Abstract
Objective: The study aimed to identify the influencing determinants of the utilisation of antenatal care services among pregnant women in Indonesia. Methods: A systematic search of English and Indonesian literature was conducted using several databases including Pubmed, Popline, Scopus, Proquest, Web of Knowledge, Google Scholar, and Google, covering the period between 1994 and 2016. The search used different key terms either in combination and/or singly. Hand searches were conducted to identify grey literature, and references of the selected articles were scrutinised to obtain additional relevant literature. Due to the limited number of articles, a narrative review was conducted to identify the emerging themes from the literatures. Findings: Results indicated that cultural determinants including traditional beliefs influenced pregnant women’s decision to seek for antenatal care. Socioeconomic factors such as level of income and antenatal care cost, lack of knowledge of healthy pregnancy, and women’s autonomy were also identified as the barriers to accessing antenatal care services among Indonesian pregnant women. Physical distance to and unavailability of health facilities and services were environmental factors that hampered pregnant women from attending antenatal care. Preference for Traditional Birth Attendant (TBA) services was the behavioural factor hindering pregnant women from accessing antenatal care. Conclusion: The findings of this review indicate the needs for the improvement of knowledge of Indonesian pregnant women on the importance of antenatal care, and the availability of and accessibility to antenatal care facilities and services, and local transport to facilitate pregnant women to seek antenatal care services.
Highlights
Maternal mortality has been a major public health concern in Indonesia
Some grey literatures were obtained from specific institution websites such as the United Nations for Population Fund (UNFPA), the World Health Organisation (WHO), Ministry of Health-Republic of Indonesia, and Statistics Indonesia
A total of six emerging themes were identified in this review, including traditional beliefs, maternal education, family income and costs of visiting antenatal care, place of residence, women’s autonomy, and preference for Traditional Birth Attendants (TBAs)
Summary
Maternal mortality has been a major public health concern in Indonesia. The Indonesian maternal mortality rate (MMR) in 2012 was 359 per 100,000 live births [1]. This number is almost threefold the United Nations’ fifth Millennium Development Goals (MDGs) target number of 102 for the country by 2015 [2]. The Indonesian Maternal Health Programme recommends pregnant women to have at least four antenatal care visits during pregnancy. Only 66% of pregnant women in Indonesia have reached the recommended number of antenatal care visits, which are still below the national target of 90% antenatal care attendance [3]. This literature review aimed to explore factors that influence the utilisation of antenatal care in Indonesia
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