Integrated Primary Service Post is a transformation of Posyandu that integrates primary health services with the aim of strengthening health services at the village/sub-district level, bringing services closer to the community of all age groups ranging from pregnant women, babies, toddlers, school children, adolescents, adults to the elderly (Yuliandri, 2023). Integrated Primary Service Post is a health service program that aims to bring health services closer to the community. This program serves the entire life cycle, from babies to the elderly.The objectives of the Integrated Primary Service Post: (1) Increase the coverage and affordability of primary health services, (2) Strengthen monitoring of local areas, (3) Meet the health service needs of individuals, families, and

communities. Integrated Primary Service Post activities are carried out on Integrated Service Post opening days, namely every month simultaneously or scheduled to reach all targets, including: pregnant women, toddlers, adolescents, adults, the elderly and outside Integrated Service Post opening days, namely during home visits, community empowerment and coordination with assistant health centers (Ministry of Health of the Republic of Indonesia, 2023). Pregnant women's service activities at the integrated health post include pregnant women's class activities: education on danger signs, risks of pregnancy complications, pregnancy exercises, sharing sessions, monitoring of blood- boosting tablets (iron, folic acid); balanced nutrition education and Provision of Additional Food for recovery for pregnant women with Calorie Energy Deficiency (Ministry of Health of the Republic of Indonesia, 2023).

The implementation of Integrated Primary Service Post is supported by trained cadres who have an important role as the vanguard with 25 competencies that must be possessed by cadres to support the integration of primary services (Yuliandri, 2023). Integrated Service Post cadres have several roles and tasks that must be carried out starting before Integrated Service Post opens, on the Integrated Service Post opens and after the Integrated Service Post opens, namely acting as motivators, counselors, recorders and reporters, community companions (Ministry of Health of the Republic of Indonesia, 2023). In the service of pregnant women, cadres play a role in collecting data on pregnant women, detecting pregnant women at risk, monitoring and assisting pregnant women, sweeping, educating on pregnancy danger signs, and other education about pregnancy during the Integrated Service Post opens, home visits and during the implementation of pregnant women's classes (Ministry of Health of the Republic of Indonesia, 2023).

Pregnant women are strongly encouraged to visit Integrated Service Post during pregnancy to maintain the health of the mother and fetus. Several factors that influence pregnant women's visits to Integrated Service Post include: Health Belief Model (HBM), transportation and access, education and knowledge, gestational age and parity, social and family support, self-efficacy and motivation (Purwanti et al, 2024; Liesmayani et al, 2025; Sabin et al, 2024). Susanti's (2020) research shows the results of the influence between the role of Integrated Service Post cadres in assisting high-risk pregnant women with pregnancy check-ups. This is supported by Yoto et al (2024) research which shows that the role of cadres and village support are important factors for the successful implementation of primary service integration at Integrated Service Post. Nevertheless, gradual adaptation efforts need to be continuously carried out, considering that Integrated Primary Service Post is a transformation of Posyandu that integrates primary health services from pregnant women, babies, toddlers, school children, adolescents, adults to the elderly. In relation to this, there has been no research that analyzes the relationship between the role of

health cadres and visits by pregnant women to the Integrated Primary Service Post. Knowledge is a very important domain in the formation of a person's attitude and behavior and a result of knowing after someone senses a certain object. A person's good knowledge is needed to encourage behavior (Susilowati, 2016). Education from health workers is closely related to the mother's knowledge so that they are aware of checking their pregnancy at the available facilities, the knowledge obtained by pregnant women that does not come from health workers can affect the mother's attitude in choosing pregnancy services. The conceptual framework of this research is shown in the figure below:

This study presented an analytical cross-sectional study (descriptive analytical research design) utilizing data from a questionnaire was conducted between November until December 2024. The survey involved a convenience sample of pregnant woman visits to Integrated Service Post. Informed written consent was obtained from all participant as inclusion criteria.

Eligible survey participants included those who self-identified as a pregnant woman visits to Integrated Service Post and hers be respondents. Exclution criteria was dizzy, painfull, or loss of consciousness. Sample of study was used Purposive sampling. Samples were 25 pregnant woman.

A paper-based survey was questionnaire consists of 20-items questions to identify the role of health cadres and visits to pregnant women.

The first stage is editing, in this stage the data is checked on the data collection sheet to ensure that no data is missing. The second stage is coding, in this stage the process of providing answer codes on the data collection sheet in the form of numbers is carried out. The third stage is transferring, in this stage the data is edited and then transferred to the mastersheet table before data analysis is carried out.

Univariate Analysis: This analysis is conducted by calculating the frequency distribution and percentage of each research variable, including the role of health cadres and visits by pregnant women. Bivariate Analysis: This analysis is conducted to prove whether or not there is a relationship between the role of health cadres and visits by pregnant women. All statisstical analyses were conducted with Chi Square.

