Abortion and Unmet Family Planning Needs: A Case Study in Java Provinces, Indonesia, 2020 (original) (raw)
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Malaysian Journal of Public Health Medicine, 2022
Government funding for contraceptive services is decreasing, which results in increasingly limited community access to contraception, especially to the poor. The aim of this study is to determine contraceptive use and assess its association with sociodemographic factors, socioeconomic status, the source of obtaining contraception and type of contraception among poor women in Indonesia. This study is a cross-sectional study using the 2017 Indonesian National SocioEconomic Survey. The sample in this study was women who had been married aged 15-49 years in urban and rural communities. The total sample is 20,642 women. Socioeconomic status is measured based on the international poverty line (IPL) set by the World Bank, which is US$ 1.9/day/capita in purchasing power parity (PPP). CPR in poor women was 52.5%. They prefer to use short-acting reversible contraceptives (SARCs) rather than long-acting reversible contraceptives (LARCs). The use of SARCs in urban areas was 76.0% and in rural areas was 78.3%. The results of multivariate logistic regression analysis found a significant positive relationship between socioeconomic status and contraceptive use with modern methods among urban and rural communities with OR = 0.92 (0.85-0.99). A significant positive relationship was also found between working poor women and the use of contraception with the modern method in urban communities with OR = 1.14 (1.01-1.28). It is necessary to increase funding for contraception by the government and to socialize the use of LARCs so that birth control can be realized in poor women.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
The aims of this paper are to analyse the unmet need situation in Indonesia, identify determining factors and the intervention policy strategy in several countries. This paper was a literature study, taken from the data of the 2012 Indonesian Demographic and Health Survey (IDHS) and various other sources. It is seen that unmet need level in Indonesia decreases from time to time. During the 1991 to 2012 IDHS, total unmet need decreased from 17% to 11% (4.5% for spacing and 6.9% for limiting). However, the number is considered still quiet high so an effort to solve it is needed. Determinants of unmet need can be associated with various factors such as demographical characteristic and social economic, education, culture, geographical access and condition in the area. Recommended to the government in order to develop policy strategy focused on intervention of unmet need determinants, improve financial resource allocation for access improvement of contraception service and develop capacity, improve service quality including staff training, and also public education in big scale to decrease social barriers.
Indonesia Maternal Mortality Rate (MMR) 230 per 100,000 live births is considered one of the highest in Southeast Asia region. Contraception is an essential part of safe motherhood, yet most Indonesian doesn’t participate in family planning. Active use of contraception on fertile couples was 62.5%. Based on Indonesia 2017 DHS, 11% fertile women had insufficient contraception need. Unmet need for contraception might contribute to the burden of MMR. A cross-sectional study was conducted to analyse which factors contribute to the occurrence of unmet need for contraception in respect of urban and rural area. Data obtained from 2017 IDHS in two locations: Jakarta and Papua. A total 1,128 Jakarta and 458 Papua respondent were enrolled. Highest occurrence of unmet need occurred in high school education group. Television use was the only factor gave a significant impact (p = 0.019) for the occurrence of unmet need for contraception in Jakarta. Husband’s education level (p = 0.000), newspape...
The Indonesian Family Planning Programme: A Success Story for Women?
Development and Change, 1991
The Family Planning Programme of Indonesia is constantly being hailed as a success story for its performance in reducing fertility rates in many parts of the country. This paper examines what this apparent success has meant for women, taking women's rights to the control of their fertility as the necessary aim for all family planning programmes, and the safeguarding of their reproductive health as an obligation. In the paper, the aims and methods of the Family Planning Programme are examined separately, in order to assess on the one hand the extent and the manner in which women's interests are acknowledged in its objectives, and, on the other, whether in its implementation the programme takes into account the needs of women, both as recipients and as family planning workers. The main conclusion of the paper is that the priorities, style of implementation and service delivery of the programme do not provide women with the means of regulating their fertility autonomously through access to freely chosen contraceptives and related services. In addition, the paper concludes that the safeguard and improvement of women's reproductive health is not among the concerns of the programme, in principle or in practice.
2022
Background. Informed choice means that women contraceptive users choose the method that best satisfies their needs after receiving information about all available contraceptive methods, side-effects of the methods, and how to deal with the side effects if experienced. Receiving adequate information is an ethical necessity and a fundamental rule in fulfilling reproductive rights because women’s decisions depend on the information. Objective. To measure the percentages of women making an informed choice of contraceptives and associated factors in Indonesia, between 2007 and 2017. This measure reflects how far Indonesia had achieved the Sustainable Development Goals (SDG) target 3.7 (“by 2030, to ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes”). Methods. Married women who used five modern contraceptive methods (the pill, ...
