Home or Healthcare Facility: Influence of Antenatal Health Service on the Decision on the Place of Birth in Indonesia

Background: Health facility is an ideal place for child birth to obtain favorable outcomes for maternal and neonatal health. Most of mothers in Indonesia have access to healthcare but 20% of them do not give birth in a healthcare facility. This study aimed to assess the association of the maternal health services and choosing a healthcare facility for birth. Methods: This research utilized Indonesia’s Survey of Health Indicators (SIRKESNAS) 2016 data and analyzed it using logistic regression model. Results: Antenatal care (ANC) (OR = 3.696; P-value = 0.004), preparedness of birth budget (OR = 2.291; P-value =0.007) and having maternal and child health (MCH) handbook (OR = 1.492; P-value = 0.103) were independently associated with the decision of healthcare facility birth. The ANC service particularly the availability of health professional provider as the first birth attendance (OR = 7.563; P-value = .00) and maternal examination as in the form of blood pressure test (OR = 5.009; P-value =.013) and ultrasonography (OR = 2.341; P-value =.001) substantially associated with the decision of the place of birth. Conclusion: In order to encourage mothers to deliver in a healthcare facility, improving the quality of ANC services including utilization of MCH handbook and expanding the coverage of delivery insurance are the prominent concerns for healthcare policy.