Collaborative governance to achieve SDGs social development: Preventing stunting lesson from Pandeglang

Preventing stunting became one of the priority programs of President Jokowi. One of the loci is Pandeglang Regency. The handling of stunting in the Pandeglang Regency still faces many obstacles, one of which is the limited human resources, tools, budget, obstacles in coordination between the actors involved, and the local government's capacity in handling stunting at the village level. So the purpose of this research is to describe the Pandeglang regency government's collaborative governance in handling stunting. Using theory Collaborative Governance by Emerson and Nabatchi and post-positivism approach, with data collection techniques through interviews, observations, and focus group discussions (FGD), it has been found, the handling of stunting program in Pandeglang still faces many formalisms. So, we cannot measure the output and outcome of the program. For this reason, researchers provide recommendations for strengthening resources support and capacity building for all components involved in this program so that the program can produce outcomes that are felt in the community.


Introduction
Indonesia is the largest archipelago country globally. More than 264 million people live in and spread across in 17.000 islands. Human Development Index score of 0,694 has placed Indonesia in the 116th rank of all countries globally. Indonesia is included in the category of Middle-Income countries since Indonesia has a gross national income of 10.846 (UNDP, 2018) [1]. In 2015, Indonesia joined the Sustainable Development Goals program whose lead by the United Nations. There are 17 global SDG goals, acceleration in ending poverty, reducing inequality, and protecting the environment (sdgsindonesia2030.org) [2]. Meadows, Randers, & Meadows (2004), the biggest challenge of creating sustainable development is balancing the high production and consumption with scarce resources, so need the systemic intervention to pull through the economic failure [3].
To achieve the global goal in SDGs, the Indonesian government issued Perpres 59/2017 as the legal basis for achieving the Sustainable Development Goals in Indonesia. Moreover, Permen PPN/Ka. Bappenas 7/2018 was issued to complement Perpres 29/2017, concerning coordination, planning, monitoring, evaluating, and reporting the implementation of SDG's program [4]. The success of program implementation is determined by involved of many stakeholders such as Government, Government, society, academics, business actors, philanthropists, media, and community organizations. After five years of implementation program, the achievement of Indonesia SDG's indicator has placed sixth regionally ASEAN, which is far from Singapore nor Vietnam. One of the indicators related to human resources development in Indonesia is the second indicator, no hunger [5].
According to Basic Health Research conducted by the ministry of health in 2018, the prevalence rate of stunting children in Indonesia is 30,8%. Almost all provinces in Indonesia had a prevalence rate of up to 20%, and only DKI Jakarta has a prevalence rate of under 20%. This prevalence rate has placed Indonesia in third place as the biggest children stunting population in the world [6]. According to WHO, stunting is a condition of stunted growth in children between 0-2 years old and 2 years old. This condition is caused by infection, malnutrition, inadequate psychosocial stimulation [7]. Stunting can find in developing countries with a malnutrition problem as the main indicator [8]. The risk of mental and motoric growth in stunted children is higher than not stunted children, which can be lead to the death of children [9]. Malnutrition in children is also related to the oxidation disorder that will lead to the obesity problem [10] and decreasing body endurance so susceptible to infectious diseases [8]. Increasing the risk of degenerative diseases or organ disorders for a long time, and based on research, stunted children usually have bad emotional growth and behavior in adolescence [11].
In order to handling stunting, the Government of Indonesia prioritized preventing, multi-sector approach, and integrated data systems. The basic framework for stunting management policies is Law Number 36 of 2009 concerning in Health, Law Number 18 of 2012 concerning food, Indonesia is also following the global Scaling Up Nutrition (SUN) movement, Presidential Decree Number 42 of 2013 concerning the National Movement for the Acceleration of Nutrition Improvement (Gernas PPG) [12]. Today, 23 ministry and agencies are involved in handling stunting and the vice president's secretary as a program coordinator. In 2018, 100 districts in Indonesia set to the locus of the intervention of stunting prevention programs [5]. One of them is Pandeglang. The stunting prevalence rate in Pandeglang is 40%. Pandeglang is one of the districts in Banten province, a total area of 2.746,90 km2, and a population of 1.149.610 people [13]. Before 2019, Pandeglang was included in the category of underdevelopment district. This causes the poverty rate in Pandeglang until now is still high. Today, Pandeglang has a good improvement, such as in a healthy problem, and decreasing the poverty rate [14]. Poverty and stunting influence each other. Webber Melvin M, (1973) said that one most difficult social problem is to overcome poverty. Many factors cause it, such as diverse information, requires a large budget, knowledge is required, and has a dependence on other dimensions, such as economy, education, and health. So it takes an integrative and implementation process and policy design [15].
