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"Dampak demografis pemakaian kontrasepsi tidak hanya tergantung pada prevalensi kontrasepsi tetapi juga tergantung pads kelangsungan pemakaian kontrasepsi. Ketidaklangsungan pemakaian kontrasepsi yang tinggi mengindikasikan adanya ketidakpuasan terhadap suatu metode kontrasepsi atau pelayanan KB yang dipcroleh dari suatu sumber alat/cara KB. Oleh karena itu penting untuk mengetahui variasi ketidaklangsungan pemakaian kontrasepsi dari sumbcr alat/Cara KB yang berbeda pada wanita dengan karakteristik sosiodemografi yang berbeda. Penelitian ini mempelajari pengaruh snmber alat/cara KB dan faktor sosiodemografi terhadap ketidaklangsungan pemakaian kontrasepsi di Indonesia, bcrdasarkan data historis pemakaian kontrasepsi dalam kalender SDKI 2007, dengan menggunakan metode analisis IW table dan rcgresi C5x. Hasil analisis lgfe table tingkat ketidaklangsungan pemakaian kontrasepsi menunjukkan bahwa tingkat ketidaklangsungan lebih tinggi pada pemakaian kontrasepsi oleh wanita dengan karakteristik: memperoleh kontrasepsi dari surnber swasta, menggunakan pil KB, bertujuan menunda kelahiran, berusia lebih muda, dengan jumlah anak Iebih sedikit, mempunyai tingkat pendidikan dan status sosialekonomi tinggi dan tinggal di daerah perkotaan. Hasil analisis multivariat menggunakan model regresi Cox menunjukkan bahwa pemakaian kontrasepsi yang berasal dari sumber Iainnya mempunyai risiko ketidaklangsungan pemakaian kontrasepsi lebih kecil daripada pemakaian kontrasepsi yang bersumber dari fasilitas swasta atau pemerintah. Pcmakaian metode kontrasepsi jangka panjang, jumlah anak masih hidup, dan motivasi yang kuat untuk membatasi kelahiran mempunyai pengaruh negatif signifikan terhadap ketidaklangsungan pemakaian kontrasepsi. Sedangkan faktor sosiodemografi seperti umur, urnur kawin penmna dan tingkat pendidikan pasangan suami istri dan bertempat tinggal di perkotaan berpengaruh positif signifikan terhadap kctidaldangsungan pcmakaian kontrascpsi.

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The effect of using contraception demographically not only depend on contraceptive prevalence but also on contraceptive continuation. Higher contraceptive discontinuation indicates dissatisfaction of using a contraceptive method. Hence, it is important to study the variation of contraceptive discontinuation of different contraceptive source on women with some socio demographic characteristics.

This research studies the effect of contraceptive source and socio demographic factors on contraceptive discontinuation in Indonesia, based on calendar data of 2007 Indonesian Demographic and Health Survey. Life table analysis and Cox regression are used to describe this effect.

Life table analysis results shows that higher contraceptive discontinuation is found on women with private contraceptive source, using pill, birth spacing as contraceptive intention, younger, viewer children, higher education, higher socio economic status and live in urban.

Cox regression model results that using contraceptive method from other source has lower contraceptive discontinuation risk than using contraceptive method from private or government Facilities. Long term method, number of living children and stronger motivation to limiting birth has significant and negative effect on contraceptive discontinuation. Socio demographic factors as age, age at first union, spouse education and live in urban has significant and positive effect on contraceptive discontinuation."

