Do the Integrated Health Posts Have Contextual Effect on Birth Weight? A Multilevel Evidence from Situbondo, East Java

Abstract

Background: Low birth weight babies (LBW) are sensitive indicators of socioeconomic condi­tions and indirectly become a benchmark for ma­­ter­­­nal and child health. This study aimed to ana­ly­ze con­tex­tual effect of integrated health post and so­cio­­economic determinants on LBW in Situbondo. Subjects and Method: This was an ob­ser­­­­vational analytic study with a case control design. The study was con­­­ducted at the integrated health posts in the Asem­bagus Health Center. The study po­pu­lation was all infants aged 0-1 years. A sample of 150 infants with normal birthweight and 50 LBW was selected by simple random samp­­ling. The depen­dent variable was LBW. The in­­­­de­­­­pendents variables were maternal age, maternal edu­cation, maternal occu­­­­pation, mater­nal knowledge, family income, ex­po­­­­sure to ciga­rette smoke, and integrated health post strata. Data were ana­lyz­ed using multilevel multi­ple logistic reg­res­sion analysis using STATA 13. Results: The risk of LBW increased with mater­nal age <20 years or ≥35 years (b= 1.78; 95% CI= 0.83 to 2.73; p<0.001), low maternal education (b= 0.­93; 95% CI <0.01 to 1.86; p= 0.049), mother working out­side the home (b= 1.24; 95% CI= 0.26 to 2.22; p= 0.013), low family income (b= 1.33; 95% CI= 0.42 to 2.24; p= 0.004), low maternal know­­­ledge (b= 1.17; 95% CI= 0.13 to 2.21; p= 0.0­26), and high ciga­rette smoke expo­sure (b= 1.11; 95% CI= 0.­08 to 2.13; p= 0.035). Integrated health post has not con­textual effect on LBW with ICC= 0.­01%. Conclusion: The risk of LBW increases with maternal age <20 years or ≥35 years, low mater­nal education, low maternal education, mother working out­side the home, low family income, low maternal know­­­ledge, and high ciga­rette smoke exposure. Integrated health post has not con­textual effect on LBW. Keywords: low birthweight, socio-economic determinants, integrated health post Correspondence: Eti Kuswandari. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Su­ta­mi 36A, Surakarta 57126, Cen­tral Java. Email:­ eti­kus­­wandari.ek@gmail.com. Mobile: +62821­32­77­­0153. Journal of Maternal and Child Health (2020), 05(03): 275-286 https://doi.org/10.26911/thejmch.2020.05.03.06