THE ROLE OF ANTENATAL CARE ON THE CHOICE OF DELIVERY SITES IN WEST JAVA 2011-2012

• Main Authors: , Indah Puspita S, , Prof. dr. Siswanto Agus Wilopo, SU., MSc., ScD.
• Format: Theses and Dissertations NonPeerReviewed
• Published: [Yogyakarta] : Universitas Gadjah Mada 2013
• Subjects: ETD
• Online Access: https://repository.ugm.ac.id/121008/; http://etd.ugm.ac.id/index.php?mod=penelitian_detail&sub=PenelitianDetail&act=view&typ=html&buku_id=61046
• Institution: Universitas Gadjah Mada

Background Homebirths in developing country associated with high maternal and newborn adverse outcome. Country report 2011 show 5/33 Provinces contributed to 50 percent national maternal mortality, West Java is the highest. Despite the advantages being close to Indonesian capitol and high coverage of antenatal care (91-95 percent), institutional births remain low. This study explores antenatal care affect on the choice of childbirth place from mother point of view in two districts in West Java. Methods Explanatory sequential design applied. Begin with quantitative analysis using secondary data from World Bank �Baseline survey for maternal and newborn healthcare system strengthening programme in Indonesia� in Bandung and Bogor 2011. Study subjected on the last pregnancy and delivery in the period of January 2010 � March 2012. Followed by qualitative part, using in-depth interview to some mothers from the previous part, selected purposively with confirming and disconfirming cases sampling technique, base on the delivery sites (institutional /home) and antenatal care status. Results From 1602 interviewed, only 1601 data used. Respondent�s age range 15-48 years old with education background vary from never attended school until higher than secondary high school. Antenatal care received by 92 percent of respondent, only 37 percent have institutional birth as the 1st choice. Multinomial logistic regression performed found that compare to the homebirth group, the institutional birth has likeliness to received better antenatal care, even after adjustment with relevant maternal and socio-demographic factors with adjusted odds ratios of 2.5 and 3.8. Mother education, household wealth index, areas remoteness, knowledge on health facility availability and the insurance were found to be other influential factor. Qualitative analysis of 36 respondents� refilled that antenatal care examination result was the major influential on choosing delivery site beside the perceived quality of service. Miss opportunity of birth planning was experience in most antenatal care. Conclusion The antenatal care is influencing mother decision on choosing the delivery sites. Antenatal care has certain passive role on improving institutional birth due to complication detection. Improve antenatal care role in promoting safer birth with birth planning and emergency preparedness is necessary.