Analysis of Factors Related to the Selection of Maternal Delivery Places in the Working Area of the Ambukha Community Health Centre, Lolofitu District, MOI, West Nias Regency in 2024

Abstrak

Background: Maternal mortality remains a significant public health concern in Indonesia, where 19.3% of deliveries are still conducted outside healthcare facilities or without skilled birth attendants. The working area of Ambukha Public Health Centre (Puskesmas) has the lowest proportion of facility-based deliveries in the West Nias District (67% in 2023), indicating the need to analyse factors associated with delivery place choice. Objective: To identify factors related to the selection of delivery place among mothers in the working area of Ambukha Public Health Centre, Lolofitu Moi Subdistrict, West Nias District. Methods: This study employed an observational analytic design with a cross-sectional approach. The population consisted of all mothers who delivered within the Ambukha Public Health Centre area in 2023 (N=78), and samples were obtained using a total sampling approach. Data were collected using structured questionnaires and analysed using Chi-square tests and logistic regression. Results: Significant associations were found between the choice of delivery place and maternal knowledge (p=0.000; OR=2.267), maternal attitude (p=0.000; OR=4.250), national health insurance (JKN) membership (p=0.000; OR=5.333), access to healthcare facilities (p=0.000; OR=6.038), husband’s support (p=0.000; OR=4.250), perceived need factors (p=0.000; OR=3.333), as well as cultural beliefs (p=0.004; OR=2.473). Multivariate logistic regression identified maternal knowledge as the most influential factor in delivery place selection, as indicated by the most significant coefficient value (B = –4.204) and statistical significance (p=0.005). Conclusion: Maternal knowledge, attitude, JKN membership, access to healthcare facilities, husband’s support, perceived need, and cultural beliefs are significantly associated with the selection of delivery place. Efforts to increase facility-based delivery coverage in this area should prioritise improving maternal knowledge, followed by strengthening other supporting factors.