"Program Keluarga Berencana selama ini telah berkontribusi dalam penurunan fenilitas di Indonesia dan semakin lama prevalensinya semakin meningkat. Peningkatan prevalcnsi pemakaian kontrasepsi yang diikuti oleh penunman angka fertilitas mengindikasikan bahwa di antara dua indikator tersebut memiliki hubungan yang sangat erat. Pencapaian TFR di Indonesia berdasarkan SDKI 2007 ternyata lebih rendah dari yang diharapkan jika. merujuk pada pencapaian CPR-nya. Kondisi ini membawa Indonesia mengalami deiisit fertilitas, yaitu suatu kondisi pencapaian angka fertilitas yang lebih rendah daripada angka fertilitas yang diharapkan. Terjadinya defisit ini diduga karena pemakaian kontrasepsi yang makin efektif dan berlangsung lame, sehingga dugaan tersebut perlu diteliti lebih lanjut. Melalui studi ini, ingin dipelajari pengaruh efektivitas pemakaian kontrasepsi dalam penurunan fertilitas dan kelangsungan pemakaian kontrasepsi berdasarkan karakteristik tingkat pendidikan, aktivitas pekerjaan, daerah tempat tinggal, tingkat kekayaan, mnur, tingkat PDRB, dan rasio fasilitas kesehatan per pasangan usia subur. Dengan mengglmakan regresi multinomial logistik dan regresi Cox, ingin dilihat kcoenderungan pemakaian alat/metodc kontrasepsi dan detenninan kelangsungan pemakaian kontrasepsi. Metode kontrasepsi jangka panjang (MKJP) ternyata masih merupakan metode yang lebih efelctif dibandingkau dengan metode lainnya. Efektivitas yang terjadi ternyata lebih efektif dari yang diduga dan sangat berkontribusi atas texjadinya deiisit fertilitas di Indonesia. Adapun karakteristik yang memiliki kecenderungan untuk menggunakan MKJP ialah mereka yang berpendidikan menengah kc atas, bekezja, tinggal di perkotaan, tingkat kekayaannya linggi, berumur 35 tahun ke atas, daerahnya kurang maju, dan rasio fasilitas kesehaian per PUS-nya makin tinggi. Karakteristik yang lebih cepat mcngalami diskontinu adalah wanita yang menggunakan non MKJP atau metode tradisional, berpendidikan menengah ke atas, tidak bekelja, tinggal di perkotaan, tingkat kekayaannya tinggi, berumur kurang dari 35 tahun, daerahnya kurang maju, dan rasio fasilitas kesehatan per PUS-nya makin tinggi.

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Family Plarming Program has been contributed to decreasing number of fertility in Indonesia. Increasing prevalence of contraceptive use which was followed by decreasing number of fertility rate indicated strong association between the two indicators. It was reported in IDHS 2007 that TFR in Indonesia was lower than expected seeing 'fiom achieved contraceptive use. This condition brought deficit of fertility in Indonesia. Later, it was guess that deficit of fertility was caused by e&`e ctiveness and longer duration of contraceptive use.

The objective of this research was to investigate the influence of effectiveness of contraceptive use toward fertility and to investigate influences of factors such as level of education, working status, place of residence, wealth status, age, GDP and ratio of health care facility and couple of child bearing age toward continuation of contraceptive use. Multinomial logistic and Cox Regression were used to examine the association.

Result of the analysis showed that long term contraceptive method was the most etfective method. The eiectiveness measured was more effective than it was expected and gave much contribution toward deiicit of fertility in Indonesia. The used of long term contraceptive method were high among those couples who were 35-49 years of ae, at least middle level of education, worked, lived in urban area, high socio economic status, lived in developing area, higher ratio of health care facilities and couple of child bearing age. Prevalence of discontinuation were high among those who were used traditional method and non long term method, at least middle level of education, not worked, lived in urban area, high socio economic status, 15-34 years of age, lived in developing area, high ratio of health care facility and couple of child bearing age."

"ABSTRAKNama : Tien IhsaniProgram Studi : Ilmu Kesehatan MasyarakatJudul : Peran Pengambil Keputusan Terhadap Penggunaan MKJP diIndonesia Analisisis Data Sekunder SRPJMN 2017 Pembimbing : Dra. Caroline Endah Wuryaningsih, M.KesMetode Kontrasepsi Jangka Panjang merupakan jenis kontrasepsi yang efektif dari segibiaya dan untuk mencegah kehamilan yang tidak diinginkan, namun peningkatanpenggunaan MKJP di Indonesia dalam beberapa tahun belakangan sangat lambat.Pengambil keputusan ber-KB merupakan target dalam sasaran program komunikasi KB.Tujuan penelitian ini adalah untuk mengetahui bagaimana peran pengambil keputusanterhadap penggunaan MKJP. Desain penelitian adalah cross sectional. Sampelpenelitian ini adalah akseptor kontrasepsi modern yang diambil data sekunder hasilSurvei Indikator Kinerja Program KKBPK RPJMN tahun 2017 sejumlah 20.109 orang.Data dianalisis dengan regresi logistik ganda. Pengambilan keputusan yang dilakukansecara bersama oleh akseptor bersama pasangan atau bersama penyedia layanan secarasubstansi mempunyai peluang yang lebih besar terhadap penggunaan MKJP. Hubunganpengambil keputusan dengan penggunaan MKJP berbeda menurut sumber layanansetelah dikontrol variabel umur, pendidikan, tempat tinggal, jumlah anak, rencana punyaanak, sumber layanan dan konseling KB. Pada sumber layanan pemerintah peluangpenggunaan MKJP menjadi kecil pada pengambilan keputusan yang dilakukan bersamadaripada pengambilan keputusan yang dilakukan oleh akseptor sendiri. Disarankanuntuk dapat meningkatkan peran pasangan odan penyedia layanan untuk mendiskusikanpemilihan alat kontrasepsi dengan akseptor.Kata kunci: Pengambil keputusan, sumber layanan, MKJP.

