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Mental disorders are health problems that affect individuals, families, and communities, where the negative stigma given by families to members with mental disorders can influence the acceptance and support they receive. This study aimed to determine the relationship between family stigma and family acceptance toward people with mental disorders (PWMD) in the working area of Ladang Tuha Public Health Center, Pasie Raja Subdistrict, South Aceh. The research employed a descriptive-analytic design with a cross-sectional approach, involving 65 families selected using the total sampling technique. The instruments used were the Internalized Stigma of Mental Illness (ISMI) questionnaire and a family acceptance questionnaire, analyzed using the Chi-Square test with a significance level of 0.05. The results showed that the majority of respondents had low stigma (67.7%) and poor acceptance (61.5%), with a p-value = 0.000, indicating a significant relationship between family stigma and family acceptance toward PWMD. The study concluded that the lower the family stigma, the better the acceptance toward PWMD; thus, educational efforts and family empowerment are needed to reduce stigma and improve acceptance.

The low level of knowledge and attitudes of mothers regarding the use of the KIA handbook is due to their suboptimal use. Many mothers view the KIA handbook as merely a record of routine checkups, thus failing to understand the information it contains. This study aims to identify factors influencing the utilization of the Maternal and Child Health (KIA) handbook among mothers with toddlers in the Kwala Bekala Community Health Center (Puskesmas), Medan, Johor, in 2025. The study used an observational analytical method with a cross-sectional approach. The sample consisted of 45 mothers of toddlers living in the area. The sampling technique used was multistage sampling, conducted in stages to obtain appropriate respondents. The results showed that 62.2% of the utilization of the KIA handbook was influenced by mothers' attitudes, particularly regarding the implementation of the immunization program for pregnant women. The more positive the mother's attitude toward immunization, the greater the support of her husband's involvement in the process. The direction of the relationship found in this study was positive. Several factors that may influence mothers' attitudes toward the use of the KIA handbook include the number of children (the majority have one child (51.1%), the mother's education level (the highest is elementary school level at 19.42%), and the mother's occupation (the most common being a housewife at 30.66%). The use of the KIA handbook is classified as good at 62.2%, and the mother's attitude toward immunization during pregnancy shows a positive attitude at 75.6%.  

Breech presentation is a condition in which the fetus is in an elongated position with the head at the uterine fundus and the buttocks in the lower part of the uterine cavity. This condition can increase the risk of labor complications, especially if accompanied by serotinus (post-term pregnancy). Based on data from the Indonesian Ministry of Health (2021), the maternal mortality rate caused by breech presentation and serotinus in Indonesia was recorded at 1,309 cases. In Central Java, the incidence of breech presentation reached 11.5% (Central Java Health Office, 2021). This study aims to determine the implementation of comprehensive midwifery care for Mrs. D, aged 24 years, with breech presentation and serotinus at Mrs. S's PMB in the Kaliwadas Community Health Center area in 2023. The research method used a qualitative descriptive design with a case study approach. Data collection was carried out through interviews, observations, physical examinations, documentation studies, and medical record searches. The results of midwifery care showed that during pregnancy, Mrs. D had a good quality of life. Mrs. D underwent three antenatal care (ANC) visits, during which signs of pregnancy complications suggestive of serotinus were detected. Delivery was performed via cesarean section due to serotinus and breech presentation. During the neonatal period, three visits were conducted, with the baby's examination results within normal limits. During the postpartum period, four visits were conducted, during which the mother's condition was generally good, but at the third postpartum visit, problems with breastfeeding were discovered. Mrs. D was also known not to be using postpartum contraception. The results of this study emphasize the importance of early detection and appropriate management of breech presentation and serotinus pregnancies to prevent complications that endanger the mother and baby. Comprehensive midwifery care covering pregnancy, labor, postpartum, and newborn care is an integral effort to ensure the safety of mothers and babies.  

