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The Impact of the COVID-19 Pandemic on Maternal Mortality Rates in Indonesia: A Retrospective Cohort Study Imanuel Simbolon; Louisa Istarini; Desiree Montesinos; Habiburrahman Said; Yi-Fen Huang
Sriwijaya Journal of Obstetrics and Gynecology Vol. 1 No. 2 (2023): Sriwijaya Journal of Obstetrics and Gynecology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjog.v1i1.21

Introduction: The COVID-19 pandemic has presented unprecedented challenges to healthcare systems worldwide. Early reports have indicated an increase in maternal mortality rates (MMR) in various settings. This study aims to investigate the impact of the COVID-19 pandemic on MMR in Indonesia, a populous country in Southeast Asia with a high MMR. Methods: A retrospective cohort study was conducted using data from the Indonesian Ministry of Health's Maternal Mortality Surveillance System (MMSS). The study population included all pregnant women who delivered in Indonesia between January 1st, 2018, and December 31st, 2022. Women were categorized into two groups: those who delivered before the pandemic (January 1st, 2018, to February 29th, 2020) and those who delivered during the pandemic (March 1st, 2020, to December 31st 2022). The primary outcome was maternal death. Multivariable logistic regression was used to assess the association between the pandemic period and maternal mortality, adjusting for potential confounders. Results: A total of 1,250,480 deliveries were included in the study. The MMR during the pandemic period was 155 per 100,000 live births, compared to 118 per 100,000 live births pre-pandemic. After adjusting for confounders such as maternal age, socioeconomic status, and access to healthcare, the pandemic period was independently associated with an increased risk of maternal mortality (adjusted odds ratio [aOR] = 1.32; 95% confidence interval [CI], 1.25-1.39). Conclusion: The COVID-19 pandemic was associated with a significant increase in MMR in Indonesia. This highlights the need for continued efforts to strengthen maternal healthcare systems and ensure access to quality care, especially during public health emergencies.

The Impact of Dental Anxiety on Oral Health-Related Quality of Life in Children: A Longitudinal Study in Jakarta, Indonesia Ni Made Nova Indriyani; Dea Albertina; Desiree Montesinos; Rheina Weisch Fedre; Winata Putri
Crown: Journal of Dentistry and Health Research Vol. 1 No. 2 (2023): Crown: Journal of Dentistry and Health Research
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/crown.v1i2.88

Introduction: Dental anxiety is a common problem among children, and it can have a significant impact on their oral health-related quality of life (OHRQoL). This longitudinal study aimed to investigate the impact of dental anxiety on OHRQoL in children in Jakarta, Indonesia. Methods: A cohort of 200 children aged 6-12 years was recruited from six elementary schools in Jakarta. Dental anxiety was assessed using the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) at baseline, 6 months, and 12 months. OHRQoL was measured using the Child Perceptions Questionnaire (CPQ11-14) at the same time points. Sociodemographic data and oral health status were also collected. Linear mixed models were used to assess the association between dental anxiety and OHRQoL over time, adjusting for potential confounders. Results: Dental anxiety was significantly associated with lower OHRQoL scores at all time points. Children with higher dental anxiety scores reported more problems with oral symptoms, functional limitations, emotional well-being, and social well-being. This association persisted even after adjusting for age, gender, socioeconomic status, and oral health status. Conclusion: Dental anxiety has a significant negative impact on OHRQoL in children. Early identification and management of dental anxiety are crucial to improve children's oral health and overall well-being.

