scholarly journals Traditional Practices Influencing the Use of Maternal Health Services in Indonesia

2020 ◽  
Author(s):  
Ni Ketut Aryastami ◽  
Rofingatul Mubasyiroh

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.

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257032
Author(s):  
Ni Ketut Aryastami ◽  
Rofingatul Mubasyiroh

Background Maternal Mortality Ratio (MMR) in Indonesia is still high, 305, compared to 240 deaths per 100,000 in South East Asian Region. The use of Traditional Birth Attendance (TBA) as a cascade for maternal health and delivery, suspected to be the pocket of the MMR problem. The study aimed to assess the influence of traditional practices on maternal health services in Indonesia. Methods We used two data sets of national surveys for this secondary data analysis. The samples included 14,798 mothers whose final delivery was between January 2005 and August 2010. The dependent variables were utilization of maternal healthcare, including receiving antenatal care (ANC≥4), attended by skilled birth attendance (SBA), and having a facility-based delivery (FBD). The independent variables were the use of traditional practices, type of family structure, and TBA density. We run a Multivariate logistic regression for the analysis by controlling all the covariates. Results Traditional practices and high TBA density have significantly inhibited the mother’s access to maternal health services. Mothers who completed antenatal care were 15.6% lost the cascade of facility-based delivery. The higher the TBA population, the lower cascade of the use of Maternal Health Services irrespective of the economic quintile. Mothers in villages with a high TBA density had significantly lower odds (AOR = 0.30; CI = 0.24–0.38; p<0.01) than mothers in towns with low TBA density. Moreover, mothers who lived in an extended family had positively significantly higher odds (AOR = 1.33, CI = 1.17–1.52; p<0.01) of using maternal health services. Discussion Not all mothers who have received proper antenatal delivered the baby in health care facilities or preferred a traditional birth attendance instead. Traditional practices influenced the ideal utilization of maternal health care. Maternal health care utilization can be improved by community empowerment through the maternal health policy to easier mothers get delivery in a health care facility.


Author(s):  
Abubakar Sadiq Umar ◽  
Chinaro Kennedy ◽  
Hebatullah Tawfik ◽  
Daniel M. N. Okenu

Although the use of antenatal and other skilled maternal health delivery services in Nigeria was reported to be on the increase, this research explored whether geopolitical zone of residence and place of domicile are associated with the number of antenatal visits and place of delivery. A quantitative cross-sectional study based on secondary data from the Demographic and Health Survey was used to examine the relationship between women’s geopolitical zone of residence, place of domicile (rural/urban), and the number of antenatal visits (categorized as fewer than four or four or more) and delivery (home or health facility). A total of 33,385 women aged 15–49 years were recruited from 888 clusters spread across all the 36 states and the federal capital territory of Nigeria using a stratified two stage proportionate to size cluster design. A higher proportion of women from the South West and North Central zones had made four or more antenatal care visits compared to the other geopolitical zones. The difference was statistically significant even after controlling for differences in education, income, ethnicity, religion, autonomy, and place of domicile (adjusted odd ratio = 2.062; 95% confidence interval [1.897, 2.241]; <em>p </em>< .05). Healthcare policy makers should consider the potential impact of geopolitical zones and place of domicile to enable the development of an all-inclusive strategy to robustly address maternal health services in Nigeria.


Author(s):  
Alem Desta Wuneh ◽  
Araya Abrha Medhanyie ◽  
Afework Mulugeta Bezabih ◽  
Lars Åke Persson ◽  
Joanna Schellenberg ◽  
...  

