Eka Diah Kartiningrum, Mochammad Ivan Abdillah Putra Ginka

Determinan Spasial Akses Pelayanan Antenatal Pada Ibu Hamil di Jawa dan Bali Pada Masa Pandemi

Introduction

Determinan spasial akses pelayanan antenatal pada ibu hamil di jawa dan bali pada masa pandemi. Analisis determinan spasial akses pelayanan antenatal ibu hamil di Jawa & Bali selama pandemi. Temukan pengaruh sumber daya wanita & komunitas terhadap layanan ANC, persalinan, nifas, dan KB.

Abstract

Latar belakang: Masa pandemi berpengaruh pada akses masyarakat terhadap pelayanan kesehatan terutama pada ibu hamil. Kecemasan terhadap penularan Covid 19 serta pembatasan sosial berdampak pada akses ibu hamil terhadap pelayanan antenatal. Penelitian ini bertujuan menganalisis determinan spasial yang mempengaruhi akses pelayanan antenatal pada ibu hamil di Jawa dan Bali pada Masa pandemi. Metode: Penelitian ini merupakan penelitian non reaktif atau unobstrusif measures di 128 kabupaten/kota yang tersebar di 6 propinsi di Pulau Jawa dan 1 propinsi di Pulau Bali sebagai unit analisis. Data yang terkumpul dianalisis dengan Structural Equation Modelling (SEM) spasial yang memperhatikan bobot spasial Hasil: Hasil penelitian menjelaskan bahwa terdapat pengaruh yang berbeda faktor sumber daya wanita (γ=0,246, p-value=0,007), keluarga (γ=0,034, p-value=0,645), dan komunitas (γ=0,287, p-value=0,004), terhadap pelayanan ANC, persalinan, nifas dan KB di setiap wilayah kabupaten/ kota di Pulau Jawa dan Bali pada masa pandemi. Semakin baik kualitas sumber daya wanita dan komunitas maka semakin baik akses pelayanan antenatal oleh ibu hamil. Kesimpulan: Tinggi rendahnya kualitas sumber daya keluarga tidak mampu mempengaruhi motivasi ibu hamil dalam memanfaatkan pelayanan antenatal.

Review

This study addresses a highly relevant and critical topic concerning the spatial determinants of antenatal care access for pregnant women in Java and Bali during the COVID-19 pandemic. The research effectively highlights how unprecedented health crises can disrupt essential healthcare services, making the investigation of underlying factors crucial. A significant strength of this work lies in its robust methodological approach, utilizing Spatial Structural Equation Modeling (SEM) across a substantial sample of 128 districts/cities. This advanced statistical technique is well-suited to uncover complex relationships while accounting for geographical dependencies, providing a more nuanced understanding of access disparities. The findings, indicating the differential influence of women's and community resources, offer valuable insights for public health policy and intervention strategies. Despite its strengths, the abstract presents several areas that could benefit from further clarification. The description of the methodology as "non-reactive or unobtrusive measures" is somewhat vague; specifying the exact nature and source of the data used would enhance transparency and allow readers to better assess the study's validity and replicability. Additionally, while the title and aim focus specifically on antenatal care, the results section broadly mentions "ANC, persalinan, nifas dan KB," suggesting a wider scope for the model's outcomes than initially stated. Clarifying whether these are individual outcomes or a composite would improve coherence. Furthermore, the conclusion introduces "motivasi ibu hamil" (pregnant women's motivation) as a concept influenced by family resources without explicitly defining or measuring motivation in the methods or results, potentially over-interpreting the statistical non-significance for the family resource variable (p-value=0.645). Overall, this research makes a commendable contribution by shedding light on the spatial dynamics of antenatal care access during a pandemic. The study's findings underscore the importance of investing in women's empowerment and strengthening community support systems to ensure continued access to vital maternal health services, even in challenging circumstances. Future iterations or the full paper would benefit from elaborating on the specific indicators used for "women's resources" and "community resources," and from a more precise alignment between the stated research aim and the breadth of the reported results. This work provides an important foundation for policymakers and healthcare providers to develop targeted, geographically informed interventions that can enhance the resilience of maternal healthcare systems in the face of future crises.

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