MODEL MANAJEMEN STRATEGIS INTEGRATIF KEBIDANAN DIGITAL DAN PEMBERDAYAAN KELUARGA DI FASILITAS KESEHATAN PRIMER PERKOTAAN MENENGAH: SYSTEMATIC LITERATURE REVIEW DENGAN VALIDASI KONTEKSTUAL

Abstract

The fragmentation of midwifery research—where strategic management, digitalization, and family empowerment
are studied in disciplinary isolation—constitutes a structural evidence gap that directly undermines maternal
health policy effectiveness in mid-sized urban Indonesian primary healthcare facilities (PHC). Metro City's
epidemiological paradox (MMR of 0/100,000 live births alongside 60% midwife digital literacy) illustrates the
urgency of an integrative model absent from the literature. This study aims to develop and validate an Integrative
Strategic Management Model (MMSI) for digital-based midwifery and family empowerment, operationally
applicable to mid-sized urban LMIC primary healthcare facilities. Systematic Literature Review (SLR) guided by
PRISMA 2020. Of 1,247 identified articles (PubMed, Scopus, Google Scholar, Garuda, SINTA; 2018–2025), 42
met rigorous inclusion criteria (minimum two of three dimensions; MMAT >80%; Cohen's Kappa = 0.82).
Thematic synthesis using NVivo 14 was augmented with contextual validation using Metro City Health Profile
2024 data. Cross-study analysis identified three systemic gaps: (1) dominant silo approaches (100% of studies
failed to integrate all three dimensions simultaneously); (2) high-income country or mega-city context bias (62%
of studies); and (3) scarcity of longitudinal designs (only 28%). MMSI comprises three interactive layers: Strategic
Core (PDCA-SWOT), Digital Enabler (EHR-SatuSehat, telemedicine, AI predictive analytics), and Family
Empowerment Layer (family certification, gamification, digital peer support). Contextual validation across 15
puskesmas in Metro City confirmed model relevance. MMSI represents the first conceptual contribution
integrating strategic management, digital health, and family empowerment into a unified double-loop feedback
architecture for mid-sized urban LMIC PHCs, offering a measurable and replicable digital midwifery
transformation roadmap toward SDGs 2030.