Unfairness in health service utilization among mothers in Indonesia

What is it about?

Over the past thirty years, the health of Indonesians has generally improved because health services are increasingly more available and accessible. However, mothers are still susceptible to die before, during, and after giving birth. Many studies in the past have established that death among mothers are linked to health service utilization. Noticeably, the death rate among mothers in Indonesia is different in different parts in Indonesia. The current study therefore aims to find out which mothers use or do not use health services that are provided for them during pregnancy and childbirth: at least one antenatal care (ANC), four or more ANC (ANC4+), childbirth in health facilities, and delivering a baby trough incision made in the mother’s abdominal wall and uterus (C-section). We examined this across different wealth groups, education background, urban-rural location, religions, and regions in Indonesia. Our results show there was a clear variation in health services utilization. Among others, the richest mothers were 5.45 times more likely to give birth in health facility and 2.83 times more likely to give birth by C-section than the poorest mothers. Mothers who lived in urban areas had 3 times likelihood to give birth in health facility and 1.45 times likelihood to have C-section compared to mothers who lived in rural areas. In addition, the utilization of all the four health services was higher in Java and Bali compared to other regions.

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Why is it important?

The results demonstrated that disadvantaged pregnant mothers still utilized health service less than more privileged mothers. It could mean that they were still facing difficulties in accessing the services. More efforts therefore are still needed to address this so that every mother in Indonesia will have the chance to have a healthy life during pregnancy as well as during and after childbirth regardless of their socioeconomic background and residence.