Analisis Kualitas Pelayanan Maternal di Rumah Sakit: Pendekatan Literatur Naratif
DOI:
https://doi.org/10.32493/frkm.v8i3.49940Keywords:
Angka Kematian Ibu; Kualitas Pelayanan Maternal; Rumah Sakit Rujukan; Efektivitas Layanan; Review Literatur; Kebijakan KesehatanAbstract
Maternal mortality in Indonesia remains relatively high compared to other ASEAN countries, even though there has been a gradual decline over the past two decades. Various efforts have been made to improve the quality of maternal health services, particularly in hospitals that serve as primary referral centers. This study aims to examine the factors that influence the effectiveness of maternal care in hospitals and to explore intervention strategies that have contributed to reducing maternal mortality. A narrative literature review was conducted, analyzing 16 national and international journal articles published between 2020 and 2025. The findings show that service effectiveness is shaped by both clinical and non-clinical factors, including geographic access, socioeconomic disparities, human resource capacity, information system integration, and the strength of referral systems. In addition, context-sensitive health policies and multisectoral approaches play a critical role in supporting sustainable and impactful interventions for reducing maternal mortality.
References
Adnan, Y., & Ekasari, R. (2025). Socioeconomic disparities in maternal health facility utilization at hospital: Evidence from Indonesia's 2018 Basic Health Research. Social Medicine, 18(1). https://doi.org/10.71164/socialmedicine.v18i01.2025.1763
Adrian, V., Sari, I. R., & Hikmahrachim, H. G. (2021). Establishing data warehouse to improve standardize health care delivery: A protocol development in Jakarta City. arXiv preprint arXiv:2108.09736. https://arxiv.org/abs/2108.09736
Aji, R. S., Efendi, F., Kurnia, I. D., Tonapa, S. I., & Chan, C. M. (2022). Determinants of maternal healthcare service utilisation among Indonesian mothers: A population-based study. F1000Research, 10, 1124. https://doi.org/10.12688/f1000research.73847.2
Aranda, Z., Binde, T., Tashman, K., Tadikonda, A., Mawindo, B., Maweu, D., ... & Fulcher, I. R. (2022). Disruptions in maternal health service use during the COVID-19 pandemic in 2020: experiences from 37 health facilities in low-income and middle-income countries. BMJ global health, 7(1), e007247. https://doi.org/10.1136/bmjgh-2021-007247
Aryastami, N. K., & Mubasyiroh, R. (2021). Traditional practices influencing the use of maternal health care services in Indonesia. PLoS One, 16(9), e0257032. https://doi.org/10.1371/journal.pone.0257032
Aryastami, N. K, & Mubasyiroh, R..(2023). Optimal utilization of maternal health service in Indonesia: a cross-sectional study of Riskesdas 2018. DOI: 10.1136/bmjopen-2022-067959
Baten, A., Biswas, R. K., Kendal, E., & Bhowmik, J. (2025). Utilization of maternal healthcare services in low-and middle-income countries: a systematic review and meta-analysis. Systematic Reviews, 14(1), 88. https://doi.org/10.1186/s13643-025-02832-0
Baumeister, R. F., & Leary, M. R. (1997). Writing narrative literature reviews. Review of general psychology, 1(3), 311-320.
CASP (Critical Appraisal Skills Programme). (2018). CASP Checklists. Retrieved from https://casp-uk.net/casp-tools-checklists/
Creswell, J. W., & Creswell, J. D. (2017). Research design: Qualitative, quantitative, and mixed methods approaches. Sage publications
Dahab, R., & Sakellariou, D. (2020). Barriers to accessing maternal care in low income countries in Africa: a systematic review. International journal of environmental research and public health, 17(12), 4292. https://doi.org/10.3390/ijerph17124292
Damayani, A. D., & Liana, D. S. (2017). Exploring determinants influencing the utilisation of antenatal care in Indonesia: A narrative systematic review. ARCHIVOS DE MEDICINA, 2(4), 69. https://doi.org/10.4172/2472-1654.100110
Dananjaya, C. R. G. (2023). Factors That Foster Collaboration Between Health Care Authorities and Community Health Workers in Rural Indonesia (Master's thesis, Harvard Medical School).
