Analisis Ekologi Persalinan di Fasilitas Pelayanan Kesehatan di Indonesia

Policies to encourage childbirth in health care facilities were emphasized to reduce maternal mortality rates that are still high in Indonesia. The study was aimed at analyzing population, socio-economic, and resource input variables related to childbirth in health care facilities. This study used an ecological study approach (an aggregate study) sourced from the 2018 Indonesia Health Profi le. Bivariate analysis was performed using scatter plots and Pearson correlation tests. The results showed a wide disparity in terms of childbirth in health care facilities coverage. Maluku was the province with the lowest coverage (45.18%), while the highest coverage was achieved by DKI Jakarta (100%). The results of scatter plots and bivariate tests showed that the more population in a province, the higher the coverage of delivery in health care facilities, the deeper and worse the poverty in a province, the lower the coverage of delivery in health care facilities. The more obstetrician and hospitals in a province, there was a tendency for coverage of births in health care facilities to be higher. In conclusion, population, the ratio of obstetricians, and the ratio of hospitals have a positive relationship with deliveries in healthcare facilities. In contrast, the Poverty Depth and Severity Index has a tendency to had a negative relationship with the coverage of deliveries in health care facilities. It was recommended that the government formulate specifi c policies to target regions with a small population, poor and have a small number of obstetricians and hospitals. Abstrak Kebijakan mendorong persalinan di fasilitas pelayanan kesehatan ditekankan untuk menurunkan angka kematian ibu yang masih tinggi di Indonesia. Studi ditujukan untuk menganalisis variabel kependudukan, sosial-ekonomi dan input sumber daya yang berhubungan dengan persalinan di fasilitas pelayanan kesehatan. Desain studi menggunakan pendekatan studi ekologi (studi agregat) bersumber data Profi l Kesehatan Indonesia Tahun 2018. Analisis bivariat dilakukan dengan menggunakan scatter plot dan uji korelasi Pearson. Hasil penelitian menunjukkan disparitas persentase cakupan persalinan ke fasilitas pelayanan kesehatan yang sangat lebar, Provinsi Maluku memiliki cakupan paling rendah (45,18%), sementara cakupan tertinggi dicapai Provinsi DKI Jakarta (100%). Hasil scatter plot dan uji bivariat menunjukkan bahwa semakin banyak jumlah penduduk pada suatu provinsi maka ada kecenderungan cakupan persalinan di fasilitas pelayanan kesehatan menjadi semakin tinggi. Semakin dalam dan parah kemiskinan pada suatu provinsi maka ada kecenderungan cakupan persalinan di fasilitas pelayanan kesehatan menjadi semakin rendah. Semakin banyak dokter spesialis obgyn dan rumah sakit pada suatu provinsi maka ada kecenderungan cakupan persalinan di fasilitas pelayanan kesehatan menjadi semakin tinggi. Disimpulkan bahwa jumlah penduduk, rasio dokter spesialis obgyn dan rasio rumah sakit (RS) memiliki hubungan positif, sementara Indeks Kedalaman dan Keparahan Kemiskinan memiliki kecenderungan hubungan negatif dengan cakupan persalinan di fasilitas pelayanan kesehatan. Disarankan pemerintah menyusun kebijakan khusus pada sasaran wilayah dengan jumlah penduduk sedikit, miskin dan memiliki dokter spesialis obgyn dan RS yang sedikit.