KnE Life Sciences | The 3rd International Meeting of Public Health and the 1st Young Scholar Symposium on Public Health | pages: 277–283

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1. Introduction

Indonesia Demographic Health Survey (IDHS) 2012, Total Fertility Rate (TFR) in Indonesia is 2.6. This means that women in Indonesia had 2-3 children during their reproductive years. These results indicate that there are still many provinces that have high fertility above the national figure. One effort to reduce TFR is the increase in contraceptive users [1].

In West Nusa Tenggara, the Population Growth Rate is around 1.17% per year, Total Fertility Rate (TFR) 2.8, Contraception Prevalence Rate (CPR) 56% where IUD (3.8%), MOW (1, 4%), MOP (0.1%) and Implant (5.4%). From this outlet, West Nusa Tenggara Province is below the national average. That is why NTB has low achievement from the national average. This is the reason why NTB became a family planning program, in particular, the use of long term contraception [2].

LAPMs is a long-term contraceptive, more than two years, effective in nesting or terminating a pregnancy in couples who do not wish to add a child. The types of methods included in this group are steroid method (male and female), implant, and Intra Uterine Device (IUD). IUD and Implant can restore fertility after not using with a period of 3 to 12 years while sterilization is a permanent method [3].

Factors woman's behavior in choosing LAPMs is demographic characteristic, reproduction history, knowledge, and discussion with health care, decision-making, belief or local customs relating to family planning [4,5]. In encouraging the woman to determine the choice of contraceptive methods, government policies play an important role due to government policies to enact legislation within the constraints of mass media to promote advertising of contraceptive methods and provide information on the place and time of service, develop and provide procedures to health care and provide quality educational facilities so that communities can Understand health information [6].

A study in district Northwestern, Ethiopia where the number of children affecting woman ages 15-49 to choose long term contraceptive method as a contraceptive needs, where if the client has a number of children living more than five or more chances of using long term contraceptive greater than woman who have children 0 to 4 [7,8]. While woman aged 15-49 years in the Southwest has children lives a little, and much does not affect the needs of long term contraceptive election [4].

LAMPs in NTB on the use of IUD (12.23%), MOW (2.12%), MOP (0.57%) and Implants (15.66%) [9], although it is known that Long term contraceptive method is very effective for controlling Fertility, but the rate of use is quite low when compared with the use of other modern methods such as injections, pills, and condoms. From this study wanted to see the number of children living on the use of Long term contraceptive method by doing further analysis related to Monitoring and Evaluation of Contraceptive Use in West Nusa Tenggara Province 2015.

2. Methods

This research uses secondary data with a structured questionnaire consisting of several topics: household members, reproduction characteristics, family planning knowledge, history of contraceptive, family decision making, the perception of innovation from Improving Contraceptive Mix Method (ICMM) in East Java and NTB at 2015 with non-experimental study and cross-sectional design. Quantitative approach with binomial log regression analysis. The research was conducted in six districts, West Lombok, East Lombok, Central Lombok, North Lombok, Bima, and Sumbawa.

Variables of this study consist of the main independent number of children with Dependent use of LAMPs which has confounding variables of age, education, occupation, decision making, and exposure information. The population of this study wreas all married woman aged 15-49 years who were in the region of six selected districts. The sample of the woman married to the age of 15-49 years who have a history of using tools/ways to delay/prevent pregnancy at the time of the interview. The sample used a hypothesis test of different proportions which obtained 631 respondents and criteria as the inclusion of 12,943 so that the data available to meet the minimum sample requirement.

3. Results

Demographic characteristics of woman respondents in NTB where the age of 20-35 years 64448 (49.8%), in most of primary school 3028 (23.4%), and occupation of respondents dominated by housewive 7573 (58.5%) (table 1). In determining the method of tools used by respondents 6149 (47.5%) chose to discuss with husband (Table 2). The information relating to contraception to be used very important regarding the purpose of the respondents using KB, for NTB the respondent's information is not getting information related to KB 11652 (90%) (table 3). The use of LAMPs in NTB is only 2327 (18%) where the 3-year implant device is selected 1109 (8.6%) (table 4) and in woman dominance with the number of children two children

9217 (71.2%) than > 2 children Life (table 5). The relation between the number of children and the use of LAMPs with positive results (p-value < 0.05) (table 6) was then performed logistic regression analysis on age, education, occupation, decision and exposure variables showed that there were no interaction variables and became variable Confounding on the relationship of the number of live children and the use of LAMPs (table 7).

Table 1

Woman Distribution According Age, Education, Job at East Nusa Tenggara Province.


