<![CDATA[Maternal and child health service utilisation and pregnancy risk-prevention behaviour remain challenging in geographically isolated and border areas. These outcomes are interrelated because knowledge and attitudes may shape health decisions, while financial, geographical, and social resources determine the ability to translate decisions into action. Purpose: This study aimed to analyse the association of predisposing, enabling, and reinforcing factors with maternal and child health (MCH) service utilisation and pregnancy risk-prevention behaviour among pregnant women in the Melonguane Community Health Centre catchment area, Talaud Islands Regency. Method: An analytical cross-sectional study was conducted among 152 pregnant women from February to May 2026 using total sampling. Data were collected through interviewer-administered questionnaires. Associations were analysed using Chi-square or Fisher’s Exact tests at p<0.05. Multivariable regression was not performed. Results: Knowledge and positive attitudes were significantly associated with both outcomes (p<0.001). JKN coverage, distance to the health centre, transport access, spousal support, and health education were also significantly associated with both outcomes, while household income and community health worker involvement were associated with MCH utilisation. Implications: Maternal health interventions should integrate health education, financial protection, improved geographical and transport access, and family- and community-based support. Conclusion: MCH service utilisation and pregnancy risk-prevention behaviour are associated with interacting individual, enabling, and reinforcing factors. Because the cross-sectional design cannot establish causality and bivariate analysis cannot identify dominant determinants, future studies should use multivariable and longitudinal or intervention designs.]]>