Ekawati, F. M., Muchlis, M., & Tuteja, A. (2023). Adopting international recommendations to design a model for maternal health service to cope with pandemic disruption for Indonesian primary care. BMC Pregnancy and Childbirth, 23, 5433. https://doi.org/10.1186/s12884-023-05433-8
Ferrari, R. (2015). Writing narrative style literature reviews. Medical writing, 24(4), 230-235. https://doi.org/10.1179/2047480615Z.000000000329
Gayatri, R. V., Hsu, Y. Y., & Damato, E. G. (2023, February). Utilization of maternal healthcare services among adolescent mothers in Indonesia. In Healthcare (Vol. 11, No. 5, p. 678). MDPI. https://doi.org/10.3390/healthcare11050678
Herwansyah, H., Czabanowska, K., Kalaitzi, S., & Schröder-Bäck, P. (2024, December). Understanding Interpersonal Influences on Maternal Health Service Utilization at Community Health Centers: A Mixed-Methods Study in Indonesia. In Healthcare (Vol. 13, No. 1, p. 42). MDPI. https://doi.org/10.3390/healthcare13010042
Hao, J. et al. (2023). Mobile Prenatal Education and Its Impact on Reducing Adverse Pregnancy Outcomes: Retrospective Real-World Study. DOI: 10.2196/46910
Idris, H., & Syafriyanti, W. (2021). Determinants of postnatal care service utilization in Indonesia: a secondary analysis using the Indonesian health and demographics survey. https://doi.org/10.7454/msk.v25i1.1260
Istifa, M. N., Efendi, F., Wahyuni, E. D., Ramadhan, K., Adnani, Q. E. S., & Wang, J. Y. (2021). Analysis of antenatal care, intranatal care and postnatal care utilization: Findings from the 2017 Indonesian Demographic and Health Survey. Plos one, 16(10), e0258340. https://doi.org/10.1371/journal.pone.0258340
Juliansyah, R., Aqid, B. M., Salsabila, A. P., & Nurfiyanti, K. (2024). Implementation of EMR system in Indonesian health facilities: Benefits and constraints. arXiv preprint arXiv:2410.12226. https://arxiv.org/abs/2410.12226
Kurniati, A., Chen, C. M., Efendi, F., & Berliana, S. M. (2018). Factors influencing Indonesian women's use of maternal health care services. Health care for women international, 39(1), 3-18. https://doi.org/10.1080/07399332.2017.1393077
Leggat, S. G., Bartram, T., Stanton, P., Bamber, G. J., & Sohal, A. S. (2015). Have process redesign methods, such as Lean, been successful in changing care delivery in hospitals? A systematic review. Public Money & Management, 35(2), 161-168. https://doi.org/10.1080/09540962.2015.1007714
Megatsari, H., Laksono, A. D., Ibad, M., Herwanto, Y. T., Sarweni, K. P., & Geno, R. A. P. (2021). The disparities in health insurance ownership of hospital-based birth deliveries in eastern Indonesia. BMC Health Services Research, 21, 7246. https://doi.org/10.1186/s12913-021-07246-x
Nababan, H. Y., Hasan, M., Marthias, T., Dhital, R., Rahman, A., & Anwar, I. (2017). Trends and inequities in use of maternal health care services in Indonesia, 1986–2012. International journal of women's health, 11-24. https://doi.org/10.2147/IJWH.S144828
Nasution, S. K. (2021). Upaya pemulihan dampak COVID-19 terhadap pelayanan kesehatan ibu dan anak/keluarga berencana di Provinsi Sumatera Utara. Jurnal Kebijakan Kesehatan Indonesia, 10(3). https://doi.org/10.22146/jkki.69496
Nuryana, D., Viwattanakulvanid, P., & Romadlona, N. A. (2022). Maternal health services utilization and its contributing factors among adolescent mothers. Journal of Public Health Science (IJPHS), 11(1), 77-87. https://doi.org/10.11591/ijphs.v11i1.21041
Osaki, K., Hattori, T., Toda, A., Mulati, E., Hermawan, L., Pritasari, K., ... & Kosen, S. (2019). Maternal and Child Health Handbook use for maternal and child care: a cluster randomized controlled study in rural Java, Indonesia. Journal of Public Health, 41(1), 170-182. https://doi.org/10.1093/pubmed/fdx175
Pant S, Koirala S, Subedi M. Maternal Health Services during COVID-19. Europasian J Med Sci. 2020; 2(Covid-19 Special Issue): 468-50. https://doi.org/10.46405/ejms.v2i2.110
Regif, S. Y., Nasution, F. A., Pattipeilohy, A., Naif, Y. I., Thamrin, M. H., & Indainanto, Y. I. (2023). Revitalizing Rural Healthcare: A Case Study of Village Maternity Cottages in Indonesia. International Journal of Sustainable Development & Planning, 18(10). https://doi.org/10.18280/ijsdp.181030
Restianingrum, M., et al. (2024). Subnational government engagement to strengthen maternal and perinatal death surveillance and response implementation to improve maternal and newborn care in East Sumba District, Indonesia. BMC Proceedings, 18(5), F29.5. https://doi.org/10.1186/s12919-024-00000-0
Roder-DeWan, S., Madhavan, S., Subramanian, S., Nimako, K., Lashari, T., Bathula, A. N., Sathurappan, R., Kumar, S., & Chopra, M. (2023). Service delivery redesign is a process, not a model of care. BMJ (Clinical research ed.), 380, e071651. https://doi.org/10.1136/bmj-2022-071651
Semrau, E.A. Katherine, Ph.D., M.P.H., Lisa R. Hirschhorn, M.D., M.P.H.et al. ( 2017), Outcomes of a Coaching-Based WHO Safe Childbirth Checklist Program in India, DOI: 10.1056/NEJMoa1701075 VOL. 377 NO. 24
