Hubungan Tingkat Pengetahuan Tentang Alat/Cara KB dengan Pemakaian Kontrasepsi Modern pada Wanita Kawin Usia Remaja di Pulau Jawa, Indonesia (Analisis Data SDKI 2017)

Prevalensi pemakaian metode KB modern pada wanita kawin usia remaja di Pulau Jawa tahun 2017 tergolong masih rendah, yakni 27,8%. Terbatasnya tingkat pengetahuan remaja mengenai pilihan kontrasepsi adalah salah satu hambatan pemakaian kontrasepsi pada remaja. Penelitian ini memiliki tujuan untuk mengetahui hubungan antara tingkat pengetahuan tentang alat/cara KB dengan pemakaian kontrasepsi modern pada wanita kawin usia remaja di Pulau Jawa. Penelitian ini menggunakan data sekunder dengan menganalisis hasil dari Survei Demografi dan Kesehatan Indonesia (SDKI) Tahun 2017. Sampel adalah 309 orang wanita berusia 15-19 tahun yang berdomisili di Pulau Jawa dengan status kawin. Pada hasil ditemukan sebanyak 62,4% responden memakai alat kontrasepsi modern. Berdasarkan Renstra BKKBN 2020-2024 angka ini masih dibawah target capaian modern Contraceptive Prevalence Rate (mCPR) yakni 63,41%. Selain itu diketahui hanya 56,4% wanita kawin usia remaja yang memiliki tingkat pengetahuan alat/cara KB yang baik (mengetahui setidaknya 7 alat/cara KB). Hasil analisis multivariat menunjukkan bahwa tingkat pengetahuan tentang alat/cara KB tidak mempengaruhi pemakaian kontrasepsi pada wanita kawin usia remaja di Pulau Jawa setelah dikontrol variabel paritas, pendidikan suami, pengambil keputusan KB, dan kepemilikan jaminan kesehatan. (PR = 0,75; CI 95% 0,42-1,36). Kuesioner SDKI kurang dapat menggambarkan tingkat pengetahuan mengenai alat/cara KB karena kurang tereskplorenya pertanyaan yang digunakan sehingga hasil ini kemungkinan masih dipengaruhi adanya bias informasi. Studi ini merekomendasikan untuk dilakukan perbaikan pada pengukuran variabel pengetahuan pada survei selanjutnya dengan menggunakan definisi yang lebih spesifik sehingga dapat menggambarkan tingkat pendidikan responden dengan lebih akurat.

701To estimate contraceptive prevalence rate and unmet need for family planning in rural Shimla

Background The utilization of family planning services has improved over the decade, but still the SDG’s health target to ensure universal access to sexual and reproductive health care services is yet to be achieved. Methods A cross-sectional study was undertaken in the rural field practice area of Department of Community Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India, from July 2018 to June 2019. Total sample size calculated was 410. Random sampling was used to select eligible couple to whom a predesigned, pretested, semi-structured and anonymous interview schedule was administered after taking consent. Results The mean age of the participants was 28.9 ± 5.9 years. The modern contraceptive prevalence rate (mCPR) was found to be 67.7% among women of reproductive age group (15-49 years). Male condom (36%), followed by female sterilisation (30%) were the most common methods preferred. Conclusions Besides male condoms and female sterilisation, other methods of contraception were adopted by meagre number of women. Though, the unmet need for family planning was lesser in this study, still, efforts are needed to plunge it, for ameliorating the contraceptive prevalence rate. Also, the availability of basket of contraceptive choices in government sector need sheer assiduity. Key messages The continuing IEC activity related to family planning methods need to be upsurged, so that the available contraceptives reach the community by and large. The government system of provision of contraceptives may be made accessible and convenient, so that the beneficiaries are inclined to utilise these services.

