Pemerintah Indonesia telah menyusun kebijakan nasional eliminasi penularan HIV, sifilis, dan hepatitis B dari ibu ke anak sejak tahun 2017 melalui pemeriksaan triple eliminasi yang diintegrasikan dalam pelayanan antenatal care (ANC). Meskipun kebijakan telah tersedia, implementasinya masih menunjukkan variasi antarprovinsi, termasuk di Pulau Jawa dan Bali. Proporsi pemeriksaan triple eliminasi lengkap di Pulau Jawa dan Bali sebesar 76,10%, dengan proporsi tertinggi di Bali (92,23%) dan terendah di Jawa Barat (59,70%). Sebelum memperhitungkan faktor individu dan kontekstual kabupaten/kota, 16,38% variasi pemeriksaan triple eliminasi lengkap dapat dijelaskan oleh perbedaan antarkabupaten/kota. Hasil analisis multilevel menunjukkan bahwa pendidikan ibu (AOR=1,402; 95% CI: 1,167–1,685; p=0,000), kepemilikan Jaminan Kesehatan Nasional (AOR=1,357; 95%CI: 1,113–1,656; p=0,002), partisipasi dalam kelas ibu hamil (AOR=1,397; 95%CI: 1,169–1,670; p=0,000), dan kunjungan ANC sesuai standar (AOR=1,650; 95%CI: 1,395–1,951; p=0,000) berhubungan dengan odds yang lebih tinggi untuk memperoleh pemeriksaan triple eliminasi lengkap. Sebaliknya, peningkatan usia ibu (AOR=0,980;95%CI: 0,965–0,996; p=0,016) dan ANC rutin di praktik bidan mandiri/klinik bersalin (AOR=0,727; 95% CI: 0,576–0,917; p=0,007) berhubungan dengan odds yang lebih rendah. Rasio bidan, rasio ATLM, rasio puskesmas per 1.000 ibu hamil, dan rasio kapasitas fiskal kabupaten/kota tidak berhubungan dengan odds pemeriksaan triple eliminasi lengkap. Temuan penelitian ini menunjukkan bahwa faktor individu lebih berperan terhadap peluang ibu hamil memperoleh pemeriksaan triple eliminasi lengkap. Namun, setelah memperhitungkan seluruh variabel dalam model, masih terdapat 13,61% variasi antarkabupaten/kota yang belum dapat dijelaskan oleh faktor-faktor kontekstual kabupaten/kota yang dianalisis dalam penelitian ini.

The Indonesian government has implemented a national policy to eliminate mother-to-child transmission of HIV, syphilis, and hepatitis B since 2017 through triple elimination screening integrated into antenatal care (ANC) services. Despite the existence of this policy, its implementation continues to vary across provinces, including those in Java and Bali. The proportion of pregnant women who received complete triple elimination screening in Java and Bali was 76.10%, with the highest proportion in Bali (92.23%) and the lowest in West Java (59.70%). Before accounting for individual- and district/city-level contextual factors, 16.38% of the variation in complete triple elimination screening was attributable to differences between districts/cities. Multilevel analysis showed that maternal education (AOR=1.402; 95% CI: 1.167–1.685; p<0.001), National Health Insurance (JKN) membership (AOR=1.357; 95% CI: 1.113–1.656; p=0.002), participation in pregnancy classes (AOR=1.397; 95% CI: 1.169–1.670; p<0.001), and receiving ANC according to the recommended standard (AOR=1.650; 95% CI: 1.395–1.951; p<0.001) were associated with higher odds of receiving complete triple elimination screening. In contrast, increasing maternal age (AOR=0.980; 95% CI: 0.965–0.996; p=0.016) and routinely receiving ANC at independent midwifery practices or maternity clinics (AOR=0.727; 95% CI: 0.576–0.917; p=0.007) were associated with lower odds of receiving complete triple elimination screening. The ratios of midwives, medical laboratory technologists, primary health centers per 1,000 pregnant women, and district/city fiscal capacity were not associated with the odds of receiving complete triple elimination screening. These findings indicate that individual-level factors play a greater role in determining pregnant women's likelihood of receiving complete triple elimination screening. However, after accounting for all variables in the model, 13.61% of the variation between districts/cities remained unexplained, suggesting the presence of other district/city-level contextual factors that were not included in this study.