Abstract Background Despite the pro-poor health policies in Ethiopia, the utilization of maternal, neonatal, and child health services remains a challenge for the country. Health equity became central in the post-2015 Sustainable Development Goals globally and is a priority for Ethiopia. The aim of this study was to assess equity in utilization of a range of maternal and child health services by applying absolute and relative equity indices. Methods Data on maternal and child health utilization emanated from a baseline survey conducted for a large project ‘Optimizing the Health Extension Program from December 2016 to February 2017 in four regions of Ethiopia. The utilization of four or more antenatal care visits; skilled birth attendance; postnatal care within 2 days after childbirth; immunization with BCG, polio 3, pentavalent 3, measles and full immunization of children aged 12–23 months; and vitamin A supplementation for 6–23 months old children were stratified by wealth quintiles. The socioeconomic status of the household was assessed by household assets and measured by constructing a wealth index using principal component analysis. Equity was assessed by applying two absolute inequity indices (Wealth index [quintile 5- quintile 1] and slope index of inequality) and two relative inequity indices (Wealth index [quintile5: quintile1] and concentration index). Results The maternal health services utilization was low and inequitably distributed favoring the better-off women. About 44, 71, and 18% of women from the better-off households had four or more antenatal visits, utilized skilled birth attendance and postnatal care within two days compared to 20, 29, and 8% of women from the poorest households, respectively. Skilled birth attendance was the most inequitably distributed maternal health service. All basic immunizations: BCG, polio 3, pentavalent 3, measles, and full immunization in children aged 12–23 months and vitamin A supplementation were equitably distributed. Conclusion Utilization of maternal health services was low, inequitable, and skewed against women from the poorest households. In contrast, preventive child health services were equitably distributed. Efforts to increase utilization and reinforcement of pro-poor and pro-rural strategies for maternal, newborn and immunization services in Ethiopia should be strengthened.


F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1061
Author(s):  
Sathirakorn Pongpanich ◽  
Abdul Ghaffar ◽  
Najma Ghaffar ◽  
Hafiz Abdul Majid

Background: Information on determinants of postnatal care is essential for maternal health services, and this information is scarce in Pakistan. This study aimed to determine the factors of newborn postnatal care utilization from the Pakistan Demographic and Health Surveys (PDHS) conducted from 2006–2018. Methods: We analyzed data from three rounds of cross-sectional, nationally representative PDHS 2006–07, 2012–13, and 2017–18. Multivariable logistic regression models were applied to explore factors associated with utilization of newborn postnatal care within two months. Results: This study included 5724 women from the 2006–07 PDHS, 7461 from the 2012–13 survey, and 8287 from the 2017–18 survey. The proportion of women receiving newborn postnatal care within the first two months of delivery increased from 13% in 2006–07 to 43% in 2012–13 but dropped to 27% in 2017–18. Respondent’s occupation and prenatal care utilization of maternal health services were common factors that significantly influenced newborn postnatal care utilization within two months. The utilization of postnatal care was greater among women having educated husbands and where the first child was a male in PDHS 2007 round. Higher wealth index and educated respondent had higher postnatal care utilization odds in DHS 2012 and DHS 2018. However, the odds of using postnatal care decreased with the number of household members and total number of children ever born in DHS 2012 and 2018 rounds. Conclusions: There was a general increase in the proportion of women who utilized postnatal care for their newborns during 2006–2013 but a decrease in 2018. The decreased utilization in 2018 warrants further investigation. Improving women’s economic status, education, employment, and antenatal care attendance and reducing parity may increase newborn postnatal care utilization.


2012 ◽  
Vol 8 (3) ◽  
pp. 325-332 ◽  
Author(s):  
Y R Baral ◽  
K Lyons ◽  
J Skinner ◽  
E R Van Teijlingen

This review is to explore the factors affecting the uptake of skilled birth attendants for delivery and the issues associated with women’s role and choices of maternal health care service for delivery in Nepal. Literature was reviewed across the globe and discussed in a Nepalese context. Delivery by Skilled Birth Attendance serves as an indicator of progress towards reducing maternal mortality worldwide, the fifth Millennium Development Goal. Nepal has committed to reducing its maternal mortality by 75% by 2015 through ensuring accessibility to the availability and utilisation of skilled care at every birth. The literature suggests that several socio-economic, cultural and religious factors play a significant role in the use of Skilled Birth Attendance for delivery in Nepal. Availability of transportation and distance to the health facility; poor infrastructure and lack of services; availability and accessibility of the services; cost and convenience; staff shortages and attitudes; gender inequality; status of women in society; women’s involvement in decision making; and women’s autonomy and place of residence are significant contributing factors for uptake of Skilled Birth Attendance for delivery in Nepal. The review found more quantitative research studies exploring the determinants of utilisation of the maternal health services during pregnancy in Nepal than qualitative studies. Findings of quantitative research show that different social demographic, economic, socio-cultural and religious factors are responsible for the utilisation of maternal health services but very few studies discussed how and why these factors are responsible for utilisation of skilled birth attendants in pregnancy. It is suggested that there is need for more qualitative research to explore the women’s role and choice regarding use of skilled birth attendants services and to find out how and why these factors are responsible for utilisation of skilled birth attendants for delivery. Qualitative research will help further exploration of the issues and contribute to improvement of maternal health services.DOI: http://dx.doi.org/10.3126/kumj.v8i3.6223 Kathmandu Univ Med J 2010;8(3):325-32 


