[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
ABSTRACTReduction of under-five mortality rate by two-thirds between 1990 and 2015is a Millennium Development Goal (MDG). Indonesia has been on track inachieving the MDG target on under-five mortality. However, slower progress oninfant mortality reduction shows that more attention should be given in order toimprove the survival of younger children. Motivated by this situation, this studyattempts to identify determinants of infant mortality in Indonesia between 1997and 2012 using the 4th, 5th and 6th rounds of the Indonesia Demographic andHealth Survey (IDHS) data. In addition, the study aims to identify externalitieswhich may be generated by investments in mother’s education, water andsanitation, and child vaccination by a household’s neighbors. The conceptualframework is based on Mosley and Chen (1984). Logistic regressions are used toestimate the effect of a variety of factors on infant mortality.The regression results shows that bio-demographic factors which includechild and maternal traits are key predictors of infant mortality in Indonesia. Malesex, birth multiplicity, higher birth rank, shorter birth interval, mother age above35 years, and complication during pregnancy are positively related to infantmortality. Behavioral practices such as institutional delivery, knowledge of OralRehydration Solutions (ORS), and especially contraceptive practice are alsoimportant factors that negatively related to infant mortality. Moreover,household’s hygiene characteristics such as safe drinking water source, privatetoilet, and improved flooring materials are also important factors that increaseinfant survival status in Indonesia. Some socio economic variables are also foundto be significant determinants of infant mortality in Indonesia. Among the variousfactors, the number of household members is the strongest factors related to infantmortality. At the community level, Sumatra and Kalimantan regions in 2012 havelower odds of infant mortality, whereas Sulawesi region in 2007 has higher oddsof infant mortality as compare to Java and Bali. Furthermore, the study finds thatimmunization participation in the community has a positive spillover effect oninfant survival status.Relevance to Development StudiesBeside economic achievement, the level of development in a country is alsoreflected in the health status of its people. Several health indicators, includingmortality rate in young children, have been used by the United NationDevelopment Programme (UNDP) as measurements of poverty. The literaturesuggests that the high numbers of Child Mortality Rate (CMR), Infant MortalityRate (IMR), and Neonatal Mortality Rate (NMR) exist in the Less DevelopedCountries (LDCs). Indonesia, a middle income country in South East Asia hasbeen successful in reducing child mortality, but has not yet made enough progressin reducing infant and neonatal mortality. Situation analysis is needed to identifyfactors which may provide insights on how greater progress may be achieved., Reduction of under-five mortality rate by two-thirds between 1990 and 2015is a Millennium Development Goal (MDG). Indonesia has been on track inachieving the MDG target on under-five mortality. However, slower progress oninfant mortality reduction shows that more attention should be given in order toimprove the survival of younger children. Motivated by this situation, this studyattempts to identify determinants of infant mortality in Indonesia between 1997and 2012 using the 4th, 5th and 6th rounds of the Indonesia Demographic andHealth Survey (IDHS) data. In addition, the study aims to identify externalitieswhich may be generated by investments in mother’s education, water andsanitation, and child vaccination by a household’s neighbors. The conceptualframework is based on Mosley and Chen (1984). Logistic regressions are used toestimate the effect of a variety of factors on infant mortality.The regression results shows that bio-demographic factors which includechild and maternal traits are key predictors of infant mortality in Indonesia. Malesex, birth multiplicity, higher birth rank, shorter birth interval, mother age above35 years, and complication during pregnancy are positively related to infantmortality. Behavioral practices such as institutional delivery, knowledge of OralRehydration Solutions (ORS), and especially contraceptive practice are alsoimportant factors that negatively related to infant mortality. Moreover,household’s hygiene characteristics such as safe drinking water source, privatetoilet, and improved flooring materials are also important factors that increaseinfant survival status in Indonesia. Some socio economic variables are also foundto be significant determinants of infant mortality in Indonesia. Among the variousfactors, the number of household members is the strongest factors related to infantmortality. At the community level, Sumatra and Kalimantan regions in 2012 havelower odds of infant mortality, whereas Sulawesi region in 2007 has higher oddsof infant mortality as compare to Java and Bali. Furthermore, the study finds thatimmunization participation in the community has a positive spillover effect oninfant survival status.Relevance to Development StudiesBeside economic achievement, the level of development in a country is alsoreflected in the health status of its people. Several health indicators, includingmortality rate in young children, have been used by the United NationDevelopment Programme (UNDP) as measurements of poverty. The literaturesuggests that the high numbers of Child Mortality Rate (CMR), Infant MortalityRate (IMR), and Neonatal Mortality Rate (NMR) exist in the Less DevelopedCountries (LDCs). Indonesia, a middle income country in South East Asia hasbeen successful in reducing child mortality, but has not yet made enough progressin reducing infant and neonatal mortality. Situation analysis is needed to identifyfactors which may provide insights on how greater progress may be achieved.] |
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