Health Professionals' and Stakeholders' Perspectives on Pharmacists' Roles in Stunting Prevention in East Nusa Tenggara, Indonesia: A Qualitative Study
Pharmacists’ Roles in Stunting Prevention
DOI:
https://doi.org/10.22146/ijp.30645Keywords:
pharmacists; stunting prevention; primary healthcare; interprofessional collaboration; qualitative studyAbstract
Stunting prevention requires coordinated action across primary healthcare, interprofessional teams, and local governance structures. Although pharmacists are present in Indonesian community health centers (Puskesmas) and have competencies relevant to preventive maternal and child health services, their roles in stunting prevention have not been examined from the perspectives of other health professionals and stakeholders. This study aimed to explore health professionals’ and stakeholders’ perspectives on pharmacists’ roles in stunting prevention in East Nusa Tenggara, Indonesia. This qualitative case study was conducted as the second phase of an exploratory sequential mixed-methods study. Data were collected through semi-structured in-depth interviews and focus group discussions involving 44 participants: 27 non-pharmacist health professionals and 17 stakeholders across primary healthcare, professional, and governance institutions. Data were analyzed using thematic analysis. Four themes were identified: policy and planning gaps in pharmacists’ formal integration; informal interprofessional collaboration and limited role recognition; organizational capacity and managerial support for pharmacists’ involvement; and limited professional and cross-sectoral legitimacy for pharmacists’ roles. The findings show that pharmacists were present within Puskesmas and possessed relevant preventive competencies, but their involvement was not yet systematically embedded in stunting prevention programs. Pharmacists were structurally present within Puskesmas but operationally constrained by weak policy recognition, limited inclusion in program planning, informal collaboration, workload pressures, uneven managerial support, and limited professional advocacy and cross-sectoral legitimacy. Strengthening pharmacists’ contribution requires service redesign that formally connects pharmacy practice with preventive nutrition and maternal-child health services in primary healthcare.
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Almarsdottir, A. B., & Granas, A. G. (2016). Social Pharmacy and Clinical Pharmacy—Joining Forces. Multidisciplinary Digital Publishing Institute Pharmacy, 4(1). https://doi.org/https://doi.org/10.3390/pharmacy4010001
Ayele, A. A., Islam, M. S., Cosh, S., & East, L. (2021). Involvement and practice of community pharmacists in maternal and child health services: A systematic review. Research in Social and Administrative Pharmacy, 17(4), 643–652. https://doi.org/10.1016/j.sapharm.2020.07.035
Bappelitbangda NTT. (2026). District-level stunting prevalence data in East Nusa Tenggara based on the 2024 Indonesian Nutritional Status Survey (SSGI). Unpublished official data. Regional Development Planning Agency of East Nusa Tenggara Province.
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa
Briggs, A. M., Valentijn, P. P., Thiyagarajan, J. A., & de Carvalho, I. A. (2018). Elements of integrated care approaches for older people: a review of reviews. BMJ Open, 8. https://doi.org/10.1136/bmjopen-2017-021194
D’Amour, D., & Oandasan, I. (2005). Interprofessionality as the field of interprofessional practice and interprofessional education: An emerging concept. Journal of Interprofessional Care, 19(1), 8–20. https://doi.org/https://doi.org/10.1080/13561820500081604
Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implementation Science, 4(50). https://doi.org/10.1186/1748-5908-4-50
Hedima, E. W., & Okoro, R. N. (2025). Primary health care roles of community pharmacists in low- and middle-income countries: a mixed methods systematic review. BMC Health Services Research, 25(1), 1–33. https://doi.org/10.1186/s12913-025-13387-0
International Pharmaceutical Federation. (2019). FIP statement of policy: The role of pharmacists in non-communicable diseases. https://www.fip.org/file/4338
Kobrai-Abkenarai, F., Salimi, S., & Pourghane, P. (2024). “Interprofessional Collaboration” among Pharmacists, Physicians, and Nurses: A Hybrid Concept Analysis. Journal Nurse Midwifery, 29(2), 238–244. https://doi.org/10.4103/ijnmr.ijnmr_336_22.
Kobun, A. L. L., & Susilo, A. M. (2025). Acceleration of Stunting Reduction: Advancing Social and Environmental Well-being through Policy, Education, and Environmental Management. Journal of Sustainability, Society, and Eco-Welfare, 2(2), 352–363. https://doi.org/10.61511/jssew.v2i2.2025.1496
Lincoln, Y. S., & Guba, E. G. (1985). Establishing Trustworthiness. In Naturalistic Inquiry. https://ethnographyworkshop.wordpress.com/wp-content/uploads/2014/11/lincoln-guba-1985-establishing-trustworthiness-naturalistic-inquiry.pdf?
