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Kematian neonatal dini merupakan penyumbang kematian bayi dan perinatal yang merupakan indikator derajat kesejahteraan dan kesehatan bangsa. Angka kematian bayi dan perinatal di Indonesia masih tergolong tinggi dibanding negara Asia lainnya. Komplikasi kehamilan diduga menjadi faktor kuat kematian neonatal dini. Penelitian bertujuan untuk mengetahui seberapa besar pengaruh adanya komplikasi kehamilan dan setiap jenis komplikasi kehamilan serta ingin mengetahui PAR (Population Attributle Risk) terhadap kematian neonatal dini di Indonesia pada anak yang lahir 2002-2007 terhadap kematian neonatal dini setelah dikendalikan seluruh confounding. Desain studi yang digunakan dalam penelitian ini adalah crossectional dengan analisis multivariat complex sample cox regression. Sampel penelitiansebanyak 13893 dari 33 provinsi Indonesia yang diambil dengan metode Stratified two-stage cluster design.
Hasil analisis menunjukkan komplikasi kehamilan terhadap kematian neonatal dini dimodifikasi oleh berat lahir. Peneliti membuat dua model untuk membuktikan pengaruh komplikasi kehamilan terhadap kematian neonatal dini. Pada model pertama, PR komplikasi kehamilan terhadap kematian neonatal dini pada strata berat lahir <2000 gram sebesar 28,74 (95%CI: 10,21-81,02) PAR 13,92%, pada stratum ≥2000 gram sebesar PR 1,03 (95%CI: 0,32-3,34) PAR 11,94%. Pada model kedua, PR prematuritas memiliki risiko tertinggi PR 3,98 (95%CI 1,36-11,63) dengan PAR 8,1%. Diharapkan pemerintah dan masyarakat dapat berperan aktif dalam penurunan dan penanggulangan komplikasi kehamilan sedini mungkin dengan Antenatal care.
Early neonatal death is a contributor to infant and perinatal mortality that is an indicator of well-being and health degree in the nation. Infant and perinatal mortality rate in Indonesia is still higher than other Asian countries. Complications during pregnancy may be a strong factor of early neonatal death. This study want to determine how much influence and PAR of complication during pregnancy to early neonatal death in Indonesia after adjusted all confounding. This study used the cross-sectional design study with complex samples cox regression to multivariat analysis. There were 13893 respondents from 33 provinces in Indonesia were taken by stratified two-stage cluster sample technique.
The Results indicated that there are effect modification of Complication during pregnancy and birth weight to early neonatal death. This study created 2fixed models in multivariat analysis. In the first model, PR complication during pregnancy with birth weight <2000 gr 28,74(95%CI 10,21-81,02) PAR 13,92, complication during pregnancy with birth weight ≥2000 gr PR 1,03 (95%CI 0,32-3,34) PAR 11,94. In third model, only proven premature has significant to be early neonatal death risk with PR 3,98 (95%CI 1,36-11,63) PAR 8,1%. Health ministry and public can improve efectiveness of ANC to reduce complication during pregnancy and premature.
