Provincial Level Research Articles

Consistency between the geographic distributions of overweight and obesity among children and adults in China

BackgroundChildhood obesity is associated with obesity in adulthood, but the consistency between the geographic distributions of obesity among children and adults in China is not fully understood. We aimed to examine the consistency of the geographic distributions of overweight and obesity between adults and children in China.MethodsThis was a cross-sectional study including 11,940 adults. Data were from the China Health and Nutrition Survey conducted in 2015. Body mass index (BMI) and waist circumference (WC) were measured. The geographical areas were categorized as low-, middle- or high-epidemic areas according to the prevalence of overweight and obesity in children at the provincial level, based on the classification system determined by the National Health Commission. We examined the differences in adult BMI, WC, prevalence of overweight and obesity, abdominal overweight and obesity across the three classification areas.ResultsIn this study, the overall prevalence of overweight/obesity and abdominal overweight/obesity were 49.8% and 61.0% respectively. We observed the prevalence of overweight and obesity among adults increased from low- to middle- and high- epidemic areas. Compared with adults from low-epidemic areas, those from middle- and high-epidemic areas had a higher odds of having overweight or obesity (odds ratio [95% confidence interval]: 1.518 [1.362, 1.692] and 2.190 [1.972, 2.433], respectively). Similar results were observed for abdominal overweight and obesity in adults.ConclusionOur study confirmed the consistency in the geographical clustering of overweight and obesity among adults and children, which suggests that interventions addressing overweight and obesity should be targeted at both local children and adults simultaneously.

Methods and Practical Considerations for Conducting Budget Impact Analysis for Non-Pharmaceutical Interventions.

Health technology assessment (HTA) can be conducted at the national, provincial, or hospital level. Although provincial and hospital-based HTAs often focus on non-pharmaceutical interventions, budget impact analysis (BIA) methods for non-pharmaceutical interventions have received less attention in the literature. We reviewed HTAs of non-pharmaceutical interventions published since 2015 by a Canadian provincial HTA agency, evaluating the characteristics and challenges of conducting a BIA. We summarized the unique characteristics of BIAs for different categories of interventions, including surgery and other procedures, diagnostic or screening tests, therapeutic programs, and digital health technologies. We then discussed specific methodological and practical considerations for conducting a BIA of a surgical or other hospital-based procedure. Critical points for BIA methods include the following: (1) when estimating the size of a target population, healthcare system capacity must be accounted for, and historical volumes may offer more realistic figures than prevalence and incidence rates; (2) factors that affect the uptake of a new intervention include guideline recommendations, labor and infrastructure requirements for implementation, and the target population size; (3) when interpreting a budget impact that shows cost savings, analysts must address where the savings are generated from and whether they can be reallocated. Some of the considerations discussed may also apply to HTAs of pharmaceuticals. When conducting a BIA of a non-pharmaceutical intervention, addressing these methodological considerations may help in better predicting the financial impact of the new intervention for the public payer and guide appropriate budget allocation for healthcare system planning.

Modeling the Determinants of Out-of-School Children in Pakistan

ABSTRACT It is well known that different socioeconomic, household sizes, school levels, and cultural factors are highly related to the problem of out-of-school children. The main objective of this study is to quantify the determinants of out-of-school children in Pakistan. For this study, the data are used from the Pakistan Social and Living Standards Measurement (PSLM) survey, collected for the year 2015–16. The children aged 6–16 years who are in or out of school are considered as a unit of the analysis. Unlike the previous studies that generally provide a theoretical framework or empirical investigation based on simple econometric models, this work used fixed and random effect models capable of accounting for the hierarchical structure present in the data. To assess the results’ reliability, the models’ predictive ability has also been tested and found satisfactory. The results reveal many important aspects of the current problem regarding disparities between gender, provinces, regions, and other variables used in the analysis. For example, parental education is highly significant and has a negative impact on out-of-school children at the province and region level for both boys and girls. In addition, income levels, child labor, household size, and residency are highly influential on the problem of out-of-school children. Therefore, the government should prioritize female education, especially in rural areas. The provision of monetary incentives and enforcement of a strict ban on child labor can reduce the problem under study.

