Table 2. Baseline Characteristics, Prevalence, Unadjusted and Adjusted OR for Not Utilizing

Table 2. Baseline characteristics, prevalence, unadjusted and adjusted OR for not utilizing postnatal care services Prevalence of non- Unadjusted OR Adjusted OR* Characteristics N (%) attendance (95% CI) (95% CI) (%)

POSTNATAL CARE SERVICES Overall 14502 (100.0) 33.5

EXTERNAL ENVIRONMENT Region and type of residence Lampung/DI Yogya** /North 784 (5.4) 27.4 1.00 1.00 Sulawesi Sumatera without Lampung : urban 1161 (8.0) 16.9 0.54 (0.35 - 0.83) 0.55 (0.37 - 0.81) Sumatera without Lampung : rural 1710 (11.8) 41.1 1.85 (1.22 - 2.79) 1.22 (0.87 - 1.72) Java region without DI Yogya : 4303 (29.7) 24.1 0.84 (0.54 - 1.30) 1.13 (0.75 - 1.69) urban Java region without DI Yogya : rural 3606 (24.9) 45.4 2.20 (1.47 - 3.31) 2.04 (1.43 - 2.93) Bali/NTB/NTT : urban 229 (1.6) 16.3 0.52 (0.31 - 0.85) 0.66 (0.39 - 1.09) Bali/NTB/NTT : rural 643 (4.4) 44.3 2.11 (1.33 - 3.35) 1.70 (1.11 - 2.61) Kalimantan: urban 349 (2.4) 17.0 0.54 (0.34 - 0.88) 0.64 (0.42 - 0.99) Kalimantan: rural 599 (4.1) 45.9 2.25 (1.43 - 3.53) 1.12 (0.75 - 1.68) Sulawesi without North Sulawesi : 418 (2.9) 24.6 0.86 (0.41 - 1.83) 0.35 (0.21 - 0.56) urban Sulawesi without North Sulawesi : 699 (4.8) 44.9 2.16 (1.45 - 3.22) 1.06 (0.71 - 1.57) rural

Percentage of infants receiving four or more antenatal care checks in the cluster 100 % 4543 (31.3) 15.1 1.00 1.00 75 – 99 % 5531 (38.1) 28.1 2.19 (1.62 - 2.96) 2.57 (1.85 - 3.57) 50 – 74 % 2685 (18.5) 51.8 6.03 (4.36 - 8.34) 5.82 (4.09 - 8.28) 0 - 49 % 1732 (11.9) 70.4 13.34 (9.07 - 19.64) 11.88 (8.28 - 17.04)

PREDISPOSING FACTORS Demographic Maternal age at delivery 30 and above 4558 (31.4) 36.3 1.00 20 – 29 years 8150 (56.2) 30.6 0.77 (0.67 - 0.89) Less than 20 years 1794 (12.4) 39.5 1.14 (0.90 - 1.45)

Paternal age at marriage Mean + SE = 23.2 + 0.15 0.93 0.91 - 0.96

Child sex Female 7010 (48.3) 33.8 1.00 Male 7492 (51.7) 33.2 0.97 (0.87 - 1.09)

Household wealth index Highest 2603 (18.0) 8.5 1.00 1.00 Second highest 2771 (19.1) 19.4 2.61 (1.90 - 3.56) 1.46 (1.02 - 2.07) Middle 2881 (19.9) 32.7 5.26 (3.74 - 7.39) 2.46 (1.67 - 3.63) Second lowest 2812 (19.4) 40.7 7.42 (5.26 - 10.46) 2.83 (1.91 - 4.19) Lowest 3434 (23.7) 58.6 15.29 (10.95 - 21.35) 4.80 (3.23 - 7.11) Prevalence of non- Unadjusted OR Adjusted OR* Characteristics N (%) attendance (95% CI) (95% CI) (%)

Social Structure Maternal education Secondary+ 3868 (26.7) 9.1 1.00 1.00 Complete primary/Incomplete 7808 (53.8) 36.3 5.70 (4.52 - 7.18) 2.22 (1.75 - 2.82) secondary None/Incomplete primary 2825 (19.5) 59.2 14.53 (11.14 - 18.96) 2.84 (2.10 - 3.85)

Paternal education None/Incomplete primary 3945 (27.2) 21.1 1.00 Complete primary/Incomplete 7034 (48.5) 36.1 2.11 (1.61 - 2.76) secondary Secondary + 3481 (24.0) 42.7 2.79 (2.06 - 3.77)

Parental occupation Maternal + paternal employed 5804 (40.0) 35.3 1.00 Mother not working + paternal 8334 (57.5) 32.7 0.89 (0.75 - 1.06) employed Paternal unemployed 223 (1.5) 28.9 0.75 (0.37 - 1.49)

Maternal marital status Widowed 297 (2.0) 40.4 1.00 Married 14206 (98.0) 33.4 0.74 (0.50 - 1.09)

Maternal final say on her own health care Only mother decision 7816 (53.9) 32.9 1.00 Both mother and someone else 4634 (32.0) 30.6 0.90 (0.74 - 1.09) Other's decision 2045 (14.1) 42.3 1.49 (1.18 - 1.88)

Birth rank 1 5048 (34.8) 25.2 1.00 1.00 2-3 6490 (44.8) 31.5 1.36 (1.20 - 1.56) 1.33 (1.13 - 1.57) 4-6 2335 (16.1) 49.2 2.88 (2.34 - 3.54) 1.96 (1.56 - 2.46)

