Market-Oriented Digital Health Co-creation Framework for Stunting Prevention in Developing Countries: Evidence from Indonesia

Stunting is a complex public health challenge that requires coordinated action across multiple stakeholders, particularly as health services become increasingly digital. Existing digital health and sustainable business model approaches often separately address service delivery, stakeholder participation, sustainability, and governance. This study develops a market-oriented digital health co-creation framework that integrates these dimensions by combining Soft Systems Methodology (SSM) with the Triple Bottom Line Co-creation Canvas, using digital stunting management in Indonesia as the empirical setting. SSM was applied to structure stakeholders’ interactions, institutional roles, operational constraints, and transformation processes. The outputs were then translated into practical elements of value creation, value delivery, collaboration, ecosystem support, governance, and sustainability. The findings identify four main user groups as community health posts, primary healthcare centers, public hospitals, and local health offices. The framework also maps stakeholder roles, collaborative activities, shared resources, co-creation mechanisms, and digital governance requirements across the stunting management ecosystem. This study further clarifies how coordination and shared digital resources can support integrated and sustainable public-health service delivery across organizational boundaries. The stakeholder-based assessment provided preliminary support for the practical relevance of the framework, while comparison with WHO guidance indicated conceptual alignment with internationally recognized digital health functions and implementation considerations. The feasibility and effectiveness of implementation require further empirical testing. This study contributes a structured approach for linking systems thinking, sustainability, multi-stakeholder collaboration, and digital governance in public health. The framework offers an analytically transferable structure that requires contextual adaptation and further empirical testing in other low- and middle-income settings. Indonesia serves as the demonstration context.

Co-creation framework; Digital health; Soft systems methodology; Stunting prevention; Triple bottom line

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