Adolescent girls (15-19 years old) experienced childbirth face the higher risk for maternal mortality than older women. This study aimed to assess the utilization level of maternal health services and to identify factors that contribute to the maternal health services utilization in Indonesian adolescent mothers. The study used secondary data from 2017 Indonesia Demographic and Health Survey (IDHS) and included women who had last birth at the age of 15-19 years old which total is 866 women. Among adolescent mothers, the highest level of utilization is post-natal care (PNC) (71.5%) followed by antenatal care (ANC) (67.2%) then delivery services (64.5%). Factors that associated with ANC utilization are husband/partner’s education, mother’s autonomy, region, husband accompanied during ANC, topic discussed during ANC, and intendedness of last birth (p<0.05). Factors contributed to delivery services are mother’s education, mother’s working status, mother’s autonomy, residence, region, wealth index, health insurance, husband accompanied during ANC, and topic discussed during ANC (p<0.05). Whereas, for PNC utilization are knowledge of danger sign during childbirth, residence, region, and delivery services utilization (p<0.05). Therefore, health strategic programs which focused on adolescent mothers are necessary to improve the maternal health in Indonesia.
Accommodating the needs of Indonesia’s rapidly growing urban population is essential to reaching national reproductive health goals and international commitments. As in other rapidly urbanizing low- and middle-income countries, satisfying the needs of Indonesia’s urban poor is both a high priority and a significant challenge. In this study, we assessed both how being from urban poor or near-poor households affects the quantity and quality of family planning and maternal health services received and the extent to which differentials had narrowed during the 2012–2017 period. This time interval is significant due to the introduction of a national social health insurance scheme in 2014, establishing the foundation for universal health care in the country. Data from the 2012 and 2017 Indonesian Demographic and Health Surveys were analyzed using logistic and multinomial logit regression. Poverty status was measured in terms of urban household wealth quintiles. For family planning, although urban poor and near-poor women made different method choices than non-poor women, no substantial 2017 differences in contraceptive prevalence, unmet need for family planning or informed choice were observed. However, urban poor women and to a lesser extent near-poor women systematically lagged non-poor urban women in both the quantity and quality of maternal health services received in connection with recent pregnancies. Significant maternal health service gains were observed for all urban women during the study reference period, with gains for poor and near poor urban women exceeding those for non-poor on several indicators. While the deployment of pro-poor interventions such as the national social health insurance scheme is likely to have contributed to these results, evidence suggesting that the scheme may not be influencing consumer health-seeking behaviors as had been anticipated along with continued limitations in public health sector supply-side readiness resulting in service quality issues suggest that more will have to be done.
Maternal Mortality Ratio (MMR) in Indonesia remains high with 305 death per 100,000 live birth in 2015. Approximately 36 of 1000 adolescent girls (15-19 years old) in Indonesia experienced childbirth and face the higher risk for maternal mortality than older women. The aims of this study are to assess maternal health services utility (antenatal care (ANC), delivery services, and postnatal care (PNC)) level and to identify determinants of maternal health services utility among adolescent mothers in Indonesia. The design of this study is cross-sectional survey using secondary data from 2017 Indonesia Demographic and Health Survey (IDHS). The study population is women who had last birth at the age of 15-19 years old which total is 866 women. The descriptive statistics was used to assess the utilization of maternal health services level along with a simple logistic regression and multivariable logistic regression to identify the contributing factors. Among adolescent mothers, the highest level of utility is PNC (71.5%) followed by ANC (67.2%) then delivery services (64.5%). Factors that associated with ANC utilization are husband/partner’s education, mother’s autonomy, region, husband accompanied during ANC, topic discussed during ANC, and intendedness of last birth (p<0.05). Factors contributed to delivery services are mother’s education, mother’s working status, mother’s autonomy, residence, region, wealth index, health insurance, husband accompanied during ANC, and topic discussed during ANC (p<0.05). Whereas, for PNC utilization are knowledge of danger sign during childbirth, residence, region, and delivery services utilization (p<0.05). As the study’s results found that knowledge or education of adolescent mothers had significant association with some maternal health services utilization but only region was significantly associated with the three utilizations, therefore strategic policies and programs’ approach to adolescent mothers should focus on 1) Expanding health care coverage in every region, 2) Providing maternal education for women and men, and 3) Expanding the health insurance coverage.
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