Shifting dynamics: Changes in the relationship between total fertility rate and contraceptive prevalence rate in Jordan between 2012 and 2017

Background: Between the two most recent Population and Family Health Surveys, Jordan saw a dramatic decline in the Total Fertility Rate (TFR) from 3.5 to 2.7 in 5.5 years. Over the same period, modern contraceptive use also declined, from 61.2% to 51.8% among married women. This decrease in both TFR and the contraceptive prevalence rate (CPR) diverges from the typical relationship seen between these two factors whereby historically as CPR increases, TFR decreases. This paper explores this unique pattern using multiple methodologies. Methods: First, we validate the survey data using nationally collected data on fertility and contraceptive distribution. Second, we look to changes that have historically influenced changes in CPR and TFR, including changes in ideal family size and wanted fertility rates. Third, we explore proximate determinants and other influences on fertility and changes in contraception, examining the changes in the method mix and unmet need; marriage patterns, including the demographics of the married population, spousal separation, and time since last sex; postpartum insusceptibility; infecundity, both primary and secondary; and abortion, to see if any have shifted significantly enough to allow for fertility to decline with less contraceptive use. Results: We find that the decline in fertility in Jordan was driven by a reduction in mistimed or unwanted pregnancies and there was a significant increase in the share of reproductive aged women who are infecund. We also concluded that the changes in fertility and contraceptive use are driven by changes in Jordanian nationals, not by the growing Syrian refugee population. Conclusions: Jordan is not the only country to be experiencing a shift in the typical relationship between CPR and TFR. Results can inform both future approaches for family planning programs and our expectations regarding what kind of change our family planning investments might buy.

Contraceptive prevalence rate and associated factors among reproductive age women in four emerging regions of Ethiopia: a mixed method study

Background Ethiopia is the second most populous country in Africa, known for its high fertility and low contraceptive use. The magnitude of contraceptive use in the emerging regions of the country is below the national average. However, there is a paucity of evidence regarding the reasons for low contraceptive use in these regions. Therefore, this study aimed to assess contraceptive use and associated factors in the emerging regions of Ethiopia. Methods For the quantitative part, a community based cross-sectional study was conducted among 2891 reproductive age women who were selected by multistage sampling technique. Data were collected face to face using an open data kit software, and STATA version 14 was used for data analysis. Frequencies, percentages, summary measures and tables were used to summarize and present the data. Bivariable and multivariable logistic regression analyses were performed to identify factors associated with contraceptive use, by computing odds ratio with 95% confidence interval. Level of significance was considered at p-value < 0.05. For the qualitative part, phenomenological study was conducted among 252 health care workers and community members who were selected purposely. The data were collected by focused group discussions, in-depth interviews and key informant interviews. The data were audio-recorded in the local languages, and then translated to English verbatim. NVivo version 11 was used to analyze the data through a thematic analysis method. Results The overall contraceptive prevalence rate was 22.2%; with 11.7, 38.6, 25.5 and 8.8% for Afar, Benshangul Gumuz, Gambela and Somali Regions, respectively. Age, religion, education, marital status, family size, ideal children, knowledge and attitude were significantly associated with contraceptive use. Additionally, the qualitative study identified three themes as barriers to contraceptive use: individual, health care system and sociocultural factors. Conclusions Contraceptive prevalence rate was low in this study compared to the national average. Age, religion, education, marital status, family size, ideal children, knowledge and attitude were significantly associated with contraceptive use. From the qualitative aspect, individual, health care system and sociocultural factors were identified as barriers to contraceptive use. Therefore, the emerging regions of Ethiopia need special focus in increasing contraceptive use through behavioral influence/change.

Determine the unmet need for family planning in a hilly area in a state of North India

Background: The utilization of family planning services has improved over the decade, but still the SDG’s health target to ensure universal access to sexual and reproductive health care services is yet to be achieved, unmet need being one of the imperative component.Methods: A cross-sectional study was undertaken in the rural field practice area of Department of Community Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India, from July 2018 to June 2019. Total sample size calculated was 316. Random sampling was used to select eligible couple to whom a predesigned, pretested, semi-structured and anonymous interview schedule was administered after taking consent.Results: The mean age of the participants was 30.2±6.1 years. The modern contraceptive prevalence rate (mCPR) was found to be 67.7% among women of reproductive age group (15-49 years). Male condom (36%), followed by female sterilisation (30%) were the most common methods preferred. Unmet need of family planning was found to be 10.4%.Conclusions: Besides male condoms and female sterilisation, other methods of contraception were adopted by meagre number of women. Though, the unmet need for family planning was lesser in this study, still, efforts are needed to plunge it, for ameliorating the contraceptive prevalence rate. Also, the availability of basket of contraceptive choices in government sector need sheer assiduity.

