Analysis of health promotion in preventing chronic energy deficiency (CED) among pregnant women in coastal and mountainous areas

Masruroh (Faculty of Health Science, Diploma Three Midwifery Study Program, Universitas Respati Yogyakarta, Indonesia)
Max Robinson Wenno (Fishery Product Technology Study Program, Faculty of Fisheries and Marine Sciences, Universitas Pattimura Ambon, Indonesia)
Tri Subaeti (Nutritional Health Sub-Coordinator, Kebumen Regency Health Office, Jawa Tengah, Indonesia)
Ida Rahmawati (Nursing Science Study Program, STIKES Tri Mandiri Sakti Bengkulu, Indonesia)

JNKI (Jurnal Ners dan Kebidanan Indonesia) (Indonesian Journal of Nursing and Midwifery)
2026: Just Accepted Manuscript and Article In Press 2026

Background: Chronic Energy Deficiency (CED) in pregnant women is a significant public health problem, especially in coastal and mountainous areas. CED is associated with insufficient energy intake and related to social, economic, cultural, and behavioral factors. Low educational attainment, traditional belief about food taboos, and limited geographic access are major obstacles to improving nutrition for pregnant women.Objectives: to analyze health promotion eforts to prevent CED in pregnant women. Methods: qualitative research design with a phenomenological approach. The research was conducted in the hall of the Kebumen District Health Office on May 26, 2025. The total number of participants was 10 people, consisting of 2 people from the Kebumen District Health Office, 6 community health center coordinator midwives (3 from the coastal/beach area and 3 from the mountainous area) and 2 village midwives (1 from the coastal area and 1 from the mountainous area). Inclusion criteria were current involvement in maternal health-promotion or CED-prevention activities, at least six months of relevant service experience, and willingness to provide informed consent. Individuals were excluded if they declined participation, could not be interviewed during the data-collection period, or did not have direct experience with the program. Informants were selected purposive sampling. Data were collected through in-depth interviews, Focus Group Discussions (FGD), and documentation of health promotion programs.Results: The results identified five main themes: (1) Strengthening Health Education and Counseling for Pregnant Women; (2) Implementation of Nutrition Programs and Cross-Sector Collaboration; (3) Intensive Assistance Through Cadres and Family Support Teams (TPK); (4) Establishment of Special High-Risk Pregnant Women's Classes; (5) Strengthening Pregnancy Examination (ANC Terpadu) for Early Detection. Conclusions: Integrated and sustainable health promotion eforts involving education, nutritional interventions, mentoring, and cross-sector collaboration have proven efective in preventing CED and supporting optimal maternal and fetal health