Urban-rural disparities of antenatal care in South East Asia: a case study in the Philippines and Indonesia

Wulandari R.D., Laksono A.D., Rohmah N.

Faculty of Public Health, Universitas Airlangga Surabaya, Campus C Mulyorejo, Surabaya, 60115, Indonesia; National Institute of Health Research and Development of The Ministry of Health of the Republic of Indonesia, Percetakan Negara 29, Jakarta, 10560, Indonesia; Faculty of Health Science, Muhammadiyah University of Jember, Gumuk Kerang, Karangrejo, Kec. Sumbersari, Jawa Timur, Kabupaten Jember, East Java 68124, Indonesia


Abstract

Background: The government is obliged to guarantee equal access to antenatal care (ANC) between urban and rural areas. This study aimed to analyze urban-rural disparities in ≥4 ANC visits during pregnancy in the Philippines and Indonesia. Methods: The study processed data from the 2017 PDHS and the 2017 IDHS. The analysis unit was women aged 15–49 years old who had given birth in the last 5 years. The weighted sample size was 7992 respondents in the Philippines and 14,568 respondents in Indonesia. Apart from ANC as the dependent variable, other variables analyzed were residence, age, husband/partner, education, parity, and wealth. Determination of urban-rural disparities using binary logistic regression. Results: The results show that women in the urban Philippines are 0.932 times more likely than women in the rural Philippines to make ≥4 ANC visits. On the other side, women in urban Indonesia are more likely 1.255 times than women in rural Indonesia to make ≥4 ANC visits. Apart from the type of residence place (urban-rural), five other tested multivariate variables also proved significant contributions to ANC’s use in both countries, i.e., age, have a husband/partner, education, parity, and wealth status. Conclusions: The study concluded that disparities exist between urban and rural areas utilizing ANC in the Philippines and Indonesia. Pregnant women in the rural Philippines have a better chance of making ≥4 ANC visits. Meanwhile, pregnant women in urban Indonesia have a better chance of making ≥4 ANC visits. © 2021, The Author(s).

Antenatal care; Disparity; Mother and child health; Southeast Asia; Urban-rural


Journal

BMC Public Health

Publisher: BioMed Central Ltd

Volume 21, Issue 1, Art No 1221, Page – , Page Count


Journal Link: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85108834692&doi=10.1186%2fs12889-021-11318-2&partnerID=40&md5=47819fddfd890c83d786860cd6c77b49