Strong leadership in the implementation program to achieve national targets is one reason why Pandeglang successfully handled stunting. Multi-sector collaboration, Pandeglang Government and Ministry of Village, Development of Disadvantaged Regions and Transmigration, Cipto Mangunkusumo Hospital/Medical Faculty of the University of Indonesia and Danone Indonesia. Specific interventions were held in Bayumundu Village, successfully reduced the stunting prevalence rate to 8% in six months. According to Agranoff & McGuire (2003), there are two main factors to success in the process of collaboration. First, resources, knowledge, and finance support. The second is to share beliefs among the stakeholders. Two main factors are dependent on each other and can not be manipulated and dominant [16]. Wood & Gay (1991) said collaboration is a process where many actors are involved, see problems from their perspective, and try to find the best solution [17]. Emerson & Nabatchi (2015) defines collaborative governance as a process and structure of public policy formulation, decision-making, public management that involves society and public bodies. They also define collaborative governances as a process and structure of government levels, the private sector, and the public society to achieve goals or public problems that cannot be solved. There are four elements, system context, drivers, collaborative governance regimes, and collaborative dynamics [18].
In the preliminary interview process researcher found at least a third problem. First, in Pandeglang, which is involved in this program, OPD does not know the existence of a legal basis for this program. Second, limited resources such as health workers, proper health facilities, financial availability, and budget to conduct specific and sensitive interventions. Third, some children who get the specific intervention before, has been surprisingly stunting in 2020 through the village midwife's measurement. This situation indicates that this program's success will not last long. In the other hand, this program is well received by the community in Bayumundu and Tegalogog Village. This program helps the children from poor family access the healthcare services, learn about how important nutrition for their children in order to avoid stunting condition.
In this study will discuss how the collaborative governance in handling stunting in Pandeglang and influences the factor of collaboration. Using collaborative governance theory by Emerson & Nabatchi (2015) [18].

Method
This research used the post-positivist approach, combining theory with social phenomena, but interprets theory with empirical facts through observations and evidence found in the field. Data collection by using in-depth interviews, observation, and literature review. This research was conducted on March to June, located in two villages, Bayumundu Village and Tegalogog Village. It was chosen for several reasons: 1. Bayumundu Village is the village where the pilot project for handling stunting was held in Pandeglang; 2. Tegalogog Village is the village with the best achievement in efforts to improve nutrition through posyandu and active cadres; 3. Both Koroncong and Kaduhejo Sub-Districts are relatively close to the city center. The informant included government actor, head of a village, cadres of the public health center, community, academics, and non-governmental association. The reason for selecting informants was due to their competence and involvement in the implementation of the stunting program, at the central, district and community levels. Interviews were conducted face-to-face, either in private or through the telephone, caused covid-19. The observation took place in the public health center, seeing a midwife practicing how to measure and determined children's status. The characteristics of the interviewees are given in Table 1.

Collaborative governance to prevent stunting in Pandeglang
Collaborative governance, according to Emerson & Nabatchi (2015), is a process, structure of public policy formulation, decision-making, involving public and community agencies, as well as the private sector to achieve public goals that cannot be resolved. In the context of handling stunting, Pandeglang Regency has not been considered effective in dealing with stunting. This is evidenced by the high prevalence of stunting in the Pandeglang Regency.
Even the prevalence rate of stunting in Pandeglang is the highest among other regencies in Banten Province. The regional leaders of the Pandeglang Regency are very aware that the handling of stunting must be using collaborative methods so that it can be handled effectively and efficiently. In Rembug Stunting, Head of Social and Cultural Affairs of Development Planning Agency at Sub-National Level said all actors involved in analyzing the situation in Pandeglang, especially at the predetermined locus. Policy selection in each related agency is carefully selected and indicators of success are determined. Program in every service agency which is involved in preventing stunting in Pandeglang, not a new program. The problem is that the stunting management program actually exists in each DPO and runs independently, as well as the focus of the program locus. So that local governments cannot monitor the success of the ongoing stunting prevention program. Cross-sectoral rules of the game are needed so that every actor involved can understand the game rules that have been agreed upon. The principle engagement in Emerson and Nabatchi is defined as problems and alternative solutions. The engagement process consists of four components, discovery, definition, deliberation, and determination. The principle of involvement is emphasized on how to create effective engagement between the actors. This requires all stakeholders to identify, agree on a joint solution, and make a joint action plan. Identifying and defining the situation is carried out by all the actors, so everyone knows what causes stunting in Pandeglang, how we choose the solution, how much resources are available and set the timeframe to achieve the target and identify the target group. This complex and critical situation must be handled together between OPD that involve in Pandeglang. Based on the interviews, the initial process of collaboration has begun with situation analysis process, to make an output (1) recommendations for program and activity, which one need to be held or to improve the quality of the previous program (2) recommendations for improving health services (3) recommendations for strengthening coordination needs both between DPOs in synchronizing programs and activities, as well as between districts and villages, as well as sub-district support. To then carry out an inventory of resources and create an action plan. Rembug Stunting facilitated this engagement process. The situation analysis results were 4 (four) causes of stunting in Pandeglang, poor parenting practices, limited health services, lack of access to nutritious food, and lack of access to clean water and poor sanitation. The health office was a little surprised at the data provided by the central government, because the prevalence rate was very high. But after the success of the specific intervention program in Bayumundu, a sense of optimism emerged, that we can tackle the stunting problem. joint commitments that occur across agencies, budget sharing and cooperation are part of joint action.
