Pembiayaan Program Gizi di Indonesia menghadapi tantangan akibat keterbatasan ruang fiskal domestik di tengah meningkatnya kebutuhan pendanaan untuk mendukung transformasi sistem kesehatan dan percepatan penurunan stunting. Penelitian ini bertujuan menganalisis struktur pembiayaan Program Gizi pada Direktorat Jenderal Kesehatan Primer dan Komunitas Kementerian Kesehatan tahun 2023-2025 berdasarkan kerangka System of Health Accounts (SHA) 2011, serta menganalisis kontribusi dan peran hibah luar negeri dalam pembiayaan program tersebut. Penelitian menggunakan pendekatan kualitatif dengan desain studi kasus. Data diperoleh melalui telaah dokumen perencanaan, penganggaran, realisasi anggaran, dokumen hibah, dan laporan kinerja, serta wawancara mendalam dengan sembilan informan. Analisis dilakukan menggunakan klasifikasi SHA 2011 pada dimensi sumber pembiayaan (financing schemes), pengelola pembiayaan (financing agents), penyedia layanan (health care providers), dan fungsi pelayanan (health care functions), yang dipadukan dengan analisis tematik. Hasil penelitian menunjukkan bahwa total realisasi pembiayaan Program Gizi selama tahun 2023-2025 mencapai Rp1.431,81 miliar, terdiri atas APBN Rupiah Murni sebesar 80,05% dan hibah luar negeri sebesar 19,95%. Meningkatnya proporsi hibah dari 5,22% pada tahun 2023 menjadi 66,53% pada tahun 2025 terutama dipengaruhi oleh penurunan pembiayaan APBN, bukan peningkatan nilai hibah. Hibah luar negeri berperan sebagai pembiayaan komplementer melalui dukungan terhadap kegiatan prioritas, penguatan kapasitas, penguatan sistem kesehatan, serta inovasi program. Penelitian juga menunjukkan bahwa perbedaan mekanisme hibah terencana dan hibah langsung berimplikasi pada kepastian pembiayaan serta pencatatan dan pelaporan hibah. Penelitian menyimpulkan bahwa hibah luar negeri melengkapi, bukan menggantikan, pembiayaan domestik. Dalam kondisi ruang fiskal yang semakin terbatas, diperlukan penguatan perencanaan, penyempurnaan pencatatan hibah, pemetaan fungsi yang memperoleh dukungan hibah secara signifikan, serta penyusunan strategi keberlanjutan program.

Nutrition program financing in Indonesia faces increasinag challenges due to constrained domestic fiscal space amid growing funding needs to support health system transformation and accelerate stunting reduction. This study aimed to analyze the financing structure of the Nutrition Program at the Directorate General of Primary and Community Health, Ministry of Health, during 2023-2025 using the System of Health Accounts (SHA) 2011 framework, and to examine the contribution and role of external grants in financing the program. This study employed a qualitative case study design. Data were collected through a review of planning documents, budget allocations, expenditure reports, grant documents, and performance reports, complemented by in-depth interviews with nine key informants. The analysis applied the SHA 2011 framework across four dimensions: financing schemes (FS), financing agents (FA), health care providers (HP), and health care functions (HC), followed by thematic analysis and data triangulation. The findings showed that total Nutrition Program financing reached IDR 1.43 trillion during 2023–2025, consisting of 80.05% domestic government funding and 19.95% external grants. Although the share of external grants increased from 5.22% in 2023 to 66.53% in 2025, this trend primarily reflected a substantial decline in domestic funding rather than an expansion of grant financing. External grants complemented domestic financing by supporting priority activities, strengthening institutional capacity and health systems, and introducing technical innovations. The study also found that differences between planned grants and direct grants affected funding certainty as well as grant recording and reporting. The study concludes that external grants complement rather than substitute domestic financing. Under increasingly constrained fiscal conditions, strengthening planning capacity, improving grant recording and disclosure, identifying program functions receiving significant grant support, and developing sustainability strategies are essential to support long-term nutrition program financing.