Latar belakang Perencanaan persalinan dan pencegahan komplikasi merupakan intervensi untuk mencegah kematian ibu, namun pelaksanaanya belum optimal dan masih berpusat difasilitas kesehatan. Opat sauyunan merupakan program pendampingan ibu hamil berbasis komunitas yang perlu ditingkatkan terutama dalam pendampingan perencanaan persalinan dan pencegahan komplikasi. Penelitian ini bertujuan untuk mengembangkan dan menilai efek strategi pendampingan ibu hamil berbasis komunitas “JABAR IMAS” dalam meningkatkan perencanaan persalinan dan pencegahan komplikasi melalui opat sauyunan. Metode penelitian menggunakan pendekatan mixed methods exploratory sequential design. Pada penelitian kualitatif menggunakan desain etnografi sedangkan untuk penelitian kuantitatif menggunakan desain Quasi Eksperimen-Pre and Post Control Group Design. Penelitian ini terdiri dari tiga tahap yaitu tahap penelitian pertama adalah studi kualitatif, tahap penelitian kedua adalah tahap pengembangan model strategi pendampingan ibu hamil dan tahap ketiga adalah intervensi opat sauyunan kepada ibu hamil. Waktu penelitian pada bulan Agustus 2024-November 2025 dengan lokasi penelitian berada di Kecamatan Bogor Selatan (daerah intervensi) dan Kecamatan Bogor Utara (daerah kontrol). Sampel penelitian berjumlah 78 ibu hamil (daerah intervensi) dan 80 ibu hamil (daerah kontrol). Analisa data yang digunakan adalah difference in difference dan Generalized Estimating Equations. Hasil penelitian menunjukan setelah dilakukannya intervensi strategi “JABAR IMAS” memiliki efek yang signifikan (p=0.0001) serta mampu meningkatkan skor perencanaan persalinan dan pencegahan komplikasi menjadi 10 dari 12 komponen. Pada akhir minggu ke-8 intervensi sebesar 81.3% ibu hamil pada kelompok intervensi berhasil mencapai status well birth planning. Kesimpulan dan saran. Model penguatan JABAR IMAS dapat memperkuat program perencanaan persalinan dan pencegahan komplikasi melalui pendampingan secara holistik di komunitas. Perlu adanya keberlanjutan pendampingan ibu berbasis komunitas hingga masa nifas untuk meningkatkan kewaspadaan terhadap tanda bahaya masa nifas, pemberian ASI eksklusif, dan perencanaan pemakaian alat kontrasepsi setelah persalinan.

Background: Birth planning and complication prevention aim to reduce maternal mortality, but implementation remains suboptimal and centered in health facilities. Opat Sauyunan is a community-based program for pregnant women that needs improvement, especially in assistance with birth planning and complication prevention. This study aims to develop and assess the effectiveness of the "JABAR IMAS" community-based pregnancy support strategy in improving birth planning and complication prevention through Opat Sauyunan. The research used a mixed-methods exploratory sequential design. The qualitative study employed an ethnographic design, while the quantitative study used a quasi-experimental pre- and post-control group design. The study had three stages: a qualitative study, development of a pregnancy support strategy model, and Opat Sauyunan intervention for pregnant women. The study period was August 2024–November 2025, with locations in South Bogor District (intervention area) and North Bogor District (control area). The sample consisted of 78 pregnant women in the intervention area and 80 in the control area. The data analysis used was difference in difference and Generalized Estimating Equations. The results showed that after the intervention, the "JABAR IMAS" strategy had a significant effect (p = 0.0001) and was able to increase the score of birth planning and complication prevention in 10 out of 12 components. At the end of the 8th week of intervention, 81.3% of pregnant women in the intervention group successfully achieved a well birth planning status. Conclusions and suggestions: The “JABAR IMAS” strengthening model can strengthen birth planning and complication prevention programs through holistic assistance in the community. There is a need for continued community-based maternal assistance until the postpartum period to increase awareness of postpartum danger signs, exclusive breastfeeding, and planning for the use of contraceptives after delivery.

