The Implementation of Toddler Public Health Center During The Covid-19 Pandemic: A Scoping review

Public Health Center shows some decreases in health service during Covid 19 Pandemic. This scoping review aims to review evidence related to the implementation of PHC during Covid-19 Pandemic. This paper adopted Arksey & O'Malley framework consisting of five stages: identifying scoping review questions and relevant articles; searching for articles, conducting charting data; compiling, summarizing and reporting results. This paper reviewed 6 articles. Three themes were obtained: the role of cadres; barriers; and innovations at PHC. The results conclude that the practice of PHC in Indonesia does not accomodate the community need adequately yet. Therefore it s necessary to evaluate PHC activities and improve partnership with community and related stakeholders. pengaruh yang sangat signifikan dengan nilai p value sistol 0,000, diastol 0,033 dan respirasi 0,000 artinya data tersebut signifikan p value < 0,05. Sedangkan pada kelompok kontrol nilai p value untuk sistol 0,139, diastol 0,065 dan respirasi 0,893 data pada kelompok kontrol menunjukkan p value > 0,05 artinya tidak terjadi pengaruh yang signifikan sebelum dan setelah penelitian. Kesimpulan Teknik relaksasi nafas dalam dan terapi murottal Al-Qur’an ada pengaruh yang signifikan terhadap tekanan darah dan respirasi pada pasien pre operasi. Kata kunci: nafas dalam; murottal Al-Qur’an; tekanan darah; respirasi Abstract Deep breathing relaxation techniques and murottal Al-Qur'an therapy are effective non-pharmacological therapies to reduce blood pressure and respiration in preoperative patients. The design of this study used a pre-experimental method with a pre-test and post-test with control group design, the sampling method used was purposive sampling, namely the sampling technique by selecting samples among the population in accordance with what the researchers wanted by getting respondents of 60 patients. The results of this study indicate that there is a significant influence on blood pressure and respiration based on Wilcoxon test analysis in the intervention group. On the average, there


