Empowering health cadres through childbirth companion team training to support early detection of maternal and neonatal risks
Pemberdayaan kader kesehatan melalui pelatihan tim pendamping persalinan untuk mendukung deteksi dini risiko maternal dan neonatal
DOI:
https://doi.org/10.53713/jcemty.v4i2.777Keywords:
early detection, health cadres, maternal complications, neonatal, trainingAbstract
Maternal and neonatal mortality remain major health problems requiring strengthened promotive and preventive efforts through community-based approaches. Health cadres play an important role in supporting early detection of pregnancy, childbirth, postpartum, and newborn complications through community assistance activities. This community service program aimed to improve the knowledge and skills of Childbirth Companion Team cadres in detecting maternal and neonatal complications and strengthening referral preparedness. The program was implemented using a community empowerment approach through participatory training methods consisting of health education, interactive discussions, simulations, and practical exercises. A total of 15 health cadres participated in this activity. Knowledge improvement was evaluated using pre-test and post-test instruments, while data analysis was performed using the Wilcoxon Signed Rank Test. The results showed an increase in the mean knowledge score from 62.4 before training to 84.7 after training, with a p-value <0.001. The skill evaluation indicated that most cadres were able to identify danger signs, complete maternal and child health records, perform rapid referral simulations, and provide health education to families. Structured cadre training can serve as an effective strategy to improve cadre capacity as community health partners in strengthening maternal and neonatal healthcare services.
References
Andriani, H., Rachmadani, S. D., Natasha, V., & Saptari, A. (2022). Continuum of care in maternal, newborn and child health in Indonesia: Evidence from the Indonesia Demographic and Health Survey. Journal of Public Health Research, 11(4), 22799036221127619.. https://doi.org/10.1177/22799036221127619
Angela, N. F., Purnamasari, W. M., & Suptiani, L. P. (2024). Knowing the signs, changing the outcome: Educational impact of the mother and child health handbook on high-risk mothers. Jurnal Kesehatan Ibu dan Anak, 18(1), 84–94.. https://doi.org/10.29238/kia.v18i1.2733
Ashaba, S., Tumuhimbise, M., Beebwa, E., Oriokot, F., Brenner, J. L., & Kabakyenga, J. (2022). Factors impacting sustainability of community health worker programming in rural Uganda: A qualitative study. African Health Sciences, 22(2), 668–677.. https://doi.org/10.4314/ahs.v22i2.76
Aurelia, S., Andini, D. N., Soloan, G., Waladhiyaputri, V., & Friska, D. (2023). Engaging mothers and community health workers: An online maternal and children’s health education in Kampung Lio, Indonesia. ASEAN Journal of Community Engagement, 7(1), 80–95.. https://doi.org/10.7454/ajce.v7i1.1191
Boerma, T., Campbell, O. M. R., Amouzou, A., Blumenberg, C., Blencowe, H., Moran, A., Lawn, J. E., & Ikilezi, G. (2023). Maternal mortality, stillbirths, and neonatal mortality: A transition model based on analyses of 151 countries. The Lancet Global Health, 11(7), e1024–e1031.. https://doi.org/10.1016/S2214-109X(23)00195-X
Crawford, K., Febres Cordero, S., Brasher, S., Kaligotla, L., Phan, Q., Steiger, L., Chicas, R., Spaulding, A., & Swan, B. A. (2025). Evaluating the impact of a community health worker training program. Journal of Health, Population and Nutrition, 44, Article 256.. https://doi.org/10.1186/s41043-025-01011-0