ABSTRAK Status kesehatan bayi merupakan salah satu indikator yang sensitif untuk menilai kesehatan masyarakat di suatu negara. Penilaian derajat kesehatan masyarakat dapat dilakukan dengan melihat beberapa indikator yang tercermin dalam kondisi morbiditas, mortalitas dan status gizi. Derajat kesehatan masyarakat di Indonesia digambarkan melalui Angka Kematian Bayi (AKB), Angka Kematian Balita (AKABA) dan Angka Kematian Ibu (AKI). Beberapa penelitian telah menunjukkan bahwa lebih dari 50% kematian bayi terjadi dalam periode neonatal, yaitu 0-28 hari pertama kehidupan. Data SDKI menunjukkan angka kematian neonatal dari tahun 1993-1997 sebesar 25 menjadi 20 per 1.000 kelahiran pada tahun 1998-2002, dan kemudian pada tahun 2003-2007 Angka Kematian Neonatal (AKN) menjadi 19 per 1.000 kelahiran (BKKBN dkk, 1997, 2003, 2007). Penelitian ini bertujuan untuk mengetahui hubungan jumlah anak yang dilahirkan dengan kejadian kematian neonatal berdasarkan data SDKI Tahun 2007. Penelitian dilakukan dengan desain cross sectional menggunakan data SDKI Tahun 2007 dengan sampel sebanyak 15.273. analisis multivariat menggunakan Logistic Regression. Hasil penelitian menunjukkan bahwa hubungan jumlah anak yang dilahirkan terhadap kejadian kematian neonatal dipengaruhi oleh tingkat pendidikan, jarak lahir, kunjungan ANC, tempat persalinan, riwayat operasi saesar dan jenis kelamin. Diketahui nilai POR sebesar 2,314 (95% CI : 1,122-4,7722) artinya ibu dengan jumlah anak yang dilahirkan 1 dan ≥ 4 memiliki risiko 2,314 kali untuk terjadinya kematian neonatal dibandingkan ibu yang memiliki jumlah anak yang dilahirkan 2-3 setelah dikontrol oleh tingkat pendidikan, jarak lahir, kunjungan ANC, tempat persalinan, operasi saesar dan jenis kelamin.
ABSTRACT Health status of infant is one sensitive indicator to assess the public health in a country. Public health status assessment can be done by looking at some indicators that reflected in the condition of morbidity, mortality and nutritional status. Public health in Indonesia is illustrated by infant mortality Rate (IMR), Child Mortality Rate (CMR) and Maternal Mortality Rate (MMR). Several studies have shown that more than 50% of infant deaths occur in the neonatal period, that is the first 0-28 days of life. IDHS data shows that neonatal mortality rate from year 1993-1997 is 25 to 20 per 1.000 live births in 1998-2002 and Neonatal Mortality Rate (NMR) is 19 per 1.000 births in 2003-2007 (BKKBN et al, 1997, 2003, 2007). This study aims to know the relationship of parity with neonatal mortality events based on IDHS data 2007. This study is done by using cross-sectional design using and taking the IDHS data 2007 with the samples of 15.273. in analysis of multivariate, it uses Logistic Regression. The results show that the relationship of parity with neonatal mortality events are influenced by education level, birth spacing, ANC visiting, childbirth place, caesar operating history and gender. The value of POR known that is 2,314 (95% CI: 1,122 to 4,7722), it means that mother and parity 1 and ≥ 4 who have 2,314 times the risks for the occurrence of neonatal death than mother who has parity 2- 3 after controlled by education level, birth spacing, ANC visiting, childbirth place, Caesar operating and gender.
Unmet need KB adalah pasangan usia subur yang tidak ingin punya anak tapi tidak menggunakan alat kontrasepsi. Unmet need KB merupakan salah satu indikator yang menggarnbarkan pelayanan KB dan merupakan salah satu capaian MDGs 2015. SDK! 2007 menunjukkan unmet need KB sebesar 9,1 persen, sedangkan SDKI 2002-2003 menunjukkan 8,6 persen. Di Indonesia, sejak 12 tahun terakhir unmet need KB stagnan di 9 persen sehfngga merupakan masalah lain yang perlu diatasi Peneiitian ini bertujuan untuk melakukan pengujian empiris untuk mengetahui faktor-faktor yang berhubungab dengan unmet need K.B. Penelitlan ini merupakan penelitian cross sectional dengan menggunakan data sekunder mengenai faktor-faktor yang berhubungan dengan unmet need KB. Jumlah sampel untuk melihat Unmet need KB Nasional adall1h seluruh PUS usia 1549 tahun yang meniklth yang terdapat dalam SDK! 2007. Sedangksn sampel untuk studi ini tidak termasuk mereka yang contraceptive failure, desire birth
