Multilevel Factors Associated With Pregnancy-Related Health Behaviors in Indonesia: Evidence From the 2007, 2012, and 2017 Indonesian Demographic Health Surveys

Asia Pac J Public Health. 2019 Sep 15:1010539519872346. doi: 10.1177/1010539519872346. Online ahead of print.

Abstract

Indonesia has one of the highest maternal mortality rates among Southeast Asia countries. Mothers' pregnancy-related behaviors were proven to be the major determinants of maternal mortality. This study attempted to measure individual- and community-level factors that contribute to pregnancy-related health behaviors among Indonesian women. This study used representative nationwide survey samples among women aged 15 to 49 years from the Indonesian Demographic Health Survey in the years 2007 (N = 15 314), 2012 (N = 15 197), and 2017 (N = 15 300). Generalized linear mixed models were constructed to simultaneously analyze relationships of pregnancy-related health behaviors with other individual- and community-level explanatory factors. We found that women's educational level, household wealth index, insurance status, access to health facilities, geographic location, general health condition, pregnancy intentions, and community-level socioeconomic status were significantly associated with different outcome behaviors. The findings of this study suggest that future policies should focus on both individual- and community-level factors to improve women's pregnancy-related behaviors.

Keywords: Indonesia; health service utilization; multilevel analysis; pregnancy-related health behaviors; women’s health.