Abstract
Background: The urban poor are a vulnerable population within society, particularly in terms of maternal health. Economic and access limitations lead to the impoverished lack of access to healthcare services, especially in the institutional delivery process. The study analyzed the barriers to institutional delivery in Indonesia's poor urban society.
Study Design: A cross-sectional study.
Methods: The data obtained from the 2023 Indonesian Health Survey, analyzed 7,548 participants. We analyzed eight independent variables, including age, education, marital status, employment, wealth, insurance, and parity, with institutional delivery as the dependent variable. The research utilized binary logistic regression.
Results: Around 38.1% of Indonesian pregnant women had non-institutional deliveries. All age groups had a higher likelihood of non-institutional delivery than those aged ≥ 45. A lower level of education is associated with a heightened probability of opting for non-institutional delivery. Married women were 0.704 times less likely than divorced/widowed to give birth in non-institutional settings (AOR 0.704; 95% CI 0.693-0.716). Unemployed women were 1.218 times higher likelihood of engaging in non-institutional delivery compared to employed women (AOR 1.218; 95% CI 1.1210-1.226). The poorest women were 0.973 times less likely than the poorer to achieve non-institutional delivery (AOR 0.973; 95% CI 0.967-0.980). Uninsured women were 2.364 times more likely than insured women to engage in non-institutional childbirth (AOR 2.364; 95% CI 2.345-2.379). All parity types are less likely than grand multiparous to engage in non-institutional delivery.
Conclusion: Seven barriers factors to institutional delivery were younger age, low education, divorce/widowed, unemployment, poorer, uninsured, and grand multiparous.