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Factors Assosiated With Hellp Syndrome On Severe Preeclampsi Dan Eclampsia In General Hospital Ulin Banjarmasin 2012-2013 zakiah zakiah; vonny khresna dewi; Ahmad rizani
Jurnal Skala Kesehatan Vol 7 No 1 (2016): JURNAL SKALA KESEHATAN
Publisher : Politeknik Kementerian Kesehatan Banjarmasin

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (356.011 KB)

Abstract

Purpose: To know the factors that assosiated with HELLP syndrome on severe preeclampsi dan eclampsia in General Hospital Ulin banjarmasin 2012-2013. Methods: the research was analytical with cross sectional study. The sampel was parturient with preeclampsia and eclampsia in General Hospital Ulin Banjarmasin periode 2012-2013. The sampels selected through simple random samplingwith 100 respondent. Data analyzed with Chi Square test(α=0,05). Result: the prevalence of HELLP syndrome at General Hospital Ulin Banjarmasin was 24%, wich consisted 61,0% multipararous, 77,0% found at maternal age ≥ 25 years and with no delivery complication. There was no assosiation between parity, age, and historical delivery. Conclusion: prevalence of HELLP syndrome was 24%, most of the cases was found at maternal age ≥ 25 years.
Faktor-Faktor yang Berhubungan dengan Kinerja Bidan dalam Pelaksanaan Kegiatan Desa Siaga di Kabupaten Tapin Suhrawardi Suhrawardi; Vonny Khresna Dewi
Jurnal Kesehatan Vol 7, No 2 (2016): Jurnal Kesehatan
Publisher : Politeknik Kesehatan Tanjung Karang

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (64.674 KB) | DOI: 10.26630/jk.v7i2.203

Abstract

Pada pengembangan Desa Siaga di  Kabupaten Tapin  terdiri dari 12 kecamatan dan mempunyai 132 desa, baru 5 desa yang mencapai strata III (Desa Siaga Purnama) dan 31 desa dengan strata II (Desa Siaga Madya) serta hanya 1 desa yang sudah dengan strata IV (Desa Siaga Mandiri), sedangkan 50 Desa Siaga lainya masih pada strata I (Desa Siaga Pratama). Tujuan penelitian ini adalah untuk mengetahui faktor-faktor yang berhubungan dengan kinerja bidan dalam pelaksanaan kegiatan Desa Siaga di Kabupaten Tapin tahun 2014. Jenis penelitian survey analitik dengan pendekatan cross sectional.  Populasi dan sampel penelitian ini adalah seluruh bidan yang bekerja di Desa Siaga Kabupaten Tapin tahun 2014  berjumlah 62 orang. Teknik pengambilan sampel adalah sampling jenuh. Teknik analisa data adalah analisis data Kuantitatif : univariat, bivariat dengan menggunakan uji chi square dan analisis data kualitatif. Hasil penelitian menunjukkan bahwa kinerja bidan yang aktif dalam pelaksanaan kegiatan Desa Siaga sebanyak 40 orang (64,5%), Pendidikan bidan sebagian besar lulusan D-III Kebidanan sebanyak 53 orang (85,5%), Umur bidan sebagian besar berusia di atas 35 tahun sebanyak 43 orang (69,3%), Bidan sebagian besar telah mengikuti pelatihan sebanyak 38 orang (61,3%), Bidan sebagian besar telah bekerja lebih dari 5 tahun sebanyak 44 orang (71%), ada hubungan pendidikan bidan dengan kinerja bidan dalam pelaksanaan Desa Siaga, ada hubungan umur bidan dengan kinerja bidan dalam pelaksanaan Desa Siaga, ada hubungan pelatihan dengan kinerja bidan dalam pelaksanaan Desa Siaga, ada hubungan yang bermakna antara lama bekerja dengan kinerja bidan dalam pelaksanaan Desa Siaga di Kabupaten Tapin.
HUBUNGAN OBESITAS DAN RIWAYAT HIPERTENSI DENGAN KEJADIAN PREEKLAMSI DI PUSKESMAS RAWAT INAP DANAU PANGGANG Vonny Khresna Dewi
An-Nadaa: Jurnal Kesehatan Masyarakat (e-Journal) Vol 1, No 2 (2014): AN-NADAA JURNAL KESEHATAN MASYARAKAT
Publisher : Universitas Islam Kalimantan Muhammad Arsyad Al Banjari Banjarmasin