Scabies is a contagious skin disease caused by Sarcoptes scabiei infestation, and generally affects children and adolescents, especially those living in crowded and unhygienic environments such as orphanages. This disease is highly contagious through direct contact and the sharing of personal items, such as towels, clothing, and bedding. Therefore, ongoing promotional and preventive efforts are crucial to prevent the spread of scabies in vulnerable communities. This community service activity was carried out at the Harapan Kita Orphanage within the Ariodillah Community Health Center (Puskesmas) working area. The main objective of the activity was to increase children's knowledge, awareness, and skills in preventing scabies transmission. The activity methods used included two-way discussion-based health education, providing real-life examples of personal hygiene, and distributing educational leaflets that are easy for children to understand. The education was conducted interactively by involving participants in questions and answers, handwashing simulations, and education on the importance of washing clothes and maintaining clean bedding. Post-activity observations showed that all participants did not experience active scabies symptoms, and there was an increase in participants' understanding of clean and healthy lifestyles. The children showed high enthusiasm and were able to reflect on the information presented. Overall, this activity proved effective in raising awareness of the importance of personal and environmental hygiene. This counseling model is highly relevant for regular implementation in orphanages or other institutions at high risk of spreading infectious skin diseases, as part of an education-based public health strategy. With the active involvement of the orphanage caregivers, it is hoped that this program can be sustainable and become part of the routine health education for children.

Type II diabetes mellitus (Type II DM) is a chronic disease that requires long-term self-care skills to prevent serious complications. However, many patients have difficulty managing blood sugar levels independently due to a lack of structured and ongoing education. The Student Creativity Program (PKM) aims to improve the self-care skills of Type II DM patients through an educational approach based on the Self-Care Deficit theory from Dorothea Orem. The activity was carried out in Bonto Ramba, the working area of the Tamalanrea Makassar Health Center, involving 35 participants (33 women and 2 men). Interventions were carried out through interactive counseling, demonstrations of diabetic foot wound care, practice simulations, and the distribution of easy-to-understand educational media. Evaluation was carried out using a pre-post test to measure knowledge improvement and an observation sheet to assess the ability of self-care practice. Results showed a significant improvement in participants' self-care knowledge and skills after the intervention. In addition, family involvement in assisting patients has also increased, strengthening the sustainability of self-care behavior. Participants gave positive feedback on the method of delivering material that was contextual and relevant to daily life. The supportive-educational approach used has been proven effective in empowering patients and building awareness of the importance of self-control of health conditions. This program not only contributes to improving the quality of life of Type II DM patients, but also strengthens the role of the family as the main support in the treatment process. In conclusion, structured education based on Orem theory can be used as an intervention model that can be replicated in other areas with high prevalence of DM, as a promotive and preventive strategy in community-based management of chronic diseases.

This study aims to examine the strategic role of the Cieurih Community Health Center in increasing public awareness of healthy lifestyles, particularly in the Cipaku Sub-district. Employing a qualitative descriptive approach, data were collected through observation, in-depth interviews with key stakeholders, and documentation of program activities. The collected data were analyzed using three stages: data reduction, data presentation, and drawing conclusions with verification to ensure validity. The analysis focuses on three main dimensions of the Health Center’s role: (1) Interpersonal Role, which involves direct interaction with the community to build trust, encourage participation, and foster behavioral change; (2) Informational Role, which encompasses the dissemination of accurate health information, educational campaigns, and correction of misinformation; and (3) Decisional Role, which relates to planning, implementing, and evaluating health programs in response to local needs.The findings reveal that the Cieurih Community Health Center has made significant contributions to raising awareness and promoting healthy living practices through these roles. Initiatives such as health counseling, mobile clinic services, and collaborative activities with community leaders have shown positive influence. However, the study also identifies persistent challenges, including low levels of community participation, insufficient financial and human resources, and the strong influence of traditional cultural practices and misinformation that hinder optimal outcomes. To address these obstacles, adaptive strategies are necessary. Recommendations include the development of personalized approaches tailored to the socio-cultural context, the use of innovative communication methods such as social media and visual storytelling, and the strengthening of cross-sectoral collaboration with educational institutions, religious leaders, and local government agencies. These measures are expected to enhance community engagement, improve the accuracy and reach of health information, and sustain the long-term impact of health promotion programs.

