Path Analysis Risk Factors that Influence Maternal Mortality in District of Brebes

Background: Maternal mortality is one of health indicators of a country. Based on demographic and health survey in Indonesia in 2012, the data presented the fact that there was a significant increase on maternal mortality which was 359 maternal mortality in every 100,000 live births. Maternal mortality rate indicated a decrease to 305 maternal mortality in every 100,000 live births which was stated as a finding in Intercensal Population Survey in 2015. District of Brebes was one of the districts in the province of Central Java which had the highest maternal mortality in 2016 which was 54 maternal mortality. This research aims to reveal the risk factors that influence maternal mortality. Those are proximate determinants, intermediate determinants and contextual determinants.Subjects and Method: This research was observational analitical study design using a case control. This research was conducted in district of Brebes, Central Java from February to March 2017. Subjects of the research were 162 which were chosen using a table of Sample Size for a Hypothesis Test of the Odds Ratio (1:2), and acquiring 54 cases and 108 controls. The dependent variables were maternal mortality, and the independent variables were maternal education, maternal job, numbers of visits to Antenatal Clinic (ANC), birth attendant, place of delivering babies, high-risk pregnancy, obstetric complications. The data was univariately, bivariately and multivariately analised using a double logistic regression, and then stata 13 path analysis.Results: The results of this research indicated that the risk factors which directly influenced maternal mortality were the amount of visits to ANC<4 times (b= 0.25; 95% CI= 0.07 to 0.42; p= 0.006;) and obstretical complications (b= 1.78; 95% CI= 1.85 to 0.14; p= 0.013). Besides of the ability to recognise the direct effects, path analysis was also to used to present the risk factors that indirectly influenced maternal mortality. Those were high level of education (b= -0.63; 95% CI= -0.91 to 0.34; p= 0.001) and maternal jobs that influenced their numbers of visits to ANC (b = 1.00; 95% CI= 0.34 to 1.67; p= 0.003).Conclusion: Amount of visits to ANC < 4 times and obstretical complications are influenced maternal mortality. High level of education and maternal jobs are influenced their numbers of visits to ANC.Keywords : maternal mortality, risk factors, case control, path analysisCorrespondence: Masturoh. Masters Program in Public Health, Sebelas Maret University, Surakarta. Email: masturoh.bmd@gmaill.com. Mobile: +628783000101.Journal of Maternal and Child Health (2017), 2(1): 11-19https://doi.org/10.26911/thejmch.2017.02.01.0