A digital-spiritual assistance Dzikry model to improve hemoglobin levels and antenatal care compliance: A quasi-experimental study.

BACKGROUND

Maternal anemia remains a significant contributor to adverse pregnancy outcomes, particularly in low- and middle-income countries. Although universal health insurance has expanded access to antenatal care (ANC), coverage alone does not guarantee optimal utilization. Innovative approaches addressing behavioral, cultural, and motivational factors are needed. This study aimed to evaluate the effectiveness of a digital-spiritual assistance Dzikry model in improving maternal hemoglobin status and ANC compliance.

MATERIALS AND

METHODS

A quasiexperimental nonequivalent control group design with pretest-posttest measurements were conducted among 60 second-trimester pregnant women at a clinic in Tangerang, Indonesia. Participants were allocated to an intervention group receiving digital education, visit reminders, and spiritually oriented motivational support, or a control group receiving standard ANC services. Hemoglobin levels were measured at baseline and follow-up. Secondary outcomes included ANC compliance, maternal knowledge, and perceived communication quality. Data were analyzed using independent t-tests, Chi-square tests, ANCOVA, and logistic regression.

RESULTS

Baseline characteristics were comparable between groups. The intervention showed a significantly greater increase in Hb levels compared to the control group (mean difference 0.7 g/dL; P = 0.004). A greater reduction in anemia prevalence was also observed. Additionally, the intervention group demonstrated higher ANC compliance, improved knowledge, and better communication scores. Women in the intervention group were more than three times as likely to achieve normal Hb status.

CONCLUSIONS

The digital-spiritual assistance Dzikry model effectively enhances maternal engagement in ANC and improves hemoglobin levels, indicating its potential as a culturally adaptive strategy to maternal anemia in primary care settings.