Sba Case Study

SBA: it ensures a quick transfer to appropriate service when obstetric emergencies arise.

These results explain that remote areas need the improvement of access to health care service and encourages them to make a right decision on their own health.

Introduction

In order to overcome the maternal mortality ratio (MMR) over 400 per 100,000 live births and to increase health access in remote areas, Indonesian government implemented the village midwife program in 1989 and had posted more than 54000 village midwives in rural areas by 1998. A village midwife was trained and certified as a skilled birth attendant (SBA) by the government. Their duties were to provide antenatal care (ANC), family planning, nutrition counseling, and to manage deliveries.

The main independent variables were problems of accessing to health care service. The participants were asked if a problem of accessing to health care was a big problem or not. As other independent variables, we included socio-demographic, socioeconomic, and maternal health care status. The age range (15-49 years old) of the sample was considered as women’s reproductive age. The age group was categorized in 3 groups; the younger group (15-24 years old), reductively appropriate group (25-34 years old), and the older group (35-49 years old). The younger and older groups were generally considered as reproductively high risk age. The wide and dispersed area of Indonesia was divided into 6 regions: Sumatera, Java, Kalimantan, Sulawesi, Maluku and Papua, and Bali and Tenggara. Residence (rural and urban), birth order (under 4 and more than 4), family size (under 5 members and more than 5 members), religion (Muslim and non-Muslim), and women’s employment status (working and not working) were dichotomized into categorical variables. Wealth index was a proxy for long-term standard of living in the household. DHS constructed it by the data of household ownership of consumer goods. Husband’s and women’s education attainments were categorized as incomplete primary education or none, completed primary or some secondary education, and completed secondary education or higher. We made an interaction term of working status and wealth status to add into a caliculation. Regarding to ANC status, the frequency of ANC visits (under 4 times and more than 4), the timing of the 1st ANC in the first trimester (yes and no), the frequency of tetanus toxoid immunization (single dose or none and more than 2 doses) were included and dichotomized. WHO defined more than 4 times of ANC visits was sufficient. The Indonesian maternal health program