Interpersonal Communication Training as an Effective Strategy to Optimize Multiple Micronutrient Supplementation (MMS) Utilization in Preventing Maternal and Neonatal Deaths

Background: Maternal mortality remains a global health problem, with approximately 800 deaths every day, mostly due to complications such as bleeding, where severe anemia is a major predisposing factor. Multiple Micronutrient Supplementation (MMS) is now recommended as a substitute for blood supplementation tablets due to its more complete nutritional content. However, utilization of MMS still faces challenges, including low knowledge of pregnant women, negative perceptions of side effects, and misinformation. Education by health workers, especially midwives, is key to overcoming these barriers. Interpersonal communication training is a relevant strategy to improve midwives' ability to deliver information effectively and build positive relationships with pregnant women. Although MMS has begun to be implemented, studies related to the effectiveness of interpersonal communication training in the context of MMS education are still limited in Indonesia. This study aims to fill this gap and strengthen the role of midwives in antenatal care. Objective: To assess the effect of interpersonal communication training on the utilization of multiple micronutrient supplementation on midwives' knowledge and skills. Methods: This study was conducted in September 2024 in Bone Bolango Regency, Gorontalo Province, involving 74 coordinating midwives and village supervisors. The design used was a quasi-experimental one-group pretest-posttest to evaluate the effectiveness of interpersonal communication training on improving midwives' knowledge and skills. Knowledge was measured using a questionnaire, while skills were assessed through a post-training observation checklist. All instruments were tested for validity and reliability. Data analysis included Wilcoxon test to compare pretest and posttest scores, Spearman test to see the relationship between knowledge and skills, and Mann-Whitney test based on midwives' characteristics. Path analysis was conducted within a Structural Equation Modeling (SEM) framework with directly observed variables. Results: The results showed that the score before the intervention was 10.80 and after the intervention was 15.23, which means there is a difference in scores between before and after the intervention. The statistical test results showed a p value (0.000) <0.05, which means that there is an effect of interpersonal communication training in the utilization of multiple micronutrient supplements (MMS) on the knowledge and skills of midwives. Conclusion: Interpersonal communication training for midwives is effective in improving midwives' knowledge and skills.