The impact of past and current district-level climatic shifts on maize production and the implications for South African farmers

South Africa’s climate studies generally focus on coarser provincial levels, which aid policy recommendations, but have limited application at the farm level. District level climate studies are essential for farmer participation in climate change mitigation strategies and management. Our study aimed to investigate historical climate data for trends and their influence on maize yields at the magisterial level. Six sites were selected from three major maize-producing provinces in South Africa: Mpumalanga, Northwest, and Free State. Magisterial districts in each province were selected from different Köppen-Geiger climate zones. The climate variables assessed by the Mann–Kendall trend test included maximum or minimum temperature, rainfall, number of extreme high-temperature days, rainfall onset and cessation from 1986 to 2016. The average maximum temperatures were observed to have significant upward trends in most locations, except for Schweizer-Reneke and Bethlehem. The fastest rate of change was observed at Klerksdorp (0.1 °C per 30 years of study), while the Schweizer-Reneke district was the slowest (0.05 °C per 30 years of study). No significant changes were observed in rainfall onset, cessation, or total rainfall in Schweizer-Reneke, Standerton, and Bethlehem, which are scattered across the different provinces. The other districts in each province showed significant changes in these parameters. Rainfall accounted for the significant variation in maize yields over the study period, explaining between 18 and 40% of the variation in the North West, and between 1 and 17% in the Free State. These findings highlight the importance of understanding location-specific changes at a finer scale, which can help farming communities adjust agronomic practices and adapt to local climate shifts.

The Formation of New Quality Productivity of Agriculture Under the Perspectives of Digitalization and Innovation: A Dynamic Qualitative Comparative Analysis Based on the “Technology-Organization-Environment” Framework

The formation and development of new quality productivity of agriculture can effectively promote agricultural sustainability and modernization. In order to explore the multiple paths of the formation of new quality productivity of agriculture, using the panel data of 30 provincial levels in China from 2012 to 2021, based on the “technology-organization-environment” framework and dynamic QCA method, this paper explores how seven factors such as agricultural technology innovation, digital infrastructure, innovation policy support, the formation of e-commerce industry, marketization level, green finance, and rural culture modernization interact to promote the formation of new quality productivity of agriculture. The findings reveal that none of the above seven factors can promote the formation of new quality productivity of agriculture, and agricultural technological innovation and digital infrastructure are becoming more and more important to the formation of new quality productivity of agriculture over time. The high new quality productivity of agriculture formation models can be categorized into four types: TOE empowers new business model development-driven, government–market–culture triple-driven, market-oriented efficient transformation of technological achievements-driven, and deep integration of agricultural technological innovation and emerging agricultural business models-driven. The configurational results exhibit significant regional effects, with diverse pathways for the formation of new quality productivity of agriculture across different provinces.

CONSTRUCTION OF BLUE ECONOMY DEVELOPMENT INDEX AT THE PROVINCIAL LEVEL IN INDONESIA USING EXPLORATORY FACTOR ANALYSIS

Indonesia, as an archipelagic country, holds marine resources of significant economic value in improving the welfare of its people. However, the community's use of marine resources does not pay attention to sustainability. The government then uses the Blue Economy concept to maximize the economic value obtained while maintaining the sustainability of the marine ecosystem through national policies and plans. In realizing blue economy development, enabler factors, such as technology and government governance, have an important role. This research aims to construct a Blue Economy Development Index (IPEB) at the provincial level in Indonesia in 2021, including enabler factors for blue economy development. The analytical method used is Exploratory Factor Analysis. The results show that the distribution of the minimum values for the indicators that make up the IPEB is found in the provinces of the Eastern Region of Indonesia. In contrast, the distribution of the maximum values of the indicators is found in the provinces of the Western Region of Indonesia. The province with the highest IPEB score is South Sulawesi, while the lowest is Central Sulawesi. The limitation of this study is the data derived from the Village Potential Survey (Potensi Desa) data collection, so several variables are not yet available in annual time. The results of this study are important in improving the ability to monitor implementation and assist in decision-making in increasing blue economic development, especially at the provincial level.