This study investigates the adoption of Electronic Medical Records (EMR) by registration staff at Tangkiling Health Center, Palangka Raya, using the Technology Acceptance Model (TAM) framework. Out of 61 total healthcare workers, five medical record staff with educational backgrounds in midwifery, nursing, dental nursing, and non-medical high school were purposively selected as research participants. The study employed a qualitative descriptive method, combining in-depth interviews and direct field observations. Results indicate that while the staff acknowledged the usefulness of EMR in improving service efficiency and data accessibility, several barriers hindered its effective use—primarily a lack of training, limited digital literacy, unstable internet connectivity, and inadequate hardware such as computers and printers. Observations showed that only the registration unit had a single shared computer, while other units like outpatient clinics, pharmacy, and cashier still relied on manual documentation. This fragmentation has led to duplicate workloads and disrupted patient data continuity. Despite these challenges, the staff demonstrated a positive attitude and strong behavioral intention to adopt EMR if provided with sufficient infrastructure and regular training. The study concludes that successful EMR implementation in primary healthcare requires not only user acceptance but also institutional readiness, adequate resources, and integrated systems across all service units.

This study aims to analyze the influence of career development and job training on employee performance, with work motivation as an intervening variable, at the Pakan Rabaa Community Health Center in Lima Puluh Kota Regency. The background of this study is based on the importance of improving the quality of human resources through career development strategies and targeted job training programs, as well as the role of work motivation as a driving factor for employee performance. The research method used is Structural Equation Modeling (SEM) with the Partial Least Square (PLS) approach. Data were collected through distributing questionnaires to 66 respondents who are employees of the Pakan Rabaa Community Health Center. The results of the study show several important findings. First, career development has a positive and significant effect on work motivation. Second, job training has a positive but insignificant effect on work motivation. Third, career development has a positive but insignificant effect on employee performance. Fourth, job training has a positive and significant effect on employee performance. Fifth, work motivation has a positive but insignificant effect on employee performance. Sixth, career development has a positive but insignificant effect on employee performance through work motivation as an intervening variable. Seventh, job training also had a positive but insignificant effect on employee performance through work motivation as an intervening variable. This finding indicates that although career development and job training have a positive relationship with performance, the effect is not always significant when mediated by work motivation. Other factors beyond work motivation may also influence employee performance at the Pakan Rabaa Community Health Center. This study recommends that management strengthen career development and job training programs relevant to employee needs, while identifying other motivational factors that can further enhance performance.

Health problems are a major problem in developing countries, including Indonesia. The Community Health Center (Puskesmas) is a first-level health service facility that organizes and coordinates promotive, preventive, curative, rehabilitative, and/or palliative health services in its working area. The purpose of this study is to understand the function of Puskesmas management in assessing the performance of Puskesmas in the working area of ​​the Mantup Puskesmas. The type of research used is qualitative descriptive research, the location of the study is the Mantup Puskesmas, Mantup District, Lamongan Regency, the informants in this study were the head of the Puskesmas, the person in charge of cluster 1, the person in charge of cluster 2, the person in charge of cluster 3, the person in charge of cluster 4 and the person in charge of cross-cluster Puskesmas Mantup. Data collection was carried out through in-depth interviews, observation and document searches, data analysis techniques using data reduction, data presentation, drawing conclusions. The results of the research for planning at the Mantup Puskesmas have been implemented well. Organizational efforts have been suboptimal, as some sub-health centers only have midwives as regional supervisors. Implementation is suboptimal due to limited staffing at sub-health centers. Supervision at Mantup Health Center has been functioning well and is being implemented regularly, but performance data is not yet available.Timely input into the existing application, considering the large number of applications that must be completed by service officers and program implementers at the Mantup Community Health Center. Suggestions included establishing a regional development team at the Assistant Community Health Center to optimize village activities, advising the Health Office on integrating health service applications at the Community Health Center, and innovations to improve Community Health Center performance.  

