Disparitas Kematian Maternal di Indonesia: Studi Ekologi dengan Analisis Spasial
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Abstract
This study is an analyze disparity of maternal mortality in Indonesia with spatial analysis using intermediatefactor such as maternal health service, reproduction status, socio economic and demography. This studyaimed to spatially analyze disparity of maternal mortality, analyze the influence and risk of maternal mortality onintermediate factors, and provide recommendations on maternal health problems in Indonesia. This study usingecological study design (agrerat studies), spatial analysis, bivariate analysis, and multivariate analysis. Unit ofanalysis in this study is districts/cities in Indonesia. The results showed that disparity of maternal mortality causedby intermediate factor gap between districts/cities in Indonesia, with the highest risk of maternal mortality occurredin eastern Indonesia. The dominant variables related to maternal mortality, namely population density withOR:0,283 (95% CI:0,185-0,430) and childbirth by skilled health personal with OR:1,745 (95% CI:1,081-2,815).The high risk of maternal mortality occurred in districts/cities with low coverage of fourth pregnancy (K4), lowbirth attendance (PN) coverage, low postpartum (KF) coverage, average number of children, low average education,and high poverty
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29. Syafiq A. Angka Kematian Ibu dan Pendidikan Perempuan di Indonesia: Tinjauan Ekologis Provinsial. Jakarta: (Disajikan Pada Konferensi Infid 2013 dengan tema “Pembanguanan Untuk Semua: MemperjuangkanKualitasPemerintah, Hak Asasi Manusia dan Inklusi dalam Rencana Pembangunan Jangka Menengah 2015-2019” Hotel Royal Kuningan Jakarta 26 – 27 November 2013); 2013.
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2. Badan Perencanaan Pembangunan Nasional. Laporan Pencapaian MDGs di Indonesia 2013. Jakarta: Bappenas; 2014.
3. Badan Pusat Statistik. Potret Awal Tujuan Pembangunan Berkelanjutan (Sustainable Development Goals) di Indonesia. Jakarta: Bappenas; 2017.
4. Astuti, KS., Aziz AM., and Insy Farisa DA. Maternal Mortality Risk Factors in dr. Hasan Sadikin General Hospital, Bandung in 2009-2013. International Journal of Integrated Health Sciences, Vol. 5, No 2 September 2017.
5. Rahman A, Nisha MK, Begum T, Ahmed S, Alam N, Anwar I. Trends, Determinants, and Inequities of 4+ ANC Utilisation in Bangladesh. J Health Popul Nutr. 36(1):2. 2017.
6. Bobo FT, Yesuf EA, and Woldie M. Inequities in Utilization of Reproductive and Maternal Health Services in Ethopia. Int J Equity Health, Jun 19;16(1):105. 2017.
7. Tarekegn SM, Liebermen LS, and Giedraitis V. Determinants of Maternal Health Service Utilization in Ethopia. Analysis of the 2011 Ethopian Demographic and Health Survey. BMC Pregnancy Childbirth, May 7;14:161. 2014.
8. Badan Pusat Statistik. Potret Awal Tujuan Pembangunan Berkelanjutan (sustainable development goals) di Indonesia. Jakarta: Bappenas; 2017.
9. Prasetyo, Budi, et.al. Maternal Mortality Audit based on District Maternal Health Performance in East Java Province, Indonesia. Bali Medical (Bali Med J) 2018, Volume 7, Number 1: 61-67.
10. Berhan Y, Berhan A. Antenatal Care as A Means of Increasing Birth in The Health Facility and Reducing Maternal Mortality: A Systemic Review. Ethiop J Health Science. 2014; September, Special Issue
11. Ikhtiar M., Hadju Veni, Thaha Ridwan and M. Syafar. Study on Health Social Determinants as Cause of Maternal Mortality in Gowa District South Sulawesi, 2013. International Journal of Scientific and Research Publications, Volume 4, Issue 6, June 2014.
12. Nababan, Y.H., et.all. Trends and Inequities in Use Maternal Health Care Service in Indonesia, 1986-2012. International Journal of Women’s Health, Vol 10. 2018.
13. Anwar I, Nababan HY, Mostari S, Rahman A, and Khan JA. Trends and Inequities in Use of Maternal Health Care Services in Bangladesh, 1911-2011. PLoS One, 10(3). 2015.
