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

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Budi Prasetyo, Alifina Izza, Zalfa Dinah Khairunnisa, M. Masrur Rizal, Fabella Elisa Cahyaningtyas, Fayka Putri Poempida, Dewi Setyowati, Agnestia Naning Dian Lovita, Farah Sajidah, Bersellynica Azarine Azzahra, Intan Fairuz Zakia

2026 Journal of Public Health Research Vol. 15 Issue 1 Article Cited by 0

Abstract

Background: Human Development Index (HDI) as a composite measure to assess well-being across districts, incorporating life expectancy, education, and living standards. In Indonesia, district-level HDI disparities may influence maternal health outcomes and the success of public health initiatives. The Triple Elimination Program, which targets the prevention of mother-to-child transmission of HIV, syphilis, and hepatitis B, shows uneven coverage. This study aims to evaluate the association between the HDI of each district in East Java and the implementation of the Triple Elimination Program. Design and Methods: A cross-sectional study analyzed January–December 2023 secondary data from all 38 East Java Province districts. HIV, syphilis, and hepatitis B screening was provided by the Provincial Health Information System and Statistics Indonesia HDI. Spearman’s rank correlation analyzed relationships. STROBE was followed for reporting. Result: HIV, syphilis, and hepatitis B case reporting in East Java varied by District Human Development Index. Syphilis screening rates for pregnant women range from 10.9% to 148.4% (Mean: 78.5%; ρ: 0.80). Pregnant women’s HIV screening rates range from 9.2% to 118.3% (mean: 79.6; ρ: 0.742) and Hepatitis B screening rates range from 59.8% to 118.5% (mean: 80.2; ρ: 0.902). Conclusion: There was no significant association between district-level HDI and Triple Elimination Program implementation, suggesting that screening performance may be influenced more by health system factors than socioeconomic conditions. A key limitation is the reliance on projected pregnant-women estimates, indicating the need for improved data accuracy and stronger local reporting systems to enhance program coverage. © The Author(s) 2026. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).

Affiliations

Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga, Indonesia; Faculty of Medicine, Universitas Airlangga, Indonesia; Master of Public Health, The University of Queensland, Brisbane, Australia; Faculty of Medicine, Universitas Airlangga, Indonesia; Faculty of Medicine, Universitas Brawijaya, Indonesia