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Determinants of Contraceptive Use Among Married Women In F1000Research 2020, 9:193 Last updated: 25 MAY 2020 RESEARCH ARTICLE Determinants of contraceptive use among married women in Indonesia [version 1; peer review: 2 approved] Alfian Gafar1, Dewi Elizadiani Suza2, Ferry Efendi 1,3, Eka Mishbahatul Mar’ah Has1, Ahmad Putro Pramono1, Ika Adelia Susanti1 1Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia 2Faculty of Nursing, Universitas Sumatera Utara, Sumatera Utara, Indonesia 3School of Nursing & Midwifery, La Trobe University, Melbourne, Australia First published: 18 Mar 2020, 9:193 Open Peer Review v1 https://doi.org/10.12688/f1000research.22482.1 Latest published: 18 Mar 2020, 9:193 https://doi.org/10.12688/f1000research.22482.1 Reviewer Status Abstract Invited Reviewers Background: Contraceptives in family planning are used to control the 1 2 timings between pregnancies. Although the number of those using family planning has increased, determinants of contraceptive use among married version 1 women in Indonesia remain insufficient. This research aimed to identify the 18 Mar 2020 report report factors associated with contraceptive use among married women in Indonesia. Methods: This study employed data from the Indonesian Demographic and Health Survey 2017. We selected 35,621 married women aged 15–49 1 Angeline Bushy , University of Central years. Then, the determinants of contraceptive use among married women Florida, Orlando, USA in Indonesia were examined by binary logistic regression. Results: Women’s age (Adjusted Odds Ratio (AOR)=0.529; 95% 2 Khatijah Binti Abdullah Lim Geok Khim , CI=0.470–0.597), the number of living children (AOR=44.024; 95% University of Malaya, Kuala Lumpur, Malaysia CI=33.193–58.390), education level (adjusted odds ratio=2.800; 95% Any reports and responses or comments on the CI=2.181–3.594), wealth index (AOR=1.104; 95% CI=0.978–1.246), frequency of watching television (AOR=1.555; 95% CI=1.321–1.829), and article can be found at the end of the article. frequency of using the Internet (AOR=0.856; 95% CI=0.794–0.924) were significantly associated with contraceptive use among married women. Conclusions: This study highlights the determinants of contraceptive use among married women in Indonesia. Women’s age, the number of living children, education level, wealth index, and access to information may influence contraceptive use among these women. This study emphasizes that health education and promotion on the importance of using contraception should be initiated in innovative ways. Keywords Contraceptive, Demographic and Health Survey (DHS), Determinants, Married Women Page 1 of 9 F1000Research 2020, 9:193 Last updated: 25 MAY 2020 Corresponding author: Ferry Efendi ([email protected]) Author roles: Gafar A: Conceptualization, Data Curation, Formal Analysis, Investigation, Writing – Original Draft Preparation; Suza DE: Writing – Original Draft Preparation, Writing – Review & Editing; Efendi F: Methodology, Writing – Original Draft Preparation, Writing – Review & Editing; Has EMM: Investigation, Methodology, Project Administration, Supervision; Pramono AP: Writing – Original Draft Preparation, Writing – Review & Editing; Susanti IA: Writing – Original Draft Preparation, Writing – Review & Editing Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2020 Gafar A et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite this article: Gafar A, Suza DE, Efendi F et al. Determinants of contraceptive use among married women in Indonesia [version 1; peer review: 2 approved] F1000Research 2020, 9:193 https://doi.org/10.12688/f1000research.22482.1 First published: 18 Mar 2020, 9:193 https://doi.org/10.12688/f1000research.22482.1 Page 2 of 9 F1000Research 2020, 9:193 Last updated: 25 MAY 2020 Introduction Variables Family planning is a conscious effort made by couples to The dependent variable of this study was contraceptive use, limit the number of children through the use of contraceptive which was defined in this study as the use of contraception by methods. Both developed and developing countries worldwide married women at the time of the survey. For the explanatory have demonstrated increased contraceptive use to control the variables, we used the women’s age, the number of living population1. Though contraceptives have been used globally, children, education level, wealth index, residential location, the they remain less prevalent in poorer countries2. In Indonesia, the frequency of watching television, and access to the Internet. prevalence of contraceptive use among married women is still low and varies between provinces, economic status, education