Indonesian Demographic And Health Survey Research Articles

Parental decision-making in taking care of child health in Indonesia: Findings from a national survey

Background: The decision-making process to search for child health services involves interaction among the mother, partner, and other family members. Parental decision-making is highly complex since it involves an emotional consideration between the benefit and the child's future. The common problem in deciding the service is the lack of capabilities, such as facility, knowledge, and skill.Objective: The purpose of this study is to analyze the influence of socio-demographic factors on parents' decision-making in obtaining health services for their children Methods: This study design was cross-sectional data from the Indonesia Demographic and Health Survey (IDHS) of 2017, which was applied in this study. The respondents involved were 8,838 women aged 15-49 who had given birth in the last five years. This study employed descriptive, chi-square, and regression statistics analysis. The results were provided as adjusted odds ratios (AORs) with 95 percent confidence intervals. The statistical analysis utilized SPSS version 21.0 software (SPSS Inc., Chicago, IL, USA).Results: Bivariate analysis revealed a significant relationship between decision-making and age, living place, educational background, and wealth index (p-values 0.030, <0.001, 0.002, and 0.006), but not with health insurance ownership (p=0.242). After multivariate analysis, only age-related decisions were associated with a significant risk. It explained that younger group (15-29) has a 0.325 times chance of making a joint decision than the 40 to 49-year-old group (AOR: 0.325; 95%CI: 0.144-0.733). Conclusion: Parental decision-making regarding childcare is related to several factors, namely age, living place, educational background, and socioeconomic status. Health education is a strategy to promote child health in Indonesia by facilitating proper decision-making.

Predictive Model Comparison for Predicting Condom Use: Comparison of Conventional Logistic Regression and Other Machine Learning

Condom use at first sex remains an important issue as it shapes future sexual behavior. This study aimed to deploy and predict condom use using five different machine learning classification models. Dataset used for this study was from Indonesian Demographic and Health Survey (IDHS) 2017 with a population of interest was male adolescents. We evaluated five different models, namely logistic regression, naïve bayes, K-Nearest Neighbors, support vector machines, and decision tree. Performances of each model were assessed using metrics such as accuracy, specificity, sensitivity, ROC Curve, and AUC Score. Study found that different models exhibit different accuracy, specificity, sensitivity, ROC Curve, and AUC Score. The decision tree and naïve bayes models remained the models with the highest specificity and sensitivity, however the KNN model expressed the highest AUC score. Result from the conventional logistic regression also explained that condom use was associated with education level, age at first sex, and attitude towards condom use. The government is advised to create equal education opportunities for every adolescent and shape better knowledge and condom attitudes. Future studies are advised to enhance the performance of machine learning models using hyperparameter tuning and other methods.

SOSIODEMOGRAPHIC FACTORS ON CONTRACEPTIVE USE AMONG MARRIED WOMAN: EVIDENCE FROM THREE INDONESIA DEMOGRAPHIC AND HEALTH SURVEY (IDHS)

Background: Data on contraceptive use are needed to evaluate contraceptive use and plan for future needs. Changes in contraceptive method use and the factors that influence contraceptive method use are serious matters that need to be considered. Methods: This study used secondary data from the Indonesian Demographic and Health Survey (IDHS) in 2007, 2012, and 2017. The research design used was cross-sectional. Researchers used descriptive analysis to determine the characteristics of married women who use contraception. Inferential analysis was used to see the relationship between sociodemographic factors and the use of contraceptive method types. Results: The results of the analysis showed that the most widely used type of contraception from 2007-2017 was injectable contraception. Most married women who used contraceptives were in the age group of 30-39 years, had only 1-2 children, had a high school education and below, and worked as housewives. Women living in rural and urban areas have equal opportunities to obtain contraceptive services. Even women with the lowest wealth index still have access to contraceptives. The chi-square test results of age, education, occupation, residence, and wealth index variables with p = 0.000 (p < 0.005) from 2007-2017, as well as the variable number of children with p = 0.000 (p < 0.005) in 2007, p = 0.002 (p < 0.005) in 2012 and p = 0.000 (p < 0.005) in 2017. Conclusion: This study found a positive association between contraceptive method use and the variables of age, education, occupation, number of children, place of residence, and wealth index.

