face dialogue as a form of communication in the framework of forming commitments. Intensive and open dialogue is essential in collaboration. This means that a collaboration begins with a dialogue, a process of dialogue, the result of the dialogue which is usually in the form of a joint consensus which is then realized in the form of action. The initial process of dialogue was carried out openly between the Convergence Task Force for Handling Stunting in East Flores Regency internally, then an open meeting was held with all stakeholders consisting of village heads/lurah (250 people), heads of Puskesmas and Pustu and Posyandu heads, all related OPDs, as well as a community group observing stunting in East Flores Regency, totaling 1,000 (one thousand) people at the Lebao football field on May 20, 2022.

The results of the face-to-face meetings conducted by the Convergence Handling Stunting Task Force ( collaborative governance) were an agreement to reduce the prevalence of stunting in East Flores Regency in 2024 to 10%, besides that it was also agreed that all activities of the Convergence Task Force for Handling Stunting in East Flores Regency would continue to follow the flow of activities as planned. stipulated in the BKKBN PERBAN Number 12 of 2021 regarding the DEFINITE NAP as shown in the diagram below.

The results of the interview with the Head of the Child Protection Office of the PP-KB-PP&PA Service said that all participants/organizations who are members of the Convergence Task Force for handling stunting in East Flores Regency during the initial meeting at the PP-KB-PP&PA Service Office agreed that the handling of stunting was carried out by following and continuing pay attention to the basic components that have been stipulated in PERBAN BKKBN Number 12/2021 concerning RAN SURE. The same thing was also conveyed by the Head of the East Flores Regency Information and Communication Service who stated that if the Task Force worked and followed the directions set out in the RAN PASTI it would facilitate coordination between members of the Task Force as well as communication and control of officers/teams at the sub-district and village levels; besides that it will be very helpful in evaluating the work of the Convergence Task Force.

b) Building Trust (trust building )

Building trust is one of the necessary conditions in building a solid collaboration. Collaboration is indeed not merely the result of negotiation, bargaining or the result of a compromise between collaborating parties, but more than that, namely with regard to efforts to build mutual trust with one another. Thus the emphasis is placed on formulating agreements to be further reflected in various forms of action that can be mutually acceptable.

Building mutual trust between parties collaborating in handling stunting in East Flores Regency is carried out through regular meetings of the Stunting Reduction Convergence Task Force at the DPP-KB-PP&PA every 4 (four) months. In this activity discussed and discussed materials related to the analysis of the situation of the stunting locus; Besides being held in the form of meetings, the East Flores Regency government website has also been opened as well as activities to disseminate stunting information to the public through local government radio broadcasts for every activity carried out in the stunting locus village --- including the dissemination of information on activities and their results through local Flores media Post. Activities to build trust between parties in this convergence Task Force are not only related to the things that have been discussed above, but also discussed information on the results of the sub-district level deliberations carried out by the sub-district level stunting management team.

DPP-KB-PP&PA Women's Empowerment ; In general, it can be said that generally the results of consultations at the sub-district level as well as an analysis of the locus village situation reviewed by the district stunting management convergence team still lead to the approach of families at risk of stunting as stipulated in the RAN PASTI; it was further said that in each meeting to discuss and analyze the situation the Convergence Handling Stunting Task Force basically had the same perception, especially with regard to approaches and priorities that had to be carried out in stunting locus villages ( as shown in the table below).

c) Commitment to the process collaborations ( commitment to the process collaborations )

In a collaborative commitment is a very important component. Commitment is closely related to the original motivation of the actors in the collaboration. Commitment requires mutual recognition, mutual trust. The existence of interdependence and responsibility of each in carrying out the rights and obligations. Commitment is a loyal attitude and responsibility of a person or group of people towards something, be it oneself, an organization, goals or certain other things, and a willingness to be involved. In another sense, commitment is a situation in which a person makes an agreement or attachment, both to himself and to another person, which is reflected in certain actions/behaviors that are carried out voluntarily or forcedly. The meaning of commitment is often aligned with consequential; meaning that what has been promised or planned must be done or completed --- so that someone who has a commitment will be responsible for something that has been planned or promised.

The researcher's interview with the Secretary of the East Flores Regency Public Works Service can be conveyed as follows .... we as parties involved in the stunting convergence Task Force often face problems with our portion as clean water and sanitation supports (through the Pamsimas program). The main problem we face is the availability of funds --- we often submit requests for funds to the center but it really depends on the willingness of the center. In relation to our institutional commitment, we are committed ---- but in relation to the availability of funds, of course, through the existing state financial mechanism. We are also involved in analyzing the situation of the locus of stunting villages and understand the importance of the availability of clean water and good sanitation. A similar opinion was conveyed by the Secretary of the Food Security Service for East Flores Regency, as the result of the following interview: --- As a party that is trusted with regard to the availability of local food, we basically have a high commitment and we present it in the acronym Solor (sorghum, kelor , eggs and fish) but in the local food supply mechanism so far it has been provided/purchased from village cadres; --- Often the stocks owned by village cadres are very small and this condition is not openly conveyed by the cadres to our side as a result when local food delivery activities are often not sufficient and this is also supported by funds for local food provided by the Health Office --- We often deal with such conditions spontaneously even though we feel it is an obstacle. The same thing was conveyed by the PKH Coordinator for East Flores Regency as follows: �... we as PKH coordinators are of course under the coordination of the Social Service, if asked about our commitment related to handling stunting in East Flores Regency we certainly have a high commitment. In our involvement as part of the convergence team we are always involved --- the obstacles we encounter are related to the disbursement of PKH funds which is once every three months so that sometimes our team cannot carry out intensive monitoring related to family consumption, especially intake of toddlers. The results of interviews with members of the convergence Task Force, whose main task (main task) is related to efforts to handle "sensitive nutrition interventions", show that the convergence Task Force remains committed to the collaboration process and in its involvement is guided by the RAN SURE as shown in the following figure.