INTRODUCTION
One of Sustainable Development Goals (SDGs) is to reduce child mortality. As one of vulnerable groups and is the next generation of the nation, infants and toddlers need special attention in improving their health such as monitoring nutritional status, infectious diseases, growth and development and increasing the coverage of basic immunizations (UNICEF, 2020). Globally 5,6 million toddlers died, 15.000 every day. In other words, there are ten toddlers died every minute. Approximately 73% of toddlers' deaths occurred in two regions in 2017, WHO Africa (49%) and WHO Southeast Asia (24%) (Sinaga et al., 2019). Indonesia has made significant progress in reducing the child mortality rate to 25,4 per 1.000 live births. Indonesia estimates that 147.000 toddlers die each year, meaning that there are still children who die every minute, with almost half of toddler deaths occurring in the first month after birth (UNICEF, 2020).
One of the government's efforts to reduce the number of illness and death of toddlers is to carry out health care. Toddler health care is emphasized on the effort of preventing and increasing health, medication, and rehabilitation which Available online at https://ejournal.unisayogya.ac.id/ejournal/index.php/ijhst  (2020) Based on the research results in table 2 regarding satisfaction with service quality for pregnant women, it is known that most of respondents were satisfied with the service quality, about 24 people (75%). Satisfaction with this service is expressed by attitudes towards the technical competence of doctors and / or other health care professionals relating to patients and outcomes of disease or how changes are felt by patients as a result of health services (Pohan, 2014). The study results support the research conducted by Winarni (2014) regarding the satisfaction of pregnant women with antenatal care services by midwives in Ngoresan health center where the research results were from 77 respondents, 53.2% or 41 respondents were very satisfied with service is reviewed from the Antenatal Care Service Standards. c. Satisfaction with the class process of pregnant women  (2020) Based on research results about pregnant women satisfaction with the class process pregnant women in table 3, it can be seen that most of respondents were satisfied as many as 23 people (71.9%). Satisfaction with the maternal class process means that health services are available when and where they are needed. This shows that the attitude of being patient, attentive, responsive in responding and recognizing the problems raised by the participants during the class implementation for pregnant women is very important for pregnant women. The level of trust and confidence in doctors, the level of understanding of the condition or diagnosis and the degree of difficulty in being able to understand the doctor's advice or treatment plan (Hamsari, 2018). d. Satisfaction of pregnant women with the class service system for pregnant women Abstrak Teknik relaksasi nafas dalam dan terapi murottal Al-Qur'an salah satu terapi non farmakologi yang efektif untuk menurunkan tekanan darah dan respirasi pada pasien pre operasi. Desain penelitian ini menggunakan metode pra eksperimen dengan desain pretest and post-test with control group desain, metode sampling yang digunakan adalah purposive sampling yaitu teknik penetapan sampel dengan cara memilih sampel diantara populasi sesuai dengan yang dikehendaki peneliti dengan mendapatkan responden sebanyak 60 pasien. Hasil penelitian ini menunjukkan ada pengaruh yang signifikan terhadap tekanan darah dan respirasi berdasarkan analisis Wilcoxon test pada kelompok intervensi rata-rata terjadi pengaruh yang sangat signifikan dengan nilai p value sistol 0,000, diastol 0,033 dan respirasi 0,000 artinya data tersebut signifikan p value < 0,05. Sedangkan pada kelompok kontrol nilai p value untuk sistol 0,139, diastol  (2020) Based on the research results in table 2 regarding satisfaction with service quality for pregnant women, it is known that most of respondents were satisfied with the service quality, about 24 people (75%). Satisfaction with this service is expressed by attitudes towards the technical competence of doctors and / or other health care professionals relating to patients and outcomes of disease or how changes are felt by patients as a result of health services (Pohan, 2014). The study results support the research conducted by Winarni (2014) regarding the satisfaction of pregnant women with antenatal care services by midwives in Ngoresan health center where the research results were from 77 respondents, 53.2% or 41 respondents were very satisfied with service is reviewed from the Antenatal Care Service Standards. c. Satisfaction with the class process of pregnant women Based on research results about pregnant women satisfaction with the class process pregnant women in table 3, it can be seen that most of respondents were satisfied as many as 23 people (71.9%). Satisfaction with the maternal class process means that health services are available when and where they are needed. This shows that the attitude of being patient, attentive, responsive in responding and recognizing the problems raised by the participants during the class implementation for pregnant women is very important for pregnant women. The level of trust and confidence in doctors, the level of understanding of the condition or diagnosis and the degree of difficulty in being able to understand the doctor's advice or treatment plan (Hamsari, 2018). d. Satisfaction of pregnant women with the class service system for pregnant women (UKBM). It is managed and organized the community in the implementation of health development as community empowerment aimed to involve the community to participate actively in public health and provide assistance to the community in obtaining primary health services, significantly to accelerate the reduction in maternal and infant mortality (Kemenkes Rl , 2011). The program is similar to the growth monitoring and promotion program (GMP) in Ethiopia, activities to provide health counseling and childcare, supplementation, and detection of infant growth and treatment of diseases in children (Tekle et al., 2019). Constraints in implementing the program include the practice of Public health center is not optimal (Adekanmbi et al., 2017). Classic problems such as financial problem, human resource capacity, medicine and equipment supplies, and inadequate collaboration between related sectors in urban and rural areas (Setiawan and Christiani, 2018). In addition to insufficient maternal knowledge about growth monitoring and promotion activities, cadres' low counseling (Daniel et al., 2017) and public awareness about the importance of Public health center activities for maternal and child health must be improved (Ediana et al., 2019).
Under normal circumstances, the implementation of Public health center in Indonesia is still a big challenge, especially in times of disaster. Currently, Indonesia is facing a non-natural national disaster, Covid-19. WHO has declared Covid-19 as a world pandemic (WHO, 2020). The Head of the National Disaster Management Agency (BNPB) through Decree No. 9 A of 2020 extended through Decree No. 13 A of 2020) has also declared the status of specific emergencies due to the Corona virus outbreak in Indonesia. Presidential Decree No. 11 of 2020 established a public health emergency status, then updated with Presidential Decree No. 12 of 2020 concerning the determination of non-natural disasters of the spread of Corona Virus Disease 2019 as a national disaster (Kemenkes RI, 2020). The government must prevent the spread of Covid-19, on the other hand, to still concern about efforts to reduce infant mortality. One of them is by activating Public health center (Kemenkes RI, 2020).
Health services for infants and toddlers during the Covid-19 pandemic are needed to strengthen Public health center programs with innovations tailored to health protocols (Bakri, 2020). There are three components of Public health center implementation in the Covid-19 pandemic era. First, cadres will make agreements, set schedules with restrictions on visits and rotating invitations (Tang, 2020); Second, make a home visit or "door to door." Infants and toddlers will be weighed using stepped scales. Once used and when it is reused, the scales are cleaned first. Besides, the tool used repeatedly can be sprayed disinfectant in advance; the last component is the implementation of Public health center through an online system.
According to data from the provisional results of a quick study of the role of health centers in handling the covid-19 outbreak in Indonesia in June 2020,  (Pohan, 2014). This study results support the research conducted by Murti (2018) regarding the analysis of factors related to the satisfaction of pregnant women on the quality of service for pregnant women in the city of Semarang. b. Satisfaction with the quality of services for pregnant women Based on the research results in table 2 regarding satisfaction with service quality for pregnant women, it is known that most of respondents were satisfied with the service quality, about 24 people (75%). Satisfaction with this service is expressed by attitudes towards the technical competence of doctors and / or other health care professionals relating to patients and outcomes of disease or how changes are felt by patients as a result of health services (Pohan, 2014). The study results support the research conducted by Winarni (2014) regarding the satisfaction of pregnant women with antenatal care services by midwives in Ngoresan health center where the research results were from 77 respondents, 53.2% or 41 respondents were very satisfied with service is reviewed from the Antenatal Care Service Standards. c. Satisfaction with the class process of pregnant women Based on research results about pregnant women satisfaction with the class process pregnant women in table 3, it can be seen that most of respondents were satisfied as many as 23 people (71.9%). Satisfaction with the maternal class process means that health services are available when and where they are needed. This shows that the attitude of being patient, attentive, responsive in responding and recognizing the problems raised by the participants during the class implementation for pregnant women is very important for pregnant women. The level of trust and confidence in doctors, the level of understanding of the condition or diagnosis and the degree of difficulty in being able to understand the doctor's advice or treatment plan (Hamsari, 2018). d. Satisfaction of pregnant women with the class service system for pregnant women  (Pritasari, 2020). The decrease in Public health center practice or the postpone of Public health center activities during the Covid-19 pandemic significantly decreases the number of visits to maternal and child (KIA) nutrition and health services. Monitoring the growth of children under five years old is not carried, while the decline of basic immunization program services can lead to the potential for double outbreaks. The existence of fictitious reports or Public health center reporting is not valid even though there must be reporting every month, which becomes the basis for planning and follow-up activities. Moreover, the Public health center five-table service is not optimal because the Public health center practice place during the Covid-19 pandemic requires a large place to set the service desk distance at least 1 meter. Counseling activities are limited so that in the end, the targets that come to Public health center are only weighed, recorded, or then the weight is written in the KMS card (Growth Chart) without clearly outlining the process and results. The findings are in accordance with several studies showing the influence of pandemics on health services. There were 50% and 32% decrease in antenatal visits and childbirth during the Ebola outbreak in Liberia (Kumar, 2017), whose trend did not improve after the outbreak ended (Delamou et al., 2017). Another study found indications of a decline in Sierra Leoneans immunizing and weighing their children in health facilities during the Ebola outbreak (Miller et al., 2018). As community facilitators during the covid-19 pandemic, Cadres have not been able to innovate services in the community that causes a decrease in public interest in visiting Public health center. People's fear of covid-19 transmission is high, making people reluctant to visit Public health center directly (Juwita, 2020). Based on the background above, researchers are interested in conducting "Scoping Review: The Implementation of Toddler Public health center during the Covid-19 Pandemic".

