Experience and Challenges Related to the Implementation of Low Birth Weight Programs in Indonesia: Perspectives from Health Care Cadres

Low birth weight (LBW) presents children with a higher risk of health problems and complications over their life course. Prevention efforts are largely carried out through health promotion programs for pregnant mothers, including monitoring those deemed to be at risk, measuring nutritional status, and ensuring timely prenatal care. These programs rely on community health workers—or ‘cadres' as they are known in Indonesia—who serve as intermediaries between the health system and the community. However, cadres often face challenges in carrying out their duties which can impact the effectiveness of LBW prevention program implementation. This study aimed to explore experiences and challenges in implementing LBW prevention programs for cadres. A qualitative study design with a descriptive phenomenological approach was used, which included a semi-structured interview guide. In-person interviews (n=11) were conducted with cadres who were active in the community and had at least one-year of experience. Interviews were recorded and transcribed, and analyzed using inductive content analysis. Our analyses revealed two main themes: (1) experiences associated with the implementation of LBW prevention programs and (2) perceived challenges. Unsurprisingly, we found that the perceived challenges faced by cadres in our sample greatly influenced the potential impact of LBW prevention programs for pregnant women in this community. There is great need to increase the capacity and continued education of cadres in order to support them in their role and prevent future LBW cases for mothers and infants.