Maternal and Child Health (MCH) remains a major challenge in Indonesia's health sector, given the high maternal and infant mortality rates, largely caused by pregnancy complications. One obstetric complication that requires special attention is Premature Rupture of Membranes (PROM), as it can increase the risk of infection in the mother and fetus and contribute to preterm birth. This study aims to analyze maternal risk factors associated with PROM in the Uteun Pulo Community Health Center (Puskesmas), Seunagan Timur District, Nagan Raya Regency, in 2025. The research method used was a retrospective survey with a quantitative approach. Data collection was conducted through a review of medical records and structured interviews. Fifty-three pregnant women with PROM participated in the study. Data analysis used a chi-square correlation test to examine the relationship between the independent variables and PROM incidence. The results showed a significant association between maternal age and PROM incidence, with a p-value of 0.023 (p < 0.05). Furthermore, parity also had a significant association with the incidence of PROM, with a p-value of 0.013 (p < 0.05). Other findings showed a significant association between maternal age and the frequency of PROM, with a p-value of 0.028 (p < 0.05). These results indicate that maternal age and previous birth history are important factors that need to be considered in PROM prevention efforts in primary healthcare. These findings are expected to inform the development of intervention strategies and education for pregnant women to minimize the risk of pregnancy complications that lead to PROM.

The number of school-age adolescent girls in Banggai Regency, Central Sulawesi, still faces serious challenges related to nutritional problems such as anemia and chronic energy deficiency (SEZ). Low nutritional literacy and unbalanced food consumption habits also worsen their nutritional status, especially during puberty when nutritional needs increase significantly. This service activity aims to increase the understanding and awareness of young women on the principles of balanced nutrition through a participatory educational approach. The implementation of the activity was carried out at SMP Negeri 2 Bunta, Simpang Raya District, involving 30 students in grades VII and VIII as well as UKS supervisory teachers. The intervention included providing material on "Fill My Plate", the 4 pillars of balanced nutrition, and the risk of nutritional disorders in adolescents. The material was delivered in the form of interactive counseling using leaflet media, accompanied by knowledge measurement through pre-test, post-test, and one-week post-activity evaluation. The results of the activity showed a significant increase in students' understanding of the principles of balanced nutrition, with the knowledge score of the good category increasing from 40% to 87%. Most of the participants were able to mention the composition of the meal portion, the importance of breakfast, restrictions on fast food consumption, and the need to drink enough water every day. This activity also has an impact on increasing the capacity of teachers in assisting and monitoring the health status of students through the UKS program. Teachers become more active in conducting periodic counseling and recording the nutritional development of female students on a regular basis. School-based balanced nutrition counseling has been proven to be effective in improving adolescent nutritional literacy. This educational model can be replicated in other regions with cross-sectoral support such as education offices, health centers, and village governments, to support the achievement of sustainable development goals in the health sector.

Pulmonary tuberculosis remains a pressing public health problem, particularly in the work area of the Duduk Health Center (UPT Puskesmas). Effective management of this disease requires a thorough understanding of the characteristics of the causes of pulmonary TB in patients. This study aims to classify pulmonary TB cases based on the main causes such as diabetes mellitus, irritant factors, pleural effusion, and family environmental conditions. The research method used is a clustering technique with the K-Means algorithm. The data used are data on pulmonary TB patients in 2020–2025 with variables of age, gender, and causative factors collected from medical records. The analysis process was carried out using MATLAB R2014b software. The clustering model was carried out in 3, 4, and 5 clusters to compare the level of segmentation efficiency. Based on the calculation results, the model with 5 clusters showed the lowest cluster variance value of 0.4889 compared to the 3-cluster model (0.7333) and 4-cluster models (0.6151), which indicates that the division into 5 clusters produces the most compact and representative data group. Each cluster shows a different combination of characteristics of pulmonary TB patients, for example: (1) elderly male patients with comorbid diabetes; (2) adolescent females with the negative influence of environmental factors; (3) adult males exposed to irritants; (4) patients with pleural effusion; and (5) groups with multiple factors. The results of this study can provide strategic input for the Finished Community Health Center UPT in formulating more targeted and targeted intervention policies in order to prevent, control, and handle pulmonary tuberculosis cases in a sustainable and effective manner.  

