ANALYSIS OF FACTORS AFFECTING INTEREST IN THE USE OF
AN INTRAUTERINE DEVICE AT PUBLIC HEALTH CENTERS
Yosi Yusrotul
Khasanah1, Heny Puspasari2, Agi Yulia Ria Din3,
Pinky Putri Lestari4
Sekolah Tinggi Ilmu
Kesehatan (STIKes) Cirebon, Indonesia
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ARTICLE INFO |
ABSTRACT |
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intra
uterine device, kb, public health center. |
The
family planning program aims to achieve prosperity by providing marriage
advice, infertility treatment, and birth spacing. Contraception is generally
divided into two types: Long Term Contraceptive Methods (MKJP) and
Non-Long-Term Contraceptive Methods (Non-MKJP). This study aims to analyze
the factors that affect the
interest in using the IUD (Intra Uterine Device) in public health centers
filled with Indramayu. This study uses quantitative methods. The population
in this study were all family planning acceptors at the Terisi Indramayu
Public Health Center. The sample in this study was all family planning
acceptors who did not use IUD KB. Data analysis used bivariate and
multivariate analysis with Chi-Square or Chi-Square tests. The trust factor
with a sample of acceptors who have positive beliefs, as many as 27 people
(20%), acceptors who have negative beliefs, as many as 108 (80%). Cultural
factors with a sample of acceptors who have a positive culture, as many as 63
people (46.6%), acceptors who have a negative culture, as many as 72 people
(53.4%). Factors experienced by other people with a sample of acceptors who
have a positive culture of as many as 42 people (31.1%) and acceptors who
have a negative culture of as many as 93 people (68.9%). Factors of belief,
Culture, and other people's experiences simultaneously influence the choice
of KB IUD (Intra Uterine Device) 95.7%, while the other 4.3% are influenced
by other factors not examined by the researcher. |
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DOI: https://doi.org/10.58860/ijsh.v1i1.5 |
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Corresponding Author: Yosi Yusrotul Khasanah
Email: yosikhasanah84@gmail.com
INTRODUCTION
The main problem faced in
Indonesia is in the field of population, which is still high in population
growth. The higher the population growth, the greater the effort made to
maintain the health and welfare of the community. Therefore, the government
continues to strive to reduce the growth rate with the Family Planning Program.
One of the goals of this program is to distance pregnancies using contraceptive
methods and to create economic and social welfare for the entire community
through population planning and control efforts (Veronica et al., 2019). (Bonnington et al., 2020).
One of the efforts to
control LPP problems is the family planning (KB) program, a new paradigm for
the national family planning program with the vision of a "Quality Family."
The family planning program is one of the efforts to achieve prosperity by
providing marriage advice, infertility treatment, and birth spacing. Family
planning is an act of helping individuals to help married couples avoid
unwanted births, to get the births they want, to regulate the interval between
births. Family planning (KB) is effort to prevent pregnancy, where these
efforts can be temporary or permanent (Purwoastuti & Walyani, 2015) (Desai et al., 2014). The general objective of the family planning
program is to form a family according to social and economic strength through
birth control and planning the number of children so that families can be happy
and prosperous. The quality of the population will increase (Zuhriah, 2013). This program requires health workers who are
competent and able to work optimally in the process of making a small family
happy and prosperous. The target is productive families, with the main focus
being couples of childbearing age (Purwoastuti & Walyani, 2015).
Contraception is
generally divided into two types: Long Term Contraceptive Methods (MKJP) and Non-Long-Term
Contraceptive Methods (Non-MKJP). MKJP includes types of contraceptive
implants, IUDs (Intra- Uterine Devices (IUD), while regular
contraception (KONTAP) are male operative methods (MOP) such as vasectomy, and
female operative methods (MOW) such as tubectomy. Meanwhile, Non-MKJP includes
condoms, birth control pills, injections, and other methods other than MKJP.
The most widely used
contraceptive method by active family planning participants in Indonesia is an injection
(47.54%), and the second most is a pill (23.58%). While the contraceptive
method that active family planning participants chose the least was the male
surgical method (MOP) (0.69%), then condoms (3.51%), and IUD as much as 10.73%.
Meanwhile, for new family planning participants, the percentage of
contraceptive methods used the most was an injection, as much as 49.67%. The
second most common method is 25.14% of pills. The method that new family
planning participants chose the least was MOP, as much as 0.21%, then the
female surgery method (MOW), as much as 1.50%; IUD, as much as 10.73%, and
condoms, as much as 5.68%. Data on IUD family planning acceptors in Indonesia
are 4,128,115. Data from the BKKBN of West Java Province for IUD KB acceptors
were 93,051, while IUD KB acceptors in Indramayu Regency were 1,513. Based on
previous research conducted by Siti Zuhro in 2015 about the factors that
influence the interest in the use of the IUD (Intra Uterine Device),
Trust is a commitment that arises and is built by two parties who have an
attachment to each other (Prakoso, 2017).