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ABSTRACTName Tien IhsaniStudy Program Public Health ScienceTitle The Role of Decision Makers Against MKJP Use inIndonesia Advanced Data Analysis of SRPJMN 2017 Counsellor Dra. Caroline Endah Wuryaningsih, M.Sc Dr.Martya Rahmaniati, S.Si, M.SiLong Acting and Permanent Method Contraceptives are a cost effective type ofcontraception and to prevent unwanted pregnancies, but increased use of MKJP inIndonesia in recent years has been very slow. Decision makers of family planning arethe targets in the target family planning communication program. The purpose of thisstudy is to know how the role of decision makers against the use of MKJP. The studydesign was cross sectional. The sample of this research is acceptors of moderncontraception taken secondary data result of Performance Indicator Survey KKBPKRPJMN program in 2017 number 20109 people. Data were analyzed by multiplelogistic regression. Decision making jointly by acceptor with partner or with serviceprovider has substantially greater chance to use LAPM. Decision making relationshipswith the use of MKJP differ by service source after controlling by age, education,shelter, number of children, desire for more children, source of FP services and FPcounseling. At government service sources, the opportunities for MKJP use to be smallon joint decision making rather than decisions made by the acceptor themselves. It issuggested to increase the role of spouses and service providers to discuss the selectionof contraceptives with acceptors.Keywords Decision maker, FP service source, LAPM"

"Pelayanan kontrasepsi adalah pemberian atau pemasangan kontrasepsi maupun tindakan – tindakan lain yang berkaitan kontrasepsi kepada calon dan peserta Keluarga Berencana yang dilakukan dalam fasilitas pelayanan KB."

"The role of contraceptive use dynamics in shaping the contraceptiveprevalence structure and ht determining its impact on fertility becomesincreasingly important for family planning program, policy mailers andprogram managers. Relatively few analyses of contraceptive use dynamicsexist for developing countries. The lack of _ such studies is that the datarequired are not often collected. This article is intended to _,fill in the gaps byanalyzing the five-year calendar data derived from the I994 IndonesiaDemographic and Health Survey (1994 DHS). The five year calendar data oncontraceptive use, pregnancy, termination and reason for discontinuation ofcontraceptive use analyzed using the life table methodologies providemeaningful insight on the quality of contraceptive use in Indonesia. It is foundthat the median duration of use is longest for the IUD and implant, whileshortest lor condom/intravag. About 27 percent of all Indonesia contraceptiveusers discontinue the use of their chosen method within a year. The reasonsfor discontinuation vary across subgroups of women. Method failure isassociated more with discontinuation of traditional method, while method-related reasons such as health concern or inconvenience of use are morelikely to be associated with discontinuation of modern method mainly lUDs,injectables and implants. There are more important factors that differentiatewomen on discontinuation qt' contraception e.g., area of residence, regioneducation, age, and contraceptive intent. These findings on discontinuationenabled the family planning program to provide more realistic and focusedservices to their clients. In conclusion, this analysis emphasizes theimportance of examining the quality of contraceptive use in Indonesia toachieve greater appreciation of the factors that affect contraceptivediscontinuation, switching behavior, and use:;i:i'lure. Special attention shouldhe addressed to health concerns as an important issue for the most popularmodern methods and to the minority of women who discontinue use within ayear and do not switch to another method."