Latar Belakang: Intrauterine Growth Restriction (IUGR) merupakan salah satu penyebab utama morbiditas dan mortalitas perinatal. Deteksi dini di Puskesmas masih menghadapi keterbatasan akses ultrasonografi, variasi kemampuan skrining, dan keterlambatan rujukan. Pemanfaatan Artificial Intelligence Clinical Decision Support System (AI-CDSS) berpotensi mendukung skrining dan pengambilan keputusan rujukan secara lebih konsisten. Tujuan: Mengembangkan model Artificial Intelligence (AI) berbasis data antenatal untuk skrining risiko IUGR di Puskesmas, menilai efikasi diagnostiknya dibandingkan metode konvensional, serta mengevaluasi dampak potensial implementasi sistem AI terintegrasi telehealth terhadap deteksi dini dan ketepatan rujukan IUGR di Puskesmas. Metode: Penelitian pengembangan dengan pendekatan multiphase mixed-methods ini dilakukan dalam lima tahap, yaitu analisis kebutuhan sistem, pengembangan model AI, evaluasi usability dan feasibility, uji efikasi diagnostik, serta evaluasi dampak potensial implementasi (simulated effectiveness). Pengembangan model menggunakan 1.761 data longitudinal dari 571 ibu hamil. Uji efikasi dan evaluasi dampak potensial melibatkan 604 ibu hamil di empat Puskesmas. Hasil: Model hybrid yang menggabungkan data maternal, tinggi fundus uteri, dan biometrik janin dari USG non-citra menunjukkan performa terbaik. AI-CDSS mencapai sensitivitas 100% (95%CI: 0,95–1,00), spesifisitas 87% (95%CI: 0,84–0,90), akurasi 89%, dan AUC 0,935 (95%CI: 0,916–0,954; p<0,001). Pada evaluasi dampak potensial implementasi, penggunaan sistem meningkatkan deteksi risiko IUGR dari 14,7% menjadi 25,8% (p=0,001) dan mengidentifikasi tambahan 67 kasus yang sebelumnya tidak terdeteksi. Kesimpulan: AI-CDSS VITA-Scan menunjukkan performa yang baik sebagai alat bantu skrining risiko IUGR di Puskesmas. Integrasi AI, aturan klinis, dan telehealth berpotensi meningkatkan deteksi dini serta mendukung ketepatan rujukan maternal.

Background: Intrauterine Growth Restriction (IUGR) remains a major contributor to perinatal morbidity and mortality. Early detection in Indonesian primary healthcare centers (Puskesmas) is often challenged by limited access to ultrasonography, variations in screening practices, and delayed referral decisions. Artificial Intelligence Clinical Decision Support Systems (AI-CDSS) may help improve screening consistency and support timely referral decisions. Objective: To develop an artificial intelligence (AI)-based antenatal screening model for identifying the risk of IUGR in primary healthcare centers, assess its diagnostic efficacy compared with conventional approaches, and evaluate the potential impact of an AI-CDSS integrated with telehealth on early detection and referral accuracy. Methods: This multiphase mixed-methods study was conducted in five stages: needs assessment, AI model development, usability and feasibility evaluation, diagnostic efficacy testing, and simulated effectiveness evaluation. Model development used 1,761 longitudinal records from 571 pregnant women. The model integrated maternal characteristics, symphysis-fundal height measurements, and non-image ultrasound fetal biometric parameters using a hybrid approach that combined machine learning and clinical rules. Diagnostic efficacy and simulated effectiveness were evaluated among 604 pregnant women from four Puskesmas. Results: The hybrid model demonstrated the best performance. The AI-CDSS achieved a sensitivity of 100% (95% CI: 0.95–1.00), specificity of 87% (95% CI: 0.84–0.90), accuracy of 89%, and an AUC of 0.935 (95% CI: 0.916–0.954; p<0.001). During simulated effectiveness evaluation, the system increased IUGR risk detection from 14.7% to 25.8% (p=0.001) and identified 67 additional cases that were not detected through routine practice. Conclusions: VITA-Scan AI-CDSS demonstrated good performance as a decision-support tool for IUGR risk screening in primary healthcare centers. The integration of AI, clinical rules, and telehealth has the potential to improve early detection and support more appropriate maternal referral decisions.

