Efendi Ferry, Ni'mah Ani Rihlatun, Hadisuyatmana Setho, Kuswanto Heri, Lindayani Linlin, Berliana Sarni Maniar
Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia.
Department of Statistics, Institut Teknologi Sepuluh Nopember, Indonesia.
ScientificWorldJournal. 2019 Jun 20;2019:9694602. doi: 10.1155/2019/9694602. eCollection 2019.
Reducing maternal mortality remains a significant challenge in Indonesia, especially for achieving the country's Sustainable Development Goals (SDGs) by 2030. One of the challenges is increasing delivery at healthcare facilities to ensure safe and healthy births. In Indonesia, research on factors affecting women's use of facility-based childbirth services is scarce.
This study was conducted to identify the determinants of facility-based deliveries in Indonesia.
This study used data from the Indonesia Demographic and Health Survey of 2012, with a cross-sectional design. An odds ratio with 95% confidence intervals (CI) was employed to outline the independent variables for the determinants, including maternal age and education, place of residence, involvement in decision-making, employment status, economic status, and number of antenatal care visits. The dependent variable in this study was the place of delivery: whether it took place in healthcare or nonhealthcare facilities. The statistical significance was set at p<0.05 using bivariate analysis and binary logistic regression.
This study showed that a high level of education (OR: 3.035, 95% CI: 2.310-3.987), high economic status (OR: 6.691, 95% CI: 5.768-7.761), urban residence (OR: 2.947, 95% CI: 2.730-3.181), working status (OR: 0.853, 95% CI: 0.793-0.918), involvement in decision-making (OR: 0.887, 95% CI: 0.804-0.910), and having more than four visits to antenatal care centers (OR: 1.917, 95% CI: 1.783-2.061) were significant determinants of delivery at healthcare facilities.
Efforts to improve facility-based childbirth in Indonesia must strengthen initiatives that promote women's education, women's autonomy, opportunities for wealth creation, and increased uptake of antenatal care, among others. Any barriers related to maternal healthcare services and cultural factors on the use of health facilities for childbirth in Indonesia require further monitoring and evaluation.
降低孕产妇死亡率在印度尼西亚仍是一项重大挑战，尤其是在2030年实现该国可持续发展目标（SDGs）方面。其中一项挑战是增加在医疗机构分娩，以确保安全健康的分娩。在印度尼西亚，关于影响妇女使用医疗机构分娩服务的因素的研究很少。
本研究旨在确定印度尼西亚医疗机构分娩的决定因素。
本研究使用了2012年印度尼西亚人口与健康调查的数据，采用横断面设计。采用比值比及95%置信区间（CI）来概述决定因素的自变量，包括产妇年龄和教育程度、居住地点、参与决策情况、就业状况、经济状况以及产前检查次数。本研究的因变量是分娩地点：是否在医疗机构或非医疗机构进行。使用双变量分析和二元逻辑回归将统计学显著性设定为p<0.05。
本研究表明，高教育水平（比值比：3.035，95%置信区间：2.310 - 3.987）、高经济状况（比值比：6.691，95%置信区间：5.768 - 7.761）、城市居住（比值比：2.947，95%置信区间：2.730 - 3.181）、工作状况（比值比：0.853，95%置信区间：0.793 - 0.918）、参与决策（比值比：0.887，95%置信区间：0.804 - 0.910）以及产前检查中心就诊次数超过四次（比值比：1.917，95%置信区间：1.783 - 2.061）是医疗机构分娩的显著决定因素。
在印度尼西亚，改善医疗机构分娩的努力必须加强促进妇女教育、妇女自主权、创造财富机会以及增加产前检查利用率等举措。任何与孕产妇医疗服务以及印度尼西亚使用医疗机构分娩的文化因素相关的障碍都需要进一步监测和评估。
