Knowledge, Perception, and Utilization of Posyandu of Mother in

Samarinda, Indonesia: A Cross-sectional Study

Ratih Wirapuspita Wisnuwardani

, Fitriani Nor Hasanah and Ismail Kamba

Faculty of Public Health, Mulawarman University, Samarinda, Indonesia

Keywords: Performance, Cadres, Toodler.

Abstract: Posyandu is a community-based activity for health care in Indonesia. We evaluate the association between

mother knowledge and perception about cadres performance with utilization of posyandu in 67 participants

(22-43 years) from the cross-sectional study of 2013. Participants were interviewed face-to-face using a

questionnaire. Chi-square analysis examined the associations between knowledge and perception about cadres

performance with the utilization of posyandu. Utilization of posyandu showed that majority mothers were

inactive participants (90%). The study revealed that the majority of mothers (80.6%) were knowledgeable

about posyandu and its function. However, only 26.9% mothers knew the others function of posyandu, except

growth monitoring. Half of mothers (55.2%) had positive perception about cadres performance. Most of them

(92.5%) stated that cadres always on time, but 70.1% cadres could not give enough information about their

health children. Mother knowledge and perception about cadres performance was associated with the

utilization of posyandu. However, there was no significant association with mothers of toddlers’ health care

needs. Mothers who were inactive participation in posyandu were more good knowledge of posyandu

(90.7%), more negative perception about cadres performance (96.7%) and more needed posyandu (79.2%).

Cadres performances are needed to explore in future studies to activate posyandu.

1 INTRODUCTION

Stunting is a health problem in Indonesia, as 30.8%

children under 5 years are stunting and severely

stunting (Indonesia Ministry of Health, 2018).

Overweight and obesity are health issues also with the

prevalence among children under-five are 8% (

Indonesia Ministry of Health, 2018). Low coverage

of growth monitoring program is one of potential

causes of stunting and overweight in Indonesia

(Sahanggamu et al., 2017). The Indonesia

government has focused on enhancing Maternal

Child Health by extending access to health care

through the organization of volunteer-staffed of

Posyandu (Health and Nutrition Integrated Service

Center) (Andriani et al., 2016). It was the merged

activities of nutrition improvement (growth

monitoring, supplemental feeding, vitamin and

mineral supplementation and nutrition education),

diarrhea prevention, immunization and family

planning, mother and child heath, as stated in the

https://orcid.org/ 0000-0002-6050-2980

Alma Ata Declaration in 1978 (Nazri et al., 2016).

However,.

Posyandu is community based programme, that

needs community participation and conducted every

month in every neighbourhood or village. Cadres are

volunteers who have to be recruited and trained from

the community to organize the activities of posyandu.

Therefore, the utilization of posyandu depends on the

cadres performances, location of posyandu and

mother’s participation (Restu et al., 2020, Nazri et al.,

2016).

Participation of mother to posyandu was

approximately 45% (Indonesia Ministry of Health,

2007, Indonesia Ministry of Health, 2010, Indonesia

Ministry of Health, 2013), which is similar in East

Kalimantan (40%). The health centre of Bengkuring,

Samarinda has the same problem with low

participation of mother to Posyandu. Therefore, the

aim of this study was to evaluate the association of

mother knowledge and perception of cadres with

utilization of posyandu in the health centre of

Bengkuring.

Wisnuwardani, R., Hasanah, F. and Kamba, I.

Knowledge, Perception and Utilization of Posyandu of Mother in Samarinda, Indonesia: A Cross-sectional Study.

DOI: 10.5220/0010757200003235

In Proceedings of the 3rd International Conference on Social Determinants of Health (ICSDH 2021), pages 143-146

ISBN: 978-989-758-542-5

143

2 MATERIALS AND METHODS

2.1 Design and Participation

This study was cross-sectional study investigating the

role of posyandu among 67 mothers who had children

under 5 years from Bengkuring’s health centre. The

data were collected from April to June 2013.

Participants were selected by purposive sampling.

Data were collected by face-to-face interview using a

questionnaire.

2.2 Socio-demographic

Mother’s occupations were reported as four

categories (housewife, private employee, government

employee, and entrepreneur). Age of children was

reported as one of three categories (below 6 months,

7-24 months and up to 25 months).

2.3 Knowledge, Perception and

Utilization of Posyandu

Knowledge of mothers was identified as knowledge

of mothers about posyandu (definition, aims,

frequency of activities, programs, and benefit).

Mother’s perception about cadres performance was

defined as the satisfaction of mothers with cadres

performances including punctuality, friendliness,

weighing skills, recording skills, and the skills to

communicate health information. The need of

mothers in posyandu services was described as the

things that were felt by mothers, so mothers wanted

the posyandu services.

The utilization of posyandu was the participation

of mothers to posyandu which were divide into two

categories (active and non-active). Active

participation was defined as 4 times participated

during 6 months in posyandu.

