Contextual Effect of Community Health Service on the Use of Triple Elimination Service

Abstract

Background: Triple elimination is the elimination of transmission of HIV, syphilis, and hepatitis B from mother to child. The Prevention of Mother to Child Transmission (PMTCT) program is a comprehensive activity. The basic condition of the case is carried out because of the importance of health promotion and early detection in strategies for managing HIV, Syphilis, and Hepatitis B infections. This study aimed to analyzecontextual effect of community health service on the use of triple elimination service in pregnant women. Subjects and Method: This was a cross sectional study conducted at 25 community health centers in Sragen Regency, Central Java, from June to July 2019. A sample of 200 pregnant women was selected by stratified random sampling. The dependent variable was the use of triple elimi­nation. The independent variables were age, perceived susceptibility, perceived seriousness, cues to action, attitude, motivation, occupation, income, and distance to health service. The data were collected by a set of questionnaire and analyzed by multilevel multiple logistic regression. Results : The use of triple elimination increased with age ≥35 years (b=1.29; 95% CI=0.37 to 2.21; p=0.006), working outside the home (b=1.20; 95%CI=0.17 to 2.23; p=0.012), income by ≥Rp 1,600,000 (b=1.52; 95% CI=0.54 to 2.50; p=0.002), perceived susceptibility (b=1.46; 95% CI=0.53 to 2.38; p=0.002), perceived seriousness (b=1.53; 95% CI=0.55 to 2.50; p=0.002), cues to action (b=1.30; 95% CI=0.30 to 2.30; p=0.010), attitude (b=1.10; 95% CI=0.02 to 2.18; p=0.046), and strong motivation (b=1.68; 95% CI=0.66 to 2.71; p=0.001). The use of triple elimination decreased by a distance ≥5km (b=-1.36; 95% CI=-2.27 to -0.46; p= 0.003). Community health center had strong contextual effect on the use of triple elimination with ICC= 22.6%. Conclusion: The use of triple elimination increases with age ≥35 years, working outside the home, income by ≥Rp 1,600,000, perceived susceptibility, perceived seriousness, cues to action, attitude, and strong motivation. The use of triple elimination decreases by a distance ≥5km. Community health center has strong contextual effect on the use of triple elimination. Keywords: triple elimination, Health Belief Model, Theory of Planned Behavior Correspondence: Prissy Verasita. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: prissyoppo@gmail.com. Mobile: +6285879-345269. Journal of Maternal and Child Health (2020), 5(1): 68-78 https://doi.org/10.26911/thejmch.2020.05.01.08