Spatial Analysis for Maternal Mortality in Special Region of Yogyakarta, Indonesia

Abstract

Nowdays, Maternal Mortality Ratio (MMR) still an
important health problem in Indonesia, including in Daerah
Istimewa Yogyakarta (DIY). Trend of MMR in DIY
over the past 3 years increased from 64 per 100,000 live
births in 2015 to 87 and 84 in 2016 and 2017. Application
of GIS in Maternal and Child Health (MCH) Program
could obtain new information that supports implementation
of program. The aims of study are to describe
geographical distribution of maternal mortality and its
determinants such as age, education level, occupation,
age of pregnancy, history of previous pregnancy (gravida,
abortion, parity), type of delay, location of death, and
accessibility to health care. Observational analytic with
cross sectional study design. Population is all women
dead which happened during pregnancy until 42 days after
giving birth in 2017 in 5 districts / cities in DIY that recorded
in MCH Provincial Health Office. Total sampling
is used as sampling method. Research instruments using
mobile data collection to collect determinant factors data
and observation checklist also mobile GPS for geotaging.
Data analysis with overlay and nearest neighbor average.
33 maternal mortallity were found in DIY, 12 cases
in Gunung Kidul Regency, 9 in Bantul, 3 in Kulonprogo,
6 in Sleman, and 4 in Yogyakarta City. The overlay results
show the distribution of risk parity and the long distance
with the largest Puskesmas in Kab. Gunung Kidul for 4
cases and 9 cases respectively. Average nearest neighbor
index show value 0.797 abd Z-Score -2.23. Maternal mortality
cases was found mostly in Gunung Kidul Regency as
well as the distribution of risky parity determinants and
long distances with health center health care facilities and
there was no pattern of maternal death distribution in DIY.