Urban-rural differences in the incompleteness of antenatal care coverage in Indonesia: A cross-sectional study.

Introduction: The estimated maternal mortality ratio in Indonesia from 2016 to 2020 was 249 maternal deaths per 100,000 live births. Currently, this ratio remains relatively high. One effort to reduce maternal mortality is to provide regular antenatal care during pregnancy. This study aimed to analyse the urban-rural differences in the incompleteness of antenatal care coverage in Indonesia.

Methods: This cross-sectional study used data from Indonesian Basic Health Research 2018. A total of 64,399 women aged 15-49 years, including 26,792 and 37,607 women from urban and rural areas, respectively, were included. Univariate (percentage), bivariate (chi-square statistics) and multivariate (logistic regression statistics) analyses were conducted.

Results: Approximately 18.2% and 26.4% of the urban and rural participants received incomplete antenatal care, respectively. Secondary and primary education, lack of health insurance, home-based antenatal care, parity greater than 2, travel time to health facilities exceeding 15 min, absence of abortion history, undesired pregnancy and absence of pregnancy complications were associated with incomplete antenatal care in rural areas. Secondary and primary education, home-based antenatal care, travel time to health facilities exceeding 15 min, parity greater than 2 and undesired pregnancy were associated with incomplete antenatal care in urban areas.

Conclusion: Incomplete antenatal care coverage is more prevalent in rural areas than in urban areas, influenced by distinct socio-demographic and healthcare access factors. Strengthening health insurance programmes, improving healthcare facility access and promoting antenatal care education are critical to reducing disparities and ensuring better maternal health outcomes in both urban and rural areas.