Assessment of Continuity of Care Policies Implementation for Low-Birth-Weight Infants in DKI Jakarta: A Nursing Perspective
DOI:
https://doi.org/10.31674/mjn.2025.v17i01.007Abstract
Background: Despite the introduction of several policies aimed at supporting continuity of care for Low Birth Weight (LBW) infants in DKI (Daerah Khusus Ibukota) Jakarta, significant challenges remain in delivering consistent and high-quality services. Community-based care programs continue to struggle with limited coverage and suboptimal quality. Data from the Central Statistics Agency of DKI Jakarta reveals a concerning increase in LBW cases—from 1,381 in 2018 to 2,145 in 2021—highlighting persistent gaps in both prevention and care. Methods: This qualitative study employed a multi-method approach, including literature reviews, policy document analysis, and in-depth interviews with healthcare professionals across six sub-districts of Central Jakarta. The analysis focused on assessing the feasibility and acceptability of current policy implementation. Results: Findings show that although policies for continuity of care for LBW infants exist, their implementation remains suboptimal. Key issues include weak coordination between hospitals and community health centres, limited trained personnel, and inadequate parental education. Nurses face challenges due to workload and lack of access to discharge information. Despite this, nurses play a pivotal role in delivering education, conducting home visits, and coordinating follow-up care. Conclusion: To improve outcomes for LBW infants in DKI Jakarta, stronger implementation of continuity of care policies is imperative. Key strategies include building nursing capacity, enhancing inter-facility coordination, and increasing support for parents. Strengthening these components is crucial to establishing sustainable, community-based care for this vulnerable population.
Keywords:
Continuity of Care, Health Policies, Low Birth Weight Infants, Morbidity RatesDownloads
References
Ahmed, S., & Fullerton, J. (2019). Challenges of reducing maternal and neonatal mortality in Indonesia: Ways forward. International Journal of Gynecology and Obstetrics, 144, 1–3. https://doi.org/10.1002/ijgo.12728
Amelia, T., Pratomo, H., Adisasmita, A. C., Martha, E., Rustina, Y., Murty, A. I., Susilowati, I. H., Tambunan, E. S., & Hasanah, I. J. (2021). Feasibility of Kangaroo Mother Care (KMC) Implementation in Depok City, Indonesia. Global Pediatric Health, 8. https://doi.org/10.1177/2333794X211012390
Andriani, H., Rachmadani, S. D., Natasha, V., & Saptari, A. (2022). Continuum of care in maternal, newborn and child health in Indonesia: Evidence from the Indonesia Demographic and Health Survey. Journal of Public Health Research, 11(4). https://doi.org/10.1177/22799036221127619
Astuti, E. S., Nursalam, N., Devy, S. R., & Etika, R. (2019). Knowledge, Family Support and Self-Reliance Capital when Caring for Low-Birth-Weight Babies. Jurnal Ners, 14(1), 10–15. https://doi.org/10.20473/jn.v14i1.12734
Astuti, E. S., Solikhah, F. K., & Ernawati, N. (2022). Peningkatan Pengasuhan bayi Berat Lahir Rendah (BBLR) oleh Tenaga Kesehatan dan Kader [Improving Care of Low Birth Weight (LBW) Babies by Health Workers and Cadres]. Jurnal Kreativitas Pengabdian Kepada Masyarakat (PKM), 5(12), 4311–4322. https://doi.org/doi.org/10.33024/jkpm.v5i12.7950
Badan Kebijakan Pembangunan Kesehatan Kementerian Kesehatan RI. (2023). Laporan Tematik Survei Kesehatan Indonesia [Thematic Report of the Indonesian Health Survey], 33–43. Retrieved from: https://www.badankebijakan.kemkes.go.id/laporan-tematik-ski/ . Accessed on 30th June 2023.
Badan Pusat Statistik Provinsi DKI Jakarta. (2023). Health Profile of DKI Jakarta Province 2022. BPS Statistics Indonesia DKI Jakarta Province. Retrieved from: https://jakarta.bps.go.id/en/publication/2023/09/22/62609a4f84e46e6c7cf5ca60/health-profile-of-dki-jakarta-province-2022.html . Accessed on 18th August, 2023.
Baysoy, N., Kavuncuoglu, S., Ramoglu, M. G., Aldemir, E. Y., & Payasli, M. (2021). Follow Up of Low Birth Weight PretermInfants After Hospital Discharge Incidence and Reasons for Rehospitalization. Journal of Tropical Pediatrics, 00, 1–11. https://doi.org/10.1093/tropej/fmab029
Bhutta, Z. A. (2017). Community-based primary health care: A core strategy for achieving sustainable development goals for health. Journal of Global Health (JoGH), 7(1), 1–2. https://doi.org/10.1056/NEJMra1111853
Braga, P. P., & de Sena, R. R. (2017). Becoming a caregiver of premature newborns and the devices part of the continuity of post-discharge care. Texto e Contexto Enfermagem, 26(3), 1–8. https://doi.org/10.1590/0104-07072017003070016
Creswell, J. W., & Poth, C. N. (2018). Qualitative inquiry and research design: Choosing among five approaches (Fourth Ed). SAGE Publications, Inc. Retrieved from: https://pubhtml5.com/enuk/cykh/Creswell_and_Poth%2C_2018%2C_Qualitative_Inquiry_4th/. Accessed on 19th April 2023.