RESEARCH METHODS
The method of this scoping review used Arksey and O'Malley framework (Arksey and Malley, 2005). There are 5 stages of the review process namely (a) identification of review questions, (b) identification of relevant studies, (c) selection of studies, (d) data mapping (data charting), and (e) compiling, summarizing, and reporting the results.

A. Identification of Review Questions
The research question is: how is the implementation of Public health center during the Covid-19 Pandemic?.  (Pohan, 2014). This study results support the research conducted by Murti (2018) regarding the analysis of factors related to the satisfaction of pregnant women on the quality of service for pregnant women in the city of Semarang. b. Satisfaction with the quality of services for pregnant women  (2020) Based on the research results in table 2 regarding satisfaction with service quality for pregnant women, it is known that most of respondents were satisfied with the service quality, about 24 people (75%). Satisfaction with this service is expressed by attitudes towards the technical competence of doctors and / or other health care professionals relating to patients and outcomes of disease or how changes are felt by patients as a result of health services (Pohan, 2014). The study results support the research conducted by Winarni (2014) regarding the satisfaction of pregnant women with antenatal care services by midwives in Ngoresan health center where the research results were from 77 respondents, 53.2% or 41 respondents were very satisfied with service is reviewed from the Antenatal Care Service Standards. c. Satisfaction with the class process of pregnant women  (2020) Based on research results about pregnant women satisfaction with the class process pregnant women in table 3, it can be seen that most of respondents were satisfied as many as 23 people (71.9%). Satisfaction with the maternal class process means that health services are available when and where they are needed. This shows that the attitude of being patient, attentive, responsive in responding and recognizing the problems raised by the participants during the class implementation for pregnant women is very important for pregnant women. The level of trust and confidence in doctors, the level of understanding of the condition or diagnosis and the degree of difficulty in being able to understand the doctor's advice or treatment plan (Hamsari, 2018). d. Satisfaction of pregnant women with the class service system for pregnant women

B. Identification of Relevant Studies
Inclusion criteria include sorting the articles published between 2016-2020, published in English or Indonesian, original articles, peer-reviewed published in the Journal and articles discussing mothers of toddlers as the respondents. In searching for evidence, relevant databases are used such as PubMed and Grey Literature used Google Scholar. Boolean operators are used to set flexible search (PubMed: The Bibliographic Database -The NCBI Handbook -NCBI Bookshelf, no date).

