Faktor Tata Kelola dan Lingkungan yang Mempengaruhi Malnutrisi Berat di Indonesia
Bukti untuk Memperkuat Program Makan Gratis yang Bergizi
DOI:
https://doi.org/10.21787/jbp.18.2026.2922Kata Kunci:
Kesiapan Tata Kelola Desa, Degradasi Lingkungan, Malnutrisi Parah, Program MBG, Pengawasan GiziAbstrak
Program Makan Bergizi Gratis (MBG) Indonesia, yang diamanatkan berdasarkan Peraturan Presiden No. 115/2025, dirancang untuk mengurangi kekurangan gizi anak melalui implementasi yang terdesentralisasi. Studi ini meneliti apakah kesiapan tata kelola desa dan degradasi lingkungan berhubungan dengan kejadian kekurangan gizi berat, yang jarang terjadi tetapi penting secara operasional untuk penargetan program. Desa digunakan sebagai unit analisis karena merupakan garda terdepan utama untuk koordinasi, pemantauan masyarakat, respons layanan, dan paparan lingkungan. Dengan menggunakan data administratif dari 2.876 desa, studi ini memperkirakan kejadian menggunakan model logit dan beban kejadian menggunakan model binomial negatif. Model hitungan binomial negatif yang stabil, yang dipertahankan setelah spesifikasi yang lebih lengkap menunjukkan masalah konvergensi dan kolinearitas, menunjukkan bahwa kesiapan tata kelola berhubungan positif dengan beban kekurangan gizi berat tetapi tidak signifikan secara statistik, sedangkan kondisi lingkungan, dukungan layanan, dan kemiskinan tetap relevan untuk interpretasi dan penargetan. Temuan ini mendukung strategi MBG berbasis risiko yang mengintegrasikan kesiapan layanan, kerentanan sosial, dan kondisi lingkungan daripada hanya mengandalkan kasus yang dilaporkan.
Referensi
Abduh, M., & Munandar, A. (2025). Menjaga Pijar Keberlanjutan: Tafsir Kritis atas Metodologi Ilmu Pemerintahan. NoerFikri Offset.
Abduh, M., & Yurista, R. (2025). Menciptakan Keadilan dengan Data: Refleksi Keberlanjutan dalam Statistik Pemerintahan. NoerFikri Offset.
Acheampong, J. O. (2022). Stakeholders Perspective of the Ghana School Feeding Program: A Case of the Denkyembour District. Interchange, 53(2), 313–333. https://doi.org/10.1007/s10780-022-09461-9
Adolphus, J., Arminen, H., & Pekkanen, T.-L. (2025). The Effect of Institutions on Clean Energy Investments and Environmental Degradation Across Income Groups: Evidence Based on the Method of Moments Quantile Estimation. Energy, 324, 136018. https://doi.org/10.1016/j.energy.2025.136018
Aiga, H., Nomura, M., Langa, J. P. M., Mahomed, M., Marlene, R., Alage, A., Trindade, N., Buene, D., Hiraoka, H., Nakada, S., Arinde, E., Varimelo, J., & Chivale, A. J. (2020). Spectrum of Nutrition-Specific and Nutrition-Sensitive Determinants of Child Undernutrition: A Multisectoral Cross-Sectional Study in Rural Mozambique. BMJ Nutrition, Prevention & Health, 3(2), 320–338. https://doi.org/10.1136/bmjnph-2020-000182
Baek, Y., & Chitekwe, S. (2019). Sociodemographic Factors Associated With Inadequate Food Group Consumption and Dietary Diversity Among Infants and Young Children in Nepal. PLOS One, 14(3), e0213610. https://doi.org/10.1371/journal.pone.0213610
Bawdekar, M., & Ladusingh, L. (2008). Contextual Correlates of Child Malnutrition in Rural Maharashtra. Journal of Biosocial Science, 40(5), 771–786. https://doi.org/10.1017/S0021932008002757
