Risk factors that influence maternal mortality in indonesia: Case study at Cilacap

Background : The maternal mortality ratio (MMR) in Indonesia remains high, i.e. 307/100.000 livebirth. McCarthy and Maine shows three factors i.e. proximate determinant, intermediate determinant and distant determinant. Cilacap is one of district in Indonesia which have maternal mortality case still high, so it is necessary to study the risk factors that influence maternal mortality.

Objective : The study was done to know the risk factors of maternal mortality, which consist of proximate, intermediate and distant determinant.

Methods : This was case control study, completed with qualitative study about the occurrence of maternal mortality and the effort to decrease MMR in Cilacap. Number of samples was 52 cases and controls. Data were analyzed by univariate analysis, bivariate analysis with chi square test, multivariate analysis with multiple logistic regression. Qualitative study was done by the method of indepth interview and were analyzed by descriptive analysis and presented in narration.

Result : The result showed that risk factors that influence maternal mortality according to multivariate analysis were pregnancy complication (p = 0,002), delivery complication (p = 0,027), post delivery complication (p = 0,034), history of mother’s illness (p = 0,002), history of using contraception (p = 0,038), and late referral (p = 0,003). Probability of mother to have risk of maternal mortality with those all risk factors above is 99%. The result of qualitative study showed that many factors influenced maternal mortality like late referral, especially first referral, low education of the mother, low of family income, and the GSI activities not well done yet in each subdistricts.

Suggestion : This research recommended that it is necessary to detect signs of pregnancy complication, delivery complication, and post delivery complication early, referral preparation, pregnancy planning and optimizing GSI activities.

Keywords : maternal mortality, risk factors, case control study