Socioeconomics Factors Associated with the Utilization of Primary Health Services of Mothers and Children at Nunukan District, North Kalimantan
Abstract
Background: One of the main health development agenda in Indonesia 2015 to 2019 is reduction in maternal mortality ratio and infant mortality rate, and improve access and quality of maternal and child health services. However, variance in socioeconomics status between individual and between rural-urban have caused to difference in utilization of health service. This study aimed to analyze socioeconomics factors associated with the utilization of primary health services of mothers and children at Nunukan District, North Kalimantan.
Subjects and Method: This was an analytic observational study with cross-sectional design. The study was conducted at six community health centers in Nunukan, North Kalimantan, from October to November, 2017. A total sample of 208 mothers was collected using multistage random sampling. The dependent variables were antenatal care (ANC) service, place of birth delivery, and basic immunization. The independent variables were maternal education, maternal employment status, family income, family welfare, and residence. The data were collected by questionnaire and analyzed by path analysis.
Results: Utilization of ANC increased with better family welfare (b= 1.42; 95% CI= 0.34 to 2.49; p=0.010). Use of basic immunization increased with higher maternal education (b= 0.71; 95% CI= 0.06 to 1.35; p= 0.032). Place of birth delivery at formal health facility increased with living in urban area (b= 3.2; 95% CI= 1.97 to 4.44; p <0.001), maternal employment (b= 2.34; 95% CI= 0.77 to 3.91; p=0.003), and regular ANC (b=1.04; 95% CI= -0.10 to 2.18; p=0.074). Family income increased with higher maternal education level (b= 1.21; 95% CI= 0.50 to 1.92; p= 0.001) and maternal employment (b= 2.54; 95% CI= 1.67 to 3.41; p <0.001). Family welfare increased with living in urban area (b= 1.4; 95% CI= 0.09 to 2.68; p=0.035) and higher family income (b=2.5; 95% CI= 0.44 to 4.54; p= 0.017). Maternal employment status increased with higher maternal education level (b= 2.45; 95% CI= 1.63 to 3.26; p <0.001).
Conclusion: Utilization of ANC directly increases with better family welfare. Utilization of basic immunization increases with higher maternal education. Place of birth delivery at formal health facility increases with living in urban area, maternal employment, and regular ANC.
Keyword: social economics factors, ANC, place of birth delivery, basic immunization, mother, children
References
Alkire S, Chatterjee M, Conconi A, Suman S, Vaz A (2014). Poverty in Rural and Urban Areas Direct comparisons using the global MPI 2014. Oxford Poverty and Human Development Initiative, 1-4.
Amanuturrohim H (2015). Pengaruh Pendapatan dan Konsumsi Rumah Tangga Terhadap Kesejahteraan Keluarga Petani Penggarap Kopi Di Kecamatan Candiroto Kabupaten Temanggung.
Badan Pusat Statistik (2012). Survei Demografi Dan Kesehatan Indonesia. http://chnrl.org/pelatihandemografi/SDKI2012.pdf.
Bappenas (2013). Health Sector Review Kumpulan Policy Brief Health Sector Review Kumpulan Policy Brief, 1
Berhan Y, Berhan A (2014). Antenatal care as a means of increasing birth in the health facility and reducing maternal mortality: a systematic review. Ethiopian Journal of Health Sciences, 24: 93
Choe SA, Kim J, Kim S, Park Y, Kullaya SM, Kim CY (2016). Do antenatal care visits always contribute to facility based delivery in Tanzania? A study of repeated crosssectional data. Health Policy and Planning, 31(3): 277
Dewi AP, Darwin E, Edison (2014). Hubungan Tingkat Pengetahuan Ibu dengan Pemberian Imunisasi Dasar Lengkap pada Bayi di Kelurahan Parupuk Tabing Wilayah Kerja Puskesmas Lubuk Buaya Kota Padang Tahun 2013. Jurnal Kesehatan Andalas, 3(2), 114
Dinas Kesehatan Provinsi Kaltara (2016). Data Dinas Kesehatan Provinsi Kalimantan Timur.
Dinas Kesehatan Nunukan (2016). Profil Kesehatan 2016. Kabupaten Nunukan Provinsi Kalimantan Utara
Djabu O (2013). Peranan Ibu Rumah Tangga yang Bekerja dalam Meningkatkan Status Sosial Keluarga di Kelurahan Teling Atas Kecamatan Wanea Kota Manado. https://ejournal.unsrat.ac.id/index.php/actadiurna/article/viewFile/2333/1887
Feriyansyah E (2015). Pengaruh Pendapatan Suami dan Istri Terhadap Ekonomi Keluarga (Studi Kasus di PT. Pagilaran Unit Kaliboja). Skripsi. Fakultas Ekonomi dan Bisnis Islam Universitas Islam Negeri Walisongo Semarang.
Galama T, Kippersluis HV (2010). A Theory of Socioeconomic Disparities in Health over the Life Cycle, 1
Ganle JK, Parker M, Fitzpatrick R, Otupiri E (2014). Inequities in accessibility to and utilisation of maternal health services in Ghana after userfee exemption: A descriptive study. International Journal for Equity in Health, 13(1).https://doi.org/10.1186/s129390140089z.
Heaton TB, Crookston B, Pierce H, Amoateng AY (2016). Social inequality and children
Isdijoso W, Suryahadi A, Akhmadi (2016). Penetapan Kriteria dan Variabel Pendataan Penduduk Miskin yang Komprehensif dalam Rangka Perlindungan Penduduk Miskin di Kabupaten/ Kota, Kertas Kerja SMERU Research Institute.
