Jurnal Loyalitas Sosial

Vol. 7 No. 1 Februari 2025

Journal of Community Services in Humanities and Social Sciences

p-ISSN | e-ISSN

Involvement Medical Students In Postpartum Depression (PPD)

Educational Program Among Community In Koper Village

Rita Komalasari

a,1*

, Siti Maulidya Sari

b,2

, Adilah Rifat Hakimah

c,3

, Dhea Putri Ardita

d,4

Helmi Fahmi Fauzi

e,5

, Lucy

f,6

, Laila Felicia

g,7

, Raysha Damatri Rasyad

h,8

a,b,c,d,e,f,g,h

Rita Komalasari; Department of Public Health, Faculty of Medicine, YARSI Universitas, Jakarta

rita.komalasari@yarsi.ac.id

* Correspondence Authors

Manuscript received: 2 Januari 2025, revised: 5 Februari 2025, approved: 28 Februari 2025

Abstract

The significant role of family members and community including cadres in identifying

and supporting the mother with PPD. However, there is a lack of knowledge and

awareness of the disorder. The aim is to increase knowledge and awareness of the

cadres, women, and their families, community toward PPD by involving medical

students in Koper Village. The educational program of PPD was conducted on 29

Desember 2022 in Koper District, Banten Province with the involvement of five medical

students and 44 participants. The program included presentation, discussion, pre and

post testing questionnaires. Data was analyzed using the SPSS 26 program. Wilcoxon

signed rank test as a non-parametric test for un- distributed normal data was used. A

significance value of 0.000 asymp.sig was obtained. (2-tailed < 0.05). This can be

concluded that there is a significant increasing knowledge and awareness of PPD

among participants toward PPD before and after the program. The involvement of

medical students in the program has had a crucial impact on increasing the knowledge

and awareness of the cadres, women, their families, and community. The sufficient

knowledge of the participants could help them in identifying and supporting the mother,

as well as the participants may also help other community members to raise awareness

about PPD.

Keywords: PPD; educational program; medical student; cadres; community

Abstrak

Peran penting anggota keluarga dan masyarakat, termasuk kader, dalam

mengidentifikasi dan mendukung ibu dengan PPD sangatlah signifikan. Namun, masih

terdapat kurangnya pengetahuan dan kesadaran mengenai gangguan ini. Tujuan dari

program ini adalah untuk meningkatkan pengetahuan dan kesadaran kader, perempuan,

keluarga, serta masyarakat terhadap PPD dengan melibatkan mahasiswa kedokteran di

Desa Koper. Program edukasi mengenai PPD dilaksanakan pada 29 Desember 2022 di

Kecamatan Koper, Provinsi Banten, dengan melibatkan lima mahasiswa kedokteran dan

44 peserta. Program ini mencakup presentasi, diskusi, serta kuesioner pre-test dan post-

test. Data dianalisis menggunakan program SPSS 26. Uji Wilcoxon Signed Rank

digunakan sebagai uji non-parametrik untuk data yang tidak berdistribusi normal. Nilai

signifikansi yang diperoleh adalah 0,000 (asymp.sig), dengan (2-tailed < 0,05). Dengan

demikian, dapat disimpulkan bahwa terdapat peningkatan yang signifikan dalam

pengetahuan dan kesadaran peserta mengenai PPD sebelum dan sesudah program.

Keterlibatan mahasiswa kedokteran dalam program ini berdampak besar dalam

meningkatkan pengetahuan dan kesadaran kader, perempuan, keluarga, dan masyarakat.

Jurnal Loyalitas Sosial

Vol. 7 No. 1 Februari 2025

Journal of Community Services in Humanities and Social Sciences

p-ISSN | e-ISSN

Pengetahuan yang cukup dari para peserta dapat membantu mereka dalam

mengidentifikasi serta mendukung ibu dengan PPD, sekaligus membantu anggota

masyarakat lainnya dalam meningkatkan kesadaran mengenai PPD.

