Perbandingan Pemanfaatan Continuum of Care Pada Pelayanan Kesehatan Ibu dan Bayi antara Ibu Remaja dan Ibu Dewasa di Indonesia : Analisis Data SKI 2023

Rahadatul 'Aisyi Wafa, Dr. Drs. Abdul Wahab, MPH ; Dr. dr. Shinta Prawitasari, M.Kes, SpOG, Subsp. Obginsos

2026 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Angka kematian ibu dan bayi di Indonesia masih menjadi masalah kesehatan masyarakat. Salah satu upaya untuk menurunkan risiko tersebut adalah melalui Continuum of Care (CoC), yaitu pelayanan kesehatan yang berkesinambungan sejak masa kehamilan hingga pascapersalinan. Namun, pemanfaatan CoC di Indonesia masih belum optimal. Sementara itu, kelahiran pada usia remaja masih terus terjadi dan kelompok ibu remaja diketahui memiliki risiko komplikasi kehamilan yang lebih tinggi serta berbagai hambatan dalam mengakses pelayanan kesehatan. Perbedaan karakteristik tersebut diduga memengaruhi pemanfaatan CoC antara ibu remaja dan ibu dewasa. Penelitian ini bertujuan untuk membandingkan pemanfaatan Continuum of Care pada pelayanan kesehatan ibu dan bayi antara ibu remaja dan ibu dewasa serta menganalisis faktor-faktor yang berhubungan dengan kelengkapan Continuum of Care di Indonesia berdasarkan data Survei Kesehatan Indonesia (SKI) 2023.

Metode: Penelitian kuantitatif dengan desain cross-sectional menggunakan data sekunder SKI 2023. Sampel penelitian terdiri dari 58.507 ibu yang memenuhi kriteria inklusi. Analisis dilakukan menggunakan perangkat lunak STATA dengan mempertimbangkan desain survei kompleks. Analisis bivariat menggunakan uji Chi-square, sedangkan analisis multivariat menggunakan regresi logistik

Hasil: Proporsi ibu yang memperoleh Continuum of Care lengkap sebesar 9,5% pada ibu remaja dan 10,9% pada ibu dewasa. Tidak terdapat hubungan yang signifikan antara usia ibu dengan kelengkapan CoC (aOR = 0,95; 95% CI: 0,74–1,22). Faktor-faktor yang berhubungan dengan kelengkapan CoC meliputi pendidikan ibu, paritas, status ekonomi, kepemilikan jaminan kesehatan, status perkawinan, dan faktor risiko kehamilan. Terdapat pola dose-response pada status ekonomi, sedangkan ibu grand multipara dan ibu dengan faktor risiko kehamilan memiliki peluang CoC lengkap yang lebih rendah.

Kesimpulan: Tidak terdapat perbedaan yang bermakna dalam kelengkapan Continuum of Care antara ibu remaja dan ibu dewasa di Indonesia. Kelengkapan Continuum of Care lebih dipengaruhi oleh faktor pendidikan, status ekonomi, kepemilikan jaminan kesehatan, status perkawinan, paritas, dan faktor risiko kehamilan dibandingkan usia ibu. Upaya peningkatan Continuum of Care perlu difokuskan pada penguatan keberlanjutan pelayanan.

Background: Maternal and infant mortality remain important public health challenges in Indonesia. One strategy to reduce these risks is the implementation of the Continuum of Care (CoC), a comprehensive and continuous approach to maternal and child health services from pregnancy through the postpartum period. However, the utilization of CoC in Indonesia remains suboptimal. Meanwhile, adolescent childbirth continues to occur, and adolescent mothers are known to face a higher risk of pregnancy-related complications as well as various barriers to accessing health services. These differences in characteristics may influence the utilization of CoC among adolescent and adult mothers. Therefore, this study aimed to compare the utilization of the Continuum of Care in maternal and child health services between adolescent and adult mothers and to analyze factors associated with the completion of the Continuum of Care in Indonesia using data from the 2023 Indonesia Health Survey (SKI 2023)

Methods: Quantitative cross-sectional design using secondary data from the 2023 Indonesia Health Survey (Survei Kesehatan Indonesia, SKI). A total of 58,507 mothers who met the inclusion criteria were included in the analysis. Data were analyzed using STATA software with a complex survey design. Bivariate analysis was performed using the Chi-square test, while multivariable analysis was conducted using logistic regression.

Results: The proportion of mothers who completed the Continuum of Care was 9.5% among adolescent mothers and 10.9% among adult mothers. Maternal age was not significantly associated with complete CoC utilization (aOR = 0.95; 95% CI: 0.74–1.22). Factors significantly associated with complete CoC included maternal education, parity, socioeconomic status, health insurance coverage, marital status, and pregnancy risk factors. A dose-response relationship was observed for socioeconomic status, while grand multiparous mothers and mothers with pregnancy risk factors were less likely to complete the Continuum of Care.

Conclusion: There was no significant difference in the completeness of the Continuum of Care between adolescent and adult mothers in Indonesia. Completion of the Continuum of Care was more strongly influenced by maternal education, socioeconomic status, health insurance coverage, marital status, parity, and pregnancy risk factors than by maternal age. Efforts to improve the Continuum of Care should focus on strengthening the continuity of maternal and child healthcare services.

Kata Kunci : Continuum of Care, pelayanan kesehatan ibu dan bayi, ibu remaja, ibu dewasa, SKI 2023