Can New Quality Productivity Promote the Carbon Emission Performance—Empirical Evidence from China

New quality productivity (NQP) has the possibility to enhance carbon emission performance which will fortify the groundwork for long-term economic expansion even further. The research examines the panel data of 30 provinces spanning the years 2012 to 2022 for an evaluation framework for NQP and carbon emission performance at the provincial level. Employing fixed effect models, mediation effect analysis, and spatial econometrics, the study explores the effect of NQP on carbon emission performance, its mediating mechanisms, and the spatial spillover effects. The findings indicate that (1) NQP significantly lowers carbon emissions for every unit of GDP and enhances carbon emission performance, and the result holds up when the instrumental variable methods are used. (2) The NQP had a significant contribution to improving carbon emission performance via advancements in green innovation. (3) The NQP does more than directly enhance the regional carbon emission performance; in contrast, it additionally positively influences the carbon emission performance level of the adjacent regions by the spatial spillover effect. (4) The impact of NQP on carbon emission performance is particularly pronounced in eastern and innovative regions. On this basis, we should vigorously develop the NQP, strengthen cross-regional policy coordination, and promote green and sustainable development.

The Illusion of Meritocracy: Evidence from Provincial Official Promotion in Post-Mao China

ABSTRACT We study the promotion of provincial level officials between 1978 and 2022 and cannot find empirical support for the meritocratic argument. Work ties with top leaders, particularly with the leadership core, have provided provincial officials with advantage in promotion. Methodologically, we use official individual fixed effects to estimate a cleaner effect of social ties and show that previous research has underestimated this impact. This study contributes to the debate about elite politics in contemporary China and offers a firmer empirical grounding for understanding the political foundation of China’s economic policies and overall development.

The Belt and Road Initiative and Urban Entrepreneurship: Evidence From the Opening Policy From China

ABSTRACTEntrepreneurship is a vital source of high‐quality employment in China and is crucial in advancing Chinese‐style modernization. Using panel data from 281 prefecture‐level cities in China from 2003 to 2021, this study employs difference‐in‐differences and double machine learning models to examine the impact of the Belt and Road Initiative (BRI) on entrepreneurship. The research findings are as follows: The BRI implementation significantly enhances entrepreneurship at city and provincial levels, with results remaining robust across various tests. The BRI promotes entrepreneurship through industrial innovation, digital trade development, and economic agglomeration. Heterogeneity analysis reveals that the BRI's positive effects on entrepreneurship are more pronounced in small and medium‐sized cities and central and western regions. Furthermore, the BRI exhibits significant spatial spillover effects, stimulating entrepreneurship in neighboring cities. The initiative also effectively reduces relative disparities in entrepreneurship across regions, particularly between eastern, central, and western areas, thus promoting coordinated regional development. Additionally, triple‐difference results indicate that the BRI's positive effects on urban industrial innovation are mainly concentrated in manufacturing sectors such as energy, equipment, and information technology. This study complements the BRI's effects and provides policy implications for narrowing regional entrepreneurship gaps and promoting high‐quality full employment in China.

Spatial-temporal distribution and evolution of medical and health talents in China

