Effectiveness of the Education Program on Increasing the Competency Level of Health Cadres in Indonesia

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.

1. Prior to the commencement of the study, the PI will visit the selected PHCs as the intervention group and control group, and then explain an overview of this study. The PI obtained the agreement to participate in this study from the head of the PHC.
2. The PI will ask the coordinator midwife at each PHC to introduce the names and phone numbers of the health cadres who will be potential participants. The PI and the researchers will contact each potential participant one by one to explain the procedure of this study and then obtain their consent to become a participant in this study. Cadres who belong to PHCs will receive the competency-based education program, and those who belong to PHCs allocated to the control group will follow the initial orientation provided by the PHC.
3. The PI and assistant (research team) will create a WhatsApp group for the intervention group and control group, and then distribute the questionnaires at an initial stage. All data will be collected at each PHC where the study will be conducted.

Eligibility Criteria:
Inclusion Criteria:

1. Currently working as a health care for at least 1 year
2. Domiciled in the local area
3. Able to operate a telephone
4. Those who agreed to give consent and are willing to participate in the study
5. Those who agreed to receive the health education program and participate in the whole evaluation process.

Exclusion Criteria:

1. Those who are planning to move out to another city during the study period.
2. Those who are no longer work as a health cadre.