•  
  •  
 

ORCID ID

Haerawati Idris : 0000-0002-3483-6717

Willyana Syafriyanti : 0000-0003-1340-4664

Abstract

Background: The World Health Organization reports that approximately 295,000 women died during or after their pregnancy and delivery in 2017. However, such deaths can be prevented by using delivery assistance from health workers. This study aims to analyze the trends and determinants of using delivery assistance by health workers in Indonesia.

Methods: A quantitative cross-sectional design is adopted to analyze secondary data from the Indonesian Health Demographic Surveys in 2007, 2012, and 2017. The sample includes married women that are selected according to inclusion and exclusion criteria: 15.011 respondents in 2007, 14.989 in 2012, and 15.179 in 2017. Data are analyzed using logistic regression statistical tests.

Results: This study shows the significant increase of using delivery assistance by health workers in Indonesia, from 53.8% in 2007, 68.8% in 2012, to 77.9% in 2017. Age, residence in the Java/Bali region, residence in urban areas, high and secondary education, high economic status, complete antenatal care visits, and knowing the signs of danger during pregnancy have significant relationships with delivery assistance by health workers among women. After being controlled by another factor, higher education is the most dominant factor associated with using delivery assistance by health workers among women in Indonesia (p < 0.001; Prevalence Ratio (PR) of 3.727 (3.123–4.447).

Conclusions: Women’s education is the most important factor in delivery assistance by health workers utilization. Increasing knowledge regarding utilization of health worker assistance during delivery can be carried out through educational information, counseling or seminars, the Internet, and other media that are expected to increase information and awareness to take advantage of such service.