"Dalam siklus reproduksi, bertambah usia, jumlah anak dan kondisi kesehatan menimbulkan kebutuhan jenis alat kontrasepsi baru yang lebih rasional. Peralihan ke metode yang tidak rasional dapat berdampak pada kehamilan tidak direncanakan. Pengetahuan yang tinggi serta persepsi efektifitas dan efisiensi penggunaan alat kontrasepsi berhubungan dengan pola penggantian metode rasional. Oleh karena itu, studi ini bertujuan untuk mengevaluasi pola penggantian metode kontrasepsi, serta membuktikan perbedaan hubungan pengetahuan serta persepsi penggunaan alat kontrasepsi dengan pola penggantian metode kontrasepsi rasional antara perempuan akseptor KB di Jawa Timur dan NTB.Studi ini menggunakan pendekatan kuantitatif dengan desain studi Cross-Sectional. Subyek penelitian adalah wanita usia subur dengan jumlah 4616 perempuan di Jawa Timur dan 4819 perempuan di NTB. Perubahan jenis kontrasepsi ditinjau dari perbedaan jenis kontrasepsi saat ini dengan sebelumnya selama rentang waktu mengikuti program KB. Penilaian rasionalitas ditinjau dari kecocokan metode kontrasepsi terakhir dengan usia, jumlah anak dan motivasi KB. Pengetahuan yang diukur terkait MKJP. Sementara persepsi yang diukur terkait efektifitas efek samping dan cara pemakaian dan efisiensi biaya dan kemudahan memperoleh alat kontrasepsi. Data dianalisis dengan meggunakan multilevel analisis regresi logistik berganda untuk membuktikan hipotesis penelitian. Pola pengantian metode kontrasepsi didominasi oleh perpindahan dari non MKJP ke non MKJP lainnya. Hanya sebagian kecil perempuan berisiko tinggi yang beralih menggunakan kontrasepsi rasional baik di NTB maupun Jawa Timur. Persepsi terhadap efek samping terbukti berhubungan dengan pola penggantian rasional pada perempuan di Jawa Timur, dan persepsi terhadap cara pemakaian alat kontrasepsi terbukti berhubungan dengan pola penggantian metode kontrasepsi rasional pada perempuan di NTB. Persepsi terhadap biaya alat kontrasepsi terbukti berhubungan dengan pola penggantian metode kontrasepsi rasional pada perempuan di Jawa Timur dan NTB.Dapat disimpulkan ada perbedaan hubungan persepsi penggunaan alat kontrasepsi dengan pola penggantian metode kontrasepsi antara Jawa Timur dan NTB. Oleh karena itu, disarankan strategi KIE pada perempuan di Jawa Timur fokus pada penyelesaian masalah persepsi terkait efek samping dan pada perempuan NTB fokus pada penyelesaian masalah persepsi cara pemakaian alat kontrasepsi. Untuk menyelesaikan permasalah terkait persepsi biaya alat kontrasepsi pada perempuan di Jawa Timur dan NTB, perlu didukung keberlanjutan program penggratisan alat kontrasepsi pada masyarakat miskin dan juga masyarakat katagori lainnya melalui program BPJS.

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In the reproductive cycle, the increasing age, number of children and health conditions lead to the need for more rational types of new contraceptives. Switching contraception to irrational methods may cause unintended pregnancies. High knowledge and perceptions of the effectiveness and efficiency of contraceptive use are related to the rational switching method pattern. Therefore, this study aims to evaluate the pattern of switching contraceptive methods, and to prove the difference association of knowledge and perception of contraceptive use with the pattern of rational switching contraceptive methods among women of Family Planning FP acceptors in East Java and West Nusa Tenggara.This study used a quantitative approach with Cross Sectional study design. Research subjects were women of reproductive age with 4616 women in East Java and 4819 women in West Nusa Tenggara. Changes in types of contraceptives were reviewed from the different types of contraceptives with the previous one during the timeframe of the FP program. Assessment of rationality was reviewed from the compatibility of the last method of contraception with age, number of children and family planning motivation. Knowledge was measured related to Long Term Contraceptive Method LTCM . While, perception rsquo s measurement was related to the effectiveness side effects and mode of use and efficiency cost and ease of obtaining of contraceptives. Data were analyzed using Multilevel Multiple Logistic Regression analysis to prove the research hypothesis.The switching pattern of contraceptive methods was dominated by changing from non LTCM to other non LTCM. Only a small proportion of high risk women switched to use rational contraception both in West Nusa Tenggara and East Java. Perceptions of side effect was associated with rational patterns of switching method in women in East Java, and perceptions of the use of contraceptives had relationship with patterns of rational contraceptive methods for women in West Nusa Tenggara. Perceptions of the cost of contraceptives was foundto be related withrational switching pattern of contraceptive methods among women in East Java and West Nusa Tenggara.In conclusion, there was a difference relationship of perceptionon contraception use and switching contraceptive method between East Java and West Nusa Tenggara. Therefore, it is recommended that Communication, Information and Education CIE strategies for women in East Java should focus on solving perceptual problems related to side effect while in West Nusa Tenggara women more focus on solving perception problems about how to use contraceptives. To solve the problems related to perception of contraceptive cost among women in East Java and West Nusa Tenggara, it is necessary to support the continuity of contraceptive application program for the poor and other categories through the Social Insurance Administration Organization Badan Penyelenggara Jaminan Sosial BPJS program."

