Analisis determinan kematian ibu di Kabupaten Kepulauan Meranti
DOI: https://doi.org/10.33024/hjk.v19i11.1858
Angka Kematian Ibu Kunjungan Antenatal Paritas Tingkat Pendidikan Usia Ekstrem
Abstract
Background: The maternal mortality rate (MMR) is a crucial indicator for assessing the success of maternal and child health services and is a key focus in achieving the Sustainable Development Goals (SDGs) with a target of <70 per 100,000 live births by 2030. Indonesia still faces significant challenges, with the MMR at 305 per 100,000 live births. In Riau Province, particularly in the Meranti Islands Regency, the rate reached 108 per 100,000 live births in 2022.
Purpose: To analyze the determinants of maternal mortality.
Method: This study used an observational analytical design with a cross-sectional approach. Conducted in the Meranti Islands Regency during the 2023–2024 period, the study included distal determinants (education, employment, income) and intermediate determinants (nutritional status, age, parity, marital status, distance to health facilities, and ANC visits). Samples were drawn using total sampling for maternal mortality cases and random sampling for the control group (1:2). Data analysis used the Chi-square test with a significance level of p < 0.05.
Results: The data show a decrease in the maternal mortality rate, from 117.10 to 100.33 per 100,000 live births. Significant factors contributing to maternal mortality were low education, extreme age (<20 or >35 years), parity ≥3, distance from home ≥5 km, and fewer than 6 ANC visits. Major complications included severe preeclampsia, uterine atony, and diabetes mellitus.
Conclusion: Social and medical factors play a significant role in the high maternal mortality rate. Efforts to improve health literacy and equitable access to antenatal care are key strategies in reducing maternal mortality.
Keywords: Age Extremes; Antenatal Visits; Education Level; Maternal Mortality Rate; Parity.
Pendahuluan: Angka Kematian Ibu (AKI) merupakan indikator penting dalam menilai keberhasilan pelayanan kesehatan ibu dan anak serta menjadi fokus utama dalam pencapaian Sustainable Development Goals (SDGs) dengan target <70 per 100,000 kelahiran hidup pada 2030. Indonesia masih menghadapi tantangan besar dengan AKI sebesar 305 per 100,000 kelahiran hidup, sementara di Provinsi Riau, khususnya Kabupaten Kepulauan Meranti, angka tersebut mencapai 108 per 100,000 kelahiran hidup pada tahun 2022.
Tujuan: Untuk menganalisis determinan angka kematian
Metode: Penelitian ini menggunakan desain analitik observasional dengan pendekatan cross-sectional. Dilakukan di Kabupaten Kepulauan Meranti periode 2023–2024, mencakup determinan jauh (pendidikan, pekerjaan, pendapatan) dan determinan antara (status gizi, usia, paritas, status marital, jarak ke fasilitas kesehatan, dan kunjungan ANC). Sampel diambil secara total sampling untuk kasus kematian ibu dan accidental sampling untuk kelompok kontrol (1:2). Analisis data menggunakan uji Chi-square dengan tingkat signifikansi p < 0.05.
Hasil: Data menunjukkan penurunan angka kematian ibu, dari 117.10 menjadi 100.33 per 100,000 kelahiran hidup. Faktor yang signifikan terhadap kematian ibu adalah pendidikan rendah, usia ekstrem (<20 atau >35 tahun), paritas ≥3, jarak rumah ≥5 km, serta kunjungan ANC kurang dari 6 kali. Komplikasi utama meliputi preeklampsia berat, atonia uteri, dan diabetes melitus.
Simpulan: Determinasi sosial dan medis berperan penting terhadap tingginya angka kematian ibu. Upaya peningkatan literasi kesehatan dan pemerataan akses layanan antenatal menjadi strategi kunci dalam menurunkan angka kematian ibu.
Kata Kunci: Angka Kematian Ibu; Kunjungan Antenatal; Paritas; Tingkat Pendidikan; Usia Ekstrem.
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