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Abstract

Program KB di Indonesia khususnya penggunaan MKJP menjadi upaya pemerintah dalam mengendalikan penduduk, khususnya pada kelompok berisiko. Namun, penggunaan mix-method MKJP di Indonesia relatif masih rendah, yaitu 24,6% dibandingkan negara ASEAN lainnya. Wanita menikah di Indonesia masih mengalami masalah dalam mengakses layanan kesehatan seperti masih tingginya angka unmet-need serta rendahnya presentase wanita terpapar informasi dari penyuluh lapangan KB dan informed choice KB. Penelitian ini bertujuan untuk mengidentifikasi indikator akses layanan kesehatan dan mengetahui hubungan akses layanan kesehatan dengan penggunaan MKJP. Penelitian ini menggunakan data SKAP KKBPK 2019 dengan desain penelitian cross-sectional. Analisis univariat dilakukan untuk mengidentifikasi indikator akses layanan kesehatan sedangkan analisis bivariat dan multivariat digunakan untuk melihat hubungan akses layanan kesehatan dengan penggunaan MKJP. Ditemukan 75,3% wanita masih mengalami minimal 1 masalah terkait akses layanan kesehatan. Proporsi penggunaan MKJP oleh wanita menikah usia 15-49 tahun di Indonesia adalah 29,2%. Ada hubungan yang signifikan antara akses layanan kesehatan dengan penggunaan MKJP setelah dikontrol variabel pendidikan dan keinginan memiliki anak (AOR=1.19; 95% CI=1.091-1.312). Disimpulkan penggunaan MKJP di Indonesia relatif rendah. Upaya pemerintah seperti memanfaatkan tim pendamping keluarga sebagai jejaring fasilitas layanan KB, mengoptimalkan penyuluhan KB dengan pendekatan keluarga sehat dan KB lestari, dan mengoptimalkan layanan KB sesuai standar perlu dilakukan untuk mengurangi masalah terkait akses layanan kesehatan.

References

1. Worldometer. Indonesia Population (2024) [Internet]. Worldometer. 2023 [cited 2023 Apr 10]. Available from: https://www.worldometers.info/world-population/indonesia-population/

2. Badan Kependudukan dan Keluarga Berencana Nasional. Laporan Kinerja Instansi Pemerintah Badan Kependudukan dan Keluarga Berencana 2021. Jakarta: Kependudukan dan Keluarga Berencana ; 2022.

3. Matahari R, Utami FP, Sugihartini S. Buku Ajar Keluarga Berencana dan Kontrasepsi. Yogyakarta: Pustaka Ilmu; 2014.

4. Akhirul A, Witra Y, Umar I, Erianjoni E. Dampak Negatif Pertumbuhan Penduduk terhadap Lingkungan dan Upaya Mengatasinya. Jurnal Kependudukan dan Pembangunan Lingkungan. 2020;1(3):76–84.

5. UNFPA. Demographic dividend [Internet]. UNFPA. 2022 [cited 2023 May 5]. Available from: https://www.unfpa.org/demographic-dividend#0

6. Badan Kependudukan dan Keluarga Berencana Nasional. Survei Kinerja dan Akuntabilitas Survei Program KKBPK (SKAP) Keluarga. Vol. 53, Badan Kependudukan dan Keluarga Berencana Nasional. Jakarta; 2019. p. 1689–99.

7. Haakenstad A, Angelino O, Irvine CMS, Bhutta ZA, Bienhoff K, Bintz C, et al. Measuring contraceptive method mix, prevalence, and demand satisfied by age and marital status in 204 countries and territories, 1970–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. 2022;400(10348):295–327.

8. BKKBN, BPS, Kemenkes RI, USAID. Survei Demografi dan Kesehatan Indonesia 2017. BKKBN, BPS, Kemenkes RI, dan USAID. Jakarta: BKKBN,BPS, Kemenkes RI, dan USAID; 2018.

9. Joshi R, Khadilkar S, Patel M. Global trends in use of long-acting reversible and permanent methods of contraception: Seeking a balance. International Journal of Gynaecology and Obstetrics. 2015;131(Suppl 1):S60–3.

10. Casey SE, Cannon A, Mushagalusa Balikubirhi B, Muyisa JB, Amsalu R, Tsolka M. Twelve-month contraceptive continuation among women initiating short- and long-acting reversible contraceptives in North Kivu, Democratic Republic of the Congo. PLoS One. 2017;12(9):e0182744.

11. Barden-O’Fallon J, Speizer IS, Calhoun LM, Corroon M. Women’s contraceptive discontinuation and switching behavior in urban Senegal, 2010–2015. BMC Womens Health. 2018;18:35.

12. Ontiri S, Were V, Kabue M, Biesma-Blanco R, Stekelenburg J. Patterns and determinants of modern contraceptive discontinuation among women of reproductive age: Analysis of Kenya Demographic Health Surveys, 2003-2014. PLoS One. 2020;15(11):e0241605.

13. USAID. Issue Brief: Long-Acting and Permanent Methods of Contraception: Meeting Clients’ Needs. USAID. Washington D.C: USAID; 2006.

14. World Health Organization. Family Planning - A global handbook for providers, 2022 edition. Geneva: World Health Organization; 2022.

15. Badan Kependudukan dan Keluarga Berencana Nasional. Peraturan Badan Kependudukan dan Keluarga Berencana Nasional Nomor 1 Tahun 2022 Tentang Perluasan Akses Pelayanan Keluarga Berencana. Badan Kependudukan dan Keluarga Berencana Nasional. Jakarta: Badan Kependudukan dan Keluarga Berencana Nasional; 2022.

16. Levesque JF, Harris MF, Russell G. Patient-centred access to health care: Conceptualising access at the interface of health systems and populations. Int J Equity Health. 2013;12:18.