Shared motivation consists of building trust, creating mutual understanding, internal legitimacy, and commitment. As mentioned before, the process of engagement is a process of building trust, but how trust can be transmitted more broadly, there must be optimal efforts to reach all the actors involved. This mutual trust can be built between DPOs, OPDs, and non-governmental actors, as well as OPD -non-government -communities. So, building trust does not have to be initiated by the government, but also the other actor. Efforts to build trust by the government are carried out by conducting monitoring meetings at the OPD level and at the district level, training for the community, and disseminating stunting programs through electronic media. Meanwhile, the private sector in building trust is considered more organized and has an impact through counseling and providing massive training to health workers and teachers in the Pandeglang district. What is surprising about the trust-building activities that are part of collaborative governance. The community is very interested in the activities carried out by private actors, because this is the first time it has been implemented in Pandeglang. The material presented is also very holistic, it is even recognized that the methods used by private actors are very different from those used by the government. This can be used as learning by the government to be implemented in future activities. We can learn from this statement that the government needs to find an alternative way to deliver the program to increase community trust.
The capacity for joint action can encourage a continuous collaborative process because institutional arrangements, leadership capacities, resources have a causal relationship to the collaborative process. There are three components, institutional arrangements, knowledge and resources, and leadership. The first component is institutional arrangements related to the distribution of authority, the protocol, procedure, and structure organization to manage multiple actors. The arrangement for stunting management programs in Pandeglang is not a new program, as said an informant from Bappeda. Whereas stunting management programs already exist in every OPD, it is just that they are more focused on local villages. The stunting action plan's concern was not in OPD, but the planning activities in the village (musyawarah rencana desa). The implementation of stunting programs should be more focused on preventing stunting in villages because stunting problems are in the village. The target is the community where lives in the village. For this reason, the village government has been given guidance that in making programs and activities, stunting is a priority, and this must be legalized in village meetings. As the village supervisor, the district must ensure that the arranged programs and activities do not fall out of the predetermined target. For the implementation of stunting handling activities carried out by DPOs, synchronization of activities between DPOs has been made. Meanwhile, implementation in the village is adjusted to what has been determined in the program planning at the beginning of the year. If the village needs technical assistance, the village can directly ask for assistance from the relevant OPD. The second component is knowledge and resources. This greatly affects the collaboration process. How much knowledge from each actor has will affect the way the actors interact. Mapping the knowledge and resources they have can make it easier for the collaborating actor to find out each other's shortcomings. Resources here can be categorized into several things, including human resources, especially health workers and community cadres, the number of health facilities, the number of facilities and infrastructure in health facilities. At the same time, knowledge is focused on knowledge of the rules/procedures/protocols related to handling stunting in the field. As with general health problems in Indonesia, the number of health workers, health facilities, and the number of people served are not proportional, but they are still deemed sufficient to deal with the current stunting problem. Training cadres overcame this limitation, but on the other hand, cadres also encountered classics problem the compensation. The third component is leadership. In this component, the leader's role in providing direction is good enough, and moving quickly in dealing with stunting.

Influencing factors in collaborative governance process to prevent stunting in Pandeglang
There are 2 (two) factors in collaborative governance, the system context and drivers. The system context consists of the policy and legal framework, socioeconomic and cultural characteristics, network characteristics, political dynamics and power relations, history of conflict, and public services or resource conditions. Meanwhile, drivers consist of uncertainty, interdependence, consequential incentives, and initiating leadership.
