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Factors associated with non-utilization of postnatal care services in Indonesia
  1. Christiana R Titaley1,
  2. Michael J Dibley2,
  3. Christine L Roberts3
  1. 1 School of Public Health, University of Sydney, Australia;
  2. 2 School of Public Health, University of Sydney & The George Institute for International Health, Australia;
  3. 3 The Kolling Institute of Medical Research, University of Sydney, Australia
  1. E-mail: ctitaley{at}health.usyd.edu.au

Abstract

Background: Postnatal care helps prevent neonatal deaths. This study aims to examine factors associated with non-utilization of postnatal care in Indonesia.

Methods: A cross-sectional analytic study was conducted using data from the 2002-2003 Indonesia Demographic and Health Survey (IDHS), which used multi-stage cluster random sampling. We used contingency table and logistic regression analyses to determine the factors associated with non-utilization of postnatal care services. Population attribution risk percent (PAR%) for non-utilization of postnatal care services was also calculated.

Results: Data were available for 15,553 singleton live-born infants. The prevalence of non-attendance at postnatal care services was consistently higher in rural areas than in urban areas. Maternal factors associated with lack of postnatal care included low household wealth index, low education levels, lack of knowledge of pregnancy-related complications, or where distance from health services was a problem. Infants of high birth rank and those reported to be smaller than average were less likely to receive postnatal care. Other indicators of access to health care services which were associated with non-utilization of postnatal care services included few antenatal care checks, use of untrained birth attendants and births outside health care facilities.

Conclusion: Public health interventions to increase the utilization of postnatal care services should target women who are poor, less educated, from rural areas, and who use untrained birth attendants. Strategies to improve the availability and accessibility of antenatal care services and skilled birth attendance including focused financial support and health promotion programs, particularly in the rural areas, should increase utilization of postnatal care services in Indonesia.

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