Factors Associated with the Use of Skilled Birth Attendants in Indonesia

S. N. Jamil, Eva Nur Octavia, Balqis Nur Fadliah, Elsa Maudi Gandirawati
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Abstract

The maternal mortality rate in Indonesia of 305/100,000 live births is still far from the SDGs target in the year 2030, which is 70/100,000 live births. The WHO states that the main causes of maternal mortality are bleeding, infection, preeclampsia-eclampsia, complications of childbirth, and unsafe abortion. This can be prevented if the mother can access health services, especially the use of skilled birth attendants to overcome complications of pregnancy and childbirth. This study aims to determine the factors associated with the use of skilled birth attendants in Indonesia. This cross-sectional study with a total sample of 4.543 women aged 15-49 years who gave birth to the last child selected in a sample of secondary data Indonesia Demographic Health Survey (IDHS) 2017. The dependent variable of the study was a skilled birth attendants and the independent variable was sociodemographic factors (age, education, employment, area of residence), antenatal factors (antenatal care examiner, antenatal place, antenatal frequency), medical factors (pregnancy complications and birth complications). The results of this study indicate that the dominant factor in the selection of skilled birth attendants is pregnancy examiners. Pregnancy examiners who examine the pregnancy by an obstetrician have the opportunity to choose a permanent delivery at an obstetrician, which is 8.33 (95% CI 6,75 – 10,29) times compared to choosing a midwife after being controlled by other variables.
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印度尼西亚使用熟练助产士的相关因素
印度尼西亚的孕产妇死亡率为305/10万活产,与2030年可持续发展目标的目标(70/10万活产)相差甚远。世卫组织指出,孕产妇死亡的主要原因是出血、感染、子痫前期、分娩并发症和不安全流产。如果母亲能够获得保健服务,特别是利用熟练的助产士克服妊娠和分娩并发症,这是可以预防的。本研究旨在确定与印度尼西亚熟练助产士使用相关的因素。这项横断面研究的总样本为4543名年龄在15-49岁之间的妇女,她们在2017年印度尼西亚人口健康调查(IDHS)的二级数据样本中选择了最后一个孩子。本研究的因变量为熟练接生员,自变量为社会人口因素(年龄、教育程度、就业、居住地区)、产前因素(产前检查医师、产前地点、产前频率)、医学因素(妊娠并发症和分娩并发症)。本研究的结果表明,在选择熟练助产士的主导因素是怀孕检查员。由产科医生检查妊娠的妊娠检查员有机会选择产科医生永久分娩,与选择助产士相比,在其他变量控制后,这是8.33 (95% CI 6,75 - 10,29)倍。
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