2.4 Statistical Analysis

Baseline characteristics were presented as

percentages for categorical variables. To evaluate the

association in mother knowledge, perception of

cadres and the need of posyandu services between the

utilization of posyandu (actve and non-active), the

Chi-square test was used. р values <0.05 (two-tailed)

were considered statistically significant, and all

analyses were performance using Statistical Package

for Social Science (SPSS, version 25).

3 RESULTS

3.1 Characteristics of Study

Participants

Participants were mothers who had children under 5

years and participated in Posyandu of Kemuning,

Bengkuring’s Health centre. The participants were

younger (22-29 years old) and more housewife (Table

1). The most participated children in posyandu were

in the age of 2-5 years old.

Table 1: Baseline characteristics of participants.

Characteristics Percenta

(

)

e of mothers

22-29 47.8

30-36 26.8

37-43 25.4

e of children under 5

ears

< 6 months 1.5

7-24 months 31.3

>25 months 67.2

Occupation of mothers

Housewife 77.6

Private em

ee 9

Government em

ee 3

Entre

reneu

10.4

3.2 Knowledge, Perception and

Utilization of Posyandu

Although the majority of participants had good

knowledge of posyandu (80.6%), but only 9.3%

participants were active participants in posyandu.

More than half participants had positive perception

about cadres performance (55.2%), with the highest

perception of punctuality. Cadres had low ability to

inform health information (70.1%). Most of

participants needed posyandu services, with

immunization was the highest needed service.

However, knowledge of mothers about posyandu

was associated with utilization of

posyandu/participation mothers in posyandu

(р=0.026). The perception about cadres performances

was significantly associated with higher participation

in posyandu (р=0.019) (Table 6). In addition, the need

of mothers in posyandu services had no association

with the participation (р=0.052) (Table 2).

ICSDH 2021 - International Conference on Social Determinants of Health

144

Table 2: Knowledge of mother about posyandu.

Participation

Mothers (%)

Р value

Active Non-

Active

Knowled

e 0.026

Good (upper

avera

)

50 86

Not good (Below

average)

50 14

Perception 0.019

Positive 90 49

ative 10 51

The needs of posyandu 0.052

Nee

100 67

Less nee

0 33

4 DISCUSSION

To our knowledge, ths is the first study to evaluate the

relation between knowledge, perception and the

needs of posyandu with the utilization of

posyandu/participation mothers in Samarinda. The

cross-sectional analyses consistently showed

knowledge and perception about cadres performance

were related to the utilization of posyandu. In

contrary, no association of the needs of posyandu

with the utilization of posyandu.

A good knowledge of posyandu was associated

with higher non active participation in posyandu in

our study. In contrary, low knowledge was associated

with low participation mothers in posyandu (Arsyad

et al., 2020). Mothers understood the definition, aims,

frequency of activities, and benefit of posyandu, that

more than 90% correct answers about these questions.

In contrary, mothers didn’t know about the growth

monitoring programme in posyandu, that only 27%

mothers had correct answers. Therefore, the nutrition

educational programme is needed for mothers.

Interestingly, half of mothers had low knowledge

but they were active participants. In fact, the location

of posyandu closed to their home and cadres invited

them to posyandu. This is in agreement with the

results from Indonesia that accessibility issues were

related with participation to posyandu and risk of

obesity (Andriani et al., 2016).

In our study, a higher perception about cadres

performance was associated with a higher

participation mothers. Indeed, cadres are one of the

supporting system to operate posyandu. The lowest

cadres performances was communication skills to

inform health information. A previous study showed

that the more frequent mothers visit to posyandu, the

greater change mothers would have to obtain

nutritional information through nutrition (Anwar et

al., 2010). Therefore, the capacity building of cadres

is needed (Nazri et al., 2016). Training, operational

assistance, certificates, transportation fees were

associated with cadres performances (Wisnuwardani,

2013). In addition, recognition from the community,

status within the system, training opportunities,

competition among communities, and small

payments provide incentives to sustain cadres

participation (Ekowati et al., 2016). Appropriate

incentives for cadres will improve cadres

performances.

Immunization is the highest reason participation

mothers. Cadres ability to integrate with the

community is the success of immunisation

programme through posyandu (Widayanti et al.,

2020). However, posyandu activities are not only for

immunization, but also for growth monitoring for

nutrition status children, vitamin A capsule program,

family planning, supplemental feeding, mother and

child health, disease control (diarrhea prevention).

Education of mothers about growth charts can

promote mothers’ interest in their children and they

can utilize posyandu as growth monitoring (Nazri et

al., 2016).

5 CONCLUSIONS

In conclusion, the capacity building for mothers and

cadres may contribute to the utilization posyandu as

knowledge, perception of cadres performance and

location are related to the participation posyandu.

Cadres have important rule in posyandu. However,

drop out cadres might influence the activity of

posyandu. Studies of incentive cadres and the

capacity building of cadres and mothers are needed to

explore the posyandu’s participation in more detail.

ACKNOWLEDGEMENTS

We acknowledge all field workers, all participating

mothers and cadres.

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