Healthcare Determinants and Dominant Factors of Maternal Mortality Ratio
Nursuciyani Jamal1*, Muhammad Alwy Arifin2, Muhammad Yusran Amir2, Sukri Palutturi2, Atjo Wahyu3
Journal of Angiotherapy 8(11) 1-7 https://doi.org/10.25163/angiotherapy.81110038
Submitted: 28 August 2024 Revised: 04 November 2024 Published: 05 November 2024
Abstract
Background: Maternal mortality remains a critical health challenge, particularly in resource-limited settings, where socio-economic and healthcare system factors exacerbate risks during pregnancy and childbirth. This study examines the dominant factors influencing maternal mortality in Suppa District, Pinrang Regency, Indonesia, focusing on variables such as antenatal care (ANC), delivery techniques, birth attendants, health service availability, accessibility, affordability, and acceptability. Methods: A cross-sectional study was conducted in 2024, involving 176 respondents. Data were collected through structured questionnaires and analyzed using Chi-square and multivariate tests to determine the relationships between maternal mortality and the studied variables. Independent variables included ANC, delivery techniques, birth attendants, and health service dimensions such as availability, accessibility, and affordability. Results: Findings indicated no significant correlation between antenatal care and maternal mortality (p = 0.141). However, significant relationships were observed between maternal mortality and delivery techniques (p = 0.007), birth attendants (p = 0.003), availability of health services (p = 0.008), accessibility (p = 0.003), and affordability (p = 0.005). Multivariate analysis identified affordability (p = 0.002), birth attendants (p = 0.003), and accessibility (p = 0.005) as the most significant factors influencing maternal mortality. Barriers included limited healthcare infrastructure, inadequate supplies, and geographic challenges. Conclusion: Maternal mortality in Suppa District is influenced by affordability, accessibility, and the role of skilled birth attendants. Interventions should focus on improving healthcare accessibility, affordability, and resource availability while ensuring the presence of trained professionals during childbirth. Policymakers must prioritize strategies to address these determinants to reduce maternal mortality effectively and sustainably.
Keywords: Maternal mortality, Accessibility, Affordability, Birth attendants, Health services
References
Agustina, E. E., & Rahayu, L. D. P. (2022). Korelasi Riwayat Penyakit dengan Munculnya Tanda Bahaya Kehamilan pada Ibu Hamil. Bidan Prada, 13(2), 37–42.
Akhtar, M. N., Haleem, A., & Javaid, M. (2023). Scope of health care system in rural areas under Medical 4.0 environment. Intelligent Pharmacy, 1(4), 217–223. https://doi.org/10.1016/j.ipha.2023.07.003
Amir, F., & Yulianti, S. (2020). Hubungan Paritas dan Usia Terhadap Persalinan Sectio Ccaesarea di RSU Bahagia Makassar Tahun 2020. Jurnal Kesehatan Delima Pelamonia, 4(2), 75–84. https://doi.org/10.37337/jkdp.v4i2.179
Andini, T. D., & Aan Julia. (2022). Pengaruh Tingkat Pendidikan, Jumlah Bidan, dan Tingkat Pendapatan terhadap Angka Kematian Ibu di 9 Provinsi Indonesia Tahun 2010-2020. Bandung Conference Series: Economics Studies, 2(2), 373–380. https://doi.org/10.29313/bcses.v2i2.3599
Ayele, A. A., Tefera, Y. G., & East, L. (2021). Ethiopia’s commitment towards achieving sustainable development goal on reduction of maternal mortality: There is a long way to go. Women’s Health, 17, 17455065211067072.
Badan Pusat Statistik Indonesia. (2020). Sensus Penduduk 2010 - Indonesia. 09, 1–44.
