Sociodemographic Determinants of Antenatal Care Utilization in Indonesia: A Multilevel Mixed-effect Analysis
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Abstract
Introduction: Antenatal Care (ANC) services provide essential interventions that effectively educate pregnant women regarding safe delivery, healthy pregnancy and postpartum family planning. This study assessed the individual and community factors associated with ANC utilisation among women aged 15–49 in Indonesia. Materials and methods: Data from the Indonesia Demographic and Health Survey 2017 were used with a sample size of 15,021 women aged 15–49 who gave birth five years before the survey. Multilevel mixed-effect logistic regression analysis was fitted to analyse the predictors of ANC utilisation after potential confounders made adjustments. A 95% confidence interval with adjusted odds ratio was reported. The community factor is the place of residence. Results: About 90% of women visited ANC services at least four times. Birth order one or two (AOR=1.69, 95% CI:1.47–1.94), women aged 20–34 (AOR=2.41, 95% CI:1.82–3.20), and women aged 35 or older (AOR=2.68, 95% CI:1.97-3.65) were factors positively associated with ANC utilisation. Higher household status, including middle-class wealth women (AOR=1.62, 95% CI:1.38–1.90) and wealthy women (AOR=2.51, 95% CI:2.10–2.99) were four times more likely to use ANC services compared to their counterparts. Secondary (AOR=1.77, 95% CI:1.56–2.02) and higher (AOR=2.70, 95% CI:2.09-3.48) educated women were associated with increased odds of ANC utilisation than primary or less educated women. Conclusion: Maternal age, birth order, maternal education, and household wealth status significantly impact ANC service utilisation. Exploring women’s and healthcare providers' views on ANC services, especially the quality of ANC services, may be beneficial for further studies.
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