de Wit, T. M. G., Doherty, T., & Hendricks, M. (2025). Community-based follow-up of very low birth weight neonates discharged from a regional hospital in Cape Town: A descriptive study. Global Health Action, 18(1). https://doi.org/10.1080/16549716.2025.2466277
Gebremedhin, A. F., Dawson, A., & Hayen, A. (2023). Determinants of continuum of care for maternal, newborn, and child health services in Ethiopia: Analysis of the modified composite coverage index using a quantile regression approach. PLoS One, 18(1 January), 1–17. https://doi.org/10.1371/journal.pone.0280629
Grewal, G., Fuller, S. S., Rababeh, A., Maina, M., English, M., Paton, C., & Papoutsi, C. (2024). Scoping review of interventions to improve continuity of postdischarge care for newborns in LMICs. BMJ Global Health, 9(1), 1–28. https://doi.org/10.1136/bmjgh-2023-012894
Gu, H., Wang, L., Liu, L., Luo, X., Wang, J., Hou, F., Nkomola, P. D., Li, J., Liu, G., Meng, H., Zhang, J., & Song, R. (2017). A gradient relationship between low birth weight and IQ: A meta-analysis. Scientific Reports, 7(1), 1–13. https://doi.org/10.1038/s41598-017-18234-9
Haile, D., Kondale, M., Andarge, E., Tunje, A., Fikadu, T., & Boti, N. (2020). Level of completion along continuum of care for maternal and newborn health services and factors associated with it among women in Arba Minch Zuria woreda, Gamo zone, Southern Ethiopia: A community based crosssectional study. PLoS ONE, 15(6), 1–18. https://doi.org/10.1371/journal.pone.0221670
Hermans, A. C. M., Boertien, S., Van Den Berg, L. M. M., De Jonge, A., Jansen, D. E. M. C., Franx, A., Van Der Kooy, J., & De Kroon, M. L. A. (2025). Parent’s perspective on continuity of care in the maternity care and child health services continuum: A qualitative systematic review. International Journal of Integrated Care, 25(1), 1–15. https://doi.org/10.5334/ijic.8645
Jornayvaz, F. R., Vollenweider, P., Bochud, M., Mooser, V., Waeber, G., & Marques-Vidal, P. (2016). Low birth weight leads to obesity, diabetes and increased leptin levels in adults: The CoLaus study. Cardiovascular Diabetology, 15(1), 1–10. https://doi.org/10.1186/s12933-016-0389-2
Kahsay, Z. H., Medhanyie, A. A., Mariam, D. H., Ersdal, H. L., & Rettedal, S. (2025). Feasibility of implementing family-integrated newborn care for hospitalised preterm and low birthweight infants in newborn care units of Ethiopia: a mixed-methods design. BMJ Open, 15(1), 1–13. https://doi.org/10.1136/bmjopen-2024-093377
Kemenkes RI. (2020). Pedoman pelayanan antenatal, persalinan, nifas, dan bayi baru lahir di Era Adaptasi Baru (Revisi 2) [Guidelines for antenatal, delivery, postpartum and newborn services in the New Adaptation Era (Revision 2)]. (Direktorat Kesehatan Keluarga (ed.)). Kementerian Kesehatan RI. Retrieved from: https://covid19.go.id/storage/app/media/Materi Edukasi/2020/Oktober/revisi-2-a5-pedoman-pelayanan-antenatal-persalinan-nifas-dan-bbl-di-era-adaptasi-kebiasaan-baru.pdf . Accessed on 18th May, 2023.
Kementerian Kesehatan Republik Indonesia. (2023). Profil Kesehatan Indonesia 2022 [Indonesia Health Profile 2022]. Retrieved from: https://kemkes.go.id/id/profil-kesehatan-indonesia-2022 . Accessed on 24th August 2023.
Kementerian Kesehatan RI. (2013). Peraturan Menteri Kesehatan Republik Indonesia Nomor 70 tahun 2013 ttg Penyelenggaraan Manajemen Terpadu Balita Sakit Berbasis Masyarakat [Regulation of the Minister of Health of the Republic of Indonesia Number 70 of 2013 concerning the Implementation of Integrated Management of Sick Toddlers Based on the Community]. Retrieved from: https://peraturan.go.id/id/permenkes-no-70-tahun-2013. Accessed on 18th November 2023.
Kementerian Kesehatan RI. (2014). Peraturan Menteri Kesehatan Republik Indonesia Nomor 53 Tahun 2014 Tentang Pelayanan Kesehatan Neonatal Esensial [Regulation of the Minister of Health of the Republic of Indonesia Number 53 of 2014 Concerning Essential Neonatal Health Services]. Retrieved from: https://peraturan.bpk.go.id/Details/154752/permenkes-no-53-tahun-2014 . Accessed on 18th May 2023.
