The Sociodemographic Factors and Accessibility in Utilizing the Maternal and Child Health Handbook for Monitoring Under-Five Children  in North Sumatera

Syafrina Ulfah; Fithri Handayani Lubis; Kiki Rismadi; Diza Fathamira Hamzah

doi:10.37034/medinftech.v4i2.149

Authors

Syafrina Ulfah Universitas Sumatera Utara
Fithri Handayani Lubis Universitas Sumatera Utara
Kiki Rismadi Universitas Sumatera Utara
Diza Fathamira Hamzah Universitas Sumatera Utara

DOI:

https://doi.org/10.37034/medinftech.v4i2.149

Keywords:

Child Health Monitoring, Healthcare Accessibility, MCH Handbook , Sociodemographic Factors, Under-Five Children

Abstract

Utilization of the Maternal and Child Health (MCH) Handbook plays a crucial role in monitoring the health and development of children under five years of age; however, its uptake remains suboptimal. According to the 2023 Indonesian Health Survey (SKI), MCH Handbook utilization for under-five growth monitoring in North Sumatra Province was only 67.9%, below the national average of 74.4%. This study aimed to analyze the influence of sociodemographic factors and healthcare accessibility on MCH Handbook utilization for under-five child monitoring in North Sumatra Province. A cross-sectional design was employed using secondary data from the 2023 SKI. The study sample comprised 4,164 under-five children who owned or had previously owned an MCH Handbook in North Sumatra. Data were analyzed through univariate frequency distribution, bivariate chi-square testing, and multivariate multiple logistic regression using the backward stepwise (likelihood ratio) method. The multivariate analysis demonstrated that health insurance ownership (AOR = 1.389; 95% CI = 1.215–1.587), maternal education (AOR = 1.326; 95% CI = 1.107–1.588), maternal age (AOR = 1.163; 95% CI = 1.009–1.339), and maternal employment (AOR = 1.161; 95% CI = 1.007–1.338) were significant positive predictors of MCH Handbook utilization, while longer travel time to health facilities (AOR = 0.690; 95% CI = 0.503–0.946) was inversely associated. Area classification was not statistically significant. These findings underscore the need for sustained health education targeting mothers, maintenance of universal health insurance coverage, and strengthening of community-based health services particularly posyandu to optimize MCH Handbook utilization in North Sumatra.

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References

H. Al Khairiyah, H. Hardinsyah, M. Dewi, P. R. Alamsyah, and A. Riawan, “Differences in the nutritional and micronutrient malnutrition status among primary school children aged 8–13 years in Bogor, Indonesia,” Amerta Nutr., vol. 9, no. 4, pp. 586–595, 2025, doi: 10.20473/amnt.v9i4.2025.586-595.

A. Kekalih, “Dietary intakes, nutritional and biochemical status of 6 months to 12-year-old children before the COVID-19 pandemic era: The South East Asian Nutrition Survey II Indonesia (SEANUTS II) study in Java and Sumatera Islands, Indonesia,” Public Health Nutr., vol. 28, no. 1, pp. 1–14, 2025, doi: 10.1017/S1368980024001654.

Ministry of Health of the Republic of Indonesia, “Survei Kesehatan Indonesia (SKI) 2023 dalam Angka,” 2023.

Ministry of Health of the Republic of Indonesia, “SSGI 2024 dalam Angka,” 2025.

P. Y. Tan, “Prevalence and key determinants of the triple burden of childhood malnutrition in Southeast Asian countries: A systematic review and meta-analysis,” Crit. Rev. Food Sci. Nutr., vol. 65, no. 28, pp. 5683–5697, 2025, doi: 10.1080/10408398.2024.2419539.

Trihono, Pendek (Stunting) di Indonesia, Masalah dan Solusinya. Jakarta: Lembaga Penerbit Balitbangkes, 2015.

N. B. G. Munthe, E. Ernawati, I. P. Setyatama, S. Patimah, R. Wulan, M. Y. Umar, E. Herdyana, Purwati, Siswati, A. Triana, and N. A. Indraswati, Asuhan Kebidanan Kasus Fisiologis pada Bayi, Balita, dan Anak Pra Sekolah. Jakarta, Indonesia: Nuansa Fajar Cemerlang, 2023.

M. A. Guntara and S. Rahmannia, “Pemanfaatan Buku Kesehatan Ibu dan Anak (KIA) oleh Ibu Hamil dan Balita: Evaluasi Pengetahuan, Sikap, dan Perilaku,” HIGEIA (Journal of Public Health Research and Development), vol. 8, no. 1, pp. 39–50, Jun. 2024, doi: 10.15294/higeia.v8i1.67181..

L. Kurniasari, “Buku KIA dan pemanfaatan untuk peningkatan kesehatan ibu dan anak,” Kesmas Wigama J. Kesehat. Masy., vol. 3, no. 1, pp. 9–18, 2017.