Bergeron, G., & Castleman, T. (2012). Program Responses to Acute and Chronic Malnutrition: Divergences and Convergences. Advances in Nutrition, 3(2), 242–249. https://doi.org/10.3945/an.111.001263
Bisyri, A. N., Hastungkoro, H., Fridayani, H. D., Nurmandi, A., & Chiang, L.-C. (2025). Integrating Nutrition Policy: Agenda-Setting Analysis of the MBG Program for Advancing Rural Sustainability in Indonesia. BIO Web of Conferences, 199, 03004. https://doi.org/10.1051/bioconf/202519903004
Budiono, P., Wulandari, C., Apriliani, A. P., & Sari, F. Y. (2024). The Impact of Village Governance Environmental Management on Community-Based Mangrove Development in Karang City, Bandar Lampung. International Journal of Environmental Impacts, 7(4), 675–683. https://doi.org/10.18280/ijei.070408
Daniel, D., Djohan, D., Machairas, I., Pande, S., Arifin, A., Al Djono, T. P., & Rietveld, L. (2021). Financial, Institutional, Environmental, Technical, and Social (FIETS) Aspects of Water, Sanitation, and Hygiene Conditions in Indigenous – Rural Indonesia. BMC Public Health, 21(1), 1723. https://doi.org/10.1186/s12889-021-11800-x
Dewi, P. E. A. P., Pandawani, N. P., Maba, W., & Vipriyanti, N. U. (2024). Strategy for Strengthening Stunting Management Implementation at Posyandu Working Area of Puskesmas Banjar I, Buleleng Regency. The 2nd International Conference on Innovation of Science and Technology for Sustainable Development: Strategic Innovation for the Acceleration of the Sustainable Life Resilience, 020005. https://doi.org/10.1063/5.0194461
Djani, W., Therikh, J. J., Long, B. L., & Adu, A. A. (2025). Implementation of Stunting Prevention Policies in Rote Ndao Regency: A Phenomenological Study. Media Publikasi Promosi Kesehatan Indonesia (MPPKI), 8(8), 798–806. https://doi.org/10.56338/mppki.v8i8.7899
Duong, C., Patel, S., Nguyen-Viet, H., Chea, R., Dang, S., Tum, S., Ramakrishnan, U., & Young, M. F. (2023). Access to Food Markets, Household Wealth and Child Nutrition in Rural Cambodia: Findings From Nationally Representative Data. PLOS One, 18(10), e0292618. https://doi.org/10.1371/journal.pone.0292618
Egbide, B.-C., Madugba, J., Otekunrin, A., Adenike, O., & Oludare, F. (2022). Responsiveness of Rural Development to Budget Management Attributes: Evidence From Ogun State, Nigeria. Problems and Perspectives in Management, 20(1), 1–13. https://doi.org/10.21511/ppm.20(1).2022.01
Gillespie, S., Haddad, L., Mannar, V., Menon, P., & Nisbett, N. (2013). The Politics of Reducing Malnutrition: Building Commitment and Accelerating Progress. The Lancet, 382(9891), 552–569. https://doi.org/10.1016/S0140-6736(13)60842-9
Hanczvikkel, A., & Tóth, Á. (2018). Quantitative Study About the Role of Environmental Conditions in the Survival Capability of Multidrug-Resistant Bacteria. Journal of Infection and Public Health, 11(6), 801–806. https://doi.org/10.1016/j.jiph.2018.05.001
Herwawan, J. H., Tasijawa, F. A., Rehena, Z., & Nindatu, M. (2026). Impact and Implementation Issues of the Free Nutritious Meal Program in the Maluku Islands: Perspectives From Students, Teachers, and Implementers. Journal of Hunger & Environmental Nutrition, 1–20. https://doi.org/10.1080/19320248.2026.2630180
