0
Abstract Views
0
PDF Download
Research Articles

Effect of cadre-based empowerment on antenatal care knowledge, attitudes, and antenatal care visit among pregnant women

, , ,
Pages 21-33

Abstract

Despite ongoing efforts to reduce maternal mortality in Indonesia, antenatal care (ANC) coverage—particularly completion of ?4 visits (K4)—remains suboptimal in regions such as Bengkulu City. The involvement of community health cadres is recognized as a key strategy to improve maternal health outcomes; however, limited research has directly examined the effect of structured cadre-based empowerment on ANC knowledge, attitudes, and service utilization. This study aimed to examine the effect of ANC cadre empowerment on ANC knowledge, attitudes, and the frequency of ANC visits among pregnant women in Bengkulu City, Indonesia.This quasi-experimental study employed a pre-test and post-test control group design involving 40 pregnant women in Bengkulu City, Indonesia divided equally into intervention and control groups. The intervention group received structured cadre-based empowerment involving trained health cadres, while the control group received standard counseling. Data were analyzed using Wilcoxon and Mann-Whitney tests to assess differences in knowledge, attitudes, and ANC visit frequency. After the intervention, the knowledge scores in the intervention group significantly increased from 53.80 to 73.90 (p=0.020), while the control group showed no significant change. Attitude scores in the intervention group also increased significantly from 35.35 to 38.25 (p=0.014), unlike the control group (p=0.320). Regarding ANC visits, the intervention group had a higher mean number of visits (mean=4) compared to the control group (mean=3), with a statistically significant difference (p=0.001). Cadre-based empowerment through structured training significantly improved pregnant women’s knowledge, attitudes, and ANC service utilization. This suggests the importance of integrating cadre empowerment models into routine maternal health programs to support improved ANC compliance.