The nutritional awareness of pregnant women in the Simpang Raya Community Health Center (Puskesmas) in Banggai Regency is still relatively low, necessitating educational efforts to increase their understanding of the importance of balanced nutrition during pregnancy. This community service activity aims to improve the knowledge of pregnant women through participatory and educational nutrition counseling held for one week in the Puskesmas hall. The methods used included interactive lectures, group discussions, and healthy menu preparation simulations, supported by leaflets adapted to the local context. A total of 40 pregnant women from various trimesters of pregnancy participated in the activity and were assessed using pre- and post-test instruments. The results of the activity showed a significant increase in participant knowledge, from 43% in the "good" category before the activity to 78% after the counseling. Most participants were able to understand the basic principles of balanced nutrition, identify food sources of important nutrients such as iron and folic acid, and prepare daily menus according to Ministry of Health guidelines. This improvement indicates that visual and interactive information delivery is easier for participants to understand, especially those with lower educational backgrounds. Furthermore, this activity also serves as a means of empowering pregnant women to be more active in maintaining their own and their fetus' health by choosing nutritious foods. Therefore, it is crucial for health workers at community health centers (Puskesmas) and integrated health post (Posyandu) cadres to continue this educational program on an ongoing basis. Structured, communicative, and participatory nutrition education is effective in increasing pregnant women's understanding and can be replicated periodically at other Posyandus (Integrated Health Posts) to support stunting prevention efforts and improve maternal and child health.

Exclusive breastfeeding coverage remains a challenge in several areas, including Bojongkerta Village, within the Cipaku Community Health Center (Puskesmas) jurisdiction, South Bogor District, Bogor City. Lack of knowledge, high levels of stress during breastfeeding, and minimal family support are often major obstacles to successful exclusive breastfeeding. One approach that can be applied to address these issues is hypnobreastfeeding, a relaxation technique combined with positive affirmations to support mothers' readiness to breastfeed. The objective of this activity is to increase the capacity of breastfeeding mothers in exclusive breastfeeding through community-based hypnobreastfeeding training, which also involves Posyandu RW 1 cadres as the main supporting partners of the activity. The method used in this activity involves three stages: first, education and training in hypnobreastfeeding techniques for breastfeeding mothers; second, practical mentoring by lecturers involving students from the Midwifery Diploma Three Program at Ummi University Bogor; and third, evaluation of results through knowledge measurement and observation of breastfeeding practices. A total of 10 breastfeeding mothers and 4 Posyandu cadres participated in this activity. The evaluation results showed an increase in understanding of the benefits of exclusive breastfeeding and a positive change in attitudes towards breastfeeding practices. Furthermore, the active involvement of Posyandu cadres is expected to strengthen ongoing support at the community level. In conclusion, the hypnobreastfeeding training had a positive impact on empowering breastfeeding mothers and strengthening the role of Posyandu cadres as supporters of the exclusive breastfeeding program at the community level. This program also has the potential to expand the reach of education about exclusive breastfeeding and increase the success of sustainable exclusive breastfeeding in the community.

