Exclusive breastfeeding remains a global public health priority, yet breastfeeding support gaps persist during the early postpartum period. Globally, only 48% of infants under six months were exclusively breastfed in 2023, indicating that more than half did not meet the recommended exclusive breastfeeding practice. In Indonesia, 68.6% of infants aged 0–5 months were exclusively breastfed in 2023, while 55.5% received exclusive breastfeeding for six months, indicating a continuing gap in sustained exclusive breastfeeding. Early postpartum challenges, including concerns about insufficient breast milk and low maternal confidence, may further affect breastfeeding continuation. This study examined the effectiveness of online peer support on breastfeeding self-efficacy and breast milk adequacy among postpartum mothers. A quasi-experimental pretest–posttest control group design was conducted involving 40 postpartum mothers recruited from independent midwife practices in Lampung, Indonesia. Participants were allocated to an intervention group receiving structured online peer support through a messaging platform for four weeks or a control group receiving standard postpartum care. Breastfeeding self-efficacy was assessed using a validated breastfeeding self-efficacy scale, while breast milk adequacy was assessed using predefined clinical indicators of adequate breastfeeding rather than expressed milk volume alone. Statistical analyses included independent and paired t-tests, Pearson correlation, multiple linear regression, path analysis, and power analysis. The intervention group showed significantly greater improvement in breastfeeding self-efficacy and breast milk adequacy than the control group. Breastfeeding self-efficacy and breast milk adequacy were strongly positively correlated (r = 0.72; 95% CI: 0.53–0.84). Regression analysis showed that online peer support significantly predicted breastfeeding outcomes. These findings suggest that structured online peer support may strengthen breastfeeding self-efficacy and support adequate breastfeeding among postpartum mothers.
Reproductive rights are a fundamental aspect of human rights, yet in Indonesia this issue is often narrowly perceived as women’s issues. Among university students, including future health professionals, limited literacy and persistent stigma restrict critical engagement with reproductive health and equity. This study explores how digital storytelling can serve as a transformative pedagogical tool to foster critical awareness and collective responsibility for reproductive rights. This qualitative case study involved 25 students from five departments in the Faculty of Medicine and Health Sciences, Universitas Jambi. Data were collected through focus group discussions, participant observation, and documentation of digital storytelling. Thematic content analysis identified key dimensions of students’ interpretations and reflections. Five interrelated themes emerged: (1) bodily autonomy and courage to speak against stigma; (2) justice and partner involvement in reproductive health access; (3) universal access and solidarity across regions; (4) cultural barriers of stigma, silence, and discrimination; and (5) hope for equity through youth agency, educational innovation, and father involvement. Students recognized reproductive rights as a collective responsibility requiring individual courage, relational support, systemic equity, and intergenerational engagement. Digital storytelling facilitated critical reflection and the production of inclusive narratives that challenged gender bias and cultural taboos. Digital storytelling is an effective educational approach to foster critical awareness and advance reproductive health equity among future health professionals. This method offers an alternative pathway to instill a more humanistic and inclusive understanding of reproductive health issues.
In the 2018 national survey, almost half of pregnant women in Indonesia were anemic (48.9%), and the national program is shifting from iron-folic acid (IFA) to multiple micronutrient supplements (MMS). This study aims to synthesize evidence on determinants of MMS adherence among pregnant women through the Health Belief Model (HBM), the Theory of Planned Behavior (TPB), and the PRECEDE-PROCEED framework, and to describe how adherence levels are associated with maternal and neonatal outcomes. This study used a systematic review following PRISMA 2020 with narrative thematic synthesis. Nine databases and two organizational portals yielded 487 records; 27 were included, namely 16 evidence-contributing studies (one individual participant data [IPD] meta-analysis of 15 randomized trials with 61,204 women, two other systematic reviews/meta-analyses, one literature review, and 12 primary studies) and 11 supporting documents. Study quality was appraised with JBI, CASP, and AMSTAR-2 tools. In the IPD meta-analysis, MMS increased birth weight relative to IFA by 56 g (95% CI: 45–67) among women with ≥90% adherence, but by only 9 g (95% CI: −17 to 35) at <60% adherence. In observational analyses among MMS recipients, adherence <75% (versus 75–90%) was associated with a higher risk of maternal anemia (RR 1.26; 95% CI: 1.11–1.43) and stillbirth (RR 1.43; 95% CI: 1.12–1.83). Perceived benefits and perceived barriers were the most consistently reported psychological determinants, followed by self-efficacy and perceived behavioral control. Enabling factors (tablet availability, distance, cost, employment) and reinforcing factors (husband and family, cadres, midwives) shaped whether intention became consumption. Higher adherence is associated with better maternal and neonatal outcomes, and individual beliefs, perceived control, and the service and social environment jointly shape adherence.