doi: 10.1186/s12889-021-11318-2

Issn: 14712458

Type: All Open Access, Gold, Green


References

Maternal and Neonatal Death in Indonesia (Kematian Maternal dan Neonatal di Indonesia) (2019) Rakerkernas 2019, 1, pp. 1-47; (2019) Maternal mortality, , World Health Organization, Geneva; Wulandari, R.D., Laksono, A.D., Determinants of knowledge of pregnancy danger signs in Indonesia (2020) PLoS ONE, 15 (5); (2020) Maternal mortality ratio (modeled estimate, per 100,000 live births), , https://data.worldbank.org/indicator/SH.STA.MMRT; (2020) Philippines – Maternal Mortality Ratio, , Manila, World Data Atlas Philippines Health; Abdulcadir, J., Rodriguez, M.I., Say, L., Research gaps in the care of women with female genital mutilation: An analysis (2015) BJOG, , https://doi.org/10.1111/1471-0528.13217; (2019) Maternal Mortality: World Health Organization, , https://www.who.int/news-room/fact-sheets/detail/maternal-mortality, Retrieved from; Bomela, N.J., Maternal mortality by socio-demographic characteristics and cause of death in South Africa: 2007-2015 (2020) BMC Public Health, 20 (1), pp. 1-20; Sageer, R., Kongnyuy, E., Adebimpe, W.O., Omosehin, O., Ogunsola, E.A., Sanni, B., Causes and contributory factors of maternal mortality: evidence from maternal and perinatal death surveillance and response in Ogun state, Southwest Nigeria (2019) BMC Pregnancy Childbirth, 19 (1), pp. 1-8; Sungkar, A., Surya, R., Antenatal Care for High Risk Pregnancy (2020) Cermin Dunia Kedokteran, 47 (10), pp. 731-733; (2016) WHO recommendation on antenatal care contact schedules, , WHO Reproductive Health Library, Geneva: Retrieved from https://extranet.who.int/rhl/topics/improving-health-system-performance/who-recommendation-antenatal-care-contact-schedules#:~:text=With the FANC model%2C the,if they experience danger signs; Laksono, A.D., Rukmini, R., Wulandari, R.D., Regional disparities in antenatal care utilization in Indonesia (2020) PLoS One, 15 (2); Wulandari, R.D., Putri, N.K., Laksono, A.D., Socioeconomic disparities in antenatal care utilisation in urban Indonesia (2020) Int J Innov Creat Change, 14 (2), pp. 498-514; Laksono, A.D., Wulandari, R.D., Lina, M., Kumalasari, F., (2020) Socioeconomic difference of husband ’ s involvement in antenatal Care in Rural Indonesia, pp. 1-12. , Research Square, Nopember; Ashar, H., Latifah, L., Kusrini, I., Tjandrarini, D.H., Relationship between antenatal care and pregnancy classes with selection of place and birth attendant in Indonesia (Hubungan antenatal care dan kelas kehamilan dengan pemilihan tempat dan penolong persalinan di Indonesia) (2019) Jurnal Kedokteran dan Kesehatan Indonesia, 10 (3), pp. 271-280; Bobo, F.T.F.T., Yesuf, E.A.E.A., Woldie, M., Inequities in utilization of reproductive and maternal health services in Ethiopia (2017) Int J Equity Health, 16 (1), p. 105; Babalola, B.I., Determinants of urban-rural differentials of antenatal care utilization in Nigeria (2014) Etude de la Population Africaine, 28 (3), pp. 1263-1273; Laksono, A.D., Wulandari, R.D., Urban-rural disparities of facility-based childbirth in Indonesia (2020) 4th international symposium on Health Research (ISHR 2019), pp. 33-39. , Atlantis Press, Denpasar; Baroma, R.S., (2018) Equity of access to maternal health care in the; Siramaneerat, I., Agushybana, F., Meebunmak, Y., Maternal risk factors associated with low birth weight in Indonesia (2018) Open Public Health J, 11 (1), pp. 376-383; Clavagnier, I., Antenatal care (2012) Revue de l’infirmière, pp. 45-46; The public health importance of antenatal care (2015) Fact Views Vision ObGyn, 7 (1), pp. 5-6; Basic Antenatal Care Approach to Antenatal Care Service Provision (2019) Selected Topics in Midwifery Care, 1, pp. 1-15; (2018) Philippine Statistics Authority and the DHS Program. Philippines National Demographic and Health Survey 2017. Quezon City: Philippine Statistics Authority (PSA) and ICF; (2018) The DHS Program. The, 2017. , https://www.dhsprogram.com/pubs/pdf/FR342/FR342.pdf, Indonesia Demographic and Health Survey. Jakarta, Retrieved from; Wulandari, R.D., Qomarrudin, M.B., Supriyanto, S., Laksono, A.D., Socioeconomic disparities in hospital utilization among elderly people in Indonesia (2019) Indian J Public Health Res Dev, 10 (11), pp. 1800-1804; National Population and Family Planning Board, Statistics Indonesia, Ministry of Health, & The DHS Program. Indonesia demographic and health survey 2017. Jakarta: National Population and Family Planning Board (BKKBN), Statistics Indonesia (BPS), Ministry of Health (Kemenkes), and ICF; 2018; Laksono, A.D., Wulandari, R.D., Soedirham, O., Urban and rural disparities in hospital utilization among Indonesian adults (2019) Iran J