Hakikat Sakit dalam Perspektif Agama dan Relevansinya Terhadap Pelayanan Kebidanan Multikultural: Tinjauan Literatur Sistematis

Abstract

The conception of illness across religious traditions profoundly shapes how patients experience pregnancy, childbirth, and postpartum recovery, yet midwifery education and practice have not systematically integrated this diversity. This systematic literature review aims to analyze religious perspectives on the nature of illness across major traditions present in Indonesia, examine their implications for multicultural midwifery care, and develop a three-dimensional framework (theological-practical-pedagogical) for integrating spiritual care into midwifery. Using PRISMA-P protocol with narrative synthesis and meta-ethnography (Noblit and Hare), 42 studies were selected from 1,247 records across eight databases (PubMed, Scopus, Web of Science, CINAHL, PsycINFO, Academic Search Complete, ProQuest Religion Database, Portal Garuda/IPI) following double screening with Cohen's Kappa = 0.84. Five major findings emerge. In Islam, illness is understood as spiritual trial (ibtila), purification (tazkiyatun nafs), and a path toward closeness to Allah (qurbatan ilallah); 78% of Muslim midwives in Malaysia integrated prayer and dhikr into complication management. Christianity understands illness through redemptive suffering and ministry of presence; 85% of Christian midwives reported that faith-based approaches improved therapeutic relationships. Hinduism frames illness within karma-dharma-moksha; Buddhism emphasizes dukkha and mindfulness-based acceptance. Local Indonesian traditions (Kejawen, Batak, Dayak) integrate cosmological balance as a determinant of health. Midwives integrating spiritual care report significantly higher patient satisfaction (M=4.2 vs 3.6, p<0.001). Spiritual care training improves midwifery students' self-efficacy with effect size = 0.67. A best practices model comprising three components is proposed: cultural-religious competency development, collaborative care with religious leaders, and patient-centered spiritual assessment. The article contributes a three-dimensional analytical framework and recommends integrating spiritual care competencies into Indonesian midwifery curricula.