There is no Figure or data content available for this article

References

  • Elfiyani NK, Pratomo H, Martha E, Saraswati PS. Dampak dan Strategi Layanan Kesehatan Ibu Hamil Selama Pandemi COVID-19. J Kesehat Reproduksi [Internet]. 2022 Oct 3 [cited 2025 Sept 20];9(2). Available from: https://jurnal.ugm.ac.id/jkr/article/view/66345
  • World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience [Internet]. Geneva: World Health Organization; 2016 [cited 2025 Sept 20]. 152 p. Available from: https://iris.who.int/handle/10665/250796
  • Ningsih F, Putri EM, Marlita M, Mantovani MR, Iman TFAH. Zoominar: Peningkatan Pengetahuan Ibu Hamil tentang Pentingnya Kunjungan Antenatal Care: Zoominar: Increasing Knowledge of Pregnant Women about the Importance of Antenatal Care Visits. PengabdianMu J Ilm Pengabdi Kpd Masy. 2022 Mar 31;7(2):314–8.
  • SDG Target 3.1 Maternal mortality [Internet]. [cited 2024 Sept 20]. Available from: https://www.who.int/data/gho/data/themes/topics/sdg-target-3-1-maternal-mortality
  • Syairaji M, Nurdiati DS, Wiratama BS, Prüst ZD, Bloemenkamp KWM, Verschueren KJC. Trends and causes of maternal mortality in Indonesia: a systematic review. BMC Pregnancy Childbirth. 2024 July 30;24(1):515.
  • Neonatal mortality [Internet]. UNICEF DATA. [cited 2024 Sept 20]. Available from: https://data.unicef.org/topic/child-survival/neonatal-mortality/
  • Kolifah K. Pengaruh Pelaksanaan Pendampingan Kader Terhadap Kunjungan Antenatal Care (ANC) Ibu Hamil Resiko Tinggi Di Megaluh Jombang. J Health Sci [Internet]. 2017 Aug 18 [cited 2025 Sept 20];10(1). Available from: https://journal2.unusa.ac.id/index.php/JHS/article/view/143
  • Badan Penelitian dan Pengembangan Kesehatan. Laporan Nasional RISKESDAS 2018. Jakarta: Lembaga Penerbit Badan Penelitian dan Pengembangan Kesehatan; 2019.
  • Idris H, Sari I. Factors associated with the completion of antenatal care in Indonesia: A cross-sectional data analysis based on the 2018 Indonesian Basic Health Survey. Belitung Nurs J. 2023;9(1):79–85.
  • Rahayu DT, Askabulaikhah A. Private Community Assistance in Antenatal Care at High Risk Pregnant Women in Public Health Center of Jelakombo Jombang: Pendampingan Kader dengan Kunjungan Antenatal Care (Anc) Ibu Hamil Risiko Tinggi Di Puskesmas Jelakombo Jombang. J Kebidanan Midwiferia. 2020 Apr 5;6(1):14–20.
  • Sakinah V, Fibriana AI. Upaya Peningkatan Pengetahuan, Sikap Dan Kunjungan Antenatal Care (ANC) Ibu Hamil Melalui Pemberdayaan Kader ANC. Unnes J Public Health. 2015;4(1):54–60.
  • Widiasih R, Sunjaya DK, Rahayuwati L, Rusyidi B, Ermiati null, Sari CWM, et al. Evaluating the knowledge, roles, and skills of health cadres in stunting prevention: A mixed-method study in Indonesia. Belitung Nurs J. 2025;11(3):330–9.
  • Susanti H, Brooks H, Yulia I, Windarwati HD, Yuliastuti E, Hasniah H, et al. An exploration of the Indonesian lay mental health workers’ (cadres) experiences in performing their roles in community mental health services: a qualitative study. Int J Ment Health Syst. 2024 Jan 17;18:3.
  • Fauziah AB, Moedjiono AI, Masni, Seweng A, Sukri, Hidayanty H. The effect of health education in improving the knowledge and attitudes of integrated service post cadres about early detection of high-risk pregnancies in the working area of the Mamajang health center, Makassar city, Indonesia. J Public Health Afr. 2023 Oct 1;14(10):2774.
  • Tumbelaka P, Limato R, Nasir S, Syafruddin D, Ormel H, Ahmed R. Analysis of Indonesia’s community health volunteers (kader) as maternal health promoters in the community integrated health service (Posyandu) following health promotion training. Int J Community Med Public Health. 2018 Feb 24;5(3):856–63.
  • Paratmanitya Y, Helmyati S, Nurdiati DS, Lewis EC, Gittelsohn J, Hadi H. The effect of a maternal mentoring program on the timing of first antenatal care visit among pregnant women in Bantul, Indonesia: Results of a cluster randomized trial. Health Promot Perspect. 2021 Aug 18;11(3):307–15.
  • Nurmilawati N, Nugroho A, Audhah NA, Febriana SKT, Noor MS. Strengthening Maternal and Child Health Services: Evaluating the KIA Book Training Program for Posyandu Cadres. Care J Ilm Ilmu Kesehat. 2024 Nov 22;12(3):424–35.
  • Laksono AD, Rukmini R, Wulandari RD. Regional disparities in antenatal care utilization in Indonesia. PloS One. 2020 Jan 1;15(2):e0224006.
  • Andriani H, Rachmadani SD, Natasha V, Saptari A. Continuum of care in maternal, newborn and child health in Indonesia: Evidence from the Indonesia Demographic and Health Survey. J Public Health Res. 2022 Oct 10;11(4):22799036221127619.
  • Wulandari RD, Laksono AD, Rohmah N. Urban-rural disparities of antenatal care in South East Asia: a case study in the Philippines and Indonesia. BMC Public Health. 2021 Dec;21(1):1221.
  • Evanjeli LA. Students’ Knowledge and Attitudes Towards Inclusion in College. J Cakrawala Pendidik. 2021 Feb 27;40(1):253–64.
  • Lee S, Kasibante S, Eminai A, Wani S, Opii DJ, Levine LD, et al. Effectiveness of a community health worker-led education intervention on knowledge, attitude, and antenatal care attendance among pregnant women in Eastern Uganda. J Health Popul Nutr. 2025 July 3;44(1):232.
  • Panday S, van Teijlingen E, Barnes A. Exploring the motivations of female community health volunteers in primary healthcare provision in rural Nepal: A qualitative study. PLOS Glob Public Health. 2024 Aug 1;4(8):e0003428.
  • Ayuni IQ, Sjaat AC. Hubungan Peran Kader Terhadap Kunjungan Antenatal Care Pada Ibu Hamil Resiko Tinggi. J-KESMAS J Kesehat Masy. 2023 Oct 28;9(1):110–8.
  • Scharff D, Enard KR, Tao D, Strand G, Yakubu R, Cope V. Community Health Worker Impact on Knowledge, Antenatal Care, And Birth Outcomes: A Systematic Review. Matern Child Health J. 2022 Jan 1;26(1):79–101.
  • Albarracin D, Shavitt S. Attitudes and Attitude Change. Annu Rev Psychol. 2018 Jan 4;69(Volume 69, 2018):299–327.
  • Verplanken B, Orbell S. Attitudes, Habits, and Behavior Change. Annu Rev Psychol. 2022 Jan 4;73(Volume 73, 2022):327–52.
  • Fang L, Zhang Q, Zhou N, Chen J, Lou H. Influencing factors and mechanisms promoting proactive health behavior intention: an integration of the health belief model and the theory of planned behavior. Front Public Health. 2025 July 10;13:1629046.
  • Kassim AB, Newton SK, Dormechele W, Rahinatu BB, Yanbom CT, Yankson IK, et al. Effects of a community-level intervention on maternal health care utilization in a resource-poor setting of Northern Ghana. BMC Public Health. 2023 Aug 4;23(1):1491.
  • Wafula ST, Nalugya A, Kananura RM, Mugambe RK, Kyangwa M, Isunju JB, et al. Effect of community-level intervention on antenatal care attendance: a quasi-experimental study among postpartum women in Eastern Uganda. Glob Health Action. 15(1):2141312.
  • Gupta A, Khan S. Importance of Community Health Workers for Maternal Health Care Management. Public Health Rev. 2024 Feb 22;45:1606803.
There is no Supplemental content for this article.

