The role of health cadres in improving maternal adherence to basic immunization among children aged 0-24 months
Abstract
Background: Basic immunization is an important preventive intervention for protecting children against vaccine-preventable diseases. However, maternal adherence to recommended immunization schedules remains a challenge in some communities. The working area of Kasihan II Public Health Center has shown uneven immunization coverage across villages, indicating the need for community-based strategies to strengthen maternal adherence. Purpose: This study aimed to explore the role of health cadres in improving maternal adherence to basic immunization and to identify barriers encountered by mothers in completing their children's immunization schedules. Method: This study used a descriptive qualitative design conducted in the working area of Kasihan II Public Health Center, Bantul, from January 9 to 13, 2026. Informants were selected purposively and consisted of four health cadres, four mothers of children under five, and one immunization coordinator midwife. Data were collected through semi-structured interviews, observations, and documentation and were analyzed thematically. Results: Three main roles of health cadres were identified: motivators, educators, and facilitators. Cadres motivated mothers by providing reassurance regarding mild post-immunization reactions, educated mothers about immunization benefits, schedules, and possible side effects, and facilitated access through WhatsApp reminders and home visits. However, barriers remained, including fear of side effects, limited maternal time due to work and household responsibilities, misinformation and personal beliefs, and limited availability of health personnel to accompany cadres during community-based services. Conclusion: Health cadres play an important role in supporting maternal adherence to basic immunization through motivation, education, and facilitation. Strengthening cadre communication skills, improving access to immunization services, and increasing collaboration between cadres and health workers are needed to address maternal concerns and improve timely immunization.