C. Selection of the Study
In the search for articles from all accessed databases, 312 articles were identified that were relevant to the scoping review question. Then the article was eliminated again after full text-reading; it was found that 6 articles could be used and reviewed independently based on predetermined inclusion and exclusion criteria. In the process of selecting the articles, the researcher used a flow chart prism to transparently describe the process that was carried out. Prism flow chart is considered appropriate because it can improve the quality of reporting publications (Liberati et al., 2009;Moher et al., 2009;Peters et al., 2015).   (2020) Based on the research results in table 2 regarding satisfaction with service quality for pregnant women, it is known that most of respondents were satisfied with the service quality, about 24 people (75%). Satisfaction with this service is expressed by attitudes towards the technical competence of doctors and / or other health care professionals relating to patients and outcomes of disease or how changes are felt by patients as a result of health services (Pohan, 2014). The study results support the research conducted by Winarni (2014) regarding the satisfaction of pregnant women with antenatal care services by midwives in Ngoresan health center where the research results were from 77 respondents, 53.2% or 41 respondents were very satisfied with service is reviewed from the Antenatal Care Service Standards. c. Satisfaction with the class process of pregnant women  (2020) Based on research results about pregnant women satisfaction with the class process pregnant women in table 3, it can be seen that most of respondents were satisfied as many as 23 people (71.9%). Satisfaction with the maternal class process means that health services are available when and where they are needed. This shows that the attitude of being patient, attentive, responsive in responding and recognizing the problems raised by the participants during the class implementation for pregnant women is very important for pregnant women. The level of trust and confidence in doctors, the level of understanding of the condition or diagnosis and the degree of difficulty in being able to understand the doctor's advice or treatment plan (Hamsari, 2018). d. Satisfaction of pregnant women with the class service system for pregnant women   (2020) Based on the research results in table 2 regarding satisfaction with service quality for pregnant women, it is known that most of respondents were satisfied with the service quality, about 24 people (75%). Satisfaction with this service is expressed by attitudes towards the technical competence of doctors and / or other health care professionals relating to patients and outcomes of disease or how changes are felt by patients as a result of health services (Pohan, 2014). The study results support the research conducted by Winarni (2014) regarding the satisfaction of pregnant women with antenatal care services by midwives in Ngoresan health center where the research results were from 77 respondents, 53.2% or 41 respondents were very satisfied with service is reviewed from the Antenatal Care Service Standards. c. Satisfaction with the class process of pregnant women  (2020) Based on research results about pregnant women satisfaction with the class process pregnant women in table 3, it can be seen that most of respondents were satisfied as many as 23 people (71.9%). Satisfaction with the maternal class process means that health services are available when and where they are needed. This shows that the attitude of being patient, attentive, responsive in responding and recognizing the problems raised by the participants during the class implementation for pregnant women is very important for pregnant women. The level of trust and confidence in doctors, the level of understanding of the condition or diagnosis and the degree of difficulty in being able to understand the doctor's advice or treatment plan (Hamsari, 2018). d. Satisfaction of pregnant women with the class service system for pregnant women   (2020) Based on the research results in table 2 regarding satisfaction with service quality for pregnant women, it is known that most of respondents were satisfied with the service quality, about 24 people (75%). Satisfaction with this service is expressed by attitudes towards the technical competence of doctors and / or other health care professionals relating to patients and outcomes of disease or how changes are felt by patients as a result of health services (Pohan, 2014). The study results support the research conducted by Winarni (2014) regarding the satisfaction of pregnant women with antenatal care services by midwives in Ngoresan health center where the research results were from 77 respondents, 53.2% or 41 respondents were very satisfied with service is reviewed from the Antenatal Care Service Standards. c. Satisfaction with the class process of pregnant women  (2020) Based on research results about pregnant women satisfaction with the class process pregnant women in table 3, it can be seen that most of respondents were satisfied as many as 23 people (71.9%). Satisfaction with the maternal class process means that health services are available when and where they are needed. This shows that the attitude of being patient, attentive, responsive in responding and recognizing the problems raised by the participants during the class implementation for pregnant women is very important for pregnant women. The level of trust and confidence in doctors, the level of understanding of the condition or diagnosis and the degree of difficulty in being able to understand the doctor's advice or treatment plan (Hamsari, 2018). d. Satisfaction of pregnant women with the class service system for pregnant women   (2020) Based on the research results in table 2 regarding satisfaction with service quality for pregnant women, it is known that most of respondents were satisfied with the service quality, about 24 people (75%). Satisfaction with this service is expressed by attitudes towards the technical competence of doctors and / or other health care professionals relating to patients and outcomes of disease or how changes are felt by patients as a result of health services (Pohan, 2014). The study results support the research conducted by Winarni (2014) regarding the satisfaction of pregnant women with antenatal care services by midwives in Ngoresan health center where the research results were from 77 respondents, 53.2% or 41 respondents were very satisfied with service is reviewed from the Antenatal Care Service Standards. c. Satisfaction with the class process of pregnant women  (2020) Based on research results about pregnant women satisfaction with the class process pregnant women in table 3, it can be seen that most of respondents were satisfied as many as 23 people (71.9%). Satisfaction with the maternal class process means that health services are available when and where they are needed. This shows that the attitude of being patient, attentive, responsive in responding and recognizing the problems raised by the participants during the class implementation for pregnant women is very important for pregnant women. The level of trust and confidence in doctors, the level of understanding of the condition or diagnosis and the degree of difficulty in being able to understand the doctor's advice or treatment plan (Hamsari, 2018). d. Satisfaction of pregnant women with the class service system for pregnant women   (2020) Based on the research results in table 2 regarding satisfaction with service quality for pregnant women, it is known that most of respondents were satisfied with the service quality, about 24 people (75%). Satisfaction with this service is expressed by attitudes towards the technical competence of doctors and / or other health care professionals relating to patients and outcomes of disease or how changes are felt by patients as a result of health services (Pohan, 2014). The study results support the research conducted by Winarni (2014) regarding the satisfaction of pregnant women with antenatal care services by midwives in Ngoresan health center where the research results were from 77 respondents, 53.2% or 41 respondents were very satisfied with service is reviewed from the Antenatal Care Service Standards. c. Satisfaction with the class process of pregnant women  (2020) Based on research results about pregnant women satisfaction with the class process pregnant women in table 3, it can be seen that most of respondents were satisfied as many as 23 people (71.9%). Satisfaction with the maternal class process means that health services are available when and where they are needed. This shows that the attitude of being patient, attentive, responsive in responding and recognizing the problems raised by the participants during the class implementation for pregnant women is very important for pregnant women. The level of trust and confidence in doctors, the level of understanding of the condition or diagnosis and the degree of difficulty in being able to understand the doctor's advice or treatment plan (Hamsari, 2018). d. Satisfaction of pregnant women with the class service system for pregnant women

