Indonesian Maternal Mortality: A Systematic Review of Three-Level Determinants 1992–2024

Abstract

In Indonesia, the occurrence of maternal mortality is significantly elevated, estimated at 94% annually, with a maternal mortality rate of 462 per 100,000 live births. Three factors contribute to the occurrence of maternal death. These factors are categorized as distant determinants, intermediate determinants, and immediate determinants. This study provides a comprehensive analysis of the factors contributing to maternal mortality, categorized into three levels of determinants, ranging from 1992 to 2024. The systematic review examines 25 Scopus and BioMed Central papers on maternal mortality causes. The data suggest that close (43%) maternal mortality causes are mentioned more than intermediate (40%) and distant (17%) causes. Journal topics are mostly medical (62.5%). However, the prevalence of some themes indicates a lack of emphasis on problem-solving. In addition to medical problems, there are other issues that are caused by economic, environmental, and a disorganized health service management system. The prevalence of maternal death in Indonesia is greatly influenced by the associated variables of maternal mortality. Hence, this study aims to propose recommendations for resolving the issue by focusing on three approaches: (1) enhancing socioeconomic conditions; (2) enhancing environmental and maternal health status; (3) promoting the consumption of healthcare services.