Child marriage and its impact on reproductive health and rights of girls in Indonesia

ABSTRACT Child marriage is often the result of gender inequality and human rights violation which disproportionately affects girls. During the pandemic period, the number of child marriages is on the rise in Indonesia and put Indonesia as the second rank in Southeast Asia. Expanding on this issue, we explored the sociodemographic and health vulnerabilities attached to the girls who performed an early marriage. We utilised nationally representative data from the 2017 Indonesia Demographic and Health Survey (IDHS). The sample was restricted to 4,017 ever-married women aged 15–24 years. The differences in vulnerability outcomes were assessed by calculating adjusted odds ratios (AORs) using logistic regression models. We found that 38.9% of ever-married women aged 15–24 reported marriage before age 18 years. Regression analyses showed that the likelihood of social vulnerabilities (low educational level, rural residence, and poverty) increased with younger marriage age. Additionally, women of earlier age at marriage were more likely to have lower antenatal care utilisation and pregnancy termination. These findings demonstrate child marriage creates a social and gendered vulnerability for girls with a major impact on health. Strict law enforcement, promoting sexual, and reproductive health rights for girls can help eliminate child marriage in Indonesia.

Determinants of Long-Term Contraceptive Method among Reproductive-Aged Women in Sulawesi Island (Data Analysis of IDHS 2017)

Introduction: Long-Term Contraceptive Methods are contraceptive methods that, once used, last for a long period, ranging from 3 years to a lifetime. LTCMs are considered highly effective compared to non-LTCMs, with a success rate above 95%. Overall, the coverage of LTCM usage in Indonesia remains low despite a noticeable increasing trend of 10.6% in 2012 and 13.2% in 2017. This coverage is far below the global average in SDGs in 2030, which was 35%, and the targets outlined in the BKKBN Strategic Plan for 2020 (25.11%) and 2024 (28.39%). Objective: The aim of this research is to identify the determinants of LTCM usage among women of reproductive age and to determine predominant the factors most associated with LTCM usage on the island of Sulawesi. Method: This cross-sectional study aims to identify the determinants of LTCM usage among reproductive-aged women in Sulawesi Island based on secondary data from the 2017 Indonesia Demographic and Health Survey (IDHS). The population in this study consists of all reproductive-aged women (15-49 years old) who are married and using contraception in the provinces of Southeast Sulawesi, South Sulawesi, West Sulawesi, Central Sulawesi, and North Sulawesi. The data utilized a survey with a complex sample design, and this taken into account during the analysis using weighting. The data analysis employed cox regression to estimate the prevalence ratio. Result: Out of 2,703 respondents, 519 (22.5%) were using LTCMs. Statistical tests indicated associations between predisposing factors such as age, education, occupation, knowledge about family planning (FP), number of children, and economic status, reinforcing factors like decision-making autonomy regarding FP, and supportive factors such as access to FP services and FP information media with LTCM usage among reproductive-aged women in Sulawesi Island. The most influential supportive factor was access to FP services in the government sector, with a 30.1% influence, having a 2.2 times higher likelihood of LTCM usage with a p-value of 0.001 and 95% CI 1.79 - 2.88. Conclusion: There is a relationship between predisposing factors such as age, education, occupation, knowledge about family planning (FP), number of children, and economic status, reinforcing factors influencing decision-making regarding family planning, and supportive factors of family planning service sources and media information on family planning, with the use of long-term contraceptive methods (LTCM) among women of reproductive age in Sulawesi Island. The most dominant factor associated is the supportive factor of family planning service sources in the government sector.

Infant and Young Child Feeding (IYCF) Practices in Rural and Urban Regions of Indonesia

