Traditional Practices Influencing the Use of Maternal Health Services in Indonesia

Abstract

Background Although infrequent, use of traditional birth attendants (TBA) for delivery still exists in Indonesia. The maternal mortality ratio (MMR) at 305 deaths per 100,000 live births in Indonesia is higher than that of the Southeast Asian region (240), and continued use of TBA is suspected to be related to this high MMR. The objective of this analysis is to study the influence of traditional practices, family structure, and TBA density on the use of maternal health services in Indonesia.Methods Secondary data analysis involved data from two national surveys— Riset Kesehatan Dasar (Riskesdas) 2010 and the Village Potential Survey 2008. The sample included 14,798 mothers whose last delivery was between January 2005 and August 2010. The independent variables were the use of traditional practices, type of family structure, and density of TBA. The dependent variables were utilization of maternal healthcare, including receiving antenatal care (ANC) and having a facility-based delivery. Multivariate logistic regression was conducted for the analysis by controlling all the covariates. Results Disregarding the costs for delivery, traditional practices and high TBA density significantly influenced mother’s access to maternal health utilization with a negative direction which is conversely to living in extended family structure. Mothers in villages with a high TBA density had significantly lower odds of receiving complete care and facility-based delivery compared to mothers in villages with low TBA density. Moreover, mothers who lived in an extended family had higher odds of using maternal health services. Conclusions Traditional practices significantly influenced the ideal utilization of maternal health care in Indonesia. Higher TBA density in the villages significantly decreased mother’s odds of using ANC, skilled birth attendance (SBA), and the complete of maternal health services. Maternal care utilization was positively influenced by living with extended family.

Analysis of the Selection of Birth Aid in Lebiti Village, Togean District, Tojo Una-Una Regency

“…Until now, traditional birth attendants are the only birth attendants who are still relied on by most pregnant women in many countries, especially in rural areas because of the experience, skills and services they provide to every pregnant woman. (G. Walraven, 1999) the tendency of pregnant women to choose traditional practices in the delivery process will affect the use of health workers by pregnant women, in practice pregnant women who use traditional birth attendants tend to be less likely to choose health workers in the next delivery (N. Aryastami, 2020).…”