Ministry of Health of the Republic of Indonesia, “Buku Kesehatan Ibu dan Anak,” 2024.

L. W. Green and M. W. Kreuter, Health Program Planning: An Educational and Ecological Approach, 4th ed. New York: McGraw-Hill Education, 2017.

R. M. Andersen, “Revisiting the behavioral model and access to medical care: Does it matter?,” J. Health Soc. Behav., vol. 36, no. 1, pp. 1–10, 1995, doi: 10.2307/2137284.

G. B. Mentari and Susilawati, “Faktor-faktor yang mempengaruhi akses pelayanan kesehatan di Indonesia,” J. Heal. Sains, vol. 33, no. 6, pp. 1–12, 2022, doi: 10.46799/jhs.v4i06.512.

V. A. Widiasari and N. A. Indriastuti, “Gambaran pemanfaatan buku KIA pada ibu hamil,” Manuju Malahayati Nurs. J., vol. 7, no. 7, pp. 3195–3209, Jul. 2025, doi: 10.33024/mnj.v7i7.20822.

N. Farida, “Determinan pemanfaatan buku kesehatan ibu dan anak (KIA) oleh ibu hamil di Puskesmas Wanakerta Kabupaten Karawang,” Southeast Asian J. Midwifery , vol. 2, no. 1, pp. 33–41, Oct. 2016, doi: 10.36749/seajom.v2i1.63.

I. Irwanto, I. Ikhtiar, I. Lutfiya, and W. Purnomo, “Determinants of Maternal and Child Health Handbook Utilization in Surabaya, Indonesia,” Folia Medica Indones., vol. 55, no. 3, p. 223, Oct. 2019, doi: 10.20473/fmi.v55i3.15506.

H. Q. Sumantri, B. Suriani, Subriah, and Marhaeni, “Pengetahuan ibu dalam pemanfaatan Buku KIA tentang SDIDTK anak usia 0-2 tahun di Puskesmas Minasa Upa Makassar,” Media Kebidanan Politek. Kesehat. Makassar, vol. 4, no. 1, pp. 35–39, 2025. Available: https://ojs3.poltekkes-mks.ac.id/index.php/medkeb/article/view/713

N. K. . Dewi, N. K. Martini, and N. Suarjana, “Factors related to the use of Maternal and Child Health Books (MCH) on monitoring toddler growth and development in the working area of Tabanan III Health Center,” J. Kesehatan, Sains, dan Teknol., vol. 3, no. 3, pp. 21–29, 2024.

K. Misrini and N. I. Wahyuni, “Efektivitas penggunaan buku KIA dengan video terhadap pengetahuan persiapan dan tanda vital persalinan pada primigravida,” Manuju Malahayati Nurs. J., vol. 6, no. 5, pp. 1960–1971, 2024, doi: 10.33024/mnj.v6i5.11267.

L. Agusmarlina and N. Khofiyah, “Effect of education about MCH Handbook for mothers of children under two years on MCH Handbook utilization,” Borneo Nurs. J., vol. 7, no. 2, pp. 139–146, 2025, doi: 10.61878/bnj.v7i2.113.

A. Aoki, “The RE-AIM framework-based evaluation of the implementation of the Maternal and Child Health Handbook program in Angola: A mixed methods study,” BMC Health Serv. Res., pp. 1–11, 2022, doi: 10.1186/s12913-022-08454-9.

S. Yaya, “Maternal healthcare insurance ownership and service utilisation in Ghana: Analysis of Ghana Demographic and Health Survey,” PLoS One, vol. 14, no. 4, 2019, doi: 10.1371/journal.pone.0214841.

A. Kuwawenaruwa, G. Mtei, J. Baraka, and K. Tani, “The effects of MCH insurance cards on improving equity in access and use of maternal and child health care services in Tanzania: A mixed methods analysis,” J. Heal. Popul. Nutr., vol. 35, no. 1, p. 37, 2016, doi: 10.1186/s41043-016-0075-8.

O. Magwood, “Effectiveness of home-based records on maternal, newborn and child health outcomes: A systematic review and meta-analysis,” PLoS One, vol. 14, no. 1, pp. 1–17, 2019, doi: 10.1371/journal.pone.0209278.

D. P. Ameriana, “Hubungan dukungan kader terhadap pemanfaatan buku KIA oleh ibu balita di Posyandu Melati 2,” Corona J. Ilmu Kesehat. Umum, Psikolog, Keperawatan dan Kebidanan, vol. 2, no. 4, pp. 22–31, 2024, doi: 10.61132/corona.v2i4.835.

J. Masriawan and Z. Ariadi, “Assessing the effectiveness of the Posyandu Program on maternal and child health outcomes in Kekalik Jaya,” Media Heal. Res., vol. 3, no. 2, pp. 75–83, 2025, doi: 10.70716/mohr.v3i2.246.