Malterud, K., Siersma, V. D., & Guassora, A. D. (2016). Sample Size in Qualitative Interview Studies: Guided by Information Power. Qualitative Health Research, 26(13), 1753–1760. https://doi.org/https://doi.org/10.1177/1049732315617444
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Palinkas, L. A., Horwitz, S. M., Green, C. A., Wisdom, J. P., Duan, N., & Hoagwood, K. (2015). Purposeful Sampling for Qualitative Data Collection and Analysis in Mixed Method Implementation Research. Administration and Policy in Mental Health and Mental Health Services Research, 42, 533–544. https://doi.org/https://doi.org/10.1007/s10488-013-0528-y
Picauly, I., Mirah Adi, A. A. A., Meiyetriani, E., Mading, M., Weraman, P., Nashiyah, S. F., Boeky, D. L. A., Lobo, V., Saleh, A., Peni, J. A., Hidayat, A. T., & Marni, M. (2024). Determinants of child stunting in the dryland area of East Nusa Tenggara Province, Indonesia: insights from a national-level survey. Journal of Medicine, and Life, 17(2), 147–156. https://doi.org/https://doi.org/10.25122/jml-2023-0313
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Reeves, S., Pelone, F., Harrison, R., Goldman, J., & Zwarenstein, M. (2017). Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, 2017(6). https://doi.org/10.1002/14651858.CD000072.pub3
Scahill, S. L., Atif, M., & Babar, Z. U. (2017). Defining pharmacy and its practice: a conceptual model for an international audience. Integrated Pharmacy Research and Practice, 6, 121–129. https://pmc.ncbi.nlm.nih.gov/articles/PMC5774311/pdf/iprp-6-121.pdf
Schot, E., Tummers, L., & Noordegraaf, M. (2020). Working on working together. A systematic review on how healthcare professionals contribute to interprofessional collaboration. Journal of Interprofessional Care, 34(3), 332–342. https://doi.org/10.1080/13561820.2019.1636007
Scott, P. A., Quotah, O. F., Dalrymple, K. V., White, S. L., Poston, L., Farebrother, J., Lakhani, S., Alter, M., Blair, M., Weinman, J., & Flynn, A. C. (2021). Community Pharmacist-Led Interventions to Improve Preconception and Pregnancy Health: A Systematic Review. Pharmacy, 9(4), 171. https://doi.org/10.3390/pharmacy9040171
Suratri, M. A. L., Putro, G., Rachmat, B., Nurhayati, Ristrini, Pracoyo, N. E., Yulianto, A., Suryatma, A., Samsudin, M., & Raharni. (2023). Risk Factors for Stunting among Children under Five Years in the Province of East Nusa Tenggara (NTT), Indonesia. International Journal of Environmental Research and Public Health, 20(2). https://doi.org/10.3390/ijerph20021640
Urionagüena, A., Piquer-Martinez, C., Gastelurrutia, M. Á., Benrimoj, S. I., Garcia-Cardenas, V., Fernandez-Llimos, F., Martinez-Martinez, F., & Calvo, B. (2023). Community pharmacy and primary health care - Types of integration and their applicability: A narrative review. Research in Social and Administrative Pharmacy, 19(3), 414–431. https://doi.org/10.1016/j.sapharm.2022.10.007
Valentijn, P. P., Schepman, S. M., Opheij, W., & Bruijnzeels, M. A. (2013). Understanding integrated care: a comprehensive conceptual framework based on the integrative functions of primary care. International Journal of Integrated Care, 13. https://ijic.org/articles/886/files/submission/proof/886-1-4411-2-10-20130322.pdf
Wiedenmayer, K., Summers, R. S., Mackie, C. A., Gous, A. G. S., Everand, M., & Tromp, D. (2006). Developing pharmacy practice. https://www.fip.org/files/fip/publications/DevelopingPharmacyPractice/DevelopingPharmacyPracticeEN.pdf
World Health Organization. (2020). Operational Framework for Primary Health Care. https://www.who.int/publications/i/item/9789240017832
Published
2026-07-30
How to Cite
Dedy, M. A. E., Satibi, S., Anna Wahyuni Widayanti, & Lele, G. (2026). Health Professionals’ and Stakeholders’ Perspectives on Pharmacists’ Roles in Stunting Prevention in East Nusa Tenggara, Indonesia: A Qualitative Study: Pharmacists’ Roles in Stunting Prevention . Indonesian Journal of Pharmacy. https://doi.org/10.22146/ijp.30645
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Section
Research Article
