PREGNANT WOMEN’S PREFERENCE FOR ANTENATAL CARE (ANC) PROVIDER: LESSONS LEARNED TO SUPPORT MATERNAL MORTALITY RATE REDUCTION STRATEGIES

Abstract

The disproportionate number and distribution of healthcare workers and facilities have become a great challenge in reducing the maternal mortality rate (MMR) in Indonesia. This study aimed to analyze pregnant women’s preference for antenatal care (ANC) providers to support MMR reduction strategies. This study used the 2018 Basic Health Research (Riskesdas) subset data. Data were analyzed from 75,155 female household members aged 10-54 years with inclusion criteria from 300,000 households spread across the 34 provinces in Indonesia. The variables studied include demographic characteristics, as well as the types of healthcare workers and their compliance in implementing ANC Minimum Service Standards (ANC-MSS). The data obtained were then processed using bivariate and binary logistic regression. Most pregnant women prefer to use midwives as their ANC providers. The majority of midwives have good compliance in implementing the ANC-MSS. Obstetrician service was relatively accessible in urban areas and very common among mothers with high education who are formal sector workers. Furthermore, obstetricians are the second most preferred antenatal provider by urban pregnant women because they tend to provide case management (TLK) immediately. Residential location, age, education level, and occupation were the significant factors influencing the selection of midwife’s service. Midwives have a potential role in reducing MMR because they are the most pregnant women preference, good compliance in implementing ANC-MSS, and the most accessible to the community. Improving their competence and increasing the obstetrician-population ratio in focused areas with high MMR and infant mortality rate (IMR) can provide valuable benefits in reducing the mortality rate.