Unmet need for family planning are couples of childbearing age who do not want to have children but do not use contraceptives. Unmet need for family planning are one of the indicators that describe family planning services and is one of the achievements of MDGs. IDHS 2007 showed unmet need for family planning of 9.1 percent, while the 2002-2003 IDHS shows 8.6 percent. In Indonesia, since last 12 years unmet need for family planning stagnant at 9 percent so that is another issue that needs to be addressed. This study aims to conduct empirical tests to determine the factors associated with unmet need family planning. This study is a cross sectional study using secondary data about the factors associated with unmet need for family planning. The number of are married couples at child bearing period, aged 15-49 years who married as stared in IDHS 2007. While the sample for !his study does not include contraceptive failure, desire birth
Coverage of modern contraceptive use in Indonesia increased from year to year.However, the scope of the use of long acting contraceptive system (LACS) is still farfrom the expected target. Based on previous study found that high-risk groups arelikely to use modern contraception. This study aimed to analyze the effect of high-riskbirths with the use of modern contraceptives, especially long acting contraceptivesystem (LACS) and determine other factors that have a value of interventions towardshigh-risk births variable relationship with the use of modern contraceptives. This studyused cross sectional design with IDHS 2007 and 2012. The sample in this study werewomen of reproductive age (15-49 years) who had delivered a maximum of 5 yearsprior to the survey. The results showed that the prevalence of high risk of 30.45%,10.96% double high risk and 19,49 single high risk. The prevalence of moderncontraceptive use by 68% and the most widely used injection method. While theprevalence of the use of LACS was 8.73% and the most widely used method of IUD.A history of high-risk births do not increase the probability of modern contraceptiveuse overall [PR 0.84; 95% CI: 0.817 - 0.861]. There are considerable opportunities touse the LACS for those who have a history of high-risk multiple births either in thewhole population [PR: 1.90; 95% CI: 1.65 - 2.13] and in a population of moderncontraceptive users [PR: 1,46; 95% CI: 1.29 to 1.64]. Population using moderncontraceptives, the biggest opportunity to use the LACS when high-risk mothers doANC at clinic midwife and deliver at the maternity hospital (RB) level health centers.Therefore, it is advisable to increase the education, promotion and counselingespecially to women of reproductive age who already have a history of delivering witha high risk in order to prevent the risk births.Keywords: Women of Reproductive Age, High-risk births, modern contraceptive,LACS, IDHS 2007 and 2012
Coverage of modern contraceptive use in Indonesia increased from year to year.However, the scope of the use of long acting contraceptive system (LACS) is still farfrom the expected target. Based on previous study found that high-risk groups arelikely to use modern contraception. This study aimed to analyze the effect of high-riskbirths with the use of modern contraceptives, especially long acting contraceptivesystem (LACS) and determine other factors that have a value of interventions towardshigh-risk births variable relationship with the use of modern contraceptives. This studyused cross sectional design with IDHS 2007 and 2012. The sample in this study werewomen of reproductive age (15-49 years) who had delivered a maximum of 5 yearsprior to the survey. The results showed that the prevalence of high risk of 30.45%,10.96% double high risk and 19,49 single high risk. The prevalence of moderncontraceptive use by 68% and the most widely used injection method. While theprevalence of the use of LACS was 8.73% and the most widely used method of IUD.A history of high-risk births do not increase the probability of modern contraceptiveuse overall [PR 0.84; 95% CI: 0.817 - 0.861]. There are considerable opportunities touse the LACS for those who have a history of high-risk multiple births either in thewhole population [PR: 1.90; 95% CI: 1.65 - 2.13] and in a population of moderncontraceptive users [PR: 1,46; 95% CI: 1.29 to 1.64]. Population using moderncontraceptives, the biggest opportunity to use the LACS when high-risk mothers doANC at clinic midwife and deliver at the maternity hospital (RB) level health centers.Therefore, it is advisable to increase the education, promotion and counselingespecially to women of reproductive age who already have a history of delivering witha high risk in order to prevent the risk births.Keywords: Women of Reproductive Age, High-risk births, modern contraceptive,LACS, IDHS 2007 and 2012