Everyday health communication in isolated villages: maternal information-seeking practices in a remote Javanese community

Israel National Obstetric Anesthesia WhatsApp group as a communication tool, before and during the COVID-19 pandemic

Integrated Services Post (Posyandu) Cadres are a volunteer that helps to manage community health care issues. Normally, they play an important role in mother, child, and elderly health issue prevention and promotion. However, in the COVID-19 pandemic time, the role of Posyandu cadres should be optimized for the prevention of the disease. This research aimed to assess the efficacy of the utilization of WhatsApp in increasing knowledge of Posyandu cadres on preventing COVID-19, through Whatsapp group (WAG). The Quasi-experiment was conducted on 30 cadres in Bekasi Barat. They were invited to received counseling sessions using the Whatsapp Group (WAG) on how to prevent the disease and how to correctly use the mask. They were provided with all the counseling material that they could read before the question and ask session with the mentor. Changes in the knowledge level of the cadres were assessed using the pretest and post-test methods. There was a significant increase in the level of knowledge (Wilcoxon Signed Ranks Test, p = 0.004) which was indicated by a higher post-test score (mean 75.46) than the pre-test score (mean 60.69). The correct use of masks was the cadres’ most significant increase in knowledge post-WAG-counseling session. Most of the cadres enjoyed the education process through WAG and would like to use the educational materials as a tool to provide education to the wider community. Education through WAG is effective for increasing the knowledge of Posyandu cadres about COVID-19 prevention and can be emulated by cadres to educate the wider community

The 11th Australian Rural and Remote Mental Health Symposium Communiqué.

Communication is an important aspect for Indonesian Migrant Workers' survival (PMI) in Hong Kong during the Covid-19 pandemic. In a crisis and uncertain situation, PMI from Bantul in Hong Kong communicate using the WhatsApp group "Bantul in Hong Kong" to stay connected with their partners. For this reason, this research aims to describe the motives of using the WhatsApp group "Bantul in Hong Kong" by PMI during the Covid-19 pandemic. This research employed qualitative case study approach. The Data was collected using in-depth interviews towards the WhatsApp group members which was selected by snowball sampling. The results showed that the motives of using WhatsApp group "Bantul in Hong Kong" were: social interaction, information seeking, entertainment, relaxation and comfort, sharing information, monitoring the other, and growing of communication empathy. In addition, the use of this platform also has negative effects such a communication irritation to group members.

Communication is an important aspect for Indonesian Migrant Workers' survival (PMI) in Hong Kong during the Covid-19 pandemic. In a crisis and uncertain situation, PMI from Bantul in Hong Kong communicate using the WhatsApp group "Bantul in Hong Kong" to stay connected with their partners. For this reason, this research aims to describe the motives of using the WhatsApp group "Bantul in Hong Kong" by PMI during the Covid-19 pandemic. This research employed qualitative case study approach. The Data was collected using in-depth interviews towards the WhatsApp group members which was selected by snowball sampling. The results showed that the motives of using WhatsApp group "Bantul in Hong Kong" were: social interaction, information seeking, entertainment, relaxation and comfort, sharing information, monitoring the other, and growing of communication empathy. In addition, the use of this platform also has negative effects such a communication irritation to group members.

This paper explains the participation of mothers, toddlers and the elders in Posyandu activities, and the diversification of posyandu cadre service strategies during the COVID-19 pandemic. Before the COVID-19 pandemic mothers, toddlers and elders people actively participate in every posyandu activity in Kampung Kagungan Rahayu, Tulang Bawang Regency, Lampung Province. This high participation is due to posyandu cadres who understand their role in realizing basic health services. During the COVID-19 pandemic, posyandu was held with attention to developments in the COVID-19 case. Based on this, posyandu cadres play an active role in diversifying service strategies so that participation of mothers, infants and elders remains high. The diversification strategies include the first posyandu cadres tidy up data on the health development of mothers, toddlers and elders. Second, posyandu cadres visit mothers, toddlers and elders directly from door to door by observing health protocols. Third, the cadres hold posyandu activities at the auxiliary puskesmas (pustu) in waves or in turns. Fourth, they also conducted direct monitoring and evaluation of services during the pandemic by telephone between the posyandu cadre leaders. We contend that the diversification of the service strategy has an impact on the high level of community participation in accessing posyandu during the COVID-19 pandemic.

