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Unwanted pregnancy is a major cause of unsafe abortion and adverse impacton women who experience it as well as the fetus. The risk of unwanted pregnancyincreased in women aged less than 20 years and more than 35 years old. Thisstudy used a cross-sectional study design to analyze further the IDHS 2012 data.Results showed 18% of pregnant women at risk of age had unwanted pregnancies,and women who experience contraceptive failure 8.5 times tended to have anunwanted pregnancies after controlled by age, number of children, economicstatus, knowledge of family planning, and access to health care variables.Keywords : unwanted pregnancy, contraceptive failure
Kata kunci: Antenatal Care, Kepatuhan, Wanita Usia Subur
Disparities in maternal health services are still a problem in Indonesia. The K4 coverage of Antenatal Care (ANC) program from 2012 to 2017 has decreased. However, it shows that the K4 ANC coverage has begun to meet the Ministry of Health Strategic Plan target in 2017. Based on data from the IDHS and the Indonesian Health Profile, it stated that some regions in Eastern Indonesia are still facing this problem. Papua, West Papua, Maluku and North Maluku itself are some provinces are always in top 10 provinces with the lowest K4 ANC coverage. The four provinces also had never met the targets of the Ministry of Health Strategic Plan since 2007, 2012, and 2017. This study aims to look at the factors that influence the level of ANC visit adherence in reproductive age women in 4 Provinces in 2012 & 2017. The sample is used in this study are the women in reproductive age in the 2012 & 2017 IDHS that are living in 4 provinces, married or are living together with their partner, and have their in the last 5 years. The number of samples in the study were 1,001 respondents in the 2012 IDHS & 1,167 respondents in the 2017 IDHS. This study itself use chi-square and multiple logistic regression. The results showed that maternal education and maternal knowledge had a consistent influence on the adherence of ANC visits for respondents in 2012 and 2017. In 2012, there are other factors that also affected ANC visit adherence in reproductive age women, namely participation in decision making and economic status. Whereas in 2017, there are also other factors that influence ANC visits adherence to reproductive age women, namely health insurance, parity, and husband support.
Key words: Antenatal Care, Adherence, Reproductive Age Women
Kehamilan tidak diinginkan di Indonesia belum menunjukkan perubahan yang konsisten dari 2002 hingga 2019 (BKKBN, 2019). Dominasi kehamilan tidak diinginkan terjadi pada kelompok usia berisiko tinggi (56% kasus) (BKKBN, 2012, 2017) dan cenderung lebih banyak ditemukan di perkotaan Indonesia. Salah satu faktor yang mempengaruhi terjadinya kehamilan tidak diinginkan yaitu penggunaan kontrasepsi modern. Penelitian ini dilakukan untuk melihat besar hubungan yang terjadi antara penggunaan kontrasepsi modern dengan kejadian kehamilan tidak diinginkan pada wanita kelompok usia berisiko tinggi di wilayah perkotaan dan pedesaan Indonesia. Desain studi pada penelitian ini merupakan cross sectional dengan analisis menggunakan chi square dan regresi logistik. Data yang digunakan merupakan data SDKI 2017. Hasil analisis menunjukkan bahwa wanita usia risiko tinggi di wilayah perkotaan Indonesia yang tidak menggunakan kontrasepsi memiliki risiko yang lebih rendah untuk mengalami kehamilan tidak diinginkan (OR: 0.76; 95% CI: 0.588-0.977). Sedangkan wanita usia risiko tinggi di wilayah pedesaan Indonesia yang tidak menggunakan kontrasepsi memiliki risiko yang lebih tinggi untuk mengalami kehamilan tidak diinginkan (OR: 1.66 95% CI: 1.035-2.648).
Unintended pregnancies in Indonesia have not shown consistent changes from 2002 to 2019 (BKKBN, 2019). In addition, unintended pregnancies mostly occur in the high-risk age group (56% of cases) (BKKBN, 2012, 2017). One of the factor that can influence incident of unintended pregnancy is the use of modern contraception. In Indonesia unintended pregnancies tend to be more common in urban areas. This research was conducted to see the relationship between modern contraception use and the incidence of unintended pregnancies in women in high-risk age groups in urban and rural areas of Indonesia. The study design in this research is cross sectional and data will be conducted with chi square and logistic regression. The data used in this research is the 2017 IDHS. The results show that women of high risk age in urban areas of Indonesia who do not use contraception have a lower risk of experiencing unwanted pregnancy (OR: 0.76; 95% CI: 0.588-0.977). Meanwhile, women of high risk age in rural areas of Indonesia who do not use contraception have a higher risk of experiencing unwanted pregnancy (OR: 1.66 95% CI: 1.035-2.648).
Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan antara pemeriksaan kehamilan dengan kejadian komplikasi persalinan.
