Relationship Geographical Access and Maternal Mortality: Spatial Analysis

AIM: Banjar District is included in the top 3 of highest maternal mortality rates in South Kalimantan, Indonesia. The purpose of the study is to analyze the relationship between accessibility (distance, time, and transportation) with the incidence of maternal mortality in Banjar District. METHODS: The study is an observational analysis using a case–control approach with a retrospective. The population was mothers who gave birth in the Banjar district on January 2015−December 2018. Criteria for inclusion of cases are mothers who experience death during pregnancy, childbirth or within 42 days before the end of the pregnancy period recorded in 2015−2018 at the Health Office and births at health facilities in Banjar District, which is represented by the family who knows the best about the mother’s condition, while controls are respondents who do not died in the same year. Sample for case group is 25, by taking the comparison case: control 1:2, then, the sample size of the control group is 50. Statistical test uses Chi-square test. RESULTS: The results show that there is the relationship between transportation (p = 0.034) and distance (p = 0.035) with the incidence of  maternal mortality with Odds ratio (OR) 3.58 and 3.27. However, there is no relationship between time (p = 0.118) with the mortality of maternal. CONCLUSION: Increasing the accessibility of health services can reduce maternal mortality, one of which is the provision of transportation to bring mothers closer to health facilities.