BackgroundIn the context of public health emergencies, the presence of medical and health talents (MHT) is critically important for support in any country or region. This study aims to analyze the spatial and temporal distributions and evolution of MHT in China and propose strategies and recommendations for promoting a balanced distribution.MethodsThis research used data from 31 provinces in China to construct a multidimensional index system for measuring the agglomeration level of MHT. The indices include talent agglomeration density (TAD), talent agglomeration scale (TAS), talent agglomeration intensity (TAI), and talent agglomeration equilibrium (TAE). Using provincial data from the years 1982, 1990, 2000, 2010, and 2020, a spatiotemporal analysis of the MHT agglomeration levels was conducted. Furthermore, the regional dynamic distribution of MHT was analyzed using kernel density estimation diagrams. The spatial autocorrelation of MHT was assessed through global and local Moran’s I, and the spatial gap and decomposition of MHT were analyzed using the Dagum Gini coefficient.ResultsFrom the temporal level, the TAD and TAI of MHT showed an increasing trend over the studied period, whereas TAS decreased and TAE first increased and then decreased from 1982 to 2020. At the spatial level, the TAD, TAS, TAI, and TAE of MHT exhibited varied patterns among the eastern, central, and western regions of China, showing significant geographical disparities, generally demarcated by the Hu Huanyong Line. The regional dynamic distribution level of MHT in the country and the three regions were expanding. Spatial autocorrelation analysis using global and local Moran’s I for TAD, TAS, TAI, and TAE demonstrated significant regional differences. The Dagum Gini coefficient of TAD, TAS, TAI, and TAE revealed divergent trends in regional disparities, with overall declines in disparities for TAD and TAI, a slight increase for TAS, and fluctuating patterns for TAE.ConclusionsFrom a temporal perspective, the overall number of MHT in China has been increasing annually at the national and provincial levels. From the spatial perspective, TAD, TAS, TAI, and TAE exhibit significant differences among the three regions. Kernel analysis reveals that the distribution differences are gradually expanding in national level and varying in regional level. Moreover, the global and local Moran’s I indices reveal varying spatial autocorrelation for TAD, TAS, TAI, and TAE. The Dagum Gini coefficients of TAD, TAS, TAI, and TAE show different patterns of decomposition.

Assessment of Environmental Suitability for the Spatial Distribution of Minority Villages in Mountainous Areas—Taking Fujian Province as an Example

The geographical environment and economic conditions that influence the spatial distribution of minority villages vary significantly, particularly in mountainous regions where they face different levels of disaster risks. Environmental suitability assessment can help us gain a deeper understanding of the differences and degrees of differences among different villages and provide a basis for resource allocation and planning. This study focuses on 499 national level and 68 provincial level minority villages in Fujian province and evaluates the environmental suitability of their spatial distribution using analysis tools such as ArcMap and GeoDetector. The research findings indicated: (1) The ratio between the influence strengths of natural geographical, socioeconomic, and disaster constraint indicators on the environmental suitability of minority villages in mountainous areas is 5:10:7, with the highest influence being the regional gross domestic product (RGDP) in the socioeconomic indicator (0.509) and the lowest influence being flood sensitivity (0.011). (2) Areas with high suitability values are in the southeast coastal and central regions. From east to west, the suitability values gradually decrease. The suitable areas cover 87.2% of the total region, including 91.9% of the minority villages. (3) The geographical correlation coefficient between the spatial distribution of minority villages and environmental suitability is 86.87, indicating a high degree of spatial interaction and fit between the two. This validates the rationality of the multi-factor evaluation model for assessing the environmental suitability of ethnic village spatial distribution in mountainous areas. (4) There is an inverse “U” relationship between environmental suitability and the distribution of national and provincial level minority villages. With the increase in the suitability index, the number of national level minority villages tends to increase, while the number of provincial level minority villages tends to decrease. The research findings have significant implications for promoting the sustainable development of minority villages in Fujian province and provide reference for the regional development and protection of minority villages in other mountainous areas.

