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Ending preventable maternal mortality (EPMM): By 2030, every country should reduce its maternal mortality ratio (MMR) by at least two-thirds from the 2010 baseline. In the era of the SDGs, an acceleration of current progress is required to achieve SGD target 3.1, working towards a vision of ending all preventable maternal mortality. In Central Java, one of the most effective efforts to reduce maternal mortality is increasing the number of human resources, who can assist pregnant mothers and supervise their period of pregnancy. The maternal mortality rate (MMR) in Banjarnegara Regency in 2021 is 287.05 per 100,000 live births, this indicates the top 10 in Central Java Province over the past 5 years. Health cadres, who are non-professional volunteer health supporters for pregnant women appointed by regional public health centers (PHCs), are expected to be the key human resources who contribute to reducing MMR in Indonesia and Banjarnegara Regency as well. However, based on an initial study by researchers conducting qualitative research with focus group discussions (FGDs) and in-depth interviews in April-July 2023, researchers found that health cadres had incorrect and unscientific knowledge. Therefore, improving the knowledge and skills of the health cadres through education programs could be expected to further improve the health outcomes of pregnant women, consequently contributing to reducing the MMR.
The purpose of this study is to improve health cadres' competency level in monitoring the risks of pregnant women. This monitoring activities for pregnant women by cadres is an effort to prevent maternal mortality, because if there are complications they can be treated as early as possible.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| intervention | Experimental | The intervention group will receive the competency-based education program for 1 month at each PHC, after baseline data collection. The education program will be conducted weekly. This education session will be conducted for 4 hours per session, with 20 health cadres in a group per PHC .The competency level is measured by the researcher developing a competency questionnaire which consists of a knowledge test, skill, and attitude checklist score at the 2nd post-assessment (2 months after being given the education program). |
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| control | Experimental | Health cadres in the control group have received the initial orientation from the PHCs. In this study, they take only the competency questionnaires including skill check will be collected following the data collection timeline. After completing the research, the control group will receive the education program material used for the intervention group if they require. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| The education program | Other | The intervention group will receive the competency-based education program for 1 month at each PHC, after baseline data collection. The education program will be conducted weekly. This education session will be conducted for 4 hours per session, with 20 health cadres in a group per PHC. The competency level is measured by the researcher developing a competency questionnaire which consists of a knowledge test, skill, and attitude checklist score at the 2nd post-assessment (2 months after being given the education program). |
| Measure | Description | Time Frame |
|---|---|---|
| The competency level of health cadres | Competency is operationally defined as the ability to integrate components of knowledge, skills, values, and attitudes into practice, and build a trusting relationship with and guide a pregnant woman and her surroundings for them to take evidence-based appropriate behavior. The competency level is measured by the researcher developing a competency questionnaire which consists of a knowledge test, skill, and attitude checklist score | baseline (T0), after 1 month from the baseline (T1) and after 3 months from the baseline (T2) |
| Measure | Description | Time Frame |
|---|---|---|
| The knowledge test scores of health cadres | researcher developing knowledge questionnaire | baseline (T0), after 1 month from the baseline (T1) and after 3 months from the baseline (T2) |
| The health assessment skills checklist score of health cadres |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Dewie Sulistyorini | Hiroshima University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Politeknik Banjarnegara | Banjarnegara | Cental Java | 53482 | Indonesia |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41469067 | Derived | Sulistyorini D, Huq KATME, Babaita AO, Aivey SA, Huiying G, Kazawa K, Fukushima Y, Kako M, Moriyama M. Effectiveness of education programme to increase competency of health cadres in Indonesia: a cluster non-randomised controlled trial. BMJ Open. 2025 Dec 29;15(12):e095428. doi: 10.1136/bmjopen-2024-095428. |
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Share according to request to the PI and researcher
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April 2025 - April 2026
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| ID | Term |
|---|---|
| D063130 | Maternal Death |
| ID | Term |
|---|---|
| D063129 | Parental Death |
| D003643 | Death |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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Intervention group control group
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| the initial orientation from the PHCs | Other | the initial orientation from the PHCs |
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researcher developing health assessment skills checklist
| after 1 month from the baseline (T1) and after 3 months from the baseline (T2) |
| The communication skills checklist score of health cadres | researcher developing communication skills checklist | after 1 month from the baseline (T1) and after 3 months from the baseline (T2) |
| The confidence score of health cadres | researcher developing communication skills checklist | after 1 month from the baseline (T1) and after 3 months from the baseline (T2) |
| The satisfaction score of health cadres | researcher developing satisfaction skills checklist | after 1 month from the baseline (T1) |