Author(s):  
Oluwasola Banke-Thomas ◽  
Aduragbemi Banke-Thomas ◽  
Charles Anawo Ameh

Abstract Background: Many Kenyan adolescents die following pregnancy and childbirth complications. Maternal health services (MHS) utilisation is key to averting such poor outcomes. Our objectives were to understand the characteristics of adolescent mothers in Kenya, describe their MHS utilisation pattern and explore factors that influence this pattern. Methods: We collected demographic and MHS utilisation data of all 301 adolescent mothers aged 15–19 years included in the Kenya Demographic Health Survey 2008/2009 (KDHS). Descriptive statistics were used to characterise them and their MHS utilisation patterns. Bivariate and multivariate analyses were used to test associations between selected predictor variables and MHS utilisation. Findings: Eighty-six percent, 48% and 86% of adolescent mothers used ante-natal care (ANC), skilled birth attendance (SBA) and post-natal care (PNC), respectively. Adolescent mothers from the richest quintile were nine (CI=2.00–81.24, p=0.001) and seven (CI=3.22–16.22, p<0.001) times more likely to use ANC and SBA, respectively, compared to those from the poorest. Those with primary education were four (CI=1.68–9.64, p<0.001) and two (CI=0.97–4.81, p=0.043) times more likely to receive ANC and SBA, respectively, compared to uneducated mothers, with similar significant findings amongst their partners. Urban adolescent mothers were six (CI=1.89–32.45, p=0.001) and four (CI=2.00–6.20, p<0.001) times more likely to use ANC and SBA, respectively, compared to their rural counterparts. The odds of Maasai adolescent mothers using ANC was 90% (CI=0.02–0.93, p=0.010) lower than that of Kalenjin mothers. Conclusions: Adolescent MHS utilisation in Kenya is an inequality issue. To address this, focus should be on the poorest, least educated, rural-dwelling adolescent mothers living in the most disadvantaged communities.


Author(s):  
Ayushi Sharma

<div><p><strong>Background</strong>: Improving maternal health is one of the eight Millennium Development Goals. It is widely accepted that the use of maternal health services helps in reducing maternal morbidity and mortality. The utilization of maternal health services is a complex phenomenon and it is influenced by several factors. Therefore, the factors at different levels affecting the use of these services need to be clearly understood. The objective of this study was to estimate the effects of individual, community and district level characteristics on the utilization of maternal health services with special reference to antenatal care (ANC), skilled attendance at delivery and postnatal care (PNC)</p><p><strong>Methods</strong>: The present paper focuses in understanding the maternal health care utilization by the ever married Rabari women of Udaipur District, Rajasthan. A purposive random sampling method was used to collect data from 122 ever married women of age group 15-49 years by using pretested and modified demographic schedule.</p><p><strong>Results: </strong>The results of this study showed that 63.11% of the respondents used ANC during their most recent pregnancy whereas only 10.65% women received PNC within two weeks of delivery. In the last delivery, 36.06% mothers were assisted by doctors and 50.81% assisted by nurse. Regarding components of ANC utilization 85.24% women reported intake of IFA (Iron and Folic Acid) tablets during pregnancy, while 77.04% of the women received Tetanus Toxoid (TT) Injection. The study reflects that higher utilization of ANC services are there and PNC services are mostly neglected among the women. The study also reflected upon the use of Birth Control Measures (BCM) among the woman. The lesser number of sample size may bind us from recommending much. But, Mothers should be motivated continuously and with every generation of nation they give birth to, they should utilize such health services for the future of the healthy society.</p></div>


2017 ◽  
Vol 24 (2) ◽  
pp. 53
Author(s):  
Wahyul Anis ◽  
Kuntoro Kuntoro ◽  
Soenarnatalina Melaniani

