Socioeconomic and Geographical Analysis on Antenatal Care Visits in Indonesia: A Cross-sectional Study

Authors

1 Doctoral Program of Faculty of Public Health, University of Airlangga, Indonesia;

2 Research Center for Public Health and Nutrition, National Research and Innovation Agency Republic of Indonesia, Cibinong Science Center, Indonesia;

3 Faculty of Public Health, University of Airlangga, Kampus C Unair, Indonesia;

4 Directorate of Laboratory Management, Research Facilities, and Science and Technology Park, National Research and Innovation Agency, Indonesia

10.30476/ijcbnm.2026.106865.2797

Abstract

Background: Antenatal care (ANC) is crucial for reducing maternal and neonatal mortality by
detecting and managing pregnancy complications. In Indonesia, a policy mandating at least six ANC
visits (K6) per pregnancy has been introduced, yet factors influencing adequate ANC under this new
policy remain unevaluated. This study examines the national and sub-national prevalence of adequate
ANC visits as well as its associated geographic and socioeconomic factors.
Methods: This cross-sectional study analyzed data from the 2023 Indonesian Health Survey, which
included 70,916 women of reproductive age. Logistic regression was used to assess predictors of ANC
adequacy, such as age, education, marital status, health insurance, employment, urbanicity, economic
status, and travel time to healthcare facilities. The data were analyzed through SPSS version 23 using
descriptive statistics, chi square test, and multiple logistic regression. Final regression model was
based on significant predictors only with calculated adjusted odd ratios and 95% confidence interval
(CI) with a significance level of 0.05.
Results: The national prevalence of adequate ANC visits was 38.65%. However, a significant disparity
was observed between provinces, with eastern areas showing much lower prevalence than provinces
in western Indonesia. ANC adequacy was highest among women aged 25–29 and lowest among those
under 20. Higher education (aOR=1.45, P<0.001), combined health insurance (aOR=2.84, P<0.001),
employment (aOR=1.07, P<0.001), urban residence (aOR=1.24, P<0.001), and higher economic status
(aOR=1.60, P<0.001) were positively associated with ANC adequacy. Conversely, being divorced
(aOR=0.76, P<0.001) and widowed (aOR=0.74, P=0.004), and longer travel times to primary healthcare
center negatively affected compliance (aOR=0.68, P<0.001).
Conclusion: Addressing geographic and socioeconomic barriers through improved healthcare
infrastructure, transportation support, and expanded insurance coverage is essential for increasing
ANC utilization and improving maternal health in Indonesia.

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