Evaluation of Preconception Health Services and Their Implications for Maternal and Neonatal Health: A Qualitative Study
https://doi.org/10.53770/medica.v8i7.1156
Keywords
Preconception Health Services Service Evaluation CIPP Model Maternal Health Neonatal HealthAbstract
Preconception health care is an effort to improve maternal and infant health by detecting and managing risk factors before pregnancy. This study aimed to evaluate preconception health services and their implications for maternal and newborn health status. This study used a qualitative evaluative design with the CIPP (Context, Input, Process, Product) approach. The study was conducted from May to December 2025 at five Community Health Centers (Puskesmas), the Office of Religious Affairs (KUA), BKKBN, and the Bantul District Health Office, Yogyakarta, Indonesia. A total of 52 participants were selected using purposive sampling, consisting of 38 premarital couples (who participated in Focus Group Discussions) and 14 key informants including health workers, health program holders, KUA staff, BKKBN officers, and a village head (who participated in in-depth interviews). Data were collected through in-depth interviews and Focus Group Discussions. Based on the CIPP framework, preconception services were found to be supported by cross-sectoral programs and the availability of basic services; however, implementation has not been optimal. Barriers identified included low community awareness, delayed access to services, variation in quality across Puskesmas, inconsistent SOPs, weaknesses in monitoring and evaluation, and poor data integration. Nevertheless, several indicators of maternal and newborn health service coverage from 2022 to 2024 showed improvement. Pregnancy and delivery complications decreased, while postpartum complications increased. The maternal mortality rate decreased, while the infant mortality rate fluctuated. It was concluded that preconception health services have the potential to contribute to increased service coverage and early detection of risk factors, but their impact on maternal and newborn health outcomes remains inconsistent. Strengthening service quality, standardization, cross-sectoral integration, and service continuity are needed to optimize maternal and infant health.
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