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (336.331 KB) | DOI: 10.31602/ann.v1i2.217

Abstract

Penyebab preeklamsi saat ini belum diketahui dengan pasti, namun ada beberapa faktor predisposisi yaitu kehamilan ganda, diabetes melitus, riwayat hipertensi ibu, molahidatidosa, obesitas, sosial ekonomi rendah, paritas ibu dan primigravida muda umur < 20 tahun dan pada primigravida tua umur > 35 tahun. Tujuan penelitian ini untuk mengetahui hubungan obesitas dan riwayat hipertensi dengan kejadian preeklamsi di Puskesmas Rawat Inap Danau Panggang Tahun 2012. Metode penelitian yang digunakan adalah survey analitik dengan pendekatan cross sectional. Populasi pada penelitian ini adalah seluruh ibu hamil yang berkunjung ke Puskesmas Rawat Inap Danau Panggang tahun 2012 berjumlah 407 orang. Teknik pengambilan sampel dengan sampling jenuh yaitu seluruh ibu hamil yang berjumlah 407 orang. Data dikumpulkan, diolah dan di analisa dengan analisa univariat dan bivariat. Hasil penelitian dari 407 ibu hamil, didapatkan ibu hamil dengan preeklamsi 75 (18,4), ibu hamil yang obesitas 26 (6,4%) dan ibu yang mempunyai riwayat hipertensi 107 (26,8%). Hasil uji chi square untuk obesitas dengan kejadian preeklamsi dengan nilai p = 0,281 > α = 0,05 artinya tidak ada hubungan obesitas dengan kejadian preeklamsi dan untuk riwayat hipertensi dengan kejadian preeklamsi dengan nilai p = 0,000 < α = 0,05 artinya ada hubungan riwayat hipertensi dengan kejadian preeklamsi. Kesimpulan dari penelitian ini bahwa riwayat hipertensi berhubungan dengan kejadian preeklamsi di puskesmas Rawat Inap Danau Panggang tahun 2012.
PEMANFAATAN UPAYA KESEHATAN BERSUMBERDAYA MASYARAKAT (UKBM) BIDANG KESEHATAN DI PUSKESMAS MARGASARI Vonny Khresna Dewi; Suhrawardi Suhrawardi; Tut Barkinah
MMJ (Mahakam Midwifery Journal) Vol 8 No 01 (2023): Mahakam Midwifery Journal (MMJ)
Publisher : Politeknik Kesehatan Kementerian Kesehatan Kalimantan Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35963/mmj.v8i01.192