Kata-kata kunci: PPD, program edukasi, mahasiswa kedokteran, kader, masyarakat

Introduction

PPD is a common mental health problem

affecting 10 to 20% of mothers globally

(Wang et al., 2021). The number is estimated

to be higher in low-income countries around

24,6% (Liu et al., 2021). The prevalence of

postpartum depression in Indonesia is around

26.15% (Nurbaeti et al., 2018). During the

transition stage to motherhood, they

experienced significant physical,

psychological, and social changes. These lead

to vulnerability of women to the onset of

PPD. PPD is defined as “a major depressive

episode with peripartum onset and onset of

mood symptoms that occurs during

pregnancy or within 4 weeks following

delivery” according to the Diagnostic and

Statistical Manual of Mental Disorder (DSM-

5) (American Psychiatric Association 2013).

The symptoms reach a peak intensity between

2 and 6 months after giving birth (Ahmed et

al., 2024).

The symptoms include low mood, low self-

esteem, loss of interest, fatigue, tearfulness,

guilty feelings, helplessness, anxiety and

irritability. These conditions have negative

consequences on the mother’s well-being,

mother’s ability to provide optimal care for

her infant, and her family members (Wan et

al., 2021). The long term impact could be a

cognitive and motor development problems,

while for mothers these included increasing

risk of self-harm and morbidity (Orui et al.,

2024).

The main risk factors of PPD related to

several conditions including a history of PPD,

mental illness during pregnancy, gestational

diabetes, and a lack of family and community

support. Other factors range from

complications during pregnancy, to low

socioeconomic status (Agrawal et al., 2022).

Social support is crucial especially for

primiparums within several weeks after

giving birth (Karimah 2023).

The integration of mental health service is

crucial in increasing service access and care

provided to mothers with PPD. However,

currently there is fragmentation of the service

from the level of mental health services at

puskesmas, self-help groups, NGOs

concerned with mental health, public

hospitals (RSU) to Mental health Hospitals

(RSJ). The number of mental health services

in primary health care in Tangerang District is

also limited with only 9 out of 44 primary

health care providing the service. A study by

Nurbaeti in 2019 showed that 69 (33.5%) of

the 206 postpartum mothers in Banten

Jurnal Loyalitas Sosial

Vol. 7 No. 1 Februari 2025

Journal of Community Services in Humanities and Social Sciences

p-ISSN | e-ISSN

Province experienced depression (Nurbaeti,

2019).

Based on these conditions above, a

community service through educational

programs play a crucial role in behavioral

change of the community. The aim of

community service is to increase the

knowledge, understanding of the Koper

Village community regarding postpartum

depression disorders including their

symptoms, prevention, and most importantly

providing support for postpartum disorder

mothers. This concern does support in

achieving one of Sustainable Development

Goals (SDGs), good health and well-being.

Method

The program was carried out at the Koper

Village Hall, Kresek District, Tangerang

Regency, Banten Province by five medical

students from YARSI University on

December 29 2022. They had a significant

role in planning and conducting the program.

The stages of activity are as follows: 1)

Survey; 2) Preparation; 3) Implementation; 4)

Evaluation.

Survey and preparation was conducted by

coordinating with local stakeholders to obtain

program permission in the Koper Village,

followed by an arranged meeting with the

cadres to identify the problem and prepare the

activity.

In the implementation stage, the activity was

held on December 29, 2022 at the Koper

Village Hall at 10.00 WIB. Pre and post

testing questionnaire was conducted to assess

44 respondents’ knowledge and awareness

including postpartum mothers and their

families, cadres followed by presenting the

material using poster, power points and

educational video, and the program was

closed by post-test questionnaire.

Result and Discussion

The evaluation stage is carried out to measure

the attendance of participants, analyze the

result of pre and post test questionnaires. This

also included assessment of participants'

engagement during discussion sessions.

Figure 1. Cadres

Jurnal Loyalitas Sosial

Vol. 7 No. 1 Februari 2025

Journal of Community Services in Humanities and Social Sciences

p-ISSN | e-ISSN

Figure 2. Poster

Figure 3. Respondents conducted the pre-test

Statistical Analysis

SPSS version 26 for Windows was used to

enter and evaluate data. Sapphire-Wilk

method was used to determine data normality

in this investigation.

