DETERMINANTS OF HIGH MATERNAL MORTALITY RATE IN INDONESIA

Abstract

Background: Maternal Mortality Rate (MMR) reflects women's health status and the quality of a country's healthcare system. In Indonesia, the MMR in 2019 was 305 per 100,000 live births, indicating a significant health issue. The high MMR is caused by various complex and interrelated determinants, including medical complications, socio-economic conditions, healthcare access, cultural factors, and nutrition. Objectives: This study aims to identify and analyze the determinants contributing to the high MMR in Indonesia and provide evidence-based recommendations for effective policies and programs to reduce MMR. Methods: This literature review uses descriptive and thematic methods, analyzing 11 articles published between 2013 and 2024. Articles were selected based on their relevance and quality in discussing maternal mortality determinants. Data were collected and analyzed to identify key factors contributing to maternal mortality. Results: The study found that obstetric complications such as postpartum hemorrhage and pre-eclampsia/eclampsia are primary causes of maternal mortality. Non-communicable diseases such as heart disease and hypertension also play a significant role. Socio-economic factors, including maternal education and employment status, influence maternal mortality risk. Limited access to and poor quality of healthcare services in rural and remote areas exacerbate the situation. Cultural beliefs and stigma towards modern healthcare services, as well as traditional health practices, hinder timely medical care. Maternal nutritional status, including anemia and chronic energy deficiency, significantly contributes to maternal mortality. Conclusions: To reduce MMR, it is necessary to improve healthcare access and quality, provide continuous health education, enhance maternal nutritional status, strengthen health policies, and improve environmental conditions. Implementing comprehensive maternal health programs and collaboration among stakeholders is crucial to achieving the target of reducing maternal mortality in Indonesia.