Husseini, M., Darboe, M. K., Moore, S. E., Nabwera, H. M., & Prentice, A. M. (2018). Thresholds of Socio-Economic and Environmental Conditions Necessary to Escape From Childhood Malnutrition: A Natural Experiment in Rural Gambia. BMC Medicine, 16(1), 199. https://doi.org/10.1186/s12916-018-1179-3
Huybregts, L., Le Port, A., Becquey, E., Zongrone, A., Barba, F. M., Rawat, R., Leroy, J. L., & Ruel, M. T. (2019). Impact on child acute malnutrition of integrating small-quantity lipid-based nutrient supplements into community-level screening for acute malnutrition: A cluster-randomized controlled trial in Mali. PLOS Medicine, 16(8), e1002892. https://doi.org/10.1371/journal.pmed.1002892
Ijaiya, M. A., Anjorin, S., & Uthman, O. A. (2022). Individual and Contextual Factors Associated With Childhood Malnutrition: A Multilevel Analysis of the Double Burden of Childhood Malnutrition in 27 Countries. Global Health Research and Policy, 7(1), 44. https://doi.org/10.1186/s41256-022-00276-w
Kamble, R., Garg, B., Raut, A., & Bharambe, M. (2018). Assessment of Functioning of Village Health Nutrition and Sanitation Committees in a District in Maharashtra. Indian Journal of Community Medicine, 43(3), 148. https://doi.org/10.4103/ijcm.IJCM_171_17
Kamuli, S., Tamu, Y., Pabbajah, M., Abdullah, I., Wantu, S. M., & Aneta, Y. (2025). Analysing the Ineffectiveness of Village Fund Utilisation in Improving Food Security. Agrekon, 64(3–4), 313–324. https://doi.org/10.1080/03031853.2025.2573274
Karikari, E., Sokolov, N., Mikerova, M., Asiedu-Ayeh, B., Karikari, M., Ameyaw, D., Kawuo, S., & Nikolic-Turnic, T. (2024). Assessment of Mothers Awareness of Acute Malnutrition. Medicinski Casopis, 58(3), 102–113. https://doi.org/10.5937/mckg58-53806
Liguori, J., Savy, M., Laar, A., & Holdsworth, M. (2026). Understanding the Decentralised School Food Procurement Model in Ghana Through the Lens of School Caterers: A Photovoice Study. Maternal & Child Nutrition, 22(1). https://doi.org/10.1111/mcn.70141
Lin, J., & Feng, X. L. (2023). Exploring the Impact of Water, Sanitation and Hygiene (Wash), Early Adequate Feeding and Access to Health Care on Urban–Rural Disparities of Child Malnutrition in China. Maternal & Child Nutrition, 19(4). https://doi.org/10.1111/mcn.13542
López-Ejeda, N., Charle Cuellar, P., Vargas, A., & Guerrero, S. (2019). Can Community Health Workers Manage Uncomplicated Severe Acute Malnutrition? A Review of Operational Experiences in Delivering Severe Acute Malnutrition Treatment Through Community Health Platforms. Maternal & Child Nutrition, 15(2). https://doi.org/10.1111/mcn.12719
Mannolkar, S., George, S. M., R, M., P, N., & Bharathi, D. P. (2025). Assistive System for Monitoring Malnutrition in Children: MalnoCare. 2025 5th International Conference on Soft Computing for Security Applications (ICSCSA), 687–694. https://doi.org/10.1109/ICSCSA66339.2025.11171179
Modjadji, P., & Madiba, S. (2022). The Multidimension of Malnutrition among School Children in a Rural Area, South Africa: A Mixed Methods Approach. Nutrients, 14(23), 5015. https://doi.org/10.3390/nu14235015
Namirembe, G., Shrestha, R., Mezzano, J., Ausman, L. M., Davis, D., Baral, K., Ghosh, S., Shively, G., & Webb, P. (2021). Effective Nutrition Governance Is Correlated With Better Nutrition Outcomes in Nepal. BMC Pediatrics, 21(1), 434. https://doi.org/10.1186/s12887-021-02898-4
