Spatial determinants affected maternal mortality of East Java province during the covid-19 pandemic era, in 2020-2021

Background. Every life aspect and group of the community have changed during the COVID-19 pandemic, including the group of pregnant, childbirth, and postpartum woman. COVID-19 Pandemic occurred in 2020-2021. Maternal mortality in East Java Province was the highest in Indonesia during the pandemic.Objective. This study analyzed the effect of spatial determi-nants that consist of antenatal, childbirth, and post-partum care on maternal mortality in East Java Province during the Pandemic.Methods. This study used a crossectional method with the unit of analysis in this study was all pregnant, childbirth and postpar-tum women in 38 districts of East Java Province from 2020 until 2021. Data were analyzed with spatial regression by using Geographically Weighted Regression Software.Results. Maternal mortality in East Java had a spreading pat-tern and negative value of the diff criterion, so we concluded that there was a spatial influence. The variables of antenatal care, accessibility of healthcare service, third postpartum visit, and com-plication service had significant effects on maternal mortality in all regions (P<0,05). There were four groups of districts that showed a similarity of significant factors. This result showed that each region's diversity of the accessibility of health services affects maternal mortality during the COVID-19 era. Antenatal services, access to health facilities and complication services affected mater-nal mortality in regions with high maternal mortality rate.Conclusion. Every region has its spatial determinants of maternal mortality. The top government should give authority to local government to have programs to reduce maternal mortality according to the condition in their region.