Improving the utilization of health services among high-risk pregnant women through community health nurse assistance

Objective: The objective of this study was to identify the impact of implementing community health nurse assistance for high-risk pregnant women on utilization of health services. Method: The study was quasi experimental with a control group design. The sample included high-risk pregnant women in 10 community health centers in Indonesia who were selected by consecutive sampling. The total sample included 66 women in both the intervention and the control groups. The high-risk pregnant women in the intervention group received nurses’ assistance during the third trimester and until giving birth. Before and after the intervention, the knowledge, attitudes, and behavior of the women were measured. Results: The average scores for the knowledge, attitudes, and behavior of women in the intervention group increased. Differences were found in health care utilization between the two groups. All women in the intervention group received antenatal care during the third trimester more than once and were assisted by skilled health personnel during childbirth, while in the control group 10.6% of respondents were assisted by a paraji shaman (traditional birth attendant). All women in the intervention group accepted family planning, and the contraceptive choice varied. Conclusions: The assistance of community health nurses improves the knowledge, attitudes, and behavior of high-risk pregnant women and positively impacts the rate of health care utilization.