Abstract

Abstract Community-based health efforts (UKBM) are a form of health service facilities managed by the community. Some known forms of UKBM are Posyandu (Integrated Service Post), Polindes (Village Maternity Cottage), and Desa Siaga. The success of UKBM implementation is inseparable from the role of the community as implementers and recipients of health services. The use of village funds for UKBM in Tapin District in 2016 only reached 3.6% of the expected 10% target. The aim of the study was to find out the factors related to the Utilization of Community-Based Health Efforts (UKBM) in the Health Sector in the Work Area of ​​the Margasari Health Center, Candi Laras Utara District, Tapin Regency in 2018. This research method uses an analytic survey design with a cross sectional approach. The instrument used in this study was a questionnaire. The study population was all mothers who had toddlers in the working area of ​​Margasari Health Center in Tapin Regency in 2017 as many as 1069 people. The sample of this study is a portion of mothers who have children under five in the work area of ​​Margasari Health Center in Tapin Regency. Calculation of sample size in this study based on the formula as many as 95 people.Date analysis using Chi Square Test. The results showed that Utilization of UKBM in the Health Sector was related to knowledge (ρ=0.000), attitude (ρ=0.000), distance to health facilities (ρ=0.000), ownership of KMS (ρ=0.000), family support (ρ=0.000), support for figures society (ρ=0.000). The conclusion is that the factors that influence the utilization of UKBM in the health sector are knowledge, attitude, distance to health facilities, KMS ownership, family support and support from community leaders. Keywords: Factor, UKBM, Health Sector Abstrak Upaya Kesehatan Bersumberdaya Masyarakat (UKBM) merupakan bentuk fasilitas pelayanan kesehatan yang dikelola oleh masyarakat.Beberapa bentuk UKBM yang dikenal adalah Posyandu (Pos Pelayanan Terpadu), Polindes (Pondok Bersalin desa) dan Desa Siaga. Keberhasilan pelaksanaan UKBM ini tidak terlepas dari peran masyarakat sebagai pelaksana dan penerima pelayanan kesehatan. Penggunaan dana desa untuk UKBM di Kabupaten Tapin tahun 2016 hanya mencapai 3,6% dari target 10% yang diharapkan.Tujuan penelitian adalah mengetahui Faktor yang berhubungan dengan Pemanfaatan Upaya Kesehatan Bersumberdaya Masyarakat (UKBM) Bidang Kesehatan di Wilayah Kerja Puskesmas Margasari Kecamatan Candi Laras Utara Kabupaten Tapin Tahun 2018. Metode penelitian ini menggunakan rancangan survei analitik dengan pendekatan cross sectional. Instrumen yang digunakan dalam penelitian ini adalah kuesioner Populasi penelitian adalah seluruh ibu yang mempunyai balita di wilayah kerja Puskesmas Margasari Kabupaten Tapin tahun 2017 sebanyak 1069 orang. Sampel penelitian ini adalah sebagian ibu yang mempunyai balita di Wilayah Kerja Puskesmas Margasari Kabupaten Tapin. Perhitungan besar sampel pada penelitian ini berdasarkan rumus sebanyak 95 orang. Analisis data menggunakan Uji Chi Square. Hasil penelitian didapatkan Pemanfaatan UKBM Bidang Kesehatan berhubungan dengan pengetahuan (ρ=0,000), sikap (ρ=0,000), jarak fasilitas kesehatan (ρ=0,000), kepemilikan KMS (ρ=0,000), dukungan keluarga (ρ=0,000), dukungan tokoh masyarakat (ρ=0,000). Kesimpulan adalah Faktor yang mempengaruhi pemanfaatan UKBM bidang kesehatan adalah pengetahuan, sikap, jarak fasilitas kesehatan, kepemilikan KMS, dukungan keluarga dan dukungan tokoh masyarakat. Kata Kunci : Faktor, UKBM, Bidang Kesahatan
PENGELOLAAN KELAS IBU HAMIL DALAM UPAYA MENINGKATKAN PEMANFAATAN BUKU KIA DI WILAYAH KERJA PUSKESMAS ASTAMBUL KABUPATEN BANJAR Vonny Khresna Dewi; Tut Barkinah; Rita Kirana
J-ABDI: Jurnal Pengabdian kepada Masyarakat Vol. 4 No. 6: Nopember 2024
Publisher : Bajang Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53625/jabdi.v4i6.8825