Shah, V., Hatamyar, J., Hidayat, T., & Kreif, N. (2025). Exploring the heterogeneous impacts of Indonesia's conditional cash transfer scheme (PKH) on maternal health care utilisation using instrumental causal forests. arXiv preprint arXiv:2501.12803. https://arxiv.org/abs/2501.12803
Soedarmono, Y. S. M. (2017). The Indonesian approach to reduce maternal mortality. ISBT Science Series, 12(1), 272-280. https://doi.org/10.1111/voxs.12317
Suparji, S., Nugroho, H. S. W., Sunarto, S., Latif, A., & Prayogi, A. S. (2024). Impact, Implications, Challenges of Accelerating Maternal Mortality Rates in Indonesia. Health Dynamics, 1(3), 104-107. https://doi.org/10.33846/hd10306
Susanti, A. I., Ali, M., Hernawan, A. H., Rinawan, F. R., Purnama, W. G., Puspitasari, I. W., & Stellata, A. G. (2022). Midwifery continuity of care in Indonesia: Initiation of mobile health development integrating midwives’ competency and service needs. International Journal of Environmental Research and Public Health, 19(21), 13893. https://doi.org/10.3390/ijerph192113893
Swarjana, I. K., Chansatitporn, N., Suwannapong, N., Lapvongwatana, P., & Amnatsatsue , K. (2020). Disparities in utilization of maternal health services in the rural areas of Indonesia: an analysis among provinces with low, middle, and high poverty rates. Journal of Public Health and Development, 18(3), 49–63. retrieved from https://he01.tci-thaijo.org/index.php/AIHD-MU/article/view/242574
Syairaji, M., Nurdiati, D., Wiratama, B.S. et al. Trends and causes of maternal mortality in Indonesia: a systematic review. BMC Pregnancy Childbirth 24, 515 (2024). https://doi.org/10.1186/s12884-024-06687-6.
Thaddeus, S., & Maine, D. (1994). Too far to walk: maternal mortality in context. Social science & medicine, 38(8), 1091-1110. https://doi.org/10.1016/0277-9536(94)90226-7
Tikkanen, R., Gunja, M. Z., FitzGerald, M., & Zephyrin, L. (2020). Maternal mortality and maternity care in the United States compared to 10 other developed countries. The Commonwealth Fund, 10, 22. https://doi.org/10.26099/411v-9255
UNFPA Indonesia. (2023). Strengthening Data to Reduce Maternal Deaths in Indonesia. https://indonesia.unfpa.org/en/news/strengthening-data-reduce-maternal-deaths-indonesia
Wahyono, T. Y. M., & Shivalli, S. (2020). Determinants of healthcare facility utilization for childbirth in Kuantan Singingi regency, Riau province, Indonesia 2017. BMC Public Health, 20, 933. https://doi.org/10.1186/s12889-020-09035-3
Wardani, Y., & Santri, I. N. (2022). Reform of maternal and child health services during the COVID-19 pandemic: Is it necessary? Epidemiology and Society Health Review, 3(2), 3865. https://doi.org/10.26555/eshr.v3i2.3865
World Health Organization. (2024). WHO, Ministry of Health and partners conduct crucial research on the impact of COVID-19 on maternal and newborn health and related service disruptions. https://www.who.int/indonesia/news/detail/24-05-2024-who--ministry-of-health-and-partners-conduct-crucial-research-on-the-impact-of-covid-19-on-maternal-and-newborn-health-and-related-service-disruptions
World Health Organization. (2024). Networks of care for maternal and newborn health: implementation guidance. World Health Organization
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Jurnal Ilmiah Manajemen Forkamma
This work is licensed under a Creative Commons Attribution 4.0 International License.
Open Access
JIMF (Jurnal Ilmiah Manajemen Forkamma) is a national peer reviewed and open access journal that publishes significant and important research from all area of agroindustry.
This journal provides immediate open access to its content that making research publish in this journal freely available to the public that supports a greater exchange of knowledge.
Copyright
Submission of a manuscript implies that the submitted work has not been published before (except as part of a thesis or report, or abstract); that it is not under consideration for publication elsewhere; that its publication has been approved by all co-authors. If and when the manuscript is accepted for publication, the author(s) still hold the copyright and retain publishing rights without restrictions. Authors or others are allowed to multiply article as long as not for commercial purposes. For the new invention, authors are suggested to manage its patent before published. The license type is CC-BY-SA 4.0.
Disclaimer
No responsibility is assumed by publisher and co-publishers, nor by the editors for any injury and/or damage to persons or property as a result of any actual or alleged libelous statements, infringement of intellectual property or privacy rights, or products liability, whether resulting from negligence or otherwise, or from any use or operation of any ideas, instructions, procedures, products or methods contained in the material therein.
