Maternal and child health book training on improving cadre skills in early detection of pregnancy risks

Background: Maternal and child health book (MCH) is one of the media for recording and reporting health that contains information on maternal health (pregnancy, childbirth and who have an important role in maternal and child health services. Cadres have a role in promoting and monitoring the health of pregnant women to carry out pregnancy checks in health facilities. Especially during the COVID-19 pandemic, it is necessary to be physically, mentally and socially prepared for pregnant women during pregnancy and childbirth. So that knowledge and skills are very important to be able to provide health services, early detection of pregnancy risks. Objectives: of this study was to determine the effect of MCH book training on skills in early detection of pregnancy risk. Methods: method is a quasi-experimental observational study with a two group pretest post test only design method with a total sample of 60 cadres. The interventions given were MCH book training with the face-to-face method in group I and MCH book training with the face-to-face method and presenting educational videos in the intervention group II. The research was conducted in the working area of Pembina and Pakjo Public Health Centers, Palembang City. Data analysis using mc nmar test and chi square test. Results: of the study found that there were differences in the skills of cadres in conducting early detection of pregnancy risk in both intervention group I (p=0.012) and intervention group II (p=0.000) and that there was an effect of MCH book training on skills in early pregnancy detection efforts (p=0.002; OR = ,16,789). Conclusion : of this study is that the MCH book training with the face-to-face method combined with the provision of early pregnancy risk education is able to improve the skills of cadres better than presenting MCH book training with the face-to-face method.

Cadres have an important role in health services, especially in maternal and child health services. Health cadres have a role in monitoring and motivating pregnant women to carry out pregnancy checks at health facilities regularly (9). year. While the Exclusion criteria were cadres were not present during face-to-face training, cadres were not able to operate android (google form), cadres did not fill out complete pretest and posttest questionnaires (11).
Data collection was carried out for two months in two working areas of the Palembang City Health Center. The data collection instrument in this study was an observation sheet.
Data collection was carried out for two months in two working areas of Palembang City Health Center. The data collection instrument in this study was an observation sheet. Data processing in this study includes the following steps editing, coding, entry, cleaning. To assess the effect of training between the intervention group I and intervention II using McNmar test and the Chi Square test (12).

RESULT
This research was conducted on 60 cadres in the working area of the Palembang City Health

Center:
The results of statistical analysis showed that from 60 respondents it was found that the majority of respondents aged 46-64 years were 32 respondents (53.3%), the majority of respondents did not work as many as 51 respondents (85%) and the majority of respondents' education was high school as many as 42 respondents (70 ,0%).
The results of statistical analysis showed that the majority of respondents' skills before face-to-face intervention was incompetent as many as 20 respondents (66.7%). While the majority of respondents' skills after face-to-face intervention were competent as many as 19 respondents (63.3%) with p < 0.001 that is there was a difference in the skills of respondents before and after face-to-face training The results of statistical analysis showed that the majority of respondents' skills before face-to-face and video interventions were incompetent as many as 27 respondents (90%).
While the majority of respondents' knowledge after face-to-face and video interventions were competent as many as 29 respondents (96.7%) with p < 0.001 that is there was a difference in respondents' skills before and after face-to-face and video training   Basically, knowledge will continue to increase and vary according to the process of human experience experienced. According to Brunner, the knowledge process involves three aspects, namely the process of obtaining information, the transformation process, and the evaluation process. The new information obtained is a substitute for the knowledge that has been previously obtained or is a refinement of the previous information. The transformation process is the process of manipulating knowledge to fit new tasks. The evaluation process is carried out by re-examining whether the method of processing information is adequate. Knowledge is the result of remembering something, including recalling events that have been experienced either intentionally or unintentionally and this occurs after people make contact or observations of a particular object. Behavior that is based on knowledge will be more lasting than behavior that is not based on knowledge (15).
Behavior change is a theory which states that the process of behavior change is essentially the same as the learning process, which consists Teaching and learning process activities usually occur anywhere, through health training a person will learn from not knowing to knowing and with an educational approach will be able to spur the development of his potential (17). will also increase one's skill in certain ways (18).
The level of knowledge of cadres on health, especially regarding early detection of pregnancy risk will affect the behavior patterns of cadres to be more active in participating and more responsive to any health incompetence that occurs in pregnancy (19).
Cadre skills by providing appropriate