WINDHU, PURNOMO (2002) Keberdayaan Ibu Dalam Keluarga Yang Merupakan Lingkungan Pengasuhan Anak Sebagai Determinan Kematian Bayi Dan Anak. Disertasi thesis, Universitas Airlangga.

Text 31. Windhu Purnomo - 099411609D.pdf Download (6MB)

Abstract

The childhood mortality is still a major public health problem in Indonesia This study investigated determinants, especially women's empowerment within the household, as a sphere of the child care, with infant (0-11 months), child (12-59 months), and multiple underfive child (0-59 months) mortality in Arjasa subdistrict, Kangean island, Sumenep district, Madura, East Java. An ex post facto study was performed by interview and observation. Data were collected in February-April, 1999. The population was women who ever bore live child. Sampling technique was random walk. The outcome variables were the infant mortality, the child mortality, and the multiple underfive child mortality. The predictor (explanatory) variables included family characteristics which consisted: women's empowerment within the household (mobility, fear of disagreeing with husband, domestic violence, access to fmancial resources, decision making autonomy on family issues, work outside horne, 6+ years older husband), assets index, wife's educational level, husband's educational level, family form, previous child death in family, and live children. Other explanatory variables were child characteristics (sex, birth order), maternal characteristics (age of mother at birth of child, birth interval), husband is blood relative, health care behaviour (health care seeking, place of child born), and distance to health facilities. Multiple logistic regression methods were used to model the infant, child, multiple underfive child mortality as the function of predictor variables. Two hundreds and four women were interviewed. The results were: generally, the level of women's empowerment within household was low (60.8 percent had no sufficient mobility, 52.9 percent expressed a lot of fear about disagreeing with their husbands, 26.4 percent had ever been beaten by their husbands, 54.4 percent had no decision making autonomy on family's issues, 62.7 percent had low educational level, although 60.8 percent had access to financial recources and only 32.8 percent had 6+ years older husband). By using the multiple logistic regression technique, this study found the results as follows: First, the determinants of the infant mortality were the assets index (p=O.OO4), 6+ years older husband (p=O.OO4 with estimate of the relative risk or eRR=O.II7), the age of mother at birth of child (p=O.045 with eRR=6.439), and the decision making autonomy on family's issues (p=O.047 with eRR=O.134); Second, the detenninants of the child mortality were the assets index (p=O.004), the decision making autonomy on family's issues (p=O.013 with eRR=O.058), and husbands 6+ years older husband (p=O.038 with eRR=O.209); and Third, no determinants of the multiple underfive child mortality were found significantly. Based on the result finding, the two important recommendations can be proposed as follows: First, a social engineering by advocating, education, training, and other activities should have be done to accelerate women's empowerment, in order that women will have awareness about their rights and sense of equality with men and others, to increasing child survival and welfare. Second, the government should give priority constantly to increase prosperity of the people who have low income, in order to access health care facilities, especially for children and women.

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