Abstract

Analysis of the partner situation based on data from the South Kalimantan Provincial Health Office found that the highest number of maternal deaths in 2021 was Tanah Laut Regency with 17 people and Banjar Regency with 16 people, while in 2022 the highest number of maternal deaths was Banjar Regency with 19 people (Hemorrhage: 1, Hypertension: 9, Covid: 1, and others: 8) and Banjarmasin Municipality with 14 people (Hemorrhage: 5, Hypertension: 2, Heart: 2, and others: 5). The cause of maternal death was Hypertension in pregnancy (32.4%), Postpartum hemorrhage (20.3%) and the period of death occurred in the Postpartum Period (48 hours after birth) by 61.6%. The high number of maternal, infant and child deaths is partly due to the delay factor (referring, arriving, getting adequate help). Some areas still have low coverage of maternal and child health programs. One of the causes is the low knowledge of mothers and families and not optimal utilization of the MCH book. Identification of partner problems from the results of the study revealed that most mothers' knowledge of the contents of the MCH book was still lacking because they did not read the book (did not have a MCH book: 19.2%, Have MCH book - can't show: 40.4% and have MCH book-can show: 40,4%). Priority efforts in reducing MMR in 2015-2019 include increasing the utilization of the MCH Book and implementing classes for pregnant women. The objective of community service is to be able to manage pregnant women's classes in an effort to increase the utilization of the MCH Book in the Working Area of Puskesmas Astambul, Banjar Regency. The solution offered is to increase knowledge and skills through the utilization of the MCH Book in the implementation of Maternity Classes to improve Maternal and Child Health in the Astambul Puskesmas Working Area of Banjar Regency. The contribution of Puskesmas Partners is as mentors, licensors, supporters and implementers of monitoring and evaluation of the sustainability of the Community Service Program. Targeted Mandatory Outputs The targeted mandatory output is the publication of the Community Service Journal “Journal of Independent Service” Target TS: Submit T+1: Accepted. Additional output is the target community service video for the year concerned. mThe target achievement of community service is an increase in the knowledge and skills of pregnant women about the implementation of pregnant women's classes for monitoring maternal and child health to 100%, and an increase in the utilization of the MCH Book to 100%. The follow-up plan of this community service activity makes a commitment with, Astambul Health Center, and related institutions to be responsible for maintaining the sustainability of this community service activity
Analisis Faktor Yang Berhubungan Dengan Kejadian BBLR di Puskesmas Sungai Cuka Tahun 2023 Yuni Hartati; Suhrawardi; Hapisah; Vonny Khresna Dewi
Jurnal Riset Multidisiplin Edukasi Vol. 2 No. 1 (2025): Jurnal Resit Multidisiplin Edukasi (Edisi Januari 2025)
Publisher : PT. Hasba Edukasi Mandiri

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71282/jurmie.v2i1.64

Abstract

Analisis Faktor yang Berhubungan dengan Kejadian Bayi Berat Badan Lahir Rendah (BBLR) di Puskesmas Sungai Cuka Tahun 2023. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berhubungan dengan kejadian BBLR, mengingat dampak serius yang ditimbulkan terhadap kesehatan bayi, termasuk risiko stunting. Metode yang digunakan adalah analisis observasional dengan pendekatan case control, melibatkan 19 kasus BBLR dan 38 kontrol. Data dianalisis menggunakan uji chi-square. Hasil penelitian menunjukkan bahwa dari 19 kasus BBLR, terdapat 11 ibu dengan anemia, 8 ibu dengan usia berisiko tinggi, dan 4 ibu yang tidak melakukan kunjungan antenatal care (ANC) sesuai standar. Analisis menunjukkan hubungan signifikan antara anemia (p=0,000), usia ibu (p=0,014), paritas (p=0,020), dan kunjungan ANC (p=0,020) terhadap kejadian BBLR. Kesimpulan dari penelitian ini adalah bahwa kejadian BBLR di Puskesmas Sungai Cuka Tahun 2023 berhubungan dengan faktor anemia, usia ibu, paritas, dan kunjungan ANC.
The PEMBERDAYAAN MASYARAKAT DALAM PENERAPAN APLIKASI WEB TENTANG PREDIKSI DAN PENCEGAHAN RESIKO PADA IBU HAMIL : COMMUNITY EMPOWERMENT IN THE IMPLEMENTATION OF WEB APPLICATIONS ON RISK PREDICTION AND PREVENTION IN PREGNANT WOMEN Hipni, Rubiati; ZAKIAH; Vonny Khresna Dewi
JURNAL RAKAT SEHAT (JRS) : Pengabdian Kepada Masyarakat Vol 4 No 2 (2025): Jurnal Rakat Sehat
Publisher : UPPM Poltekkes Kemenkes Banjarmasin

