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INEQUITY ISSUES AND MOTHERS' PREGNANCY, DELIVERY AND EARLY-AGE SURVIVAL EXPERIENCES IN ENDE DISTRICT, INDONESIA

Published online by Cambridge University Press:  15 December 2014

JERICO FRANCISCUS PARDOSI ,
NICK PARR  and
SALUT MUHIDIN
JERICO FRANCISCUS PARDOSI*
Affiliation:
Department of Marketing and Management, Faculty of Business and Economics, Macquarie University, Sydney, Australia
NICK PARR
Affiliation:
Department of Marketing and Management, Faculty of Business and Economics, Macquarie University, Sydney, Australia
SALUT MUHIDIN
Affiliation:
Department of Marketing and Management, Faculty of Business and Economics, Macquarie University, Sydney, Australia
*
1Corresponding author. Email: Jerico.Pardosi@mq.edu.au
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Summary

Indonesia's infant mortality rates are among the highest in South-East Asia, and there are substantial variations between its sub-national regions. This qualitative study aims to explore early mortality-related health service provision and gender inequity issues based on mothers' pregnancy, delivery and early-age survival experience in Ende district, Nusa Tenggara Timur province. Thirty-two mothers aged 18–45 years with at least one birth in the previous five years were interviewed in depth in May 2013. The results show most mothers have little knowledge about the danger signs for a child's illness. Mothers with early-age deaths generally did not know the cause of death. Very few mothers had received adequate information on maternal and child health during their antenatal and postnatal visits to the health facility. Some mothers expressed a preference for using a traditional birth attendant, because of their ready availability and the more extensive range of support services they provide, compared with local midwives. Unprofessional attitudes displayed by midwives were reported by several mothers. As elsewhere in Indonesia, the power of health decision-making lies with the husband. Policies aimed at elevating mothers' roles in health care decision-making are discussed as measures that would help to improve early-age survival outcomes. Widening the public health insurance distribution, especially among poorer mothers, and equalizing the geographical distribution of midwives and health facilities are recommended to tackle geographical inequities and to increase early-age survival in Ende district.

Type
Articles
Information
Journal of Biosocial Science , Volume 47 , Issue 6 , November 2015 , pp. 780 - 802
Copyright
Copyright © Cambridge University Press 2014 

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References

Abu-Ghaida, D. & Klasen, S. (2004) The costs of missing the Millennium Development Goal on gender equity. World Development, 32(7), 1075–1107.Google Scholar
Adair, T., Pardosi, J., Rao, C., Kosen, S. & Tarigan, I. (2012) Access to health services and early-age mortality in Ende, Indonesia. Indian Journal of Pediatrics 79(5), 612–618.Google Scholar
Anggorodi, R. (2009) Dukun Bayi Dalam Persalinan Oleh Masyarakat Indonesia []. MAKARA of Health Series 13(1), 9–14.Google Scholar
Aune, I., Amundsen, H. H. & Skaget Aas, L. C. (2014) Is a midwife's continuous presence during childbirth a matter of course? Midwives' experiences and thoughts about factors that may influence their continuous support of women during labour. Midwifery 30(1), 89–95.Google Scholar
Beegle, K., Frankenberg, E. & Thomas, D. (2001) Bargaining power within couples and use of prenatal and delivery care in Indonesia. Studies in Family Planning 32(2), 130–146.Google Scholar