Structural Divergence in Reproductive Agency: Unraveling the 'Matrilineal Buffer' Against Contraceptive Discontinuation in Indonesia Using Multi-Group SEM Leonardo Simanjuntak; Cinthya Callathea; Desiree Montesinos; Firzan Dahlan
Open Access Indonesia Journal of Social Sciences Vol. 8 No. 2 (2025): Open Access Indonesia Journal of Social Sciences
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijss.v8i2.299

Despite the historical success of Indonesia's family planning program, the contraceptive prevalence rate (CPR) has stagnated, driven largely by high rates of contraceptive discontinuation (29%). Conventional demographic analyses often attribute this to biomedical side effects, overlooking the structural influence of kinship systems and the potential confounding role of socioeconomic status. This study aims to analyze the structural pathways linking patriarchal gender norms to contraceptive discontinuation, mediated by reproductive autonomy, while explicitly controlling for educational attainment. We compare Indonesia’s two dominant cultural groups: the matrilineal Minangkabau and the patriarchal Javanese. A comparative cross-sectional study was conducted with 1,450 married women of reproductive age in West Sumatra (Minangkabau, n=725) and Central Java (Javanese, n=725). We employed Multi-Group Structural Equation Modeling (MG-SEM) with a rigorous invariance testing protocol. The model tested the "Patriarchal Norms → Reproductive Autonomy → Discontinuation Propensity" pathway, adjusting for age and education level. Measurement invariance (Configural and Metric) was established, allowing for valid group comparisons. The Minangkabau group exhibited significantly higher education levels (p<0.001). However, even after controlling for education, the structural analysis revealed a distinct divergence. Among Javanese women, patriarchal norms significantly suppressed autonomy (β = -0.58, p < 0.001), leading to higher discontinuation propensity. Conversely, Minangkabau women displayed a "Matrilineal Buffer"; the path from patriarchal norms to autonomy was non-significant (β = -0.09, p > 0.05), suggesting that cultural leverage protects decision-making power regardless of internalized gender norms. In conclusion, the mechanism of contraceptive discontinuation is culturally distinct. The "Matrilineal Buffer" is a robust structural phenomenon that persists independent of educational advantages. Interventions in patriarchal settings must dismantle barriers to female autonomy, while programs in matrilineal settings should focus on quality of care.

Structural Divergence in Reproductive Agency: Unraveling the 'Matrilineal Buffer' Against Contraceptive Discontinuation in Indonesia Using Multi-Group SEM Leonardo Simanjuntak; Cinthya Callathea; Desiree Montesinos; Firzan Dahlan
Open Access Indonesia Journal of Social Sciences Vol. 8 No. 2 (2025): Open Access Indonesia Journal of Social Sciences
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijss.v8i2.299

Despite the historical success of Indonesia's family planning program, the contraceptive prevalence rate (CPR) has stagnated, driven largely by high rates of contraceptive discontinuation (29%). Conventional demographic analyses often attribute this to biomedical side effects, overlooking the structural influence of kinship systems and the potential confounding role of socioeconomic status. This study aims to analyze the structural pathways linking patriarchal gender norms to contraceptive discontinuation, mediated by reproductive autonomy, while explicitly controlling for educational attainment. We compare Indonesia’s two dominant cultural groups: the matrilineal Minangkabau and the patriarchal Javanese. A comparative cross-sectional study was conducted with 1,450 married women of reproductive age in West Sumatra (Minangkabau, n=725) and Central Java (Javanese, n=725). We employed Multi-Group Structural Equation Modeling (MG-SEM) with a rigorous invariance testing protocol. The model tested the "Patriarchal Norms → Reproductive Autonomy → Discontinuation Propensity" pathway, adjusting for age and education level. Measurement invariance (Configural and Metric) was established, allowing for valid group comparisons. The Minangkabau group exhibited significantly higher education levels (p<0.001). However, even after controlling for education, the structural analysis revealed a distinct divergence. Among Javanese women, patriarchal norms significantly suppressed autonomy (β = -0.58, p < 0.001), leading to higher discontinuation propensity. Conversely, Minangkabau women displayed a "Matrilineal Buffer"; the path from patriarchal norms to autonomy was non-significant (β = -0.09, p > 0.05), suggesting that cultural leverage protects decision-making power regardless of internalized gender norms. In conclusion, the mechanism of contraceptive discontinuation is culturally distinct. The "Matrilineal Buffer" is a robust structural phenomenon that persists independent of educational advantages. Interventions in patriarchal settings must dismantle barriers to female autonomy, while programs in matrilineal settings should focus on quality of care.