Background. The global strategy on infant and child feeding recommends the best pattern of feeding for infants and young child feeding (IYCF) from birth to 24 months. Practices of proper feeding of children up to 2 years of age contribute to a child’s survival, growth, and development because they can prevent micronutrient deficiencies, morbidity, and obesity in later life. This study aims to determine the risk factors for the failure of IYCF practice in urban and rural Indonesia. Materials and Methods. The study used Indonesia Demographic and Health Survey (IDHS) 2017 data with a cross-sectional research design. The sampling technique used systematic probability proportional to size sampling. The number of samples was 4,869 children consisting of 2,424 children in urban and 2,445 children in rural. Bivariate analysis using chi-square test. Multivariate analysis using multivariate logistic regression. Results. The study found that most of the children in urban (79.3%) and rural (97.2%) did not practice IYCF under the recommendations. There is a difference in the proportion of IYCF practices between urban and rural areas (p <0.001). The risk factors for the failure of IYCF practice in urban areas are socioeconomic, maternal age, and age at first marriage. The poorest socioeconomic is at risk of 2.4 times, maternal age > 35 years are at risk of 1.5 times, age at first marriage is less than 21 years at risk of 2.1 times carrying out IYCF practices not according to recommendations compared to the comparison group. The risk factors for the failure of IYCF practice in rural are socioeconomic, maternal education, quantity, and quality of antenatal care (ANC). The poorest socioeconomic is at risk of 2.1 times, mothers with primary education are at 1.5 times, the quantity of ANC is not good at risk at 1.9 times, the quality of ANC is not good risk at 1.5 times practicing IYCF is not according to the recommendations compared to the comparison group. Conclusion. The practice of IYCF in Indonesia starting from giving early breastfeeding initiation, exclusive breastfeeding, and complementary feeding according to recommendations is still low. The priority of IYCF intervention through education and assistance to pregnant women needs to be a sustainable program.

Continuum of care in maternal and child health in Indonesia.

This paper aims to empirically analyze the socioeconomic and demographic correlates of maternal and child health (MCH) care utilization in Indonesia using the continuum of care (CoC) concept. The concept of CoC has emerged as an important guiding principle in reproductive, maternal, newborn, and child health. Indonesia's maternal mortality rate, neonatal mortality, and under-five mortality rates are among the highest in the Southeast Asian region. Using pooled data from four successive waves of the nationally representative Indonesian Demographic and Health Survey (IDHS) conducted in the years 2002, 2007, 2012, and 2017, we use multivariate regression models to analyze care across four components of the continuum: antenatal care (ANC), institutional delivery, postnatal care for children, and full immunization (IM). CoC at each stage of MCH care has improved continuously over the period 2002-2017 in Indonesia. Despite this, just less than one out of two children receive all four components of the CoC. The overall coverage of CoC from its second stage (four or more ANC visits) to the final stage (full child IM) is driven by the dropouts at the ANC visit stage, followed by the loss of postnatal checkups and child IM. We find that the probability of a child receiving CoC at each of the four stages is significantly associated with maternal age and education, the household's socioeconomic and demographic characteristics, and economic status. Complete CoC with improved, affordable, and accessible MCH care services has the potential to accelerate the progress of Sustainable Development Goal 3 by reducing maternal and childhood mortality risks. Our findings show that in Indonesia, the CoC continuously declines as women proceed from ANC to other MCH services, with a sharp decline observed after four ANC visits. Our study has identified key socioeconomic characteristics of women and children that increase their probability of failing to access care.

Factors Influencing Birth in Adolescents in the Province of West Nusa Tenggara

Background: Adolescent childbirth is a global problem, especially in developing countries. Based on data from the 2017 Indonesian Demographic and Health Survey (SDKI), the ASFR 15-19 at the national level is 36 per 1000 women while the NTB Province is 42 per 1000 women, so it is still in a position above the national level. Aims: To know the factors that influence teenage births. Methods: This research is an analytical study using secondary data from the results of the 2017 Indonesian Demographic and Health Survey (IDHS) by using a cross-sectional approach. The population in this study was 1368 respondents. sampling technique using purposive sampling obtained as many as 806 respondents. Data analysis was using univariate, bivariate analysis with chi-square, and multivariate with logistic regression analysis. Results: Based on the results of bivariate analysis, it was found that there was a significant relationship between the factors of education (CI 95% 2.996-16.366), age of first sex (CI 95% 2.271-11.853), use of contraception (CI 95% 0.292-0.846), number of children born (CI 95% 0.378-0.880) to teenagers. Factors of employment status (CI 95% 0.667-1.482) and living area (CI 95% 0.635-1.406) did not have a significant relationship with teenage births, while the results of multivariate analysis showed that the R2 value was 0.603 which means that education, age of first sex, use of contraceptives, and number of children contributed to teenage births of 60.3%, the remaining 39.7% is caused by other variables. Conclusion: Factors of education, age of first sex, use of contraceptives, and the number of children have a significant relationship with teenage births. It is hoped that the BKKBN of West Nusa Tenggara Province will evaluate the programs that have been established to determine the effectiveness of these programs in overcoming the problem of teenage births.

