07 Bridging the Communication Gap in Neonatal Care: A Midwife-Led, Rights-Based, Community Approach from a High-Burden District in Indonesia

Speaker:- Mira Miraturrofiah

Facilitator:- Bronwyn Rideout

Abstract:- Background: Preterm birth is a leading cause of neonatal morbidity and mortality, particularly in high-burden, low-resource districts where access to skilled care and reliable information remains uneven. Midwives play a vital role in ensuring equitable care, yet communication barriers and social disparities limit their effectiveness in supporting families of preterm infants. In one such district in Indonesia, systemic gaps in care communication reflect both logistical shortcomings and violations of women’s rights to informed, respectful, and participatory care.

 Objective: To explore how mothers of preterm infants, community health cadres, and midwives experience and navigate communication challenges in neonatal care, and to propose a midwife-led, rights-based communication model responsive to local needs.

 Methods: A thematic analysis was conducted on five in-depth interviews with mothers and two focus group discussions involving ten health cadres and nine midwives. Open coding was used to identify key themes related to access, equity, and maternal dignity.

 Results: Mothers often felt confused and hesitant to ask questions due to fear or shame. Midwives and cadres served as informal communicators but often lacked adequate tools or training in rights-based communication. Structural gaps such as absent neonatal units, fragmented referral systems, and unclear insurance procedures deepened information inequities. Participants consistently called for clear, consistent, and culturally sensitive explanations.

 Conclusion: Neonatal care communication is not merely clinical—it is a matter of ethics and equity. Midwives must be equipped with rights-based competencies and supported by systems that elevate maternal voice. A midwife-led, community-based model can promote dignity, autonomy, and improved outcomes in high-burden settings.

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