Empowering Community Health Volunteers to Strengthen Integrated Primary Care Posyandu Sustainability: A Quasi-Experimental Evaluation

Abstract

Indonesia’s Integrated Primary Service model expands the remit of the community Posyandu and increases the importance of competent, supported health volunteers. This study examined empowering community health volunteers to strengthen integrated primary care posyandu sustainability using a two-group quasi-experimental evaluation. The study took place at the Tegal Barat Primary Health Centre catchment, especially Kraton subdistrict, Tegal, Indonesia, during 2026 and included 125 community health volunteers, of whom 63 were assigned to intervention Posyandu and 62 to comparison Posyandu. The intervention consisted of module-based training, mentoring, supervision and monitoring and evaluation, delivered through four meetings across one month. Outcomes were assessed using Program Sustainability Assessment Tool (PSAT), comprising eight domains. The intervention group increased its total sustainability score by 47.48 points compared with 1.02 points among controls. Each of the eight PSAT domains improved in the empowerment group. For political support, means increased from 9.08 to 15.57; for funding stability, from 10.10 to 14.95. The analysis reports between-group differences in change for the total score and eight domains (all p < 0.001). Baseline domain tests were not significant in the source tables. In interpretation, volunteers require organisational support and operational competence to sustain an integrated service model. The combination of training and mentoring plausibly makes scheduling, partnership-building and routine evaluation more feasible than information delivery alone. The design and measurement constraints mean that associations should not be represented as definitive causal effects.