An Atoin Amaf Social Capital Model for Integrated Prenatal Care and Stunting Prevention

Abstract

Stunting remains a major public health concern in East Nusa Tenggara (NTT), particularly in Timor Tengah Selatan (TTS) District. This study aimed to explore prenatal care practices among Timor Dawan women, examine the role of family and Atoin Amaf in supporting pregnant women, and evaluate initial changes in knowledge, attitude, and behavior regarding prenatal care after a health promotion intervention. A sequential exploratory mixed-methods design was employed. The qualitative phase involved 12 informants, and the data were analyzed thematically. The quantitative phase consisted of a single-group pretest–posttest pilot evaluation involving 30 pregnant women without a control group. The two-day intervention was conducted in collaboration with a midwifery coordinator, with Atoin Amaf accompanying pregnant women during nutritional assessments. The qualitative findings indicated increased acceptance of maternal health services, changes in food-related beliefs following health education, and inconsistent family support. Knowledge scores increased from 38.83 ± 13.31 to 84.50 ± 7.23, with a mean difference of 45.67 (95% CI: 40.21–51.12; t(29) = 17.125; p < 0.001; dz = 3.13). Attitude scores increased from a median of 80.00 to 93.00 (Z = −4.791; p < 0.001; r = 0.875), while behavior scores increased from 57.87 ± 15.21 to 89.70 ± 4.86, with a mean difference of 31.83 (95% CI: 26.08–37.59; t(29) = 11.318; p < 0.001; dz = 2.07). These preliminary findings indicate improvements in knowledge, attitudes, and behaviors following the intervention. However, the findings do not establish a causal relationship or demonstrate a reduction in stunting, as the study did not include a control group or measurements of child growth.