From outreach to ownership: community health volunteers and the sustainability of maternal health education in rural Indonesia

Abstract

Background: Amanuban Tengah District, with 17,346 residents and a regency-level stunting prevalence of 50.1%, required locally embedded maternal-health education capable of continuing beyond externally led outreach. Objective: This community engagement program aimed to strengthen 18 community health volunteers as facilitators and local co-owners of maternal-health education for 45 pregnant or recently postpartum women across Tumu, Sopo, and Taebesa. Method: A participatory planning–implementation–monitoring-evaluation design combined coordination records, needs matrices, attendance sheets, pre-post questionnaires, competency rubrics, structured observations, focus-group discussions, and institutional follow-up indicators. Results: Planning comprised three coordination meetings, four needs matrices, five stakeholder groups, five measurement instruments, and nine scheduled mentoring observations. Implementation recorded 88.9% volunteer workshop attendance, 16 completed practice outputs, six village education sessions, and 14 volunteers actively facilitating during mentoring. Monitoring-evaluation retained 40 matched maternal respondents and 16 matched volunteers, with normalized volunteer knowledge scores changing from 54 to 76, 15 acceptable outputs, 15 volunteers active at follow-up, and independently organized activities documented in two of three villages. Novelty: This program integrates measurable capacity development, supervised community practice, participatory validation, and institutionally documented continuity, repositioning volunteers from temporary message distributors to emerging educational co-owners while treating sustainability as graduated evidence rather than an assumed outcome in practice.