Trends and Determinants of The Maternal Mortality Ratio Based on Healthcare Resources
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Abstract
ABSTRACT
Health resources play an essential role in realizing the unattainable Sustainable Development Goals targets in lowering maternal mortality ratio (MMR) globally. The study aimed to analyze trends and determinants of MMR based on the number of healthcare resources in Indonesia. This study was a descriptive retrospective study with a cross-sectional approach. Data on the health program achievements in Central Java province, Indonesia from 2016 to 2020 was analyzed using bivariate analysis with scatter plots, statistical analysis with Pearson correlation tests, and multiple linear analysis using Tableau software. Results showed that the MMR was decreased in 2016-2019, however it was increased in 2020. The ratio of obstetrics-gynecology specialists and nutritional personnel had impact on the maternal mortality ratio in 2016 (p-value <0.05). While the general practitioners and nutritional workers ratio also affected the maternal mortality ratio in 2017 and 2019 to 2020 with p-value <0.05. Our study concluded that the trend of MMR in Indonesia was affected by the number of healthcare personnel resources. It is recommended that the Indonesian government should fulfill the quantity and equalization of the distribution of healthcare personnel resources particularly the obstetrics-gynecology specialists, general practitioners, and nutritional workers so the MMR could be decreased.
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How to Cite
Sejati, E., Rosa, E., & Pramesona, B. (2023). Trends and Determinants of The Maternal Mortality Ratio Based on Healthcare Resources. Unnes Journal of Public Health, 12(1), 1-11. https://doi.org/10.15294/ujph.v12i1.57020
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Zhao, P., Diao, Y., You, L., Wu, S., Yang, L. & Liu, Y. 2019. The influence of basic public health service project on maternal health services: an interrupted time series study. BMC Public Health, 19, 824.
Arifin, Z. & Gusnedi, G. 2014. Obstacles and Potential of Local Resources In An Effort to Reduce the Risk of Maternal Death in Tigo Lurah District, Solok Regency, West Sumatra Province. Indonesian Journal of Reproductive Health, 5, 1-13.
Asrofin, B. 2017. Determinant maternal mortality in Nganjuk Regency. 2-Trick: Health Research Shoots, 7, 293-295.
Ayazbekov, A., Nurkhasimova, R., Kulbayeva, S., Bolat, K., Kurmanova, A. M., Yeskarayeva, A., Sarbassova, M. & Kemelbekov, K. S. 2020. Features of Pregnancy, Childbirth and Postpartum Period of Young Mothers. Electronic Journal of General Medicine, 17.
Callister, L. C. & Edwards, J. E. 2017. Sustainable development goals and the ongoing process of reducing maternal mortality. Journal of Obstetric, Gynecologic & Neonatal Nursing, 46, e56-e64.
Cameron, L., Contreras Suarez, D. & Cornwell, K. 2019. Understanding the determinants of maternal mortality: An observational study using the Indonesian Population Census. PloS one, 14, e0217386.
Cerf, M. E. 2018. The Sustainable Development Goals: Contextualizing Africa's Economic and Health Landscape. Global Challenges, 2, 1800014.
Choirunnisa, S. 2021. Comparison of Pregnant Women's Service Arrangements on Maternity Guarantee (Jampersal) and National Health Insurance (JKN-BPJS). Universitas Muhammadiyah Malang.
Diana, S., Wahyuni, C. U. & Prasetyo, B. 2020. Maternal complications and risk factors for mortality. Journal of Public Health Research, 9.
Diaz‐Sarachaga, J. M., Jato‐Espino, D. & Castro‐Fresno, D. 2018. Is the Sustainable Development Goals (SDG) index an adequate framework to measure the progress of the 2030 Agenda? Sustainable Development, 26, 663-671.
Ekasafitri, D., Hikayati, H. & Kusumaningrum, A. Experience of The Implementation of Maternal and Neonatal Emergency Case Referral System at Indralaya Health Center. Proceedings of the National Seminar on Nursing, 2019. 96-102.
Ernawati, A. 2017. Nutritional Problems in Pregnant Women. Journal of R&D: Research, Development and Science and Technology Information Media, 13, 60-69.
Fathani, A. T., Sujud, S. & Widowaty, Y. 2021. Analysis of Sustainable Health Development Goals in Improving Public Health. Advances in Digital Science: ICADS 2021, 1352, 242.
