Access and utilization of health services improved by trained posyandu cadres in rural Indonesia

Abstract

Abstract Posyandu stands for ‘Pos Pelayanan Terpadu’ in Bahasa, meaning ‘Integrated Service Post,’ a community-based health center to provide a range of services for mothers and under five children in Indonesia. Each Posyandu center s served by five posyandu cadres who are community-based health workers and responsible to deliver essential health services and counseling to their communities. In Central Lombok district, Indonesia, we facilitated building capacity and skill of posyandu cadres for counseling and health education and to encourage the community to attend Posyandu center as well as to seek care from nearby Puskesmas and Polindes (other community based static health facilities). During January - August 2022, we trained 1100 posyandu cadres and equipped them with pictorial cards with health education and counseling messages. We retrieved monthly attendance and care seeking data from Puskesmas, Polindes and Posyandu centers through routine health management information system for January 2022 to February 2023 and we compared pre-training (January-August 2022) and post-training (September 2022-February 2023) data. Monthly average number of pregnant women and sick children who were brought to nearby Puskesmas and Polindes for care during pre-training period was 1553 which was significantly increased to 1844 during post-training period (p < 0.001). We also observed statistically significant ((p < 0.001) increase in average monthly attendance of mothers and children at Posyandu centres (from 12,751 in pre-training period to 14,677 in post-training period). This incremental attendance at Posyandu centers and increased care seeking from Puskesmas and Polindes can potentially be attributable to counseling-education session by trained and skilled posyandu cadres and it reconfirms the worthiness of additional investment for capacity and skill building of posyandu cadres to improve community health in rural Indonesia. Key messages • Posyandu cadres have potential strength to make significant improvement in community health care service delivery by educating and counseling communities in rural Indonesia. • Investment on capacity building and training of posyandu cadres can pay off by improving access and utilization of health care services by pregnant women and children.