Accuracy of Antenatal Visits in West Java Province: Comparison between Rural and Urban Areas Data Analysis of the Indonesian Demographic and Health Survey 2017

Accuracy of antenatal visits plays a crucial role in reducing the risk of maternal death during pregnancy. West Java is a province in Indonesia that has the highest maternal mortality cases. An analysis of the accuracy of antenatal visits using a spatial approach, involving the distribution of villages and cities, was conducted to understand the interaction between humans and the environment, both physically and socially. This study aims to determine the differences in the accuracy of antenatal visits based on residential status in West Java Province in 2017. The research conducted is quantitative research using secondary data from the Indonesian Demographic and Health Survey (IDHS) 2017. The data used includes the number of pregnant women who received antenatal visits in urban and rural areas. The analysis was done by comparing rural and urban areas using the Chi-Square test. The results of the study indicate that there are differences in the accuracy of antenatal visits between rural and urban areas, with a p-value of 0.000 (less than 0.005, which means there is a difference).

Factors associated with knowledge of mother-to-child transmission of HIV among reproductive-age women in Indonesia: a multilevel analysis

BackgroundMaternal transmission of human immunodeficiency virus (HIV) commonly occurs from mother to child during pregnancy, delivery, and breastfeeding which accounts for almost all the new HIV infections among children aged 0–14 years. Despite major efforts and progress in controlling and preventing HIV, it continues to pose a great public health threat, especially in Indonesia. This study assessed the factors associated with the knowledge of mother-to-child transmission (MTCT) of HIV among reproductive-age women in Indonesia.MethodsThis study used data from the 2017 Indonesian Demographic and Health Survey (IDHS). We sampled 39,735 reproductive-age women (15–49 years) for analysis. Using Stata version 16.0, multilevel logistic regression models were fitted, and the results were presented as adjusted odds ratios (aORs) with their confidence intervals (CIs).ResultsThe study found that 72% of women had knowledge of MTCT of HIV. Women who were aged between 45 and 49 years (aOR = 1.65, 95%CI = 1.46–1.88) had higher odds of knowledge of MTCT of HIV than those aged 15–19 years. Women who attained higher education (aOR = 2.92, 95%CI = 2.06–4.15) had increased odds of knowledge of MTCT of HIV than those with no formal education. Women who had four children (aOR = 1.19, 95% CI = 1.05–1.35) had higher odds of knowledge of MTCT of HIV than nulliparous women. Women who frequently read newspapers/magazines (aOR = 1.14, 95%CI = 1.06–1.25) and frequently used the internet almost every day (aOR = 1.28, 95%CI = 1.19–1.38) had higher odds of knowledge of MTCT of HIV than those who did not read newspapers/magazines and non-users of internet, respectively. Women within the richer (aOR = 1.11, 95%CI = 1.02–1.20) and the richest (aOR = 1.14, 95%CI = 1.04–1.25) wealth quintile higher odds of knowledge of MTCT of HIV than those in the poorest wealth quantile. Women who resided in rural areas were less likely to have knowledge of MTCT of HIV (aOR = 0.79, 95% CI = 0.74–0.86) than those in urban settlements.ConclusionsKnowledge of MTCT of HIV was slightly above average. The study findings on the factors associated with knowledge of MTCT of HIV provide evidence for policymakers and clinicians to utilize in the quest to eliminate MTCT of HIV among children. We recommend that awareness programs should consider the key findings from this study when delivering public education or when developing interventions to improve women’s knowledge on MTCT of HIV.

The socio-economic factors influencing adolescent childbirth in Indonesia

Adolescent childbirth (ages 15-19) is a global issue that can result in morbidity and mortality among adolescents. The rate of adolescent childbirth is of particular concern to the Indonesian government as it has not yet reached the desired targets. The aim of this research is to analyze the socio-economic factors influencing adolescent childbirth (ages 15-19) in Indonesia based on data from the 2017 Indonesian Demographic and Health Survey (IDHS). This study utilizes secondary data from the 2017 Indonesian Demographic and Health Survey, with a sample size of 7,930 adolescents. Data were analyzed using univariate, bivariate, and multivariate descriptive statistical methods. Adolescent childbirth in Indonesia among ages 15-19 is observed in 416 adolescents (5.2%). Based on multivariate analysis, it was found that variables significantly associated with adolescent childbirth are educational level and economic status. Adolescents with low education are 27 times more likely to experience childbirth (aOR: 27.756; 95% CI: 12.007 - 64.163) compared to those with higher education. Furthermore, adolescents with the lowest economic status have a 2 times higher risk (aOR: 2.644; 95% CI: 2.014 - 3.470) of experiencing adolescent childbirth compared to those with the highest economic status. Adolescent childbirth is a health issue that warrants attention in Indonesia. Enhancing education, empowerment, awareness, and support for adolescent girls, along with policy implementation, is crucial for reducing the adolescent childbirth rate.