FAKTOR-FAKTOR YANG MEMENGARUHI TINGKAT PREVALENSI KONTRASEPSI MODERN DI INDONESIA TAHUN 2017

Contraceptive Prevalence Rate (CPR) atau tingkat prevalensi kontrasepsi merupakan indikator yang digunakan untuk melihat seberapa besar pemakaian kontrasepsi di suatu wilayah, sedangkan CPR modern merupakan indikator yang dikhususkan pada pemakaian kontrasepsi dengan cara modern. Dari tahun 2015 hingga 2017, angka CPR baik untuk semua metode maupun modern terus mengalami penurunan dan masih belum mencapai target dari BKKBN meskipun target CPR telah diturunkan. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang memengaruhi tingkat prevalensi kontrasepsi modern dengan menggunakan metode analisis regresi linear berganda, dimana model terbaik dipilih dengan metode best subset regression. Data yang digunakan merupakan data sekunder yang diperoleh dari Survei Demografi dan Kesehatan Indonesia (SDKI) 2017, Data dan Informasi Kemiskinan Kabupaten/Kota tahun 2017, serta Laporan Akuntabilitas Kinerja Instansi Pemerintah BKKBN 2017. Hasil analisis menunjukkan bahwa model terbaik yang terpilih adalah model dengan variabel bebas persentase penduduk miskin, umur kawin pertama dan pengetahuan pria kawin tentang kontrasepsi. Berdasarkan uji secara simultan diperoleh kesimpulan bahwa minimal terdapat satu variabel bebas yang signifikan terhadap tingkat prevalensi kontrasepsi modern. Sedangkan secara parsial hanya variabel umur kawin pertama dan pengetahuan pria kawin tentang kontrasepsi yang signifikan terhadap tingkat prevalensi kontrasepsi modern, dimana umur kawin pertama berpengaruh negatif dan pengetahuan pria kawin tentang kontrasepsi berpengaruh positif.

QUADRANT ANALYSIS OF TOTAL FERTILITY RATE AND CONTRACEPTIVE PREVALENCE RATE OF DISTRICT AND CITY IN EAST JAVA

One of the indicators determine the wellness of Family Planning Program is the high number of participants enrolling, or commonly known as the Contraceptive Prevalence Rate (CPR) and the number of children born known as the Total Fertility Rate (TFR) of a maximum of 2 children. There are several regions in East Java where the situation of TFR and CPR does not show the ideal conditions. This shows that there are problems in the current family planning program. This research was conducted to map districts and cities in East Java based on TFR and CPR data respectively in quadrant form. This type of research is on-reactive research which utilizes secondary data from Indonesia - National Socio-Economic Survey in 2015. The research method used is recapitulating data and classifying districts and cities in the form of quadrants by comparing to data on achievement of TFR and CPR in East Java using SPSS. The results of the study have mapped districts and cities in East Java which are described in quadrant form. The regions that need major attention from the government are regions in quadrants I and II. Quadrant III is included in an abnormal condition and quadrant IV is a quadrant that has an area where TFR and CPR conditions are ideal. The conclusions of this study are the areas in quadrant I, namely: Sampang (district), Blitar (city), Blitar (district), Tulungagung (district), Ponorogo (district), Madiun (city), and Pasuruan (city) are the priority in getting the FP program improvements. The advice that can be given is to evaluate the ongoing family planning program to find out the factors that cause the TFR and CPR conditions are not in line with government expectations.

