Utilization of Health Facilities Providing Childbirth Care in Rural Indonesia: the Importance of Birth Preparedness Plans During Pregnancy

Abstract

Utilization of maternal health care during childbirth is the best approach to reduce maternal death. Health facility based childbirth care utilization in Indonesia remains low compared to other countries in the region. This cross-sectional study was conducted to ascertain and understand factors associated with the utilization of health facilities providing childbirth care in Sampang District. The study sample were 250 mothers who lived and delivered in Camplong and Omben subdistricts in 2010 and came to the immunization centre of 6 villages in Camplong and Omben subdistricts. Respondents were interviewed in February and March 2011, by structured questionnaire, which had 74 questions and was devided in to 8 parts. Relationships between utilizing childbirth care and independent variables were analyzed using descriptive statistics, chi square tests and simple logistic regression. The survey indicated that 93.15% of the mothers had utilized health facility during childbirth, and 24.60% delivered using private health care facilities. A definite intention to deliver in a health facility had the strongest positive association with utilizing a health facility providing childbirth care (OR: 33.33, 95% CI: 10.70 to 21.27, p-value: <0.001). Positive associations were also observed for positive perception of safe delivery (OR : 12.19, 95% CI: 2.72 to 54.57, p-value:<0.000), Frequency of antenatal care (ANC) (OR: 8.45, 95% CI: 2.73 to 26.23, p-value:< 0.001), Place of ANC (OR: 5.88, 95% CI: 1.31 to 26.27, p-value: 0.009) and labelling mother’s house with birth preparedness and complication readiness (BPCR) sticker by midwives (OR: 3.703, 95% CI: 1.08 to 12.33, p-value: 0.028). Access to health care and information were very important in encouraging mothers to utilize health facilities during childbirth. Antenatal care represents a convenient and important opportunity for pregnant mothers to gain sufficient information about danger signs and risks during pregnancy and about making good childbirth care plans.