•  
  •  
 

Abstract

Background: The postnatal complication that occurs in the first week after childbirth is one of the causes of maternal death in Indonesia. However, it can be prevented with postnatal care (PNC). This study aims to analyze the determinants of PNC service utilization in Indonesia.

Methods: This quantitative study employed a cross-sectional study design and used secondary data from the Indonesian Health and Demographics Survey of 2017. The sample consisted of 14,724 women aged 15–49 years. We assessed the predictors of PNC service utilization using multivariate logistic regression models.

Results: About 78.4% of the respondents utilized PNC services. The factors that have a significant association with PNC service utilization include the following: college and secondary of level education, working status, high economic status, residence in the Java–Bali region, delivery assistance by a health worker, delivery by cesarean section, and complete antenatal care during pregnancy. Among these, residence in the Java–Bali region is the most dominant factor associated with PNC service utilization in Indonesia.

Conclusions: The difference area is a key factor in PNC service utilization. Government efforts to improve PNC service utilization must consider the equitable distribution of health facilities and health workers throughout the country.

References

  1. UNFPA, World Health Organization, UNICEF, World Bank Group, the United Nations Population Division. Trends in maternal mortality: 2000 to 2017. Geneva: World Health Organization; 2019.
  2. Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, et al. global causes of maternal death: a who systematic analysis. Lancet Glob Health. 2014;2:e323–33.
  3. World Health Organization. Postnatal care for mothers and newborns: Highlights from the World Health Organization 2013 Guidelines. Geneva: World Health Organization; 2015.
  4. Statistics Indonesia. Profil Penduduk Indonesia Hasil SUPAS 2015. Jakarta: Statistics Indonesia; 2015.
  5. Ministry of Health Republic of Indonesia. Profil Kesehatan Indonesia 2018. Jakarta: Ministry of Health Republic of Indonesia; 2019.
  6. Andersen RM. Revisiting the behavioral model and access to medical care: Does it matter? J Health Soc Behav. 1995;36:1–10.
  7. Gebrehiwot G, Medhanyie AA, Gidey G, Abrha K. Postnatal care utilization among urban women in Northern Ethiopia: Cross-sectional survey. BMC Womens Health. 2018;18:78.
  8. Khaki JJ, Sithole L. Factors associated with the utilization of postnatal care services among Malawian women. Malawi Med J. 2019;31:2–11.
  9. Mon AS, Phyu MK, Thinkhamrop W, Thinkhamrop B. Utilization of full postnatal care services among rural Myanmar women and its determinants: A cross-sectional study. F1000Res. 2018;7:1167.
  10. Nurrizka RH, Wahyono TYM. Disparitas kematian maternal di Indonesia: Studi ekologi dengan analisis spasial. Indonesian J Pub Health. 2018;14:119–27.
  11. Laksono AD, Rukmini R, Wulandari RD. Regional disparities in antenatal care utilization in Indonesia. PLoS One. 2020;15:e0224006.
  12. Barber SL, Gertler PJ, Harimurti P. Differences in access to high-quality outpatient care in Indonesia. Health Aff (Millwood). 2007;26:w352–66.
  13. Koma YRN, Purwanto E, Suminto F, Muli M, Marthias T. Healthcare Service utilisation for elderly people and adolescents in Indonesia. In Padudu H, Priyarsono DS, Yusuf AA, Hartono D, Resosudamo BP. Eds. Regional Development in Indonesia: Some Notes for the Jokowi Government. UNPAD PRESS; 2017. p.165–87.
  14. Bwalya BB, Mulenga MC, Mulenga JN. Factors associated with postnatal care for newborns in Zambia: Analysis of the 2013-14 Zambia demographic and health survey. BMC Pregnancy Childbirth. 2017;17:418.
  15. Hermawan A. Analisis distribusi tenaga kesehatan (dokter, perawat dan bidan) di Indonesia pada 2013 dengan menggunakan index gini. Bull Health Syst Res. 2019;22:167–75.
