Access to Health Services and Early Age Mortality in Ende, Indonesia
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Improvements in child survival to achieve Millennium Development Goal 4 require highly accessible and effective maternal and child health (MCH) services. This article seeks to fill the gap in information for local government in Indonesia about early age mortality and access to appropriate care to inform the evaluation and planning of MCH services.
The Ende Child Mortality Survey (ECMS) was conducted in the district of Ende in Nusa Tenggara Timur (NTT), one of the poorest provinces in Indonesia. The ECMS is a cross-sectional household survey, providing information on child survival, MCH service utilisation, and socio-economic characteristics of the population. Multivariate logistic regression was conducted to examine the association of mortality, health service utilisation and socio-economic variables.
Use of an unskilled birth attendant (45% of births) and giving birth at home are most common among the poorest and least educated women. The children of these women have the highest risk of infant mortality. The infant mortality rate differs greatly by region within Ende. Time to the preferred provider of child health care is longest in regions with the highest under-five mortality risk.
Many women in Ende do not receive vital interventions during labour to reduce infant mortality. The ECMS demonstrates the feasibility in implementing a low cost survey to provide evidence for MCH investments to improve accessibility to appropriate health services and reduce mortality risk.
- UN. The Millennium development goals report 2010. New York: United Nations; 2000.
- Jones G, Steketee RW, Black RE, Bhutta ZA, Morris SS, the Bellagio Child Survival Study Group. How many child deaths can we prevent this year? Lancet. 2003;362:65–71. CrossRef
- Burke L, Suswardany DL, Michener K, et al. Utility of local health registers in measuring perinatal mortality: A case study in rural Indonesia. BMC Pregnancy Childbirth. 2011;11:20. CrossRef
- Black RE, Cousens S, Johnson HL, et al. Global, regional and national causes of child mortality. Lancet. 2010;375:1969–87. CrossRef
- Gwatkin D, Rutstein S, Johnson K, Wagstaff A. Socio-economic differences in health, nutrition and population in Indonesia. Washington, DC: HNP/Poverty Thematic Group of the World Bank; 2003.
- BPS. Laporan bulanan: data sosial ekonomi, Februari 2011 (Monthly report: socio-economic data, February 2011), Edition 9. Jakarta: Badan Pusat Statistik; 2011.
- Statistics Indonesia, Macro International. Indonesia Demographic and Health Survey 2007. Calverton: BPS and Macro International; 2008.
- BPS, ORC Macro. Indonesia Demographic and Health Survey 2002–2003. Calverton: Badan Pusat Statistik-Statistics Indonesia and ORC Macro; 2003.
- Australia Indonesia Partnership. Australia Indonesia Partnership for Maternal and Neonatal Health (AIPMNH). Canberra: AusAID; 2011. http://www.aipmnh.org Date accessed: 23 February 2011.
- MEASURE DHS. Demographic and Health Surveys: about DHS. Calverton, MD: ICF Macro; 2011. http://www.measuredhs.com/aboutdhs/ Date accessed: 30 July, 2011
- Rutstein SO, Johnson K. The DHS wealth index. DHS Comparative Reports no. 6. Calverton: MEASSURE DHS; 2004.
- MEASURE DHS. Early childhood mortality rates. Calverton, MD: ICF Macro; 2011. http://www.measuredhs.com/help/Datasets/Methodology_of_DHS_Mortality_Rates_Estimation.htm Date accessed: 5 January 2011.
- Kirkwood B, Sterne J. Essential medical statistics. 2nd ed. Malden: Blackwell Science Ltd; 2003. pp. 237.
- Vittinghoff E, Glidden DV, Shiboksi SC, McCulloch CE. Regression methods in biostatistics: linear, logistic, survival, and repeated measures models. New York: Springer; 2005. pp. 312.
- Mosley WH, Chen LC. An analytical framework for the study of child survival in developing countries. Popul Dev Rev. 1984;10:25–45. CrossRef
- StataCorp. Stata 11. College Station: StataCorp; 2009.
- Bhutta ZA, Ahmed T, Black RE, et al. Maternal and child undernutrition: What works? Interventions to affect maternal and child undernutrition and survival globally. Lancet. 2008;371:417–40. CrossRef
- Niehof A. Mediating roles of the traditional birth attendant in Indonesia. In: van Bemmelen S, Djajadiningrat-Nieuwenhuis M, Locher-Scholten E, Touwen-Bouwsma E, eds. Women and Mediation in Indonesia. Leiden: KITLV Press; 1992. pp. 167–86.
- Caldwell JC. Education as a factor in mortality decline: An analysis of Nigerian data. Popul Stud. 1979;33:395–413. CrossRef
- Pebley AR, Goldman N, Rodriguez G. Prenatal and delivery care and childhood immunization in Guatemala: Do family and community matter? Demography. 1996;33:231–47. CrossRef
- de Souza AC Terra, Petersen KE, Andrade FMA, et al. Circumstances of post-neonatal deaths in Ceara, Northeast Brazil: Mothers’ health care-seeking behaviors during their infants’ fatal illness. Soc Sci Med. 2000;51:1675–93. CrossRef
- Kristiansen S, Santoso P. Surviving decentralisation? Impacts of regional autonomy on health service provision in Indonesia. Health Policy. 2006;77:247–59. CrossRef
- Thouw J. Delegation of obstetric care in Indonesia. Int J Gynecol Obstet. 1992;38:S45–7. CrossRef
- Black RE, Morris SS, Bryce J. Where and why are 10 million children dying every year? Lancet. 2003;361:2226–34. CrossRef
- Pelletier D. Relationship between child anthropometry and mortality in developing countries: implications for policy, programs and future research. J Nutr. 1993;124:2047–81.
- Shah NM, Shah MA. Socioeconomic and health care determinants of child survival in Kuwait. J Biosoc Sci. 1990;22:239–53. CrossRef
- Adair T. Child outpatient care utilisation in the mega-urban regions of Jabotabek, Bandung and Surabaya. J Population. 2006;12:21–57.
- Access to Health Services and Early Age Mortality in Ende, Indonesia
The Indian Journal of Pediatrics
Volume 79, Issue 5 , pp 612-618
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Infant mortality
- Socioeconomic factors
- Maternal-child health services
- Industry Sectors
- Author Affiliations
- 1. School of Population Health, University of Queensland, Public Health Building, Herston Rd, Herston, Brisbane, QLD 4006, Australia
- 2. National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia