Analysis of Factors Related to the Selection of Maternal Delivery Places in the Working Area of the Ambukha Community Health Centre, Lolofitu District, MOI, West Nias Regency in 2024 / Analisis Faktor-Faktor yang Berhubungan dengan Pemilihan Tempat Persalinan Ibu di Wilayah Kerja Puskesmas Ambukha Kecamatan Lolofitu MOI Kabupaten Nias Barat Tahun 2024

Background: Maternal mortality remains a significant public health concern in Indonesia, where 19.3% of deliveries are still conducted outside healthcare facilities or without skilled birth attendants. The working area of Ambukha Public Health Centre (Puskesmas) has the lowest proportion of facility-based deliveries in the West Nias District (67% in 2023), indicating the need to analyse factors associated with delivery place choice. Objective: To identify factors related to the selection of delivery place among mothers in the working area of Ambukha Public Health Centre, Lolofitu Moi Subdistrict, West Nias District. Methods: This study employed an observational analytic design with a cross-sectional approach. The population consisted of all mothers who delivered within the Ambukha Public Health Centre area in 2023 (N=78), and samples were obtained using a total sampling approach. Data were collected using structured questionnaires and analysed using Chi-square tests and logistic regression. Results: Significant associations were found between the choice of delivery place and maternal knowledge (p=0.000; OR=2.267), maternal attitude (p=0.000; OR=4.250), national health insurance (JKN) membership (p=0.000; OR=5.333), access to healthcare facilities (p=0.000; OR=6.038), husband’s support (p=0.000; OR=4.250), perceived need factors (p=0.000; OR=3.333), as well as cultural beliefs (p=0.004; OR=2.473). Multivariate logistic regression identified maternal knowledge as the most influential factor in delivery place selection, as indicated by the most significant coefficient value (B = –4.204) and statistical significance (p=0.005). Conclusion: Maternal knowledge, attitude, JKN membership, access to healthcare facilities, husband’s support, perceived need, and cultural beliefs are significantly associated with the selection of delivery place. Efforts to increase facility-based delivery coverage in this area should prioritise improving maternal knowledge, followed by strengthening other supporting factors.

Latar Belakang: Tingkat kematian ibu masih menjadi masalah kesehatan masyarakat di Indonesia, di mana 19,3% persalinan tidak dilakukan di fasilitas kesehatan (faskes) atau tidak ditolong tenaga kesehatan. Wilayah kerja Puskesmas Ambukha memiliki persentase persalinan di faskes terendah di Kabupaten Nias Barat (67% pada 2023), sehingga perlu dianalisis faktor-faktor yang berhubungan dengan pemilihan tempat persalinan. Tujuan: Mengidentifikasi faktor-faktor yang berhubungan dengan pemilihan tempat persalinan di wilayah kerja Puskesmas Ambukha, Kecamatan Lolofitu Moi, Kabupaten Nias Barat. Metode: Penelitian analitik observasional dengan pendekatan cross-sectional. Populasi adalah seluruh ibu bersalin di wilayah kerja Puskesmas Ambukha tahun 2023 (N=78), dengan sampel diambil menggunakan teknik total sampling. Data dikumpulkan melalui kuesioner dan dianalisis dengan uji Chi-square serta regresi logistik. Hasil: Terdapat hubungan yang signifikan antara pemilihan tempat persalinan dengan pengetahuan ibu (p=0,000; OR=2,267), sikap ibu (p=0,000; OR=4,250), kepesertaan JKN (p=0,000; OR=5,333), akses ke faskes (p=0,000; OR=6,038), dukungan suami (p=0,000; OR=4,250), faktor kebutuhan (p=0,000; OR=3,333), serta budaya dan keyakinan (p=0,004; OR=2,473). Hasil analisis regresi logistik multivariat menunjukkan bahwa faktor pengetahuan merupakan variabel yang paling dominan berhubungan dengan pemilihan tempat persalinan, dengan nilai koefisien B terbesar (-4,204) dan signifikan secara statistik (p=0,005). Kesimpulan: Faktor pengetahuan, sikap, kepesertaan JKN, akses, dukungan suami, kebutuhan, serta budaya dan keyakinan berhubungan signifikan dengan pemilihan tempat persalinan. Intervensi peningkatan cakupan persalinan di faskes di wilayah ini perlu memprioritaskan upaya peningkatan pengetahuan ibu, diikuti dengan penguatan faktor-faktor pendukung lainnya.