The Relationship between Maternal Participation in Household Decision-Making and Birth Attendant Selection: Evidence from Indonesia Demographic and Health Survey

Putu Sri Devi Tari; Helen Andriani

doi:10.3889/oamjms.2022.9514

Authors

Putu Sri Devi Tari Master of Public Health Science Study Program, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
Helen Andriani Department of Health Policy and Administration, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia https://orcid.org/0000-0001-5057-0851

DOI:

https://doi.org/10.3889/oamjms.2022.9514

Keywords:

Delivery attendants, Indonesia, Maternal participation, Household decision-making, Population-based study

Abstract

BACKGROUND: The decreasing maternal mortality rate (MMR) is an important indicator in achieving health development. The Ministry of Health has mandated delivery assistance by competent health personnel to achieve the MMR targets set out in the UN sustainable development goals.

AIM: This study aims to determine the relationship between maternal participation in household decision-making and the selection of birth attendant in Indonesia.

METHODS: The study uses secondary data from the 2017 Indonesia demographic and health survey, as part of a cross-sectional and large-scale national survey. The study involved ever-married women of reproductive age (15–49 years) and had given birth in the last 5 years prior to the survey (n = 14,193).

RESULTS: Of all birth attendants, 4,630 (32.6%) were non-health workers and 9,563 (67.4%) were health workers. Midwives account for the largest proportion of the health workers (61.8%). Decisions in healthcare, household expenses, visits to family/relatives’ decisions are significantly associated with birth attendant selection. However, husband’s income use decision had no significant relationship with birth attendant selection. The final multivariate model found that grand multipara mothers had a 1.9 times higher risk of choosing non-health birth attendants than primipara mothers (OR = 1.90, 95% CI = 1.60–2.25).

CONCLUSION: Findings demonstrated the importance of improving health education for men and women as well as women’s decision-making autonomy. Health workers (especially midwives) should improve knowledge and communication between couples in choosing skilled birth attendants, especially for mothers with grand multiparity.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

World Health Organization. Trends in Maternal Mortality 2000 to 2017: Estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division: Executive summary. Geneva: World Health Organization; 2015. https://doi.org/10.1111/padr.12033 DOI: https://doi.org/10.1111/padr.12033

WHO, UNICEF, UNFPA, Group WB, Division tUNP. Maternal Mortality Ratio (Modeled Estimate, Per 100,000 Live Births)- Myanmar, Indonesia, Vietnam, Thailand, Malaysia, Brunei Darussalam, Singapore, Cambodia, Lao PDR 2019. Available from: https://www.data.worldbank.org/indicator/SH.STA.MMRT?end=2017&locations=MM-ID-VN-TH-MY-BN-SG-KH-LA&start=2015 [Last accessed on 2020 Sep 23].

Rizkianti A, Afifah T, Saptarini I, Rakhmadi MF. Women’s deacision-making autonomy in the household and the use of maternal health services: An Indonesian case study. Midwifery. 2020;90:102816. https://doi.org/10.1016/j.midw.2020.102816 PMid:32823256 DOI: https://doi.org/10.1016/j.midw.2020.102816

Statistics ICAO. Profile of Indonesian Population Results SUPAS 2015 2016. Available from: https://www.bps.go.id/publication/2016/11/30/63daa471092bb2cb7c1fada6/profil-penduduk-indonesia-hasil-supas-2015.html [Last accessed on 2020 Oct 03].

Indonesia PRotRO. Presidential Regulation Number 18 of 2020: National Medium-Term Development Plan 2020-2024-Annex II: Strategic Priority Projects 2020. Available from: https://www.peraturan.bpk.go.id/Home/Details/131386/perpres-no-18-tahun-2020 [Last accessed on 2021 Jan 15].

