Yuly Astuti, NFN Widayatun


Maternal and child mortality is still considered a health issue in Indonesia. Health behavior during pregnancy is an essential factor that determines the health of mother and baby. This study aims to examine the behavior of maternal health during pregnancy in Medan City and to analyze its important social determinants. Quantitative data collection using a survey of 400 households in 20 urban villages in Medan City, North Sumatera Province. This study found that 49% of respondents had good behaviors during pregnancy, while those with moderate and poor behaviors during pregnancy were 22% and 29%, respectively. Ordinal logistic regression model indicates husband education, insurance ownership, service quality, and household financial autonomy as social determinants of maternal health behavior during pregnancy. Many factors influenced maternal health behavior during pregnancy both from supply and demand side of health services. Thus, to improve maternal health behavior during pregnancy, it is essential to develop the mother’s knowledge of the importance of antenatal care. Besides that, health service providers also need to ensure the quality of their health services


maternal health behaviors; pregnancy period; social determinants; Medan City

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Agus, Y., & Horiuchi, S. (2012). Factors influencing the use of antenatal care in rural West Sumatra, Indonesia. Pregnancy and Childbirth, 12(9). crossref

Astuti, Y., & Widayatun. (2017). Determinan sosial perilaku kesehatan ibu dan pola pengasuhan anak di Kota Medan di era globalisasi (Laporan Penelitian). Jakarta: P2 Kependudukan LIPI.

Astuti, Y., Widayatun, & Rahadian, A.S. (2016). Peran dan interaksi keluarga di era globalisasi dalam pengasuhan anak pada periode emas kehidupan: Kasus Kota Medan (Laporan Penelitian). Jakarta: P2 Kependudukan LIPI.

Babalola, S., & Fatusi, A. (2009). Determinants of use of maternal health services in Nigeria: Looking Beyond individual and household factors. BMC Pregnancy and Childbirth, 9(43). crossref

Badan Penelitian dan Pengembangan Kesehatan [Balitbangkes] Kementerian Kesehatan. (2013). Pokok-pokok hasil Riskesdas Provinsi Sumatera Utara. Jakarta: Balitbangkes Kementerian Kesehatan. Retrieved from :

Badan Koordinasi Keluarga Berencana Nasional [BKKBN], Badan Pusat Statistik [BPS], Kementerian Kesehatan, & United States Agency for Development [USAID]. (2013). Survei demografi dan kesehatan Indonesia. Jakarta: BKKBN, BPS, Kementerian Kesehatan, dan USAID.

Broeck, J.V., Jong, E., Klomp, T., Putman, K., & Beeckman, K. (2016). Antenatal care use in urban areas in two European countries: Predisposing, enabling and pregnancy-related determinants in Belgium and the Netherlands. BMC Health Services Research, 16(337). crossref

Celik, Y. & Hotchkiss, D.R. (2000). The Socio-economic determinants of maternal health care utilization in Turkey. Journal of Social Science and Medicine, 50(12), 1797-1806. crossref

Chakraborty, N., Islam, M. A., Chowdhury, R. I., Bari, W., & Akhter, H.H. (2003). Determinants of the use of maternal health services in rural Bangladesh. Health Promotion International, 18(4), 327-337.

Ciceklioglu, M., Soyer, M.T., & Ocek, Z.A. (2005). Skilled attendance at delivery in Bangladesh: An etnographic study. Research Monograph Series Vol. 22. Research and Evaluation Division, BRAC, Dhaka, Bangladesh. Retrieved from:

Dar, S.S. (2013). Socio- Economic Determinants of Maternal Health Behavior in Pakistan: An Instrumental Variable Approach (Doctoral Dissertation). Lahore School of Economics. Retrieved from:

Darega, B., Dida, N., Tafese, F., & Ololo, S. (2016). Institutional delivery and postnatal care services utilizations in Abuna Gindeberet District, West Shewa, Oromiya Region, Central Ethiopia: A community-based cross sectional study. BMC Pregnancy and Childbirth, 16(149). crossref

Dinas Kesehatan Kota Medan. (2016). Profil kesehatan Kota Medan tahun 2015. Medan: Dinas Kesehatan Kota Medan.

Dinas Kesehatan Provinsi Sumatera Utara. (2017). Profil kesehatan Provinsi Sumatera Utara tahun 2016. Medan: Dinas Kesehatan Provinsi Sumatera Utara.

Fawole, O.I., & Adeoye, I.A.(2015). Women’s status within the household as a determinant of maternal health care use in Nigeria. Afr Health Sci, 15(1), 217-225.

Furuta, M., & Salway, S. (2006). Women’s position within the household as a determinants of maternal health care use in Nepal. Int Fam Plan Perspect, 32(1), 17-27.

Gray, R., Bick, D., & Chang. (2014). Health in pregnancy and post-birth: Contribution to improved child outcomes. Journal of Children’s Services, 9(2), 109-127.

Indarwati, L. (2010). Faktor-faktor yang mempengaruhi motivasi ibu hamil untuk memeriksakan kehamilannya dengan menggunakan USG di Poliklinik Kandungan BPRSUD Salatiga tahun 2008. Jurnal Kebidanan, 2(2). Retrieved from:

Islam, M.M., & Masud, M.S. (2018). Health care seeking behavior during pregnancy, delivery and the postnatal period in Bangladesh: Assessing the compliance with WHO Recommendations. Midwifery, 63, 8-16.

Kamal S.M., Hassan, C.H., & Alam, G.M. (2015). Determinants of Institutional Delivery among Women in Bangladesh. Asia Pac J Public Health, 27(2), NP1372 - NP1388.

