The Paradox of Stunting: Differences in the Perception of Health Workers in Community Health Centers and Experts in Hospitals on Low Birth Weight and Stunting Data

Objective: This study aims to identify differences in the perception of health workers in Community Health Centers (CHCs) and hospital experts regarding Low Birth Weight (LBW) and Stunting, derived from community-based nutrition reporting (e-CBNRR). Methods: The design was mixed-methods. Quantitative data uses secondary data from e-CBNRR for the years 2020 to 2024. Starting in 2022, LBW data are collected retrospectively through 2020 and prospectively through 2024 for subjects who meet the inclusion criteria. A total of 715 subject data were obtained. This consists of 287 LBW and 428 non-LBW in 141 sub-districts. Quantitative results were then used for qualitative exploration. Qualitative data was collected through in-depth interviews and analyzed thematically. Results: Stunting at birth in the LBW and non-LBW groups reached 40.30% and 10.60%, respectively. Stunting in the LBW group decreased to 14.30% at 6 months of age. In contrast, the stunting rate rose again, reaching 51.20% at 48 months in the non-LBW group, which was higher than in the LBW group (49.30%). Health workers (HW) at CHC have never conducted advanced data analysis from e-CBNRR. HCWs fail to understand the relationship between the available data and the interventions needed for LBW and stunting cases. Conclusion: LBW babies suffered from stunting 4 times higher than that of the Non-LBW group. The stunting can decline during the breastfeeding period, especially in the LBW group. Ironically, it increased again as the children grew in both groups. Health workers' perceptions of stunting and LBW information differ between health workers in CHC and experts in secondary health services. e-CBNRR data can be used to dig deeper into valuable information and develop appropriate interventions for stunting and LBW cases.