Pendahuluan: Pandemi COVID-19 menciptakan permintaan layanan kesehatan masyarakat yang belum pernah terjadi sebelumnya, dan universitas memobilisasi mahasiswa sukarelawan untuk membantu memenuhi kebutuhan tersebut; namun, hanya sedikit penelitian yang mengevaluasi proses ini. Penelitian ini bertujuan untuk mengevaluasi kegiatan mahasiswa sukarelawan dalam Proyek Kemanusiaan "Merdeka Belajar Kampus Merdeka" (MBKM) yang diselenggarakan oleh Universitas Muhammadiyah Surakarta (UMS) selama pandemi COVID-19. Metode: Penelitian dengan metode campuran (mixed-method) ini mengkaji lima kegiatan kemanusiaan terkait COVID-19 yang melibatkan mahasiswa sukarelawan UMS dalam konteks pelaksanaan MBKM. Kami mengukur tingkat kepatuhan pelaksanaan menggunakan rubrik penilaian terstruktur dan mendeskripsikan karakteristik responden. Persepsi mengenai kontribusi layanan kesehatan dan hambatan yang dihadapi dianalisis secara tematik (metode Braun–Clarke) berdasarkan jawaban survei daring terbuka dari sukarelawan yang dipilih secara purposif (n=24), dengan pelaporan yang disesuaikan dengan standar SRQR. Hasil: Lima jenis kegiatan menunjukkan kontribusi layanan yang nyata: bantuan bagi vaksinator dan dukungan registrasi/TI, pengawasan penggunaan masker dan jaga jarak di lokasi pemungutan suara, serta dukungan non-klinis di rumah sakit yang memungkinkan pengalihan tugas (task-shifting). Manfaat yang dirasakan terutama terkait dengan kelancaran alur pasien dan efisiensi operasional. Namun, tingkat kepatuhan pelaksanaan MBKM tergolong rendah hingga sedang (22,2–50%) dan terkendala oleh SOP yang tidak jelas, pengawasan yang terbatas, serta ketidakjelasan peran. Di sisi lain, mahasiswa mengalami peningkatan keterampilan lunak (soft skills) selama kegiatan berlangsung. Kesimpulan: Mahasiswa sukarelawan memberikan nilai tambah bagi kesehatan masyarakat dengan memperkuat operasional vaksinasi, mendorong kepatuhan terhadap protokol kesehatan, dan memungkinkan pengalihan tugas dalam alur kerja rumah sakit; SOP yang jelas, serta pengawasan dan pemantauan yang memadai, diperlukan untuk meningkatkan dampak kesehatan dan kompetensi sukarelawan. Background: The COVID-19 pandemic created an unprecedented demand for public health services, and universities mobilized student volunteers to help meet these needs, yet few studies have evaluated this process. This study aims to evaluate the activities of student volunteers in the Humanitarian Project "Merdeka Belajar Kampus Merdeka" organized by the University of Muhammadiyah Surakarta (UMS) during the Covid-19 Pandemic. Method: This mixed-methods study assessed five COVID-19 humanitarian activities involving UMS student volunteers within an MBKM implementation context. We quantified implementation adherence using a structured scoring rubric and described respondent characteristics. Perceived health-service contributions and barriers were examined through thematic analysis (Braun–Clarke) of open-ended online survey responses from purposively sampled volunteers (n=24), with reporting aligned to SRQR. Results: Five activity types showed tangible service contributions: assistance with vaccinators and registration/IT, supervision of masking and distancing at polling sites, and non-clinical hospital support enabling task-shifting. Perceived benefits centred on smoother patient flow and operational efficiency. However, MBKM implementation adherence was modest (22.2–50%) and constrained by unclear SOPs, limited supervision, and role ambiguity. However, students experienced an increase in soft skills during the event. Conclustion: Student volunteers added public-health value by bolstering vaccination operations, promoting protocol compliance, and enabling task-shifting in hospital workflows.; clear SOPs, supervision, and monitoring are needed to enhance health impact and volunteer competency.