Pencegahan malaria dalam kehamilan dilakukan melalui penggunaan kelambu berinsektisda sepanjang kehamilan yaang diperoleh melalui layanan ANC terpadu dengan pelayanan malaria. Faktor sosial budaya menjadi penentu ibu hamil untuk mengakses layanan ANC dan mendapatkan kelambu berinsektisida. Kecamatan Kodi Utara merupakan salah satu daerah endemis malaria di Pulau Sumba. Ibu hamil yang tinggal di wilayah ini beresiko tinggi terinfeksi malaria namun akses ibu hamil terhadap kelambu dan pemanfaatannya masih rendah. Penelitian ini bertujuan untuk menyusun sebuh model pemberdayaan masyarakat berbasis sosial budaya untuk dapat meningkatkan penggunaan kelambu berinsektisida di Kecamatan Kodi Utara.  Desain pada penelitian ini menggunakan mix method dengan desain exploratory sequensial dengan subjek penelitian adalah ibu hamil. Jumlah sampel pada penelitian sebesar 144 ibu hamil yaitu  71 ibu hamil pada kelompok kontrol dan 73 ibu hamil pada kelompok intervensi. Efek intervensi diketahui dengan menggunakan analisis  diference in difference. Setelah dilakukan identifikasi  sosial budaya dan bentuk partisipasi masyarakat terkait penggunaan kelambu berinsektisida, kemudian disusun model pemberdayaan masyarakat berdasarkan hasil identifikasi tersebut dan kemudian intervensi dilakukan selama 2 bulan pada kelompok intervensi terdapat peningkatan pengetahuan ibu sebesar 21,13% dan praktik penggunaan kelambu yang benar  sebesar  20,83% lebih baik daripada kelompok kontrol. Peneliti menyarankan agar dalam menyusun sebuah strategi pencegahan malaria dalam kehamilan dengan mempertimbangkan faktor sosial budaya dan melibatkan secara aktif setiap komponen masyarakat. selain itu secara regulasi perlu untuk membuat aturan turunan mengenai edukasi penggunaan kelambu berinsektisida kepada ibu hamil yang dilakukan saat pembagian kelambu ru tin pada layanan malaria terinterasi KIA di Kabupaten Sumba Barat Daya 

Malaria prevention during pregnancy is achieved through the use of insecticide-treated mosquito nets, which can be obtained through integrated ANC services that include malaria services. Socio-cultural factors are determinants of pregnant women's access to ANC services and obtaining insecticide-treated mosquito nets. Kodi Utara District is one of the malaria-endemic areas on Sumba Island. Pregnant women who live in this area are at high risk of being infected with malaria, but pregnant women's access to mosquito nets and their utilization are still low. This study aims to develop a model of community empowerment based on socio-culture to increase the use of insecticide-treated mosquito nets in the Kodi Utara District. The design in this study used a mixed-methods method with an exploratory sequential design with pregnant women as the research subjects. The number of samples in the study was 144 pregnant women, namely 71 pregnant women in the control group and 73 pregnant women in the intervention group. The effect of the intervention was known using difference-in-difference analysis. After the identification of socio-cultural and forms of community participation related to the use of insecticide-treated mosquito nets, a community empowerment model was then prepared based on the results of the identification and then the intervention was carried out for 2 months in the intervention group there was an increase in maternal knowledge by 21.13% and the practice of using mosquito nets correctly by 20.83% better than the control group. The researcher suggests that in developing a malaria prevention strategy in pregnancy, consideration should be given to socio-cultural factors and actively involving every component of society. In addition, in terms of regulation, it is necessary to make derivative rules regarding education on the use of insecticide-treated mosquito nets for pregnant women, which is carried out during routine mosquito net distribution at integrated malaria services for KIA in West Sumba Regency