Kamal N, Curtis S, Hasan MS, Jamil K (2016). Trends in equity in use of maternal health services in urban and rural Bangladesh. International Journal for Equity in Health, 15(1), 1
Kementerian Desa, Pembangunan Daerah Tertinggal dan Transmigrasi Republik Indonesia (2015). Rencana Strategis (Renstra) Direktorat Jenderal Pembangunan Daerah Tertinggal Tahun 2015-2019.
Kementerian Kesehatan RI (2008). Keputusan Menteri Kesehatan RI N0. 828/MENKES/SK/IX/2008 tentang Petunjuk Teknis Standar Pelayanan Minimal Bidang Kesehatan di Kabupaten/Kota.https://doi.org/10.1017/CBO9781107415324.004.
Kementerian Kesehatan RI (2014). Infodatin Pusat Data dan Informasi Kementerian Kesehatan RI. Pusat Data Dan Informasi Kementrian Kesehatan RI: Penyebab Kematian Ibu. www.depkes.go.id/resources/download/pusdatin/infodatin/infodatinibu.pdf
Kementerian Kesehatan RI (2016). profil Kesehatan Indonesia. Kesehatan (Vol. 70).https://doi.org/10.1111/evo.12990
Kementerian Kesehatan RI (2017). Data dan Informasi Profil Kesehatan Indonesia 2016. Kementerian KesehatanRI, 100. Retrieved from http://www.depkes.go.id/resources/download/pusdatin/lainlain/Data dan Informasi Kesehatan Profil Kesehatan Indonesia 2016 smaller sizeweb.pdf.
Mahwati Y (2013). Pemanfaatan Pelayanan Kesehatan Ibu di Jawa Barat Maternal Health Care Utilization in West Java, Jurnal Kesehatan Masyarakat Nasional 7(6).
Maidartati, Parsaulin P (2015). Gambaran Pengetahuan Ibu Hamil Trimester I Tentang Pengaruh Rokok Terhadao Tumbuh Kembang Janin di Poli Kandungan RSUD Kota Bandung. Jurnal Ilmu Keperawatan, III(1), 38
Obiyan MO, Kumar A (2015). Socioeconomic Inequalities in the Use of Maternal Health Care Services in Nigeria: Trends Between 1990 and 2008. SAGE Open, 5(4). https://doi.org/10.1177/2158244015614070.
Parenden RD (2015). Analisis Keputusan Ibu Memilih Penolong Persalinan Di Wilayah Puskesmas Kabila Bone Analysis of Decision Mother to Choosing Delivery Helper In Kabila Bone Health Center. Bapelkesman Propinsi Gorontalo 2) Fakultas Ilmu Kesehatan Masyarakat Universitas Sam Ratulangi Manado, 5, NO, 362
Pertiwi P (2015). Analisis Faktor-Faktor Yang Mempengaruhi Pendapatan Tenaga Kerja Di Daerah Istimewa Yogyakarta. Skripsi. Fakultas Ekonomi Universitas Negeri Yogyakarta.
Pervin J, Moran A, Rahman M, Razzaque, A, Sibley L, Streatfield PK, Rahman A (2012). Association of antenatal care with facility delivery and perinatal survival a populationbased study in Bangladesh. BMC Pregnancy and Childbirth, 12(1), 1. https://doi.org/10.1186/1471239312111.
Pusdatin (2016). Estimasi Jumlah Penduduk Indonesia Tahun 2015: Ringkasan Eksklusif Data dan Informasi Kesehatan Kalimantan Utara, Kementerian Kesehatan RI.
Putri MD (2016). Faktor Faktor Yang Berhubungan Dengan Pemilihan Tempat Persalinan. Jurnal Kesehatan Masyarakat, 4(April), 55
Rammohan A, Awofeso N, Fernandez RC (2012). Paternal education status significantly influences infants measles vaccination uptake, independent of maternal education status. BMC Public Health, 12(1), 1. https://doi.org/10.1186/1471245812336.
Saripudin D (2008). Pembangunan Pendidikan Dan Pertumbuhan Ekonomi Indonesia, International Seminar on Lifelong Education (ISLE), 1
Seth A, Tomar S, Singh K, Chandurkar D, Chakraverty A, Dey A, Silverman JG (2017). Differential effects of community health worker visits across social and economic groups in Uttar Pradesh, India: A link between social inequities and health disparities. International Journal for Equity in Health, 16(1), 1
/10.1186/s1293901705386.
Setiani B (2013). Kajian Sumber Daya Manusia Dalam Proses Rekrutmen Tenaga Kerja Di Perusahaan. Jurnal Ilmiah Widya, 1(1), 38
Sugiharti, Lestary H (2011). Faktor-faktor yang Mempengaruhi Pemanfaatan posyandu/Polindes pada Ibu Hamil di Indonesia. Jurnal Ekologi Kesehatan, 10, 65
Sunarti E (2006). Indikator Keluarga Sejahtera: Sejarah Pengembangan, Evaluasi, dan Keberlanjutannya, 116. Dr.EuisSunartiKependudukandanKeluargaSejahtera2A.pdf.
Tran TK, Nguyen CTK, Nguyen HD, Eriksson B, Bondjers G, Gottvall K, Petzold M (2011). UrbanRural disparities in antenatal care utilization: A study of two cohorts of pregnant women in Vietnam. BMC Health Services Research, 11(1), 120. https://doi.org/10.1186/1472696311120
Unicef (2012). Kesehatan Ibu & Anak. UNICEF Indonesia, (Gambar 2), 1
Woolf SH, Simon SM, Aron L, Zimmerman E, Dubay L, Luk KX (2015). How Are Income and Wealth Linked to Health and Longevity? Urban Institute, (April), 1