ASUHAN KEBIDANAN KOMPREHENSIF PADA NY.N DI WILAYAH PUSKESMAS PEKAUMAN BANJARMASIN

According to the Indonesian Demographic and Health Survey (IDHS) 2017, the Maternal Mortality Rate (MMR) related to pregnancy, childbirth and the postpartum period is 265 per 100,000 live births, while the infant mortality rate is 27 per 1,000 live births. Number of live and active babies born. In reducing MMR and IMR, as well as preventing complications in pregnancy and childbirth, early detection of high risk is very necessary with the support of quality services and other events such as counseling, classes for pregnant women and comprehensive care. Objective: To carry out comprehensive midwifery care for Mrs. H from pregnancy to family planning. Research method: This research is a case study by understanding the condition of the client and the problems faced by Mrs. P 22 years G1P0A0 UK 33 weeks, conducted in October 2020-January 2021, data collection namely observation, interviews, measurements and documentation using a case study instrument in the form of the SOAP midwifery care format. Results: Based on the assessment during pregnancy, Mrs. P is normal and has no complaints. Evaluation of the client in good and normal condition. Smooth delivery. The baby was born normal, during the visit no problems were found. Uterine involution is normal and there are no complaints. KB care for Mrs. P plans to take lactation pills. The care provided is in accordance with the standard of care

Antenatal care utilization on low birth weight children among women with high-risk births.

Low birth weight (LBW) is a major public health problem in Indonesia, and is a leading cause of neonatal mortality. Adequate antenatal care (ANC) utilization would help to prevent the incidence of LBW babies. This study aims to examine the association between ANC utilization and LBW children among women with high-risk birth criteria. High-risk birth criteria consisted of 4T which were too young (mother's age <20 years old), too old (mother's age >35 years old), too close (age gap between children <2 years), and too many (number of children >2 children). This study utilized calendar data from the women's module from the 2017 Indonesia Demographic and Health Survey (IDHS), with the unit of analysis only the last birth of women of childbearing age (15-49), which numbered 16,627 women. From this number, analysis was done by separating the criteria for women with high-risk birth. Multivariate logistic regression analyses were employed to assess the impact of ANC and socio-demographic factors on LBW among women with high-risk birth criteria. This study revealed that only among women with too many children criteria (>2 children), adequate ANC utilization was significantly associated with LBW of children, even after controlling for a range of socio-demographic factors (p < 0.05). In all four women criteria, preterm birth was more likely to have LBW than those infants who were born normally (above and equal to 2500 grams) (p < 0.001). According to WHO, qualified ANC standards have not been fully implemented, including in the case of ANC visits of at least eight times, and it is hoped that ANC with health workers at health facilities can be increased. There is also a need for increased monitoring of pregnant women with a high risk of 4T to keep doing ANC visits to reduce LBW births.

Linkages of Mother’s Status and Autonomy in the Household With Childhood Stunting in Indonesia

Maternal status and autonomy play a crucial role in achieving gender equality, which in turn has the potential to decrease the incidence of stunting, a persisting challenge in Indonesia. This study explores the correlation between stunting and factors such as maternal status and autonomy at the provincial level across Indonesia. It employs methodologies like cross-tabulation and odds ratio, complemented by the Mantel-Haenszel test for analytical purposes. The research utilizes data from the 2017 Indonesia Demographic and Health Survey (IDHS), the Indonesian Nutrition Status Survey (SSGI) of 2022, and publications by the Central Statistics Agency from 2021 and 2022. Findings indicate a notable correlation between the prevalence of stunting and women’s participation in decision-making, particularly regarding physical mobility and the Net Enrollment Rate (NER) for junior high school females. To address this discovery, there is a pressing need for governmental and other relevant entities to focus on enhancing educational attainment and ensuring that all initiatives are grounded in principles of gender equality.