Transnational Networks and Social Cohesion Among Climate-Displaced Populations: A Cross-Sectional Study in Coastal Indonesia Immanuel Simbolon; Desiree Montesinos; Jujuk Maryati
Open Access Indonesia Journal of Social Sciences Vol. 9 No. 1 (2026): Open Access Indonesia Journal of Social Sciences
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijss.v9i1.319

Climate-induced displacement in coastal Indonesia creates unprecedented challenges for affected populations seeking economic stability and psychological resilience. This cross-sectional analytical study examined the role of transnational networks, social cohesion, government support, and digital connectivity in climate adaptation success among 373 internally displaced persons (IDPs) across three coastal districts (Demak, Pekalongan, and Indramayu) in Central Java from January to June 2024. Using binary logistic regression, we assessed nine predictors of successful climate adaptation, defined as sustainable livelihood restoration and psychological well-being. Transnational Network Strength (TNS) emerged as the strongest predictor (adjusted odds ratio [AOR] = 2.58, 95% CI 1.59–4.18, p < 0.001), followed by Social Cohesion (AOR = 2.14, 95% CI 1.33–3.44, p = 0.002) and Government Support (AOR = 1.62, 95% CI 1.03–2.56, p = 0.038). Digital Connectivity Index and low psychological distress were also significant protective factors (AOR = 1.68, p = 0.034 and AOR = 1.82, p = 0.014, respectively). The multivariate model demonstrated good discrimination (area under the curve = 0.81) and acceptable calibration (Hosmer-Lemeshow p = 0.592), with 75.3% overall accuracy. Partial correlation analysis revealed a moderate positive association between TNS and social cohesion (r = 0.47, controlling for confounders). These findings underscore the critical importance of fostering transnational connections, strengthening community bonds, and expanding digital access to enhance adaptation outcomes among climate-displaced populations in vulnerable coastal regions.

Transnational Networks and Social Cohesion Among Climate-Displaced Populations: A Cross-Sectional Study in Coastal Indonesia Immanuel Simbolon; Desiree Montesinos; Jujuk Maryati
Open Access Indonesia Journal of Social Sciences Vol. 9 No. 1 (2026): Open Access Indonesia Journal of Social Sciences
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijss.v9i1.319

Climate-induced displacement in coastal Indonesia creates unprecedented challenges for affected populations seeking economic stability and psychological resilience. This cross-sectional analytical study examined the role of transnational networks, social cohesion, government support, and digital connectivity in climate adaptation success among 373 internally displaced persons (IDPs) across three coastal districts (Demak, Pekalongan, and Indramayu) in Central Java from January to June 2024. Using binary logistic regression, we assessed nine predictors of successful climate adaptation, defined as sustainable livelihood restoration and psychological well-being. Transnational Network Strength (TNS) emerged as the strongest predictor (adjusted odds ratio [AOR] = 2.58, 95% CI 1.59–4.18, p < 0.001), followed by Social Cohesion (AOR = 2.14, 95% CI 1.33–3.44, p = 0.002) and Government Support (AOR = 1.62, 95% CI 1.03–2.56, p = 0.038). Digital Connectivity Index and low psychological distress were also significant protective factors (AOR = 1.68, p = 0.034 and AOR = 1.82, p = 0.014, respectively). The multivariate model demonstrated good discrimination (area under the curve = 0.81) and acceptable calibration (Hosmer-Lemeshow p = 0.592), with 75.3% overall accuracy. Partial correlation analysis revealed a moderate positive association between TNS and social cohesion (r = 0.47, controlling for confounders). These findings underscore the critical importance of fostering transnational connections, strengthening community bonds, and expanding digital access to enhance adaptation outcomes among climate-displaced populations in vulnerable coastal regions.

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