Dynamic Trends in Aquatic Product Supply and Consumption in China: Implications for Sustainable Diets and Environmental Impact Reduction

Aquatic foods play a pivotal role in transforming food systems. As the world’s leading producer, consumer, and trader of aquatic products, China’s potential for sustainable supply and consumption is critical to understand. The aim of this study was to depict the dynamic trends of aquatic products and the consequences of sustainable diets and environmental impacts. A panel dataset about Chinese aquatic products covering the period from 1952 to 2023 was drawn for analysis. Diet sustainability was assessed with the deviation from the Dietary Guidelines for Chinese Residents (2022) and EAT-Lancet recommendations. The environmental impacts of aquatic products’ supply and consumption were assessed using carbon footprints and water footprints. The findings reveal that aquatic products’ supply increased from 4.65 million tons to 71.16 million tons from 1978 to 2023, and annual aquatic food consumption per capita increased from 3.50 kg in 1978 to 15.20 kg. While overall supply meets consumption needs, structural imbalances persist at the provincial level. Over time, the influence of marine fishery products has declined from 1.06 million tons (63.63%) in 1952 to 35.85 million tons (50.38%) in 2023, whereas offshore aquaculture shows promising potential for meeting future supply demands (23.96 million tons in 2023, accounting for 66.82% of marine fishery production). To align with healthy dietary goals and environmentally sustainable food systems, provincial aquatic food demand across China was adjusted. The carbon footprints and water footprints of both current and adjusted consumption patterns were also assessed. The results indicate that adjusting consumption based on the Dietary Guidelines for Chinese Residents (2022) and EAT-Lancet recommendations could reduce environmental impacts to different degrees. The findings could offer valuable references and insights into developing sustainable strategies in aquatic product management and advancing food system transformation.

Policy analysis of self-care program: a qualitative study protocol

BackgroundOver the recent years, the self-care program has been a significant policy in the field of health. The WHO recommended self-care for every country and economic setting for reaching universal health coverage, promoting health, keeping the world safe and serving the vulnerable. Conducting a policy analysis study can be useful in closely examining the self-care program’s content, process, context and actors.MethodsA qualitative policy analysis will be conducted in four phases to analyse the self-care program, focussing in Iran. The first phase will involve a scoping review to identify policies related to self-care worldwide. In the second phase, a qualitative study will be conducted to determine the status of the self-care program in Iran. The third phase will involve analysing the self-care program in Iran using the policy triangle framework of Walt and Gilson (1994). In the final phase, initial policy recommendations related to the self-care program will be formulated, and validation and finalization of the initial recommendations will be carried out in a panel of experts.DiscussionTo thoroughly examine the self-care program’s content, process, context and actors, a policy analysis study can be helpful. Therefore, this study will aim to analyse the self-care program using policy analysis approach. By identifying the challenges of the program’s content, process, context and actors, corrective solutions to improve the program’s current status, as well as policy recommendations appropriate to the country’s context, will be provided. In addition, policy-makers in various authorities at the national, regional and provincial levels would benefit from the results of this study.

The potential of interprovincial money laundering in Indonesia: investigation on the attractiveness and destination choice

PurposeThe purpose of this study is to ascertain the level of attractiveness of each province in Indonesia as a potential destination for money laundering activities originating from Jakarta.Design/methodology/approachAdopting a quantitative approach, this study uses the Walker Gravity Model, which has been modified in two key components: the attractiveness and distance variables. The first modification is achieved by using proxy economic variables, for which data is available at the provincial level within a country. The utilization of proxy data serves to circumvent certain data limitations inherent to the original model, which is only accessible at the country level. The second modification is introduced to the distance component, wherein this study develops a distance index that is deemed to be more representative than physical distance used in the original model.FindingsThe research findings indicate a notable correlation between economic activity and the risk of money laundering, with provinces in closer proximity to Jakarta exhibiting a higher likelihood of being targeted for money laundering activities. However, there are exceptions for some provinces that, despite their distance from Jakarta, also demonstrate a high potential for money laundering due to their strong economic ties to the capital city.Originality/valueThe existing studies on money laundering attractiveness, extent and flow at the provincial level in Indonesia using quantitative approaches are limited. This paper provides new insights into the economic and governance landscapes of Indonesian provinces, highlighting the need for tailored anti-money laundering strategies.

Self-Regulated Learning Assessment in Young Soccer Players: Beyond Competitive Levels.