Meanwhile, according to
research conducted by Murdiono Jakarsih, Community culture is "everything
that individuals from the community obtain, including beliefs, customs, artistic
norms, eating habits, skills that are obtained not because of their
creativity but are a legacy of the past that can be inherited. Through formal
or informal education” (Notoatmodjo, 2012). And to research conducted by Andheri Paraga in
2017, The experiences of others can usually be obtained or felt when events
have just happened or have been going on for a long time. The experience that
occurs can be given to anyone to use and become a guide and human learning (Dahlan, 2018).
The midwife's
authority in contraception services is to communicate, provide information,
educate, counsel, and provide contraceptive services by the provisions of the
legislation (Hidayati, 2017). Meanwhile, according to the Decree of the
Indonesian Ministry of Health (KMK), No. 320 of 2020 concerning Midwifery
Professional Standards, the authority of midwives is to provide family planning
services before pregnancy, postpartum family planning services, postpartum
family planning services, postpartum family planning services and intermediate
family planning services.
Based on the
above background, this research aims to analyze the factors influencing the
interest in using the IUD (Intra Uterine Device) in a public health center
filled with Indramayu.
METHOD
This study uses
quantitative methods. Quantitative research is a method based on positivism,
used to examine certain populations or samples, data collection using research
instruments, and quantitative/statistical data analysis to test predetermined
hypotheses (Saragih
et al., 2021). The design used in this
research is descriptive-analytic. The population is the total number of
subjects to be studied by a researcher (Sahir,
2021). The population in this study
were all family planning acceptors at the Terisi Indramayu Public Health
Center. The sample is part of the population with characteristics like the
population. The sample in this study was all family planning acceptors who did
not use an IUD (Intra Uterine Device). Analysis of the data used to examine the
factors that influence the use of the IUD (Intra Uterine Device) at the Terisi
Indramayu Health Center uses bivariate analysis and multivariate analysis with
Chi-Square or Chi-Square tests.
RESULTS AND DISCUSSION
The characteristics of this research
sample are as follows:
Table 1. Characteristics of
All Acceptors at the
Indramayu Public Health
Center in 2021-2022
|
Characteristics |
F |
% |
|
Trust |
|
|
|
Positive |
27 |
20% |
|
Negative |
108 |
80% |
|
Culture |
|
|
|
Positive |
63 |
46.6% |
|
Negative |
72 |
53.4% |
|
Other people's
experiences |
|
|
|
Positive |
42 |
31.1% |
|
Negative |
93 |
68.9% |
The table above
shows the results of the research sample, mostly on negative beliefs of as many
as 108 acceptors (80%), with negative Culture as 72 acceptors (53.4%) and negative
experiences of others as 93 acceptors (68.9%).
Factors that
influence the interest in using the IUD (Intra Uterine Device) at the Terisi
Indramayu Health Center include others' beliefs, Culture, and experiences. The
data obtained by the multiple linear regression test with spss shows the
following results:
Table
2. Multivariate Analysis of Factors
Affecting
Specialization in IUD Use
|
Variable |
P |
rSquare |
|
Trust |
0.00 |
|
|
Culture |
0.03 |
1.03 |
|
Experience |
1.00 |
|
The results
of the chi-square statistical test analysis with SPSS showed that the factor
that influences the interest in IUD contraception is Culture. The three factors
(belief, Culture, experience) together influence the interest in IUD (Intra
Uterine Device) contraception, but the most significant is Culture, with a p-value
of <0.05.
There
is a belief factor that affects the interest in using the IUD (Intra Uterine
Device) as evidenced by the research that has been done by the author; as many
as 27 respondents (20%) have positive confidence in the IUD (Intra Uterine
Device), and 108 respondents (80%) have negative confidence in the IUD. KB IUD
(Intra Uterine Device). From the results of research conducted by the authors,
respondents who believe negatively in the IUD (Intra Uterine Device) conjecture
that family planning is prohibited by religion. There are cultural factors that
influence the interest in using the IUD (Intra Uterine Device) as evidenced by
the research conducted by the author, as many as 63 respondents (46.6%) have a
positive culture towards the IUD (Intra Uterine Device) and 72 respondents
(53.4%). Has a negative culture toward the IUD (Intra Uterine Device). From the
results of 27 studies conducted by the authors, respondents with a negative
culture of IUD (Intra Uterine Device) KB think that using an IUD (Intra Uterine
Device) KB requires a lot of money and installation cannot be made at the
midwife's house.
