Factors Contributing to the Increase of Caesarean Section Among Members of National Health Insurance in Indonesia

Abstract

Every member of the National Health Insurance has the right to get the benefits package according to medical indications and service standards, not at their request. Nevertheless, by many scholars, it is considered ambiguous in reviewing the increasing utilization of caesarean section procedures because of the absence of guideline-defined indications of caesarean sections in Indonesia, which leads to the question of whether it is guideline-defined indications, doctor-defined indications, or maternal request. This study fills this research gap by identifying predisposing, enabling and need factors on the actual behaviour of caesarean section based on the Health-Seeking Behaviour model. Data for the study were obtained through a purposive sample of 564 postpartum women in three provinces. We used logistic regression models to examine factors influencing the caesarean section among NHIS' members. This study highlights self-rated health, religion, non-employee (BP), and moderate-socioeconomic (C status) influence the increasing caesarean section among mothers in the context of the NHI scheme. The most important finding from this study is that individuals in self-rated health with good conditions were also more likely to choose a caesarean section. Implications for consumers education and suggestions for future research are discussed.

Keywords: education, enabling factors, Health-Seeking Behaviour, need factors, predisposing factors, self-rated health.

DOI: 10.7176/EJBM/13-20-02

Publication date:October 31^st 2021