Utilization of Postnatal Care Service in Indonesia and its Association with Women’s Empowerment: An Analysis of 2017 Indonesian Demographic Health Survey Data

Abstract

Objective The coverage of postnatal care (PNC) is among the lowest globally when compared with other maternal and child interventions. This study aims to assess PNC utilisation in Indonesia and its association with women’s empowerment indicators to provide evidence for the need for policy change. Methods Data from the 2017 Indonesian Demographic Health Surveys was analyzed for any use of PNC, early first PNC (within 2 days of birth) and PNC after discharge for newborns. Women’s empowerment factors were calculated using a principal component analysis of 17 indicators. The association between women’s empowerment factors and PNC was assessed using logistic regression adjusted for covariates and complex survey design. Results The prevalence of any PNC by skilled professionals in Indonesia was high but PNC after discharge was very low. Labor-force participation and women’s knowledge level were associated with any PNC, but the association between women’s knowledge level and any PNC was modified by place of birth. Disagreement towards justification of wife beating and women’s knowledge level were associated with early PNC but the association was modified by place of birth. Decision-making power was also associated with early PNC but modified by infant’s gender. Disagreement towards justification of wife beating was negatively associated with PNC after discharge, but the association between decision-making power and PNC after discharge was modified by the infant’s size at birth. Conclusions for Practice PNC coverage after discharge in Indonesia needs improvement. Women’s empowerment indicators need to be addressed in improving PNC coverage. Supplementary Information The online version contains supplementary material available at 10.1007/s10995-021-03324-y.

Attitude and utilization of postnatal care services among women of reproductive age in the rural and urban communities in Northern Nigeria

“…[17] Another explanation could be the high rate of home deliveries in the rural community which was found to be a significant determinant of PNC attendance in other studies done in Indonesia and Nepal which found that infants delivered outside a health-care facility were significantly less likely to utilize PNC services. [18,19] This differs from a study done in Nigeria that showed a statistically significant association between the place of delivery and the utilization of PNC services where children delivered in a non-healthcare facility had higher odds of not utilizing PNC services. [20] The explanation given for that was that probably mothers who deliver at the health facility may feel quite confident about their health and the health of their newborn and may not see the need to return for check-ups while those that did not deliver in the health facility would like the health of the child to be checked and, hence, are more likely to utilize PNC services.…”

Factors Associated with Post-Natal Care Utilization among the Women of Reproductive age Group: Evidence from Bangladesh Demographic and Health Survey 2017–18

“…40 This figure is higher to some extent than the prevalence reported in BDHS 2014 (34%). 41 Though the prevalence has risen over the years, this figure is not so impressive compared to other neighboring countries such as India (65%), 18 Myanmar (68%), 42 Nepal (59%), 43 Indonesia (78.5%) 34 and African countries such as Benin (68%) 44 and Zambia (63%). 35 While some other African countries such as Nigeria, 19 Ethiopia, 3 Rwanda, 45 and Kenya 46 have a lower prevalence of PNC than Bangladesh.…”

“…This interesting finding resonates with the results of several previous studies to some extent. 3 , 13 , 19 , 22 , 24 , 27 – 32 , 34 , 35 In Bangladesh almost 50% of the delivery is done at home in the presence of a traditional birth attendant and nearest relatives which poses a great challenge for the mother to utilize PNC from trained providers. 40 Alternatively, institutional delivery provides more opportunities for the mothers to pursue knowledge about the importance, accessibility, and availability of PNC utilization as they had to stay in the facility for a significant duration of time.…”

“…An ample of studies highlighted the association between PNC utilization and various factors such as socioeconomic factors (educational level, employment status, and economic status of individuals), 3,12–24 demographic characteristics (administrative division, place of residence, and mother's age at birth), 3,12,13,19–22,25,26 and birth-related factors (antenatal care visits and, place and mode of delivery). 3,13,16,18,19,21,22,24,27–35 Although, a body of literature in Bangladesh have focused on post-natal care services of mothers from the perspectives of different region, 36–38 income level 39 or age, 12 a dearth of studies using recent nationally representative data in this topic is still dominant. Furthermore most of the studies focused on early utilization of PNC 13 ; whereas the condition of the mother can worsen at any time during the post-partum period which makes the entire period of PNC highly crucial for maintaining maternal well-being.…”

Early postnatal care contact within 24 hours by skilled providers and its determinants among home deliveries in Myanmar: Further analysis of the Myanmar Demographic and Health Survey 2015–16

“…Therefore, the World Health Organization (WHO) recommends early PNC as early as possible within the first 24 hours after birth for home deliveries and continue monitoring until six weeks post-delivery [5]. However, use of PNC among the deliveries by skilled providers in the some developing countries remains unsatisfactory [8][9][10][11][12]. Several factors were associated with the uptake of PNC including wealth, mother's education, uptake of antenatal care, place of delivery and access to media [8,9,11].…”