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31964/jrs.v4i2.122

Abstract

Early detection and prevention of risks in pregnant women are very important to ensure the health of both mother and fetus. Lack of access to information leads to limited knowledge. Therefore, efforts are needed to improve risk prediction in pregnant women and risk prevention efforts in pregnant women. The community of Cempaka Village, especially pregnant women who are vulnerable to risky pregnancies, and Posyandu cadres are the main partners in handling this problem. Lack of access to information leads to limited knowledge. Therefore, efforts are needed to improve risk prediction in pregnant women and risk prevention efforts in pregnant women. The solution used to solve the problem in Cempaka Village is to provide counseling, training, education and assistance related to Prediction and Prevention of Risks in Pregnant Women by implementing a Web Application. This community service aims to increase public awareness of the importance of early detection and Screening Efforts for Pregnant Women at Risk, Increase accessibility of health information for pregnant women in the Cempaka Village area. Increased knowledge about Prediction and Prevention of Risks in Pregnant Women and reduce risks in pregnant women. The implementation method includes an initial survey to assess the level of public awareness and knowledge regarding the health of pregnant women with a questionnaire, training by providing education to 12 pregnant women and 12 Posyandu cadres, practice and assistance in using information-based web applications that include Prediction and Prevention of Risks in Pregnant Women, Implementation of Web Applications to the community, monitoring their use and Evaluation. The results of the activity increased the knowledge and skills of pregnant women and cadres in using applications for early detection of risks in pregnant women. It is recommended that this activity can be carried out continuously in collaboration with other health workers and the sub-district.
Faktor yang Berhubungan dengan Pemilihan Alat Kontrasepsi di Desa Telang Baru Wilayah Puskesmas Telang Siong Tahun 2025 Rini Astuti; Tri Tunggal; Vonny Khresna Dewi; Erni Yuliastuti
Sinergi : Jurnal Ilmiah Multidisiplin Vol. 1 No. 2 (2025): Sinergi: Jurnal Ilmiah Multidisiplin
Publisher : PT. AHLAL PUBLISHER NUSANTARA

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Abstract

The Barito Timur Regency Health Office in 2024 reported that 66.3% of couples were active family planning participants. At Telang Siong Community Health Center, there were 1,207 active FP participants, with 2.48% using IUDs, 46.89% injections, 30.24% pills, 16.48% implants, and 2.65% MOW, MOP, or condoms. This study used an analytic survey design with a cross-sectional approach and an accidental sampling technique involving 73 respondents. The instrument used was a questionnaire, and data were analyzed using the Chi-Square test. Results showed that 74.0% of acceptors used non-long-term contraceptive methods (non-LTCM), 52.1% had low knowledge, 61.6% had negative attitudes, and 58.9% did not receive husband support. There was a significant correlation between knowledge (p = 0.000), attitude (p = 0.000), and husband support (p = 0.000) with the selection of contraceptive methods. Health workers are advised to provide clear and appropriate counseling so that the community is informed about the benefits, types, and advantages of contraceptive methods.   Dinas Kesehatan Kabupaten Barito Timur tahun 2024 melaporkan penggunaan KB aktif sebesar 66,3%. Di Puskesmas Telang Siong terdapat 1.207 peserta KB aktif dengan 2,48% menggunakan AKDR, 46,89% suntik, 30,24% pil, 16,48% implan, dan 2,65% MOW, MOP, atau kondom. Penelitian ini menggunakan desain survei analitik dengan pendekatan potong lintang dan teknik accidental sampling terhadap 73 responden. Instrumen yang digunakan adalah kuesioner, dan data dianalisis menggunakan uji Chi-Square. Hasil menunjukkan 74,0% akseptor menggunakan kontrasepsi non-MKJP, 52,1% memiliki pengetahuan rendah, 61,6% bersikap negatif, dan 58,9% tidak mendapatkan dukungan suami. Terdapat hubungan signifikan antara pengetahuan (p = 0,000), sikap (p = 0,000), dan dukungan suami (p = 0,000) dengan pemilihan alat kontrasepsi. Disarankan tenaga kesehatan memberikan penyuluhan yang jelas dan tepat agar masyarakat mengetahui manfaat, jenis, dan keunggulan alat kontrasepsi. Kata Kunci: Alat Kontrasepsi, Dukungan Suami, Pengetahuan, Sikap  
Hubungan Pemberian Asi Eksklusif Dengan Status Gizi Pada Bayi Usia > 6 Sampai 12 Bulan Di Wilayah Puskesmas Padang Batung Mariah; Rafidah; Megawati; Vonny Khresna Dewi
Sinergi : Jurnal Ilmiah Multidisiplin Vol. 1 No. 2 (2025): Sinergi: Jurnal Ilmiah Multidisiplin
Publisher : PT. AHLAL PUBLISHER NUSANTARA

