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Maternal Mortality in Klaten Regency (Determinant Factors Analysis)

Arfan Syahfani Sesunan, Supriyadi Hari Respati, Sri Sulistyowati

Abstract

Background: Failure in reducing maternal mor­­­­­­tality has become one of the world's health prob­­­lems. Indonesia ranks third on the list of the highest MMR in ASEAN countries. The incidence of maternal mortality is caused by several factors, including reproductive status, obstetric compli­ca­tions, health services, and socioeconomic con­di­tions.

Subjects and Method: This study was an ana­ly­tic observational study using a case-controlled study design. The study subjects were selected by using fixed random sampling with a total sample of 129 people consisting of 43 cases of maternal mor­tality in Klaten Regency and 86 controls. Ma­ter­nal mortality data were taken in Klaten Re­gen­cy from 2017 to 2019. The independent variables were pregnancy complications, delivery comp­li­ca­tions, postpartum complications, age of preg­nant women, pregnancy spacing, parity, delay in mak­ing decisions, referral delay due to in­ade­quate transportations, delay in handling by heal­th workers, the quantity of ANC, maternal edu­ca­tion, maternal occupation, and family income. The dependent variable was maternal mortality in Klaten Regency. The data collection of this stu­dy used a questionnaire. Data analysis was car­ri­ed out by univariate, bivariate, and multivariate met­­h­ods using the chi-square test. Path analysis and descriptive analysis were performed and pre­sent­ed in narrative form.

Results: The delay in making decisions in­creas­es with family income below the city mini­mum wa­ge (OR = 1.69; p = 0.09). Referral delay in­c­rea­s­­es with family income below the minimum wage (OR = 1.73; p = 0.08). Maternal mortality increas­ed with delay in decision making (OR = 5.­28; p = 0.00), quantity of ANC (OR: 2.37; p: 0.­02), income (OR: 3.92; p: 0.00), delivery com­p­li­ca­tions (OR: 2.71; p: 0.01) ), postpartum com­pli­ca­tions (OR: 6.33; p: 0.00). Maternal mortality was indirectly affected by income.

Conclusion: Pregnancy complications, delivery com­­plications, postpartum complications, ANC exa­­minations, delay in making decisions, delay in reaching the referral place, maternal education and income are associated with an increased risk of maternal mortality. While, maternal age, pa­ri­ty, pregnancy spacing, delay in handling by heal­th workers, and maternal occupation have no sig­ni­­ficant association with maternal mortality.

Keywords: Determinant Factors, Maternal Mor­tality, Klaten Regency

Correspondence: Arfan Syahfani Sesunan. Department Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi Hospital, Sura­karta, Central Java. Mobile: 08127949433. Email: arfansyahfani.s@gmail.com.

Journal of Maternal and Child Health (2021), 06(02): 183-196
https://doi.org/10.26911/thejmch.2021.06.02.06

 

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