Pemanfaatan Pertolongan Persalinan Tenaga Kesehatan Oleh Peserta Program Jaminan Pemeliharaan Kesehatan Masyarakat Miskin

Abstract

The Utilization of Childbirth Assistance Provided By Health Professionals By Participants of Health Care Insurance Program for Poor Community

Background: The proportion of childbirth assisted by skilled health professionals is still 68.4%. Monetary crisis
which happened in 1997 still has influence in the increasing health cost which limits access of poor community
to health services. Major problems of health service for poor community are cost and transportation.

Objective: To find out the increase of the utilization of childbirth assistance provided by health professionals by participants of health care insurance program for poor community and assesses factors affecting the utilization of childbirth assistance provided by health professionals.

Methods: The study was a cross sectional observation which used both qualitative and quantitative approaches. Participation in the health insurance for poor community as independent variable and childbirth attended by health professionals as dependent variable were simultaneously observed. Samples of the study were 104 mothers who gave birth in 2006. Quantitative analysis used univariate analysis with frequency distribution, bivariate with chi square and multivariate with logistic regression test. Qualitative analysis used in-depth
interview.

Results: There was significant relationship between perception in health insurance for poor community and childbirth attended by health professionals (OR=4.23, 95%CI=1.43-12.47, p=0.00). Variables of transportation and availability of midwives had significant relationship with childbirth attended by health professionals (OR=4.5,95%CI=1.45-13.96, p=0.00) and OR=4.43, 95%CI=1.56-12.57, p=0.00). Length of time to reach health service facility for childbirth had no significant relationship with the utilization of childbirth attended health professionals.

Conclusion: Participants of health care insurance for poor community utilized childbirth assistance provided by health professionals more than those who were not participants. Other factors affecting the utilization of childbirth attended by health professionals were distance, transportation and availability of midwives at the service point. Transportation and availability of midwives at the service point were confounding variables of participation in health care insurance for poor community and childbirth provided by health professionals.

Keywords: childbirth attended by health professionals, program of health insurance for poor community