The inequality in infant mortality in Indonesia: evidence-based information and its policy implications

Siswo Poerwanto

Research output: ThesisDoctoral Thesis

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Abstract

[Truncated abstract] The aims of the study were twofold; firstly, to describe the inequality in infant mortality in Indonesia namely, to look at the extent and magnitude of the problem in terms of the estimated number of infant deaths, the differentials in infant mortality rates, the probability of infant deaths across provinces, urban and rural areas, and across regions of Indonesia. Secondly, to examine the effect of family welfare status and maternal educational levels on the probability of infant deaths. The study design was that of a population-based multistage stratified survey of the 1997 Indonesian Demographic and Health Survey. Results of the study were obtained from a sample of 28,810 reproductive women aged 15 to 49 years who belonged to 34,255 households. A binary outcome variable was selected, namely, whether or not each of the live born infant(s) from the interviewed women was alive or dead prior to reaching one year of age. Of interest were the variables related to socio-economic status, measured by Family Welfare Status Index and maternal educational levels. The following risk factors were also investigated: current contraceptive methods; birth intervals; maternal age at first birth; marital duration; infants’ size perceived by the mothers; infants’ birth weight; marital status; prenatal care by health personnel; antenatal TT immunization; place of delivery; and religion. Geographical strata (province) and residence (urban and rural areas) were also considered. Both descriptive and multivariate analyses were undertaken. Descriptive analysis was aimed at obtaining non-biased estimates of the infant mortality rates at the appropriate levels of aggregation. Multivariate analysis involved a logistic regression model using the Generalized Estimating Equations (GEE) model-fitting technique. The procedure, a multilog-cumlogit , uses the Taylor Series Linearization methods to compute modelbased variance, and which adjusts for the complex sampling design. Results of descriptive analysis indicate that, indeed, there are inequalities in infant mortality across administrative divisions of the country, represented by provinces and regions, as well as across residential areas, namely urban and rural areas. Also, the results suggested that there is socio-economic inequality in infant mortality, as indicated by a dose-response effect across strata of family welfare and maternal educational levels, both individually and interactively. These inequalities varied by residence (urban and rural), provinces and regions (Java Bali, Outer Java Bali I and Outer Java Bali II). Furthermore, the probability of infant mortality was significantly greater among highrisk mothers, characterized by a number of risk factors used in the study
Original languageEnglish
QualificationDoctor of Philosophy
Publication statusUnpublished - 2003

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