Public Health, 48 (2), pp. 247-255; Li, J., Shi, L., Liang, H., Ding, G., Xu, L., Urban-rural disparities in health care utilization among Chinese adults from 1993 to 2011 (2018) BMC Health Serv Res, 18 (102), pp. 1-9; Seran, A.A., Laksono, A.D., Sujoso, A.D.P., Masruroh, I., I., Marasabessy, N. baharia, … Adriyani, R (2020) Does Contraception Used Better in Urban Areas?: An Analysis of the 2017 IDHS (Indonesia Demographic and Health Survey). Syst Rev Pharmacy, 11 (11), pp. 1892-1897. , https://doi.org/10.31838/srp.2020.11.266; El-Khatib, Z., Odusina, E.K., Ghose, B., Yaya, S., Patterns and predictors of insufficient antenatal care utilization in Nigeria over a decade: a pooled data analysis using demographic and health surveys (2020) Int J Environ Res Public Health, 17 (21), pp. 1-14; Shibre, G., Zegeye, B., Idriss-Wheeler, D., Ahinkorah, B.O., Oladimeji, O., Yaya, S., Socioeconomic and geographic variations in antenatal care coverage in Angola: further analysis of the 2015 demographic and health survey (2020) BMC Public Health, 20 (1), p. 1423; Sarker, B.K., Rahman, M., Rahman, T., Rahman, T., Khalil, J.J., Hasan, M., Rahman, F., Rahman, A., Status of the WHO recommended timing and frequency of antenatal care visits in northern Bangladesh (2020) PLoS ONE, 15 (11); Langa, N., Bhatta, T., The rural-urban divide in Tanzania: residential context and socioeconomic inequalities in maternal health care utilization (2020) PLoS ONE, 15 (11); Perez, A., Pagatpatan, C., Incentivizing (and disincentivizing) mothers to utilize maternal health services: a focus group study (2020) Philipp J Nurs, 90 (1), pp. 27-35; Ngaya-An, F.V., Fowler, C., The role of ayod community health teams in promoting maternal and infant health in a municipality in Ifugao, Philippines (2014) Acta Med Philippina, 48 (4), pp. 47-52; Hattar-Pollara, M., Barriers to education of Syrian refugee girls in Jordan: gender-based threats and challenges (2019) J Nurs Scholarsh, 51 (3), pp. 241-251; Dey, A., Hay, K., Afroz, B., Chandurkar, D., Singh, K., Dehingia, N., Raj, A., Silverman, J.G., Understanding intersections of social determinants of maternal healthcare utilization in Uttar Pradesh, India (2018) PLoS ONE, 13 (10); Chanda, S.K., Ahammed, B., Howlader, M.H., Ashikuzzaman, M., Shovo, T.-E.-A., Hossain, M.T., Factors associating different antenatal care contacts of women: a cross-sectional analysis of Bangladesh demographic and health survey 2014 data (2020) PLoS One, 15 (4); Okedo-Alex, I.N., Akamike, I.C., Ezeanosike, O.B., Uneke, C.J., Determinants of antenatal care utilisation in sub-Saharan Africa: a systematic review (2019) BMJ Open, 9 (10); Rurangirwa, A.A., Mogren, I., Nyirazinyoye, L., Ntaganira, J., Krantz, G., Determinants of poor utilization of antenatal care services among recently delivered women in Rwanda; a population based study (2017) BMC Pregnancy Childbirth, 17 (1), p. 142; Sumankuuro, J., Mahama, M.Y., Crockett, J., Wang, S., Young, J., Narratives on why pregnant women delay seeking maternal health care during delivery and obstetric complications in rural Ghana (2019) BMC Pregnancy Childbirth, 19 (1), p. 260; Jungari, S., Paswan, B., What he knows about her and how it affects her? Husband’s knowledge of pregnancy complications and maternal health care utilization among tribal population in Maharashtra, India (2019) BMC Pregnancy Childbirth, 19 (1), p. 70; Sakuma, S., Yasuoka, J., Phongluxa, K., Jimba, M., Determinants of continuum of care for maternal, newborn, and child health services in rural Khammouane, Lao PDR (2019) PLoS ONE, 14 (4); Ahmed, S., Jafri, H., Rashid, Y., Yi, H., Dong, D., Zhu, J., Ahmed, M., Autonomous decision-making for antenatal screening in Pakistan: views held by women, men and health professionals in a low–middle income country (2019) Eur J Hum Genet, 27 (6), pp. 848-856; Oguntunde, O., Nyenwa, J., Yusuf, F.M., Dauda, D.S., Salihu, A., Sinai, I., Factors associated with knowledge of obstetric danger signs and perceptions of the need for obstetric care among married men in northern Nigeria: a cross-sectional survey (2019) BMC Pregnancy Childbirth, 19 (1), p. 123; Wulandari, R.D., Laksono, A.D., Education as predictor of the knowledge of pregnancy danger signs in rural Indonesia (2020) Int J Innov Creat Change, 13 (1), pp. 1037-1051; Påfs, J., Musafili, A., Binder-Finnema, P., Klingberg-Allvin, M., Rulisa, S., Essén, B., Beyond the numbers of maternal near-miss in Rwanda – a qualitative study on women’s perspectives on access and experiences of care in early and late stage of pregnancy (2016) BMC Pregnancy Childbirth, 16 (1), p. 257; Megatsari, H., Laksono, A.D., Ridlo, I.A., Yoto, M., Azizah, A.N., Community perspective about