Six aspects affect the system context in collaborative governance, resource conditions, policy and legal frameworks, economic social and cultural characteristics, network characteristics, political dynamics, and conflict history. The condition of resources refers to the percentage of village funds used for handling stunting, which is still small, and cadres' knowledge is limited. The competence of the cadre to handling children in the Integrated Healthcare Center for the community is crucial. The limited number of cadres in the village is very influential. Before the covid-19 pandemic, there were five cadres in each village, but during the pandemic more cadres were needed, because they had to make house visits or surveillances, because posyandu could not operate during pandemic.
The legal and policy framework, namely regulations from the central government and cascading down to the regency and city levels, is deemed complete enough. However, to find out which ones are overlapping, it takes time to analyze. The capacity of district governments in translating central policies is critical to the program's success. Economic, social, and cultural characteristics also greatly influence, there are still many poor people, lack of environmental hygiene, and culture who prefer to go to a "dukun" rather than to a health community center while they are sick. The habits of the people in Pandeglang are also one of the reasons for the high rate of stunting. Some of the habits that still need to be improved include the habit of going to a dukun when sick, and defecating in any place, especially for people living in coastal areas.
There are three things the characteristics of the network that should be a concern. Even though the network between OPDs is felt to be strong, especially OPDs that have the same program targets, then the communication network from the district to the village level through the sub-district is intense within the framework of using ADD. However, the village government's capacity to build external networks to tackle stunting in the village is still lacking, so it needs to increase the village government's capacity. In the aspect of political dynamics, it can be said that it tends to be stable, the current leader is supported by a solid coalition of parties, kinship relations, characterize important positions in several OPDs, leadership is fully supported by ulama, and no history of the conflict is found.
Drivers consist of uncertainty, interdependence, consequential incentives, and initiating leadership. Uncertainty, the covid-19 pandemic's existence has made the Pandeglang district government sluggish because it is waiting for a legal basis from the central government. This is felt not only by the district government but also down to the village government level. Dependence, this aspect shows how significant the interaction between DPOs is the success of the stunting management program in one DPO is greatly influenced by the program's success in other DPOs. Incentives, the real incentive is success in tackling stunting in Pandeglang. Leadership Initiation this is what is needed. It is very basic. Leadership is able to reduce uncertainty and dependence. One important factor in collaborative governance in handling stunting, which non-government actors perceive is the importance of leadership. with strong leadership, resource mobilization will be easy, networks will be easy to build, and challenges can be anticipated.

Conclusion
Collaborative governance to prevent stunting in Pandeglang has been implemented in accordance with the rules determined by the central government. However, there are still several problems, one of the dominant ones being the availability of resources (health personnel, health facilities, budget). The output achievement is in the form of a report, but the outcome of stunting treatment in Pandeglang cannot be measured and cannot be said to be sustainable. Researchers can say that the program being implemented is only "formalism" to meet the central government's performance requirements. The programs run by OPD have their targets that are not linked to one another, so it can be seen that the performance of the stunting management coordination team is only measured by the performance of the health office. This mindset must be changed, that the program's success depends very much on the coordination team's action. So it can be said that the collaborative management of stunting handling in Pandeglang is still weak, because it has not been able to show the sustainability of the program and produce a significant impact. Collaborative management of stunting handling in Pandeglang is strongly influenced by the leadership dimension. This is because the implementation of collaborative governance will create a high dependence on the actors' interaction. The current uncertainty caused by the Covid-19 pandemic has resulted in confusion at the leadership level because, on the one hand, the stunting management program must continue. However, the challenges in overcoming the pandemic must also be put first. Meanwhile, the handling of stunting and the Covid-19 pandemic is very closely related. Stopping the stunting response program to cope with the pandemic means piling up problems to be learned in the future. Researchers provide recommendations related to the application of collaborative governance, as follows: a. Strengthen resource support so that the stunting management program in Pandeglang can achieve the optimal results. It gives importance related to the existence of a stunting management coordination team that has been established. Then make a comprehensive guide for actors regarding what kind of model is ideal that can be used in handling stunting in Pandeglang, as well as also a greater portion of village funds for human resource development; b. There are two steps to increasing the village government's capacity in increasing efforts to deal with stunting in the village. First, focus on capacity building to create competent and professional human resources who handle the stunting program at every level, such as training programs, work practices, and recruiting a professional nutritionist. Second, organizing management in order to increase the success of roles and function, such as the incentive system for cadre, building communication and coordination system, also create a good culture in handling stunting; c. Various researches related to collaborative governance have been carried out in various regions with different backgrounds. However, a pattern that is formed does not necessarily match the existing context. Everything is very contextual, so the solution to the problem of stunting cannot be generalized.