The Hexahelix Collaboration Model for Stunting Prevention: A Case Study of Collaborative Governance in Rancakalong, Sumedang
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Hexahelix Collaboration Model,
Public Health,
Stunting Prevention
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Cece Mulyadi
Bintarsih Sekarningrum
Deni Kurniadi Sunjaya
R. Anang Muftiadi
Abstract
Background: Child stunting remains a critical global health and development issue with profound long-term consequences.
Aims: This study aims to analyze the application of the hexahelix collaboration model in the stunting prevention program in Rancakalong District, Sumedang Regency, Indonesia.
Methods: A qualitative case study approach was used to identify and analyze six key helices: Government, Community, Private Sector, Academics, Media, and Policy. The research examines the roles, contributions, and interactions of these six actors within a single, integrated framework to address the multi-causal nature of stunting.
Results: The analysis reveals a novel conceptualization of Policy as a distinct, foundational helix that acts as the primary governance structure. Findings show that a layered, synchronized policy framework from the national to the village level facilitates the integration of diverse stakeholder efforts. The collaboration leverages technological innovation (e.g., the SIMPATI application), community-based action rooted in local wisdom, strategic private-sector partnerships, and evidence-based input from academia. The media's role in public education and social accountability further strengthens the model's effectiveness. Data indicates a significant decrease in stunting prevalence in Rancakalong from 27.61% in 2017 to 7.59% in 2025.
Conclusion: These findings demonstrate that a well-defined policy helix can mitigate common challenges in multi-actor interventions. The hexahelix model provides a replicable empirical framework for tackling complex public health issues in developing contexts.
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Copyright (c) 2026 Cece Mulyadi, Bintarsih Sekarningrum, Deni Kurniadi Sunjaya, R. Anang Muftiadi
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
References
Abi Khalil, H., Hawi, M., & Hoteit, M. (2022). Feeding patterns, mother–child dietary diversity and prevalence of malnutrition among under-five children in Lebanon: A cross-sectional study based on retrospective recall. Frontiers in Nutrition, 9, 1–10. https://doi.org/10.3389/fnut.2022.815000
Affairs, U. N. D. of E. and S. (2024). The Sustainable Development Goals Report 2024. In The Sustainable development goals report. United Nations. https://doi.org/10.18356/9789213589755
Arianny, M. P., & Adisasmito, W. (2024). Collaborative Governance in Public Health Policy Implementation: A Literature Review in the Southeast Asia Region Including Indonesia. Devotion Journal of Research and Community Service, 5(7), 803–810. https://doi.org/10.59188/devotion.v5i7.760
Ansell, C., & Gash, A. (2008). Collaborative governance in theory and practice. Journal of Public Administration Research and Theory, 18(4), 543–571. https://doi.org/10.1093/jopart/mum032
Bryson, J. M., Crosby, B. C., & Stone, M. M. (2015). Designing and implementing cross-sector collaborations: Needed and challenging. Public Administration Review, 75(5), 647–663. https://doi.org/10.1111/puar.12432
Cai, Y., & Lattu, A. (2022). Triple helix or quadruple helix: Which model of innovation to choose for empirical studies? Minerva, 60(2), 257–280. https://doi.org/10.1007/s11024-021-09453-6
Carayannis, E. G., Barth, T. D., & Campbell, D. F. J. (2012). The quintuple helix innovation model: Global warming as a challenge and driver for innovation. Journal of Innovation and Entrepreneurship, 1(1), Article 2. https://doi.org/10.1186/2192-5372-1-2
Elni, E., & Julianti, E. (2021). The correlation between feeding habit factor and the incidence of stunting in children under five years. Jurnal Keperawatan Padjadjaran, 8(3), 283–291. https://doi.org/10.24198/jkp
Emerson, K., Nabatchi, T., & Balogh, S. (2012). An integrative framework for collaborative governance. Journal of Public Administration Research and Theory, 22(1), 1–29. https://doi.org/10.1093/jopart/mur011
Etzkowitz, H., & Leydesdorff, L. (1995). The triple helix University industry government relations: A laboratory for knowledge-based economic development. EASST Review, 14(1), 14–19. Google Schoolar
Giddens, A. (1984). The constitution of society: Outline of the theory of structuration. University of California Press.
Gunawan, A. (2022, October). Angka stunting di Sumedang terus menurun. Pemerintah Kabupaten Sumedang. https://sumedangkab.go.id/berita/detail/angka-stunting-di-sumedang-terus-menurun
Gustini, E. (2022). Statistik daerah Kabupaten Sumedang 2022. Badan Pusat Statistik Kabupaten Sumedang. https://sumedangkab.bps.go.id/id/publication/2022/12/22/0898558e93d75c758308ae9f/statistik-daerah-kabupaten-sumedang-2022.html
Head, B. W. (2008). Wicked problems in public policy. Public Policy, 3(2), 101–118.
Huber, M. N. (2022). How the qualities of actor–issue interdependencies influence collaboration patterns. Ecology and Society, 27(4), Article 6. https://doi.org/10.5751/ES-13536-270406
Huxham, C., & Vangen, S. (2005). Managing to collaborate: The theory and practice of collaborative advantage. Routledge.