Kementerian Kesehatan & World Health Organization [WHO]. (2013). Buku Saku Pelayanan Kesehatan Ibu di Fasilitas Kesehatan Dasar dan Rujukan. Jakarta: Kementerian Kesehatan dan WHO.

Klawetter, S. (2014). Conceptualizing Social Determinants of Maternal and Infant Health Disparities. Journal of Women and Social Work. 29(2), 131-141.

Kusuma, D., Cohen, J., McConnell, M., & Berman, P. (2016). Can Cash Transfers Improve Determinants of Maternal Mortality? Evidence from the Household and Community Programs in Indonesia. Soc Sci Med, Vol 163, 10-20.

Larsen, A., Exavery, A., Philips, J.F., Tani, K., & Kanté, A.M. (2016). Predictors of Health Care Seeking Behavior During Pregnancy, Delivery and the Postnatal Period in Rural Tanzania. Matern Child Health J. 20(8), 1726-1734.

Magadi, M.A., Madise, N.J., & Rodrigues, R.N. (2000). Frequency and Timing of Antenatal Care in Kenya: Explaining the Variations Between Women of Different Communities. Social Science and Medicine, 51(4), 551-561.

Mahato, P.K., Teijlingen, E. V., Simkhada, P., Sheppard, Z.A., & Silwal, R. C. (2017). Factors Related to Choice of Place of Birth in A District in Nepal. Journal of Sexual and Reproductive Healthcare. 13, 91-96.

MÃ¥lqvist, M., Phuong Hoa, Dinh Thi, & Thomsen, S. (2012). Causes and Determinants of Inequity In Maternal and Child Health in Vietnam. BMC Public Health. 12(641).

McCarthy, J., & Maine, D. (1992). A Framework for Analyzing the Determinants of Maternal Mortality. Studies in Family Planning. 23(1).23-33.

Mistry, R., Galal, O., & Lu, M. (2009). Women’s autonomy and pregnancy care in rural India: A contextual analysis. Social Science and Medicine, 69(6), 926-933.

Mugo, N.S., Dibley, M.J., & Agho, K.E. (2015). Prevalence and Rick Factors for Non-use of Antenatal Care Visits: Analysis of the 2010 South Sudan Household Survey. BMC Pregnancy Childbirth, 15(68).

Mullany, B.C, Becker, S., & Hindin, M.J. (2007). The Impact of Including Husbands in Antenatal Health Education Services on Maternal Health Practices in Urban Nepal: Results from A Randomized Controlled Trial. Health Education Research, 22(2), 166-176.

Navaneetham, K., & Dharmalingam, A. (2002). Utilization of Maternal Health Care Services in Southern India. Journal of Social Science and Medicine. 55 (10), 1849-1869.

Nielsen, B.B., Hedegaard, M., Liljestrand, J., Thilsted, S.H., & Joseph, A. (2001). Characteristics of Antenatal Care Attenders in a Rural Population in Tamil Nadu, South India: A Community-based cross-sectional Study. Health and Social Care in the Community, 9(6), 327-333.

Nuraini, E., & Parker, E. (2005). Improving Knowledge of Antenatal Care (ANC) Among Pregnant Women: A Field Trial in Central Java, Indonesia. Asia-Pacific Journal of Public Health, 17(1).

Oktaviani, I., Makalew, L., & Solang, S.D. (2016). Profil Haemoglobin pada Ibu Hamil Dilihat dari Beberapa Faktor Pendukung. Jurnal Ilmiah Bidan, 4(1). 22-30 Retrieved from:

Prusty, R.K., Buoy, S., & Kumar, P. (2015). Factors Associated with Utilization of Antenatal Care Services in Cambodia. J Public Health, 23, 297-310.

Sado, L., Spaho, A., & Hotchkiss, D.R. (2014). The influence of women’s empowerment on maternal health care utilization: evidence from Albania. Social Science and Medicine, 114, 169-177.

Shahjahan. M., Chowdhury, H.A., Al-Hadhrami, A.Y., & Harun, G.D. (2017). Antenatal dan Postnatal Care Practices Among Mothers in Rural Bangladesh: A Community Based Cross-sectional Study. Midwifery, 52, 42-48.

Simkhada, B., Porter, M.A., & van Teijlingen, E.R. (2010). The Role of Mothers-in-law in Antenatal Care Decision-Making in Nepal: A Qualitative Study. Pregnancy and Childbirth, 10(34).

The ASEAN Secretariat Jakarta. (2017). ASEAN Statistical Report on Millennium Development Goals 2017. Jakarta: The ASEAN Secretariat. Retrieved from Association of Southeast Asian Nation Website:

Tsegay, Y., Gebrehiwot, T., Goicolea, I., Edin, K., Lemma, H., & Sebastian, M.S. (2013). Determinants of Antenatal dan Delivery Care Utilization in Tigray Region, Ethiopia: A Cross-sectional Study. Journal for Equity in Health, 12(30).

United Nation. (2009). The Millennium Development Goals Report 2009. New York: United Nations Retrieved from United Nations website:

United Nations Children’s Fund [UNICEF] Indonesia. (2012, Oktober). Ringkasan Kajian Kesehatan Ibu dan Anak. Retrieved from:

Wichaidit, W., Alam, M.U., Halder, A.K., Unicomb, L., Hamer, D.H., & Ram, P.K. (2016). Availability and Quality of Emergency Obstetric and Newborn Care in Bangladesh. The American Journal of Tropical Medicine and Hygiene, 95 (2), 298-306.

World Health Organization [WHO]. (2011). World Conference on Social Determinants of Health. Retrieved from:

Yegezu, R.T. dan Kitila, S.B. (2014). Assessment of Factors Affecting Choice of Delivery Place among Pregnant Women in Jimma Zone, South West Ethiopia: Cross Sectional Study. Journal of Women’s Health Care. 4(1).


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