Badariati, B., Devi, R., & Parmin, P. (2022). Peran Bidan di Puskesmas Terhadap Pelayanan Kesehatan Ibu Hamil pada Masa Era New Normal Covid-19 di Kota Palu. Ghidza: Jurnal Gizi Dan Kesehatan, 6(2), 224–229. https://doi.org/10.22487/ghidza.v6i2.571
Bauserman, M., Nowak, K., Nolen, T. L., Patterson, J., Lokangaka, A., Tshefu, A., Patel, A. B., Hibberd, P. L., Garces, A. L., Figueroa, L., Krebs, N. F., Esamai, F., Liechty, E. A., Carlo, W. A., Chomba, E., Mwenechanya, M., Goudar, S. S., Ramadurg, U., Derman, R. J., … Bose, C. (2021). The relationship between birth intervals and adverse maternal and neonatal outcomes in six low and lower-middle income countries. Reproductive Health, 17(Suppl 2), 1–10. https://doi.org/10.1186/s12978-020-01008-4
Bucyibaruta, J. B., Peu, M. D., Bamford, L., & Musekiwa, A. (2023). A tool to define and measure maternal healthcare acceptability at a selected health sub-district in South Africa. BMC Pregnancy and Childbirth, 23(1), 1–16. https://doi.org/10.1186/s12884-023-05475-y
Dewi, C., & Nurjannah, A. (2020). Hubungan Model 4a (Four As) Dalam Pemanfaatan Layanan Kesehatan Pasien Rawat Inap Peserta BPJS Kesehatan Non PBI Di RSUD Kabupaten Pangkep. Jurnal Promotif Preventif, 3(1), 1–13. https://doi.org/10.47650/jpp.v3i1.148
Goodstats. (2023). rasio-kematian-ibu-di-negara-asean-indonesia-masuk-deretan-3-terburuk (1).
Gunawan, S. F., Putri, R., & Novita, A. (2023). Hubungan Keterjangkauan Lokasi Faskes, Persepsi Pasien Dan Sumber Informasi Terhadap Penggunaan Bpjs Kesehatan Untuk Ibu Bersalin Di Wilayah Puskesmas Wanaraja Kabupaten Garut Tahun 2023. SENTRI: Jurnal Riset Ilmiah, 2(11), 4810–4823. https://doi.org/10.55681/sentri.v2i11.1816
Istiana, S., Rahmawati, A., & Kusumawati, E. (2020). Pengaruh derajat laserasi perineum terhadap skala nyeri perineum pada ibu post partum. Jurnal Kebidanan, 9(1), 53. https://doi.org/10.26714/jk.9.1.2020.53-60
Jaya, I. made laut mertha. (n.d.). Metode penelitian kuantitatif dan kualitatif.
Jayanti, K. D., Basuki N, H., & Wibowo, A. (2016). Faktor Yang Memengaruhi Kematian Ibu (Studi Kasus Di Kota Surabaya). Jurnal Wiyata, 3(1), 46–53.
Kesehatan, D. (2020). Laporan Kinerja Dinas Kesehatan Provinsi Sulawesi Selatan. 0751.
Kibret, G. D., Demant, D., & Hayen, A. (2022). Geographical accessibility of emergency neonatal care services in Ethiopia: analysis using the 2016 Ethiopian Emergency Obstetric and Neonatal Care Survey. BMJ Open, 12(6). https://doi.org/10.1136/bmjopen-2021-058648
Maharani, Ridha, Simanjorang, Asyiah, & Jamaluddin. (2022). Perilaku Bidan dalam Penatalaksanaan Pencegahan Infeksi Terhadap Kejadian Infeksi pada Pertolongan Persalinan di Wilayah Kerja Puskesmas Natam Kutacane. Excellent Midwifery Journal, 5, 28.
Manyeh, A. K., Nathan, R., & Nelson, G. (2018). Maternal mortality in ifakara health and demographic surveillance system: Spatial patterns, trends and risk factors, 2006 - 2010. PLoS ONE, 13(10). https://doi.org/10.1371/journal.pone.0205370
Metcalfe, A., Wick, J., & Ronksley, P. (2018). Racial disparities in comorbidity and severe maternal morbidity/mortality in the United States: an analysis of temporal trends. Acta Obstetricia et Gynecologica Scandinavica, 97(1), 89–96. https://doi.org/10.1111/aogs.13245
Musfirowati, F. (2021). Faktor Penyebab Kematian Ibu yang Dapat di Cegah di Kabupaten Pandeglang Tahun 2021. Jurnal Rumpun Ilmu Kesehatan, 1(1), 78–96.