Lemke, A. A., & Harris-Wai, J. N. (2015). Stakeholder engagement in policy development: Challenges and opportunities for human genomics. Genetics in Medicine. https://doi.org/10.1038/gim.2015.8
Masthalina, H., Letelay, A. M., & Doloksaribu, T. H. (2025). Household social context and health behaviors influencing child stunting: insights from North Sumatra, Indonesia. African Journal of Food Agriculture Nutrition and Development, 25(6), 27122–27141. https://doi.org/10.18697/ajfand.143.25825
McGovern, M. E., Krishna, A., Aguayo, V. M., & Subramanian, S. V. (2017). A review of the evidence linking child stunting to economic outcomes. International Journal of Epidemiology, 46(4), 1171–1191. https://doi.org/10.1093/ije/dyx017
Mertens, A., Benjamin‐Chung, J., Colford, J. M., Coyle, J., Laan, M. J. van der, Hubbard, A., Rosete, S., Malenica, I., Hejazi, N. S., Sofrygin, O., Cai, W., Li, H., Nguyen, A., Pokpongkiat, N. N., Djajadi, S., Seth, A., Jung, E., Chung, E. O., Jilek, W., Yori, P. P. (2023). Causes and consequences of child growth faltering in low-resource settings. Nature, 621(7979), 568–576. https://doi.org/10.1038/s41586-023-06501-x
Mulyadi, C., & Muchtar, H. N. (2026). A Digital-Based Collaborative Strategy for Stunting Prevention through Community and Village Government Synergy. International Journal of Humanities Law and Politics, 4(1), 1–9. https://doi.org/10.46336/ijhlp.v4i1.301
Mulyani, A. T., Khairinisa, M. A., Khatib, A., & Chaerunisaa, A. Y. (2025). Understanding Stunting: Impact, Causes, and Strategy to Accelerate Stunting Reduction—A Narrative Review. Nutrients, 17(9), 1493. https://doi.org/10.3390/nu17091493
Pemerintah Kabupaten Sumedang. (2019). Peraturan Bupati Sumedang Nomor 82 Tahun 2019 tentang percepatan penurunan dan pencegahan stunting terintegrasi. https://peraturan.bpk.go.id/Home/Details/210734/perbup-kab-sumedang-no-82-tahun-2019
Pemerintah Republik Indonesia. (2021). Peraturan Presiden Nomor 72 Tahun 2021 tentang percepatan penurunan stunting. https://peraturan.bpk.go.id/Details/174964/perpres-no-72-tahun-2021
Pradana, M., Pérez-Luño, A., & Fuentes-Blasco, M. (2020). Innovation as the key to gain performance from absorptive capacity and human capital. Technology Analysis & Strategic Management, 32(7), 822–834. https://doi.org/10.1080/09537325.2020.1714578
Putri, Y., Harahap, M., Hasibuan, D. A., Siregar, R. W., Hafni, S., & Rangkuti, L. F. (2025). The Role of Cadres in the Implementation of Posyandu Activities in Pudun Jae Lk I Village, Batunadua Health Center Working Area, Padangsidimpu City, in 2025. International Journal of Public Health Excellence (IJPHE), 5(1), 190–195. https://doi.org/10.55299/ijphe.v5i1.1646
Rachim, A., Warella, Y., Astuti, R. S., & Suharyanto, S. (2020). Hexa helix: Stakeholder model in the management of floodplain of Lake Tempe. Prizren Social Science Journal, 4(1), 20–27.
Ryan, M. P. (2024). Collaborative governance on big health problems in developing countries. Open Access Government, 42(1), 28–29. https://doi.org/10.56367/oag-042-11439
Sharn, A. R., Oliveros, E., Lai, S., Sánchez, C., Guno, M. J. V.-R., & Montenegro, C. R. (2025). Multi-faceted nutritional interventions are imperative to reduction of stunting among children in low- and middle-income countries. Frontiers in Nutrition, 12(2), 1479850. https://doi.org/10.3389/fnut.2025.1479850
Sinaga, E. D., Sirait, A. I., Silaban, M. A., & Pratiwi, S. (2025). Penguatan Kapasitas Kader Melalui Revitalisasi Posyandu dalam Upaya Peningkatan Layanan Kesehatan di Puskesmas Mutiara Kabupaten Asahan. Panggung Kebaikan, 2(4), 217–224. https://doi.org/10.62951/panggungkebaikan.v2i4.2526
Taplin, R. (Ed.). (2013). Intellectual property valuation and innovation. Routledge. https://doi.org/10.4324/9781315881515
United Nations. (2018). The Sustainable Development Goals report 2018. United Nations.
United Nations Children’s Fund (UNICEF). (2023). Improving child nutrition: The achievable imperative for global progress. UNICEF.
Widyaningsih, V., Mulyaningsih, T., Rahmawati, F. N., & Adhitya, D. (2022). Determinants of socioeconomic and rural–urban disparities in stunting: Evidence from Indonesia. Rural and Remote Health, 22(1), 1–9. https://doi.org/10.22605/RRH7082
World Bank. (2020). Stakeholder communication and engagement. https://ppp.worldbank.org/stakeholder-communication-and-engagement
World Health Organization. (2023). Levels and trends in child malnutrition: UNICEF/WHO/World Bank Group joint child malnutrition estimates. World Health Organization.
Yuan, Q., Doke, K., Gasco-Hernandez, M., Gil-Garcia, J. R., Zheleva, M., & Bogdanov, P. (2022). Understanding drivers and challenges of multi-actor collaborations at the local level. In Proceedings of the 55th Hawaii International Conference on System Sciences (pp. 2594–2604). https://hdl.handle.net/10125/79655
Zaenuri, M., Hidayat, R., & Prasetyo, K. B. (2023). Collaborative governance in stunting prevention policy in Indonesia. Journal of Governance and Public Policy, 10(2), 145–160. https://doi.org/10.18196/jgpp.v10i2.18123