A Path Analysis on the Socioeconomics Factors Affecting the Utilization of Primary Health Services of Mothers and Children at Nunukan District, North Kalimantan

Abstract

Background: Primary Health Care (PHC) was adopted as a basic mechanism to promote health care to the population. This system brings health care as close as possible to where people live and work and it constitutes the first element of a continuing health care process. The previous study reported that in developing county health care services have remained inaccessible in many respects and have therefore negatively affected its optimum utilization. This study aimed to analyze the socioeconomics factors affecting the utilization of primary health services of mothers and children at Nunukan District, North Kalimantan. Subjects and Method: This was a cross-sectional study was conducted at six community health centers in Nunukan, North Kalimantan, from October to November 2017. A total sample of 208 mothers was collected using stratified multi-stage random sampling. The dependent variables were antenatal care (ANC) service, place of birth delivery, and basic immunization.The independent variables were maternal education, maternal employment status, family income, family welfare, and residence. The data were collected by questionnaire and analyzed by path analysis. Results: Utilization of ANC increased with better family welfare (b=1.42; 95% CI= 0.34 to 2.49; p=0.010). Use of basic immunization increased with higher maternal education (b=0.71; 95% CI= 0.06 to 1.35; p=0.032). Place of birth delivery at formal health facility increased with living in urban area (b= 3.2; 95% CI= 1.97 to 4.44; p< 0.001), maternal employment (b=2.34; 95% CI= 0.77 to 3.91; p= 0.003), and regular ANC (b= 1.04; 95% CI= -0.10 to 2.18; p=0.074). Family income increased with higher maternal education level (b=1.21; 95% CI= 0.50 to1.92; p=0.001) and maternal employment (b= 2.54; 95% CI= 1.67 to 3.41; p <0.001). Family welfare increased with living in urban area (b= 1.4; 95% CI= 0.09 to 2.68; p= 0.035) and higher family income (b= 2.5; 95% CI= 0.44 to 4.54; p= 0.017). Maternal employment status increased with higher maternal education level (b= 2.45; 95% CI= 1.63 to 3.26; p< 0.001). Conclusion: Utilization of ANC directly increases with better family welfare. Utilization of basic immunization increases with higher maternal education. Place of birth delivery at formal health facility increases with living in urban area, maternal employment, and regular ANC. Keywords: social economics factors, ANC, place of birth delivery, basic immunization, mother, children