Siti I, Siahaan S, Wanggae G, Widyasari R, Kurniawan A, Aryastami NK, et al. Gender dynamics on access to maternal health services for nine ethnicities in Indonesia. Bul Penelitian Sistem Kesehatan. 2019;22(1):1-9. https://doi.org/10.22435/hsr.v22i1.652 DOI: https://doi.org/10.22435/hsr.v22i1.652

Development NIfHRa. Final Report of Indonesia Basic Health Research 2018 (RISKESDAS 2018). Jakarta: Ministry of Health Republic of Indonesia; 2018. https://doi.org/10.25133/jpssv27n1.003 DOI: https://doi.org/10.25133/JPSSv27n1.003

Parenden RD. Analysis of mother’s decision to choose childbirth assistant in Kabila bone community health center area. J Ilmu Kesehatan Masyarakat Unsrat. 2015;5:362-72.

Agus Y, Horiuchi S, Iida M. Women’s choice of maternal healthcare in Parung, West Java, Indonesia: Midwife versus traditional birth attendant. Women Birth. 2018;31(6):513-9. https://doi.org/10.1016/j.wombi.2018.01.007 PMid:29454665 DOI: https://doi.org/10.1016/j.wombi.2018.01.007

Wulandari MD, Zoraya E. The effect of women’s empowerment on the selection of birth attendants in skilled health workers. Med Kesehatan Masyarakat Indones. 2020;16(3):293-304. https://doi.org/10.30597/mkmi.v16i3.9048 DOI: https://doi.org/10.30597/mkmi.v16i3.9048

Diamond-Smith N, Treleaven E, Murthy N, Sudhinaraset M. Women’s empowerment and experiences of mistreatment during childbirth in facilities in Lucknow, India: Results from a cross-sectional study. BMC Pregnancy Childbirth. 2017;17(2):335. https://doi.org/10.1186/s12884-017-1501-7 DOI: https://doi.org/10.1186/s12884-017-1501-7

Hameed W, Azmat SK, Ali M, Sheikh MI, Abbas G, Temmerman M, et al. Women’s empowerment and contraceptive use: The role of independent versus couples’ decision-making, from a lower middle income country perspective. PLoS One. 2014;9(8):e104633. https://doi.org/10.1371/journal.pone.0104633 DOI: https://doi.org/10.1371/journal.pone.0104633

Samari G. First birth and the trajectory of women’s empowerment in Egypt. BMC Pregnancy Childbirth. 2017;17(Suppl 2):362. https://doi.org/10.1186/s12884-017-1494-2 PMid:29143631 DOI: https://doi.org/10.1186/s12884-017-1494-2

National Population, Family Planning Board, Statistical Indonesia, Ministry of Health Republic of Indonesia, ICF. In: Indonesia Demographic and Health Survey 2017. Jakarta, Indonesia: BKKBN, BPS, Kemenkes, and ICF; 2018. https://doi.org/10.25133/jpssv27n3.0016 DOI: https://doi.org/10.25133/JPSSv27n3.0016

Prabosiwi R. Women and its role on social welfare development. J Natapraja Kajian Ilmu Adm Negara. 2015;3(1):41-56. DOI: https://doi.org/10.21831/jnp.v3i1.11957

King R, Jones L. Key factors deterring women’s engagement with skilled birth attendants in three districts of Timor-Leste. A qualitative descriptive study. Midwifery. 2019;79:102555. https://doi.org/10.1016/j.midw.2019.102555 PMid:31634757 DOI: https://doi.org/10.1016/j.midw.2019.102555

Nurrachmawati A, Wattie AM, Hakimi M, Utarini A. Women’s autonomy and tradition in making decision on place of delivery and birth attendants. J Kesehatan Masyarakat Andalas. 2018;12(2):342. https://doi.org/10.24893/jkma.v12i2.342 DOI: https://doi.org/10.24893/jkma.v12i2.342

Nurgahayu N, Amelia AR, editors. Reasons for selection of birth attendants by maternal Maternity on Papandangan Island Mattiroujung Village Liukang Tupabbiring District, Pangkep Regency. Seminar Nasional Pertama Sinergitas Multidisiplin Ilmu Pengetahuan dan Teknologi; 2018.

