Analisis fishbone tingginya prevalensi stunting - Sarwendah, Sarwendah; Lamtiur, Posma Rohana; Herniwanti, Herniwanti; Dewi, Oktavia (Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati, 2026)
Background: Stunting remains a significant public health problem in Kuantan Singingi Regency, with a prevalence of 23.1%. Data from the 2024 Indonesian Nutritional Status Survey ranked this regency as having the third highest prevalence in Riau Province. Purpose: To analyze the situation, establish priority issues, identify root causes, and formulate evidence-based interventions to accelerate stunting reduction. Method: This qualitative study, using a problem-solving cycle approach, was conducted in October 2025 at the Kuantan Singingi Regency Health Office. Four key informants, including one Division Head and three Public Health Section Heads, participated through in-depth interviews, focus group discussions (FGDs), and document review. Results: Based on the Urgency, Severity, and Growth (USG) method, the stunting prevalence of 23.1% was identified as a top priority. Root cause analysis using a fishbone diagram identified six key factors: human factors (low family knowledge and ineffective educational methods), limited facilities and utilization of integrated health posts, suboptimal sanitation conditions, limited provision of locally based supplementary feeding, limited operational budgets, and weak cross-sectoral coordination. Conclusion: Accelerating stunting reduction requires the integration of Water, Sanitation, and Hygiene (WASH) interventions. Environmental factors, such as access to safe drinking water, proper sanitation, and waste management, have been shown to significantly influence stunting prevalence through disease risk. The program's success depends on cross-sectoral collaboration, optimizing the role of community health workers, and educating children about sustainable behavior change. Suggestion: The Health Office is expected to continuously intensify the five-pillar Community-Based Total Sanitation program, implement a regular Household Drinking Water Quality Monitoring program, and optimize monitoring and evaluation activities. This program must actively involve community health workers to ensure the sustainability of behavior change in the community. Keywords: Clean and Healthy Living Behavior; Drinking Water; Environmental Sanitation; Stunting. Pendahuluan: Stunting masih menjadi masalah kesehatan masyarakat yang signifikan di Kabupaten Kuantan Singingi dengan prevalensi sebesar 23.1%. Berdasarkan data Survei Status Gizi Indonesia (SSGI) tahun 2024, menempatkan kabupaten ini sebagai peringkat ketiga tertinggi di Provinsi Riau. Tujuan: Untuk menganalisis situasi, menetapkan masalah prioritas, mengidentifikasi akar penyebab, dan merumuskan intervensi berbasis bukti dalam upaya mempercepat penurunan angka stunting. Metode: Penelitian kualitatif dengan pendekatan siklus pemecahan masalah yang dilaksanakan pada bulan Oktober 2025, di Dinas Kesehatan Kabupaten Kuantan Singingi dengan melibatkan 4 informan kunci, terdiri dari 1 Kepala Bidang dan 3 Kepala Seksi Kesehatan Masyarakat, melalui wawancara mendalam, Focus Group Discussion (FGD), dan tinjauan dokumen. Hasil: Berdasarkan metode Urgency, Seriousness, and Growth (USG), prevalensi stunting sebesar 23.1% ditetapkan sebagai prioritas utama. Analisis akar masalah menggunakan diagram fishbone yang mengidentifikasi 6 faktor utama, yaitu faktor manusia (rendahnya pengetahuan keluarga dan metode edukasi yang kurang efektif), keterbatasan sarana dan pemanfaatan posyandu, kondisi sanitasi yang belum optimal, keterbatasan Pemberian Makanan Tambahan (PMT) berbasis pangan lokal, keterbatasan anggaran operasional, dan lemahnya koordinasi lintas sektor. Simpulan: Percepatan penurunan stunting memerlukan integrasi intervensi Water Sanitation and Higiene (WASH). Faktor lingkungan, seperti akses minum aman, sanitasi layak, dan pengolahan sampah terbukti signifikan memengaruhi prevalensi stunting melalu risiko penyakit. Keberhasilan program bergantung pada kaloborasi lintas sektor, optimalisasi peran kader, dan edukasi perubahan perilaku berkelanjutan. Saran: Dinas kesehatan diharapkan dapat mengintensifkan program 5 pilar Sanitasi Total Berbasis Masyarakat (STBM) secara berkelanjutan, melaksanakan program Surveilans Kualitas Air Minum Rumah Tangga (SKAMRT) secara periodik dan mengoptimalkan kegiatan monitoring serta evaluasi. Program tersebut hendaknya melibatkan kader kesehatan lingkungan secara aktif untuk memastikan keberlangsungan perubahan perilaku di masyarakat. Kata Kunci: Air Minum; Perilaku Hidup Bersih dan Sehat (PHBS); Sanitasi Lingkungan; Stunting.