Home Deliveries in Indonesia: Who Provides Assistance?

Abstract

Indonesia has set an ambitious target of reducing its maternal mortality rate to 125 maternal deaths per 100,000 live births by the year 2010. This poses formidable challenges in a geographically diverse country where the majority of births occur at home. One option for the Indonesian government in order to reduce its maternal mortality would be to increase rates of skilled assistance for home deliveries. In order to design appropriate policies to achieve this, it is imperative to understand the determinants of use of birth attendants by mothers delivering at home. We use the Andersen Behavioral Model as a theoretical framework to understand the determinants of the use of a trained provider, traditional birth attendant, or no trained assistance during home deliveries in Indonesia. The 1997 Indonesia Demographic and Health Survey (IDHS) was used, and data from the most recent home delivery was abstracted for analysis. Out of a total sample of 10,692 home deliveries, a majority (53%) used the services of a TBA, 40% had a doctor, nurse or midwife in attendance, and only 7% delivered with the help of family and/or friends. A multinomial logit model was used to predict determinants of use. Our results indicate that maternal education, religion, asset index quartile and number of antenatal visits are significant determinants among all choice sets.

Determinants of Skilled Birth Attendant Utilization in Afghanistan: A Cross-Sectional Study

“…16,17 The Afghan Ministry of Public Health has been promoting health care for the poor, and evidence from other studies has shown success in providing outpatient services to the poor in Afghanistan. 13 However, we found that use of skilled birth attendants was highly inequitable in Afghanistan, with the poor being at a stark disadvantage.…”

Attending Home vs. Clinic-Based Deliveries: Perspectives of Skilled Birth Attendants in Matlab, Bangladesh

“…Key aspects of safe delivery practices include the physical setting, availability of supplies and equipment, level of skill and selfconfidence of the provider and a supportive environment. 10 While the constraints faced by women living in developing countries in accessing professional birthing care and quality of care issues are well researched, [11][12][13][14][15] the views and experiences of skilled attendants assisting childbirth in women's homes have not been available. This paper examines the experiences of skilled birth attendants carrying out home-based deliveries in a rural setting in Bangladesh, in comparison with deliveries attended by the same attendants in health facilities.…”

The Migrant–Nonmigrant Differentials in Prenatal Care Utilization: Evidence from Indonesia

“…The underlying social causes of maternal mortality in Indonesia include early marriage, limited resources and incapability of the infrastructure (Beegle et al 2001;Thind and Banerjee 2004). The common medical causes of maternal mortality include postpartum hemorrhage, eclampsia, abortion complications, infections and prolonged labor (Beegle et al 2001;Thind and Banerjee 2004). There is widespread evidence that most Indonesian women still sought the services of traditional birth attendants (TBAs) and home delivery is still predominant, especially in rural areas (Thind and Banerjee 2004).…”

“…The common medical causes of maternal mortality include postpartum hemorrhage, eclampsia, abortion complications, infections and prolonged labor (Beegle et al 2001;Thind and Banerjee 2004). There is widespread evidence that most Indonesian women still sought the services of traditional birth attendants (TBAs) and home delivery is still predominant, especially in rural areas (Thind and Banerjee 2004). However, home deliveries by traditional birth attendants (TBAs) can lead to untreated obstetric complications (e.g., prolonged labor, excessive bleeding, fever, anemia, ruptured uterus, and maternal convulsions) especially if the mothers are not able to obtain the necessary higher level care when complications arise (Thind and Banerjee 2004).…”