Development of IBU KELANA: a mobile health application to optimise antenatal care and high-risk pregnancy detection in primary health care Seberang Padang, Indonesia

Abstract Background Maternal and neonatal mortality remain major challenges in Indonesia, largely due to incomplete antenatal care (ANC) and delayed identification of high-risk pregnancies. Mobile health applications (mHealth) offer opportunities to improve maternal healthcare delivery through education, systematic risk assessment, and digital reporting. Objective To describe the systematic development and planning of IBU KELANA, a mobile health application designed to enhance ANC monitoring, high-risk pregnancy detection, and reporting in primary care. Methods A pre-development survey was conducted among health cadres at Puskesmas Seberang Padang to assess baseline knowledge of maternal health and ANC procedures. Findings informed the design of the IBU KELANA application, which integrates educational content, Poedji Rochjati Risk Score (KSPR)-based high-risk pregnancy screening, digital record-keeping, and automated reporting. The Plan-Do-Check-Action (PDCA) cycle guided iterative development. A working prototype was subsequently evaluated in facilitated group sessions with health cadres, midwives, and Puskesmas programme managers, who completed a guided walkthrough of each module and provided structured qualitative feedback on usability, compatibility with existing ANC workflows, and acceptability. Results The survey identified substantial gaps in health cadre knowledge (44% correct responses), particularly in recognising high-risk pregnancies and adhering to ANC protocols. Using the PDCA framework, the application was developed with four integrated modules: Education, Risk Assessment, Digital Records and Reporting, and Reminders. In prototype testing, participants navigated the core screening pathway without assistance after a single demonstration, judged the digital KSPR form to fit the existing home-visit and Posyandu routine, and expressed willingness to adopt the application in routine practice. The feedback they raised concerned font size, terminology, the number of steps required to complete a KSPR entry, and the timing of reminder notifications; each of these was addressed in the subsequent design iteration. Conclusion IBU KELANA demonstrates a systematic, quality-driven approach to mHealth development for maternal care. The application addresses critical gaps in health cadre knowledge, ANC adherence, and reporting efficiency, providing a scalable model for primary care facilities in Indonesia and similar low-resource settings.