Health IMo. Indonesia Health Profile 2018. Available from: https://www.pusdatin.kemkes.go.id/resources/download/pusdatin/profil-kesehatan-indonesia/PROFIL_KESEHATAN_2018_1.pdf [Last accessed on 2021 Apr 18].

Health IMo. Minister of Health Regulation No.97 of 2014 Concerning Health Services 2015. Available from: https://www.kesga.kemkes.go.id/assets/file/pedoman/PMK%20No.%2097%20ttg%20Pelayanan%20Kesehatan%20Kehamilan.pdf [Last accessed on 2021 May 06].

Wardhani DP. The Relationship of Women’s Participation in Decision Making in the Household with the Choice of Place of Delivery. In: Indonesian Health Demographic Survey Data Analysis 2017. Indonesia: Universitas Indonesia; 2020.

Novianti I, Karimuna SR, Tina L. Study on determinants of birth attendant selection by health workers and dukun/paraji in the work area of Puuwatu public health center, Kendari city in 2016. J Ilm Mahasiswa Kesehatan Masyarakat. 2018;3(1):1-9.

Wiknjosastro H. Midwifery. 4th ed. Jakarta: PT Bina Pustaka Sarwono Prawirohardjo; 2010.

Nurhayati N, Sugiharto M. The behavior of choosing birth aid for mothers in childbirth in Blambangan Village, Penengahan District, South Lampung Regency, Indonesia. Bul Penelitian Kesehatan. 2019;47:165-74. https://doi.org/10.22435/bpk.v47i3.1468 DOI: https://doi.org/10.22435/bpk.v47i3.1468

Kebede A, Hassen K, Nigussie Teklehaymanot A. Factors associated with institutional delivery service utilization in Ethiopia. Int J Womens Health. 2016;8:463-75. https://doi.org/10.2147/ijwh.s109498 PMid:27672342 DOI: https://doi.org/10.2147/IJWH.S109498

Manyeh AK, Akpakli DE, Kukula V, Ekey RA, Narh-Bana S, Adjei A, et al. Socio-demographic determinants of skilled birth attendant at delivery in rural Southern Ghana. BMC Res Notes. 2017;10(1):268. https://doi.org/10.1186/s13104-017-2591-z PMid:28693617 DOI: https://doi.org/10.1186/s13104-017-2591-z

Efendi F, Sebayang SK, Astutik E, Hadisuyatmana S, Has EM, Kuswanto H. Determinants of safe delivery utilization among Indonesian women in Eastern part of Indonesia. F1000Res. 2020;9:332. https://doi.org/10.12688/f1000research.23324.2 PMid:32864103 DOI: https://doi.org/10.12688/f1000research.23324.2

Health IMo. Guidelines for the Implementation of the Midwife and Shaman Partnership 2018. Available from: https:/www.docplayer.info/30482400-Pedoman-pelaksanaan-kemitraan-bidan-dan-dukun-kementerian-kesehatan-republik-indonesia.html [Last accessed on 2021 July 16].

Hutapea E. Factors Related to the Selection of Childbirth Assistants in the Work Area. Cibungbulang Health Center: Cibungbulang District, Bogor Regency; 2012.

Nurlatifah N. Factors associated with the selection of childbirth aid in the work area of the Garawangsa health center, Sucinaraja District, Garut regency. J Asuhan Ibu Anak. 2019;4(2):129. https://doi.org/10.33867/jaia.v4i2.129 DOI: https://doi.org/10.33867/jaia.v4i2.129

Tadese F, Ali A. Determinants of use of skilled birth attendance among mothers who gave birth in the past 12 months in Raya Alamata District, North East Ethiopia. Clin Mother Child Health. 2014;11(1):9-15. https://doi.org/10.4172/2090-7214.1000164 DOI: https://doi.org/10.4172/2090-7214.1000164