A groundbreaking study by the UGM Center for Tropical Medicine (PKT UGM) has demonstrated that early and increased testing for HIV, syphilis, and hepatitis B among pregnant women significantly improves prevention of mother-to-child transmission of these infections. The research, conducted across 22 community health centers (puskesmas) in Bandung City and Bogor Regency from March to September 2024, highlights the impact of innovative service delivery and cross-sector collaboration on maternal and child health outcomes.
Study Background and Approach
The MENJAGA study—named after the Indonesian word for “care” (derived from antenatal care, ANC)—was implemented at 22 intervention puskesmas in Bandung and Bogor. Over eight months, the study employed a Continuous Quality Improvement (CQI) approach to increase the coverage of triple elimination testing: screening for HIV, syphilis, and hepatitis B in pregnant women during early pregnancy.
Professor Ari Probandari, a leading researcher from PKT UGM, emphasized that these interventions significantly enhanced testing coverage through innovative puskesmas-based services and coordinated efforts between health sectors. “Our study is expected to strengthen Indonesia’s maternal and child health services and the overall health system,” he stated in a press release on May 15, 2025.
Key Findings: Dramatic Increases in Testing Coverage
The study revealed remarkable improvements in testing coverage. For example, at Rumpin Community Health Center in Bogor Regency, only 50% of pregnant women were tested for all three infections in the first trimester in early 2023. Following two cycles of CQI-driven changes and village-based innovations, testing coverage surged to 126.8% by December 2024, the highest increase among all participating centers.
Dr. Kuncahyo Sri Harri Murthi, Head of Rumpin Community Health Center, expressed pride in the success: “Our facility’s innovation, inspired by this study, won first place in the district-level innovation competition. We are grateful for being chosen for this intervention.”
Similarly, puskesmas in Bandung City achieved greater testing coverage by strengthening networks with private midwives, forming cross-program CQI teams, and developing integrated reporting formats. These efforts led to more systematic problem analysis and solution implementation.
Impact and Future Directions
Ira Jani Dewi, MD, Head of the Disease Prevention and Control Division at the Bandung City Health Office, noted the study’s influence on local health workers: “This study encouraged us to analyze problems using a more structured and systematic approach, improving service quality.”
Professor Probandari, principal investigator of the MENJAGA study, hopes the findings will drive widespread adoption of CQI approaches at puskesmas throughout Indonesia. He encourages health center managers nationwide to identify root causes of gaps in antenatal testing, tailor solutions to local contexts, and continuously monitor progress.
Collaborative Efforts Towards Triple Elimination
The MENJAGA study is a collaborative effort between PKT UGM, Universitas Sebelas Maret, the London School of Hygiene & Tropical Medicine (LSHTM), and the University of New South Wales (UNSW), with support from the UK Medical Research Council. The project aligns with Indonesia’s commitment to achieve triple elimination of mother-to-child transmission of HIV, syphilis, and hepatitis B.
Through sustained quality improvement and multi-sector cooperation, this research offers a scalable model to enhance early detection and treatment of infections during pregnancy, ultimately reducing the risk of transmission to newborns and improving long-term health outcomes for mothers and children.
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