Pendahuluan: Malnutrisi pada perempuan usia produktif, khususnya pada calon ibu yang sedang mempersiapkan kehamilan, merupakan penyebab utama morbiditas, mortalitas, dan luaran kelahiran yang buruk. Tujuan penelitian ini adalah untuk memahami pengaruh aspek prakonsepsi pada perempuan usia produktif dalam mendukung kebijakan intervensi gizi balita. Metode: Penelitian ini menggunakan metode kuantitatif dengan sampel sebanyak 95 orang yang dipilih melalui teknik purposive sampling. Analisis data dilakukan menggunakan uji regresi linear. Hasil: Hasil penelitian menunjukkan adanya pengaruh yang signifikan dan simultan dari variabel skrining kesehatan dan gizi, akses terhadap mikronutrien esensial, perawatan khusus bagi perempuan berisiko, serta konseling pola makan dan gaya hidup; nilai F-hitung tercatat sebesar 3,445 dengan nilai signifikansi 0,011. Kesimpulan: Diperlukan peningkatan kesadaran bagi perempuan untuk merencanakan kehamilan sejak masa remaja dan usia produktif, bukan hanya setelah menikah. Penelitian ini dapat menjadi landasan bagi penelitian selanjutnya yang berfokus pada pengembangan dan pengujian intervensi berbasis kebijakan. Penelitian semacam itu diharapkan dapat memberikan wawasan mengenai status gizi prakonsepsi, pengetahuan, sikap, perilaku, dan akses terhadap layanan kesehatan—serta faktor-faktor yang memengaruhi kesiapan perempuan usia reproduksi dalam mempersiapkan kehamilan yang sehat—sehingga memperkuat kebijakan untuk mempercepat penurunan stunting dan masalah gizi melalui pendekatan siklus hidup, sekaligus mendukung penguatan layanan kesehatan primer yang terintegrasi dan berkelanjutan. Introduction: Malnutrition in women of productive age, especially in mothers preparing for pregnancy, is a major cause of morbidity, mortality, and adverse birth outcomes. The purpose of this study was to understand the influence of preconception in women of productive age in supporting toddler nutrition intervention policies. Method: The research method used was a quantitative study with a sample of 95 people using purposive sampling techniques. The analysis test was carried out using linear regression analysis. Results: The results showed a significant and simultaneous influence on the variables of health and nutrition screening, access to essential micronutrients, special care for at-risk women, and diet and lifestyle counseling, where the Fcount was 3.445 with a significance value of 0.011. Conclusion: It is necessary to increase awareness for women to plan pregnancy from adolescence and productive age, not only when they are married. This study can serve as a foundation for future research focused on developing and testing policy-based interventions. Such research is expected to provide insights into the preconception nutritional status, knowledge, attitudes, behaviors, and access to healthcare services—as well as the factors influencing the readiness of women of reproductive age to prepare for a healthy pregnancy—thereby strengthening policies to accelerate the reduction of stunting and nutritional issues through a life-cycle approach, while also supporting the reinforcement of integrated and sustainable primary healthcare services.
