Abstract

The utilization of delivery at health facilities is a major intervention in reducing 16 to 33% of deaths. This study aimed to determine the model of utilization of delivery at health facilities in Indonesia in 2017 and its influential factors. This study used secondary data from the 2017 Indonesian Demographic and Health Survey using a Spatial Durbin Model (SDM) approach. The population was mothers aged 15 – 49 years, spread across 34 provinces of Indonesia, and had 15,321 samples. The results showed that the Moran’s I value was positive (0.146) and significant at p-value = 0.007, indicating clustered regions with similar characteristics. The SDM modeling estimation results (R2 = 91.61%) presented those dependent and independent variables that influenced the utilization of delivery at health facilities and its influential factors. The significant and most dominant direct factor that influenced the utilization of delivery at health facilities was pregnancy visits, while the most dominant indirect factor was socioeconomic status. Therefore, further policy planning is expected to be based on regional specificities, and effective intervention programs should be designed based on these factors.

References

1. World Health Organization. Trends in maternal mortality 2000 to 2017: Estimates by WHO, UNICEF, UNFPA, World Bank Group, and the United Nations Population Division. Geneva: World Health Organization; 2019.

2. World Health Organization. World Health Statistics 2023: Monitoring Health for the SDGS, sustainable development goals. Geneva: World Health Organization; 2023.

3. Indra I, Nazara S, Hartono D, et al. Expenditure inequality and polarization in Indonesia, 2002-2012. Int J Soc Econ. 2018; 45 (10): 1469–1486. DOI: 10.1108/IJSE-02-2017-0051.

4. Yarinbab TE, Lema TB, Kitila SB. Delays in Utilization of Institutional Delivery Service and its Determinants in Yem Special Woreda, Southwest Ethiopia: Health Institution Based Cross-Sectional Study. J Gynecoel Woemens Health. 2018; 10 (3): 555793. DOI: 10.19080/JGWH.2018.10.555793.

5. Yoseph M, Abebe SM, Mekonnen FA, et al. Institutional delivery services utilization and its determinant factors among women who gave birth in the past 24 months in Southwest Ethiopia. BMC Health Serv Res. 2020; 20: 265. DOI: 10.1186/s12913-020-05121-9.

6. National Population and Family Planning Board (BKKBN), Statistics Indonesia (BPS), Ministry of Health (Kemenkes), and ICF. Indonesia Demographic and Health Survey 2017. Jakarta, Indonesia: BKKBN, BPS, Kemenkes, and ICF; 2018.

7. Badan Pusat Statistik. Profil Kesehatan Ibu dan Anak 2022. Jakarta: Badan Pusat Statistik; 2022.

8. Kenea D, Jisha H. Urban-rural disparity and determinants of delivery care utilization in Oromia region, Ethiopia: Community-based cross-sectional study. Int J Nurs Pract. 2017; 23 (1). DOI: 10.1111/ijn.12510.

9. Kementerian Perencanaan Pembangunan Nasional/Badan Perencanaan Pembangunan Nasional. Laporan Pelaksanaan Pencapaian Tujuan Pembangunan Berkelanjutan 2023. Jakarta: Kementerian Perencanaan Pembangunan Nasional/Badan Perencanaan Pembangunan Nasional; 2023.

10. Laksono AD, Wulandari RD, Rukmini R. The determinant of healthcare childbirth among young people in Indonesia. J Public Health Res. 2021; 10 (1): 1890. DOI: 10.4081/jphr.2021.1890.

11. Assefa M, Fite RO, Taye A, et al. Institutional delivery service use and associated factors among women who delivered during the last 2 years in Dallocha town, SNNPR, Ethiopia. Nurs Open. 2019; 7 (1): 186-194. DOI: 10.1002/nop2.378.

12. Setu SP, Islam MA, Halim SFB. Individual and Community-Level Determinants of Institutional Delivery Services among Women in Bangladesh: A Cross-Sectional Study. Int J Clin Pract. 2022; 2022: 3340578. DOI: 10.1155/2022/3340578.

13. Mitikie KA, Wassie GT, Beyene MB. Institutional delivery services utilization and associated factors among mothers who gave birth in the last year in Mandura district, Northwest Ethiopia. PLoS One. 2020; 15 (12): e0243466. DOI: 10.1371/journal.pone.0243466.

14. Atahigwa C, Kadengye DT, Iddi S, et al. Trends and determinants of health facility childbirth service utilization among mothers in urban slums of Nairobi, Kenya. Glob Epidemiol. 2020; 2: 100029. DOI: 10.1016/j.gloepi.2020.100029.