Malaysian Journal of Public Health Medicine
The birth rate in Indonesia is still high at 2.45 in 2019 because couples of childbearing age do not take advantage of the family planning program (unmet need) which reaches 12.4%. West Nusa Tenggara province ranks second with the highest incidence of unmet needs, 17.4%, due to unwanted pregnancy. This study aims to investigate the determinants of factors that influence women of childbearing age in determining the use of contraceptive methods in the Province of West Nusa Tenggara, Indonesia. The present research design with a cross-sectional approach uses secondary data from the Family Planning and Family Development Program Accountability Performance Survey (SKAP 2019) in West Nusa Tenggara Province, Indonesia. Bivariate analysis employed chi-square test and multivariate with logistic regression. Determinant factors that affect women of childbearing age in using contraceptives are Unmet Need of women of childbearing age (<0.01), age (<0.01), number of living children (<0.0...
Women’s Involvement in Decision Making and Unmet Need for Contraception in Indonesia
Indian Journal of Public Health Research & Development, 2020
Background: The issue of gender inequality in reproductive health has a role in determining contraceptive use in women. Gender issues related to inequality in decision making are the main context in family planning interventions. The purpose of this study is to assess women's participation in decision making and its relation to unmet need. Method: A cross-sectional study was conducted using IDHS data in 2012. The study involved 1516 women of childbearing age (15-49 years) with married categories in areas with high unmet need (West Papua) and the lowest unmet need area (Bangka Belitung) Results: Married women in the Bangka Belitung region have more power in decision making than married women in West Papua. Involvement in economic matters and the decision to use contraception as the most dominant factor and involvement in the household have a significant relationship with the occurrence of unmet need, as well as education, wealth and experience in using contraception related to unmet need. while age, fertility preference, husband's desire to have children and involvement in health and mobility were not directly related to unmet need. Conclusions: Better participation in decision making is higher for women in the Bangka Belitung region than in Papua. Empowerment of women in terms of the economy and the use of contraception needs to be improved so that they have power in decision making.
Population Health Metrics
Background Although efforts to reduce high maternal mortality in countries such as Indonesia tend to focus on addressing health risks among pregnant women, family planning has been shown globally to reduce maternal mortality by reducing both total and higher-risk pregnancies. This article assesses past contributions of family planning to the reduction of maternal mortality in Indonesia and the potential future contribution toward achieving the 2030 SDG maternal mortality goal. Methods The study takes advantage of data from long series of population censuses and large-scale surveys that are available in few other low- and middle-income countries. We use the decomposition method suggested by (Matern Child Health J, 16:456–463, 2012) and regression-based policy simulations to estimate the number of maternal deaths averted during 1970–2017 due to contraceptive use and project potential future contributions to the year 2030. Results It is estimated that between 523,885 and 663,146 matern...
Family planning: Choices and challenges for developing countries
2014
While slow and uneven progress has been made on maternal health, attaining the 1994 Cairo International Conference on Population and Development (ICPD) goal for achieving universal access to reproductive health remains elusive for many developing countries. Assuring access to sexual and reproductive health services, including integrated family planning services, remains a critical strategy for improving the health and wellbeing of women and alleviating poverty. Family planning not only prevents maternal, infant, and child deaths, but also empowers women to engage fully in socioeconomic development and provides them with reproductive choices. This paper will discuss the current landscape of contraception in developing countries, including options available to women and couples, as well as the challenges to its provision. Finally we review suggestions to improve access and promising strategies to ensure all people have universal access to reproductive health options.
The Lancet, 2013
Background Data for trends in contraceptive use and need are necessary to guide program and policy decisions and to monitor progress towards Millennium Development Goal 5, which calls for universal access to contraceptive services. We therefore aimed to estimate trends in contraceptive use and unmet need in developing countries in 2003, 2008, and 2012. Methods We obtained data from national surveys for married and unmarried women aged 15-49 years in regions and subregions of developing countries. We estimated trends in the numbers and proportions of women wanting to avoid pregnancy, according to whether they were using modern contraceptives, or had unmet need for modern methods (ie, using no methods or a traditional method). We used comparable data sources and methods for three reference years (2003, 2008, and 2012). National survey data were available for 81-98% of married women using and with unmet need for modern methods. Findings The number of women wanting to avoid pregnancy and therefore needing effective contraception increased substantially, from 716 million (54%) of 1321 million in 2003, to 827 million (57%) of 1448 million in 2008, to 867 million (57%) of 1520 million in 2012. Most of this increase (108 million) was attributable to population growth. Use of modern contraceptive methods also increased, and the overall proportion of women with unmet need for modern methods among those wanting to avoid pregnancy decreased from 29% (210 million) in 2003, to 26% (222 million) in 2012. However, unmet need for modern contraceptives was still very high in 2012, especially in sub-Saharan Africa (53 million [60%] of 89 million), south Asia (83 million [34%] of 246 million), and western Asia (14 million [50%] of 27 million). Moreover, a shift in the past decade away from sterilization, the most effective method, towards injectable drugs and barrier methods, might have led to increases in unintended pregnancies in women using modern methods. Interpretation Achievement of the desired number and healthy timing of births has important benefits for women, families, and societies. To meet the unmet need for modern contraception, countries need to increase resources, improve access to contraceptive services and supplies, and provide highquality services and large-scale public education interventions to reduce social barriers. Our findings confirm a substantial and unfinished agenda towards meeting of couples' reproductive needs.