Determinants of early neonatal mortality: secondary analysis of the 2012 and 2017 Indonesia Demographic and Health Survey.

Most neonatal deaths occur during the first week of life (i.e., early neonatal deaths). In this analysis, we aimed to investigate the determinants of early neonatal deaths in a nationally representative sample of births in Indonesia over the five years before each survey. Data were obtained from the 2012 and 2017 Indonesia Demographic and Health Survey (IDHS), including information from 58,902 mothers of children aged <5 years of age. The outcome variable was early neonatal death (death of a newborn within the first six days of life). Explanatory variables were categorized into environmental, household, maternal, pregnancy, childbirth, and child characteristics. Multivariate regression methods were employed for analysis. Increased odds of early neonatal deaths were associated with mothers who lacked formal education or had incomplete primary schooling (adjusted odd ratio [OR] = 2.43, 95% confidence interval [CI]: 1.18-5.01), worked outside the house in agricultural (aOR = 5.94, 95% CI: 3.09-11.45) or non-agricultural field (aOR = 2.98, 95% CI: 1.88-4.72), and were required to make a joint decision about health care with their partner or another household member (aOR = 1.79, 95% CI: 1.12-2.84). Increased odds were also observed in smaller-than-average infants, particularly those who received low-quality antenatal care services (aOR = 9.10, 95% CI: 5.04-16.41) and those whose mothers had delivery complications (aOR = 1.72, 95% CI: 1.10-2.68) or who were delivered by cesarean section (aOR = 1.74, 95% CI: 1.07-2.82). Furthermore, male infants showed higher odds than female infants (aOR = 1.85, 95% CI: 1.23-2.76). A multifaceted approach is essential for curtailing early neonatal mortality in Indonesia. Enabling workplace policies, promoting women's empowerment, strengthening the health system, and improving the uptake of high-quality antenatal care services are among the critical steps toward preventing early neonatal deaths in Indonesia.

Sexual Risk Behavior and its Impact on Unwanted Pregnancy Among Adolescents

Sexual activity among adolescents is increasingly alarming; the results of a national survey identified about 4.5% of teenage boys and 0.7% of teenage girls have had sexual intercourse that triggers unwanted pregnancies. This study analyzed the influence of risky sexual behavior factors in adolescents on the incidence of unwanted pregnancy. This research is a secondary data analysis sourced from Indonesian Demographic and Health Survey (IDHS) data in 2017 using a cross-sectional design. The study sampled 15-24-year-olds who had sexual intercourse with as many as 1532 people. Data were analyzed univariately while bivariate analysis using Chi-Square test and multivariate analysis with logistic regression test of the risk factor model. The results showed unwanted pregnancy occurred in 8.6% of adolescents who had a history of having sexual intercourse. In addition, it will be 4.5 times greater risk of unwanted pregnancy occurred in adolescents who performed risky behaviors such as fingering and stimulating each other after being controlled by variable confounding age and age when first having sex (PR = 4.570). Therefore, equal access to reproductive health education is needed both in educational institutions and in the community as an effort to prevent unwanted pregnancy.

Determinants of Antenatal Care Visits in Indonesia with Synthetic Minority Over-Sampling Techniques for Imbalance Data

Maternal mortality and infant mortality are two indicators that describe the degree of public health as well as indicators of sustainable development in Indonesia. The acceleration of reduction these two indicators must be supported by antenatal care services since pregnancy for the safety of mothers and babies. Based on the results of the IDHS 2017, antenatal care coverage in Indonesia (77.4%) is still far from the target in 2024 (95%.) This study used logistic regression analysis with Synthetic Minority Oversampling Technique (SMOTE) resampling method because of imbalance data to explore the determinants of complete antenatal care visits in Indonesia and descriptive analysis to find out an overview of complete antenatal care associated with factors that are considered influencing it. Data that was used in this study is the Indonesia Demographic and Health Survey (IDHS) 2017 with unit of analysis for women of childbearing age who are married or live together and gave birth to their last child in the period 2012-2017. The logistic regression results of the SMOTE method show that the variables of mother's education, husband's work status, knowledge of pregnancy danger signs, distance to health facilities, timing first antenatal check, mother's age, economic status, birth order, and number of problems during pregnancy significantly affect the completeness of antenatal care visits. The policy recommendations in this study are expected to be adopted by government to increase antenatal care visits in Indonesia as an effort to reduce maternal and infant mortality.

