Maternal Mortality in Klaten Regency (Determinant Factors Analysis)

Abstract

Background: Failure in reducing maternal mortality has become one of the world's health problems. Indonesia ranks third on the list of the highest MMR in ASEAN countries. The incidence of maternal mortality is caused by several factors, including reproductive status, obstetric complications, health services, and socioeconomic conditions. Subjects and Method:This study was an analytic observational study using a case-controlled study design. The study subjects were selected by using fixed random sampling with a total sample of 129 people consisting of 43 cases of maternal mortality in Klaten Regency and 86 controls. Maternal mortality data were taken in Klaten Regency from 2017 to 2019. The independent variables were pregnancy complications, delivery complications, postpartum complications, age of pregnant women, pregnancy spacing, parity, delay in making decisions, referral delay due to inadequate transportations, delay in handling by health workers, the quantity of ANC, maternal education, maternal occupation, and family income. The dependent variable was maternal mortality in Klaten Regency. The data collection of this study used a questionnaire. Data analysis was carried out by univariate, bivariate, and multivariate methods using the chi-square test. Path analysis and descriptive analysis were performed and presented in narrative form. Results:The delay in making decisions increases with family income below the city minimum wage (OR = 1.69; p = 0.09). Referral delay increases with family income below the minimum wage (OR = 1.73; p = 0.08). Maternal mortality increased with delay in decision making (OR = 5.-28; p = 0.00), quantity of ANC (OR: 2.37; p: 0.-02), income (OR: 3.92; p: 0.00), delivery complications (OR: 2.71; p: 0.01) ), postpartum complications (OR: 6.33; p: 0.00). Maternal mortality was indirectly affected by income. Conclusion: Pregnancy complications, delivery complications, postpartum complications, ANC examinations, delay in making decisions, delay in reaching the referral place, maternal education and income are associated with an increased risk of maternal mortality. While, maternal age, parity, pregnancy spacing, delay in handling by health workers, and maternal occupation have no significant association with maternal mortality.

Key Success Factors in Maternity Waiting Home Implementation: A Qualitative Study in Rural Indonesia

“…7,8 Indirect causes of maternal death include socio-cultural and socioeconomic factors, occupation, income level, access to health services, and delay in receiving treatment by health workers. 9 In general, poor women in remote and rural areas experience the most di culty obtaining adequate health services due to the low number of professional health workers and di culty in reaching health facilities. 5 In general, the MMR in South Sulawesi Province reached 129 per 100,000 live births in 2021.…”