Regional disparities in postnatal care among mothers aged 15-49 years old: An analysis of the Indonesian Demographic and Health Survey 2017

Abstract

Background: In Indonesia, maternal mortality remains high, significantly 61.59% occur in the postnatal period. Postnatal care (PNC) provision is a critical intervention between six hours and 42 days after childbirth and is the primary strategy to reduce maternal mortality rates. However, underutilisation of PNC in Indonesia still remains high, and limited studies have shown the regional disparities of PNC in Indonesia. Methods: This study aims to explore the gaps between regions in PNC service for mothers who have had live births during the last five years in Indonesia. This study was a secondary data analysis study using the Indonesian Demographic and Health Survey (IDHS) in 2017. A total of 13,901 mothers aged 15-49 years having had live births within five years were included. Chi-squared test and binary logistic regression were performed to determine regional disparities in PNC. Results: Results indicated that the prevalence of PNC service utilisation among mothers aged 15-49 years was 70.94%. However, regional gaps in the utilisation of PNC service were indicated. Mothers in the Central of Indonesia have used PNC services 2.54 times compared to mothers in the Eastern of Indonesia (OR = 2.54; 95% CI = 1.77-3.65, p<0.001). Apart from the region, other variables have a positive relationship with PNC service, including wealth quintile, accessibility health facilities, age of children, childbirth order, mother's education, maternal occupation, spouse's age, and spouse's education. Conclusion: The results suggest the need for national policy focuses on service equality, accessible, and reliable implementation to improve postnatal care utilisation among mothers to achieve the maximum results for the Indonesian Universal Health Coverage plan.

Trend of sociodemographic and economic inequalities in the use of maternal health services in Lao People’s Democratic Republic from 2006 to 2017: MICS data analysis

“…In 2017, the coverage of at least one ANC visit with skilled personnel and institutional delivery more than doubled compared to the year 2006, with an over 23% increase since 2012. This is similar to the trend in neighboring countries such as Myanmar, Cambodia, and Indonesia, which also achieved substantial improvement in maternal health service utilization over the past decades due to efforts to achieve Millennium Development Goals and sustainable development goals [32][33][34]. Meanwhile, Lao PDR currently has almost the same coverage levels of skilled birth attendance and ANC uptake as Myanmar and Indonesia, but the coverages are quite a bit lower compared to those in Cambodia by a difference of over 20% [35][36][37].…”

Trend of sociodemographic and economic inequalities in the use of maternal health services in Lao People’s Democratic Republic from 2006 to 2017: MICS data analysis

“…In 2017, the coverage of at least one ANC visit with skilled personnel and institutional delivery more than doubled compared to the year 2006, with an over 23% increase since 2012. This is similar to the trend in neighboring countries such as Myanmar, Cambodia, and Indonesia, which also achieved substantial improvement in maternal health service utilization over the decades due to efforts to achieve Millennium Development Goals and sustainable development goals [32][33][34]. Lao PDR currently has almost the coverage levels of birth attendance and ANC uptake as Myanmar and but the are quite a bit compared to those in Cambodia difference of over 20% [35][36][37].…”

“…This re ects efforts by the government of the country to improve the utilization of all services across the continuum of care for reproductive, maternal, newborn, child, and adolescent health since 2011 through capacity building [54]. Due to delayed global efforts towards improving the coverage of PNC as compared to ANC and facility-based delivery, the lowest coverage is commonly in PNC in many developing countries [33,35,37,55,56]. Low PNC utilization may be due to barriers to accessing services including costs of services, indirect costs, and a low understanding of the importance of PNC visits [57].…”

Family support and peer support related to the physical activity of the prospective bride and groom

“…The mortality rate of mothers in Indonesia is still fairly high (1)(2)(3). According to Statistics Indonesia on maternal mortality ratio per 100 000 live births, there were approximately 305 deaths of women while pregnant and within 42 days of termination of pregnancy in 2015.…”