  16. Sisay MM, Geremew TT, Demlie YW, Alem AT, Beyene DK, Melak MF, et al. Spatial patterns and determinants of postnatal care use in Ethiopia: Findings from the 2016 demographic and health survey. BMJ Open. 2019;9: e025066.
  17. Berhe A, Bayray A, Berhe Y, Teklu A, Desta A, Araya T, et al. Determinants of postnatal care utilization in Tigray, Northern Ethiopia: A community based cross-sectional study. PLoS One. 2019;14:e0221161.
  18. Akibu M, Tsegaye W, Megersa T, Nurgi S. Prevalence and determinants of complete postnatal care service utilization in Northern Shoa, Ethiopia. J Pregnancy. 2018;2018:8625437.
  19. Ulfa ZD, Kuswardinah A, Mukarromah SB. Faktor-faktor yang mempengaruhi pemanfaatan pelayanan kesehatan maternal secara berkelanjutan. Pub Health Perspect J. 2017;2:184–90.
  20. Parangka C, Mandagi CK, Engkeng S. Hubungan antara pengetahuan, sikap dan pendapatan keluarga peserta bpjs dengan pemanfaatan pelayanan kesehatan di Puskesmas Wawonasa Kecamatan Singkil Kota Manado. Ikmas. 2017;1:24–39.
  21. Abota TL, Atenafu NT. Postnatal Care utilization and associated factors among married women in Benchi-Maji Zone, Southwest Ethiopia: A community based cross-sectional study. Ethiop J Health Sci. 2018;28:267–76.
  22. Neupane S, Doku D. Utilization of postnatal care among Nepalese women. Mater Child Health J. 2013;17:1922–30.
  23. Ewa E, Lasisi C, Maduka S, Ita A, Ibor U, Anjorin O. Perceived factors influencing the choice of antenatal care and delivery centres among childbearing women in Ibadan North South-Western, Nigeria. Ethiop J Environ Stud Manag. 2012;5:373–83.
  24. Khanal V, Adhikari M, Karkee R, Gavidia T. Factors associated with the utilisation of postnatal care services among the mothers of Nepal: Analysis of Nepal demographic and health survey 2011. BMC Womens Health. 2014;14:19.
  25. Tarekegn SM, Lieberman LS, Giedraitis V. Determinants of maternal health service utilization in Ethiopia: Analysis of the 2011 Ethiopian Demographic and Health Survey. BMC Pregnancy Childbirth. 20147;14:161.
  26. Helmizar. Evaluasi kebijakan jaminan persalinan (jampersal) dalam penurunan angka kematian ibu dan bayi di Indonesia. Jurnal Kesehatan Masyarakat. 2014;9:197–205.
  27. Chaka EE, Abdurahman AA, Nedjat S, Majdzadeh R. Utilization and determinants of postnatal care services in Ethiopia: A systematic review and meta-analysis. Ethiop J Health Sci. 2019;29:935–44.
  28. Singh N, Ponna SN, Upadrasta VP, Dudala SR, Sadasivuni R. Determinants of utilization of antenatal and postnatal care services in Telangana. Int J Reprod Contracept Obstet Gynecol. 2017;6:3352–61.
  29. Izudi J, Akwang GD, Amongin D. Early postnatal care use by postpartum mothers in Mundri East County, South Sudan. BMC Health Serv Res. 2017;17:442.
  30. Mohan D, Gupta S, LeFevre A, Bazant E, Killewo J, Baqui AH. Determinants of postnatal care use at health facilities in rural Tanzania: Multilevel analysis of a household survey. BMC Pregnancy Childbirth. 2015;15:282.
  31. Halle-Ekane G, Emade F, Bechem N, Palle J, Fongaing D, Essome H, et al. Prevalence and risk factors of primary postpartum hemorrhage after vaginal deliveries in the Bonassama District Hospital, Cameroon. Int J Trop Dis Heal. 2016;13:1–12.
  32. Hordofa MA, Almaw SS, Berhanu MG, Lemiso HB. Postnatal Care service utilization and associated factors among women in Dembecha District, Northwest Ethiopia. Sci J Pub Health. 2015;3:686–92.
  33. Magoma M, Requejo J, Campbell O, Cousens S, Merialdi M, Filippi V. The effectiveness of birth plans in increasing use of skilled care at delivery and postnatal care in rural Tanzania: A cluster randomised trial. Trop Med Int Health. 2013;18:435–43.
  34. National Research Council. Reducing maternal and neonatal mortality in Indonesia: Saving lives, saving the future. Washington, DC: The National Academies Press; 2013.

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.