Background: The World Health Organization’s recommendation for infant feeding is exclusive breastfeeding for the first six months followed by semi-solid food. The purpose of the study is to analyse determinant factors related to low exclusive breastfeeding’s practice in the urban slum community of Surabaya. Methods: This is a qualitative study with a case study in one of the urban slum areas of Surabaya. Data were collected by in-depth interviews and focus group discussion (FGD) with mothers, interviews with key-informants; posyandu cadre and the community leader for validation. Ishikawa diagram tool was used to identify and categorize determinant factors. The Urgency, Seriousness, Growth (USG) method was used to prioritize factors.Results: There are 9 determinant factors categorized into 5 categories; two ‘main’ factors, three ‘method’ factors, two ‘material’ factors, one ‘money’ factor and one ‘environment’ factor. The one factor that was considered the priority to be resolved is from the environment factor that is local beliefs of breastfeeding and expressed breast milk.Discussions and Conclusions: Education of mothers about expressed breast milk is an initial step to overcome low exclusive breastfeeding’s practice in this community due to mothers having to work outside the house. There is also a need for strengthening support groups so working mothers continuously exclusive breastfeed and provide optimal nutrition for infants.

Background: The role of posyandu (integrated health post) cadres constitutes a critical pillar in accelerating stunting reduction efforts in Indonesia. Nevertheless, in practice, their contribution is often perceived as supplementary within primary healthcare services. Objective: This study aims to conduct an in-depth analysis of the strengths of posyandu cadres in assuming an active role in stunting reduction efforts in the stunting locus area of Dapu-dapura Village. Methods: This qualitative study employed three data collection techniques: focus group discussions (FGDs), in-depth interviews, and direct observations. Two FGD sessions were conducted, and interview transcripts were analyzed using content analysis. Informants included posyandu cadres, healthcare workers, mothers of stunted children, and local government representatives. A total of 16 participants aged 28 to 63 years were involved. Results: The findings indicate that elderly cadres (60+ years) possess greater experience and employ interpersonal approaches that are more readily accepted by the community than younger cadres. These senior cadres have effectively shifted maternal perceptions related to stunting stigma, particularly among those hesitant to attend posyandu. They serve as key intermediaries connecting healthcare workers responsible for program implementation with mothers as service users. Strategic efforts are needed to prepare younger cadres to gradually assume these roles as part of cadre regeneration. Conclusion: Posyandu cadres in Dapu-dapura Village play an essential intermediary role in stunting prevention; however, their performance is constrained by social stigma, limited maternal nutritional literacy, and geographic barriers. Strengthening competencies in management, measurement accuracy, and counseling is necessary to enhance their effectiveness in contributing to stunting reduction at the community level.

Introduction Accredited Social Health Activists (ASHAs) are community health workers established under the National Rural Health Mission (NRHM). ASHAs have played a crucial role in responding to the COVID-19 pandemic. The COVID-19 pandemic has prompted ASHAs to adapt their strategies and methods to effectively address the challenges and ensure the well-being of the communities they serve. Objectives This study was done to explore the impact of the COVID-19 pandemic on the duties and performance of ASHAs. Methods A qualitative study was conducted over one month in the rural Primary Health Center (PHC) area of Thrissur district, Kerala. Focus group discussions (FGDs) were conducted among ASHAs and in-depth interviews with a Junior Health Inspector (JHI) and a Junior Public Health Nurse (JPHN). Results During the COVID-19 pandemic, the healthcare system shifted its focus toward managing the virus, leading to changes in the responsibilities of ASHA workers. They were assigned additional duties, and their routine services were disrupted due to lockdown measures. Despite the challenges, several factors played a crucial role in facilitating their services, including social support, teamwork, and personal satisfaction. However, there were several barriers that affected their effectiveness, such as inadequate and inconsistent remuneration, lack of recognition, transportation difficulties, safety concerns, and out-of-pocket expenses. Conclusion ASHAs effectively managed the challenging situation during the COVID-19 pandemic by taking diligent measures and showing a high level of commitment to their duties. It is essential to prioritize regular evaluations of their performance to ensure ongoing quality and effectiveness.