 Matra Health is a form of health service specifically designed to maintain and improve public health in dynamic, complex, and constantly changing environmental conditions. This service plays a very vital role, especially in facing and handling various types of disasters, both natural disasters such as earthquakes, floods, and landslides, as well as non-natural disasters such as residential fires. One form of non-natural disaster that often occurs in densely populated areas is residential fires. This is caused by various factors such as unsafe electrical installations, a lack of public awareness of the dangers of fire, and buildings that are not resistant to heat or fire. Residential fires not only cause physical damage to buildings and infrastructure, but also cause various health problems, ranging from burns, respiratory problems due to smoke exposure, to psychological trauma, especially in vulnerable groups such as children, the elderly, and pregnant women. In response to these conditions, a dimensional health intervention activity was carried out from June 23 to 26, 2025 in areas affected by the fires under the coordination of the South Sumatra Regional Crisis Center. This activity aims to reduce health risk factors that arise after the fires through a series of actions such as multi-sector health surveillance, public health education, and distribution of logistical assistance. The activity also includes conducting rapid assessments using the Rapid Health Assessment (RHA) method, providing education on fire impact prevention, and distributing supplementary food to vulnerable groups. The results of the activity showed a significant increase in public understanding of the dangers of fire and the importance of preparedness for its impacts. Furthermore, the need to strengthen cross-sectoral coordination, such as health, disaster management, and social sectors, in disaster management was identified. It is hoped that this activity can serve as a model for strengthening community-based emergency response systems.

Breast milk production in the early postpartum period is a crucial factor for successful breastfeeding, particularly among primiparous mothers who often experience lactation difficulties during days 3–7 after childbirth. Non-pharmacological interventions such as oxytocin massage and breast care are considered effective approaches to support milk production by enhancing hormonal release and breast stimulation.This study employed a quantitative quasi-experimental design with a one-group pretest–posttest approach. The study was conducted at the Sahu Public Health Center, West Halmahera, involving 20 primiparous breastfeeding mothers on days 3–7 postpartum selected through purposive sampling. Oxytocin massage and breast care were administered according to standardized procedures. Breast milk production was assessed before and after the intervention using observational indicators of milk flow. Data were analyzed using the Wilcoxon Signed Rank Test. The results showed a significant improvement in breast milk production after the intervention. The mean breast milk production score decreased from 1.95 before the intervention to 1.15 after the intervention, indicating smoother milk flow. Statistical analysis revealed a significant difference in breast milk production before and after oxytocin massage and breast care (Z = −3.358; p = 0.001). Oxytocin massage combined with breast care significantly improves breast milk production among primiparous breastfeeding mothers during days 3–7 postpartum. These non-pharmacological interventions are safe, practical, and effective, and are recommended to be integrated into routine postpartum care to support early lactation success.

Growth and development disorders in children can have a significant impact on their overall well-being, manifesting in various forms such as delays in fine and gross motor development, speech and hearing impairments, and even intellectual disabilities. Early detection of these issues is crucial for initiating timely interventions that can improve the child's quality of life. With technological advancements, various applications have emerged, providing an accessible means for parents to independently monitor their children's growth and development. One such tool is the PrimaKu application, which enables parents to track and assess their children's growth and developmental milestones at home. The aim of this service is to empower parents by enhancing their understanding and knowledge regarding the monitoring of their children's development, thereby promoting early detection of potential growth issues. The approach utilized in this service involves providing counseling on child growth and development, alongside demonstrations on how to use the PrimaKu application effectively. A survey conducted during the service activities revealed that the majority of participants (70%) had limited knowledge about child development, while 20% demonstrated adequate knowledge, and only 10% exhibited good knowledge. These findings indicate a significant gap in parents' awareness of child development. As a result, it is recommended that ongoing educational efforts be made at posyandu centers to further educate parents about child development. Introducing the PrimaKu application at these centers could also facilitate better tracking of children's growth and developmental progress, as the app serves as a useful tool for both parents and healthcare providers in ensuring that children meet important developmental milestones. The continuous integration of technology, such as the PrimaKu app, into child healthcare services could significantly contribute to improving early intervention practices and overall child development outcomes.

