Health Cadre Mentoring Model in Stunting Prevention Programs: A Systematic Literature Review

Stunting remains a major public health problem in low- and middle-income countries, including Indonesia, with long-term consequences for physical growth, cognitive development, and adult productivity. Health cadres (community health workers/CHWs) play a crucial role in community-based stunting prevention; however, evidence regarding effective mentoring models remains fragmented.

This review aims to synthesize evidence on health cadre mentoring models in stunting prevention, with particular attention to behavioral change components and their theoretical underpinnings.

A systematic literature review was conducted following PRISMA 2020 guidelines. Articles published between 2014 and 2025 were retrieved from five databases: PubMed, ScienceDirect, Google Scholar, SpringerLink, and Scopus. A total of 1475 records were identified, with 1310 articles remaining after duplicate removal. After title and abstract screening, 99 full-text articles were assessed for eligibility, and 52 studies were included. Methodological quality was appraised using the Joanna Briggs Institute (JBI) tools. Data were analyzed using a thematic (narrative) synthesis and mapped to behavior change theories.

The 52 included studies describe diverse mentoring models, including structured training, interpersonal communication, participatory approaches, growth monitoring, quality improvement, and digital platforms. These interventions were associated with improvements in cadre knowledge, skills, and engagement, and with changes in family health behaviors. Evidence regarding impacts on child growth and stunting outcomes was mixed and context-dependent. Key enabling factors included continuous supervision, cultural adaptation, and multisectoral collaboration, while challenges related to sustainability and resource constraints were frequently reported.

Health cadre mentoring models show potential to strengthen cadre capacity and support behavior change for stunting prevention. However, the effectiveness of these interventions varies across contexts and implementation characteristics, and evidence on long-term impacts on child nutritional status remains limited. Further research is needed to develop sustainable, context-specific, and system-integrated mentoring approaches.