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PurposeThis study was aimed to evaluate the implementation of an integrated antenatal care (ANC) scheme through a retrospective document study using a checklist for measuring the adequacy of the cohort ANC register documented by midwives in an urban area and to describe the barriers for the midwives during the ANC record process.Design/methodology/approachAn exploratory descriptive study using a sequential mixed method was utilised where a quantitative method was employed by collecting secondary data of 150 entries of the cohort ANC register and followed by in-depth interviews among midwives and community health workers.FindingsThe results show that the cohort registry indicators for integrated care such as laboratory and management were poorly recorded. Several barriers were found and categorised during the implementation of the integrated ANC, namely (1) governance and strategy, (2) process of care, (3) organisation and management support.Research limitations/implicationsThe contribution of this present research is that it provides empirical data of the integrated ANC implementation in primary health care (PHC) which has the responsibility to deliver an integrated level of care for ANC using a cohort registry for pregnancy registration monitoring which facilitates the continuity and quality of care.Practical implicationsPractical implication of the finding is that functional integration such as the clinical information system to facilitate an efficient and effective approach during the implementation of integrated ANC in primary care should be considered to support the clinical, professional, organisational, system and normative integration.Originality/valueSince only limited studies have been conducted to assess the quality of the cohort ANC registry and to investigate the barriers against integrated ANC implementation in Indonesia, the research findings are valuable information for the national and local governments to improve the ANC service in Indonesia.

Exclusive breastfeeding intention is a mother’s intention to provide her baby only breast milk since the infant was born until at the age of 6 months. Intention in prenatal period is the direct affirmation of exclusive breastfeeding. This study aimed to find out the most dominant factor related to exclusive breastfeeding intention among pregnant women at a mother and child hospital in South Tangerang. A cross-sectional study design was conducted primarily. The samples were 143 pregnant women on their third semester pregnancy selected by purposive sampling. Intention was measured by the Infant Feeding Intention scale questionnaire. Meanwhile, attitude, subjective norms, and perceived behavioral control were measured by the modified Breastfeeding Attrition Prediction Tool questionnaire. Data were analyzed using the multivariate logistic regression analysis. It was 61.5% mother had strong exclusive breastfeeding intention. Perceived behavioral control dominantly influenced the exclusive breastfeeding intention (p value = 0.007; Odds Ratio 3.030; 95% CI = (1.361-6.746)). The other factors influencing intention were attitude, exposure to exclusive breastfeeding from social media, health workers’ support, previous breastfeeding experienceand mothers’ occupation. A mother with high perceived behavioral control has three times more likely to have ‘high exclusive breastfeeding intention’ than those having the low ones.AbstrakIntensi pemberian ASI eksklusif adalah intensi ibu untuk memberikan hanya ASI pada bayinya sejak dilahirkan hingga berusia enam bulan. Intensi pada periode prenatal merupakan penentu langsung pemberian ASI eksklusif. Penelitian ini bertujuan mengetahui faktor paling dominan berhubungan dengan intensi pemberian ASI eksklusif pada ibu hamil di sebuah rumah sakit ibu dan anak di Kota Tangerang Selatan. Penelitian dengan desain studi potong lintang dilakukan secara primer. Sampel berjumlah 143 ibu hamil trimester ketiga dipilih secara purposive sampling. Intensi pemberian ASI eksklusif diukur menggunakan kuesioner the Infant Feeding Intentions scale. Sedangkan sikap, norma subjektif dan persepsi kontrol perilaku dinilai menggunakan modifikasi kuesioner Breastfeeding Attrition Prediction Tool. Data dianalisis menggunakan analisis regresi logistik ganda. Sebanyak 61,5% ibu memiliki intensi kuat memberikan ASI eksklusif. Persepsi kontrol perilaku paling dominan berhubungan dengan intensi pemberian ASI eksklusif, (p=0,007; Odds Ratio 3,030; 95% CI (1,361-6,746). Faktor lainnya yang berhubungan dengan intensi adalah sikap, keterpaparan ibu terhadap ASI eksklusif dari media sosial, dukungan tenaga kesehatan, pengalaman menyusui sebelumnya, dan pekerjaan ibu dengan persepsi kontrol perilaku tinggi berpeluang tiga kali lebih besar memiliki ‘intensi tinggi’ untuk memberikan ASI eksklusif dibandingkan ibu berpersepsi kontrol perilaku rendah.

Hillary was talking about raising children when she said "it takes a village…" In the case of my dissertation, it has taken a village to complete, in part because of a child, my daughter, Willa. We headed out for my 1999 field season when she was only 5 weeks old-the overwhelming support and generous help I received that summer from family and friends will always be remembered and held dear. I want to thank my committee members, Brent Bailey, Donna Ford-Werntz, Ray Hicks and Richard Thomas, for their guidance and thoughtful suggestions throughout my research and preparation of my final document. Very special thanks to my committee chair, Jim McGraw, who stayed the distance with me in spite of my northward migration. The intellectual stimulation and creative thinking have taught me so much, thank you.