Stunting as social practice: monitoring, evaluation, and accountability bridging the coordination, funding, capacity, and performance of governance programs

Introduction This study conceptualizes stunting-program governance, rather than stunting itself, as an organizational social practice enacted through the routinized activities of public actors responsible for planning, coordination, financing, monitoring, evaluation, and accountability. The study examines perceived organizational implementation performance rather than child-level outcomes, household nutritional practices, or broader sociocultural behavior. Methods Cross-sectional survey data were collected from 260 organizational units across all 19 districts and cities in West Sumatra, Indonesia. A partial least squares structural equation model comprising reflective and formative constructs was estimated. Results Coordination was the strongest upstream correlate of Monitoring and Evaluation (M&E) and Accountability, while Funding and Organizational Capacity were also positively associated with both mechanisms. M&E and Accountability were positively associated with Program Performance and carried significant indirect associations from the three upstream conditions. Policy Synchronization was directly and positively associated with Program Performance; however, its interactions with M&E and Accountability were not statistically significant. Discussion The findings indicate that resources and formal governance arrangements are associated with stronger implementation performance when translated into routine information use, answerability, and corrective follow-up. Because the evidence is cross-sectional and perception-based, the relationships should be interpreted as organizational-level associations rather than causal effects or evidence of reduced child-level stunting prevalence.