How Local Culture Shapes Maternal Decision-Making During the First 1,000 Days of Life ?: A Phenomenological Study in West Aceh, Indonesia

Abstract

Introduction: Childhood stunting remains a major public health challenge in Indonesia. Although cultural factors influence maternal and child health behaviours, limited evidence explains how cultural norms, local traditions, and community beliefs interact to shape maternal decision-making during the first 1,000 days of life. This study explored how local culture shapes maternal decision-making related to childhood stunting during the first 1,000 days of life in West Aceh Regency, Indonesia Methods: A qualitative phenomenological study was conducted involving 14 purposively  selected participants, including mothers, village midwives, ma'blien (traditional birth  attendants), grandmothers, and Posyandu cadres. Data were collected through semi structured in-depth interviews and analyzed using thematic analysis. Trustworthiness was enhanced through triangulation, member checking, peer debriefing, and reflexive documentation. Results: Three interrelated themes emerged: cultural norms, local traditions, and community beliefs. Cultural norms influenced maternal diet and behaviour during pregnancy and the postpartum period. Local traditions, including the role of ma'blien, shaped maternal and newborn care. Community beliefs influenced breastfeeding, complementary feeding, healthcare-seeking, and childcare through intergenerational knowledge transmission. Together, these dimensions constituted an interconnected sociocultural system that shaped maternal decision-making. Conclusion: Maternal decision-making related to childhood stunting is embedded within an interconnected sociocultural system rather than isolated cultural practices. Effective stunting prevention strategies should integrate culturally sensitive interventions while engaging influential community members. These findings provide a conceptual framework for culturally responsive maternal and child health programmes.