References

  1. WHO, UNICEF, UNFPA WBG and the UNPD. Trends in Maternal Mortality: 2000 to 2017. New York: WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division, 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 Heal. 2014;2:323–33.
  3. Badan Pusat Statistik Indonesia. Profil Penduduk Indonesia Hasil SUPAS 2015. Jakarta: Badan Pusat Statistik Indonesia, 2015.
  4. Indonesian Ministry of Health. Profil Kesehatan Indonesia Tahun 2019. Jakarta: Indonesian Ministry of Health, 2020.
  5. Badan Pusat Statistik Indonesia. Profil Kesehatan Ibu dan Anak 2020. Jakarta: Badan Pusat Statistik Indonesia, 2020.
  6. Indonesian Ministry of Health. Laporan Kinerja Direktorat Jenderal Masyarakat Tahun 2020. Jakarta: Indonesian Ministry of Health, 2020.
  7. Andersen. Revisiting The Behavioral Model and Access to Medical Care Does It Matter? J Health Soc Behav. 1975;6:1–10.
  8. Ayele GS, Melku AT, Belda SS. Utilization of skilled birth attendant at birth and associated factors among women who gave birth in the last 24 months preceding the survey in Gura Dhamole Woreda, Bale zone, southeast Ethiopia. BMC Pub Health. 2019;19:1–14.
  9. Tessema ZT, Tesema GA. Pooled prevalence and determinants of skilled birth attendant delivery in East Africa countries: A multilevel analysis of Demographic and Health Surveys. Ital J Pediatr. 2020;46:1–11.
  10. Dufera A, Bala ET, Desta HO, Taye K. Determinants of Skilled Birth Attendant Utilization at Chelia District, West Ethiopia. Int J Rep Med. 2020;2020:1–8.
  11. Manyeh AK, Akpakli DE, Kukula V, Ekey RA, Narh-Bana S, Adjei A, et al. Socio-demographic determinants of skilled birth attendant at delivery in rural southern Ghana. BMC Res Notes. 2017;10:1–7.
  12. Gitimu A, Herr C, Oruko H, Karijo E, Gichuki R, Software P, et al. Determinants of use of skilled birth attendant at delivery in Makueni, Kenya: A cross-sectional study. BMC Preg Childbirth. 2015;15:1–7.
  13. Singh PK, Rai RK, Alagarajan M, Singh L. Determinants of maternity care services utilization among married adolescents in rural India. PLoS One. 2012;7:e31666.
  14. Saaka M, Akuamoah-Boateng J. Prevalence and determinants of rural-urban utilization of skilled delivery services in Northern Ghana. Scientifica. 2020;2020.
  15. Grossman M. Health capital. J Polit Econ. 1972;80:223–55.
  16. Mende M, Melkenesh NB. Status of skilled birth attendance utilization and determinants among women of child-bearing age in Chencha Woreda, Gamo Gofa Zone, Southern Ethiopia, December 2016. MOJ Women's Health. 2019;8:178–90.
  17. Bobo FT, Yesuf EA, Woldie M. Inequities in utilization of reproductive and maternal health services in Ethiopia. Int J Equity Health. 2017;16:1–8.
  18. Nababan HY, Hasan M, Mathias T, Dhital R, Rahman A, Anwar I. Trends and inequities in use of maternal health care services in Indonesia, 1986–2012. Int J Women's Health. 2018;10:11–24.
  19. Boyle M, Plummer V, Suryant. Healthcare Workforce in Indonesia. Asia Pacif J Health Manag .2017;12:32–40.
  20. UNICEF. Unicef Indonesia improving maternal and newborn health services in eastern Indonesia. Indonesia: UNICEF. 2017.
  21. Dickson KS, Amu H. Determinants of skilled birth attendance in the northern parts of Ghana. Adv Pub Health. 2017;2017:1–8.
  22. Kibria GM Al, Ghosh S, Hossen S, Barsha RAA, Sharmeen A, Uddin SMI. Factors affecting deliveries attended by skilled birth attendants in Bangladesh. Matern Health Neonatol Perinat. 2017;3:1–9.
  23. Alemayehu M, Mekonnen W. The prevalence of skilled birth attendant utilization and its correlates in Northwest Ethiopia. Biomed Res Int. 2015;2015:436938.
  24. Kumi-Kyereme A, Amo-Adjei J. Effects of spatial location and household wealth on health insurance subscription among women in Ghana. BMC Health Serv Res. 2013;13:58–77.
  25. Ahinkorah BO, Seidu AA, Agbaglo E, Adu C, Budu E, Hagan JE, et al. Determinants of antenatal care and skilled birth attendance services utilization among childbearing women in Guinea: Evidence from the 2018 Guinea Demographic and Health Survey data. BMC Preg Childbirth. 2021;21:1–11.
  26. Islam N, Islam MT, Yoshimura Y. Practices and determinants of delivery by skilled birth attendants in Bangladesh. Rep Health. 2014;11:1–7.
  27. Tesfaye B, Atique S, Azim T, Kebede MM. Predicting skilled delivery service use in Ethiopia: Dual application of logistic regression and machine learning algorithms. BMC Med Info Decis Mak. 2019;19:1–10.
  28. Doctor HV, Findley SE, Cometto G, Afenyadu GY. Awareness of critical danger signs of pregnancy and delivery, preparations for delivery, and utilization of skilled birth attendants in Nigeria. J Health Care Poor Underserved. 2013;24:152–70.
  29. Bakar RR, Mmbaga BT, Nielsen BB, Manongi RN. Awareness of danger signs during pregnancy and post-delivery period among women of reproductive age in Unguja Island, Zanzibar: A qualitative study. Afr J Reprod Health. 2019;23:27–36.
  30. Mwilike B, Nalwadda G, Kagawa M, Malima K, Moselle L, Horiuchi S. Knowledge of danger signs during pregnancy and subsequent healthcare-seeking actions among women in Urban Tanzania: A cross-sectional study. BMC Preg Childbirth. 2018;18:1–8.

Creative Commons License

Creative Commons Attribution-Share Alike 3.0 License
This work is licensed under a Creative Commons Attribution-Share Alike 3.0 License.

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.