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

A mixed-methods study of pregnancy-centered antenatal care strategies for stunting prevention in Jepara Regency

Ita Rahmawati (Midwifery Study Program, Faculty of Health, Universitas Al Hikmah Jepara, Indonesia)
Roihatul Zahro (Nursing Science Study Program, Faculty of Health Sciences, Universitas Gresik, Indonesia)
Devi Rosita (Midwifery Study Program, Faculty of Health, Universitas Al Hikmah Jepara, Indonesia)



Article Info

Publish Date
31 Jul 2026

Abstract

Background: Stunting remains a major public health challenge rooted in the prenatal period. Although antenatal care (ANC) coverage in Indonesia is high, gaps in ANC quality, nutrition counseling, and risk-responsive care limit its effectiveness for stunting prevention.Objectives: This study examined pregnancy-centered ANC strategies for stunting prevention in Jepara Regency using a mixed-methods approach integrating quantitative and qualitative findings.Methods: An explanatory sequential mixed-methods design was applied. The quantitative phase involved a cross-sectional survey of 212 pregnant women receiving routine ANC. ANC quality was assessed using the Content-Qualified Antenatal Care (ANCq) indicator, dietary diversity using the Minimum Dietary Diversity for Women (MDD-W), and stunting prevention knowledge and practices through structured questionnaires. Multivariable generalized linear models identified predictors of stunting prevention practices. The qualitative phase included in-depth interviews with 24 purposively selected pregnant women. Reflexive thematic analysis and narrative integration were conducted.Results: The mean ANCq score was 7.1 ± 1.8, indicating moderate ANC adequacy, while only 46.2% of participants achieved minimum dietary diversity (MDD-W ≥5). Higher ANCq scores (β = 2.84; p < 0.001), adequate dietary diversity (β = 5.96; p < 0.001), maternal education, and partner support were significantly associated with stronger stunting prevention practices. Qualitative findings revealed limited understanding of stunting prevention despite regular ANC attendance, a knowledge–practice gap caused by economic and pregnancy-related barriers, and the important role of family and health-system support.Conclusions: Pregnancy-centered stunting prevention is strongly influenced by ANC quality, dietary diversity, education, and partner support. Strengthening risk-responsive ANC and practical nutrition counseling may improve early stunting prevention outcomes.

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Journal Info

Abbrev

JNKI

Publisher

Subject

Health Professions Medicine & Pharmacology Nursing Public Health Other

Description

Jurnal Ners dan Kebidanan Indonesia (Indonesian Journal of Nursing and Midwifery) abbreviated JNKI (p-ISSN 2354-7642 and e-ISSN 2503-1856) is the journal of nursing and midwifery published by Department of Nursing and Department of Midwifery, Faculty of Health Sciences, Alma Ata University in ...