Determinants of Female Fertility Based on Social and Cultural Perspective in South Sulawesi Province

The phenomenon of the population continuing to grow rapidly means that the government needs to focus its efforts on controlling fertility. This is because fertility is more complex than mortality, in which a woman can only die once but can give birth many times. This research aims to find out the determinants of fertility from a social and cultural perspective. This research used data from 3,108 women aged 15 to 49 years old from the 2017 Indonesia Demographic and Health Survey (IDHS). Apart from that, in-depth interviews were also conducted with female respondents aged 15 to 49 years old as the main research subjects. On the quantitative data, binary logistic regression analysis was carried out to test the determinants of fertility and the results showed that education, work status, media exposure to family planning, use of contraceptives, and area of residence had affected fertility. Apart from that, there are also cultural phenomena, such as panaik money, which influence women’s fertility.

Effect of education level on delivery at home evidence from eastern Indonesia

&lt;p&gt;&lt;strong&gt;&lt;em&gt;Background:&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; Eastern is an area that tends to be lagging in terms of health development in Indonesia, including delivery services. &lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Objectives:&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; The study aims to analyzes the effect of education level on delivery at home in eastern Indonesia. &lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Methods:&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; The study employed secondary data from the 2017 Indonesian Demographic and Health Survey (IDHS). The samples of this study were women of childbearing age, who labored in the last five years, and there were 2,299 respondents. Apart from education level as an exposure variable, the study used seven control variables, i.e., residence, age, employment, marital, parity, health insurance, and wealth status. In addition, the study employed binary logistic regression in the final stage. &lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Results:&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; The results inform women with primary education have a 1.520 times higher probability than women with higher education to deliver at home (AOR 1.520; 95% CI 1.520-1.521). Moreover, women with secondary education are 1.206 times more likely than women with higher education to deliver at home (AOR 1.206; 95% CI 1.206-1.207). Thus, the results of this analysis inform the lower the education level, the higher the possibility for delivery at home. Apart from education level, the study also found other control variables significantly related to maternal delivery at home in eastern Indonesia.&lt;/em&gt; &lt;em&gt;Seven control variables are proven to be related to home delivery in Eastern Indonesia. The first lives in the countryside, the second is younger, the third does not work, the fourth has a partner, the fifth is multiparous, the sixth has no insurance, and the seventh is very poor. &lt;/em&gt;&lt;/p&gt;&lt;strong&gt;&lt;em&gt;Conclusions:&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; The study concluded that education level affects maternal delivery at home in eastern Indonesia.The recommendation from this research is the need for policies that can minimize the limitations of vulnerable groups in utilizing help in hospitals. &lt;/em&gt;

Relationship between Sexual Behavior and Early Menarche in Indonesian Adolescents

Background: Menstruation is one of the signs that a woman is entering adolescence. Menarche is the first menstrual event in women which generally occurs at the age of 12 to 15 years. An increase in the number of adolescents who experience menarche before the age of 12 years occurs in several countries. Sexual behavior in adolescents that can be positive or negative can be the reason for the increase and development of hormones in the human body. Objectives: The study was conducted to determine the relationship between sexual behavior and the incidence of early menarche in adolescent girls in Indonesia in 2017. Methods: The study is a quantitative descriptive study with a cross sectional research design using secondary data obtained from the 2017 Indonesian Demographic and Health Survey (IDHS) conducted in 34 provinces in Indonesia starting on July 24 and ending on December 30, 2017. The sample in this study was 1,494 adolescent girls in Indonesia with the age of 15 years, unmarried, and already experiencing menstruation. The variables involved in this study were sexual behavior and the incidence of early menarche in adolescent girls in Indonesia in 2017. Data analysis in this study used bivariate analysis by displaying frequency distribution tables along with analysis tables with chi-square tests. Results: The majority of respondents (71.2%) in this study had high-risk sexual behavior, the incidence of early menarche in adolescents aged ≤13 years was 77.4% and the p-value &lt;0.05 on the relationship between sexual behavior and the incidence of menarche in adolescent girls in Indonesia in 2017. Conclusions: This study shows that there is an association between sexual behavior and the incidence of early menarche in adolescent girls in Indonesia. Education and parental supervision of sexual relationships and behavior in adolescents need to be done to minimize the incidence of early menarche in adolescent girls in Indonesia.