17. Andersen RM. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav. 1995;36(1):1–10.

18. Gayatri M. The Utilization of Long-Acting Reversible Contraception and Associated Factors Among Women in Indonesia. Glob J Health Sci. 2020;12(3):110–20.

19. Dau H, Kakaire O, Karim ME, Nakisige C, Vidler M, Ogilvie G. Understanding the association between informed choice and long-term reversible contraception among women aged 15-49 in Uganda: findings from the 2016 Demographic Health Survey [Internet]. 2022. Available from: https://www.researchsquare.com

20. Babazadeh S, Anglewicz P, Wisniewsk JM, Kayemb PK, Hernandez J, Bertran JT. The influence of health facility-level access measures on modern contraceptive use in Kinshasa, DRC. PLoS One. 2020;15(7):e0236018.

21. Gayatri M. Analisis Pemakaian Kontrasepsi di Wilayah Miskin Perkotaan di Indonesia. Jurnal Keluarga Berencana. 2022;7(1):44–53.

22. Oesman H. Pola Pemakaian Kontrasepsi Dan Pemanfaatan Kartu Badan Penyelengara Jaminan Sosial (BPJS) Kesehatan Dalam Pelayanan Keluarga Berencana Di Indonesia. Indonesian Journal of Reproductive Health. 2017;1(8):15–29.

23. Tumwesigye NM, Makumbi F, Mukose A, Atuyambe L, Namanda C, Ssali S, et al. Ability and willingness to pay for family planning services in low resource settings: evidence from an operational research. Afr Health Sci. 2022;22(1):28–40.

24. Desalegn M, Belachew A, Gizaw M, Kejela G, Gudeta R. Utilization of long-acting and permanent contraceptive methods and associated factors among married women in Adama town, Central Ethiopia: community based cross-sectional study. Contracept Reprod Med. 2019;4:22.

25. Fekadu GA, Omigbodun AO, Roberts OA, Yalew AW. Factors associated with long acting and permanent contraceptive methods use in Ethiopia. Contraception and Reproductive Medicine 2019 4:1. 2019;4:9.

26. Ujah OI, Kirby RS. Long-Acting Reversible Contraceptive Use by Rural-Urban Residence among Women in Nigeria, 2016-2018. Int J Environ Res Public Health. 2022;19(20):13027.

27. Gashaye KT, Tsegaye AT, Abebe SM, Woldetsadik MA, Ayele TA, Gashaw ZM. Determinants of long acting reversible contraception utilization in Northwest Ethiopia: An institution-based case control study. PLoS One. 2020;15(10):e0240816.

28. Wondie KY, Badi MB, Tamiru AT. Rural–Urban Differentials of Long-Acting Contraceptive Method Utilization Among Reproductive-Age Women in Amhara Region, Ethiopia: Further Analysis of the 2016 EDHS. Journal of Contraception. 2020;11:77–89.

29. Yimer AH, Seid MS, Walelign F, Damtie Y, Seid AM. Utilization of long-acting contraceptive methods and associated factors among female healthcare providers in South Wollo Zone hospitals, Northeast, Ethiopia. A cross-sectional multicenter study. PLOS Global Public Health. 2023;3(3):e0001692.

30. Thompson KMJ, Rocca CH, Kohn JE, Goodman S, Stern L, Blum M, et al. Public funding for contraception, provider training, and use of highly effective contraceptives: A cluster randomized trial. Am J Public Health. 2016;106(3):541–6.

31. Russell S. Ability to pay for health care: concepts and evidence. Health Policy Plan. 1996;11(3):219–37.

32. Bhandari R, Pokhrel KN, Gabrielle N, Amatya A. Long acting reversible contraception use and associated factors among married women of reproductive age in Nepal. PLoS One. 2019;14(3):e0214590.

33. Wado YD, Gurmu E, Tilahun T, Bangha M. Contextual influences on the choice of long-acting reversible and permanent contraception in Ethiopia: A multilevel analysis. PLoS One. 2019;14(1):e0209602.

34. Ontiri S, Ndirangu G, Kabue M, Biesma R, Stekelenburg J, Ouma C. Long-Acting Reversible Contraception Uptake and Associated Factors among Women of Reproductive Age in Rural Kenya. International Journal of Environmental Research and Public Health . 2019;16(9):1543.

35. Demeke CA, Kasahun AE, Belay WS, Chekol AN, Getaneh RA, Yimenu DK. Utilization Pattern of Long-Acting and Permanent Family Planning Methods and Associated Factors: A Community-Based Cross-Sectional Study in Ethiopia. Open Access J Contracept. 2020;11:103–12.

36. Artini NNA, Martha E, Putra IGNE. Association between empowerment factors and the utilization of long-acting and permanent contraceptive methods among married women in Indonesia. Public Health and Preventive Medicine Archive. 2021;9(1):51–8.

37. Sonfield A, Hasstedt K, Kavanaugh ML, Anderson R. The Social and Economic Benefits of Women’s Ability To Determine Whether and When to Have Children [Internet]. Guttmacher Institute. 2013 [cited 2023 Apr 10]. Available from: https://www.guttmacher.org/report/social-and-economic-benefits-womens-ability-determine-whether-and-when-have-children

38. Gebremariam A, Addissie A. Intention to use long acting and permanent contraceptive methods and factors affecting it among married women in Adigrat town, Tigray, Northern Ethiopia. Reprod Health. 2014;11(1):24.

39. Ebrahim OA, Zeleke EG, Muluneh AG. Geographic variation and associated factors of long-acting contraceptive use among reproductive-age women in Ethiopia: a multi-level and spatial analysis of Ethiopian Demographic and Health Survey 2016 data. Reprod Health. 2021;18:122.

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