Abstract
Aim
Working mothers are a group that tends to be independent in determining the ownership of health insurance, and this situation allegedly increased the utilization of cesarean deliveries among them. The study analyzes the role of health insurance in cesarean delivery among working mothers in Indonesia.
Subject and methods
The investigation employed secondary data from the 2017 Indonesia Demographic and Health Survey. The analysis included 7293 working moms who gave birth in the previous five years. The study used eight control factors in addition to delivery mode and health insurance ownership: the place of residence, age group, education level, marital status, parity, wealth status, antenatal care, and birth type. We applied the regression on binary logistics in the analysis.
Results
The results showed that working mothers with health insurance were 1.536 times more likely to have a cesarean delivery than uninsured women (AOR 1.536; 95% CI 1.324–1.781). Moreover, the study also found five control variables significantly related to cesarean delivery utilization among working mothers in Indonesia. The five were the place of residence, age group, education level, wealth status, and antenatal care visits.
Conclusion
The study concluded that health insurance had a role in cesarean delivery among working mothers in Indonesia. Insured working mothers were one and a half times more likely to have a cesarean delivery than uninsured working mothers.
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Data availability
The author cannot publicly share the data because a third party and the ICF who own it do not have permission to share it. The 2017 IDHS data set name requested from the ICF (data set of childbearing age women) is available from the ICF contact https://dhsprogram.com for researchers who meet the criteria for access to confidential data.
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Acknowledgements
The authors would like to thank ICF International, which agreed to allow the authors to analyze the 2017 IDHS data in this article.
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RDW and ADL developed a proposal and analyzed and interpreted the patient data. RM contributed significantly to conducting the study, interpreting the data, and writing the manuscript. NR contributed substantially to conducting the research, analyzing the data, and writing the manuscript. All authors read and approved the final manuscript.
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The study employed secondary data from the 2017 IDHS for a materials analysis. The survey erased all respondents’ identities from the 2017 IDHS dataset. Participants in this study provided written informed consent, and parental or legal guardian consent was sought before enrollment (under 16 years). For this study, the author was granted permission to use information from the website https://dhsprogram.com.
The Institutional Review Board of ICF International has approved the Demographic and Health Surveys Program (DHS-7) Standard survey protocol, which was also examined and approved by the ORC Macro IRB in 2002 before being used for the 2017 IDHS. The DHS-7 program approval document is provided and designates DHS surveys that adhere to the Standard as authorized. ICF International’s Institutional Review Board complied with the “Protection of Human Subjects” regulations set forth by the US Department of Health and Human Services (45 CFR 46).
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Wulandari, R.D., Laksono, A.D., Matahari, R. et al. The role of health insurance in cesarean delivery among working mothers in Indonesia. J Public Health (Berl.) (2024). https://doi.org/10.1007/s10389-024-02208-z
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DOI: https://doi.org/10.1007/s10389-024-02208-z