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Factors associated with institutional delivery in remote areas: a cross-sectional
survey in Papua Region, Indonesia
#MMPMID41121089
Putri NK
; Laksono AD
; Ernawaty
; Kusrini I
; Astuti Y
; Matahari R
BMC Pregnancy Childbirth
2025[Oct]; 25
(1
): 1124
PMID41121089
show ga
BACKGROUND: Indonesia is the third country in Southeast Asia with the highest
maternal mortality ratio. In its remotest area, Papua, pregnant women still face
limited access to safe delivery in health facilities, despite being covered by
national health insurance. OBJECTIVE: This study examined the factors associated
with institutional delivery in the Papua Region, Indonesia. METHODS: This
cross-sectional study analysed 2,275 women aged 15 or older who had given birth
in the last five years. The outcome variable was institutional delivery, while
nine independent variables were assessed: province, residence, age, marital
status, education, employment, wealth, parity, and completeness of antenatal care
(ANC). Binary logistic regression was used to identify associated factors.
Additionally, a Geographic Information System (GIS) was employed to map
disparities in institutional delivery across the region. RESULTS: The overall
coverage of institutional delivery in the Papua Region was 50.1%. Coastal areas
showed higher prevalence, while the Central Mountains region had the lowest
coverage. Institutional delivery was significantly associated with all nine
independent variables. Women with lower education and without partners were less
likely to deliver in health facilities, even when financially covered by health
insurance. CONCLUSIONS: The findings suggest that a combination of demographic,
socioeconomic, and healthcare access factors influences the use of institutional
delivery in Papua. Improving access requires multisectoral strategies, including
infrastructure development, health education, and equitable healthcare delivery,
particularly for women in remote and underserved areas.
|*Delivery, Obstetric/statistics & numerical data
[MESH]
|*Health Facilities/statistics & numerical data
[MESH]
|*Health Services Accessibility/statistics & numerical data
[MESH]
|*Maternal Health Services/statistics & numerical data
[MESH]
|Adolescent
[MESH]
|Adult
[MESH]
|Cross-Sectional Studies
[MESH]
|Female
[MESH]
|Healthcare Disparities/statistics & numerical data
[MESH]
|Humans
[MESH]
|Indonesia
[MESH]
|Logistic Models
[MESH]
|Middle Aged
[MESH]
|Pregnancy
[MESH]
|Prenatal Care/statistics & numerical data
[MESH]
|Rural Population/statistics & numerical data
[MESH]
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