Dampak Asuhan Berkelanjutan pada Ibu Hamil terhadap Kematian Neonatus di Perkotaan dan Pedesaan: Analisis Demographic and Health Surveys Indonesia 2017

Sonia Miyajima Anjani; Asri C. Adisasmita

doi:10.7454/epidkes.v7i2.7838

Dampak Asuhan Berkelanjutan pada Ibu Hamil terhadap Kematian Neonatus di Perkotaan dan Pedesaan: Analisis Demographic and Health Surveys Indonesia 2017

Sonia Miyajima Anjani, Asri C. Adisasmita

Abstract

Upaya menurunkan angka kematian neonatus (AKN) membutuhkan suatu pelayanan kesehatan yang berkesinambungan, dikenal dengan istilah asuhan berkelanjutan atau Continuum of care. Asuhan berkelanjutan pada ibu hamil di daerah perkotaan bisa saja berbeda dengan di pedesaan. Penelitian ini ingin mengetahui dampak asuhan berkelanjutan pada ibu hamil terhadap kematian neonatus, serta peran tempat tinggal ibu hamil terhadap hubungan tersebut. Studi ini merupakan studi potong lintang menggunakan set data Demographic and Health Surveys (DHS) Indonesia tahun 2017. Variabel dependen pada studi ini adalah kematian neonatus dari anak terakhir yang dilahirkan responden antara 2012 hingga 2017. Variabel independennya adalah asuhan berkelanjutan pada ibu hamil yang terdiri dari asuhan antenatal, asuhan persalinan, dan asuhan pasca persalinan yang optimal. Analisis multivariat menggunakan regresi logistik ganda. Cakupan asuhan antenatal optimal, asuhan persalinan optimal dan asuhan pasca persalinan optimal adalah 25,97%, 72,77%, dan 51,88%. Secara keseluruhan, asuhan berkelanjutan diperoleh 13,87% ibu hamil. Dari 14.862 persalinan, terdapat 153 kematian neonatus (11 kematian neonatus per 1000 kelahiran hidup). Ibu hamil yang tidak menjalani asuhan berkelanjutan memiliki risiko 10,77 kali lebih tinggi mengalami kematian neonatus (POR=10,77; IK95% 2,56-45,37). Tidak ditemukan perbedaan efek tersebut antara kelompok subjek yang tinggal di perkotaan dan pedesaan (nilai p=0,564). Asuhan berkelanjutan pada ibu hamil menurunkan angka kematian neonatus. Tidak terdapat perbedaan dampak tersebut di perkotaan maupun pedesaan.

Keywords

Asuhan Berkelanjutan; Ibu Hamil; Kematian Neonatus; Tempat Tinggal

Full Text:

PDF

References

BPS. Angka kematian neonatal (AKN) dan angka kematian bayi per 1000 kelahiran menurut provinsi 2012-2017 Jakarta: Badan Pusat Statistik; 2023 [cited 2023 Oct 20]. Available from: https://www.bps.go.id/indicator/30/1383/1/angka-kematian-neonatal-akn-dan-angka-kematian-bayi-per-1000-kelahiran-menurut-provinsi.html.

The World Bank. Mortality rate, neonatal (per 1000 live births): The World Bank Group; 2023 [cited 2023 Oct 20]. Available from: https://data.worldbank.org/indicator/SH.DYN.NMRT?locations=ID-PH-PK.

Benova L, Tunçalp Ö, Moran AC, Campbell OMR. Not just a number: examining coverage and content of antenatal care in low-income and middle-income countries. BMJ Glob Health. 2018;3(2):e000779.

Chilot D, Aragaw FM, Belay DG, Asratie MH, Merid MW, Kibret AA, et al. Effectiveness of eight or more antenatal contacts on health facility delivery and early postnatal care in low- and middle-income countries: a propensity score matching. Frontiers in Medicine. 2023;10.

Zelka MA, Yalew AW, Debelew GT. Effectiveness of a continuum of care in maternal health services on the reduction of maternal and neonatal mortality: Systematic review and meta-analysis. Heliyon. 2023;9(6):e17559.

Kementerian Kesehatan RI. Laporan kinerja direktorat kesehatan keluarga tahun anggaran 2021. Jakarta: Kementerian Kesehatan 2021; 2021.

Andriani H, Rachmadani SD, Natasha V, Saptari A. Continuum of care in maternal, newborn and child health in Indonesia: Evidence from the Indonesia Demographic and Health Survey. J Public Health Res. 2022;11(4):22799036221127619.

