Thriving beyond survival: Understanding utilization of perinatal health services as predictors of birth registration: A cross-sectional study

BMC International Health and Human Rights

Lindsay Stark¹  Santi Kusumanigrum³  Putu Duff²  Michelle Jackson¹ 

[1] Program on Forced Migration and Health, Columbia University Mailman School of Public Health, 60 Haven Ave B-4 Suite 432, New York 10032, NY, USA;School of Population and Public Health, University of British Columbia, 608-1081 Burrard St, Vancouver V5N 1P5, BC, Canada;Center on Child Protection at the University of Indonesia, Gedung Nusantara II (Ex PAU Ekonomi) FISIP, Lantai 1, Kampus UI, Depok 16424, Indonesia

关键词: Civil registration and vital statistics (CRVS);    Indonesia;    Health services utilization;    Child protection;    Birth registration;   

Others  :  1103233
DOI  :  10.1186/s12914-014-0038-3

 received in 2014-07-23, accepted in 2014-12-11,  发布年份 2014

【 摘 要 】

Background

There are an estimated 35 million unregistered children in Indonesia. To understand ways to best leverage existing health system-related resources and ensure greater protective measures for these vulnerable children, this study explores the predictive relationship between the utilization of perinatal health services and birth certificate ownership in two Indonesian provinces.

Methods

This study employed a cross-sectional design with interviewer-administered household surveys to heads of households in West Nusa Tenggara and East Nusa Tenggara from May to July of 2013. The primary outcome of interest was birth certificate ownership among children under the age of 5 years old. Bivariate and multivariable regression analyses using Generalized Estimating Equations (GEE) considered a set of covariates that represented child and household socio-demographic characteristics along with health services utilization variables during pregnancy and post-pregnancy periods.

Results

389 heads of households were interviewed, yielding data on a sample of 451 children under the age of 5. Fewer than 28% of children in this sample possessed a birth certificate. Nearly 57% (n = 259) of children were delivered in a clinical facility, though only 36% (n = 93) of these were legally registered. Of children born in the home (n = 194), registration dropped to 16% (n = 31). Adjusted analyses accounting for socio-demographic factors suggest that children born in a clinic facility (AOR = 2.33, 95% CI: 1.27, 4.33), hospital (AOR = 2.38, 95% CI: 1.12, 5.09), or in the presence of a skilled birth attendant (AOR = 2.35, 95% CI: 1.31, 4.23) were significantly more likely to be registered. Children whose mothers sought post-natal care were 2.99 times more likely to possess a birth certificate (AOR = 2.99, 95% CI: 1.1, 7.57). Pre-natal care was not associated with birth registration.

Conclusion

These findings suggest that use of perinatal health services increases the likelihood of registering a child’s birth despite a lack of formal integration of vital registration with the health sector. Formally leveraging existing community-based health workers and perinatal services may serve to further increase registration rates in hard to reach areas of Indonesia.

【 授权许可】

   
2014 Jackson et al.; licensee BioMed Central.

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