Socioeconomic and Geographical Analysis on Antenatal Care Visits in Indonesia: A Cross-sectional Study

Abstract

Background: Antenatal care (ANC) is crucial for reducing maternal and neonatal mortality by detecting and managing pregnancy complications. In Indonesia, a policy mandating at least six ANC visits (K6) per pregnancy has been introduced, yet factors influencing adequate ANC under this new policy remain unevaluated. This study examines the national and sub-national prevalence of adequate ANC visits as well as its associated geographic and socioeconomic factors. Methods: This cross-sectional study analyzed data from the 2023 Indonesian Health Survey, which included 70,916 women of reproductive age. Logistic regression was used to assess predictors of ANC adequacy, such as age, education, marital status, health insurance, employment, urbanicity, economic status, and travel time to healthcare facilities. The data were analyzed through SPSS version 23 using descriptive statistics, chi square test, and multiple logistic regression. Final regression model was based on significant predictors only with calculated adjusted odd ratios and 95% confidence interval (CI) with a significance level of 0.05. Results: The national prevalence of adequate ANC visits was 38.65%. However, a significant disparity was observed between provinces, with eastern areas showing much lower prevalence than provinces in western Indonesia. ANC adequacy was highest among women aged 25–29 and lowest among those under 20. Higher education (aOR=1.45, P<0.001), combined health insurance (aOR=2.84, P<0.001), employment (aOR=1.07, P<0.001), urban residence (aOR=1.24, P<0.001), and higher economic status (aOR=1.60, P<0.001) were positively associated with ANC adequacy. Conversely, being divorced (aOR=0.76, P<0.001) and widowed (aOR=0.74, P=0.004), and longer travel times to primary healthcare center negatively affected compliance (aOR=0.68, P<0.001). Conclusion: Addressing geographic and socioeconomic barriers through improved healthcare infrastructure, transportation support, and expanded insurance coverage is essential for increasing ANC utilization and improving maternal health in Indonesia. Show more