The characteristic of respondent consist of

gender, age, education, and occupation

described as follows:

Table 1. Characteristics of Participant

Based on the pre-test results, an average value

of 7 questions of 58.4%. After the team

provided material regarding postpartum

depression, participants obtained an average

score of post-test of 94.4% (Table 2). These

results indicate an increase in their knowledge

about postpartum depression.

Jurnal Loyalitas Sosial

Vol. 7 No. 1 Februari 2025

Journal of Community Services in Humanities and Social Sciences

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Table 2. Pre and Post Testing Analysis

Furthermore, a statistical test was carried out

to determine the significance of the test

results. The statistical test was selected based

on the results of the normality test to

determine the selected parametric and

nonparametric tests. Normality test of

Sapphire-WilkT was conducted because the

sample number (N) was less than 50, which is

presented in Table 3.

Table 3. Normality Test

Based on the table above it can be seen the

value of the results of the test Shapiro-Wilk

shows a p of 0.002 for pre-test and 0,000 for

post-test, with the p value p < 0.05. These

results indicate that the data is not normally

distributed. Therefore, the selected statistical

test is a non-parametric test, namely the

Wilcoxon test.

Table 4. Comparison Value Of Pre And Post

Test Testing

Positive Ranks in the table above shows that

there is an increase in scores between the pre-

test and post-test. Negative ranks indicate a

decrease in value and Ties show the same

value. There are no respondents who have a

value post-test lower than pre-test, 42

respondents have a value post-test result

which is bigger in comparison to the pre-test

result, and 2 respondents have the same value

between pretest andpost-test. Test results of

Wilcoxon show a significance value of 0.000.

Sig value < 0.05 indicates that there is a

significant difference between the values pre-

test and value post-test.

The results of this study show that the

characteristics of respondents based on

gender consist of 42 (95%) women and 2

(5%) men. The sex of participants in the

educational program was dominated by

women. Social support both from family and

community has a crucial role in decreasing

the potential of postpartum depression among

mothers. Particularly the support from

husband mothers experiencing multiparity,

pregnancy loss.11 Therefore increasing

understanding and awareness of husbands is

Jurnal Loyalitas Sosial

Vol. 7 No. 1 Februari 2025

Journal of Community Services in Humanities and Social Sciences

p-ISSN | e-ISSN

also important in supporting the mothers.

Providing health education for family and

community are needed in efforts to prevent

postpartum depression.

Data on the characteristics of respondents

based on age shows that the majority of

respondents are aged 26- 35 years, namely 23

people (52%) while the majority of

respondents who had completed junior school

were also 23 people. The characteristic of

participants such as age, level of education

has an influence in the comprehension of

understanding the intervention.

Based on the results of the analysis it was

found that the post-test score increased, where

initially the respondents obtained an average

score of 58.4% to 94.4% after the team

provided material about postpartum

depression. Table 4 shows that there is an

increase in value post-test after being given

intervention about postpartum depression

which was declared significant using

statistical testsWilcoxon signed rank with a

value of p = 0.000 (p ≤ 0.05). From these

results it can be stated that there was a

significant increase in participants'

knowledge about postpartum depression

before and after being given intervention.

This inline with previous study that indicated

health education about recognizing and

preventing postpartum depression has been

proven to increase public knowledge.

Conclusion

Hhealth education about recognizing and

preventing postpartum depression was

considered effective in increasing the

knowledge and awareness of the participants

as indicated by the results of differences in

valuespre-test and post-test which is expected

to increase knowledge and awareness of

postpartum mothers and their families,

cadres, and the community so that on the

other hand it can also optimize the role of

cadres in recognizing, treating and preventing

symptoms of postpartum depression. It is

hoped that outreach activities like this will be

carried out periodically in coordination with

the health care centre and related

stakeholders.

Acknowledgments

The researchers are grateful to the Indonesia-

USAID programme DHS for allowing

permission to utilize Indonesian Demography

and Household Survey_2017 data.

Conflict Of Interests

The researcher has received institutional grant

support through University YARSI. Other

authors report no potential conflicts.

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