Trecroci, A, Cavaggioni, L, Rossi, A, Bongiovanni, T, Invernizzi, PL, Formenti, D, and Longo, S. Self-regulated learning assessment in young soccer players: beyond competitive levels. J Strength Cond Res 39(1): e56-e61, 2025-This study explores self-regulated learning (SRL) among young soccer players, transcending the traditional focus on competitive levels. One hundred twenty-four soccer players of regional and provincial levels from under 14 to under 17 age groups voluntarily participated in the study and were combined into a single group. A median-split method based on total time performance was used to separate players into low performers (LPs) and high performers (HPs) from a 90° change of direction dribbling test. The self-regulation of learning-self-report scale for sport practice (SRL-SRS-SP) with a 5-factor solution (planning, reflection, effort, self-efficacy, and self-supervision) and 31 items was used. The score was based on a 1-5 Likert scale. The level of significance was set at p -value < 0.05. The SRL-SRS-SP total score by HP players differed significantly from that of LP players ( p = 0.015). Regarding each subscale, HP players showed significantly higher scores than LP players ( p = 0.011) for planning, whereas no differences were observed for the remaining factors ( p ≥ 0.05). The main observation of this study revealed that HP soccer players had a greater level of engagement in the learning process with a remarkable ability to plan for specific improvement than LP peers. This suggests that the competitive level might not be the sole determinant of differences in SRL. Therefore, strength and conditioning coaches should emphasize metacognitive and motivational components because of their crucial role in enhancing technical and physical performance.

Export competitiveness network of Chinese provincial agricultural products: E volution, performance, and influencing factors.

The development of top-tier agricultural product bases and demonstration zones aims to propel Chinese agriculture into the global market, form international competitiveness, and advance to the high end of the global industrial and value chain. This study contributes to the existing literature by investigating the performance and factors influencing the competitiveness of Chinese agricultural product exports at the provincial level, using a complex network perspective, and offers recommendations for improvement. In this regard, the article uses agricultural product export data from 2015 to 2022 to create export competitiveness networks of Chinese provincial agricultural products. Our analysis revealed four primary observations. Firstly, significant opportunities exist to improve the competitive edge of agricultural product exports across various Chinese provinces. Secondly, with the exception of Guangdong Province, the types of competitively robust agricultural products exported by each province are inconsistent. Thirdly, international sister-city relationships can foster the development of an export competitiveness network of Chinese provincial agricultural products, while geographic distance may hinder this network. These findings are consistent. Lastly, the development of this competition-focused export network is also influenced by province-level and national characteristics, and these influences have unique differences. All provinces should strive to produce distinctive and globally competitive agricultural goods to build their competitive advantage in international trade. They should also implement strategic regional planning to support the global expansion of their agricultural products.

Developing a new index with time series Sentinel-2 for accurate tidal flats mapping in China.

Tidal flats are essential habitats for a wide variety of plants and animals along the coast, contributing significantly to biodiversity preservation. Despite efforts to employ remote sensing technology for mapping these areas, misidentification remains a persistent issue. Within the context of tidal flat mapping, one of the primary challenges lies in distinguishing between tidal flats and turbid water bodies. This is primarily attributed to the high sediment content in turbid water bodies, which renders their spectral characteristics similar to those of tidal flats, consequently leading to confusion. To this end, this study developed a novel Tidal Flats-Water Difference Index (TWDI) with time series Sentinel-2 to accurately map tidal flats in China for the year 2020. The index demonstrates robust performance in distinguishing between tidal flats and water bodies, particularly in turbid water conditions. It reduces the likelihood of misclassifying water bodies as tidal flats, thus enhancing the accuracy of tidal flats mapping. Based on this index, we generated Tidal Flats Map of China at 10m (TFMC) in 2020 based on the GEE. With validation from 10,234 samples, the TFMC map attained an overall accuracy (OA) and F1 score of 0.97. Based on our calculations, the total area of tidal flats in China was 9195.80km2, with Jiangsu Province accounting the largest area at the provincial level (2467.71km2). This study is the first attempt to address the issue of misclassification of turbid water bodies as tidal flats. TWDI can serve as the spectral index in tidal flats mapping or as input features for training classification models of coastal wetland. The TFMC map can serve as foundational data to promote the protection of tidal flats and the sustainable development of coastal wetland ecosystems.