d ) Shared understanding

In the process of collaboration, stakeholders must develop a shared understanding of what collectively can be achieved together. Common understanding is often equated with a 'shared mission' (Alexander, Comfort, and Weiner: 1998); 'similarity' (Wondolleck and Yaffee : 2000); 'common goals' (Tett, Crowther, and O'hara: 2003); 'shared vision' (Manring and Pearsall: 2004).

The results of interviews with universities stated that ---' as a non-bureaucratic party entrusted to be involved in the convergence team; we have an obligation to always be ready for use and at any time be involved in stunting management and reduction activities. Basically we do not have any special tendencies or attention to gain anything in this collaboration such as praise, benefits or incentives of any kind --- we only seek to engage with other members in the form of providing thoughts, suggestions, suggestions or agreeing together in determining solutions the best in handling and preventing stunting in East Flores district' . Almost the same opinion was conveyed by the head of IBI, East Flores Regency: --- that efforts to handle and prevent stunting really need the presence of a team in an integrated, integrated and trusted manner so that there will be one voice and one view in efforts to handle and prevent stunting --- In the past sometimes there were noisy voices from the community regarding the government's performance in handling stunting, but now with the formation of the convergence team it turns out that the results/performance have led to positive results (there has been a decrease in the number of stunting). This actually happened as a result of the common views and actions of the convergence team that had been formed and worked together .

The results of the interview above, when confirmed with data from the work of the confirmation team which always follow the workflow stipulated in the Regulation of the Head of the National Family Planning Coordinating Board, can be read in the data below.

e) Intermediate outcomes

Several case study results show that collaboration is more likely to occur when the possible goals and benefits of collaboration are relatively real and when " win win ." solutions� of collaboration is possible (Chrislip and Larson : 1994). These small gains/wins can feed back into the collaboration process, driving a virtuous cycle of trust and commitment building.

The results of interviews with the head of the public health sector at the East Flores District Health Office regarding this temporary impact sub focus, can be conveyed as follows: ---' that for the time being the work of the convergence team for handling stunting in East Flores Regency has shown quite promising results, namely a reduction of 2% as stated by the Deputy Regent of East Flores at the call for all civil servants at the regional secretariat on August 22, 2022. Furthermore, it was conveyed that the results of the work of the sub-district rebug team also reported that based on the results of observations and results of team assistance in the field, it showed that the parenting and consumption patterns of families who have stunted children/toddlers are currently always active and comply with various inputs from the team . The results of this interview when confirmed with the head of the basic education section at the East Flores District PKO Office basically showed no different opinion, conveyed as follows: ---' that the convergence team has shown good interim results; this is evident from the decrease in the number of stunting based on the team's work report.

The results of the work of the convergence team can then be analyzed to have shown a temporary impact, namely to produce the expected feedback, namely positive feedback, which can be said to be ' small wins ' or by borrowing the term Roberts and Bradley (1991) as temporal properties . This small victory will increase the expectations of each actor in collaboration so as to increase trust and commitment. These results are also in accordance with the results of observations by the sub-district rembug team which show that there has been an increase in the intensity of local food consumption and an increase in the quality of parenting for stunting families.

The diagram below shows the decline in the number of stunting in the East Flores district in the recent past after being supported by the convergence team for handling stunting in the East Flores Regency.

CONCLUSION

Based on the research data that has been presented, in the following several points of conclusion are presented.

Overall, the interim results of the work of the Stunting Convergence Handling Task Force in East Flores Regency show promising results.

With regard to the face-to-face dialogue sub-focus, the results of the study show that face-to-face dialogue is carried out internally (specifically the Stunting Convergence Task Force) and open dialogue with various related parties is very strategic in an effort to achieve goals.

For the trust building sub-focus, the intensity of the process of building trust between parties needs to be increased.

Commitment to the collaboration process (commitment to the process), a commitment has been formed between the parties involved in the Stunting Handling Convergence Task Force which is quite solid.

The sub-focus of shared understanding as a whole has formed a common understanding for handling stunting in an integrated and comprehensive manner.

Sub focus on temporary impacts (intermediate outcomes), the temporary results obtained can be a source of motivation and the basis for the solidity of the next Task Force.

Islamic boarding schools have a major role in molding the spirit of sharia entrepreneurship, namely creating a business sector by empowering students and the community through entrepreneurship programs so that they can support and improve the welfare of students and the community in creating many jobs. Through the involvement of students in entrepreneurship in Islamic boarding schools, they have succeeded in educating alumni to establish business fields.

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Copyright holders:

Dominikus Fernandes, Jacoba Daud Niga, Rikhardus Seran Klau (2022)

First publication right:

Devotion - Journal of Research and Community Service

This article is licensed under a Creative Commons Attribution-ShareAlike 4.0 International