Why do women not utilize maternal health services at Puskesmas? an explorative qualitative study of healthcare workers in Indonesia
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Maastricht University, Department of International Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine, and Life Sciences, Maastricht University, Duboisdomein 30, 6229 GT, Maastricht, Netherlands
Indiana University
University of Applied Sciences for Police and Public Administration in North Rhine-Westphalia, Institute of History and Ethics of Police and Public Administration (IGE), University of Applied Sciences for Police and Public Administration in North Rhine-Westphalia, Dennewartstrasse 25-27, 52068 Aachen, Germany
Publication date: 2023-04-26
Popul. Med. 2023;5(Supplement):A1099
Maternal health services at the Community Health Center (Puskesmas) are generally underutilized. The importance of service utilization at this healthcare facility is aimed at improving maternal health quality in response to maternal mortality reduction. Sociodemographic factors are primarily associated with low utilization of maternal healthcare services in primary care settings. Many women, including the healthcare women cohort, preferred to visit other healthcare facilities instead of the Puskesmas. The purpose of this study was to explore and describe the reasons why female healthcare workers do not use maternal health services at Puskesmas. This descriptive explorative qualitative study was conducted in eleven Puskesmas in the Municipality of Sungai Penuh, Indonesia. Eleven Focus Group Discussions (FGDs) were carried out with female healthcare workers from those eleven Puskesmas. The Attride-Stirling’s thematic network analysis approach was employed to analyse the data. Finding suggests that although the participants considered the maternal health services at Puskesmas as one of the essential programs, they preferred seeking the services at other maternity care facilities. The underlying reasons were often conditioned by the women’s motivation to obtain services from private clinics or hospitals. They believed that these facilities provide comprehensive maternity care services, which include well-equipped examination tools, the quality of services, and the availability of specialist doctors. Other related reasons include a lack of self-motivation to use the services at Puskesmas due to working conditions. The healthcare workers contended that they have to focus on their responsibilities in their stations without interrupting other staff serving other clients. Hence, they chose other healthcare facilities that open after working hours. Individual-level factors influence female health workers not to utilize the services. The sociodemographic factors of the participants should be adequately considered in the design of the appropriate interventions to raise awareness of the importance of maternal health service utilization at Puskesmas.
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