E-Conference Unair
International Symposium of Public Health and International Conference of Epidemiology Public Health

FAMILY ROLE, SOCIAL SUPPORT, AND HEALTH SYSTEM PERFORMANCE AS DETERMINANTS OF MATERNAL AND NEONATAL MORTALITY REDUCTION IN THE OSING ETHNIC COMMUNITY

Date Published : 15 September 2026

Contributors

Neni Oktavia

Universitas Jember
Author

Farida Wahyu Ning Tyias

Universitas Jember
Author

Irma Prasetiyowati

Universitas Jember
Author

Iis Rahmawati

Universitas Jember
Author

Keywords

maternal mortality neonatal mortality Osing community high-risk pregnancy cultural partnership

Proceeding

(2026): PROCEEDING OF 9th INTERNATIONAL SYMPOSIUM OF PUBLIC HEALTH (ISOPH)

Track

General Track

License

Copyright (c) 2026 International Symposium of Public Health and International Conference of Epidemiology Public Health

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Abstract

Background: Maternal and neonatal mortality remain major public health concerns in Indonesia. In 2023, Banyuwangi Regency reported 28 maternal and 203 neonatal deaths, many of which occurred in the Osing community where reliance on traditional birth attendants persists. Addressing this issue requires culturally sensitive approaches that integrate family and community roles. This study aimed to analyze the influence of family involvement, social support, and health-system performance on reducing maternal and neonatal mortality in the Osing community. Methods: An analytical observational study with a cross-sectional design was conducted among 107 high-risk pregnant women selected through multistage sampling. Data were obtained via structured questionnaires and analyzed using binary logistic regression (outcome coded 1=successful, 0=not successful; probability cut-off 0.50). Results: The model achieved 72.0% overall accuracy, with 84.4% accuracy for the successful class and 53.5% for the not-successful class. Family involvement was significantly associated with program success (OR 1.097, 95% CI 1.037–1.161, p=0.001) and so was social support (OR 1.083, 95% CI 1.032–1.137, p=0.001). Health-system performance showed a positive, non-significant association (OR 1.038, 95% CI 0.997–1.081, p=0.067). Model fit was acceptable (Hosmer–Lemeshow p=0.62), and explained variance was moderate (Nagelkerke R²=0.51). Conclusion: Family and social support were more influential than formal health-system performance in relation to reductions in maternal–neonatal mortality in the Osing community. Strengthening culturally grounded, family-centered partnerships—engaging families, midwives, cadres, traditional birth attendants, and local leaders—may enhance complication preparedness and offer a replicable approach for similar indigenous settings.

