Selection of Antenatal and Childbirth Care in Rejang Ethnic Group Based on Rational Choice Perspective

Abstract

The focus of this research is the rationality of Rejang Ethnic community in the Pagar Jati subdistrict in Bengkulu Tengah Distric, Bengkulu Province in choosing antenatal care and birth attendants services according to the perspective of Coleman’s rational choice theory. The study used qualitative methods with ethnographic approach. The data was collected by participant-observation technique through direct observation and in-depth interview to obtain data that cannot be observed with participant-observation. In addition, to complete the data, documentation was done by using the camera. The data was analyzed inductively with an interactive model based on qualitative interpretation with emic approach. The study found that people still put TBAs (Traditional Birth Attendants) services for antenatal care and delivery assistance. The role of TBAs cannot be replaced completely by medical midwife personnel. Coleman’s rational choice theory says that the actor seeks to reduce costs and maximize the purpose. The endeavor is also determined by the resources and social institution, preferences and external conditions. The effort to take into account the costs in decision making raised by Coleman has been proven by the fact that more actors choose TBAs for antenatal care and childbirth assistance. However, the cost is not the major consideration, as people all have health insurance cards for the poor that can be used to obtain medical services. The rationality of the society considers TBAs to be the first choice because; trust in the TBAs are still very high, the type of service received more and more satisfying, lower costs, payment terms are not specified, the service time is not limited and can be adjusted in accordance with the wishes of pregnant women, examination and help always start with a prayer or mantra, comfort in speech in the local language, and the strong relational and kinship between TBAs and the community. While most of these considerations are not owned by the medical officers (midwives and village midwives). Resources, social institution, preferences and external conditions are necessary for the actors and taken into consideration in determining the service selection. While, the rational action of the community belongs to value oriented- rational action.

Keywords: Traditional Birth Attendant, Medical Officer, Resource, Social Institutions,  Preferences, external conditions, Rational Choice.