Biopsychosocial and Environmental Determinants of Toddler Health Service Utilization in Kediri City, Indonesia

Aims: Utilization of child health services through routine visits to community health posts (Posyandu) is essential for growth monitoring, immunization, and disease prevention among toddlers. This study aimed to analyze the biopsychosocial and household environmental determinants of health service utilization among toddlers in Kediri City, Indonesia. Instrument & Methods: This cross-sectional study was conducted among 515 toddlers selected through random sampling. Data were collected using a validated and reliable structured questionnaire administered to the toddlers’ mothers. Data were analyzed using chi-square tests and multivariable logistic regression. Findings: Of 515 toddlers, 406 (78.8%) routinely attended Posyandu, while 109 (21.2%) attended nonroutinely. Most mothers were aged ≥36 years (90.3%), had completed antenatal care (72.8%), and were multiparous (65.0%); BPJS enrollment and access to health information were reported by 81.7% and 85.4% of respondents, respectively. Significant associations were found between service utilization and parental age and education, antenatal care history, parity, maternal malnutrition, pregnancy complications, and comorbidities (p≤0.020). After adjustment, several individual, healthcare, and household factors remained significant predictors, and the model explained 68.7% of the variance in utilization (Nagelkerke R²=0.687). Conclusion: Toddler health service utilization is influenced by multiple biopsychosocial and environmental factors.