SANPIISAN is a groundbreaking initiative addressing maternal, infant mortality, and stunting in Semarang City. Its continuum-of-care spans pre-conception to toddlerhood, ensuring seamless healthcare. Transformative components include pre-marital education, equipping couples with knowledge for healthier family planning. The "Sayang Bunda" app enables door-to-door screening, identifying high-risk pregnancies for timely intervention. Targeted services offer weekly high-protein meals for undernourished pregnant mothers, directly addressing nutritional deficiencies. Healthy women worker movement extends workplace support, benefitting working mothers' health.

SANPIISAN started in 2015 as a health service innovation programme as a form of solution and action of concern for maternal and child health problems, both promotive, preventive and curative. All aspects involved work together and collaborate to reduce maternal and child mortality. This is marked by the existence of regulations that support the regulation of Regional Regulation No. 2 of 2015 concerning maternal and child safety. And experienced development in 2019, the involvement of cross-sectors. And experiencing adaptations during the Covid-19 pandemic in 2020, sanpiisan continues to run by using community self-funding and CSR support. and running until now with the development of goals, namely reducing stunting rates.

Innovative collaboration in maternal care involves diverse groups, including women and varied gender identities. With representatives from community organizations, professional associations, hospitals, religious groups, government bodies, educational institutions, and NGOs, the initiative ensures inclusivity. Strengthened by joint agreements and commitments, this approach accommodates diverse perspectives and needs. The result is a more holistic Outreach Service for Maternal Care sustainable

Pregnant women and families directly benefit from this innovation comprehensive maternal and child health services. Community organizations, leaders, and professional groups contribute expertise. Hospitals, religious groups, government organizations, and educational institutions actively shape and support the initiative. NGOs provide resources and community engagement. The general public gains awareness, ensuring a holistic and inclusive impact on maternal and child health.

In 2015, before the innovation, Maternal Mortality Rate (MMR) was 128/100,000 live births, Infant Mortality Rate (IMR) was 8.38/1,000 live births, and high-risk pregnancies contributed to 43% of mortality. Antenatal Care (ANC) was low at 53%, with limited health service access. By 2019 (Stage 1), MMR decreased to 71.35, IMR to 6.09, high-risk pregnancy contribution reduced to 13%, and ANC increased to 100%. In 2019-2022 (Stage 2), MMR further decreased to 67,25 IMR to 5.6, high-risk pregnancy to 12%, with 100% ANC, health services for prospective brides, grooms, and working mothers, real-time reporting via Sayang Bunda, and significant reductions in cases of undernutrition and anemia positively impacting stunting (4.10% to 1.63%).

Risk mitigation in the innovation includes addressing Cultural resistance is the belief that dying during childbirth is jihad – holy war and decision-making should have the husband's approval. to address by engaging religious and community leaders to shift perceptions on maternal health. The risk of a lack of public awareness of maternal health problems because this problem is only considered as a domestic matter. This risk is overcome by increasing public awareness through training of female health volunteers and outreach to regional stakeholders. This step will help reach out to the community and achieve community support for maternal and child health care.

Maternal and child health in Semarang City demands strategic solutions for easy access. SANPIISAN utilizing a stakeholder approach, fosters community movement and cross-sector collaboration through joint commitments. SANPIISAN optimizes collaboration to address health challenges. This tacit becomes the main pillar of implementing innovation by involving the government, community, community leaders, and non-government to build diverse support from multi-stakeholders.Mobilizing internal resources via meetings and socialization, and external resources through coordination and outreach. This initiative integrates pregnant women, families, communities, and sectors, emphasizing the crucial goal of promoting maternal health

SANPIISAN supports Sustainable Development through community empowerment and Stake-Holder commitment supported by an open-source information system, so that innovations from SANPIISAN have the potential to be applied and adapted in other cities / districts. This is evidenced by comparative studies from districts/cities to replicate the SANPIISAN concept. Some of those who visited include: Bukit Tinggi, Kendal, Banyumas. Banyumas Regency has replicated SANPIISAN by recruiting midwives to be placed in 27 sub-districts. In addition, Semarang City has become a Pilot Project for Family Data Collection by the National BKKBN as a form of appreciation for efforts to reduce MMR, the best IMR nationally.

The SANPIISAN initiative offers valuable lessons for addressing maternal and child health challenges:
Multi-Stakeholder Collaboration: Engaging diverse stakeholders, including community organizations, professional associations, hospitals, religious groups, government bodies, educational institutions, and NGOs, is crucial. Community Empowerment: Empowering local communities through awareness campaigns, training programs for health volunteers, and mobilization of community leaders fosters a cultural change in attitudes toward maternal and child health. These lessons emphasize the importance of a holistic, collaborative, and adaptive approach in addressing complex healthcare challenges, particularly in maternal and child health

Maternal and child health is not just about health, but this problem is a multidimensional problem that requires a comprehensive approach. Sanpiisan provides Continuum of Care Approach: Implementing a comprehensive continuum-of-care strategy, covering pre-conception to toddlerhood, ensures holistic healthcare provision at critical life stages. Besides that, Innovative Use of Technology: Leveraging technology enhances accessibility, data accuracy, and interaction in healthcare. And with Gender-Inclusive Approach: Ensuring representation and involvement of women and diverse gender identities in the design and implementation of healthcare initiatives lead to more inclusive and effective solutions.