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Abstract

Exclusive breastfeeding is the practice of providing only breast milk to infants from birth until 6 months without additional food or drink, except for medications. At Padang Batung Health Center, exclusive breastfeeding coverage increased from 50% in 2023 to 64.3% in 2024, but remains below the national target of 80%. This study aimed to analyze the relationship between exclusive breastfeeding and nutritional status of infants aged >6 to 12 months. An analytic observational study with a case-control design was conducted on 112 infants (1:1). The variables were exclusive breastfeeding and nutritional status, with secondary data analyzed using the chi-square test. Results showed that among 72 infants (64.3%) who received exclusive breastfeeding, 9.8% were malnourished, 80.4% had good nutrition, and 9.8% were obese, while of the 40 infants (35.7%) without exclusive breastfeeding, 20% were malnourished, 70% had good nutrition, and 10% were obese. Chi-square analysis revealed a significant relationship between exclusive breastfeeding and nutritional status (p<0.05). In conclusion, exclusive breastfeeding is significantly associated with the nutritional status of infants. Abstrak ASI eksklusif merupakan pemberian hanya Air Susu Ibu kepada bayi sejak lahir hingga usia 6 bulan tanpa tambahan makanan atau minuman lain, kecuali obat-obatan. Di Puskesmas Padang Batung, cakupan ASI eksklusif meningkat dari 50% pada tahun 2023 menjadi 64,3% pada tahun 2024, namun masih di bawah target nasional sebesar 80%. Penelitian ini bertujuan menganalisis hubungan pemberian ASI eksklusif dengan status gizi bayi usia >6 hingga 12 bulan. Metode penelitian menggunakan observasional analitik dengan desain case-control pada 112 bayi (1:1). Variabel penelitian meliputi pemberian ASI eksklusif dan status gizi, dengan data sekunder yang dianalisis menggunakan uji chi-square. Hasil penelitian menunjukkan dari 72 bayi (64,3%) yang memperoleh ASI eksklusif, 9,8% mengalami gizi kurang, 80,4% gizi baik, dan 9,8% obesitas; sedangkan 40 bayi (35,7%) yang tidak memperoleh ASI eksklusif terdiri dari 20% gizi kurang, 70% gizi baik, dan 10% obesitas. Analisis chi-square menunjukkan adanya hubungan signifikan antara pemberian ASI eksklusif dengan status gizi (p<0,05). Kesimpulan penelitian ini adalah pemberian ASI eksklusif berhubungan dengan status gizi bayi. Kata kunci: ASI eksklusif, status gizi, bayi.
GERMAS BERLIAN: GERAKAN MASYARAKAT BERDAYAKAN KELUARGA UNTUK IBU DAN ANAK DENGAN PENDEKATAN NEUROBEHAVIOUR, SOSIAL, DAN BUDAYA Fitria Jannatul Laili; Megawati, Megawati; Vonny Khresna Dewi; Rafidah, Rafidah; Erni Yuliastuti; Nur Rohmah Prihatanti; Efi Kristiana; Isnaniah, Isnaniah; Zakiah, Zakiah; Khairir Rizani; Suryanti, Suryanti
JURNAL PENGABDIAN MANDIRI Vol. 4 No. 11: Nopember 2025
Publisher : Bajang Institute

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Abstract

The Cempaka Subdistrict in Banjarbaru City faces several maternal and child health challenges, including low awareness of clean and healthy living behaviors, limited antenatal care visits, anemia among pregnant women and adolescents, suboptimal exclusive breastfeeding practices, incomplete basic immunization, and inadequate neonatal care knowledge. These problems are compounded by limited access to health services and varying levels of health literacy within the community. This community service program, Germas Berlian (Community Movement to Empower Families for Maternal and Child Health through Neurobehavioral, Social, and Cultural Approaches), aims to enhance community knowledge, skills, and health practices across the life cycle. The activities included coordination and field observation, Focus Group Discussions (FGD), integrated health education, health screenings for pregnant women, adolescents, and toddlers, capacity-building training, and home visits for prioritized families. Post-intervention evaluations demonstrated significant improvements in participants’ knowledge, nutritional awareness, health practices, and screening outcomes. The program highlights the effectiveness of integrated and culturally appropriate educational interventions to empower families and improve maternal and child health in underserved areas.