15. Gilano G, Hailegebreal S, Seboka BT. Determinants and spatial distribution of institutional delivery in Ethiopia: Evidence from Ethiopian Mini Demographic and Health Surveys 2019. Arch Public Health. 2022; 80 (1): 65. DOI: 10.1186/s13690-022-00825-2.

16. Tesema GA, Mekonnen TH, Teshale AB. Individual and community-level determinants, and spatial distribution of institutional delivery in Ethiopia, 2016: Spatial and multilevel analysis. PLoS One. 2020; 15 (11): e0242242. DOI: 10.1371/journal.pone.0242242.

17. Eryando T. Spatial Analysis for Enhancing the Use of Health Data Availability from Different Sources to Help the Decision-Making Process. Kesmas. 2022; 17 (3): 165–168. DOI: 10.21109/kesmas.v17i3.6196.

18. Yasin H, Hakim AR, Warsito B. Regresi Spasial (Aplikasi dengan R). Ponorogo: Wade Group; 2020.

19. Laksono AD, Wulandari RD. Regional disparities of facility-based childbirth in Indonesia. Trends Sci. 2021; 18 (21): 387. DOI: 10.48048/tis.2021.387.

20. Anselin L, Rey SJ, eds. Perspectives on Spatial Data Analysis. Berlin: Springer; 2010. DOI: 10.1007/978-3-642-01976-0.

21. Doctor HV, Nkhana-Salimu S, Abdulsalam-Anibilowo M. Health facility delivery in sub-Saharan Africa: Successes, challenges, and implications for the 2030 development agenda. BMC Public Health. 2018; 18 (1): 765. DOI: 10.1186/s12889-018-5695-z.

22. Teshale AB, Alem AZ, Yeshaw Y, et al. Exploring spatial variations and factors associated with skilled birth attendant delivery in Ethiopia: Geographically weighted regression and multilevel analysis. BMC Public Health. 2020; 20 (1): 1444. DOI: 10.1186/s12889-020-09550-3.

23. Lam HY, de Vera R, Rivera AS, et al. Describing the Health Service Delivery Netwoerk oef an Urban Poeoer Area and a Rural Poeoer Area. Acta Med Philipp. 2018; 52 (5): 438–446. DOI: 10.47895/amp.v52i5.316.

24. Laksono AD, Wulandari RD. Urban-Rural Disparities of Facility-Based Childbirth in Indonesia. In: Proceedings of the 4th International Symposium on Health Research (ISHR 2019). Adv Health Res. Atlantis Press. 2020; 22: 33-39. DOI: 10.2991/ahsr.k.200215.007.

25. Laksono AD, Mubasyiroh R, Laksmiarti T, et al. Aksesibilitas Pelayanan Kesehatan di Indoenesia. Supriyanto S, Chalidyanto D, Wulandari RD, editors. Yogyakarta: PT Kanisius; 2016.

26. Rinardi H, Indrahti S, Masruroh NN. Ketimpangan Ekonomi Jawa dan Luar Jawa dan Perkembangan Perdagangan Antarpulau di Indonesia. J Sej Citra Lekha. 2023; 8 (1): 29-43. DOI: 10.14710/jscl.v8i1.54443.

27. Tanou M, Kamiya Y. Assessing the impact of geographical access to health facilities on maternal healthcare utilization: Evidence from the Burkina Faso demographic and health survey 2010. BMC Public Health. 2019; 19: 838. DOI: 10.1186/s12889-019-7150-1.

28. Kumbeni MT, Apanga PA. Institutional delivery and associated factors among women in Ghana: Findings from a 2017-2018 multiple indicator cluster survey. Int Health. 2021; 13 (6): 520-526. DOI: 10.1093/inthealth/ihab002.

29. Rashid M, Chowdhury MRK, Kader M, et al. Determinants of Utilization of Institutional Delivery Services in Zambia: An Analytical Cross-Sectional Study. Int J Environ Res Public Health. 2022; 19 (5): 3144. DOI: 10.3390/ijerph19053144.

30. Mocumbi S, Högberg U, Lampa E, et al. Mothers' satisfaction with care during facility-based childbirth: A cross-sectional survey in southern Mozambique. BMC Pregnancy Childbirth. 2019; 19 (1): 303. DOI: 10.1186/s12884-019-2449-6.

31. Dankwah E, Zeng W, Feng C, et al. The social determinants of health facility delivery in Ghana. Reprod Health. 2019; 16: 101. DOI: 10.1186/s12978-019-0753-2.

Download

Share

COinS