The Effect of Flipchart-Based Health Education on Knowledge and Self-Efficacy Regarding High-Risk Pregnancy among Pregnant Women

Sri Hardi Wuryaningsih (Department of Nursing, Poltekkes Kemenkes Surabaya, Surabaya, Indonesia)
Adin Mu’afiro (Department of Nursing, Poltekkes Kemenkes Surabaya, Surabaya, Indonesia)
Miadi (Department of Nursing, Poltekkes Kemenkes Surabaya, Surabaya, Indonesia)
Nimas Dhalita Audria Hanun (Department of Nursing, Poltekkes Kemenkes Surabaya, Surabaya, Indonesia)

International Journal of Advanced Health Science and Technology
Vol. 6 No. 3 (2026): June

Maternal mortality remains a major public health challenge in Indonesia, and limited knowledge of high-risk pregnancy is one of the factors that may delay appropriate decision-making and reduce women’s confidence in managing pregnancy-related complications. This study aimed to examine the effect of flipchart-based health education on the knowledge and self-efficacy of pregnant women regarding high-risk pregnancy. A pre-experimental study with a one-group pretest-posttest design was conducted at the Kapas Health Center, Bojonegoro Regency. The population consisted of 302 pregnant women, and a sample of 51 participants was selected using the Lemeshow formula. The independent variable was health education delivered through flipchart media, while the dependent variables were knowledge and self-efficacy regarding high-risk pregnancy. Data were collected using structured questionnaires and analyzed using the Wilcoxon signed-rank test with a significance level of 0.05. The results showed a statistically significant improvement in knowledge after the intervention (p = 0.008). Before the intervention, 27 participants (53%) had poor knowledge, 20 (39.2%) had adequate knowledge, and 4 (7.8%) had good knowledge. After the intervention, the proportion with poor knowledge decreased to 16 participants (31.4%), while 24 (47%) had adequate knowledge and 11 (21.6%) had good knowledge, indicating that 68.6% achieved adequate-to-good knowledge after the intervention. A significant improvement was also observed in self-efficacy (p = 0.000). Prior to the intervention, 12 participants (23.5%) had low self-efficacy and 39 (76.5%) had high self-efficacy; after the intervention, all participants (100%) demonstrated high self-efficacy. In conclusion, flipchart-based health education was effective in improving both knowledge and self-efficacy among pregnant women regarding high-risk pregnancy. This approach may serve as a practical, low-cost, and accessible educational strategy for use in community health centers to support better maternal awareness, confidence, and decision-making.