Görücü, S., Türk, G., & Karaçam, Z. (2024). The effect of simulation-based learning on nursing students' clinical decision-making skills: Systematic review and meta-analysis. Nurse Education Today, 140, 106270.. https://doi.org/10.1016/j.nedt.2024.106270
Guérin Benz, J., Stancanelli, G., Zambruni, M., Ramasy Paulin, M., Hantavololona, H., Andrianarisoa, V. R., Rakotondrazanany, H., Martinez de Tejada Weber, B., Mangeret, F. R., Reich, M. R., Guyer, A., & Benski, C. (2024). Simulation training on respectful emergency obstetric and neonatal care in north-western Madagascar: A mixed-methods evaluation of an innovative training program. Advances in Simulation, 9, Article 18.. https://doi.org/10.1186/s41077-024-00289-0
Gupta, A., & Khan, S. (2024). Importance of community health workers for maternal health care management. Frontiers in Public Health, 12, 1606803.. https://doi.org/10.3389/phrs.2024.1606803
Jannah, R., Arisanti, D., Arifin, S., Sopiana, Y., Suryadi, B., Yunani, A., & Erlyani, N. (2025). Age, education level, and length of service: A triad of factors influencing the performance of community health workers in a community-based stunting prevention program in Barito Kuala Regency. Journal of Health and Nutrition Research, 5(2). https://doi.org/10.56303/jhnresearch.v5i2.858
Jittimanee, S., & Suwankij, J. (2024). Competency assessment of health volunteers in recording and reporting community health status in Thailand. Journal of Rural Community Nursing Practice, 1(2). https://doi.org/10.58545/jrcnp.v1i2.208
Joubert, A., & Reid, M. (2023). Knowledge, skills, and training of community health workers to contribute to interprofessional education: A scoping review. Journal of Interprofessional Care, 38(2), 308–318.. https://doi.org/10.1080/13561820.2023.2176472
Kalter, H. D., Setel, P. W., Deviany, P. E., Nugraheni, S. A., Sumarmi, S., Weaver, E. H., Latief, K., Rianty, T., Nandiaty, F., Anggondowati, T., & Achadi, E. L. (2023). Modified Pathway to Survival highlights importance of rapid access to quality institutional delivery care to decrease neonatal mortality in Serang and Jember districts, Java, Indonesia. Journal of Global Health, 13, 04020.. https://doi.org/10.7189/jogh.13.04020
Lee, S., Kasibante, S., Eminai, A., Wani, S., Opii, D. J., Levine, L. D., & Kanyike, A. M. (2025). Effectiveness of a community health worker-led education intervention on knowledge, attitude, and antenatal care attendance among pregnant women in Eastern Uganda. Journal of Health, Population and Nutrition, 44, Article 232.. https://doi.org/10.1186/s41043-025-00876-5
Lokuge, K., Wemin, F., Joshy, G., & Di Mola, G. (2024). Evaluation of an obstetric and neonatal care upskilling program for community health workers in Papua New Guinea. BMC Pregnancy and Childbirth, 24, Article 357.. https://doi.org/10.1186/s12884-024-06531-x
Malatji, H., Griffiths, F., & Goudge, J. (2022). Supportive supervision from a roving nurse mentor in a community health worker programme: A process evaluation in South Africa. BMC Health Services Research, 22, Article 323.. https://doi.org/10.1186/s12913-022-07635-w
Mamta, Tara, T., & Singh, G. (2024). Effectiveness of awareness training on birth preparedness and complication readiness among community health workers of New Delhi, India. Indian Journal of Community Medicine, 49(5), 713–718.. https://doi.org/10.4103/ijcm.ijcm_97_23
Miranda, J., Miller, S., & colleagues. (2024). Global health systems strengthening: FIGO's strategic view on reducing maternal and newborn mortality worldwide. International Journal of Gynecology & Obstetrics, 165(3), 849–853.. https://doi.org/10.1002/ijgo.15553
Nida, S., Tyas, A. S. A., & Putri, N. E. (2024). A systematic review of the types, workload, and supervision mechanism of community health workers: Lessons learned for Indonesia. BMC Primary Care, 25, 82.. https://doi.org/10.1186/s12875-024-02319-2
