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Abstract

Upaya menurunkan angka kematian neonatus (AKN) membutuhkan suatu pelayanan kesehatan yang berkesinambungan, dikenal dengan istilah asuhan berkelanjutan atau Continuum of care. Asuhan berkelanjutan pada ibu hamil di daerah perkotaan bisa saja berbeda dengan di pedesaan. Penelitian ini ingin mengetahui dampak asuhan berkelanjutan pada ibu hamil terhadap kematian neonatus, serta peran tempat tinggal ibu hamil terhadap hubungan tersebut. Studi ini merupakan studi potong lintang menggunakan set data Demographic and Health Surveys (DHS) Indonesia tahun 2017. Variabel dependen pada studi ini adalah kematian neonatus dari anak terakhir yang dilahirkan responden antara 2012 hingga 2017. Variabel independennya adalah asuhan berkelanjutan pada ibu hamil yang terdiri dari asuhan antenatal, asuhan persalinan, dan asuhan pasca persalinan yang optimal. Analisis multivariat menggunakan regresi logistik ganda. Cakupan asuhan antenatal optimal, asuhan persalinan optimal dan asuhan pasca persalinan optimal adalah 25,97%, 72,77%, dan 51,88%. Secara keseluruhan, asuhan berkelanjutan diperoleh 13,87% ibu hamil. Dari 14.862 persalinan, terdapat 153 kematian neonatus (11 kematian neonatus per 1000 kelahiran hidup). Ibu hamil yang tidak menjalani asuhan berkelanjutan memiliki risiko 10,77 kali lebih tinggi mengalami kematian neonatus (POR=10,77; IK95% 2,56-45,37). Tidak ditemukan perbedaan efek tersebut antara kelompok subjek yang tinggal di perkotaan dan pedesaan (nilai p=0,564). Asuhan berkelanjutan pada ibu hamil menurunkan angka kematian neonatus. Tidak terdapat perbedaan dampak tersebut di perkotaan maupun pedesaan

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