RESULTS AND DISCUSSION
Stage 5: compiling, summarizing and reporting the results

A. Characteristics of Articles
Based on the articles obtained, as many as 6 articles were selected using 2 qualitative methods, 3 articles of cross Sectional, and 1 article of mix methods with grade A as many as 4 articles and grade B as many as 2 articles. The articles from low middle income country (LMIC), 5 articles from Indonesia and 1 article from Sierra Leone.   (2020) Based on the research results in table 2 regarding satisfaction with service quality for pregnant women, it is known that most of respondents were satisfied with the service quality, about 24 people (75%). Satisfaction with this service is expressed by attitudes towards the technical competence of doctors and / or other health care professionals relating to patients and outcomes of disease or how changes are felt by patients as a result of health services (Pohan, 2014). The study results support the research conducted by Winarni (2014) regarding the satisfaction of pregnant women with antenatal care services by midwives in Ngoresan health center where the research results were from 77 respondents, 53.2% or 41 respondents were very satisfied with service is reviewed from the Antenatal Care Service Standards. c. Satisfaction with the class process of pregnant women  (2020) Based on research results about pregnant women satisfaction with the class process pregnant women in table 3, it can be seen that most of respondents were satisfied as many as 23 people (71.9%). Satisfaction with the maternal class process means that health services are available when and where they are needed. This shows that the attitude of being patient, attentive, responsive in responding and recognizing the problems raised by the participants during the class implementation for pregnant women is very important for pregnant women. The level of trust and confidence in doctors, the level of understanding of the condition or diagnosis and the degree of difficulty in being able to understand the doctor's advice or treatment plan (Hamsari, 2018). d. Satisfaction of pregnant women with the class service system for pregnant women

B. Themes
In this mapping step, the researcher mapped 3 themes, namely Cadre role: activeness of cadres and weak involvement of cadres; Public health center barriers: fear and anxiety of mothers having baby under five; Innovation in implementing Public health center during the covid-19 pandemic.  The activeness of cadres in providing motivation, information about health protocols, and the need to monitor the growth of toddlers by health workers can improve maternal compliance in visiting Public health center. Compliance refers to a situation when an individual's conduct is commensurate with the recommended action or advice proposed by a health practitioner or information obtained from another source of [CATEGOR Y NAME] 5 Article [CATEGOR