Connell, R. (2012) Gender, health and theory: conceptualizing the issue, in local and world perspective. Social Science & Medicine 74(11), 1675–1683.Google Scholar
Cui, Y., Zhang, Q., Yang, L., Ye, J. & Lv, M. (2010) Effect of married women's beliefs about gender equity on their use of prenatal and delivery care in rural China. International Journal of Gynecology & Obstetrics 111(2), 148–151.Google Scholar
Dahlberg, U. & Aune, I. (2013) The woman's birth experience – the effect of interpersonal relationships and continuity of care. Midwifery 29(4), 407–415.Google Scholar
D'Ambruoso, L., Achadi, E., Adisasmita, A., Izati, Y., Makowiecka, K. & Hussein, J. (2009) Assessing quality of care provided by Indonesian village midwives with a confidential enquiry. Midwifery 25(5), 528–539.Google Scholar
Djaja, S. & Soemantri, S. (2003) The cause of neonatal death and the attributed health care system in Indonesia: mortality study of household survey 2001. Buletin Penelitian Kesehatan [] 31(3), 155–165.Google Scholar
Duflo, E. (2011) Women's empowerment and economic development: National Bureau of Economic Research. Journal of Economic Literature 50(4), 1051–1079.Google Scholar
Ellis, A., Doumbia, S., Traoré, S., Dalglish, S. L. & Winch, P. J. (2013) Household roles and care-seeking behaviours in response to severe childhood illness in Mali. Journal of Biosocial Science 45, 743–759.Google Scholar
Ende District Health Office (2012) Profil Kesehatan Kabupaten Ende 2012 []. Dinas Kesehatan Kabupaten Ende, Provinsi Nusa Tenggara Timur, Ende.Google Scholar
Ensor, T., Quayyum, Z., Nadjib, M. & Sucahya, P. (2009) Level and determinants of incentives for village midwives in Indonesia. Health Policy and Planning 24(1), 26–35.Google Scholar
Frankenberg, E., Suriastini, W. & Thomas, D. (2005) Can expanding access to basic healthcare improve children's health status? Lessons from Indonesia's ‘midwife in the village’ programme. Population Studies 59(1), 5–19.Google Scholar
Gabrysch, S. & Campbell, O. M. (2009) Still too far to walk: literature review of the determinants of delivery service use. BMC Pregnancy and Childbirth 9(1), 34.Google Scholar
Gwatkin, D. R. (2002) Reducing health inequalities in developing countries. Oxford Textbook of Public Health 3, 1791–1810.Google Scholar
Halldorsdottir, S. & Karlsdottir, S. I. (2011) The primacy of the good midwife in midwifery services: an evolving theory of professionalism in midwifery. Scandinavian Journal of Caring Sciences 25(4), 806–817.Google Scholar
Hansen, E. C. (2006) Successful Qualitative Health Research. Allen & Unwin, Australia.Google Scholar
Harimurti, P., Pambudi, E., Pigazinni, A. & Tandon, A. (2013) The nuts and bolts of Jamkesmas: Indonesia's Government Financed Health Coverage Program. Universal Health Coverage Studies (UNICO) Series No. 8. The World Bank, Washington DC.Google Scholar
Hatt, L., Stanton, C., Makowiecka, K., Adisasmita, A., Achadi, E. & Ronsmans, C. (2007) Did the strategy of skilled attendance at birth reach the poor in Indonesia? Bulletin of the World Health Organization 85(10), 774–782.Google Scholar
Hatt, L., Stanton, C., Ronsmans, C., Makowiecka, K. & Adisasmita, A. (2009) Did professional attendance at home births improve early neonatal survival in Indonesia? Health Policy and Planning 24(4), 270–278.Google Scholar
Hidayat, B., Thabrany, H., Dong, H. & Sauerborn, R. (2004) The effects of mandatory health insurance on equity in access to outpatient care in Indonesia. Health Policy and Planning 19(5), 322–335.CrossRefGoogle ScholarPubMed