Geller, S. E., Koch, A. R., Garland, C. E., MacDonald, E. J., Storey, F. & Lawton, B. 2018. A global view of severe maternal morbidity: moving beyond maternal mortality. Reproductive health, 15, 31-43.
Harso, A. D., Siswantoro, H. & Syarif, A. K. 2020. Relationship of Public Health Centers Accreditation Status with The Achievement of Antenatal Care Program. Health Research and Development Media, 30.
Hoyert, D. L. 2020. Maternal mortality rates in the United States, 2019. National Center for Health Statistics.
Indonesia, C. J. P. H. O. 2020. Health PocketBook of the Year 2019. Semarang: Central Java Provincial Health Office Indonesia.
Indonesia, C. J. P. H. O. 2021a. Health Profile of Central Java Province in 2020, Central Java Provincial Health Office Indonesia.
Indonesia, M. o. H. o. t. R. o. 2021b. Indonesia Health Profile 2020, Jakarta, Ministry of Health of the Republic of Indonesia.
Kevaladandra, Z. & Martha, E. 2021. Impact of COVID-19 on Health of both Mother and Child Services in Cilegon City. Jurnal Keperawatan Muhammadiyah, 6.
Kotsadam, A., Lind, J. T. & Modalsli, J. 2018. Call the Midwife-Health Personnel and Mortality in Norway 1887-1921.
Laksono, A. D. & Sandra, C. 2020. Analysis of Childbirth Ecology in Health Care Facilities in Indonesia. Health System Research Bulletin, 23, 1-9.
Mahmood, M. A., Mufidah, I., Scroggs, S., Siddiqui, A. R., Raheel, H., Wibdarminto, K., Dirgantoro, B., Vercruyssen, J. & Wahabi, H. A. 2018. Root-cause analysis of persistently high maternal mortality in a rural district of Indonesia: role of clinical care quality and health services organizational factors. BioMed research international, 2018.
Merdad, L. & Ali, M. M. 2018. Timing of maternal death: levels, trends, and ecological correlates using sibling data from 34 sub-Saharan African countries. PLoS One, 13, e0189416.
Omer, S. 2019. The social and cultural factors of maternal mortality in the context of three delays: the perspective of lady health workers of South Punjab, Pakistan. Pakistan Vision, 20, 1.
Pascoe, M., Mahura, O. & Dean, J. 2020. Health resources for South Africa: A scoping review. Health SA Gesondheid, 25.
Putra, M. A. R., Yo, E. C., Phowira, J. & Anggraeni, T. D. 2020. Efforts to Reduce Maternal Mortality due to Postpartum Bleeding in Indonesia through Health Service System Innovation. Mirror of the Medical World, 47, 785-791.
Singh, V. & Barik, A. 2021. Maternal Near-Miss as a Surrogate Indicator of the Quality of Obstetric Care: A Study in a Tertiary Care Hospital in Eastern India. Cureus, 13.
Snyder, J. E., Stahl, A. L., Streeter, R. A. & Washko, M. M. 2020. Regional variations in maternal mortality and health workforce availability in the United States. Annals of Internal Medicine, 173, S45-S54.
Sun, J. & Luo, H. 2017. Evaluation on equality and efficiency of health resources allocation and health services utilization in China. International journal for equity in health, 16, 1-8.
Susilawati, D. & Nilekesuma, N. F. 2020. Quality of Comprehensive Midwifery Care as A Determinants of The Quality of Life of A Postpartum Mother. JHE (Journal of Health Education), 5, 72-77.
WHO 2018. A vision for primary health care in the 21st century: towards universal health coverage and the Sustainable Development Goals. World Health Organization.
WHO 2019. Trends in maternal mortality 2000 to 2017: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division.
Wirakusumah, F. F., Sukandar, H., Husin, F., Hidayat, Y. M. & Yudatmo, U. 2019. Analysis of the Role of Maternal Death Factors that can be Prevented against Delays in Referral and Handling in Karawang Regency, West Java Province. Indonesian Trust Health Journal, 2, 214-225.
Xiao, X., Ngai, F.-w., Zhu, S.-n. & Loke, A. Y. 2020. The experiences of early postpartum Shenzhen mothers and their need for home visit services: a qualitative exploratory study. BMC pregnancy and childbirth, 20, 1-12.
Zhao, P., Diao, Y., You, L., Wu, S., Yang, L. & Liu, Y. 2019. The influence of basic public health service project on maternal health services: an interrupted time series study. BMC Public Health, 19, 824.