Data analysis level, and residential location3. Based on data from the The data were analyzed using the STATA statistical software Indonesian health ministry, the percentage of contraception is version 14. Before the analysis, the dataset was weighted to divided into the following four categories: 59.3% of married account for any differences, considering the nature of the women aged 15–49 years use modern contraception methods sampling design method. Univariate analysis and bivariate (implants, tubectomy, vasectomy, intrauterine devices, condoms, analysis were performed using the chi-square test. Finally, the injections, and pills), 0.4% use traditional methods (lactation determinants of contraceptive use among married women were amenorrhea methods, periodic abstinence, and interrupted into identified using the binary logistic regression. intercourse), 24.7% have done family planning at least once, and 15.5% have never done family planning3–5. Although the Ethical review and consent number of those who actively use family planning has increased, The IDHS in 2017 obtained ethical permits from the Ministry it has not been able to sustain or increase the prevalence of of Health of Indonesia. All respondent identifiers were deleted contraceptive use6. from the data, and written informed consents were provided by each participant. The ICF International, which is part of the National data show that contraceptive use fell from 61.75% in DHS program, approved the use of such data in this study. 2014 to 59.98% in 20156. One of the challenges in increasing the number of family planning participants is the high level of Results concern from couples of reproductive age regarding the side More than half of the respondents used contraception effects of contraceptive drugs and equipment6. Researchers in (63.60%) in which majority of them aged 35–49 years (54.77%). Ghana have performed a study to identify the factors related According to the data, contraceptive use was most prevalent in to the low contraception use. They found that such factors married women who had 1–2 children (62.58%). Furthermore, included the residential location, knowledge, marital status, most of the respondents had completed secondary education religion, and partner’s approval and support7. All efforts (52.03%) and were classified as richer by the wealth index that can improve women’s health should be implemented, (21.22%). Meanwhile, slightly more than half of them were particularly regarding maternal healthcare services8. Thus, the from rural areas (51.62%). Regarding information access, current study aimed to identify factors that are associated with 34,367 (96.48%) relied on watching television, whereas contraceptive use among married women in Indonesia. 12,733 (35.74%) relied on the Internet. Data are presented in Table 1. Methods Data In the bivariate analysis, all of the variables, except for the The data for this study were collected from the 2017 residential location, were significantly associated with contracep- Indonesia Demographic and Health Survey (DHS), which is the tive use among married women (Table 2). eighth survey since 1987. The IDHS in 2017 was performed with the cooperation of the Central Statistics Agency, the National In the multivariate analysis, the association between the Population and Family Planning Agency, and the Ministry of independent and dependent variables was assessed by binary Health, with technical assistance from the Inner City Fund logistic regression (Table 3). Married women aged 35–49 years (ICF) internationally through the Demographic Project and were less likely to use contraceptives than married women Health Surveys (DHS) Program. We used the individual recoded aged 15–24 years (Adjusted Odds Ratio (AOR) =0.529; 95% dataset in this study. CI=0.470–0.597). Furthermore, married women with more than five children were more likely to use contraception than Sample size and sampling those without children (AOR=44.024; 95% CI=33.193–58.390). Our sample was composed of married women aged 15–49 Women who had completed higher education had 2.8 times years who were using contraception in Indonesia. The survey greater odds of using contraceptives (AOR=2.800; 95% successfully interviewed 49,627 women. Based on the inclusion CI=2.181–3.594) than those who had not completed any formal criteria, 35,621 women remained. The IDHS used two-stage education. Women classified as the richest by the wealth index stratified cluster sampling to select the sample, including 1,970 were 1.1 times more likely to use contraceptives than those census blocks covering urban and rural areas. The inclusion classified
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