"Tujuan: Mengetahui status asam folat dan perilaku tentang asupan asam folat pada akseptor KB, sehingga dapat dipertimbangkan perlu tidaknya suplementasi asam folat pada akseptor KB, khususnya akseptor pil. Tempat: RW 014 Kelurahan Pisangan Baru, Kecamatan Matraman, Jakarta Timur. Bahan dan Cara: Penelitian crows-sectional dan subjek penelilian adalah semua akseptor KB yang memenuhi kriteria penelitian. Data yang dikumpulkan meliputi data sosio demografi, pola makan, asupan giri (makro matrial dan asam folat), status kadar asam folat serum dan sel darah merah (SDM). Hasil: Tidak didapatkan kadar asam folat serum < 3 ag/ml. Status asam folat serum subjek tidak berhubungan dengan pemakaian pil, karakteristik demografi, asupan gizi dan status gizi. Persentase kadar asam folat SDM < 160 mg/ml. adalah 3,5%. Kadar asam folat SDM subjek pil tidak berbeda dengan subjek bukan pil, namun ada kecenderungan kadar asam folat SDM subjek pil lebih rendah dari subjek bukan pil. Secara bermakna kadar asam folat SDM subjck bcrhubungan dengan kebiasaan mengkonsumsi sayur hijau dan kelompok umur. Perbedaan dalam mengolah sayur menyebabkan perbedaan bermakna pada jumlah subjek yang mempunyai kadar asam folat SDM < 160 mg/ml. Rata-rata asupan zat-zat gizi subjck penelitian di bawah AKG yang dianjurkan. Subjek pil mempunyai rata-rasa asupan asam folat lebih rendah bermakna dari subjek bukan pil, namun tidak didapatkan korelasi antara asupan asam folat dengan kadar asam folat serum dan SDM subjek penelitian. Kcsimpulan: Status asam folat serum dan SDM subjek penelitian tidak berhubungan dengan pemakaian pil dan bukan pil, sehingga belum diperlukan suplementasi pada subjek penelitian khususnya subjek pil.

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Objective: To determine the folic acid slates and the behavior of folic acid intake in contraceptive users. This is in order to decide whether folic acid supplemeration is necessary, especially for pill users.

Location: RW 014 Kelurahan Pisangan Baru, Kecamatan Matraman, Jakarta Timur.

Methods: cross-sectional study and subjects were all contraceptive users who fulfill study criteria. Data ' collected were socio-demographic, eating paucrn, nutritional intake (macro nutrient and folic acid), nutritional status, serum and RISC folic acid level.

Results: Serum folic acid level of < 3 mg/ml, was not found, Scrum folic acid level was not associated with using pill or non pill, socio-demographic, eating pattern, nutritional intake and nutritional status. The percentage of RISC folic acid level of N 160 mg/ml, was 3.5%. RISC folic acid level was not associated with using pill or non-pill, but there was a tendency Chef ItBC folic acid level in pill users was lower than non-pill users, There was a significant correlation between R13C folic acid level wish the frequency of green vegetables consumption and age group, 'Ihe difference in the manner of cooking significantly associated with the number of subject with RBC folic acid level of 160 mg/ml. Nutritional intake was under RDl level in almost subjects. Pill users had in average significant lower folic acid intake compare to non-pill users, but there was no correlation between folic acid intake with scrum and RBC folic acid level.

Conclusions: Serum and RHC folic acid stains is not associated with using pill or non-pill. From this study it is still not necessary for folic acid supplementation, especially for pill users."

"Contraception is an integral dimension of women'shealth both of them are components of the broader- objectives offamily planning and life long well-being i.e., controlling ones lifepattern. Research data indicates of decline in fertility rates. infantmortality and child mortality rates with womens' development andeconomic advancement, women ?s acknowledge the need forcontraception and limiting the number of pregnancies. This studyused the Indian National Family Health Survey (NFHS-2, l 998-99),2000, for currently married women aged l5-49 years. The objectiveof the study is to explore the substantial impact of the use moderncontraceptive methods on fertility, infant and child mortality ratesin India. The knowledge of modern contraceptive methods is nearlyuniform (99%) among the currently married women irrespective oftheir socioeconomic and geographical affiliation. The practice ofcontraception does not only reduce the fertility, infant, and childmortality rates, but also has major impact on the quality of theirlives and reproductive health status. The strong, consistent, andnegative significant eject of family planning methods have beenobserved on aggregate decline of fertility. infant, and childmortality. The socioeconomic background of women (education,religion, and standard of living) influenced the practice of familyplanning methods significantly. The use of family planning methodssubsequently help to bring down the fertility, infant, and childmortality rates."