Other
experience factors affect the interest in using the IUD (Intra Uterine Device),
as evidenced by the research conducted by the author. As many as 42 respondents
(31.1%) had positive experiences with the IUD (Intra Uterine Device), and 93
respondents (68, 9%) had a negative experience with the IUD (Intra- Uterine
Device). The results of research that has been carried out by the authors of
respondents who have negative experiences with IUD KB (Intra- Uterine Device)
assume that using an IUD (Intra Uterine Device) is painful during the
installation process and costs a lot of money.
The
results of multivariate analysis with multiple linear regression test with spss
show the results factors that influence the interest in IUD contraception
(Intra Uterine Device) studied by the researchers are belief, Culture, and experience.
The most significant factor is Culture. Based on the research conducted by
S.wulandari in 2013 entitled "The relationship of socio-cultural factors
with the participation of IUD KB at Mergangsan Health Center in 2013," the
author finds other challenges in family planning are from various aspects,
namely in terms of service, in terms of the availability of contraceptives, in
terms of the delivery of counseling and IEC, in terms of cultural barriers that
in some areas people are still familiar with "many children, many fortunes";
"each child brings their own fortune" or a child to depend on in old
age."
While
the research conducted by the author shows that Culture can affect the use of an
IUD (Intra Uterine Device) because it is considered painful during the
installation process, and the cost is not small. The sample in this research is
more respondents with a negative culture on the IUD (Intra Uterine Device)
contraception, so respondents choose short-term contraception with no side
effects and ease of use. Use it; therefore, the respondents chose a 3-month
injection KB. The questionnaire results also show that respondents chose a
3-month injection KB compared to a 1-month injection KB because respondents do
not need to inject family planning in the near term and do not often spend a
lot of money per month. Respondents also thought 3-month injectable
contraception was more effective because fertility returns were not too fast.
Other
people's experience is not so significant as to influence the choice of IUD
(Intra Uterine Device) contraception. The sample in this study was more
negative about the respondent's Culture, where knowledge about contraception
was not too deep. Currently, knowledge and information about contraception can
now be obtained with the help of the internet and social media. Currently,
health workers often provide information about contraception. Knowledge and
Culture affect receiving new information from others, including information
about this contraceptive. Still, in this study, the researchers found that
Culture was very significant in choosing IUD (Intra Uterine Device) contraception.
Based
on the results of the study (Maheasy & Indrawati, 2015) stated that the acceptors
did not affect the choice of contraception; this was caused by some family
planning respondents who gave positive opinions to the acceptors. This is not
in line with the research obtained by researchers, where the samples obtained
were many respondents who had a positive opinion about KB IUD (Intra- Uterine
Device). From the questionnaire results, respondents argued that the IUD KB has
high effectiveness and only requires one pairing, even though the installation
costs are less affordable for some acceptors.
The
results of the chi-square statistical test showed that the factors that
influenced the interest in the use of the IUD (Intra Uterine Device) KB with a
value of p < 0.05 were cultural factors (p = 0.03). Thus, it can be
concluded that cultural factors can significantly influence acceptors in the
interest in using the IUD (Intracal) family planning Uterine Device) at the
Filled Indramayu Health Center. The factors studied by the researchers, namely
beliefs, Culture, and other people's experiences, simultaneously influenced the
selection of the IUD (Intra Uterine Device) by 95.7%. In comparison, the other
4.3% were influenced by other factors not examined by the researchers.
CONCLUSION
Based
on the results of research and discussion of Factors Affecting Interest in the
Use of the IUD (Intra Uterine Device) at the Terisi Indramayu Health Center, it
was concluded that: 1). The trust factor in this study with a sample of
acceptors who had positive beliefs as many as 27 people (20%), acceptors who
had negative beliefs as many as 108 people (80%). 2). Cultural factors in this
study with a sample of acceptors who have a positive culture of as many as 63
people (46.6%), acceptors who have a negative culture of as many as 72 people
(53.4%) 3). Factors of other people's experiences in this study with a sample
of acceptors of 42 people (31.1%), who have a negative culture, 93 people
(68.9%). 4). The results of the chi-square statistical test showed that the
factor influencing the use of the IUD (Intra Uterine Device) at the Terisi
Indramayu Health Center with a p-value of <0.05 was a cultural factor (p =
0.03). Thus, it can be concluded that cultural factors can significantly
influence acceptors in the interest in using IUD (Intra Uterine Device)
contraceptives at the Terisi Indramayu Health Center.
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