Napirah, M. R., Vidyanto, V., Rahman, N., Ningrum, A. S., Asmawati, A., & Veruswati, M. (2024). Implementation of National Movement for the Acceleration of Nutrition Improvement Policy for the First 1,000 Days of Life in Indonesia. Kesmas: Jurnal Kesehatan Masyarakat Nasional, 19(1), 67. https://doi.org/10.21109/kesmas.v19i1.8045
Ogobara Dougnon, A., Charle-Cuéllar, P., Toure, F., Aziz Gado, A., Sanoussi, A., Lazoumar, R. H., Alain Tchamba, G., Vargas, A., & Lopez-Ejeda, N. (2021). Impact of Integration of Severe Acute Malnutrition Treatment in Primary Health Care Provided by Community Health Workers in Rural Niger. Nutrients, 13(11), 4067. https://doi.org/10.3390/nu13114067
Orish, C., Battistini, B., Bocca, B., & Frazzoli, C. (2026). Malnutrition, Nutrition, and Dietary Toxins. In Swaiman’s Pediatric Neurology (pp. 312-318.e2). Elsevier. https://doi.org/10.1016/B978-0-443-10944-7.00037-8
Pacetti, E. J., McMurray, D., & Baca, J. (2025). Quality Improvement in Acute Care Malnutrition: Impact on Payment and Patient Outcomes. Journal of the Academy of Nutrition and Dietetics, 125(9), S24–S35. https://doi.org/10.1016/j.jand.2025.05.018
Pradita, A. B., Sepwantoro, G., Auliya, V., & Uwem, I. E. (2025). Realizing Public Welfare from the Nation’s Kitchen: A Fiqh Siyasah Perspective on the Makan Bergizi Gratis (MBG) and Its Impact on the Muslim Community. Nusantara: Journal of Law Studies, 4(2), 100–113. https://doi.org/10.5281/zenodo.17341164
Pramesthi, I. L., Wiradnyani, L. A. A., Anggraini, R., Februhartanty, J., Widaryat, W., Waluyo, B. H., Wahyunto, A. T., Mansyur, M., & Fahmida, U. (2025). Evaluating the Impact of Indonesia’s National School Feeding Program (ProGAS) on Children’s Nutrition and Learning Environment: A Mixed-Methods Approach. Nutrients, 17(22), 3575. https://doi.org/10.3390/nu17223575
Purnaningsih, N., Eny Palupi, Sulassih, S., & Anita Primaswari Widhiani. (2025). Optimizing Local Resources for Stunting Prevention and Community Health Promotion in Indonesia: A Mixed-Methods Study on Collaborative Communication and Extension. Media Publikasi Promosi Kesehatan Indonesia (MPPKI), 8(8), 676–688. https://doi.org/10.56338/mppki.v8i8.7520
Rajaa, S., Ramalingam, S., Chokashi, M., & Mokashi, T. (2024). Roles, Responsibilities, and Functions of Village Health, Sanitation, and Nutrition Committees in India: A Qualitative Evidence Synthesis. Indian Journal of Public Health, 68(2), 262–267. https://doi.org/10.4103/ijph.ijph_149_23
Razak, M. R. R., B, S., Sofyan, W., Lubis, S., & Rais, T. R. (2024). Development of Integrated Village Fund Governance Model With Siberas Public Service Application. Edelweiss Applied Science and Technology, 8(5), 2184–2198. https://doi.org/10.55214/25768484.v8i5.1969
Regeru, R. N., Chikaphupha, K., Bruce Kumar, M., Otiso, L., & Taegtmeyer, M. (2020). ‘Do You Trust Those Data?’—A Mixed-Methods Study Assessing the Quality of Data Reported by Community Health Workers in Kenya and Malawi. Health Policy and Planning, 35(3), 334–345. https://doi.org/10.1093/heapol/czz163
Saleh, A. A., Abdullah, S., Muhammad, R., Amir, M. Y., & Sulvinajayanti, S. (2025). Rethinking School Nutrition via Community Engagement: A Review with Implications for Indonesia’s MBG Program. Media Kesehatan Masyarakat Indonesia, 21(3), 259–273. https://doi.org/10.30597/mkmi.v21i3.46204
