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The Smart Book Effect of Pregnancy – Postpartum Care Towards The Family Medicine & Primary Care Review 2020; 22(2): 133–139 https://doi.org/10.5114/fmpcr.2019.90164 ISSN 1734-3402, eISSN 2449-8580 ORIGINAL PAPERS © Copyright by Wydawnictwo Continuo The smart book effect of pregnancy – postpartum care towards the husband’s knowledge and reduction of reproductive health problems ROSMALA NUR1, A–G, INDAH PUSPASARI KIAY DEMAK2, B, C, F, NURHAYA S. PATUI1, B, C, D, ORCID ID: 0000-0002-8693-0182 MUHAMMAD RUSYDI3, A, C–F, NENITA P. DOMINGO4, A, C–F, SYAIFUL HENDRA5, B–E ORCID ID: 0000-0003-3631-7686 ORCID ID: 0000-0002-0037-5895 HAJRA RASMITA NGEMBA6, B–E ORCID ID: 0000-0001-8727-9267 1 Public Health Department, Faculty of Public Health, Tadulako University, Palu, Indonesia 2 Medical Department, Faculty of Medicine, Tadulako University, Palu, Indonesia 3 Geophysics Department, Faculty of Mathematics and Natural Sciences, Tadulako University, Palu, Indonesia 4 Asian Languages and Cultures Department, California University, California City, USA 5 Informatic Study Programme, Department of Information Technology, Engineering Faculty, Tadulako University, Palu Indonesia 6 Informatic Study Programme, Department of Information Technology, Engineering Faculty, Tadulako University, Palu Indonesia A – Study Design, B – Data Collection, C – Statistical Analysis,D – Data Interpretation,E – Manuscript Preparation,F – Literature Search, G – Funds Collection Summary Background. In the pregnancy-postpartum process, husbands play a very decisive and critical role. Poor decision making in relation to reproductive health for pregnant women in Central Sulawesi often causes delays in getting them to health services. This condition is one of the main causes of the high maternal mortality rate in Central Sulawesi. Objectives. The purpose of this study is to examine the effect of the smart book about pregnancy-postpartum care on husbands’ knowledge and the reduction of reproductive health problems. Material and methods. This study used mixed methods (quasi-experiment and descriptive percentages). Quasi experiment employed a control group design, pre-test and post-test. Interventions using smart books on pregnancy-postpartum care were applied to the treatment group, while the control group was not given this option. A sample of 20 husbands for each group was taken, making a total sample of 40 people. Results. There were differences in the scores of pre-test and post-test on the husbands’ knowledge in the treatment group in relation to pregnancy (p = 0.000), childbirth (p = 0.000) and postpartum (p = 0.000) care. In the control group, there was no differences between pre-test and post-test scores in relation to pregnancy (p = 0.326), childbirth (p = 0.300) and postpartum (p = 0.129) care. In the treat- ment group, only 10% (2) of husbands had wives who experienced reproductive health problems (bleeding). Meanwhile, 45% (9) of the control group had wives who experienced reproductive health problems (bleeding, complications of pregnancy, miscarriage, low birth weight, fever/seizures and infant mortality). Conclusions. The smart book of pregnancy-postpartum care increased husbands’ knowledge and decreased wives’ reproductive health problems. Key words: reproductive health, postnatal care, knowledge. Nur R, Demak IPK, Patui NS, Rusydi M, Domingo NP, Hendra S, Ngemba HR. The smart book effect of pregnancy – postpartum care towards the husband’s knowledge and reduction of reproductive health problems. Fam Med Prim Care Rev 2020; 22(2): 133–139, doi: https://doi.org/10.5114/fmpcr.2019.90164. Background deaths [2], one of the highest maternal mortality ratios in Cen- tral Sulawesi. Similarly, the infant mortality rate is 11 per 1,000 live births [1]. This data indicates the low reproductive health The 2012, Indonesian Demographic and Health Survey of mothers in Sigi Regency. Thus, it is necessary to discover the (IDHS) data [1] showed that the maternal mortality ratio in In- causal factors and possible solutions. donesia ranks the highest in ASEAN countries, reaching 359 per This high mortality ratio can be due to direct or indirect fac- 100,000 live births [1]. In Central Sulawesi, the maternal mor- tors. The direct factors include bleeding, eclampsia, infection tality ratio reached 358 per 100,000 live births, and in 2016, and pregnancy compilations [1, 2]. Indirect factors encompass this ratio dropped to 208 per 100,000 live births. This ratio is the completeness and accuracy of the implementation of an- still relatively high compared to other provinces in Indonesia. tenatal care [3], the lack of blood tablet supplementation and In Sigi Regency, the maternal mortality ratio is 309 per 100.000 haemoglobin examination that causes anaemia in pregnant This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0). License (http://creativecommons.org/licenses/by-nc-sa/4.0/). 