Regional disparities in postnatal care among mothers aged 15-49 years old: An analysis of the Indonesian Demographic and Health Survey 2017.

Background: In Indonesia, maternal mortality remains high, significantly 61.59% occur in the postnatal period. Postnatal care (PNC) provision is a critical intervention between six hours and 42 days after childbirth and is the primary strategy to reduce maternal mortality rates. However, underutilisation of PNC in Indonesia still remains high, and limited studies have shown the regional disparities of PNC in Indonesia. Methods: This study aims to explore the gaps between regions in PNC service for mothers who have had live births during the last five years in Indonesia. This study was a secondary data analysis study using the Indonesian Demographic and Health Survey (IDHS) in 2017. A total of 13,901 mothers aged 15-49 years having had live births within five years were included. Chi-squared test and binary logistic regression were performed to determine regional disparities in PNC. Results: Results indicated that the prevalence of PNC service utilisation among mothers aged 15-49 years was 70.94%. However, regional gaps in the utilisation of PNC service were indicated. Mothers in the Central of Indonesia have used PNC services 2.54 times compared to mothers in the Eastern of Indonesia (OR = 2.54; 95% CI = 1.77-3.65, p<0.001). Apart from the region, other variables have a positive relationship with PNC service, including wealth quintile, accessibility health facilities, age of children, childbirth order, mother's education, maternal occupation, spouse's age, and spouse's education. Conclusion: The results suggest the need for national policy focuses on service equality, accessible, and reliable implementation to improve postnatal care utilisation among mothers to achieve the maximum results for the Indonesian Universal Health Coverage plan.

Husband's knowledge related to their role in caring wives with preeclampsia risk

OBJECTIVE: Around the world, preeclampsia still become a problem. It is affected nearly eight percent of total pregnancies and resulted in women's morbidity and mortality. Pregnant women who are at risk for preeclampsia certainly need support from the family, especially their husband. Some studies suggest that the expecting fathers was less involved in pregnancy. Other studies also suggested that men have less knowledge about pregnancy complication. The purpose of this study was to analyze the correlation between husband's knowledge and their role in caring wives with preeclampsia risk. METHOD: The design in this study was cross-sectional with purposive sampling. There were 93 husbands involved in the study. Data collection used questionnaires and analyzed by Spearman's rho test (α≤0.01). The independent variable was husband's knowledge and the dependent variable was their role in caring wives with preeclampsia risk. RESULT: More than 60% participant had less knowledge about preeclampsia especially the signs and the risk factors. The majority of husband performed moderate role in caring their wives. Their role included attends antenatal visit, motivates their wives to reduce salt intake and limit tiring activity. Only less than 20% always avoid smoking while at home, helps with house chores, and seeking information related preeclampsia. The results showed that there was a correlation between husband's knowledge and their role in caring wife with preeclampsia risk (p = 0.000; r=0.440). CONCLUSION: Husbands with more knowledge about preeclampsia performed better role in caring wives with preeclampsia risk

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Self-care model application to improve self-care agency, self-care activities, and quality of life in patients with systemic lupus erythematosus.

OBJECTIVES: This study aimed to examine the effect of the application of a self-care model to improve self-care agency (SCA), self-care operation, and quality of life (QoL) in patients with systemic lupus erythematosus (SLE). METHODS: This study employed a pre-experimental design with one pretest-posttest group. Thirty-six respondents were selected through total sampling. The experimental group was provided self-care management training, followed by four weekly home visits. Self-care agency was measured with the self-care agency scale, the other variables through self-rated abilities on the health practices scale and Lupus quality inventory. Data were analysed using paired t-tests with α < 0.05. RESULTS: SLE was common in actively working married women of childbearing age, most of whom had had SLE for 1-2 years (33.3%), with arthritis being the most common symptom (reported by 61.1%). The major flare trigger factor was physical stress (66.7%), resulting in fatigue. On average, the self-care model was able to improve SCA by 19.93%, self-care operation by 17.53%, and QoL by 12.19%. It was significantly effective in enhancing SCA, self-care operation, and QoL in patients with SLE (p < 0.001). CONCLUSIONS: The application of Orem's self-care model is effective in improving SCA, self-care, and QoL, and this study provides evidence of the benefits of its use in the nursing care of patients with SLE in a community setting. Health care providers should incorporate Orem's self-care model in nursing care to enhance SCA, self-care, and QoL in patients with SLE.