Muthoharoh, N. A., Imam, P., & Rr.Vita, N. (2016). Faktor – faktor yang berhubungan dengan kematian maternal. Jurnal Kesehatan Masyarakat, 6(1), 1–18.
Nkosi, M. Z. P. (2024). Patients’ experiences in the use of mobile health clinics in KwaMachi rural area of KwaZulu-Natal, South Africa. Dialogues in Health, 4(December 2023), 100164. https://doi.org/10.1016/j.dialog.2023.100164
Nyamtema, A. S., Urassa, D. P., & van Roosmalen, J. (2023). Maternal health interventions in resource limited countries: A systematic review of packages, impacts and factors for change. BMC Pregnancy and Childbirth, 11. https://doi.org/10.1186/1471-2393-11-30
Pinrang, D. kesehatan kabupaten. (2022). Laporan Kinerja Instansi pemerintah (LKJIP) kabupten pinrang. 1–23.
Putri, D. U., Putriady, E., Fatharani, R., & Gurning, F. P. (2022). Dea+Utami+Putri,+Ellisha+Putriady,+Ratih+Fatharani,+Fitriani+Pramita+Gurning. 1(2), 65–71.
R, N., & Hamzah, H. (2021). Hubungan Antara Jarak Kelahiran Dan Usia Dengan Kejadian Pre Eklampsia Pada Ibu Hamil. Jurnal Penelitian Keperawatan Kontemporer, 1(1), 1–9. https://doi.org/10.59894/jpkk.v1i1.191
Retnaningtyas, E., Wahyuni, C., Siwi, R. P. Y., Natalia, S., Wulandari, A., & Putri, E. N. K. (2022). Faktor - Faktor Yang Mempengaruhi Keteraturan Pemeriksaan Antenatal Care Pada Ibu Hamil Aterm. Public Health and Safety International Journal, 2(01), 1–10. https://doi.org/10.55642/phasij.v2i01.128
Stowman, K. (2023). World health statistics. In The Milbank Memorial Fund quarterly (Vol. 27, Issue 2). https://doi.org/10.2307/3348165
Sulsel, B. B. dinkes prov. (2022). Profil kesehatan tahun 2022. 1–23.
Suparti, S., & Nur Fauziah, A. (2021). Determinan Kepatuhan Bidan Dalam Melaksanakanstandar Asuhanpersalinannormal. Jurnal Kebidanan Indonesia, 12(2), 99–110. https://doi.org/10.36419/jki.v12i2.501
Syukaisih, S., Alhidayati, A., Kursani, E., & Ali, M. (2022). Penyebab Rendahnya Cakupan Persalinan Di Fasilitas Kesehatan Di Wilayah Kerja Upt Puskesmas Benteng. Menara Ilmu, 16(1), 102–112. https://doi.org/10.31869/mi.v16i1.3115
Wahyuni, S., Hariyanti, R., Rahmah, R., & Ningsih, N. K. (2023). Hubungan Jarak Kehamilan Dan Indeks Massa Tubuh dengan Kejadian Preeklampsia pada Ibu Hamil di RSUD H. Abdul Manap Kota Jambi. Jurnal Ilmiah Ners Indonesia, 4(2), 189–197. https://doi.org/10.22437/jini.v4i2.27508
Walker, R. E. B. R. L. M. T. N. (2020). Reproductive, Maternal, Newborn, and Child Health (Issue 112).
Weraman, P., Primer, P. K., & Pedesaan, K. M. (2024). PRIMER. 7, 9142–9148.
WHO. (2024). Maternal Mortality. WHO.
Wika Hartanti1), Siti Ni’amah2), Suwi’i3), E. D. A. (2024). Hubungan senam hamil dengan kelancaran proses persalinan normal di Puskesmas Wara. Jurnal Penelitian Pendidikan Bidan, 6(1), 7–13.
Zuchro, F., Zaman, C., Suryanti, D., Sartika, T., & Astuti, P. (2022). Analisis Antenatal Care (Anc) Pada Ibu Hamil. Jurnal ’Aisyiyah Medika, 7(1), 102–116. https://doi.org/10.36729/jam.v7i1.777
View Dimensions
View Altmetric
Save
Citation
View
Share