Does Economic Disparity in Maternal Mortality Still Persist in Indonesia ?

Vitri Widyaningsih, Khotijah, Balgis

Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia

Introduction Results
 There has been significant improvement in • Economic disparity of maternal mortality is
maternal health in Indonesia during the past different by region; less disparity shown in Java
decades. Maternal Mortality Ratio (MMR) has Bali compared to other islands ( p < 0.001)
decreased from over 326 deaths/100,000 live Fig 2. Reported Maternal Mortality by
births in 1990s to 214 deaths/100,000 live births Economic Status and Region, DHS 2012
in 2012. Poorest Poorer Middle Richer Richest
2.41.9 5.3
 Socioeconomic factors have been shown to 10.0
17.2
6.3
5.2
effect maternal mortality, with the poor have 29.5
25.5
higher risk of maternal mortality.
35.0
 This study aim to assess the trends of 19.1

economic disparity in maternal mortality and

22.0
differences based on geographic location. 43.6
57.8

19.6

Methods JAVA BALI MORE DEVELOP LESS DEVELOP

• We conducted secondary analyses of • There was a substantial difference of maternal
Indonesian Demographic and Health Survey mortality proportion by wealth and type of
(IDHS) from three waves: 2002, 2007 and 2012. residence, with less disparity in urban
• The data were collected from a total of compared to rural area (p < 0.001)
104,415 women, through stratified clustered Fig 3. Reported Maternal Mortality by
random sampling to obtain a nationally Economic Status and Type of
representative data. Residence, IDHS 2012
1.4
9.1
• Exposure: wealth 14.8
Poorest
12.9
• Outcome: reported sibling’s maternal death 28.1
21.0 Poorer

20.1
Middle
Results Richer
• There were significant different in proportion of 34.6
55.7
Richest
maternal mortality across three different
2.5
waves of DHS ( p < 0.0001)
URBAN RURAL
• The proportion of maternal mortality is highest
in the poorest economic class
• The rates of maternal mortality is increasing in
Conclusions
the poorest group from 2002 to 2012 showing • Economic disparity in maternal mortality still
increased disparity with women from higher persist in Indonesia, with more profound
economic status (Fig 1). disparity in less developed and rural area.
• Intervention should focus on women from
Fig 1. Proportion of Reported lower socioeconomic status, specifically in less
Maternal Mortality by Wealth developed region
INDEX : IDHS 2002-2012
Poorest Poorer Middle Richer Richest Selected References
7.2 6.8
18.2 • Kassebaum, Nicholas J et al. “Global, Regional, and National
18.1 16.8 Levels and Causes of Maternal Mortality during 1990–2013: A
Systematic Analysis for the Global Burden of Disease Study
26.1 16.6 15.8 2013.” The Lancet 384.9947 (2014): 980–1004. Web. 18 Apr. 2015.

9.9 • Prata, Ndola et al. “Maternal Mortality in Developing Countries:

26.5 Challenges in Scaling-up Priority Interventions.” Women’s Health
34.9
19.3 6.2 (2010): 311–327. Web. 18 Apr. 2015.

34.1
26.4 23.3
Acknowledgement
2002 2007 2012 • This study is funded through PNBP Sebelas Maret
University Funding (2016).