Improving a long-acting reversible contraception usage by understanding client perspectives
BACKGROUND Despite the limited use of long-acting reversible contraception (LARC) in Indonesia, they have proven to be cost-effective in family planning programs. This study was aimed to identify the elements of ideas and views that people hold and their association with the use of LARC (intrauterine devices and implants) as a means of improving its utilization in Nusa Tenggara Barat (NTB) Province, Indonesia.
METHODS Data were derived from the Improving Contraceptive Mix Methods survey of 6,384 respondents in Bima District, Central Lombok, and North Lombok, NTB Province, in 2015. Confirmatory factor analysis was used to identify suitable elements of 19 variables and generate three ideation elements on attitude, knowledge, and interpersonal communication. Subsequently, the association of three ideation elements with LARC use in NTB was examined.
RESULTS Multivariate analysis revealed that LARC use was higher among women with a positive attitude toward LARC and high frequency of interpersonal communication. Women with positive attitudes had 7 times greater odds of using LARC than women with negative attitudes (adjusted odds ratio [aOR] = 7.18; 95% confidence interval [CI] = 6.09â8.55). Women with a high frequency of interpersonal communication were 2.4 times more likely to use LARC than women with low communication frequency (aOR = 2.40; 95% CI = 1.94â2.99).
CONCLUSIONS To increase the use of LARC in NTB, family planning programs should not only focus on improving womenâs knowledge but also prioritizing the promotion of positive attitudes toward LARC and facilitating interpersonal communication.
Cleland J, Conde-Agudelo A, Peterson H, Ross J, Tsui A. Contraception and health. Lancet. 2012;380(9837):149-56. https://doi.org/10.1016/S0140-6736(12)60609-6
Mavranezouli I, LARC Guideline Development Group. The cost-effectiveness of long-acting reversible contraceptive methods in the UK: analysis based on a decision-analytic model developed for a National Institute for Health and Clinical Excellence (NICE) clinical practice guideline. Hum Reprod. 2008;23(6):1338-45. https://doi.org/10.1093/humrep/den091
Weisberg E. Promoting the use of long-acting reversible contraceptives. Austin J Obstet Gynecol. 2014;1(6):6-11.
Statistics Indonesia (Badan Pusat Statistik), National Population and Family Planning Board (BKKBN), Ministry of Health (Kemenkes), and ICF International. Indonesia demographic and health survey 2012 [Internet]. Jakarta: BPS, BKKBN, Kemenkes, and ICF International; 2013. Available from: https://dhsprogram.com/pubs/pdf/FR275/FR275.pdf. Indonesian.
National Population and Family Planning Board (BKKBN). 2015 BKKBN government agency performance report. Jakarta: Center for Research and Development of Family Planning and Family Safe; 2016. Indonesian.
Center for Health Research Universitas Indonesia, National Population and Family Planning Board (BKKBN). Operational Research on family planning advocacy to improve contraceptive method mix (ICMM) in East Java and West Nusa Tenggara Provinces, a baseline study. 2013. Indonesian.
Piotrow PT, Kincaid DL, Rimon JG, Rinehart W. Health communication: lessons from family planning and reproductive health. London: Praeger Publishers; 1997.
Babalola S, Kusemiju B, Calhoun L, Corroon M, Ajao B. Factors associated with contraceptive ideation among urban men in Nigeria. Int J Gynaecol Obstet. 2015;130 Suppl 3:E42-6. https://doi.org/10.1016/j.ijgo.2015.05.006
Babalola S, John N, Ajao B, Speizer I. Ideation and intention to use contraceptives in Kenya and Nigeria. Demographic Res. 2015;33(8):211-38. https://doi.org/10.4054/DemRes.2015.33.8
Kincaid DL. Mass media, ideation, and behavior: a longitudinal analysis of contraceptive change in the Philipines. Commun Res. 2000;27(6):723-63. https://doi.org/10.1177/009365000027006003
Babalola S, Vonrasek C. Communication, ideation and contraceptive use in Burkina Faso: an application of the propensity score matching method. J Fam Plann Reprod Health Care. 2005;31(3):207-12. https://doi.org/10.1783/1471189054484022
Blake M, Babalola S. Impact of a male motivation campaign on family planning ideation and practice in Guinea. Baltimore: Johns Hopkins University Bloomberg School of Public Health, Center for Communication Programs; 2002.
Krenn S, Cobb L, Babalola S, Odeku M, Kusemiju B. Using behavior change communication to lead a comprehensive family planning program: the Nigerian Urban Reproductive Health Initiative. Glob Heal Sci Pract. 2014;2(4):427-43. https://doi.org/10.9745/GHSP-D-14-00009
Kincaid D, Storey J, Figueroa M, Underwood C. Communication, ideation, and contraceptive use: the relationships observed in five countries. Paper presented at the World Congress on Communication for Development, Rome, Italy, 2006.
Gultie T, Hailu D, Workineh Y. Predictors of long acting contraceptives utilization among reproductive age women in Arba Minch Zuria district, Ethiopia. Qual Prim Care. 2016;24(1):17-22. https://doi.org/10.1155/2016/6072437
Feldman RS. Understanding psychology. 10th ed. New York: McGraw Hill; 2011.
O'Sullivan GA, Yonkler JA, Morgan W, Merritt AP. A field guide to designing a health communication strategy. Baltimore: Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs; 2003. p. 12, 23, 195.
Mulatu K, Mekonnen W. Men's involvement in long acting and permanent contraceptive use in Mizan-Aman district Southwestern Ethiopia: a community based cross-sectional study. Health Sci J. 2016;10(2):2.
Takele A, Degu G, Yitayal M. Demand for long acting and permanent methods of contraceptives and factors for non-use among married women of Goba Town, Bale Zone, South East Ethiopia. Reprod Health. 2012;9:26. https://doi.org/10.1186/1742-4755-9-26
Melka AS, Tekelab T, Wirtu D. Determinants of long acting and permanent contraceptive methods utilization among married women of reproductive age groups in western Ethiopia: a cross-sectional study. Pan Afr Med J. 2015;21:246. https://doi.org/10.11604/pamj.2015.21.246.5835
Elias B, Hailemariam T. Implants contraceptive utilization and factors associated among married women in the reproductive age group (18-49 year) in Southern Ethiopia. J Women's Heal Care. 2015;4(7). https://doi.org/10.4172/2167-0420.1000281
Phiri M, King R, Newell JN. Behaviour change techniques and contraceptive use in low and middle income countries: a review. Reprod Health. 2015;12:100. https://doi.org/10.1186/s12978-015-0091-y
National Population and Family Planning Board (BKKBN), Statistics Indonesia (Badan Pusat Statistik), Ministry of Health (Kemenkes), and USAID. Indonesia demographic and health survey 2017. Jakarta: BKKBN; 2018. Indonesian.
National Population and Family Planning Board (BKKBN). National population and family planning board strategic plan for 2015-2019. Jakarta: BKKBN; 2015. Indonesian.
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