THE 1000 HARI PERTAMA KEHIDUPAN PROGRAM AS AN EFFORTS TO EMPOWER THE PERCENTAGE OF POOR NUTRITION IN BANGKALAN MADURA DISTRICT (the Aspects of Problem Characteristics, Policy Characteristics, and Policy Environment)

DiA: Jurnal Administrasi Publik, 2021 December Vol. 19 No. 2, e-ISSN: 2615-7268 THE 1000 HARI PERTAMA KEHIDUPAN PROGRAM AS AN EFFORTS TO EMPOWER THE PERCENTAGE OF POOR NUTRITION IN BANGKALAN MADURA DISTRICT (the Aspects of Problem Characteristics, Policy Characteristics, and Policy Environment) Eliviana Ary Risyananda Faculty of Social and Political Science University of Airlangga, Surabaya Ekky Fiorentina Asterix Faculty of Social and Political Science University of Airlangga, Surabaya Erna Setijaningrum Faculty of Social and Political Science University of Airlangga, Surabaya ABSTRACT Bangkalan Regency was the region that contributed to the highest cases of malnutrition in East Java in 2018. The Bangkalan Regency Government has implemented the 1000 Hari Pertama Kehidupan program which is a mandate from the Peraturan Presiden Nomor 42 Tahun 2013 concerning the National Movement for the Acceleration of Nutrition Improvement. However, in its implementation, the 1000 Hari Pertama Kehidupan program still encounters many obstacles so that the implementation is not optimal. This study aims to examine the 1000 Hari Pertama Kehidupan program by reviewing the aspects of problem characteristics, policy characteristics, and policy environment using the implementation theory proposed by Daniel A. Mazmanian and Paul A. Sabatier. The method used is a descriptive qualitative approach using data collection techniques through five sources, including archival documents, in-depth interviews, participant observation, and other physical devices. The informant determination technique was carried out by purposive sampling and the number of informants was 10 people. The results showed that the implementation of the 1000 HPK program in tackling malnutrition in Bangkalan Regency was not optimal. In terms of characteristics, the problem has a fairly high level of technical difficulty and the behavior of the target group is not right. In terms of policy characteristics, program objectives have not been optimally achieved, financial resources are limited, coordination between implementors is not optimal, and the Bangkalan Regency Government does not yet have binding decision rules between OPDs. Then in terms of the policy environment, social, economic, and 154 DiA: Jurnal Administrasi Publik, 2021 December Vol. 19 No. 2, e-ISSN: 2615-7268 technological conditions have not supported program implementation, and public support has not been optimal. Keywords: Implementation, Malnutrition 1000 Hari Pertama Kehidupan Program, A. PRELIMINARY Indonesia is a country that until now has not been separated from the problem of malnutrition. Malnutrition is a condition status experienced by a person characterized by nutritional deficiencies, or in other words, the nutrients contained in the body are below average (Alamsyah, et al, 2017). In general, the problem of malnutrition is suffered by children under five with an average age of 12-59 months because they lack several types of vitamins needed by the body. The occurrence of malnutrition has the potential to cause other health problems such as delays in the growth process, reduced immunity, disruption of physical and mental growth, even the most fatal can cause death in children. A child can be identified as suffering from malnutrition if he has carried out certain examinations and measurements by health workers using the Z-Score. The Z-score itself is the value of the deviation of body weight or height from the value of normal weight or height according to the growth standards that have been set by WHO. A child can be said to be malnourished if he has a z-score of less than -3.0 standard deviation. (The Keputusan Menteri Kesehatan Republik Indonesia Nomor 1995/MENKES/SK/XII/2010 Tahun 2010). East Java Province is one of the provinces that until now has not been separated from cases of malnutrition. Based on East Java basic health research data in 2018 there are 17 out of 38 cities/districts in East Java that have a percentage of malnutrition above the average percentage of East Java. Percentage of Malnutrition Age 0-59 Months Based on BB/U Index by City/Regency in East Java in 2018 Source: Basic Health Research of East Java Province in 2018 The graphic data above shows that the proportion of malnutrition by city/regency in East Java in 2018 was occupied by Bangkalan as the region with the highest percentage of malnutrition in East Java in 2018. 155 DiA: Jurnal Administrasi Publik, 2021 December Vol. 19 No. 2, e-ISSN: 2615-7268 In relation to problems related to nutrition itself, it has actually been regulated in the Undang-Undang Nomor 36 Tahun 2009 concerning Health as the top rule. In addition, there are other regulations under it as implementing regulations of the Undang-Undang Nomor 36 tahun 2009, namely the Peraturan Presiden Nomor 42 Tahun 2013 which regulates the National Movement for the Acceleration of Nutrition Improvement. In accordance with the Peraturan Presiden Nomor 42 Tahun 2013 pasal 2 ayat 1 that the general purpose of the national movement to accelerate nutrition improvement is aimed at accelerating the improvement of priority community nutrition in the first thousand days of life or from the time the child is in the womb until the child is 2 years old after birth. The period of the first 1000 days is often called the golden period because during pregnancy/fetal age until the child is two years old, there has been a very fast, massive, permanent growth and development process, and does not occur in other age groups. Therefore, the fulfillment of nutritional intake in the first 1000 days of a child's life is very important because it affects the growth of children in the future. In order to achieve the acceleration of nutrition improvement, cross-sectoral support is needed. The contribution from the health sector in this effort to accelerate nutrition improvement only contributed 30%, in fact, the non-health sector contributed more, namely 70%. In the program planning guidebook for the national movement to accelerate nutrition improvement in the first 1000 days of life (the 1000 Hari Pertama Kehidupan/HPK movement) compiled by the Coordinating Ministry for People's Welfare, it has been explained that to deal with nutritional problems, intervention from two sectors is needed simultaneously, namely intervention specific or sensitive. Specific nutrition interventions are carried out by the health sector while sensitive interventions are carried out by the non-health sector. In Bangkalan Regency, the priority program of the 1000 Hari Pertama Kehidupan aims to reduce the number of malnutrition, because seeing the urgency of the problem of malnutrition in Bangkalan Regency is very worrying (bangkalankab.go.id). Problems related to malnutrition in Bangkalan Regency are serious and complex problems in terms of their causes. According to the Head of the Bangkalan District Health Office, Mr. Bambang Sudibyo, the problems related to (...truncated)