A Cipp-Based Evaluation of Integrated Antenatal Care Program in Bantul, Indonesia

In 2022, Bantul Regency had the highest MMR in Yogyakarta Province's Special Region, with 146.8 per 100,000 live births. An integrated antenatal care (ANC) program is essential for identifying high-risk pregnant women and lowering maternal mortality. This study aims to evaluate the integrated ANC program's implementation in the Bantul Regency.

This study used a descriptive approach with CIPP model evaluation to assess program implementation in context (guidelines and SOPs), input (resources, funding, and infrastructure), process (implementation of ANC standards and obstacles), and product (ANC implementation coverage). We interviewed 18 program managers—17 PHCs and 1 district health office—using questionnaires and observation checklists in February 2024.

Most study participants were doctors with undergraduate or professional degrees (72.22%). ANC guidelines and SOPs were available in all PHCs, however 29.41% lacked psychologists to provide psychological care. The lowest coverage was found in pregnancy tests, iron supplementation, and delivery counseling. The primary challenges highlighted were lack human resources (40.00%), longer integrated ANC times (20.00%), and data entry problems (10.00%).

In Bantul Regency, integrated ANC coverage exceeds the requirements, but psychological care, pregnancy testing, iron supplementation, and delivery counseling are inadequate. Due to the absence of psychologists at some PHCs, human resources and service delivery must be prioritized to enhance maternal health outcomes, especially in high-risk populations.

The integrated ANC program in Bantul Regency meets implementation standards, but requires enhanced monitoring, targeted human resources, and service enhancements for low coverage. Enhanced worker capacity, service coverage, and program evaluation may improve maternal health.