Does human development index's level shape maternal triple elimination program? Insights from East Java, Indonesia

Area of Science:

• Public Health
• Socioeconomic Determinants of Health
• Maternal Health

Background:

• District-level Human Development Index (HDI) disparities in Indonesia may impact maternal health and public health initiatives.
• The Triple Elimination Program aims to prevent mother-to-child transmission of HIV, syphilis, and hepatitis B, but its coverage is uneven.
• Understanding the link between socioeconomic factors and program implementation is crucial for improving maternal and child health outcomes.

Purpose of the Study:

• To evaluate the association between the Human Development Index (HDI) of districts in East Java and the implementation of the Triple Elimination Program.
• To determine if socioeconomic well-being influences the success of preventing mother-to-child transmission of HIV, syphilis, and hepatitis B.

Main Methods:

• A cross-sectional study analyzed secondary data from all 38 districts in East Java Province from January to December 2023.
• Data on HIV, syphilis, and hepatitis B screening were obtained from the Provincial Health Information System and Statistics Indonesia HDI.
• Spearman's rank correlation was used to analyze the relationship between district-level HDI and program implementation, adhering to STROBE guidelines.

Main Results:

• Screening rates for syphilis, HIV, and Hepatitis B among pregnant women in East Java showed significant variation across districts.
• Syphilis screening rates ranged from 10.9% to 148.4% (mean 78.5%), HIV screening rates from 9.2% to 118.3% (mean 79.6%), and Hepatitis B screening rates from 59.8% to 118.5% (mean 80.2%).
• No significant association was found between district-level HDI and the implementation of the Triple Elimination Program.

Conclusions:

• District-level Human Development Index (HDI) was not significantly associated with the implementation of the Triple Elimination Program in East Java.
• Screening performance for HIV, syphilis, and hepatitis B may be more influenced by health system factors than socioeconomic conditions.
• Improved data accuracy and local reporting systems are needed to enhance program coverage and address limitations in current estimates.