Hoque, M. M., Khan, M. F. H., Begum, J. A., Chowdhury, M. A. & Persson, L. A. (2012) Newborn care practices by the mother/care givers' and their knowledge about signs of sickness of neonates. Bangladesh Journal of Child Health 35(3), 90–96.Google Scholar
Kalsum, U. (2013) Child morbidity, level of parent's education, and accessibility to health facilities as factors affecting Posyandu utilization. Health Science Journal of Indonesia 4(1), 27–31.Google Scholar
Kashanian, M., Javadi, F. & Haghighi, M. M. (2010) Effect of continuous support during labor on duration of labor and rate of cesarean delivery. International Journal of Gynecology & Obstetrics 109(3), 198–200.Google Scholar
Laksono, A. D. & Rachmawati, T. (2013) Determinan Sosial Kesehatan Ibu dan Anak []. Penerbit Kanisius, Yogyakarta.Google Scholar
Makowiecka, K., Achadi, E., Izati, Y. & Ronsmans, C. (2008) Midwifery provision in two districts in Indonesia: how well are rural areas served? Health Policy and Planning 23(1), 67–75.Google Scholar
Manalu, H. S. P., Prasodjo, R. S. & Kasnodihardjo, K. (2005) Persepsi ibu hamil terhadap keberadaan bidan di desa []. Jurnal Ekologi Kesehatan 4(3), 320–325.Google Scholar
Ministry of Health (2010a) Indeks Pembangunan Kesehatan Masyarakat (IPKM) []. Ministry of Health, Badan Penelitian dan Pengembangan Kesehatan, Jakarta.Google Scholar
Ministry of Health (2010b) Laporan Hasil Kajian Pelaksanaan Program Jampersal di 6 Kabupaten []. Kementerian Kesehatan, United Nations Population Fund (UNFPA), Jakarta.Google Scholar
Ministry of Health (2010c) Pedoman Pemantauan Wilayah Setempat Kesehatan Ibu dan Anak (PWS–KIA) []. Direktorat Jenderal Bina Kesehatan Masyarakat, Direktorat Bina Kesehatan Ibu, Jakarta.Google Scholar
Ministry of Health (2012) Pedoman Pelaksanaan Kemitraan Bidan dan Dukun []. Direktorat Jenderal Bina Kesehatan Masyarakat, Direktorat Bina Kesehatan Ibu, Jakarta.Google Scholar
Mullany, B. C., Becker, S. & Hindin, M. J. (2007) The impact of including husbands in antenatal health education services on maternal health practices in urban Nepal: results from a randomized controlled trial. Health Education Research 22(2), 166–176.Google Scholar
NIHRD (2012) Peran Sosial Budaya dalam Upaya Meningkatkan Pemanfaatan Program Jaminan Persalinan (Jampersal) []. Badan Penelitian dan Pengembangan Kesehatan (National Institute of Health Research and Development–NIHRD), Kementerian Kesehatan RI, Jakarta.Google Scholar
NTT Provincial Health Office (2012) Pedoman Revolusi KIA di Provinsi NTT [], Revised Edition. Kupang.Google Scholar
Pardosi, J. F., Adair, T., Rao, C., Kosen, S. & Tarigan, I. U. (2011) Measuring subnational under-5 mortality: lessons from a survey in the Eastern Indonesian District of Ende. Asia-Pacific Journal of Public Health 26(4), 367–377.Google Scholar
Phipps, H., Charlton, S. & Dietz, H. P. (2009) Can antenatal education influence how women push in labour? Australian and New Zealand Journal of Obstetrics and Gynaecology 49(3), 274–278.Google Scholar
Pitriyan, P. & Siregar, A. Y. (2013) Health Inequity in Indonesia: Is it Declining? Department of Economics, Padjadjaran University, Bandung.Google Scholar
Ronsmans, C., Endang, A., Gunawan, S., Zazri, A., McDermott, J., Koblinsky, M. & Marshall, T. (2001) Evaluation of a comprehensive home-based midwifery programme in South Kalimantan, Indonesia. Tropical Medicine & International Health 6(10), 799–810.Google Scholar
