ArticleBMC pregnancy and childbirth2025
Factors associated with institutional delivery in remote areas: a cross-sectional survey in Papua Region, Indonesia.
Article in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIndonesia 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.
objectiveThis study examined the factors associated with institutional delivery in the Papua Region, Indonesia.
methodsThis 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.
resultsThe 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.
conclusionsThe 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.
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