Australia's Rural Health Multidisciplinary Training program: Preparing for the rural health workforce that Australia needs.

Background: Semarang City has successfully reduced in reducing the stunting rate by 2.7% in 2018 and 2.5% in 2019. With the Covid-19 pandemic, the stunting prevention program in Semarang City faces problems that have the potential to increase the prevalence risk of stunting. The problem are limited access of intervention and decline of the stunting program quality in work area of the Puskesmas in Semarang City. In addition, it is still unknown how the stunting program was implemented at the puskesmas during the Covid-19 pandemic.Objectives: The purpose of this research was to identify and evaluate the implementation of the stunting prevention program in Semarang City during the Covid-19 pandemic by using the CIPP model.Materials and Methods: This research used a survey research with a qualitative approach. This research was carried out from August to October 2021. The informants for this study consisted of 5 main informants: nutritionists at the puskesmas, 15 triangulation informants, the head of the puskesmas, posyandu cadres, and mothers who had stunted children in five health centers in Semarang City, namely Bandarharjo Health Center, Lamper Tengah Health Center, Tlogosari Wetan Health Center, Gunungpati Health Center, and Pegandan Health Center. Determination of informants using a purposive technique based on the geographic location of the Public Health Center. In-depth interviews used prepared guidelines. Data analysis used content analysis.Results: The results showed that the in the context component, the nutritionists had understood goals and targets of the stunting program. The input component showed that Human Resources was not optimal because they helped in succeed in the Covid-19 program. Funding was disrupted because there were still no technical guidelines for funding during the Covid, infrastructures were not optimal due to a lack of training for posyandu cadres. The process components included: a monitoring program that was carried out door to door, no administration of PMT F100, ineffective online counseling, fewer mothers who were participated in nutrition consultations, no monitoring related to vitamin A administration.Conclusion: The stunting prevention program in the work area of the puskesmas during the Covid-19 pandemic has not been able to be implemented well during the Covid-19 pandemic.

During the Covid-19 Pandemic, learning is carried out from home through online system. This study aims to determine utilizing WhatsApp group as an alternative media of learning early childhood during the Covid-19 Pandemic. This research is carried out in an Islamic Kindergarten in Ciamis Regency. In this research, the writers then set forth two research questions: (1) How is the parents’ response in joining the online learning via WhatsApp group during the Covid-19 Pandemic? (2) What obstacles do the parents have in joining the online learning via WhatsApp group during the Covid-19 Pandemic? To answer the research questions, the researchers employ a qualitative descriptive study. The results of the present research show that utilizing WhatsApp group by the early childhood parents during the Covid-19 Pandemic is categorized good. It refers to the average percentage of 78%. It means that the early childhood parents accept in utilizing WhatsApp group as an alternative media of online learning during the Covid-19 Pandemic. In addition, the parents’ obstacles in joining the online learning via WhatsApp group during the Covid-19 Pandemic covers 3 points. Those are: 8% of the parents have obstacle in the internet access, 7% of parents have obstacle in the internet data, and 7% of parents have obstacle in the cell phone facility.

Posyandu cadres play an important role in assisting Public Health Center in carrying out the functions of implementing health efforts and have a strategic position to prevent stunting problems, especially in time the Covid-19 pandemic. This study aimed to describe the implementation of Integrated Health Post (Posyandu) in the working area of ​​the Campalagian Health Center during the Covid-19 pandemic in 2020. This study qualitative used a phenomenology approach which was carried out in the working area of ​​the Campalagian Health Center in July - September 2020. A total of 10 Posyandu cadres were the main informants. Data were collected through in-depth interviews for 60 – 90 minutes conducted at the homes of Posyandu cadres while still paying attention to health protocols. Cadres did not carry out Posyandu in April and May 2020 following local government regulations or in certain months when there was an increase in cases of Covid-19 in the area. In implementing the Posyandu during the pandemic, cadres made several innovations such as setting up emergency handwashing facilities, arranging visit schedules, and the distance of waiting chairs at the Posyandu, requiring them to bring their own sharoong from home for weighing toddlers and disinfecting the Posyandu room. In conclusion, cadres make innovations in the implementation of Posyandu during the pandemic such as preparing emergency hand washing facilities, arranging visit schedules and waiting chair spacing at Posyandu, requiring them to bring their own gloves and disinfecting the Posyandu room. The implementation of Posyandu during the Covid-19 pandemic can prevent an increase in nutritional problems in mothers and stunting problems in toddlers. Therefore, the local government is expected to support the implementation of Posyandu routinely such as ensuring the availability of PPE for posyandu cadres, mothers and toddlers. So that Posyandu can still be implemented while still observing health protocols.