health services access (2018) Bull Health Syst Res, 21, pp. 247-253; Islam, M.A., Kabir, M.R., Talukder, A., Triggering factors associated with the utilization of antenatal care visits in Bangladesh: An application of negative binomial regression model (2020) Clin Epidemiol Global Health, 8 (4), pp. 1297-1301; Wairoto, K.G., Joseph, N.K., Macharia, P.M., Okiro, E.A., Determinants of subnational disparities in antenatal care utilisation: a spatial analysis of demographic and health survey data in Kenya (2020) BMC Health Services Research, 20 (1), p. 665; Emiru, A.A., Alene, G.D., Debelew, G.T., Individual, household, and contextual factors influencing the timing of the first antenatal care attendance in Northwest Ethiopia: a two-level binary logistic regression analysis (2020) Int J Womens Health, 12, pp. 463-471; Megatsari, H., Laksono, A.D., Ibad, M., Herwanto, Y.T., Sarweni, K.P., Geno, R.A.P., Nugraheni, E., The community psychosocial burden during the COVID-19 pandemic in Indonesia (2020) Heliyon, 6 (10); Ipa, M., Widawati, M., Laksono, A.D., Kusrini, I., Dhewantara, P.W., Variation of preventive practices and its association with malaria infection in eastern Indonesia: findings from community-based survey (2020) PLoS One, 15 (5); Laksono, A.D., Wulandari, R.D., The barrier to maternity Care in Rural Indonesia (2020) J Public Health, , https://doi.org/10.1007/s10389-020-01274-3; Rohmah, N., Yusuf, A., Hargono, R., Laksono, A.D., Masruroh, I., Walid, S., Determinants of teenage pregnancy in Indonesia (2020) Indian J Forensic Med Toxicol, 14 (3), pp. 2080-2085; Jardine, J., Blotkamp, A., Gurol-Urganci, I., Knight, H., Harris, T., Hawdon, J., van der Meulen, J., Pasupathy, D., Risk of complicated birth at term in nulliparous and multiparous women using routinely collected maternity data in England: cohort study (2020) BMJ, 371, p. m3377; You, H., Yu, T., Gu, H., Kou, Y., Xu, X.-P., Li, X.-L., Cui, N., Bai, L., (2019) Factors associated with prescribed antenatal care utilization: a cross-sectional study in eastern rural china, p. 56. , Inquiry, United States; Tikmani, S.S., Ali, S.A., Saleem, S., Bann, C.M., Mwenechanya, M., Carlo, W.A., Figueroa, L., Goldenberg, R.L., Trends of antenatal care during pregnancy in low- and middle-income countries: findings from the global network maternal and newborn health registry (2019) Semin Perinatol, 43 (5), pp. 297-307; Mumtaz, S., Bahk, J., Khang, Y.-H., Current status and determinants of maternal healthcare utilization in Afghanistan: analysis from Afghanistan demographic and health survey 2015 (2019) PLoS ONE, 14 (6); Konlan, K.D., Saah, J.A., Amoah, R.M., Doat, A.R., Mohammed, I., Abdulai, J.A., Konlan, K.D., Factors influencing the utilization of focused antenatal care services during pregnancy, a study among postnatal women in a tertiary healthcare facility, Ghana (2020) Nursing Open, 7 (6), pp. 1822-1832; Yaya, S., Da, F., Wang, R., Tang, S., Ghose, B., Maternal healthcare insurance ownership and service utilisation in Ghana: analysis of Ghana demographic and health survey (2019) PLoS One, 14 (4), pp. 1-13; Zakar, R., Zakar, M.Z., Aqil, N., Chaudhry, A., Nasrullah, M., Determinants of maternal health care services utilization in Pakistan: evidence from Pakistan demographic and health survey, 2012–13 (2017) J Obstet Gynaecol, 37 (3), pp. 330-337; Olaitan, T., Okafor, I.P., Onajole, A.T., Abosede, O.A., Ending preventable maternal and child deaths in western Nigeria: do women utilize the life lines? (2017) PLoS ONE, 12 (5); Wilson, M., Patterson, K., Nkalubo, J., Lwasa, S., Namanya, D., Twesigomwe, S., Anyango, J., Assessing the determinants of antenatal care adherence for indigenous and non-indigenous women in southwestern Uganda (2019) Midwifery, 78, pp. 16-24; Atuhaire, R., Atuhaire, L.K., Wamala, R., Nansubuga, E., Interrelationships between early antenatal care, health facility delivery and early postnatal care among women in Uganda: a structural equation analysis (2020) Global Health Action, 13 (1), p. 1830463; Mulondo, S.A., Factors associated with underutilisation of antenatal care services in Limpopo, South Africa (2020) Br J Midwifery, 28 (11), pp. 788-795; Pratiwi, N.L., Fitrianti, Y., Nuraini, S., Rachmawati, T., Laksono, A.D., Afreni, M., Concealed pregnant women or Kemel of Gayo ethnic in Blang Pegayon District, Gayo Lues District, Aceh (2019) Bull Health Syst Res, 22 (2), pp. 81-90; Laksono, A.D., Soerachman, R., Angkasawati, T.J., Case study of Muyu Ethnic’s maternal health in Mindiptara District-Boven Digoel (Studi Kasus Kesehatan maternal Suku Muyu di Distrik Mindiptana, Kabupaten Boven Digoel) (2016) J Reprod Health, 7 (3), pp. 145-155

Indexed by Scopus

Leave a Comment