Maternal health services utilization and its contributing factors among adolescent mothers

Abstract

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.

Predictors of childbirth services in Indonesia

“…Innovative health intervention which initiating mother and husband engagement to health facility during pregnancy is important to initiate their willingness for choosing facilitybased delivery [28], [29]. Whereas, delivery services utilization itself will impact the mother utilization on postnatal care [30]. All in all, women's decision to use a safe childbirth service is hindered by demanding access to reach an institutionalized healthcare facility.…”

Factors that influence the uptake of postnatal care among adolescent girls: a qualitative evidence synthesis

“…Ensuring that adolescent-sensitive services exist starting from the antenatal stage and offering continuity of care by trusted providers through to the postnatal period can enhance uptake of maternal health services at every stage. 49 Across the qualitative studies included in this review, participants often described access barriers to ANC as also impeding access to PNC, highlighting the significance of the continuum of care from ANC to delivery to PNC. Indeed, access to ANC and to delivery services often predicts access to PNC as identified by quantitative evidence around use and access to maternal healthcare among adolescent mothers in low-income and middle-income countries (LMICs).…”

“…This finding is supported by quantitative evidence as well where adolescent girls accompanied by a partner during ANC have higher rates of PNC utilisation. 49 In addition, adolescent girls’ partners expressed a desire to be more actively engaged and to have better access to information to effectively support their partners. Approaches that seek to increase partner engagement should account for potential unintended consequences, such as the risk of further stigmatising those without partners.…”

“…Ensuring that adolescent-sensitive services exist starting from the antenatal stage and offering continuity of care by trusted providers through to the postnatal period can enhance uptake of maternal health services at every stage 49. Across the qualitative studies included in this review, participants often described access barriers to ANC as also impeding access to PNC, highlighting the significance of the continuum of care from ANC to delivery to PNC.…”

Perceived susceptibility, barriers, and cues to action as determinant factors of reproductive health behavior

“…Knowledge is one of the riding elements in behavior change [21]. Some research has proven that adolescents with a proper understanding of reproductive health will enjoy the offerings to be had [22]. Adolescents have to be assured that barrier to the health-in search of behavior may be overcome and that those barriers do now no longer outweigh the benefits derived from gaining access to reproductive Int J Public Health Sci ISSN: 2252-8806  Perceived susceptibility, barriers, and cues to action as determinant factors of… (Wahyu Setyaningsih) 889 health information and offerings [23].…”