Variable Total Percentage
Age
35 5.0990 46.3
20 - 35 64.448 49.8
< 20 505 3.9
Education
Not educated 972 7.5
Not Finished Elementary 1.176 9.1
Elementary 4.205 32.5
Junior High School 3.028 23.4
Senior High School 2.689 20.8
Academi (D1/D2/D3) 255 2.0
University (S1/S2/S3) 618 4.8
Job
Government Employee 238 1.8
Professional 74 0.6
Employee 151 1.2
Farmer, Fisherman 1.303 10.0
Entrepreneur 293 2.3
Trader 1.065 8.2
Blue Colar 1.773 13.7
Honorer 386 3.0
Wifehouse 7.573 58.5
Unemployment 45 0.3
Table 2

Woman Distribution According to Decision Making at East Nusa Tenggara Province.


Variable Total Percentage
Decision Maker
Her Self 5.866 45.3
Her Self and Husband 6.149 47.5
Her Self and others 99 0.8
Husband and others 829 6.4
Table 3

Woman Distribution According Information Exposure from Health Care at East Nusa Tenggara Province.


Variable Total Percentage
Information Family Planning Exposure forms Health Care.
Yes 1.291 10.0
No 11.625 90.0
Table 4

Woman Distribution Methods at East Nusa Tenggara Province.


Variable Total Percentage
Long Term Contraceptive
Tubektomi 175 1.4
Implant 5 247 1.9
Implant 3 1.109 8.6
Implant 2 77 0.6
IUD 719 5.6
Short Term Contraceptive
Inject 3 Month 8.539 66.0
Inject 1 Month 284 2.2
Pil 1.711 13.2
Emergency Contraceptive 1 0
Natural ( Breastfeeding, calendar, fasting) 52 0.4
Others 29 0.2
Table 5

Woman Distribution According to Total Child at East Nusa Tenggara Province.


Variable Total Percentage Mean -Median SD Min - Mac
Total Child
> 2 3,726 28.8 2.06 1.118 0 - 13
2 9,217 71.2 2.00
Table 6

Relation of Number living Child and Ling Term Contraceptive Use at East Nusa Tenggara Province.


Total Living Child Long Term Contraceptive Use p-value PR (95% CI)
LAPMs Non-LAPMs Total
n % n % n %
> 2 927 24.9 2,799 75.1 3,726 100.0 0.005 1.63
2 1,400 15.5 7,817 84.8 9,217 100.0 (1.684 – 2.031)
Total 2,327 18.0 10,616 82.0 12,943 100.0
Table 7

Model Logistic Regression.


Variable p-value PR 95% CI
Living Child 0.005 1.121 1.089 – 1.153
Age 0.005 1.054 1.030 – 1.078
Decision 0.005 1.033 1.014 – 1.052
Info 0.314 1.023 0.977 – 1.072

4. Discussion

This study shows that the use of long term contraceptive in West Nusa Tenggara Province is only 2,327 (18%) where this incidence is almost comparable to the research done in Debre-table long term contraceptive request (17%) [8] while lower in Mekele City with long term contraceptive use (12.3%) [10]. But it is higher than research in Adigrat City where the use of long term contraceptive is (48.4%) [11]. This may occur due to the different sample size and rural and urban environmental factors in Euthopia in access to information.

Implants are the most dominant methods selected by woman in NTB, and the result of research is supported in woman in the United States and Euthopia which prefer to use Long Term Contraception (Implant and IUD) because the failure rate of this product is very low, it is easier to use because it is not necessary Time-intensity each month to conduct inspection visits, the perceived contraindications are so limited and cost-effective that doctors strongly recommend that fertile women who want to use contraception [10-12]. The use of Long Term Contraception in West Nusa Tenggara only (18%) is not withby the Family Planning Program target set in the RPJMN 2015-2019, ie, the use of Long Term Contraception of 23.5%. (BKKBN, 2016). The use of Long Term Contraception in NTB has not been fully accepted for family planning services for several reasons such as uncomfortable because the IUD insertion should open the inside vagina of femininity (cervix), pain complaints about implant use and considered to be contradictory by religion because it is permanent (MOW) [13].

In this study, there is a significant relationship between the number of children living with the use of Long Term Contraception. Respondents who have children > 2 have 1.6 times greater chance of using Long Term Contraception than respondents who have two children to use Long Term Contraception. The results of this study were supported by research conducted in Bahir Dar City and Amhara District indicated that women of infertile age who had children > 2 were more likely to use long-term contraception [14,15], while in the study in Goba City showed no effect Number of children to use Long Term Contraception [4]. This is due to differences in location from data collection in urban and rural areas and the influence of communities in the environment.

5. Conclusions and Recommendations

The number of children and the use of long term contraceptive controlled with age, education, occupation, decision making and exposure of information from health care have no interaction and not as confounding variables.

The woman in NTB who have children > 2 were counseled on the use of LTCM, and for the woman of childbearing age who had live children, two children were given health promotion related to the LTCM preference to set the number of children.

Ethical Clearance

This study does not require ethical clearance due to the use of secondary data.

References

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