The role of cadres is very important, because cadres are responsible for implementing Integrated Service Post . If cadres are not active, then the implementation of Integrated Service Post will also not be optimal. The role of cadres greatly influences the success rate of the Integrated Service Post program, especially in monitoring child growth and development and maternal health. According to Martinah (2008), only 40% of cadres are active in Integrated Service Post activities in Indonesia. Therefore, it is necessary to take steps to empower cadres to be more professional in monitoring child growth and development and maternal health, as well as building community partnerships to increase support and optimally utilize posyandu. So that empowering cadres is very important to optimize Integrated Service Post Revitalization (Nurhidayah, 2019).

Adequate knowledge is possessed by health cadres to be able to provide education to the community in increasing visits to Integrated Service Post . The role of health workers cannot be separated from this, so it is necessary to build a strong synergy between cadres and health workers so that they can become an extension in efforts to increase visits. If the community has good knowledge and awareness of the importance of monitoring during pregnancy, it will reduce the number of morbidity and mortality in pregnant women (Rohmah, 2021; Directorate of Promotion and Community Empowerment, 2018).

The results of the study showed a high level of closeness between the role of cadres and the compliance of pregnant women in visiting Integrated Primary Service Post in Sidorahayu Village, Wagir District, Malang Regency. Several factors that influence pregnant women's visits to Integrated Service Post include: Health Belief Model (HBM), transportation and access, education and knowledge, gestational age and parity, social and family support, self-efficacy and motivation (Purwanti et al, 2024; Liesmayani et al, 2025; Sabin et al, 2024).

Cadres have several roles, including: as motivators, extension workers, recording and reporting, and community companions. As motivators, cadres have a role to invite the community to come on the Posyandu opening day through local residents' meetings/WhatsApp/letters/etc., especially for the Posyandu targets, including: Pregnant women, postpartum mothers, breastfeeding mothers, toddlers, school age and adolescents, adults and the elderly; preparing the place for implementing the Integrated Service Post and preparing Integrated Service Post facilities. In addition, as extension workers, cadres have a role to provide education according to the needs of the targets and provide motivation, appreciation and guidance to the targets, and ask the targets to contact the cadres if there are health problems in the family. This is what makes

cadres have an important role in the behavior of pregnant women in implementing clean and healthy living behaviors, one of which is to be able to visit the integrated health post in order to monitor health every month.

Susanti's research (2020) showed the results of the influence between the role of integrated health post cadres in assisting high-risk pregnant women with pregnancy checks. This is supported by research by Yoto et al (2024) which shows that the role of cadres and village support are important factors for the successful implementation of primary service integration at integrated health posts. Several of the research results above support the results of research that has been conducted that there is a relationship between the role of cadres and the compliance of pregnant women in visiting the Integrated Primary Service Post in Sidorahayu Village, Wagir District, Malang Regency.

Yoto, et al (2024) showed the resulths that other factors that support mothers to visit the Integrated Primary Service Post include transportation and access, knowledge, and self-efficacy. Accessibility of services is the reachability of health service locations that can be assessed from the distance, time, and ease of transportation to the health service location. Accessibility means the ease for the community to reach health services without being hindered by geographical conditions. Easily accessible health services support pregnant women to utilize ANC services because the distance from the mother's house to the service location is close and can be reached on foot or by means of transportation, the cost is cheap, and it also does not take much time during the trip. Likewise, ANC services that are difficult to reach tend to make mothers less likely to utilize ANC services. Difficult access to health facilities will tend to make mothers lose their motivation to utilize ANC services. The further the distance, the more likely it is for mothers to think twice about making ANC visits because it will take a lot of energy and time every time they visit (Tassi, 2021).

Knowledge is a very important domain in the formation of a person's attitude and behavior and a result of knowing after someone senses a certain object. A person's good knowledge is needed to encourage behavior (Susilowati, 2016). Education from health workers is closely related to the mother's knowledge so that they are aware of checking their pregnancy at the available facilities, the knowledge obtained by pregnant women that does not come from health workers can affect the mother's attitude in choosing pregnancy services. Therefore, health facilities are not visited by pregnant women to check their pregnancy. Most mothers are primigravidas who have no previous experience of giving birth so that the level of compliance with the midwife's recommendations is much higher than the mother's knowledge (Sinambela, 2021).

According to Pender, et al., self-efficacy is a person's belief in their ability to perform an action. Self-efficacy refers to the extent to which an individual estimates their ability to be able to carry out a task or obligation that aims to achieve a certain result. Pregnant women's self-efficacy can be used to predict healthy behavior and can facilitate behavior modification. Self-efficacy is an important determining factor in increasing the mother's confidence in carrying out activities or actions that are believed to be able to help achieve goals and the right solutions if there are problems in her pregnancy. Emphasis on the use of

self-efficacy can also be useful in increasing psychological adaptation skills from early pregnancy, recognizing danger signs of pregnancy and childbirth so that they are able to prepare for birth and be ready to face complications (Laila, 2022). Caroline revealed that when individuals have high self-efficacy, it will affect their socializing abilities in a better direction, in other words, individuals will try and have the desire to develop themselves to have better health (Welly and Rahmi, 2021). Self-efficacy can also be used as a determining factor that can influence individuals in carrying out self-management to overcome problems in terms of their health (Laila, 2022).