The Relationship between Maternal Participation in Household Decision-Making and Birth Attendant Selection: Evidence from Indonesia Demographic and Health Survey

Abstract

BACKGROUND: The decreasing maternal mortality rate (MMR) is an important indicator in achieving health development. The Ministry of Health has mandated delivery assistance by competent health personnel to achieve the MMR targets set out in the UN sustainable development goals. AIM: This study aims to determine the relationship between maternal participation in household decision-making and the selection of birth attendant in Indonesia. METHODS: The study uses secondary data from the 2017 Indonesia demographic and health survey, as part of a cross-sectional and large-scale national survey. The study involved ever-married women of reproductive age (15–49 years) and had given birth in the last 5 years prior to the survey (n = 14,193). RESULTS: Of all birth attendants, 4,630 (32.6%) were non-health workers and 9,563 (67.4%) were health workers. Midwives account for the largest proportion of the health workers (61.8%). Decisions in healthcare, household expenses, visits to family/relatives’ decisions are significantly associated with birth attendant selection. However, husband’s income use decision had no significant relationship with birth attendant selection. The final multivariate model found that grand multipara mothers had a 1.9 times higher risk of choosing non-health birth attendants than primipara mothers (OR = 1.90, 95% CI = 1.60–2.25). CONCLUSION: Findings demonstrated the importance of improving health education for men and women as well as women’s decision-making autonomy. Health workers (especially midwives) should improve knowledge and communication between couples in choosing skilled birth attendants, especially for mothers with grand multiparity.

Relationships of deworming drug consumption and animal protein intake with stunting

“…Approximately 9.2% and 32.6% of mothers gave birth without the assistance of healthcare workers, as found in this research and the 2017 Indonesia Demographic and Health Survey, respectively ( Tari and Andriani, 2022 ). Although this condition can occur due to several factors ( Kumbani et al, 2013 ), the risk of health problems during and after childbirth is still very high.…”