Peer-reviewed article
Determinants of the Use of Maternal and Child Health Services and Pregnancy Risk Prevention Behaviour among Pregnant Women in the Service Area of the Melonguane Community Health Centre, Talaud Islands Regency, North Sulawesi
Samuel Hadjo, Wahyuni ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This cross-sectional study looked at what is linked to pregnant women using maternal and child health services and taking steps to prevent pregnancy risks. It surveyed 152 pregnant women in the area served by the Melonguane Community Health Centre in Talaud Islands Regency, North Sulawesi, a remote island and border area. Women with more knowledge and more positive attitudes were more likely to use services and practise risk prevention. National health insurance (JKN) coverage, shorter distance, transport access, spousal support and health education were also linked to both outcomes. The authors recommend combining health education, financial protection, better transport and access, and family and community support.
Key points
- 152 pregnant women were surveyed using total sampling with interviewer-administered questionnaires.
- Knowledge and positive attitudes were significantly associated with both service use and pregnancy risk-prevention behaviour (p<0.001).
- JKN coverage, distance to the health centre, transport access, spousal support and health education were significantly associated with both outcomes.
- Household income and community health worker involvement were associated with MCH service utilisation.
- The authors recommend integrated education, financial protection, improved access and family and community support.
Limitations
The cross-sectional design cannot show cause and effect, and the bivariate analysis (no multivariable regression) cannot show which factors matter most. The abstract reports no child health outcomes and no effect sizes, and the findings come from one health centre area.
Abstract
Maternal and child health service utilisation and pregnancy risk-prevention behaviour remain challenging in geographically isolated and border areas. These outcomes are interrelated because knowledge and attitudes may shape health decisions, while financial, geographical, and social resources determine the ability to translate decisions into action. Purpose: This study aimed to analyse the association of predisposing, enabling, and reinforcing factors with maternal and child health (MCH) service utilisation and pregnancy risk-prevention behaviour among pregnant women in the Melonguane Community Health Centre catchment area, Talaud Islands Regency. Method: An analytical cross-sectional study was conducted among 152 pregnant women from February to May 2026 using total sampling. Data were collected through interviewer-administered questionnaires. Associations were analysed using Chi-square or Fisher’s Exact tests at p<0.05. Multivariable regression was not performed. Results: Knowledge and positive attitudes were significantly associated with both outcomes (p<0.001). JKN coverage, distance to the health centre, transport access, spousal support, and health education were also significantly associated with both outcomes, while household income and community health worker involvement were associated with MCH utilisation. Implications: Maternal health interventions should integrate health education, financial protection, improved geographical and transport access, and family- and community-based support. Conclusion: MCH service utilisation and pregnancy risk-prevention behaviour are associated with interacting individual, enabling, and reinforcing factors. Because the cross-sectional design cannot establish causality and bivariate analysis cannot identify dominant determinants, future studies should use multivariable and longitudinal or intervention designs.