134 R. Nur et al. • The smart book, husband’s knowledge, reproductive health women [4, 5], as well as a lack of knowledge about the signs Objectives of high risk pregnancy [6, 7]. In fact, pregnant women and their husbands can make preventive efforts to reduce the factors that The purpose of this study is to examine the effect of the smart are associated with maternal and infant mortality. book about pregnancy-postpartum care on husbands’ knowledge The Government of Central Sulawesi has made efforts to and on the reduction of reproductive health problems. reduce the maternal mortality ratio (MMR) and infant mortal- ity rate (IMR) through movements such as ‘safe motherhood’, ‘making pregnancy safer’ and ‘simultaneous movement to de- Material and methods crease maternal mortality towards zero MMR’. However, these efforts are still top-down in nature and, under certain condi- Research design tions, cannot be the main choice, as they have not touched upon the grassroots problem [8]. The issue of maternal mortal- This study used a quantitative-qualitative mixed methods ity cannot be resolved merely using a medical approach but re- quires community participation [9]. It is very unlikely to reduce approach [15]. A quasi-experiment with a control group design, maternal mortality without innovative alternative efforts to in- pre-test and post-test design approach was used to examine crease community involvement in health development [3, 10]. the effects of the smart book on husbands’ knowledge about In the pregnancy-postpartum process, the husbands’ role pregnancy-postpartum care. Meanwhile, a descriptive percent- is very decisive and needed [11, 12]. Poor decision making in age design was used to assess its impact on reproductive health. relation to reproductive health for pregnant women in Central Sulawesi often causes delays in getting them to health services Research sample and results in them being late for necessary treatments. This issue of maternal reproductive health can occur due to unequal Samples were taken using the non-probability sampling power relations [13]. technique with the type of consecutive sampling in which the So far, pregnant women have received education and in- samples were selected if they met certain criteria. The sample formation about pregnancy-postpartum care through the book in this study was husbands whose wives were in the second “maternal and child health”, which is distributed to every preg- trimester of pregnancy (> 4 months), those willing to be a re- nant woman by the Ministry of Health of the Republic of Indo- spondent and who were able to speak Indonesian. The treat- nesia [14]. The husbands have not received such education and ment group and the control group had a sample of 20 people information, even though they really need it. This research is each. The total sample was 40 people. Interventions with the aimed at examining models for improving reproductive health smart book were given to the treatment group, while the con- education and information for husbands in an effort to reduce trol group did not receive any treatment. maternal and infant mortality in the form of a smart book on pregnancy-postpartum care. This method is simple and easy to understand and does not amount to a high cost. This model is Setting and time of research relatively new, since it involves husbands as the decision maker in the household. Pregnant women and their husbands need infor- This research was carried out at the Tinggede community mation and education that are easily understood and applied in health centre, which encompassed the villages of Tinggede, pregnancy-postpartum care. If husbands have the knowledge and South Tinggede and Sunju. The data was collected during a pe- skills about pregnancy-postpartum care, their wives can undergo riod of 6 months from June 2018 to December 2018. pregnancy and childbirth safely and comfortably. The results are a healthy baby delivery and a surviving mother. The husbands get Indicator of variables knowledge and skill through reading a smart book of pregnant care contained one very useful achievement in family medication The indicator of variables in this research can be seen in and primary care to improve maternal and child health. Table 1. Table 1. Indicator of variables Variable Indicators Knowledge differences Knowing the signs of pregnancy, providing regular and complete antenatal care (ANC), supplementing neces- on pregnancy care sary Fe tablets and taking Hb examination, detecting the potential high-risks and dangers of pregnancy early, maintaining healthy life behaviours, arousing a sense of calmness
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