The role of health insurance in cesarean delivery among working mothers in Indonesia

Aim
Working mothers are a group that tends to be independent in determining the ownership of health insurance, and this situation allegedly increased the utilization of cesarean deliveries among them. The study analyzes the role of health insurance in cesarean delivery among working mothers in Indonesia.

Subject and methods
The investigation employed secondary data from the 2017 Indonesia Demographic and Health Survey. The analysis included 7293 working moms who gave birth in the previous five years. The study used eight control factors in addition to delivery mode and health insurance ownership: the place of residence, age group, education level, marital status, parity, wealth status, antenatal care, and birth type. We applied the regression on binary logistics in the analysis.

Results
The results showed that working mothers with health insurance were 1.536 times more likely to have a cesarean delivery than uninsured women (AOR 1.536; 95% CI 1.324–1.781). Moreover, the study also found five control variables significantly related to cesarean delivery utilization among working mothers in Indonesia. The five were the place of residence, age group, education level, wealth status, and antenatal care visits.

Conclusion
The study concluded that health insurance had a role in cesarean delivery among working mothers in Indonesia. Insured working mothers were one and a half times more likely to have a cesarean delivery than uninsured working mothers.