How to Cite This

Yuniarti, Y., Yorita, E. ., Widiyanti, D., & Destariyani, E. (2024). Effect of cadre-based empowerment on antenatal care knowledge, attitudes, and antenatal care visit among pregnant women. Jurnal Kesehatan Ibu Dan Anak, 18(1), 21–33. https://doi.org/10.29238/kia.v18i1.2245

Article Metrics

Download Statistics

Downloads

Download data is not yet available.

Other Statistics

Verify authenticity via CrossMark

Copyright and Permissions

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Publishing your paper with Jurnal Kesehatan Ibu dan Anak means that the author or authors retain the copyright in the paper. Jurnal Kesehatan Ibu dan Anak granted an exclusive reuse license by the author(s), but the author(s) are able to put the paper onto a website, distribute it to colleagues, give it to students, use it in your thesis etc, even commercially. The author(s) can reuse the figures and tables and other information contained in their paper published by Jurnal Kesehatan Ibu dan Anak in future papers or work without having to ask anyone for permission, provided that the figures, tables or other information that is included in the new paper or work properly references the published paper as the source of the figures, tables or other information, and the new paper or work is not direct at the private monetary gain or commercial advantage.

Jurnal Kesehatan Ibu dan Anak provides immediate open access to its content on the principle that making research freely available to the public supports a greater global exchange of knowledge. This journal is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. This license lets others remix, transform, and build upon the material for any purpose, even commercially.

Jurnal Kesehatan Ibu dan Anak Open Access articles are distributed under this Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA). Articles can be read and shared for All purposes under the following conditions:

  • BY: You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
  • SA:  If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.

Data Availability