Multiple barriers to high quality maternity care have been identified in Indonesia. One barrier is the shortage of well-trained maternity care providers, particularly in remote and rural areas. Maternity care training programs do not consistently prepare their graduates to provide high quality care. Poor pre-service training may then be compounded by a lack of post-service supervision and inadequate multispecialty teamwork. Maternity care continuing education is an important means to reinforce and improve the skills needed to provide high quality maternity care. Programs that have been developed for low- to middle-income countries focus on providing culturally appropriate information to improve competency, communication and teamwork. Improvement in quality of care has been documented, showing a decrease in maternal morbidity and mortality. This trend is reflected in improvements in patient satisfaction and trust, and ultimately supports the tenets of patient-centered care.
Background: The behavior of a pregnant woman in maintaining her health during pregnancy is influenced by her knowledge of pregnancy. The greater the knowledge of pregnant women about pregnancy, the better the attitude of pregnant women in maintaining their pregnancy. Consequently, a primary care physician who is a health manager of pregnant women needs to pay attention to this knowledge aspect. Primary care physicians should be able to quickly identify the level of knowledge of pregnant women about pregnancy and determine whether that knowledge is sufficient. For that purpose, primary care physicians need to have the right measurement instruments.Objectives: This study aimed to develop, validate and test the instruments that primary care physicians can use to identify and add to pregnant women’s level of knowledge about pregnancy.Methods: This study involved research and development of a validated instrument that consisted of several stages, namely development, validation and testing. Validation was done through two stages, specifically content validation by experts and face validation by 7 doctors. The experimental phase was a quasi-experimental research with 35 pregnant women who presented for antenatal examination at the Puskesmas Banguntapan I (Community and Primary Health Care Center). T-tests were used to determine whether there was a significant difference between the knowledge of pregnant women before and after using the Maternity Education Control Cards.Results: The validated instrument called the Maternity Education Control Card developed by primary care physicians can be used to identify and increase the level of knowledge of pregnant women about pregnancy. The Maternity Education Control Card was validated by several experts, including communication experts, obstetricians and the Maternal and Child Health Program Coordinator at Bantul Regency. Layout, style, accessibility, and feasibility were assessed by a team of validators at the Puskesmas Banguntapan I (7 doctors and 1 midwife coordinator). The data analysis showed that there was a significant difference between pre-test and post-test scores (p = 0.000). This value was not influenced by age variables, educational level, number of pregnancies nor previous antenatal care frequency, but the level of education did affect the post-test value. The duration required for education was between 9 - 20 minutes, with an average of 14.63 minutes (± 2.61). The duration required for education related to the delta of pre and post-test values. The greater the delta, the longer time required for education.Conclusions: Maternity Education Control Card has been successfully established, validated and proven to significantly increase pregnant women’s knowledge about pregnancy.
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