Latar Belakang Penurunan usia menarche di Indonesia menyebabkan sebagian siswi SD telah mengalami menstruasi pada usia dini, sehingga meningkatkan risiko ketidaksiapan dalam menjaga kesehatan menstruasi. Dalam konteks masyarakat Sunda, faktor sosiokultural turut memengaruhi pemahaman dan praktik menstruasi, sehingga diperlukan pendekatan yang kontekstual dengan melibatkan ibu sebagai aktor utama. Penelitian ini bertujuan mengembangkan model edukasi berbasis sosiokultural untuk meningkatkan dukungan ibu terhadap kesehatan menstruasi siswi SD di Kabupaten Garut. Metode Penelitian menggunakan desain Mixed Method Exploratory Sequential Design dalam tiga tahap, yaitu studi kualitatif, pengembangan model, dan uji intervensi dengan desain quasi experiment. Penelitian dilaksanakan pada 16 SD di Kabupaten Garut pada  tahun 2024–2025. Sampel  adalah ibu siswi yang telah mengalami menstruasi sebanyak 166 orang, terdiri dari 83 kelompok intervensi dan 83 kelompok kontrol. Analisis data dilakukan menggunakan Generalized Estimating Equations (GEE) dan Difference-in-Differences (DiD). Hasil: Hasil penelitian kualitatif dan pengembangan model menghasilan edukasi Ambu Binangkit yaitu  model edukasi kesehatan menstruasi yang dikembangkan dengan pendekatan sosiokultural Sunda. Dengan analisis statistik GEE diperlihatkan bahwa skor dukungan ibu pada kelompok intervensi meningkat sebesar 18,30 (95% SK: 15,48–21,12; p < 0,001)  Hasil analisis DiD terdapat peningkatan skor dukungan ibu pada kelompok intervensi dibandingkan kelompok kontrol dengan koefisien sebesar 21,077 (p < 0,001). Intervensi model berkontribusi terhadap peningkatan dukungan ibu sebesar 68% pada posttest pertama  dan 77% pada posttest kedua   Peningkatan terbesar terjadi pada dukungan instrumental yaitu 20.15 (95% SK: 16.33–23.97; <0.001) dan dukungan pendampingan yaitu 19.06 (95%SK: 14.83–23.30;<0.001) sementara dukungan emosional dan informasional juga meningkat secara signifikan meskipun dengan besaran efek yang lebih rendah. Kesimpulan dan Saran Model Ambu Binangkit efektif dalam meningkatkan dukungan ibu terhadap kesehatan menstruasi anak melalui pendekatan sosiokultural yang kontekstual pada tatanan SD. Model ini berpotensi dikembangkan sebagai strategi intervensi berbasis keluarga dalam meningkatkan kesehatan menstruasi sejak usia SD. Implementasi model perlu diperkuat melalui integrasi dengan program sekolah dan layanan kesehatan guna menjamin keberlanjutan dan perluasan dampak Kata kunci: kesehatan menstruasi, dukungan ibu, sosiokultural, Ambu Binangkit, SD

Background: The declining age at menarche in Indonesia has resulted in some primary school girls experiencing menstruation at an early age, thereby increasing their risk of being unprepared to manage menstrual health. In the Sundanese community context, sociocultural factors influence menstrual understanding and practices, highlighting the need for a contextual approach that involves mothers as key actors. This study aimed to develop a sociocultural-based educational model to improve maternal support for the menstrual health of primary school girls in Garut Regency. Methods: This study employed an exploratory sequential mixed methods design conducted in three stages: a qualitative study, model development, and an intervention trial using a quasi-experimental design. The study was conducted in 16 primary schools in Garut Regency from 2024 to 2025. The sample consisted of 166 mothers of schoolgirls who had experienced menstruation, comprising 83 participants in the intervention group and 83 participants in the control group. Data were analyzed using Generalized Estimating Equations (GEE) and Difference-in-Differences (DiD). Results: The qualitative findings and model development process resulted in the Ambu Binangkit educational model, a menstrual health education model developed through a Sundanese sociocultural approach. The GEE analysis showed that maternal support scores in the intervention group increased by 18.30 points (95% CI: 15.48–21.12; p < 0.001). The DiD analysis indicated a greater increase in maternal support scores in the intervention group compared with the control group, with a coefficient of 21.077 (p < 0.001). The intervention model contributed to a 68% increase in maternal support at the first posttest and a 77% increase at the second posttest. The largest increases were observed in instrumental support, with a coefficient of 20.15 (95% CI: 16.33–23.97; p < 0.001), and accompaniment support, with a coefficient of 19.06 (95% CI: 14.83–23.30; p < 0.001). Emotional and informational support also increased significantly, although with smaller effect sizes. Conclusion and Recommendations: The Ambu Binangkit model was effective in improving maternal support for children’s menstrual health through a contextual sociocultural approach within the primary school setting. This model has the potential to be developed as a family-based intervention strategy to improve menstrual health from primary school age. Its implementation should be strengthened through integration with school programs and health services to ensure sustainability and broader impact. Keywords: menstrual health, maternal support, sociocultural, Ambu Binangkit, primary school.

