Determinants of maternal health services utility among adolescent mothers in Indonesia : an analysis of 2017 Indonesia demographic and health survey

Abstract

Maternal Mortality Ratio (MMR) in Indonesia remains high with 305 death per 100,000 live birth in 2015. Approximately 36 of 1000 adolescent girls (15-19 years old) in Indonesia experienced childbirth and face the higher risk for maternal mortality than older women. The aims of this study are to assess maternal health services utility (antenatal care (ANC), delivery services, and postnatal care (PNC)) level and to identify determinants of maternal health services utility among adolescent mothers in Indonesia. The design of this study is cross-sectional survey using secondary data from 2017 Indonesia Demographic and Health Survey (IDHS). The study population is women who had last birth at the age of 15-19 years old which total is 866 women. The descriptive statistics was used to assess the utilization of maternal health services level along with a simple logistic regression and multivariable logistic regression to identify the contributing factors. Among adolescent mothers, the highest level of utility is PNC (71.5%) followed by ANC (67.2%) then delivery services (64.5%). Factors that associated with ANC utilization are husband/partner’s education, mother’s autonomy, region, husband accompanied during ANC, topic discussed during ANC, and intendedness of last birth (p<0.05). Factors contributed to delivery services are mother’s education, mother’s working status, mother’s autonomy, residence, region, wealth index, health insurance, husband accompanied during ANC, and topic discussed during ANC (p<0.05). Whereas, for PNC utilization are knowledge of danger sign during childbirth, residence, region, and delivery services utilization (p<0.05). As the study’s results found that knowledge or education of adolescent mothers had significant association with some maternal health services utilization but only region was significantly associated with the three utilizations, therefore strategic policies and programs’ approach to adolescent mothers should focus on 1) Expanding health care coverage in every region, 2) Providing maternal education for women and men, and 3) Expanding the health insurance coverage.