[ABSTRAK
Salah satu tujuan pembangunan milenium dari tahun 1990 sampai dengan2015 adalah mengurangi tingkat kematian balita hingga dua per tiga. Sampaidengan saat ini, Indonesia telah berada pada jalur yang tepat dalam mencapaitarget tersebut. Akan tetapi, perkembangan yang lambat pada penurunan kematianbayi menunjukkan bahwa diperlukan perhatian lebih untuk meningkatkankeselamatan pada bayi usia muda. Termotivasi oleh kondisi tersebut, penelitian inihendak mengidentifikasi determinan kematian bayi di Indonesia pada tahun 1997sampai dengan 2012 menggunakan data Indonesia Demographic and HealthSurvey (IDHS) periode ke 4, 5 dan 6. Disamping itu, penelitian ini juga bertujuanuntuk mengidentifikasi eksternalitas yang dapat diperoleh dari investasi padapendidikan ibu, sarana dan prasarana yang memadai pada sumber air minum dansanitasi, serta vaksinasi anak di lingkungan sekitar rumah tangga. Kerangkakonseptual dari penelitian ini didasarkan pada kerangka teoritis Mosley dan Chen(1984). Penelitian ini menggunakan regresi logistik untuk mengestimasi pengaruhdari berbagai macam faktor yang mempengaruhi kematian bayi.Hasil regresi menunjukkan bahwa faktor bio-demografis, yaknikarakteristik ibu dan anak adalah faktor kunci dalam memprediksi kematian bayidi Indonesia. Bayi berjenis kelamin pria, anak kembar, ibu dengan tingkatkelahiran tinggi, jarak kelahiran yang pendek antar bayi, usia ibu diatas 35 tahun,dan komplikasi kehamilan merupakan faktor-faktor yang terbukti berhubunganpositif dengan kematian bayi. Faktor perilaku antara lain institusi kelahiran,pengetahuan tentang cairan rehidrasi oral, dan praktek kontrasepsi merupakanfaktor-faktor penting yang memiliki hubungan negatif dengan kematian bayi.Selain itu, higienitas pada tempat tinggal seperti ketersediaan sumber air minumyang bersih, kepemilikan toilet pribadi, dan penggunaan material lantai yanglebih baik juga merupakan faktor penting yang dapat meningkatkan statusketahanan hidup bayi di Indonesia. Beberapa variabel sosio ekonomis jugaterbukti merupakan determinan penting dari tingkat kematian bayi di Indonesia.Diantara berbagai jenis faktor tersebut, jumah anggota rumah tangga merupakanfaktor yang memiliki keterkaitan yang paling kuat dengan kematian bayi. Padalevel komunitas, regional Sumatra dan Kalimantan pada periode 2012 memilikitingkat keterjadian kematian bayi yang lebih rendah dibandingkan denganregional Jawa dan Bali sedangkan regional Sulawesi pada periode 2007 memilikitingkat keterjadian kematian bayi yang lebih tinggi. Lebih lanjut, penelit ian inimenemukan bahwa partisipasi masyarakat pada program imunisasi pemerintahnasional memberikan efek eksternalitas yang positif pada tingkat ketahanan hidupbayi di Indonesia

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ABSTRACT

Reduction of under-five mortality rate by two-thirds between 1990 and 2015

is a Millennium Development Goal (MDG). Indonesia has been on track in

achieving the MDG target on under-five mortality. However, slower progress on

infant mortality reduction shows that more attention should be given in order to

improve the survival of younger children. Motivated by this situation, this study

attempts to identify determinants of infant mortality in Indonesia between 1997

and 2012 using the 4th, 5th and 6th rounds of the Indonesia Demographic and

Health Survey (IDHS) data. In addition, the study aims to identify externalities

which may be generated by investments in mother’s education, water and

sanitation, and child vaccination by a household’s neighbors. The conceptual

framework is based on Mosley and Chen (1984). Logistic regressions are used to

estimate the effect of a variety of factors on infant mortality.

