Background Although efforts to reduce high maternal mortality in countries such as Indonesia tend to focus on addressing health risks among pregnant women, family planning has been shown globally to reduce maternal mortality by reducing both total and higher-risk pregnancies. This article assesses past contributions of family planning to the reduction of maternal mortality in Indonesia and the potential future contribution toward achieving the 2030 SDG maternal mortality goal. Methods The study takes advantage of data from long series of population censuses and large-scale surveys that are available in few other low- and middle-income countries. We use the decomposition method suggested by (Matern Child Health J, 16:456–463, 2012) and regression-based policy simulations to estimate the number of maternal deaths averted during 1970–2017 due to contraceptive use and project potential future contributions to the year 2030. Results It is estimated that between 523,885 and 663,146 maternal deaths were averted from 1970 to 2017 due to contraceptive use, a 37.5–43.1% reduction. If the contraceptive prevalence rate (CPR) were to rise from 63% in 2017 to 70% in 2030 and unmet need for family planning were to fall to from 10 to 7%, an additional 34,621–37,186 maternal deaths would be averted, an 18.9–20.0% reduction. A 2030 CPR of 75% and unmet need for family planning of 5% would result in 51,971–54,536 maternal deaths being averted, a 28.4–29.4% reduction. However, the CPR growth rate would have to nearly double the 2000–2017 rate to reach 70% CPR by 2030 and more than triple to reach 75%. Achieving the most ambitious target would still leave the maternal mortality ratio at 125 in 2030 without corresponding improvements in maternal health services. Conclusions Although substantial reductions in maternal mortality between 1970 and 2017 can be attributed to contraceptive use and further contributions to the year 2030 are probable, smaller contributions are likely due to the already relatively high CPR and the challenges that must be overcome to move the CPR significantly higher. The ability of Indonesia to reach the 2030 SDG maternal mortality target of 70 maternal deaths per 100,000 live births will depend primarily upon health system effectiveness in addressing health risks to women once they are pregnant.
Background Prior studies have shown that contraceptive use reduces maternal mortality independently of other maternal health services. The present study took advantage of geographically detailed Indonesian data to study the interplay between contraceptive use and other risk and protective factors for maternal mortality at the community level, a level of analysis where the protective effects of family planning can be best understood. Methods Data from the 2015 Intercensal Population Survey (SUPAS) and the 2014 Village Potential Survey (PODES) were used to construct a series of census block-level variables measuring key risk and protective factors for maternal mortality. The relationships between these factors and maternal mortality, measured via natural log-transformation of past five-year maternal mortality ratios in each of the 40,748 census blocks were assessed via log-linear regressions. Results Higher community maternal mortality ratios were associated with lower community contraceptive prevalence, higher percentage of parity four-plus births, higher proportion of poor households, lower population density of hospitals, higher density of traditional birth attendants (TBA), and residence outside of Java-Bali. For every percentage point increase in CPR, community maternal mortality ratios were lower by 7.0 points (95% CI = 0.9, 14.3). Community-level household wealth was the strongest predictor of maternal mortality. Conclusions Community contraceptive prevalence made a significant contribution to reducing maternal mortality net of other risk and protective factors during 2010–2015. Increased health system responsiveness to the needs of pregnant women and reductions in socioeconomic and geographic disparities in maternal health services will be needed for Indonesia to reach the 2030 SDG maternal mortality goal.
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.
Pos pelayanan terpadu (Posyandu) merupakan kegiatan yang melibatkan masyarakat melalui pemberdayaan sebagai wujud pelayanan kesehatan dengan menggerakkan Kader. Salah satu kegiatan yang berjalan di Posyandu Mawar di wilayah kerja Puskesmas Polowijen adalah posyandu balita. Pada tahun 2021, tercatat 12 anak kategori stunting yang mana setelah dilakukan pengecekan ulang hanya ada 3 balita yang termasuk dalam kategori stunting. Sehingga perlu dilakukan upaya peningkatan pengetahuan dan keterampilan bagi kader dalam pengukuran antropometri agar tidak ada salah pengukuran dan pencatatan. Metode pelaksanaan menggunakan metode strategi perencanaan dan evaluasi program berdasarkan pada akar penyebab masalah. Hasil pengabdian kepada masyarakat diperoleh adanya peningkatan pengetahuan kader sebelum dan setelah melakukan pengukuran antropometri sebesar 11,0 menjadi 11,3. Dari kegiatan ini diharapkan adanya pemantauan berkala dan berkelanjutan terkait pengukuran antropometri pada kader dengan dalam rangka penncegahan dini stunting pada balita.
Family environment has an important role in determining the personality and behavior of a child. This study examined the impact of family environment on alcohol and drug misuse among Indonesian students. Data were obtained from National Illicit Drug Use surveys of students in Indonesia 2016, conducted in 18 provinces. Subjects were 1,284 schools and 35,340 students. The surveys used the self-administrated Modified-UNODC Structured Illicit Drug questionnaire. Results show 13.7 % students ever drink alcohol, and drug misuse were accounted for 2.1% students within the past year. Among students who drink alcohol, 11% also drug users. In the latter group, they were likely to receive verbal and physical violence from their parents and never discuss any problems with their parents. Individual living in a family with existing risky behavior (alcohol drinking and/or drug misuse) is the strongest risk factor of alcohol drinking (aOR: 4.78; 4.27-5.37) and drug misuse (aOR: 2.32; 1.79-3.01). The result indicates that family environment affects these risky behaviors in a target population. Adjustment through parental support, control, and parenting style, particularly in initiating parent-child communication, may demonstrate positive roles in preventing alcohol drinking and drug use strategies in this target population.
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