The KIA (Maternal and Child Health) Telemedicine Model as a Strategic Innovation in Midwifery Services in Remote Areas of Indonesia

Abstract

Introduction: KIA or Maternal and Child Health (MCH) constitutes a critical indicator of health system performance; however, in Indonesia’s remote regions, its advancement remains hindered by geographical inaccessibility, inadequate infrastructure, and limited digital literacy among healthcare providers.

Objective: This study seeks to evaluate the effectiveness of the MCH Telemedicine model in enhancing midwives’ professional capacity and to establish a conceptual framework for its systematic implementation in 3T areas (underdeveloped, frontier, and outermost regions).

Methods: A sequential mixed-methods design was employed, encompassing qualitative exploration (focus group discussions and in-depth interviews), pre-experimental assessment (one-group pretest–posttest, n = 424), and a quasi-experimental approach (pretest–posttest with control group, n = 424). Quantitative analysis was conducted using paired t-tests and intergroup comparison, triangulated with qualitative findings.

Result: The exploratory phase revealed substantial barriers in service accessibility and digital literacy, although a general readiness to adopt innovation was evident. The pre-experimental phase demonstrated a significant improvement in knowledge (+25.81 points; p < 0.001) and digital competencies (+51 points; p < 0.001). In the quasi-experimental phase, the intervention group exhibited statistically significant gains, whereas the control group did not display meaningful change. These findings underscore that the effectiveness of telemedicine interventions hinges on structured implementation, empowerment of midwives, community-wide digital literacy, and coherent cross-sectoral policy alignment.

Conclusion: The proposed MCH Telemedicine conceptual model has been empirically validated as both effective and contextually appropriate for strengthening healthcare capacity in remote areas, and it holds considerable potential as a strategic framework for scaling up digital midwifery services across Indonesia.