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Background: Maternal mortality can be prevented by delivering in a health care facility. Women who are not involved in decision making are barriers to using health facilities. Pregnant women often cannot determine the place of delivery because the decision is determined by their husband, parents-in-law or other family members. The delays of decision- making at the family level results in delays in getting help at health facilities. Objective: To determine the relationship between women's participation in household decision making with the selection of place of delivery based on analysis of the 2017 Indonesian Demographic Health Survey data. Methods: Designs study was sross-sectional and data was obtained from the Indonesia Demographic Health Survey 2017. Sample was women of childbearing age 15-49 years who had given birth to the last child in 2012-2017 with complete data, total 14,310 respondents. Data were analyzed using Cox regression and the effect was expressed by prevalence ratio (PR) with a 95% confidence interval (CI). Results: The proportion of women giving birth in non-health facilities was 26.5%, and 30.7% of women were not involved in in household decision making. After controlling residence and economic status, women who did not participate in household decision making had a risk of 1,633 (1,531-1,741) times to give birth in non-health facilities compared to women who participated in household decision making. Conclusion: Women who did not participate in household decision making were significantly related to deliveries in non-health facilities. Therefore, the government needs to promote women's reproductive, gender equality, and conduct a study of regions that still birth in dukun.
ABSTRAK Nama : Bambang Heriyanto PrgramStudi : Epidemiologi Judul : Hubungan Kepemilikan Jaminan Kesehatan dengan Pemilihan Persalinan di Fasilitas Kesehatan Pembimbing : Prof. Dr. dr. Sudarto Ronoatmodjo, SKM, M.Sc Di Provinsi Jambi, kabupaten dengan cakupan persalinan terendah di fasilitas kesehatan yaitu kabupaten Tanjung Jabung Timur sebesar 32,42% pada tahun 2016.Secara nasional, sebanyak 50,5% penduduk Indonesia belum memiliki jaminan kesehatan. Di Provinsi Jambi, sebanyak 61,9% penduduk belum memiliki jaminan kesehatan. (Riskesdas, 2013). Tujuan penelitian adalah diketahuinya hubungan antara kepemilikan jaminan kesehatan terhadap pemilihan persalinan di Fasilitas Kesehatan di Kabupaten Tanjung Jabung Timur tahun 2018 dan menilai hubungan antara kepemilikan jaminan terhadap pemilihan persalinan di Fasilitas Kesehatan setelah dikontrol dengan variabel-variabel lain seperti: usia, pendidikan, pekerjaan dan keterjangkuan fasilitas kesehatan.Penelitian ini menggunakan desain mixed method, yang mengkombinasikan antara pendekatan kuantitatif dan pendekatan kualitatif. Dengan menggunakan data sekunder yaitu data dari hasil pendataan keluarga sehat Program Indonesia Sehat dengan Pendekatan Keluarga (PIS-PK) yang telah dilaksanakan di kabupaten Tanjung Jabung Timur Tahun 2017. Populasi target dalam penelitian ini adalah seluruh keluarga yang menjadi target pendataan di wilayah kerja kabupaten Tanjung Jabung Timur Tahun 2017. Sampel adalah ibu rumah tangga yang memiliki anggota keluarga berumur < 12 bulan, yaitu sebanyak 484 responden. Uji statistik pada analisis bivariat menggunakan chisquare test dan multivariat menggunakan cox regresi. Hasil analisis menunjukkan prevalensi ibu bersalin melakukan persalinan di fasilitas kesehatan sebesar 64,3%, ibu bersalin yang memiliki jaminan kesehatan 49%, serta terdapat hubungan antara kepemilikan jaminan kesehatan dengan pemilihan persalinan di fasilitas kesehatan, Ibu bersalin yang memiliki jaminan kesehatan mempunyai peluang 1,9 kali melakukan pemilihan persalinan di fasilitas kesehatan dibandingkan dengan ibu bersalin yang tidak memiliki jaminan kesehatan setelah dikontrol dengan variabel-variabel usia, pendidikan, pekerjaan dan keterjangkuan fasilitas kesehatan (PR : 1,934 95%CI : 1,146 – 3,263). Alasan ibu bersalin memilih persalinan difasilitas kesehatan karena memiliki jaminan kesehatan dan keterjangkauan fasilitas kesehatan di Kabupaten Tanjung Jabung Timur tahun 2018. Disarankan perlu peningkatan dalam hal penyebarluasan informasi mengenai keikutsertaan jaminan kesehatan (BPJS) terutama dalam hal prosedur pendaftaran dan infromasi yang lain, peningkatan pemberdayaan masyarakat melalui penyediaan Rumah Tunggu Kelahiran untuk mengatasi masalah akses persalinan di fasilitas kesehatan. Kata kunci : Persalinan di fasilitaskesehatan, jaminankesehatan, mixed method
ABSTRACT Name : BambangHeriyanto Prgram Study : Epidemiology Title : Relationship of Ownership of Health Insurance with Elections Delivery at Health Facilities Counselor : Prof. Dr. dr. Sudarto Ronoatmodjo, SKM, M.Sc In Jambi Province, the district with the lowest coverage in health facilities is East TanjungJabung Regency at 32.42% in 2016. Nationally, 50.5% of Indonesians do not have health insurance. In Jambi Province, 61.9% of the population does not have health insurance. (Riskesdas, 2013). The objective of the study is to know the relationship between health insurance ownership to the election of delivery at Health Facility in East TanjungJabung Regency in 2018 and to assess the relationship between the ownership of the guarantee on the selection of delivery at the Health Facility after being controlled with other variables such as age, education, employment and health facility. This research uses mixed method design, which combines quantitative approach and qualitative approach. By using secondary data that is data from the result of healthy family data collection of Healthy Indonesia Program with Family Approach (PIS-PK) which has been implemented in East TanjungJabung Regency Year 2017. Target population in this research is all family which become target of data at work area of Regency TanjungJabungTimur Year 2017. Samples are housewives who have family members <12 months old, that is as many as 484 respondents. Statistical test on bivariate analysis using chi square test and multivariate using cox regression.The results of the analysis show that the prevalence of maternity delivery in health facilities is 64.3%, maternity mothers with 49% health insurance, and there is a relationship between the ownership of health insurance with the selection of delivery in health facilities, 9 times the selection of deliveries in health facilities compared with mothers who do not have health insurance after being controlled with age, education, employment and health facilities (PR: 1,934 95% CI: 1,146 - 3,263). The reasons for maternity mothers choose delivery in health facilities because they have health insurance and affordability of health facilities in the district of TanjungJabungTimur 2018. It is suggested to increase the dissemination of information regarding the participation of health insurance (BPJS) especially in the procedures of registration and other information, the improvement of community empowerment through the provision of Birth Ward to address the issue of access to delivery at a health facility. eywords : Delivery in health facilities, health insurance, mixed method