Bring mutual trust back: explaining underdevelopment among privileged regions

ABSTRACT This article examines how trust between the regional government and its citizens contributes to the embodiment of participatory policymaking at the provincial level and impacts regional development. Different from previous studies on trust, which focused primarily on quantitative approaches and thereby left the social-political context out, this study employs a qualitative approach to present more profound findings and contextual aspects that reflect actors’ trust. The context is the existence of a local political dynasty that dominates the political, bureaucratic and business arenas. It also captures a regional development paradox in which a province is persistently underprivileged among well-developed adjacent regions. Primary data collection involves in-depth interviews with selected business actors, academics, NGOs and high-, middle- and low-ranking government officials at the provincial level. The findings reveal a lack of trust between the regional government and citizens, which explains poor participation in policymaking hence sluggish regional development. Each actor seems to lack the necessary competence, integrity and benevolence to cooperate in regional policymaking. These findings also fill a theoretical gap left by previous studies on trust which have primarily focused on citizen trust in government. At the same time, this article also pays more attention to government trust in citizens, which remains understudied.

Evaluation of Tuberculosis Disease Surveillance System in DKI Jakarta Province in 2024: Structure, Function and Attribute Analysis

Indonesia ranks second worldwide in tuberculosis cases. Surveillance components for tuberculosis reporting have been facilitated by SITB. Program improvement recommendations should be implemented by smaller units, such as Public Health Centers, by analyzing data and disseminating it to relevant parties, with recommendations also made at the provincial level. This evaluation aims to describe the implementation of tuberculosis surveillance in DKI Jakarta. This descriptive study uses a mixed-methods approach of observation and structured interviews conducted in DKI Jakarta from April to June 2024. Data were sourced from SITB tuberculosis reports and in-depth interviews with nine tuberculosis officers from the Health Sub-Office, Public Health Centers, and hospitals. Surveillance system evaluation covered system structure, core functions, support functions, and system attributes based on WHO guidelines. System structure aspects related to legal aspects, networks, and partnerships are functioning well, although hospitals lack specific implementers. Core functions like detection, data collection, reporting, dissemination, and feedback operate optimally, though analysis and result interpretation are suboptimal. Support functions involving training and resources also need improvement. System attributes such as simplicity, completeness, representativeness, acceptability, and usefulness are optimal, but timeliness remains a challenge. Recommendations include increasing human resource capacity, reporting accuracy, and coverage of preventive therapy.

Model of Multisector And Multidimensional Approaches: An Effort to Stunting Prevention Education in Kuantan Singingi Regency, Indonesia

This study aims to determine how the multisector and multidimensional approach model is in efforts to prevent stunting in Kuantan Singingi Regency. The method used qualitative descriptive approach. The selection of informants using a purposive sample of 5 people : 1 person from the Population Control, Family Planning, Women's Empowerment and Child Protection Service (DP2KBP3A), 1 person Health Service, 1 person Health Center, 1 person the Stunting Acceleration Team (TPPS) and 1 person from the head of Posyandu. Data collection used in-depth interviews, participatory observation and documentation studies. Data analysis used qualitative analysis. The results showed that the multisector approach model was integrated from the central level, provincial level, district/city, external to village. Collaborating with the Education, Health, social, economic, agricultural, plantation sectors, etc. involving the central and regional governments, Community Institutions, community leaders and the general public. Multidimensional targets are mothers, toddlers, teenagers, prospective brides, pregnant women, children, and the elderly. The results show that stunting rates are decrease. Supporting factors are government support and an integrated stunting prevention education model with various sectors. Obstacles factors are the quality of human resources, the social culture of the local community and the stigma of stunting as negative