Ismainar Hetty, Subagio Hertanto W, Widjanarko Bagoes, Hadi Cahyono
Doctoral Program, Faculty of Public Health, Diponegoro University, Semarang, Indonesia.
Department of Nutrition, Faculty of Medicine, Diponegoro University, Semarang, Indonesia.
Risk Manag Healthc Policy. 2020 Aug 4;13:1007-1014. doi: 10.2147/RMHP.S242724. eCollection 2020.
Maternal mortality rate (MMR) in Indonesia is still relatively high, at 305 per 100.000 live births (2015). Routine visit to antenatal care is the best way to reduce MMR. Inspite of this, the number of antenatal care visits among pregnant women is still low. This study aimed to measure the influence of behavioral ecological factors with the compliance of pregnant women to visit antenatal care.
Study population was pregnant women living in Dumai City, Indonesia. This study was a quantitative research design with a cross-sectional. We used the cluster system to select participants. A total of 369 subjects participated with a gestation age between >12 until 40 weeks. The data were collected by face-to-face interviews using validated questioners. The analysis was done by bivariate analysis using the Spearman correlation test. Multivariate using multiple linear regression.
This study showed that factors of the ecological model of behavior were related to antenatal care compliance ( value<0.05) with a coefficient correlation (0.330-0.569). Multivariate analysis showed that all variables associated significantly (adjusted R; 0.104-0.311). Five variables were dominant; knowledge, cultural beliefs, family support, friend support, and health facilities with adjusted R= 0.518.
Five factors in an ecological model of behavior, such as knowledge, cultural beliefs, family support, friend support, and health facilities, proportion (51,8%) of contributing to antenatal care compliance. We recommend a health district program to make services more accessible to pregnant women. Health education programs need to increase the knowledge of pregnant women and families to provide support in antenatal care compliance. Local governments shall improve antenatal care quality by mapping, planning, and evaluating this program.
印度尼西亚的孕产妇死亡率（MMR）仍然相对较高，每10万例活产中有305例（2015年）。定期进行产前检查是降低孕产妇死亡率的最佳方法。尽管如此，孕妇进行产前检查的次数仍然较低。本研究旨在衡量行为生态因素对孕妇遵守产前检查的影响。
研究人群为居住在印度尼西亚杜迈市的孕妇。本研究采用横断面定量研究设计。我们使用整群抽样系统选择参与者。共有369名受试者参与，孕周在>12周至40周之间。数据通过使用经过验证的问卷进行面对面访谈收集。分析采用Spearman相关检验进行双变量分析。多变量分析采用多元线性回归。
本研究表明，行为生态模型的因素与产前检查依从性相关（P值<0.05），相关系数为（0.330 - 0.569）。多变量分析表明，所有变量均显著相关（调整R；0.104 - 0.311）。五个变量占主导地位；知识、文化信仰、家庭支持、朋友支持和卫生设施，调整R = 0.518。
行为生态模型中的五个因素，如知识、文化信仰、家庭支持、朋友支持和卫生设施，占产前检查依从性影响因素的比例为（51.8%）。我们建议开展一项健康区计划，使孕妇更容易获得服务。健康教育计划需要增加孕妇及其家庭的知识，以在产前检查依从性方面提供支持。地方政府应通过规划、实施和评估该计划来提高产前检查质量。