14. Black RE, Laxminarayan R, Marleen T, Walker N. Disease Control Priorities Third Edition: Reproductive, Meternal, Newborn, Child Health. Washington DC: World Bank; 2016.
15. Mustapha AK, Yusuf MA, Abdulkarim GM, and Muhammad C. Spatial and Temporal Variations of Maternal Deaths in Borno State of Nigeria: Institutional Based Study. International Journal of Tropical Disease and Health, 27(1): 1-14. 2017.
16. Hoo, ZH., Candlish, J. and Teare, M.D. What is an ROC Curve? Emergency Medicine Journal. 2017.
17. Krupinski, A.K. Receiver Operating Characteristic (ROC) Analysis. Frontline Learning Research, Vol 5, No 3 (2017).
18. Rothman KJ et all. Modern Epidemiology: Third Edition. USA; 2008.
19. Saputra W, Nurrizka R. Strategi Menurunkan Angka Kematian Ibu dan Angka Kematian Anak di Indonesia. Depok: Prakarsa; 2014
20. Say L, Chou D, Gemmill A, Tuncalp O, Moller AB, Daniels J, Gulmezoglu AM, Temmerman M, Alkema L. Global causes of maternal death: A WHO Systematic Analysis. Lancet Glob Health. 2014; Jun;2(6): e323-33. doi: 10.1016/S2214-109 X (14)70227-X. Epub 2014 May 5.
21. Sulistiyowati, N, Puti Sari, H, dan Dwi Hapsari, T. Kesinambungan Pemanfaatan Pelayanan Kesehatan Maternal di Indonesia. Buletin Penelitian Kesehatan. 2017; Vol. 45, No. 3,177 – 186.
22. Mellisa B, Adrien L, Vanessa T, Antoinette T et all. Risk factors for maternal death and trends in maternal mortality in low and middle-income countries: a prospective longitudinal cohort analysis. BMC Reproductive Health. 2015; 12 (Suppl 2): S5.
23. Aeni N. Faktor Risiko Kematian Ibu. Jurnal Kesehatan Masyarakat Nasional. 2013; Vol 7, No 10, Mei 2013.
24. Nurfatimah. Determinan Penyulit Persalinan. Jurnal MKMI. September 2014; hal 160-165.
25. World Health Organization. The Prevention and Elimination of Disrespect and Abuse During Facility Based Childbirth: WHO; 2014.
26. Sparrow R, Suryahadi A, and Widyanti W. Social Health Insurance for the Poor: Targeting and Impact of Indonesia’s Askeskin Programme. Soc Sci Med. 96:264-271. 2013.
27. Harimurti P, Pambudi E, Pigazzini A, and Tandon A. The Nuts and Bolts of Jamkesmas Indonesia’s Government-Financed Health Coverage Program for the Poor and Near-Poor. Washington DC: World Bank. 2013. (UNICO Studies Series No. 8).
28. Ahmed S, Creanga AA, Gillespie DG, and Tsui AO. Economic Status, Education and Empowerment: Implications for Maternal Health Service Utilization in Developing Countries. PLoS One, 5(6). 2010.
29. Syafiq A. Angka Kematian Ibu dan Pendidikan Perempuan di Indonesia: Tinjauan Ekologis Provinsial. Jakarta: (Disajikan Pada Konferensi Infid 2013 dengan tema “Pembanguanan Untuk Semua: MemperjuangkanKualitasPemerintah, Hak Asasi Manusia dan Inklusi dalam Rencana Pembangunan Jangka Menengah 2015-2019” Hotel Royal Kuningan Jakarta 26 – 27 November 2013); 2013.
30. Meliala A, Hort K, and Trisnantoro L. Addressing the Unequal Geographic Distribution of Specialist Doctors in Indonesia: The Role of the Private Sector and Effectiveness of Current Regulations. Soc Sci Med, 82:30-34. 2013.
Authors
Nurrizka, R. H., & Wahyono, T. Y. M. (2018). Disparitas Kematian Maternal di Indonesia: Studi Ekologi dengan Analisis Spasial. Media Kesehatan Masyarakat Indonesia, 14(2), 119-127. https://doi.org/10.30597/mkmi.v14i2.3630
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