Sen, G. & Ostlin, P. (2010) Gender inequity in health. In Lee, J. H. & Sadana, R. (eds) Improving Equity in Health by Addressing Social Determinants by the Commission on Social Determinants of Health Knowledge Networks. World Health Organization, Geneva, pp. 59–87.Google Scholar
Shrestha, R. (2010) The village midwife program and infant mortality in Indonesia. Bulletin of Indonesian Economic Studies 46(2), 193–211.Google Scholar
Simmonds, A. & Hort, K. (2013) Institutional Analysis of Indonesia's Proposed Road Map to Universal Health Coverage. Noosal Institute for Global Health, University of Melbourne.Google Scholar
Singh, K., Bloom, S. & Brodish, P. (2013) Gender equality as a means to improve maternal and child health in Africa. Health Care for Women International, doi: 10.1080/07399332.2013.824971.Google Scholar
Statistics Ende District (2013a) Hasil Sensus Penduduk 2010 Kabupaten Ende []. Badan Pusat Statistik, Kabupaten Ende.Google Scholar
Statistics Ende District (2013b) Ende dalam angka []. Badan Pusat Statistik, Kabupaten Ende.Google Scholar
Statistics Indonesia (2013) Indonesia Demographic and Health Survey 2013. Badan Pusat Statistik (BPS), National Population and Family Planning (BKKBN), Kementerian Kesehatan (MOH) and ICF International. Jakarta.Google Scholar
Statistics Nusa Tenggara Timur Province (2011) Nusa Tenggara Timur Dalam Angka []. BPS Propinsi Nusa Tenggara Timur, Kupang, Indonesia.Google Scholar
Starfield, B. (2007) Pathways of influence on equity in health. Social Science & Medicine 64(7), 1355–1362.Google Scholar
Sugiharti, S. & Lestary, H. (2011) Faktor-Faktor yang mempengaruhi pemanfaatan posyandu/polindes pada ibu hamil di Indonesia []. Jurnal Ekologi Kesehatan 10 (2 June), 65–71.Google Scholar
Titaley, C., Dibley, M., Agho, K., Roberts, C. & Hall, J. (2008) Determinants of neonatal mortality in Indonesia. BMC Public Health 8(1), 232.Google Scholar
Titaley, C. R., Hunter, C. L., Dibley, M. J. & Heywood, P. (2010) Why do some women still prefer traditional birth attendants and home delivery? A qualitative study on delivery care services in West Java Province, Indonesia. BioMed Central (BMC) Pregnancy and Childbirth 10(1), 43.Google Scholar
Tweheyo, R., Konde-Lule, J., Tumwesigye, N. M. & Sekandi, J. N. (2010) Male partner attendance of skilled antenatal care in peri-urban Gulu district, Northern Uganda. BioMed Central (BMC) Pregnancy and Childbirth 10(1), 53.Google Scholar
UNICEF (2013) Levels and Trends of Child Mortality: Report 2013. Estimates developed by the UN Inter-Agency Group for Child Mortality Estimation, New York, Washington and Geneva.Google Scholar
UNDP (2011) Indonesia: Progress Report on the Millennium Development Goals. BAPPENAS, Government of Indonesia, Jakarta.Google Scholar
Utomo, B., Sucahya, P. K. & Utami, F. R. (2011) Priorities and realities: addressing the rich–poor gaps in health status and service access in Indonesia. International Journal for Equity in Health 10, 47.Google Scholar
Victora, C. G., Wagstaff, A., Schellenberg, J. A., Gwatkin, D., Claeson, M. & Habicht, J. P. (2003) Applying an equity lens to child health and mortality: more of the same is not enough. The Lancet 362(9379), 233–241.Google Scholar
Wahab, A., Winkvist, A., Stenlund, H. & Wilopo, S. A. (2001) Infant mortality among Indonesian boys and girls: effect of sibling status. Annals of Tropical Paediatrics: Paediatrics and International Child Health 21(1), 66–71.CrossRefGoogle ScholarPubMed
Wamala, S. & Ågren, G. (2002) Gender inequity and public health getting down to real issues. European Journal of Public Health 12(3), 163–165.Google Scholar