Posyandu cadres are an important part of the program journey in Indonesia which has long been integrated into various programs. Including in the health program, cadres are the spearhead of community health activities based on community empowerment through Integrated Service Posts (Posyandu). The problem of Posyandu operational costs and economic cadres often become obstacles for developing Posyandu, so that the Posyandu productivity decreases. Therefore, it is necessary to strengthen entrepreneurship for Posyandu cadres to increase Posyandu funding while increasing the family economy. This study uses a qualitative approach to portray efforts to strengthen Posyandu through entrepreneurship in Posyandu cadres. Posyandu cadres are the main informants whose information is obtained through in-depth interviews, after which in-depth interviews with stakeholders will be conducted. The results showed that Posyandu cadres who have entrepreneurship are still active in running Posyandu and have good performance, and are classified as active cadres. Entrepreneurs that are being carried out by cadres are still individual and do not affect their performance as cadres, in fact entrepreneurs who are run a lot help posyandu activities, cadres can help household financing while helping Posyandu operations. Cadre business is going well because the government is strengthening cadres in training to improve the quality of entrepreneurship, then supported by licenses issued by the district. Business incubation also impacts cadre business.

The 14th National Rural Health Conference in Cairns saw the convergence of rural health delegates from across Australia to share their experiences, challenges and successes in rural health. What is always remarkable is the almost tangible atmosphere of fraternity and collegiality among this diverse group. Also on display is the shared commitment to rural health and the collective strength of the rural health sector. It is a strong cohesive sector with a clear voice and the ear of decision makers. What more could we want? The conference developed seven priority recommendations. One of these recommendations relates to increasing the investment in research and evidence-based practice. It was heartening to see the presentation of so many innovative projects and programs. So much good research has already been published, and is currently being conducted, on models of care and rural health practice. Some of this work could serve as a foundation for large multi-site, multi-sector and multi-institution research projects. Our collective voice would be strengthened by increasing the number of collaborative rural health research projects. Research and practice proven in different locations and contexts has much greater generalisability, field validity and credibility. Further, it can draw on already existing partnerships, relationships and networks. There is an opportunity to use current networks and build on previous research to develop targeted national collaborative research projects. The 14th National Rural Health Conference produced five other priority recommendations relating to: Aboriginal and Torres Strait Islander health, a healthy start to life, digital health, arts in health and the health workforce. These recommendations provide some initial directions for developing agreed collaborative research priorities. The other conference priority recommendation is the development of a National Rural Health Strategy and an associated National Implementation Plan. Building the evidence base and enhancing research in rural health should be a key plank of this strategy and plan, and collaborative research should be prioritised. Multi-site, multi-organisation, multi-sector collaborative research further strengthens and focuses an already strong rural voice. It can provide data and findings with good field validity and generalisability across different settings and contexts. It could transform evidence-based practice research into ‘practice-based evidence’ translatable to the rural service context. The development of rural health research priorities could be supported by the Rural Health Commission and aligned to the research priorities in the National Rural Health Strategy. This would encourage major funding bodies to prioritise and incentivise collaborative rural health research. Research collaborations should involve partnerships between the research, clinical and service delivery sectors and consumers and carers. They should also extend across geographic and service boundaries. The rural sector already has a strong voice. We have a large population base and a powerful constituency. We have a collaborative sector with a shared commitment to rural health. We have the opportunity to strengthen our message based on solid national research. Let's support our rural health advocates by conducting quality, multi-site, collaborative research on the issues that matter and providing compelling evidence to inform and support our arguments. In rural health we excel at cooperation. Extending this to clinical and research groups, across organisational and geographical boundaries is our next challenge. We should aim to work together, focussing on a research agenda aligned with the 14th National Rural Health Conference priority recommendations and the priorities of our much-anticipated Rural Health Strategy. A strong, unified voice backed by strong national evidence. Better together.