Background and aims: Health literacy is an essential factor for a healthy pregnancy. Improved maternal health literacy is associated with better outcomes throughout pregnancy, childbirth, postpartum period, breastfeeding, and child-rearing. However, research on maternal health literacy among pregnant women in Indonesia is limited, likely due to the lack of valid and reliable measurement tools. This study aims to translate and validate the maternal health literacy inventory in pregnancy (MHELIP) into Bahasa Indonesia.
Methods: The method for translating the maternal health literacy instrument refers to Brislin's guidelines. The instrument was adapted through a five-step process: translation, back translation, committee review, expert judgment, and pilot testing. To support construct validity, a contrasted group analysis was conducted by recruiting 67 pregnant women who were divided into first-trimester and third-trimester groups. Their mean scores were compared using an independent t-test.
Results: The 48-item maternal health literacy instrument, covering four components (knowledge, information seeking, information assessment, and decision-making/behaviors), showed good validity (p<0.00) and high reliability (Cronbach’s alpha=0.96). The culturally adapted translation is suitable for use among pregnant women in Indonesia. Moreover, the construct validity analysis using contrasted groups revealed significant score differences between first-trimester and third-trimester pregnant women.
Conclusion: MHELIP is a valid and reliable tool for measuring maternal health literacy among pregnant women in Indonesia. Stakeholders and midwives should use this instrument to improve maternal health literacy in antenatal care and other midwifery services.