Saputra, Y. A., Lisa, M., Hikmi, N., Irawati, S., Azhari, A. R., & Muharramah, D. H. (2025). Association of Inadequate WaSH, Housing, and Infectious Diseases With Undernutrition Hotspots Among Children Under Five: Findings From a National Survey in Indonesia. Clinical Epidemiology and Global Health, 36, 102211. https://doi.org/10.1016/j.cegh.2025.102211
Scott, K., George, A. S., Harvey, S. A., Mondal, S., Patel, G., Ved, R., Garimella, S., & Sheikh, K. (2017). Beyond Form and Functioning: Understanding How Contextual Factors Influence Village Health Committees in Northern India. PLOS ONE, 12(8), e0182982. https://doi.org/10.1371/journal.pone.0182982
Sojobi, A. O., & Zayed, T. (2022). Impact of Sewer Overflow on Public Health: A Comprehensive Scientometric Analysis and Systematic Review. Environmental Research, 203, 111609. https://doi.org/10.1016/j.envres.2021.111609
Srirejeki, K., & Khairurrizqo, K. (2025). The Role of Community Engagement As Corruption Control Strategy in Local Governments: Insights From Indonesia. International Journal of Public Sector Management, 38(7), 872–894. https://doi.org/10.1108/IJPSM-12-2024-0407
Sudirman, Budiman, & Sriyani Oktavia. (2026). Cadre Disposition as a Key Determinant of Local-Food Supplementary Feeding: A Mixed-Methods Study. Media Publikasi Promosi Kesehatan Indonesia (MPPKI), 9(1), 198–212. https://doi.org/10.56338/mppki.v9i2.8658
Supranoto, Sasmito, L., Indriastuti, S., Prayitno, H., & Sawir, M. (2025). From Parallel to Partnership Governance: Strengthening Institutional Synergy for Stunting Reduction in Decentralized Indonesia. Social Sciences & Humanities Open, 12, 102051. https://doi.org/10.1016/j.ssaho.2025.102051
Syafrawati, S., Lipoeto, N. I., Masrul, M., Novianti, N., Gusnedi, G., Susilowati, A., Nurdin, A., Purnakarya, I., Andrafikar, A., & Umar, H. B. (2023). Factors Driving and Inhibiting Stunting Reduction Acceleration Programs at District Level: A Qualitative Study in West Sumatra. PLOS ONE, 18(3), e0283739. https://doi.org/10.1371/journal.pone.0283739
Wells, J. C., Sawaya, A. L., Wibaek, R., Mwangome, M., Poullas, M. S., Yajnik, C. S., & Demaio, A. (2020). The Double Burden of Malnutrition: Aetiological Pathways and Consequences for Health. The Lancet, 395(10217), 75–88. https://doi.org/10.1016/S0140-6736(19)32472-9
Wulandari, R., Iswara, A. P., Qadafi, M., Prayogo, W., Astuti, R. D. P., Utami, R. R., Jayanti, M., Awfa, D., Suryawan, I. W. K., Fitria, L., & Andhikaputra, G. (2024). Water Pollution and Sanitation in Indonesia: A Review on Water Quality, Health and Environmental Impacts, Management, and Future Challenges. Environmental Science and Pollution Research, 31(58), 65967–65992. https://doi.org/10.1007/s11356-024-35567-x
Yakubu, T., Apprey, C., & Annan, R. A. (2025). Exploring Current Barriers and Enablers of Severe Acute Malnutrition Management Among Children (6–59 Months): Perspectives From Health Professionals in Northern Ghana. BMC Nutrition, 11(1), 90. https://doi.org/10.1186/s40795-025-01075-5
Zhang, Q., Ye, C., & Duan, J. (2022). Multi-dimensional Superposition: Rural Collaborative Governance in Liushe Village, Suzhou City. Journal of Rural Studies, 96, 141–153. https://doi.org/10.1016/j.jrurstud.2022.10.002
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