Metode: Penelitian ini menggunakan desain cross-sectional dengan menganalisis data Survei Demografi Kesehatan Indonesia tahun 2017. Sampel pada penelitian ini ialah 18.765 wanita usia 15-49 tahun yang melahirkan anak terakhir baik lahir hidup maupun lahir mati selama 5 tahun terakhir. Analisis multivariat menggunakan uji regresi cox untuk mengetahui besaran risiko pemeriksaan kehamilan dengan kejadian komplikasi persalinan.
Hasil: Dari hasil analisis diperoleh bahwa terdapat 21,1% wanita mengalami 3 dari 6 gejala komplikasi persalinan dan kejadian komplikasi persalinan yang paling banyak terjadi pada ibu yang tidak melakukan kunjungan pemeriksaan antenatal (ANC) secara lengkap dan tidak mendapatkan layanan 7T sebesar, yakni 28,9%. Wanita Usia Subur (WUS) yang melakukan kunjungan ANC secara lengkap dan tidak mendapatkan layanan 7T berisiko 1,19 kali untuk mengalami kejadian komplikasi persalinan, WUS yang tidak melakukan kunjungan ANC secara lengkap dan mendapatkan layanan 7T memiliki besaran risiko yang sama untuk mengalami kejadian komplikasi persalinan dan WUS yang tidak melakukan kunjungan ANC secara lengkap berisiko 1,43 kali untuk mengalami kejadian komplikasi persalinan setelah melakukan kontrol terhadap variabel penolong persalinan, riwayat ibu bersalin dan variabel interaksi.
Kesimpulan: Penelitian ini mengimplikasikan ibu yang tidak melakukan kunjungan ANC secara lengkap dan tidak mendapatkan layanan 7T dapat meningkatkan risiko mengalami kejadian komplikasi persalinan.
Kata Kunci: Komplikasi persalinan, pemeriksaan kehamilan, kunjungan ANC dan layanan 7T
Introduction: Indonesia is the country with the second highest maternal mortality rate in Southeast Asia which is directly related to the incidence of labor complications. Pregnancy is marked as the most vulnerable period which can increase the risk of labor complications.
Objective: This study aims to determine the relationship between antenatal care with the incidence of labor complications.
Method: This study used a cross-sectional design by analyzing data from Indonesian Health Demographic Survey 2017. The sample in this study was 18,765 women aged 15- 49 who gave birth to the last child, both live and stillbirth during the last 5 years. Multivariate analysis using cox regression test to determine the magnitude of the risk of antenatal care with the incidence of childbirth complications.
Results: From the analysis, there were 21.1% of women experiencing 3 of the 6 symptoms of childbirth complications and the most frequent occurrence of labor complications in mothers who did not have complete antenatal care (ANC) visit and did not get 7T services of 28 9%. Fertile Age Women who make a complete ANC visit and do not get 7T services have a risk of 1.19 times to experience the incidence of labor complications, WUS who do not complete the ANC visit and get 7T services have the same magnitude of risk for experiencing the incidence of labor complications and WUS who did not make a complete ANC visit had a risk of 1.43 times to experience the incidence of labor complications after controlling for the birth attendants, maternal history and interaction variable.
Conclusion: This study implies that mothers who did not complete ANC visits and did not receive 7T services could increase the risk of experiencing labor complications.
Key words: Labor complications, antenatal care, ANC visits and 7T services
Kata kunci: kehamilan tidak diinginkan, kematian neonatal, faktor risiko, perdesaan, perkotaan
This study discusses the effect of unwanted pregnancies towards neonatal mortality. The purpose of this study is to determine how unwanted pregnancy affecting the risk of neonatal mortality and the dominant risk factors for neonatal death among women at risk of childbirth considering their residence, rural and urban areas. The study design of this research is a cross sectional with multivariable logistic regression analysis using IDHS 2017. The number of research subject used in this study were 1618 live births in urban areas and 1645 live births in rural areas among women at risk of childbirth population. The results showed that unwanted pregnancy was not statistically associated to neonatal mortality both in urban and rural area. The results of the bivariate analysis showed that the variable which statistically associated to neonatal mortality both in urban and rural area is low birth weight (lbw) (purban=0,001; prural=0,002). Even After the unwanted pregnancy variables were being controlled by other variables using regression logistic analysis, it remains unrelated and does not increase the risk of neonatal mortality both in urban and rural areas. In urban area, multivariable analysis results show risk factors for neonatal mortality are lbw (OR = 10.14), low education (OR = 2.67), parity 2-3 (OR = 8.4), and parity> 3 (OR = 32). In rural area, the risk factors for neonatal death are lbw (OR = 11), antenatal care 3 births for urban area and lbw for rural area. It can be concluded that unwanted pregnancy is not directly associated to neonatal mortality. However, previous studies have explained there are changes in maternal behavior towards inappropriate pregnancy care. Risk factors for neonatal death vary according to types of residence, urban and rural area.
Keywords: unwanted pregnancy, neonatal mortality, risk factors, rural, urban
