This study aimed to examine factors associated with utilization of village midwife and other trained delivery attendants for home deliveries. Information from 14,672 cases of the most recent home deliveries of mothers in the 5 year-period prior to the Indonesia Demographic and Health Survey 2002/2003 and 2007 were analysed. Multinomial logistic regression analysis was performed. The association between 26 factors categorised into external environment, predisposing, enabling, need and previous utilization of maternal health services, and utilization of village midwife and other trained delivery attendants, such as nurses, other midwives and doctors, for home deliveries was examined. The population attributable risk of selected significant predictors was calculated. The odds of using village midwives and other trained delivery attendants at childbirth for home deliveries increased with increasing household wealth index and levels of parental education. The odds increased among first birth, mothers who were exposed to mass media, mothers with knowledge of delivery complications, and mothers who had any delivery complications. However, mothers who attended less than four antenatal care visits, who had high parity, or who reported distance and transportation to health facilities was a major problem, had significantly reduced odds for utilizing any trained delivery attendants. Health promotion strategies to raise community awareness about the importance of safe delivery should target low educated parents, mothers from low household economic status, as well as high parity mothers. Efforts to promote antenatal care visits are likely to increase utilization of trained delivery attendants for home deliveries in Indonesia.

译文

这项研究旨在研究与利用乡村助产士和其他训练有素的送货服务员进行家庭送货有关的因素。分析了印度尼西亚人口与健康调查2002/2003和2007之前5年期间14,672例母亲最近一次在家分娩的信息。进行多项logistic回归分析。研究了26个因素之间的关联,这些因素分为外部环境,孕产妇保健服务的诱因,使人,需要和以前的利用,以及乡村助产士和其他受过训练的分娩服务员 (例如护士,其他助产士和医生) 的家庭分娩。计算选定重要预测因子的人群归因风险。随着家庭财富指数和父母教育水平的提高,在分娩时使用乡村助产士和其他训练有素的分娩服务员进行家庭分娩的几率增加。首次分娩,接触大众媒体的母亲,了解分娩并发症的母亲以及有任何分娩并发症的母亲的几率增加。然而,参加不到四次产前检查的母亲,她们的均等程度很高,或者报告说距离和到卫生设施的交通是一个主要问题,她们利用任何训练有素的分娩服务员的几率大大降低了。提高社区对安全分娩重要性的认识的健康促进战略应针对受教育程度低的父母,家庭经济状况低的母亲以及均等的母亲。在印度尼西亚,促进产前护理就诊的努力可能会增加训练有素的分娩服务员在家分娩的利用率。

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