The Model of Midwife Performance of Antenatal Care in Banda Aceh

Abstract

Background: Maternal Mortality Rate (MMR) is considered as one of the health indicators to evaluate health status of population. Indonesia had the highest MMR (305 per 100,000 live births) compared to other countries in South East Asia. Efforts to reduce MMR have been developed including increasing the quality of antenatal care (ANC). The high coverage of ANC through first and fourth visit only describe the accessibility of the ANC. This study aims to find a model of antenatal care, both from accessibility and quality of care in Aceh Province, Indonesia. Methods: This is an explanatory study using cross sectional design, with the population of all village midwifes in Aceh province. Cluster sampling was used for all midwife in Banda Aceh municipality, totaling 105 respondents. Data was collected using a structured questionnaire, maternal and child health books, and mother’s cohort books. Statistical analysis was conducted using Structural Equation Model (SEM) Amos 16 to estimate the relationship of midwife’s characteristic, organization and psychology towards quality of antenatal care and midwife performances. Results: Individual midwife characteristics, organization, and midwife psychology had a significant and positive relationship with the quality of antenatal care and midwife performances. Quality of antenatal care also had a significant and positive relationship with midwife performance. The results indicated that variables of individual, organization and psychological midwife had direct and indirect relationship with midwife performance through the quality of antenatal care as the intervening variable. Antenatal care quality was significantly mediated the correlation between the individual, organization, and psychological variables with midwife performance. Conclusion: Variable of organization had the highest correlation with the quality of antenatal care and midwife performances. Thus, it is suggested the improvement of incentives, leadership and resources as the organization indicators.