B. Themes
In this mapping step, the researcher mapped 3 themes, namely Cadre role: activeness of cadres and weak involvement of cadres; Public health center barriers: fear and anxiety of mothers having baby under five; Innovation in implementing Public health center during the covid-19 pandemic.  The activeness of cadres in providing motivation, information about health protocols, and the need to monitor the growth of toddlers by health workers can improve maternal compliance in visiting Public health center. Compliance refers to a situation when an individual's conduct is commensurate with the recommended action or advice proposed by a health practitioner or information obtained from another source of  (Pohan, 2014). This study results support the research conducted by Murti (2018) regarding the analysis of factors related to the satisfaction of pregnant women on the quality of service for pregnant women in the city of Semarang. b. Satisfaction with the quality of services for pregnant women  (2020) Based on the research results in table 2 regarding satisfaction with service quality for pregnant women, it is known that most of respondents were satisfied with the service quality, about 24 people (75%). Satisfaction with this service is expressed by attitudes towards the technical competence of doctors and / or other health care professionals relating to patients and outcomes of disease or how changes are felt by patients as a result of health services (Pohan, 2014). The study results support the research conducted by Winarni (2014) regarding the satisfaction of pregnant women with antenatal care services by midwives in Ngoresan health center where the research results were from 77 respondents, 53.2% or 41 respondents were very satisfied with service is reviewed from the Antenatal Care Service Standards. c. Satisfaction with the class process of pregnant women  (2020) Based on research results about pregnant women satisfaction with the class process pregnant women in table 3, it can be seen that most of respondents were satisfied as many as 23 people (71.9%). Satisfaction with the maternal class process means that health services are available when and where they are needed. This shows that the attitude of being patient, attentive, responsive in responding and recognizing the problems raised by the participants during the class implementation for pregnant women is very important for pregnant women. The level of trust and confidence in doctors, the level of understanding of the condition or diagnosis and the degree of difficulty in being able to understand the doctor's advice or treatment plan (Hamsari, 2018). d. Satisfaction of pregnant women with the class service system for pregnant women  Sari and Utami's research (2020) stated that the level of compliance in Public health center visits from the research results is that most respondents are obedient in implementing Public health center during the Covid-19 pandemic from August to October 2020 (Sari and Utami, 2020). According to Miller et al. (2018) research, cadres' primary role is social mobilization and community involvement in Ebola prevention and control. Activities include raising awareness about Ebola, explain how to avoid Ebola, advocate the implementation of prevention strategies and distribute basic ingredients, including buckets, soaps, hand sanitizers, and gloves. These activities include raising awareness about Ebola; explain how to avoid it, advocate for the implementation of prevention strategies, and distribute basic materials including buckets, soap, hand sanitizers and gloves. Cadres are also tasked with carrying out tracer contacts, namely by creating and searching a list of all contacts known to be associated with Ebola cases, isolating and monitoring them to determine whether they have Ebola symptoms or not. Any contact who shows signs or symptoms, cadres will report and refer them for treatment. Cadres are also trained and deployed as active case seekers, cadres will isolate and report cases to health workers and make referrals to health facilities (Miller et al., 2018).

b. Weak involvement of cadres
According to Miller (2018) there was a sharp decline in maternal and child health services when the Ebola outbreak occurred in Sierra Leone. Weak healthcare delivery, confusing policies, and the overwhelming nature of the Ebola outbreak were making the case even worse. This happened because there was unclear and consistent guidance for cadres and community leaders during the pandemic. In addition, there was also no facilitation from the Government in developing cadres' abilities in emergency preparedness, response plans and responsibilities as well as a reporting system for cadres and figures (Miller et al., 2018). The stigma in society also arose, where many people blamed the health system for the Ebola outbreak. They considered cadres to be carriers of the plague who spread Ebola so that people were afraid and reluctant to come to health services. This had an impact on decreasing visits for infants and toddlers, thereby disrupting the process of monitoring their growth and administering immunizations. This posed a challenge to the role of cadres. On the other hand, cadres also faced challenges because they were not given adequate incentives and inadequate facilities even though they remained active in providing services during the pandemic.
According to Nazri's (2016) research, Public health center cadres are required to have sufficient knowledge of their duties and responsibilities, such as weighing methods, filling KMS (growth chart) and providing additional food. The lack of cadres at the time of implementing Public health center cause cadres to do multiple jobs such as registering as well as measuring children and plotting KMS. In fact, there were still many who did not plot the results of weighing on KMS,  (2020) Based on the research results in table 2 regarding satisfaction with service quality for pregnant women, it is known that most of respondents were satisfied with the service quality, about 24 people (75%). Satisfaction with this service is expressed by attitudes towards the technical competence of doctors and / or other health care professionals relating to patients and outcomes of disease or how changes are felt by patients as a result of health services (Pohan, 2014). The study results support the research conducted by Winarni (2014) regarding the satisfaction of pregnant women with antenatal care services by midwives in Ngoresan health center where the research results were from 77 respondents, 53.2% or 41 respondents were very satisfied with service is reviewed from the Antenatal Care Service Standards. c. Satisfaction with the class process of pregnant women  (2020) Based on research results about pregnant women satisfaction with the class process pregnant women in table 3, it can be seen that most of respondents were satisfied as many as 23 people (71.9%). Satisfaction with the maternal class process means that health services are available when and where they are needed. This shows that the attitude of being patient, attentive, responsive in responding and recognizing the problems raised by the participants during the class implementation for pregnant women is very important for pregnant women. The level of trust and confidence in doctors, the level of understanding of the condition or diagnosis and the degree of difficulty in being able to understand the doctor's advice or treatment plan (Hamsari, 2018). d. Satisfaction of pregnant women with the class service system for pregnant women interpretations of changes in body weight had not been carried out correctly, and counseling had not gone well (Nazri et al., 2016). Counseling and outreach activities were carried out only if there were health workers. Cadres felt unable to conduct counseling and outreach activities due to a lack of knowledge and skills (Aditianti et al., 2019), so that in the end those who came to Public health center were only weighed, recorded or written down the results of their weighing in the KMS without being clearly explained the process and results. In addition, mothers of toddlers whose children had received complete immunization did not want to come to Public health center again because they felt they had not benefited from this activity (Nazri et al., 2016). From this explanation, it can be concluded that the Public health center activities have been running well but have not implemented the function of monitoring the growth of children under five. Therefore, it is necessary to reposition Public health center as a means of monitoring the growth of children under five. Efforts to increase the knowledge of health workers and cadres are also needed.