Objectives: to analyze the efforts of maternal health services that may affect maternal mortality rate.Materials and Methods: The study was conducted at the Health Office of East Java using secondary data from 38 districts/cities in East Java in 2015 that includes performance antenatal care K1 and K4, postnatal care, early detection of complications in pregnant women, natal in health workers and health facilities, management of complications by health workers and MMR. Data were analyzed with statistical method with spatial regression and illustrated with thematic maps by application ArcView statistics.Results: the highest MMR was in Bojonegoro district, Lumajang, Probolinggo, Bondowoso, Situbondo and Probolinggo city. Some districts/cities that have the highest maternal mortality has proximity of areas, namely the district Lumajang, Probolinggo, Bondowoso, Situbondo and Probolinggo city. Their proximity concluded an association condition and the causes of MMR between districts so they can be studied more in depth about the causes of MMR kind of social, cultural and geographical characteristics. The coverage maternal health services to all districts/cities in East Java province is not much difference.Conclusion: the maternal mortality rate in the district/city of East Java province in 2015 was not much affected by maternal health services so we need more research on other causes of MMR in districts/city of East Java Province.


2021 ◽  
Vol 55 (No 1) ◽  
pp. 145-158
Author(s):  
Ghulam Rasool Shah ◽  
Ghulam Ali Jariko

The study aims to analyze impact of Lady Health Worker program on use of maternal health services in community with a lady health worker. The main focus was the rural districts of Sindh for this case study. The maternal health service is determined by at least four Antenatal care (ANC) visits provided to mother and receipt of at least two Tetanus Toxoid (TT) injections to mother during pregnancy. These have direct impact on maternal mortality rate and infant mortality rate. Secondary data pertaining to all districts of Sind for three years (2017-2019) was collected from the Sindh Lady Health Worker program office Hyderabad for analysis purpose. Further secondary data of Pakistan Demographic and Health Survey (2017-18) was also used to see the impact of intervention of LHW program implemented by Ministry of Health Pakistan in 1994 and then devolved to provinces after the implementation of 18th Constitutional Amendment in 2010. The study found that the services provided by the lady health workers in communities in these districts has positively influenced the uptake of maternal health services as determined by the variables like antenatal visits by pregnant mothers to nearest health facilities and receipt of Tetanus Toxoid injection during pregnancy.


2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Eden Girmaye ◽  
Kassa Mamo ◽  
Birhanu Ejara ◽  
Fikadu Wondimu ◽  
Maru Mossisa

Background. This study aimed to assess women’s knowledge, attitude, and practice towards skilled assistance seeking maternal healthcare services in West Shoa Zone, Oromia Region, Ethiopia. Methods. Cross-sectional survey design was conducted from 1 February to 23 March 2018 in West Shoa Zone, Oromia, Ethiopia. A simple random sampling technique was used to select the participants. The data were collected using a pretested and structured questionnaire. Data were entered using EpiData version 3.1, and descriptive analysis and bivariate and multivariate logistic regression analyses were carried out using SPSS version 20 statistical software package. Results. The study revealed that the knowledge, attitude, and practice towards skilled maternal health services were found such that 473.3 (72.4%) of the study participants had good knowledge, 180.7 (27.6%) had poor knowledge, and 400 (61.3%) had positive attitude, 254 (38.84%) had negative attitude, 460.3 (70.4%) had good practice, and 193.7 (29.6%) had poor practice towards skilled maternal health services. Factors that had a significant association with antenatal care utilization were planned pregnancy (AOR = 8.2, 95% CI = 3.39-19.78-0.87) and access to transport (AOR = 3.1, 95% CI = 1.46–6.61). Attending ANC at least once (AOR = 3.1, 95% CI = 1.13–8.41), women’s education (AOR = 3.0, 95% CI = 1.18–7.84), and unplanned pregnancy (AOR = 0.3, 95% CI = 0.21–0.75) were factors associated with skilled delivery service utilization. Attending ANC at least once (AOR = 2.1, 95% CI = 1.1–4.2), birth complications (AOR = 2.2, 95% CI = 1.35–3.66), unplanned pregnancies (AOR = 0.3, 95% CI = 0.22–0.68), and awareness about skilled obstetric care (AOR = 3.7, 95% CI = 1.68–12.79) were factors associated with postnatal care utilization. Conclusions. This study found that the knowledge, attitude, and practice of skilled maternal health services among the study participants are low, showing less than three-quarters of the total sample size. Therefore, this study implied that interventions are required to improve women’s knowledge, attitude, and practice of skilled maternal health services in the study area. Furthermore, women’s education is significantly associated with skilled delivery service utilization. Accordingly, this study recommends that improving equity among the marginalized population is needed to increase maternal health service coverage.


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