7+ 629 (4.3) 63.0 5.06 (3.40 - 7.54) 2.20 (1.39 - 3.48)

Health Beliefs and Knowledge Frequency of reading newspaper At least once a week 2320 (16.0) 10.7 1.00 1.00 Less than once a week 4681 (32.3) 25.5 2.86 (2.26 - 3.62) 1.42 (1.08 - 1.86) Never 7482 (51.6) 45.6 7.00 (5.44 - 9.00) 1.61 (1.24 - 2.09)

Frequency of listening to radio At least once a week 5470 (37.7) 29.3 1.00 Less than once a week 4883 (33.7) 31.2 1.09 (0.91 - 1.31) Never 4128 (28.5) 41.9 1.74 (1.45 - 2.10) Prevalence of non- Unadjusted OR Adjusted OR* Characteristics N (%) attendance (95% CI) (95% CI) (%)

Frequency of watching television At least once a week 10931 (75.4) 27.1 1.00 Less than once a week 2061 (14.2) 47.8 2.47 (2.01 - 3.04) Never 1494 (10.3) 61.1 4.24 (3.42 - 5.25)

Knowledge on complications during pregnancy Yes 5899 (40.7) 21.2 1.00 1.00 None 8595 (59.3) 42.0 2.70 (2.26 - 3.21) 1.40 (1.16 - 1.68)

Knowledge on complications during delivery Yes 6470 (44.6) 22.1 1.00 None 8029 (55.4) 42.7 2.63 (2.25 - 3.08)

Knowledge on complications post delivery Yes 4037 (27.8) 21.5 1.00 None 10455 (72.1) 38.2 2.25 (1.90 - 2.67)

Initiation of breastfeeding More than 1 hour to 1 day 2363 (16.3) 33.2 1.00 More than 1 day 5194 (35.8) 33.2 1.00 (0.83 - 1.20) One hour or less 6437 (44.4) 34.6 1.06 (0.86 - 1.32)

ENABLING FACTORS Knowing where to go to seek health care services Not a big problem 13833 (95.4) 32.8 1.00 Big problem 667 (4.6) 48.5 1.93 (1.48 - 2.52)

Permission to go to visit health care services Not a big problem 13859 (95.6) 32.8 1.00 Big problem 641 (4.4) 49.2 1.99 (1.52 - 2.59)

Getting money to pay health care services Not a big problem 10745 (74.1) 28.2 1.00 Big problem 3755 (25.9) 48.8 2.43 (2.04 - 2.89)

Distance to health care services Not a big problem 12468 (86.0) 29.7 1.00 1.00 Big problem 2034 (14.0) 57.1 3.15 (2.55 - 3.89) 1.57 (1.29 - 1.92)

Transportation to health care services Not a big problem 12535 (86.4) 30.0 1.00 Prevalence of non- Unadjusted OR Adjusted OR* Characteristics N (%) attendance (95% CI) (95% CI) (%)

Big problem 1964 (13.5) 55.8 2.94 (2.38 - 3.65)

No companion Not a big problem 13208 (91.1) 32.4 1.00 Big problem 1293 (8.9) 44.5 1.67 (1.32 - 2.12)

No female health worker Not a big problem 13633 (94.0) 33.0 1.00 Big problem 858 (5.9) 41.4 1.43 (1.00 - 2.05)

NEED Delivery complications Yes 3965 (27.3) 30.7 1.00 1.00 None 10367 (71.5) 34.3 1.18 (1.00 - 1.40) 1.31 (1.08 - 1.58)

Birth size Larger than average 4350 (30.0) 27.1 1.00 1.00 Average 7740 (53.4) 33.3 1.35 (1.15 - 1.57) 1.17 (0.97 - 1.41) Smaller than average 1879 (13.0) 36.1 1.52 (1.26 - 1.83) 1.31 (1.04 - 1.66)

Desire for pregnancy Wanted later 1381 (9.5) 30.1 1.00 1.00 Wanted then 12071 (83.2) 33.2 1.16 (0.91 - 1.46) 1.56 (1.20 - 2.02) Wanted no more 1033 (7.1) 41.1 1.62 (1.19 - 2.20) 1.21 (0.85 - 1.72)

PREVIOUS UTILIZATION OF HEALTH SERVICES Delivery attendance Doctors 1515 (10.4) 4.9 1.00 1.00 Nurse/midwives 8120 (56.0) 8.9 1.88 (1.05 - 3.37) 0.93 (0.48 - 1.83) Untrained attendants 4826 (33.3) 83.6 98.19 (53.50 - 180.21) 31.83 (14.48 - 70.01)

Mode of delivery Caesarean section 573 (4.0) 6.0 1.00 Non-Caesarean section 13929 (96.1) 34.6 8.23 (3.83 - 17.68)

Place of delivery Health facility 5813 (40.1) 5.2 1.00 1.00 Non-health facility 8678 (59.8) 52.4 20.21 (15.72 - 25.99) 1.71 (1.23 - 2.39)

TT vaccination pre-marriage Two or more 2302 (15.9) 18.1 1.00 Once 4613 (31.8) 24.4 1.46 (1.12 - 1.90) None 7547 (52.0) 43.8 3.52 (2.69 - 4.60) Prevalence of non- Unadjusted OR Adjusted OR* Characteristics N (%) attendance (95% CI) (95% CI) (%)

*) 1650 missing cases were excluded from the analysis **) special district of Yogyakarta The analysis presented in this table has been weighted by the DHS sampling weights