Public health center barriers (fear and anxiety of mothers having baby under five)
There were several concerns and anxieties felt by Public health center participant mothers, the worst worry was that they were afraid of their child and them would be infected with Covid-19 when they came to Public health center. The anxiety that is felt is natural because until now the Covid-19 outbreak has not been resolved. Anxiety is a common feeling of fear and anxiety. This is a natural feeling of the body that signals the impending danger and the need to take action (Anggraini and Agustin, 2020). This anxiety can be minimized by several things, including active Public health center cadres and health workers in providing information about Covid-19 and always reminding about the implementation of health protocols that must be obeyed when implementing Public health center.
During this pandemic, the community would experience high panic and anxiety so that it would have an impact on people's behavior, especially those related to health. There were several health behaviors that had improved such as wearing masks, washing hands, exercising, but there were also several health behaviors that had decreased such as fear of coming to health services, fear of seeking treatment or fear of leaving the house to come to Public health center. They felt anxious about contracting Covid-19 from health workers or from other health service visitors (Sari and Utami, 2020). If the anxiety was excessive, there would be symptoms such as generalized anxiety disorder, depression, stress, anger, and difficulty in sleeping. These findings are in line with research that showed people's anxiety and fear of Covid-19 transmission was greater and this made people reluctant to visit Public health center directly (Juwita, 2020).

Innovation in implementing Public health center during the Covid-19 pandemic
The implementation of Public health center activities is one of the government's efforts to detect early nutrition problems in children under five,   (2020) Based on the research results in table 2 regarding satisfaction with service quality for pregnant women, it is known that most of respondents were satisfied with the service quality, about 24 people (75%). Satisfaction with this service is expressed by attitudes towards the technical competence of doctors and / or other health care professionals relating to patients and outcomes of disease or how changes are felt by patients as a result of health services (Pohan, 2014). The study results support the research conducted by Winarni (2014) regarding the satisfaction of pregnant women with antenatal care services by midwives in Ngoresan health center where the research results were from 77 respondents, 53.2% or 41 respondents were very satisfied with service is reviewed from the Antenatal Care Service Standards. c. Satisfaction with the class process of pregnant women  (2020) Based on research results about pregnant women satisfaction with the class process pregnant women in table 3, it can be seen that most of respondents were satisfied as many as 23 people (71.9%). Satisfaction with the maternal class process means that health services are available when and where they are needed. This shows that the attitude of being patient, attentive, responsive in responding and recognizing the problems raised by the participants during the class implementation for pregnant women is very important for pregnant women. The level of trust and confidence in doctors, the level of understanding of the condition or diagnosis and the degree of difficulty in being able to understand the doctor's advice or treatment plan (Hamsari, 2018). d. Satisfaction of pregnant women with the class service system for pregnant women namely by monitoring growth and giving immunizations. Public health center activities are the first step to detect toddlers with growth problems so that they can be immediately referred to health workers for treatment as soon as possible (Kemenkes Rl, 2011). In the Covid-19 pandemic situation, monitoring the growth of children under five was still carried out through the application of health protocols, namely by complying with the principles of infection prevention and physical distancing, namely: a) Cleaning and ensuring that Public health center service area was sterile before and after service according to the principle of preventing infection transmission; b) Adjusting the distance of the table (minimum 1-2 meters) so that it was not too close; c) Health workers / cadres made rotating schedules with clear times for mothers and toddlers so that the queue was not long because in one Public health center the maximum consisted of only 10 people; d) Appealing to parents / caregivers of babies and toddlers to bring their own cloth or sarong for weighing or to weigh babies together with parents; e) Cadres helped ensure that toddlers and parents / caregivers were in good health; f) Visitors who entered the service area were arranged as best as possible so that not many people gathered in one room (maximum 10 people in the service area including officers); g) Provision of means of washing hands using soap with running water or disinfectant which was available in the Public health center area; h) Application of the principle of safety injection, namely before returning home, children who had been immunized (injected) were asked to wait around (outside) the service area for about 30 minutes in an open place (Kemenkes RI, 2020).