Latar Belakang: Perkawinan anak merupakan bagian dari pelanggaran hak anak. Paska berlakunya UU Perkawinan No.16 Tahun 2019, terkait perubahan Batasan usia dari 16 menjadi 19 tahun, jumlah dispensasi perkawinan anak meningkat 2-3 kali lipat dan 99,9% perkara yang masuk ke pengadilan agama dikabulkan di Indonesia. Provinsi Kalimantan Selatan Provinsi Kalimantan Selatan (Kalsel) memiliki angka perkawinan anak yang cukup tinggi diatas rata-rata nasional, salah satunya adalah Provinsi Kalimantan Selatan yang berada di peringkat ke-8 tertinggi nasional di tahun 2025. Tujuan: mengeksplorasi determinan pengambilan putusan dan merumuskan integrasi pertimbangan kesehatan reproduksi dalam putusan dispensasi kawin guna memperkuat perlindungan hak anak di Provinsi Kalimantan Selatan Metode: menggunakan desain multiphase mixed methods yang terdiri dari tiga tahap. Tahap satu melakukan telaah kebijakan, telaah dokumen perkara dispensasi kawin, wawancara mendalam dan FGD dengan hakim serta pemangku kepentingan terkait. Tahap dua dilakukan pengembangan model intervensi. Tahap tiga melakukan uji coba intervensi melalui pre-experimental (one group pre & post-test) untuk mengukur perubahan pengetahuan dan sikap hakim. Hasil: Analisis regresi logistik menemukan bahwa variabel paling dominan yang memengaruhi hakim untuk menolak permohonan adalah hasil pemeriksaan psikologis (OR=174,037) dan pemeriksaan kesehatan (OR=10,505). Ditemukan fenomena "pergeseran prosedural", di mana penurunan dispensasi di pengadilan diikuti lonjakan pernikahan tidak tercatat (siri) guna menghindari kerumitan administratif. Pertimbangan mengenai "alasan mendesak" masih subjektif dan cenderung menggunakan narasi standar (template). Intervensi Buku Panduan terbukti secara signifikan meningkatkan skor rata-rata pengetahuan hakim (56,05 ke 87,91) dan sikap (70,13 ke 81,76) Kesimpulan dan Saran: Model penguatan putusan berbasis kesehatan reproduksi efektif meningkatkan kapasitas hakim. Disarankan adanya standarisasi format "Resume Medis Yuridis" dan pengembangan sistem rujukan otomatis pasca-putusan untuk mencegah migrasi risiko ke jalur pernikahan siri.

Background: Child marriage constitutes a violation of children's rights. Following the enactment of Marriage Law No. 16 of 2019, which raised the minimum marriageable age from 16 to 19 years, the number of child marriage dispensation requests surged two- to three-fold, with a 99.9% approval rate for cases submitted to religious courts in Indonesia. South Kalimantan Province maintains child marriage rates significantly above the national average, ranking as the 8th highest province nationally in 2025 Objectives: This study aims to explore the determinants of judicial decision-making and formulate the integration of reproductive health considerations into child marriage dispensation rulings to strengthen the protection of children’s rights in South Kalimantan Province Metode: This research employed a multiphase mixed-methods design consisting of three phases. Phase one involved policy reviews, a review of marriage dispensation case documents, and qualitative exploration through in-depth interviews and focus group discussions (FGDs) with judges and relevant stakeholders. Phase two focused on the development of an intervention model. Phase three involved a pre-experimental trial (one-group pre- and post-test) to measure changes in judges' knowledge and attitudes Results: Logistic regression analysis revealed that the most dominant variables influencing judges to reject dispensation requests were the results of psychological examinations (OR=174.037) and reproductive health assessments (OR=10.505). A "procedural shifting" phenomenon was identified, where a decline in court-sanctioned dispensations was followed by a surge in unregistered (siri) marriages as a means to circumvent administrative complexity. Findings indicate that judicial interpretations of "urgent reasons" remain highly subjective and often rely on standardized narrative templates. The Guidebook intervention was proven to significantly improve judges' average knowledge scores (from 56.05 to 87.91) and attitude scores (from 70.13 to 81.76) Conclusion and Recommendations: The model for strengthening judicial decisions based on reproductive health is effective in increasing judges' capacity. It is recommended to standardize the "Juridical Medical Resume" format and develop an automatic referral system for post-decision assistance to prevent risk migration toward unregistered marriages