Kementerian Kesehatan RI. (2016). Peraturan Menteri Kesehatan Republik Indonesia No 39 Tahun 2016 Tentang Pedoman Penyelenggaraan Program Indonesia Sehat dengan Pendekatan Keluarga [Regulation of the Minister of Health of the Republic of Indonesia No. 39 of 2016 concerning Guidelines for the Implementation of the Healthy Indonesia Program with a Family Approach]. Retrieved from: https://peraturan.bpk.go.id/Details/113087/permenkes-no-39-tahun-2016 . Accessed on 16th April 2023.
Lawn, J. E., Blencowe, H., Oza, S., You, D., Lee, A. C. C., Waiswa, P., Lalli, M., Bhutta, Z., Barros, A. J. D., Christian, P., Mathers, C., & Cousens, S. N. (2014). Every newborn: Progress, priorities, and potential beyond survival. The Lancet, 384(9938), 189–205. https://doi.org/10.1016/S0140-6736(14)60496-7
Maluni, J., Oluoch, D., Molyneux, S., Boga, M., Jones, C., Murila, F., English, M., Ziebland, S., & Hinton, L. (2025). After neonatal care, what next? A qualitative study of mothers’ post-discharge experiences after premature birth in Kenya. International Journal for Equity in Health, 24(1), 17. https://doi.org/10.1186/s12939-024-02340-y
Mitchell, E. J., Pallotti, P., Qureshi, Z. P., Daniels, J. P., Oliver, M., Were, F., Osoti, A., Gwako, G., Kimani, V., Opira, J., & Ojha, S. (2021). Parents, healthcare professionals and other stakeholders’ experiences of caring for babies born too soon in a low-resource setting: A qualitative study of essential newborn care for preterm infants in Kenya. BMJ Open, 11(6), 1–9. https://doi.org/10.1136/bmjopen-2020-043802
Nalwadda, C., Tusubira, A. K., Nambuya, H., Namazzi, G., Muwanguzi, D., Waiswa, P., Kurinczuk, J., Kelley, M., & Nair, M. (2023). Transition from hospital to home care for preterm babies: A qualitative study of the experiences of caregivers in Uganda. PLoS Global Public Health, 3(5), 1–16. https://doi.org/10.1371/journal.pgph.0000528
Natarajan, G., & Shankaran, S. (2016). Short- and long-term outcomes of moderate and late preterm infants. American Journal of Perinatology, 33(3), 305–317. https://doi.org/10.1055/s-0035-1571150
Rustina, Y., Nursasi, A. Y., Budiati, T., Syahreni, E., & Fitriyani, P. (2014). The influence of family empowerment on the health status of Low Birth Weight Infant in Jakarta. Makara Journal of Health Research, 18(1). https://doi.org/10.7454/msk.v18i1.3089
Tanaka, M. C., Bernardino, F. B. S., Braga, P. P., Alencastro, L. C. da S., Gaíva, M. A. M., & Viera, C. S. (2024). Weaknesses in the continuity of care for preterm infants discharged from the neonatal unit. Revista Da Escola de Enfermagem, 58, 1–9. https://doi.org/10.1590/1980-220X-REEUSP-2023-0228PT
United Nations Children's Fund (UNICEF). (2025). Child survival and the SDGs. Retrieved from: https://data.unicef.org/topic/child-survival/child-survival-sdgs/ . Accessed on 18th July 2023.
Vulcănescu, A., Siminel, M. A., Dinescu, S. N., Boldeanu, M. V., Dijmărescu, A. L., Manolea, M. M., & Văduva, C. C. (2025). Systematic review: Maternal risk factors, socioeconomic influences, neonatal biomarkers and management of early-onset sepsis in late preterm and term newborns—A focus on European and Eastern European Contexts. Life, 15(2), 1–20. https://doi.org/10.3390/life15020292
World Health Organization (WHO). (2017). Guideline : Protecting, promoting dan suporting Breastfeeding in Facilities providing maternity and newborn services. Retrieved from: http://apps.who.int/iris/bitstream/10665/259386/1/9789241550086-eng.pdf. Accessed on 16th May 2023.
World Health Organization. (2022). Request for proposals: Assessment of burden and management of low birth weight at primary and referral health care facilities in Indonesia (RFP 166-2022). WHO Indonesia – Family Health. Retrieved from: https://cdn.who.int/media/ . Accessed on 18th January 2023.
Yu, S., Lui, K., Fiebig, D. G., Travadi, J., Homer, C. S., Sinclair, L., Scarf, V., & Viney, R. (2025). The impact of neonatal care on moderate-risk infants: Evidence from healthcare use in the first two years of life. Journal of Health Economics, 102(December 2023). https://doi.org/10.1016/j.jhealeco.2025.102995
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