References

Ayati S, Pourali L, Jeddi L, et al.(2020) Neonatal Outcomes of Continues Fetal Heart Rate Monitoring in Low Risk Pregnant Women During Labor. Acta Med Iran. 2020;58(4):155-160. doi:10.18502/acta.v58i4.3919
Chan, G. J., Hunegnaw, B. M., Van Wickle, K., Mohammed, Y., Hunegnaw, M., Bekele, C., Goddard, F. G. B., Tadesse, F., & Bekele, D. (2021). Birhan maternal and child health cohort: A study protocol. BMJ Open, 11(9), 10–15. https://doi.org/10.1136/bmjopen-2021-049692
Dagher, R. K., & Linares, D. E. (2022). A Critical Review on the Complex Interplay between Social Determinants of Health and Maternal and Infant Mortality. Children (Basel, Switzerland), 9(3), 394. https://doi.org/10.3390/children9030394
Dalal, S., Nagar, R., Hegde, R., Vaishnav, S., Abdullah, H., & Kasper, J. (2022). Referral care for high-risk pregnant women in rural Rajasthan, India: A qualitative analysis of barriers and facilitators. BMC Pregnancy and Childbirth, 22(310). https://doi.org/10.1186/s12884-022-04601-6
Dinas Kesehatan Kabupaten Banyuwangi. (2022). Profil Dinas Kesehatan Kabupaten Banyuwangi tahun 2022. Banyuwangi: Dinas Kesehatan Kabupaten Banyuwangi.
Dinas Kesehatan Kabupaten Banyuwangi. (2023). Profil Dinas Kesehatan Kabupaten Banyuwangi tahun 2023. Banyuwangi: Dinas Kesehatan Kabupaten Banyuwangi.
Dinas Kesehatan Provinsi Jawa Timur. (2023). Profil Dinas Kesehatan Provinsi Jawa Timur tahun 2023. Surabaya: Dinas Kesehatan Provinsi Jawa Timur.Sholikah, S. M., Nurwulansari, F., Aini, E. N., Wardoyo, S., & Pramudita, J. J. (2025). The role of continuity of care in high-risk pregnant women in Indonesia. European Journal of Midwifery, 9(January), 2. https://doi.org/10.18332/ejm/195831
Duarsa, A. B. S., & Arjita, I. P. D. (2020). Model modification of participatory of community asset development research in action (YUDHIA) for childbirth and pregnancy. International Journal of Medical Research & Health Sciences, 9(12), 33–51. Retrieved from http://www.ijmrhs.com
Gordon, R. D., Kishi, A., Brown, J. A., Voisin, C., Thomas, N., Riley, S. R., Fareed, N., Bunger, A., Gillespie, S. L., Venkatesh, K. K., Juckett, L., & Brill, S. B. (2025). Rural maternal health interventions: A scoping review and implications for best practices. The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association, 41(1), e70007. https://doi.org/10.1111/jrh.70007
Kabimba, A. W., Matheka, E., & Wakasiaka, S. N. M. (2020). Family and social support system in reducing neonatal morbidity and mortality among neonates born to adolescent mothers. Saudi Journal of Nursing and Health Care, 3(6), 153–160. https://doi.org/10.36348/sjnhc.2020.v03i06.003
Nelson, J. R., Gren, L. H., Dickerson, T. T., Benson, L. S., Manortey, S. O., Ametepey, R., Avorgbedor, Y. E., & Alder, S. C. (2021). Using the Health Belief Model to explore rural maternal utilisation of skilled health personnel for childbirth delivery: A qualitative study in three districts of the Eastern Region of Ghana. Journal of Global Health Reports, 5, e2021102. https://doi.org/10.29392/001c.29883
Prafitri, Lia & Suparni, Suparni & Setianto, Gigih. (2024). Pendampingan Ibu Hamil Dalam Upaya Deteksi Dini Resiko Tinggi Kehamilan. Journal of Community Development. 5. 423-433. 10.47134/comdev.v5i3.287.
Sholikah, S. M., Nurwulansari, F., Aini, E. N., Wardoyo, S., & Pramudita, J. J. (2025). The role of continuity of care in high-risk pregnant women in Indonesia. European Journal of Midwifery, 9(January), 2. https://doi.org/10.18332/ejm/195831
Silva, L. A., Gil, B. M. B., Robledo, F. P., Pires, I. M., Leithardt, V. R. Q., & da Rocha Fernandes, A. M. (2024). Integrating AI and Telemedicine in Maternal-Infant Care: An Innovative Approach for Personalized Healthcare. Procedia Computer Science, 241(2019), 600–605. https://doi.org/10.1016/j.procs.2024.08.087
Souza, J. P., Day, L. T., Rezende-Gomes, A. C., Zhang, J., Mori, R., Baguiya, A., Jayaratne, K., Osoti, A., Vogel, J. P., Campbell, O., Mugerwa, K. Y., Lumbiganon, P., Tunçalp, Ö., Cresswell, J., Say, L., Moran, A. C., & Oladapo, O. T. (2024). A global analysis of the determinants of maternal health and transitions in maternal mortality. The Lancet Global Health, 12(2), e306–e316. https://doi.org/10.1016/S2214-109X(23)00468-0
Sulthoni, A., & Soetopo, D. (2020). Dialektika Bahasa Jawa Dalam Adat Perang Bangkat Suku Osing Kecamatan Singojuruh. In Khazanah Pendidikan.
WHO (2021) Ending Preventable Maternal Mortality (EPMM) A Renewed Focus For Improving Maternal And Newborn Health And Well-Bein.

Downloads

How to Cite

Neni Oktavia, N. O., Farida Wahyu Ning Tyias, F. W. N. T., Irma Prasetiyowati, I. P., & Iis Rahmawati, I. R. (2026). FAMILY ROLE, SOCIAL SUPPORT, AND HEALTH SYSTEM PERFORMANCE AS DETERMINANTS OF MATERNAL AND NEONATAL MORTALITY REDUCTION IN THE OSING ETHNIC COMMUNITY . International Symposium of Public Health and International Conference of Epidemiology Public Health, 104-111. https://e-conference.unair.ac.id/isoph/paper/view/1569