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NURUL FAIZATUL AMIRA BT AB MUTALIB

11-2012-228KEPANITERAAN ILMU KESEHATAN MASYARAKAT

INFLUENCE OF SOCIO-ECONOMIC

BACKGROUND AND ANTENATALCARE PROGRAMMES ON

MATERNAL MORTALITY IN

SURABAYA, INDONESIA

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Masalah

What are the risk factors responsible for high maternalmortality in Surabaya, Indonesia?

Does socio-economic background and antenatal careprogrammes have influence on maternal mortality inSurabaya, Indonesia?

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Kerangka Konsep

Maternalmotality

Socio-economic status

Living conditions

Distance and traveltime to hospital

Womens educationalattainment

Employment status

Possession ofautomobile andelectrical appliances

Availability of cleanwater and toilet facilities

Antenatal care

Frequency of antenatal visits

Initial visit to antenatal carefacilities

Facility of antenatal care

Type of antenatal care providerand referral from other facilities

Family planning

Interval betweendeliveries

Age at time of firstdelivery

Method ofcontraception

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Variabel

Variabel X: Race, Religion, Living area, Travel time to the

hospital, Educational attainment of patient, employment of

patient, availability of automobile, availability of cleanwater, availability of toilet facility, frequency of antenatal

care, Initial visit to antenatal care facilities, antenatal care

facilities, Birth interval, Age at first delivery.

Variabel Y: Maternal mortality

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Desain

Desain penelitian analitik.

Studi kasus kontrol.

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Metode Pengumpulan Data

Questionnare was translated into Indonesian and

administered to the patient or family by midwife.

Medical records.

Personal interview with the patients or their families.

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Populasi

Populasi target : Women in Surabaya, Indonesia

Populasi terjangkau : Women admitted to Dr SoetomoHospital from January 1996 to December 1999.

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Kriteria inklusi

Case: Maternal deaths from January 1996 to December

1999 at Dr Soetomo Hospital.

Control:

Admitted to the same hospital as cases from January to

December 1999.

Has matching age (20-34 years) and gradivity as the cases.

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Kriteria eksklusi

The information on socio-economic background,

antenatal care and family planing was insufficient for

cases.

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Sampel

Kasus: 59 maternal deaths in the Dr Soetomo Hospital

from 1996 to 1999.

Kontrol: 177 women survivors in the Dr Soetomo

Hospital from January to December 1999.

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Teknik Pengambilan Sampel

Systematic random sampling.

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Analisis data

All variables are compared between cases and controls

using measures of central tendency: mean, median,

mode and standard deviation with paired t-test and chi-

squared test. Bivariate analysis between indicators and maternal

mortality are carried out by chi-squared test.

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Hasil

In bivariate analysis, significant risk factors for maternal

mortality are living outside Surabaya, no education past

primary school, unemployment, unavailability of toilet

facilities, antenatal visit

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Kesimpulan

This study shows that low socio-economic factors, such

as living in a rural area, unemployment, poor hygiene

and unavailability of antenatal care have an influence on

the high maternal mortality in Surabaya, Indonesia. A minimum of 4 antenatal visits and with initial visit by

the end of the 4thmonth could decrease the risk of

maternal mortality.

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Saran

Health education on pregnancy and delivery, and

improvement of basic medical care are needed to help

women utilize health services, especially in rural areas

where sources of information are limited.