BACKGROUND:
In 2020, as many as 392,079 women in Karawang Regency are workers, this phenomenon creates a double threat to efforts to prevent stunting during pregnancy. These workers face occupational, structural, and systemic challenges that hinder the uptake of stunting prevention services.

OBJECTIVES:
This study explores the challenges and barriers in the implementation of stunting prevention programs among pregnant workers.

METHODS:
A mixed-methods design was used. Quantitative data were collected from all pregnant workers who gave birth at Citra Sari Husada Hospital, Karawang Indonesia in October-November 2024, met inclusion criteria (singleton pregnancy, no congenital anomalies), and were assessed through a checklist on iron tablet consumption, antenatal frequency and birth outcomes. Qualitative data were obtained via in-depth interviews with mothers who failed to meet iron supplementation standards and standardized antenatal care frequency.

RESULTS:
Among 110 pregnant workers, 21.8% did not consume iron supplements according to the recommended standard, and 62.7% did not perform the 6 times minimum frequency of antenatal care. Moreover, 17.3% of babies were born at risk of stunting (birth weight <2500g and length <48 cm). Qualitative findings revealed key barriers including inflexible work conditions, lack of workplace health support, weak policy integration between public health and labor sectors, and low maternal agency in workplace decision-making.

CONCLUSIONS:
Pregnant workers remain underserved by current maternal health and stunting prevention policies. Structural barriers in industrial environments especially those related to time, access, and authority limit program effectiveness and threaten pregnancy outcomes.

KEY MESSAGE:
Health policies must integrate with labor systems, strengthen workplace-based maternal services, and promote women’s empowerment. Newborn 2