THE STRUCTURAL PRODUCTION OF ETHICAL DILEMMAS IN COMMUNITY-BASED STUNTING POLICY: SOCIAL WORK AND THE LOCAL IMPLEMENTATION OF STUNTING POLICY IN INDONESIA

Abstract

The village-level implementation of Indonesia’s BKKBN stunting reduction program involves challenges that extend beyond technical delivery to encompass structural constraints and ethical tensions. This study examines program implementation in Marampiau Hilir Village, Tapin Regency, focusing on how social workers and frontline implementers navigate competing obligations within a family-based social policy framework. Using a qualitative case study design, data were generated through participatory observation, structured discussions with program actors, and the researcher’s direct engagement in community-based stunting interventions. The findings identify five interrelated barriers: limited community understanding of stunting, inadequate human-resource capacity, fragmented intersectoral coordination, inaccurate beneficiary targeting, and centralized performance pressures. Together, these conditions place frontline implementers in ethical gray zones where professional values, community empowerment, administrative compliance, and performance targets cannot always be reconciled. The study’s principal contribution lies in demonstrating that ethical dilemmas are not merely individual problems of professional judgment but are structurally produced through the interaction between centralized policy design, local institutional capacity, and community realities. By positioning frontline ethics as a critical dimension of implementation effectiveness, this study extends social work and social policy scholarship on stunting prevention. It argues that effective intervention requires not only improved technical coordination and targeting accuracy but also adaptive governance mechanisms that provide frontline workers with contextual discretion, ethical support, and meaningful community participation.