Information-motivation-behavioral-skills Model-based Training to Improve Community Cadres Behavioral Performance for Post-partum Hemorrhage and Pre-eclampsia Prevention

Introduction: Postpartum hemorrhage and pre-eclampsia are the biggest causes of maternal death worldwide. The lack of health workers contributes to the under-detection of pregnancy risks. The informational-motivation-behavioral-skills model based on training theory is applied to increase cadres' performance to develop preventive behavior against postpartum hemorrhage and pre-eclampsia. The study aims to analyze the effects of training and the direct and indirect influence of cadres' knowledge, skills, and motivation on preventive behavior for pre-eclampsia and postpartum hemorrhage. Materials and methods:The quasi-experiment was conducted from October to December 2022 by taking an intervention group from the Muslimat NU organization and a control group of existing cadres. A total of 97 Muslimat NU were given training in preventing pre-eclampsia and postpartum hemorrhage while 91 control group cadres carried out routine activities. Knowledge and skills were measured before and after training, while behavior was measured twice over three months. Data were tested using the Wilcoxon Test and Path Analysis using Stata software version 16.00. Results: The intervention group's screening behavior remained relatively good until the third month, while the control group experienced a decline. Skills have a direct effect on preventive behavior (b=0.43; 95% CI= 0.29 to 0.57; p<0.001). Knowledge has an indirect effect on preventive behavior through skills (b=0.47; 95% CI= 0.36 to 0.58; p<0.001) as well as motivation (b=0.14; 95% CI= 0.01 to 0.26; p=0.027). Conclusion: The informational-motivation-behavioral-skills theory based on training is increasing the performance of community cadres to carry out preventive behavior for pre-eclampsia and postpartum hemorrhage.