Socioeconomic Difference and Adequate Antenatal Care in Indonesia: Evidence from a Nationwide Household Survey

Abstract

BACKGROUND: Inadequate antenatal care (ANC) has been identified as a risk factor for poor pregnancy outcomes in low-income nations. The World Health Organization recommends adequate ANC for a minimum of eight visits. While universal health coverage has been implemented since 2014, Indonesia as fourth largest populous country encounters challenge on socioeconomic disparities. AIM: This study aims to explore the socioeconomic difference of adequate ANC in Indonesia. METHODS: Data from the Indonesia Demographic and Health Survey 2017 was used for the analysis and includes 15,313 mothers age 15–49 who had a last live birth in the 5 years preceding the survey. Multivariate logistic regression was employed to assess correlation between socioeconomic status and adequate ANC. RESULTS: About 20.8% of mothers had adequate ANC and the proportion ranging between 11.4% in the poorest group and 34.5% in the richest group. Poorest (adjusted odds ratio [AOR]: 0.68; 95% CI: 0.54–0.86) and poorer (AOR 0.79; 95% CI: 0.64–0.97) mothers are less likely to have adequate ANC compared to the richest mothers. In addition, mothers who lived in Java-Bali region, had better knowledge on danger sign of pregnancy, exposed to internet every day, health insurance ownerships, and having ANC at health facilities were more likely to have adequate ANC. CONCLUSION: Socioeconomic status was significantly associated with adequate ANC, where inequality was profound among poor mothers. Therefore, specific intervention to expand universal health coverage for poor mothers is essential to reduce socioeconomic disparities.