DOI: https://doi.org/10.14710/jgi.14.2.145-156

Knowledge and attitudes of health workers determine maternal nutrition counseling practices: a cross-sectional study

1Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia

2Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia

3Primary Care Family Medicine Specialist Program, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia

4 School of Vocational Studies, Universitas Padjadjaran, Sumedang, West Java, Indonesia

5 Department of Pediatrics, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia

View all affiliations
Received: 4 Feb 2026; Revised: 20 May 2026; Accepted: 25 May 2026; Available online: 30 Jun 2026; Published: 30 Jun 2026.

Citation Format:
Abstract

ABSTRACT

Background: Maternal ignorance regarding nutritional needs during pregnancy and breastfeeding is influenced by the knowledge, attitudes, and practices (KAP) of health workers in providing nutrition counseling to mothers.

Objective: This study aims to analyze the knowledge, attitudes, and practices (KAP) of health professionals regarding maternal nutrition.

Materials and Methods: A cross-sectional study was conducted between April-June, 2025 in Bandung, Indonesia. A census approach was used by inviting all 80 Primary Healthcare Centers (PHCs/Puskesmas) to participate; 77 PHCs/Puskesmas returned completed questionnaires. All eligible healthcare workers involved in maternal and child health services within participating PHCs/Puskesmas were invited to complete a validated questionnaire administered via Google Forms. Knowledge and practice items were scored dichotomously (1 = correct/appropriate; 0 = incorrect), while attitudes were measured on a 5-point Likert scale. Median values were used to categorize KAP outcomes, and associations were analyzed using chi-square tests and multivariable logistic regression with statistical significance set at p < 0.05.

Results: Results showed that 75.07% of healthcare workers demonstrated good knowledge, yet only 61.13% exhibited positive attitudes. Knowledge gaps existed for portion recommendations. Bivariate analysis revealed significant associations between profession and attitudes (p=0.043) and practices (p=0.002), and between training attendance and attitudes (p=0.015). Multivariate analysis identified profession as the strongest independent predictor of practices: midwives (OR=6.664; 95% CI: 2.166-20.504; p<0.001), nutritionists (OR=3.952; 95% CI: 1.315-11.876; p=0.014) and public health officer (OR=4.483; 95% CI: 1.829-10.987; p=0.001) showed significantly higher odds compared to doctors. Only 15.13% had attended recent maternal nutrition training.

Conclusion: Professional background is the strongest determinant of maternal nutrition counseling effectiveness. Addressing the KAP gap through profession-specific, continuous training is crucial to enhance nutrition services during pregnancy and lactation and support stunting prevention efforts.

Keywords : Attitude; healthcare workers; knowledge; maternal; nutrition counseling

Fulltext View|Download Email colleagues
Keywords: Attitude; healthcare workers; knowledge; maternal; nutrition counseling

Article Metrics:

Article Info
Section: Articles
Language : EN
Most cited articles
Pengaruh pendidikan gizi terhadap pengetahuan dan sikap tentang gizi anak Sekolah Dasar Front Matter Faktor determinan produktivitas kerja pada pekerja wanita Front Matter Faktor risiko stunting pada anak umur 6-24 bulan di kecamatan Penanggalan kota Subulussalam provinsi Aceh More cited articles
  1. Kinshella MLW, Moore SE, Elango R. The missing focus on women’s health in the First 1,000 days approach to nutrition. Public Health Nutr. 2021;24(6):1526–30. doi: 10.1017/S1368980020003894
  2. Likhar A, Patil MS. Importance of maternal nutrition in the first 1,000 days of life and its effects on child development: a narrative review. Cureus. 2022;14(10):e30083. doi: 10.7759/cureus.30083
  3. Purkiewicz A, Regin KJ, Mumtaz W, Pietrzak-Fiećko R. Breastfeeding: the multifaceted impact on child development and maternal well-being. Nutrients. 2025 Apr 11;17(8):1326. doi: 10.3390/nu17081326
  4. Amaha ND, Woldeamanuel BT. Maternal factors associated with moderate and severe stunting in Ethiopian children: analysis of some environmental factors based on 2016 demographic health survey. Nutr J. 2021 Feb 27;20:18. doi: 10.1186/s12937-021-00677-6
  5. Agustina R, Rianda D, Lasepa W, Birahmatika FS, Stajic V, Mufida R. Nutrient intakes of pregnant and lactating women in Indonesia and Malaysia: Systematic review and meta-analysis. Front Nutr. 2023;10:1030343. doi: 10.3389/fnut.2023.1030343
  6. Badan Kebijakan Pembangunan Kesehatan, Kementerian Kesehatan RI. Hasil Utama SKI 2023 [Internet]. [cited 2025 Oct 13]. Available from: https://www.badankebijakan.kemkes.go.id/daftar-frequently-asked-question-seputar-hasil-utama-ski-2023/hasil-utama-ski-2023/
  7. Widyawaty ED. Hubungan riwayat status gizi ibu saat hamil dengan berat badan lahir. NERSMID: Jurnal Keperawatan dan Kebidanan. 2019;2(1):1-7. Available from: https://nersmid.unmerbaya.ac.id/index.php/nersmid/en/article/view/49
  8. Jamshed S, Khan F, Begum A, Barkat Ali B, Akram Z, Ariff M. Frequency of low birth weight and its relationship with maternal nutritional and dietary Factors: A Cross-Sectional Study. Cureus. 12(6):e8731. doi: 10.7759/cureus.8731
  9. Saleh A, Syahrul S, Hadju V, Andriani I, Restika I. Role of maternal in preventing stunting: a systematic review. Gac Sanit. 2021;35:S576–82. doi: 10.1016/j.gaceta.2021.10.087
  10. Carretero-Krug A, Montero-Bravo A, Morais-Moreno C, Puga AM, Samaniego-Vaesken M de L, Partearroyo T, et al. Nutritional status of breastfeeding mothers and impact of diet and dietary supplementation: a narrative review. Nutrients. 2024 Jan 19;16(2):301. doi: 10.3390/nu16020301
  11. Rahmawati W, van der Pligt P, Willcox JC, Worsley AF. Sources of nutrition information for Indonesian women during pregnancy: how is information sought and provided? Public Health Nutr. 24(12):3859–69. doi: 10.1017/S1368980021002317
  12. Handayani L, Petralina B, Maryuni, Esterilita M, Istianah I. Asuhan gizi untuk bayi, balita dan anak pra sekolah: panduan gizi optimal mengurangi stunting. Padang: Get Press Indonesia; 2024
  13. Rohmawati N, et al. Pedoman pelayanan antenatal terpadu. Ed. ke-3. Jakarta: Kementerian Kesehatan RI; 2020
  14. Shakhshir M, Alkaiyat A. Healthcare providers’ knowledge, attitude, and practice on quality of nutrition care in hospitals from a developing country: a multicenter experience. J Health Popul Nutr. 2023 Mar 7;42:15. doi: 10.1186/s41043-023-00355-9
  15. Setiawati HN. Uji tahap awal instrumen kuisioner pengetahuan dan sikap nutrisi ibu hamil dan menyusui: content validity ratio (CVR) [Skripsi]. Bandung: Fakultas Kedokteran, Universitas Padjadjaran; 2022
  16. Vrkatić A, Grujičić M, Jovičić-Bata J, Novaković B. Nutritional knowledge, confidence, attitudes towards nutritional care and nutrition counselling practice among general practitioners. Healthcare. 2022 Nov 7;10(11):2222. doi: 10.3390/healthcare10112222
  17. Rizk J, Andreou E, Hileti D, Ghaddar A, Zampelas A. Assessing health care providers’ knowledge and practices of nutrition during pregnancy in Lebanon: a cross-sectional study. Medicina (Mex). 2023 Aug 16;59(8):1471. doi: 10.3390/medicina59081471
  18. Sunguya BF, Poudel KC, Mlunde LB, Urassa DP, Yasuoka J, Jimba M. Nutrition training improves health workers’ nutrition knowledge and competence to manage child undernutrition: a systematic review. Front Public Health. 2013 Sep 24;1:37. doi: 10.3389/fpubh.2013.00037
  19. Hennop I, Carboo JA, Nel M, Walsh CM. Knowledge, attitudes and support practices related to breastfeeding promotion of doctors and nurses in Motheo district, Free State province, South Africa. South Afr J Clin Nutr. 2024 Dec;37(4):166–79. doi: 10.1080/16070658.2024.2399123
  20. Nguyen PH, Tran LM, Kachwaha S, Sanghvi T, Mahmud Z, Zafimanjaka MG, et al. Enhanced quality of nutrition services during antenatal care through interventions to improve maternal nutrition in Bangladesh, Burkina Faso, Ethiopia, and India. J Glob Health. 15:04054. doi: 10.7189/jogh.15.04054
  21. Rahmawati W, Van Der Pligt P, Worsley A, Willcox JC. Indonesian antenatal nutrition education: a qualitative study of healthcare professional views. Womens Health. 2021 Jan;17:17455065211066077. doi: 10.1177/17455065211066077
  22. Erbe K, Liese K, Tussing-Humphreys L, Papautsky EL, Rutherford J, Koenig MD. Midwives’ and obstetric physicians’ practices related to pregnancy nutrition counseling: a scoping review. 2025. 2024 Jul 10;70(1):61–76. doi: https://doi.org/10.1111/jmwh.13661
  23. Alehegn MA, Fanta TK, Ayalew AF. Exploring maternal nutrition counseling provided by health professionals during antenatal care follow-up: a qualitative study in Addis Ababa, Ethiopia-2019. BMC Nutr. 2021 Dec;7(1):20. doi: 10.1186/s40795-021-00427-1
  24. Adams KM, Kohlmeier M, Zeisel SH. Nutrition education in U.S. medical schools: latest update of a national survey. Acad Med J Assoc Am Med Coll. 2010 Sep;85(9):1537–42. doi: 10.1097/ACM.0b013e3181eab71b
  25. Crowley J, Ball L, Hiddink GJ. Nutrition in medical education: a systematic review. Lancet Planet Health. 2019 Sep 1;3(9):e379–89. doi: 10.1016/S2542-5196(19)30171-8

Last update:

No citation recorded.

Last update: 2026-07-02 20:23:16

No citation recorded.