R E P E A T I S S U E
Cadres as implementing Public health center activities during the Covid-19 pandemic were not able to innovate services to the community which resulted in a decrease in the number of Public health center visits. The mothers of toddlers hoped that cadres could innovate in providing services because they needed information, monitoring the growth and development of infants and toddlers was still running, and face-to-face services were not expected to reduce the essence of Public health center services (Juwita, 2020). This could be done by utilizing online media such as social media, videos and so on. Thus Public health center services could run well by utilizing social media which was integrated with home visits (Kemenkes RI, 2020). However, this online program was less effective, because not all mothers were aware of social media, especially those who lived in rural areas (Miller et al., 2018).

CONCLUSION
Public health center can provide basic health services by monitoring the growth and development of infants and toddlers so that they can detect health problems early and they can get prompt and precise treatment. From the results of the review, it was found that a gap was still limited in literature discussing the topic so that further research was needed on the implementation of Public health center for toddlers during the Covid-19 pandemic.   (2020) Based on the research results in table 2 regarding satisfaction with service quality for pregnant women, it is known that most of respondents were satisfied with the service quality, about 24 people (75%). Satisfaction with this service is expressed by attitudes towards the technical competence of doctors and / or other health care professionals relating to patients and outcomes of disease or how changes are felt by patients as a result of health services (Pohan, 2014). The study results support the research conducted by Winarni (2014) regarding the satisfaction of pregnant women with antenatal care services by midwives in Ngoresan health center where the research results were from 77 respondents, 53.2% or 41 respondents were very satisfied with service is reviewed from the Antenatal Care Service Standards. c. Satisfaction with the class process of pregnant women  (2020) Based on research results about pregnant women satisfaction with the class process pregnant women in table 3, it can be seen that most of respondents were satisfied as many as 23 people (71.9%). Satisfaction with the maternal class process means that health services are available when and where they are needed. This shows that the attitude of being patient, attentive, responsive in responding and recognizing the problems raised by the participants during the class implementation for pregnant women is very important for pregnant women. The level of trust and confidence in doctors, the level of understanding of the condition or diagnosis and the degree of difficulty in being able to understand the doctor's advice or treatment plan (Hamsari, 2018). d. Satisfaction of pregnant women with the class service system for pregnant women received stigma from the community, so it was necessary to evaluate the implementation of Public health center activities and increased community partnerships with community leaders. Of the 6 articles studied, no cadres training was found on emergency preparedness and response when a pandemic occurred. Therefore, it is necessary to have a policy to provide training to cadres and involve the community as an important partner in emergency preparedness and response. In addition, there were no articles that discussed information technology-based Public health center services. It is expected that Public health center cadres and supervisors will be more creative in providing information technology-based services so that monitoring of the health development of infants and toddlers can still be done.  (2020) Based on the research results in table 2 regarding satisfaction with service quality for pregnant women, it is known that most of respondents were satisfied with the service quality, about 24 people (75%). Satisfaction with this service is expressed by attitudes towards the technical competence of doctors and / or other health care professionals relating to patients and outcomes of disease or how changes are felt by patients as a result of health services (Pohan, 2014). The study results support the research conducted by Winarni (2014) regarding the satisfaction of pregnant women with antenatal care services by midwives in Ngoresan health center where the research results were from 77 respondents, 53.2% or 41 respondents were very satisfied with service is reviewed from the Antenatal Care Service Standards. c. Satisfaction with the class process of pregnant women  (2020) Based on research results about pregnant women satisfaction with the class process pregnant women in table 3, it can be seen that most of respondents were satisfied as many as 23 people (71.9%). Satisfaction with the maternal class process means that health services are available when and where they are needed. This shows that the attitude of being patient, attentive, responsive in responding and recognizing the problems raised by the participants during the class implementation for pregnant women is very important for pregnant women. The level of trust and confidence in doctors, the level of understanding of the condition or diagnosis and the degree of difficulty in being able to understand the doctor's advice or treatment plan (Hamsari, 2018). d. Satisfaction of pregnant women with the class service system for pregnant women