DISCONTINUITY OF THE MATERNAL AND CHILD CASCADE OF CARE: EVIDENCE FROM INDONESIAN DEMOGRAPHIC AND HEALTH SURVEY

Vitri Widyaningsih1,2, Tri Mulyaningsih3, Septyan D Nugroho1,4, Nurussyifa A Zaen1,4, Akhmad Azmiardi5,6 and Ari Probandari1,2

Abstract

Lack of maternal and child health services lead to the maternal and infant mortality problems. The cascade of care for pregnant and postpartum women must be carried out, starting from antenatal care throughout delivery and beyond. Therefore, this study aimed to assess maternal and child health continuity using a cascade-of-care approach. The researchers analyzed data from the latest Indonesian and Demographic Surveys (IDHS) 2017. The sample of this study was 14,398 mothers. The cascade of care was then analyzed descriptively, covering all indicators of the continuum of care for maternal and child health on an ongoing basis, including antenatal care (ANC 4 visits or more), skilled birth attendant (SBA), facility delivery (FD), postnatal care (PNC1 means receiving medical attention in less than 2 days after delivery and PNC2 within 28 days after delivery), family planning (FP), and immunization. The analyses uncovered that of 14,398 mothers, 80.7% made ANC visits four times or more, but only 73.1% of those mothers continued to use the assistance of health workers during the delivery process. Furthermore, only 65.1% of mothers gave birth in health facilities, and 45.1% of them received PNC1 and PNC2. Of the mothers who received the two PNCs, 32.5% had followed the family planning program, and 16.8% of their children had received ten complete doses of the basic immunization recommendation. The findings also revealed a loss of continuity of care across the maternal and child health care indicators. Only 45.1% of mothers who had received antenatal care and safe facility delivery continued to have postnatal care. The numbers were even lower for immunization and family planning. Based on these findings, improving access and willingness to receive the continuum of care in maternal and child health is necessary.