Tsega D, Admas M, Talie A, Tsega TB, Birhanu MY, Alemu S, et al. Maternity Continuum Care Completion and Its Associated Factors in Northwest Ethiopia. Journal of Pregnancy. 2022;2022:1309881.

Abdullah A, Hort K, Butu Y, Simpson L. Risk factors associated with neonatal deaths: a matched case-control study in Indonesia. Glob Health Action. 2016;9:30445.

Kementerian Kesehatan RI. Pedoman pelayanan antenatal terpadu. Jakarta: Kementerian Kesehatan RI; 2020.

Lehtonen L, Gimeno A, Parra-Llorca A, Vento M. Early neonatal death: A challenge worldwide. Semin Fetal Neonatal Med. 2017;22(3):153-60.

Peter MM, Lenka B, Jessie P, Aline S, Andrea BP, Aliki C, et al. Neonatal and perinatal mortality in the urban continuum: a geospatial analysis of the household survey, satellite imagery and travel time data in Tanzania. BMJ Global Health. 2023;8(4):e011253.

Hong R, Ahn PY, Wieringa F, Rathavy T, Gauthier L, Hong R, et al. The unfinished health agenda: Neonatal mortality in Cambodia. PLoS One. 2017;12(3):e0173763.

PMNCH. Conceptual and institutional framework Geneva: PMNCH; 2016 [updated 2016, Jul 24; cited 2023, Dec 1. Available from: https://pmnch.who.int/resources/publications/m/item/conceptual-and-institutional-framework.

Kikuchi K, Okawa S, Zamawe CO, Shibanuma A, Nanishi K, Iwamoto A, et al. Effectiveness of Continuum of Care-Linking Pre-Pregnancy Care and Pregnancy Care to Improve Neonatal and Perinatal Mortality: A Systematic Review and Meta-Analysis. PLoS One. 2016;11(10):e0164965.

Iqbal S, Maqsood S, Zakar R, Zakar MZ, Fischer F. Continuum of care in maternal, newborn and child health in Pakistan: analysis of trends and determinants from 2006 to 2012. BMC Health Services Research. 2017;17(1):189.

Buli TD, Wakgari N, Ganfure G, Wondimu F, Dube DL, Moti G, et al. Completion of the continuum of maternity care and associated factors among women who gave birth in the last 6 months in Chelia district, West Shoa zone, Ethiopia: A community-based cross-sectional study. Front Public Health. 2022;10:1026236.

Islam MM, Masud MS. Health care seeking behaviour during pregnancy, delivery and the postnatal period in Bangladesh: Assessing the compliance with WHO recommendations. Midwifery. 2018;63:8-16.

Sakuma S, Yasuoka J, Phongluxa K, Jimba M. Determinants of continuum of care for maternal, newborn, and child health services in rural Khammouane, Lao PDR. PLoS One. 2019;14(4):e0215635.

Akira S, Francis Y, Sumiyo O, Emmanuel M, Kimiyo K, Clement N, et al. The coverage of continuum of care in maternal, newborn and child health: a cross-sectional study of woman-child pairs in Ghana. BMJ Global Health. 2018;3(4):e000786.

Cherie N, Abdulkerim M, Abegaz Z, Walle Baze G. Maternity continuum of care and its determinants among mothers who gave birth in Legambo district, South Wollo, northeast Ethiopia. Health Sci Rep. 2021;4(4):e409.

Sampurna MTA, Handayani KD, Utomo MT, Angelika D, Etika R, Harianto A, et al. Determinants of neonatal deaths in Indonesia: A national survey data analysis of 10,838 newborns. Heliyon. 2023;9(1):e12980.

Shrimpton R. Preventing low birthweight and reduction of child mortality. Transactions of the Royal Society of Tropical Medicine and Hygiene. 2003;97(1):39-42.

van den Broek NR, White SA, Goodall M, Ntonya C, Kayira E, Kafulafula G, et al. The APPLe study: a randomized, community-based, placebo-controlled trial of azithromycin for the prevention of preterm birth, with meta-analysis. PLoS Med. 2009;6(12):e1000191.

Surawijaya HB GE, Attamimi A. Hubungan onset preeklamsia dengan luaran neonatus di RSUP Dr. Sardjito Yogyakarta. Jurnal Kesehatan Reproduksi. 2023;10.

Målqvist M. Neonatal mortality: an invisible and marginalised trauma. Global Health Action. 2011;4(1):5724.

DOI: http://dx.doi.org/10.7454/epidkes.v7i2.7838