Thriving beyond survival: Understanding utilization of perinatal health services as predictors of birth registration: A cross-sectional studyReport as inadecuate

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BMC International Health and Human Rights

, 14:306

Health and human rights of marginalized populations


BackgroundThere are an estimated 35 million unregistered children in Indonesia. To understand ways to best leverage existing health system-related resources and ensure greater protective measures for these vulnerable children, this study explores the predictive relationship between the utilization of perinatal health services and birth certificate ownership in two Indonesian provinces.

MethodsThis study employed a cross-sectional design with interviewer-administered household surveys to heads of households in West Nusa Tenggara and East Nusa Tenggara from May to July of 2013. The primary outcome of interest was birth certificate ownership among children under the age of 5 years old. Bivariate and multivariable regression analyses using Generalized Estimating Equations GEE considered a set of covariates that represented child and household socio-demographic characteristics along with health services utilization variables during pregnancy and post-pregnancy periods.

Results389 heads of households were interviewed, yielding data on a sample of 451 children under the age of 5. Fewer than 28% of children in this sample possessed a birth certificate. Nearly 57% n = 259 of children were delivered in a clinical facility, though only 36% n = 93 of these were legally registered. Of children born in the home n = 194, registration dropped to 16% n = 31. Adjusted analyses accounting for socio-demographic factors suggest that children born in a clinic facility AOR = 2.33, 95% CI: 1.27, 4.33, hospital AOR = 2.38, 95% CI: 1.12, 5.09, or in the presence of a skilled birth attendant AOR = 2.35, 95% CI: 1.31, 4.23 were significantly more likely to be registered. Children whose mothers sought post-natal care were 2.99 times more likely to possess a birth certificate AOR = 2.99, 95% CI: 1.1, 7.57. Pre-natal care was not associated with birth registration.

ConclusionThese findings suggest that use of perinatal health services increases the likelihood of registering a child’s birth despite a lack of formal integration of vital registration with the health sector. Formally leveraging existing community-based health workers and perinatal services may serve to further increase registration rates in hard to reach areas of Indonesia.

KeywordsBirth registration Child protection Health services utilization Indonesia Civil registration and vital statistics CRVS  Download fulltext PDF

Author: Michelle Jackson - Putu Duff - Santi Kusumanigrum - Lindsay Stark


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