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Regional disparities in antenatal care utilization in Indonesia

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  • Agung Dwi Laksono
  • Rukmini Rukmini
  • Ratna Dwi Wulandari

Abstract

Introduction: The main strategy for decreasing maternal morbidity and mortality has been antenatal care (ANC). ANC aims to monitor and maintain the health and safety of the mother and the fetus, detect all complications of pregnancy and take the necessary actions, respond to complaints, prepare for birth, and promote a healthy lifestyle. This study aims to analyze interregional disparities in ≥4 ANC visits during pregnancy in Indonesia. Methods: Data was acquired from the 2017 Indonesian Demographic and Health Survey (IDHS). The unit of analysis was women aged 15–49 years old, and a sample of 15,351 women was obtained. In addition to ANC as the dependent variable, the other variables analyzed in this study were a place of residence, age, husband/partner, education, parity, wealth status, and health insurance. For the final analysis, binary logistic regression was used to determine disparity. Results: With the Papua region as a reference, all regions showed a gap except for the Maluku region, which was not significantly different in the use of ANC compared to the Papua region. Women in the Nusa Tenggara have 4.365 times the chance of making ≥4 ANC visits compared to those in the Papua region (95% CI 3.229–5.899). Women in Java-Bali have 3.607 times the chance of making ≥4 ANC visits compared to women in the Papua region (95% CI 2.741–4.746). Women in Sumatra have 1.370 times the chance of making ≥4 ANC visits compared to women in the Papua region (95% CI 1.066–1.761). Women in Kalimantan have 2.232 times the chance of making ≥4 ANC visits compared to women in the Papua region (1.664–2.994). Women in Sulawesi have 1.980 times more chance of making ≥4 ANC visits compared to women in the Papua region (1.523–2.574). In addition to the region category, other variables that contributed to the predictor were age, husband/partner, education, parity, wealth and insurance. Conclusion: There were disparities in ANC utilization between the various regions of Indonesia. The structured policy is needed to reach regions that have low coverage of ≥4 ANC. Policymakers need to use the results of this study to take the necessary policies. Policies that focus on service equality to reduce disparities.

Suggested Citation

  • Agung Dwi Laksono & Rukmini Rukmini & Ratna Dwi Wulandari, 2020. "Regional disparities in antenatal care utilization in Indonesia," PLOS ONE, Public Library of Science, vol. 15(2), pages 1-13, February.
  • Handle: RePEc:plo:pone00:0224006
    DOI: 10.1371/journal.pone.0224006
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    References listed on IDEAS

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    1. Johar, Meliyanni & Soewondo, Prastuti & Pujisubekti, Retno & Satrio, Harsa Kunthara & Adji, Ardi, 2018. "Inequality in access to health care, health insurance and the role of supply factors," Social Science & Medicine, Elsevier, vol. 213(C), pages 134-145.
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    3. Sarwat Mumtaz & Jinwook Bahk & Young-Ho Khang, 2019. "Current status and determinants of maternal healthcare utilization in Afghanistan: Analysis from Afghanistan Demographic and Health Survey 2015," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-14, June.
    4. Luginaah, Isaac N. & Kangmennaang, Joseph & Fallah, Mosoka & Dahn, Bernice & Kateh, Francis & Nyenswah, Tolbert, 2016. "Timing and utilization of antenatal care services in Liberia: Understanding the pre-Ebola epidemic context," Social Science & Medicine, Elsevier, vol. 160(C), pages 75-86.
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    1. Ravi Durga Prasad & Somya Arora & Pradeep S. Salve & Srinivas Goli & K. S. James & Saseendran Pallikadavath & Udaya S. Mishra & Irudaya S. Rajan, 2022. "Why there is underutilization of four and more antenatal care services despite the colossal rise in institutional deliveries in Bihar, India," Journal of Social and Economic Development, Springer;Institute for Social and Economic Change, vol. 24(2), pages 355-378, December.

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