Olaniran, A., Banke-Thomas, A., Bar-Zeev, S., & Madaj, B. (2022). Not knowing enough, not having enough, not feeling wanted: Challenges of community health workers providing maternal and newborn services in Africa and Asia. PLOS ONE, 17(9), e0274110.. https://doi.org/10.1371/journal.pone.0274110
Randell, M., Li, M., Rachmi, C. N., Jusril, H., Abimbola, S., Tama, A. Y., Aswitama, T., Phebe, N., Sulasmi, Alam, N. A., Negin, J., & Bernays, S. (2024). “Of” the community but not “of” the health system: Translating community health workers’ knowledge into credible advice in Aceh, Indonesia. Discover Health Systems, 3, Article 5.. https://doi.org/10.1007/s44250-024-00069-7
Rogers, A., Goore, L. L., Wamae, J., Starnes, J. R., Okong’o, S. O., Okoth, V., & Mudhune, S. (2023). Training and experience outperform literacy and formal education as predictors of community health worker knowledge and performance, results from Rongo sub-county, Kenya. Frontiers in Public Health, 11, 1120922.. https://doi.org/10.3389/fpubh.2023.1120922
Sangwa, Y., Ndaruhutse, V., Radeny, S., Ndatimana, D., Niragire, F., Kanakuze, C. A., Gasamagera, J. C., Umunyana, J., & Mazimpaka, C. (2024). Using eLearning to improve and retain the knowledge of community health workers in maternal and neonatal health in Rwanda: A cohort study. Public Health Challenges, 3(2), e174.. https://doi.org/10.1002/puh2.174
Scharff, D., Enard, K. R., Tao, D., Strand, G., Yakubu, R., & Cope, V. (2022). Community health worker impact on knowledge, antenatal care, and birth outcomes: A systematic review. Maternal and Child Health Journal, 26, 79–101.. https://doi.org/10.1007/s10995-021-03299-w
Souza, R. S., Moreira, J. A. M., Dias, A. A. L., Coelho, A. D. C. O., Amendoeira, J. J. P., & Lanza, F. M. (2023). Simulation-based training in Leprosy: development and validation of a scenario for community health workers. Revista Brasileira de Enfermagem, 76(Suppl 2), e20230114.. https://doi.org/10.1590/0034-7167-2023-0114
Stansert Katzen, L., Dippenaar, E., Laurenzi, C. A., Rotheram-Borus, M. J., le Roux, K., Skeen, S., & Tomlinson, M. (2022). Community health workers’ experiences of supervision in maternal and child health programmes in low- and middle-income countries: A qualitative evidence synthesis. Health & Social Care in the Community, 30(6), 2170–2185.. https://doi.org/10.1111/hsc.13893
Sultan, M. A., Miller, E., Tikkanen, R. S., Singh, S., Kullu, A., Cometto, G., Fitzpatrick, S., Ajuebor, O., Gillon, N., Edward, A., Moleman, Y. P., Pandya, S., Park, I., Shen, J. Y., Yu, Y., Perry, H., Scott, K., & Closser, S. (2025). Competency-based education and training for community health workers: A scoping review. BMC Health Services Research, 25, 263.. https://doi.org/10.1186/s12913-025-12217
Sulistyorini, D., Huq, K. A. T. M. E., Babaita, A. O., Aivey, S. A., Huiying, G., Kazawa, K., Fukushima, Y., Kako, M., & Moriyama, M. (2025). Effectiveness of education programme to increase competency of health cadres in Indonesia: A cluster non-randomised controlled trial. BMJ Open, 15(12), e095428.. https://doi.org/10.1136/bmjopen-2024-095428
Zaman, S. B., Singh, R., Evans, R. G., Singh, A., Singh, R., Singh, P., Prakash, H., Kumar, M., & Thrift, A. G. (2024). Development and evaluation of a training program on non-communicable diseases to empower community health workers in rural India. PEC Innovation, 4, 100305.. https://doi.org/10.1016/j.pecinn.2024.100305
Zelka, M. A., Yalew, A. W., & Debelew, G. T. (2023). Effectiveness of a continuum of care in maternal health services on the reduction of maternal and neonatal mortality: Systematic review and meta-analysis. Heliyon, 9(6), e17559.. https://doi.org/10.1016/j.heliyon.2023.e17559