Chronic Energy Deficiency (CED) in pregnant women remains a major nutritional problem in Indonesia and contributes to various maternal and neonatal complications. CED reflects a long-term energy and macronutrient deficit, often influenced by inadequate nutritional intake and socioeconomic limitations. This study aims to analyze nutritional intake and economic status as risk factors for Chronic Energy Deficiency (CED) in pregnant women in the Patilanggio Community Health Center (Puskesmas) working area. This study used a quantitative observational design with a cross-sectional approach. The study sample consisted of 30 pregnant women selected using a total sampling technique. Data were collected through interviews using a respondent characteristics questionnaire and food recall to assess energy and protein intake, as well as Mid-Upper Arm Circumference (MUAC) measurements to determine CED status. Data analysis was conducted descriptively and cross-descriptively. The results showed that all respondents had energy and protein intakes below 90% of the Recommended Dietary Allowance (RDA) and all were categorized as CED based on the MUAC measurement. All respondents were also categorized as low economic status, reflecting a homogeneous socioeconomic condition. These findings indicate that CED in pregnant women at the study site is associated with inadequate nutritional intake and limited economic status. In conclusion, CED in pregnant women is a chronic nutritional problem influenced by nutritional and socioeconomic factors, necessitating comprehensive prevention and treatment efforts based on primary health care services.

Exclusive breastfeeding during the first six months of life is a key strategy for improving infant health and reducing morbidity and mortality. However, the coverage of exclusive breastfeeding remains suboptimal in many areas, often due to limited maternal knowledge, inadequate support, and insufficient lactation counseling. Intensive lactation counseling is expected to enhance mothers’ understanding, confidence, and commitment to exclusive breastfeeding. This study aimed to analyze the effect of intensive lactation counseling on exclusive breastfeeding practices up to three months postpartum at the Paguat Community Health Center (UPTD). This study employed a pre-experimental design with a one-group pretest–posttest approach. A total of 30 breastfeeding mothers were selected as participants using purposive sampling techniques. Data on exclusive breastfeeding practices were collected before and after the implementation of intensive lactation counseling using structured questionnaires and observation sheets. The counseling intervention was conducted intensively through individualized sessions focusing on breastfeeding techniques, benefits of exclusive breastfeeding, and problem-solving strategies. Data were analyzed using the Wilcoxon signed-rank test with a significance level set at p < 0.05. The results showed a significant effect of intensive lactation counseling on exclusive breastfeeding practices up to three months postpartum. The Wilcoxon signed-rank test yielded a p-value of 0.000, indicating a statistically significant improvement in exclusive breastfeeding behavior after the intervention. In conclusion, intensive lactation counseling has a significant positive effect on exclusive breastfeeding up to three months. Strengthening lactation counseling services at community health centers recommended to improve exclusive breastfeeding coverage and support maternal and infant health outcomes.

Christian leadership can be understood as leadership rooted in the truth of God’s Word and exemplified through the life and ministry of Jesus Christ. In the Gospel narratives, Jesus consistently displayed leadership qualities that were grounded in service, sacrifice, humility, and the nurturing of His disciples. However, in today’s context, many church environments face a crisis of leadership characterized by corruption, arrogance, lack of integrity, and resistance to constructive criticism, all of which deviate from the biblical image of Christ as the Good Shepherd. This study aims to explore the biblical foundation of Jesus Christ’s leadership, focusing on both its character and technical dimensions as reflected in the Gospel of John, and to examine its implementation in the local ministry setting of GPdI Bethesda Kabanjahe. The research employs a qualitative method with two primary dimensions: a theological-biblical approach and a case study approach. The findings reveal that, first, the pastoral leadership model in the Gospel of John presents Jesus as the Good Shepherd who builds intimate relationships, willingly sacrifices, and develops the character of His followers. While these values are normatively acknowledged by church ministers, their implementation in GPdI Bethesda remains partial, fragmented, and not yet systematically embedded into the overall ministry structure. Second, theological reflection and practical implications highlight the urgent need for renewal that encompasses both organizational systems and the personal spiritual formation of leaders. Recommendations emerging from this study include leadership training grounded in Christlike character, developing an organizational structure that ensures regeneration, cultivating a healthy spiritual community, and contextually internalizing Gospel values into ministry practices. Strengthening these areas is essential for building authentic, sustainable, and Christ-centered leadership that responds to contemporary challenges and restores the church’s witness to the surrounding community.