The regression results shows that bio-demographic factors which include

child and maternal traits are key predictors of infant mortality in Indonesia. Male

sex, birth multiplicity, higher birth rank, shorter birth interval, mother age above

35 years, and complication during pregnancy are positively related to infant

mortality. Behavioral practices such as institutional delivery, knowledge of Oral

Rehydration Solutions (ORS), and especially contraceptive practice are also

important factors that negatively related to infant mortality. Moreover,

household’s hygiene characteristics such as safe drinking water source, private

toilet, and improved flooring materials are also important factors that increase

infant survival status in Indonesia. Some socio economic variables are also found

to be significant determinants of infant mortality in Indonesia. Among the various

factors, the number of household members is the strongest factors related to infant

mortality. At the community level, Sumatra and Kalimantan regions in 2012 have

lower odds of infant mortality, whereas Sulawesi region in 2007 has higher odds

of infant mortality as compare to Java and Bali. Furthermore, the study finds that

immunization participation in the community has a positive spillover effect on

infant survival status.

Relevance to Development Studies

Beside economic achievement, the level of development in a country is also

reflected in the health status of its people. Several health indicators, including

mortality rate in young children, have been used by the United Nation

Development Programme (UNDP) as measurements of poverty. The literature

suggests that the high numbers of Child Mortality Rate (CMR), Infant Mortality

Rate (IMR), and Neonatal Mortality Rate (NMR) exist in the Less Developed

Countries (LDCs). Indonesia, a middle income country in South East Asia has

been successful in reducing child mortality, but has not yet made enough progress

in reducing infant and neonatal mortality. Situation analysis is needed to identify

factors which may provide insights on how greater progress may be achieved.

, Reduction of under-five mortality rate by two-thirds between 1990 and 2015

is a Millennium Development Goal (MDG). Indonesia has been on track in

achieving the MDG target on under-five mortality. However, slower progress on

infant mortality reduction shows that more attention should be given in order to

improve the survival of younger children. Motivated by this situation, this study

attempts to identify determinants of infant mortality in Indonesia between 1997

and 2012 using the 4th, 5th and 6th rounds of the Indonesia Demographic and

Health Survey (IDHS) data. In addition, the study aims to identify externalities

which may be generated by investments in mother’s education, water and

sanitation, and child vaccination by a household’s neighbors. The conceptual

framework is based on Mosley and Chen (1984). Logistic regressions are used to

estimate the effect of a variety of factors on infant mortality.

The regression results shows that bio-demographic factors which include

child and maternal traits are key predictors of infant mortality in Indonesia. Male

sex, birth multiplicity, higher birth rank, shorter birth interval, mother age above

35 years, and complication during pregnancy are positively related to infant

mortality. Behavioral practices such as institutional delivery, knowledge of Oral

Rehydration Solutions (ORS), and especially contraceptive practice are also

important factors that negatively related to infant mortality. Moreover,

household’s hygiene characteristics such as safe drinking water source, private

toilet, and improved flooring materials are also important factors that increase

infant survival status in Indonesia. Some socio economic variables are also found

to be significant determinants of infant mortality in Indonesia. Among the various

factors, the number of household members is the strongest factors related to infant

mortality. At the community level, Sumatra and Kalimantan regions in 2012 have

lower odds of infant mortality, whereas Sulawesi region in 2007 has higher odds

of infant mortality as compare to Java and Bali. Furthermore, the study finds that

immunization participation in the community has a positive spillover effect on

infant survival status.

Relevance to Development Studies

Beside economic achievement, the level of development in a country is also

reflected in the health status of its people. Several health indicators, including

mortality rate in young children, have been used by the United Nation

Development Programme (UNDP) as measurements of poverty. The literature

suggests that the high numbers of Child Mortality Rate (CMR), Infant Mortality

Rate (IMR), and Neonatal Mortality Rate (NMR) exist in the Less Developed

Countries (LDCs). Indonesia, a middle income country in South East Asia has

been successful in reducing child mortality, but has not yet made enough progress

in reducing infant and neonatal mortality. Situation analysis is needed to identify

factors which may provide insights on how greater progress may be achieved.

]