Maternal Mortality in Indonesia. What is the difference between 2019-2023?: A Health Profile-Based, Geographical Analysis

The maternal mortality ratio (MMR) is an indicator of healthcare system performance, and Indonesia is among the five Southeast Asian countries with the highest MMR. The Indonesian Health Profile as a resource for identifying the causes of mortality; however, spatial analysis has not been performed yet. This study aims to analyze the differences in MMR determinants in Indonesia from 2019 to 2023 using spatial analysis methods. This research utilized a cross-sectional design, analyzing data from the Indonesian Health Profile from 2019 to 2023. It focused on indirect factors affecting maternal mortality. Data analysis was performed descriptively using spatial analysis and inferential methods. This study found a significant correlation between MMR and all indirect factors in 2023, including the availability of inpatient community health centers, the number of midwives, the coverage of the fourth antenatal care visit, the proportion of deliveries in health facilities, and the provision of iron and folic acid supplements. MMR was associated with hospital availability in 2021, hepatitis screening coverage in 2022, and tetanus toxoid immunization coverage in 2023 (p-value < 0.001). Conclusion: The factors influencing MMR in Indonesia changed between 2019 and 2023, with almost all indirect factors being associated with MMR in 2023.