Shifting dynamics: Changes in the relationship between total fertility rate and contraceptive prevalence rate in Jordan between 2012 and 2017

Background: Between the two most recent Population and Family Health Surveys, Jordan saw a dramatic decline in the Total Fertility Rate (TFR) from 3.5 to 2.7 in 5.5 years. Over the same period, modern contraceptive use also declined, from 61.2% to 51.8% among married women. This decrease in both TFR and the contraceptive prevalence rate (CPR) diverges from the typical relationship seen between these two factors whereby historically as CPR increases, TFR decreases. This paper explores this unique pattern using multiple methodologies. Methods: First, we validate the survey data using nationally collected data on fertility and contraceptive distribution. Second, we look to changes that have historically influenced changes in CPR and TFR, including changes in ideal family size and wanted fertility rates. Third, we explore proximate determinants and other influences on fertility and changes in contraception, examining the changes in the method mix and unmet need; marriage patterns, including the demographics of the married population, spousal separation, and time since last sex; postpartum insusceptibility; infecundity, both primary and secondary; and abortion, to see if any have shifted significantly enough to allow for fertility to decline with less contraceptive use. Results: We find that the decline in fertility in Jordan was driven by a reduction in mistimed or unwanted pregnancies and there was a significant increase in the share of reproductive aged women who are infecund. We also concluded that the changes in fertility and contraceptive use are driven by changes in Jordanian nationals, not by the growing Syrian refugee population. Conclusions: Jordan is not the only country to be experiencing a shift in the typical relationship between CPR and TFR. Results can inform both future approaches for family planning programs and our expectations regarding what kind of change our family planning investments might buy.

A community-based study to estimate the contraceptive prevalence rate among the women of reproductive age group in rural North India

Background: The utilization of family planning services has improved over the decade, but still the SDG’s health target to ensure universal access to sexual and reproductive health care services is yet to be achieved.Methods: A cross-sectional study was undertaken in the rural field practice area of Department of Community Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India, from September to December 2019, with sample size of 316. The eligible participants were administered a predesigned, pretested, semi-structured and anonymous interview schedule after taking consent.Results: The mean age of the participants was 30.2±6.1 years. The modern contraceptive prevalence rate (mCPR) was found to be 67.7% among women of reproductive age group 15-49 years. Male condom 36%, followed by female sterilization 30% were the most common methods preferred.Conclusions: Besides male condoms and female sterilisation, other methods of contraception were adopted by meagre number of women. Though, the unmet need for family planning was lesser in this study, still, efforts are needed to plunge it, for ameliorating the contraceptive prevalence rate. Also, the availability of basket of contraceptive choices in government sector need sheer assiduity.

Pemodelan Fertilitas Di Indonesia Tahun 2017 Menggunakan Pendekatan Regresi Nonparametrik Kernel dan Spline

Tujuan dari penelitian ini adalah untuk menganalisis pola hubungan Total Fertility Rate (TFR) dengan Contraceptive Prevalence Rate (CPR). Analisis yang sering digunakan untuk pemodelan adalah analisis regresi. Analisis regresi menurut pendekatannya dapat dibedakan menjadi dua, parametrik dan nonparametrik. Metode regresi nonparametrik yang sering digunakan adalah regresi kernel dan spline. Pada penelitian ini untuk regresi kernel yang digunakan adalah regresi kernel dengan metode penaksir Nadaraya-Watson (NWE) dan penaksir polinomial lokal (LPE), sedangkan untuk regresi spline yang digunakan adalah smoothing spline dan b-splines. Hasil pengepasan kurva (fitting curve) menunjukkan bahwa model regresi nonparametrik terbaik adalah model regresi b-splines dengan degree 2 dan jumlah knot 5. Hal ini dikarenakan model regresi b-splines memiliki kurva yang halus dan terlihat lebih mengikuti sebaran data dibandingkan kurva model regresi lainnya. Model regresi b-splines terpilih memiliki nilai koefisien determinasi R2 sebesar 76.86%, artinya besarnya variasi variabel TFR yang dijelaskan oleh model regresi b-splines sebesar 76.86%, sedangkan sisanya 23.14% dijelaskan oleh variabel lainnya yang tidak dimasukkan ke dalam model.