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Abstrak :
Rasio angka kematian ibu melahirkan di Indonesia masih tinggi. Keluarga Berencana (KB) berkontribusi secara langsung terhadap penurunan rasio angka kematian ibu. Namun, kebutuhan KB yang tidak terpenuhi dan angka penggunaan kontrasepsi cara modern di Indonesia masih stagnan. Belum ada definisi dan pengukuran baku mengenai partisipasi laki-laki dalam KB. Tujuan penelitian ini untuk mengetahui tren partisipasi laki-laki dalam KB di Indonesia pada tahun 2007, 2012 dan 2017 dengan alasannya. Penelitian ini menggunakan pendekatan kuantitatif dengan desain penelitian potong lintang berdasarkan data pasangan dari Survei Demografi dan Kesehatan Indonesia (SDKI) tahun 2007, 2012 dan 2017. Subyek penelitian adalah pasangan (suami dan istri) yang berhasil diwawancarai dalam SDKI namun mereka menyatakan bahwa istrinya tidak sedang hamil dan menyatakan tidak ingin memiliki anak. Jumlah subyek penelitian sebesar 4.661 pasangan pada tahun 2007, 4.553 pasangan pada tahun 2012 dan 5.117 pasangan pada tahun 2017. Variabel bebas pada penelitian ini adalah sumber informasi KB yang diterima oleh suami baik melalui tenaga kesehatan, tenaga penyuluh KB atau media. Variabel terikat pada penelitian ini adalah partisipasi laki-laki dalam keluarga berencana yang diukur berdasarkan hasil analisis faktor dari pengetahuan suami mengenai kontrasepsi, sikap suami mengenai KB, sikap suami mengenai kontrasepsi, komunikasi pasangan mengenai KB, pengambil keputusan mengenai kontrasepsi, dan penggunaan kontrasepsi. Variabel kontrol adalah karakteristik sosial demografi pasangan. Analisis menggunakan analisis satu arah (oneway) dan analisis varians ganda (multiway Analysis of Variance-ANOVA). Dapat disimpulkan bahwa pemberian informasi secara langsung antara suami dengan tenaga kesehatan dan tenaga penyuluh KB berhubungan secara signifikan dengan partisipasi laki-laki dalam KB. Suami yang mendapat informasi KB dari tenaga penyuluh KB memiliki skor partisipasi yang baik daripada suami yang mendapat informasi dari tenaga kesehatan. Media tidak berhubungan secara signifikan dengan partisipasi laki-laki dalam KB. Disarankan tenaga penyuluh KB maupun tenaga kesehatan memberikan informasi KB secara langsung kepada suami dengan pendekatan yang sensitif jender. ......Indonesian Demographic and Health Surveys Indonesia faces huge challenges for reducing maternal mortality ratio. Family planning has direct contribution for reducing maternal mortality ratio. Nevertheless, the unmet need for family planning and contraceptive prevalence rate for modern methods remains stagnan. No universal measurement of male engagement in FP. Hence, the objective of this research is to analyze various factors associated with low male engagement in family planning in Indonesia during 2007, 2012 and 2017. This cross-sectional study utilized a quantitative approach based on couplematched data from 2007, 2012 and 2017 Indonesian Demographic and Health Surveys (IDHS). Research subjects were couples (husbands and wives) who had successfully interviewed by the IDHS but they declared that their wives were not pregnant and they were not want any child. The numbers of research subjects were 4.661 couples in 2007, 4.553 couples in 2012 and 5.117 couples in 2017. The independent variable of this study was source of family planning information received by husbands, either through health workers, family planning field workers or the media (television, radio, newspaper/magazine). This study conducted a factor analysis for reducing a set of complex variables in terms of male engagement in family planning, as the dependent variable of this study, measured by husband's knowledge on contraception, husband's attitude about family planning, husband's attitude about contraception, inter-spousal communication regarding family planning, contraceptive decision-maker, and contraceptive use. The control variable was the socio-demographic characteristics of couples. This research utilized one-way and multi-way Analysis of Variance (ANOVA). The conclusion that family planning field workers and health workers revealed significant association to male engagement into FP. Husbands who received FP information from family planning field worker had higher score of male engagement of FP than husbands who received information from health workers. Media has no correlation with male engagement into FP. Hence, it is recommended that family planning field worker and health workers provide face-to-face counselling of FP to husbands with gender sensitive approach.

Abstrak :
Unmet need KB di Indonesia belum mencapai target khususnya di Pulau Kalimantan. Penurunan unmet need KB dapat mencegah kematian ibu. Adanya desentralisasi menuntut pemerintah daerah membuat kebijakan kesehatan seperti program KB. Analisis spatio-temporal dibutuhkan untuk menyelidiki unmet need KB yang berguna untuk memantau program KB. Tujuan penelitian ini adalah mengetahui pola spasial dan faktor faktor yang mempengaruhi unmet need KB tahun 2018-2021 di tingkat Kabupaten/Kota di Pulau Kalimantan, Indonesia. Studi ekologi dilakukan pada 56 Kabupaten/kota di Pulau Kalimantan pada tahun 2018-2021. Data berbentuk agregat dan bersumber dari Laporan Pengendalian dan Pelayanan Kontrasepsi BKKBN, Buku Publikasi Badan Pusat Statistik (BPS) dan Website Dewan Jaminan Sosial Sistem Informasi Terpadu. Analisis data dengan menggunakan Geographically Temporal Weighted Regression. Hasil penelitian menunjukkan Bulungan, Malinau, Nunukan, Tana Tidung, Kota Tarakan, Bontang, Kutai Kartanegara, dan Kutai Timur konsisten berada pada klaster I (High-high) pada tahun 2018-2021. Pemodelan unmet need KB yang didapatkan pada tingkat Kabupaten/kota di Pulau Kalimantan selama 2018-2021 adalah kemiskinan, pendapatan, non cakupan JKN, rasio praktik bidan mandiri, rasio faskes KB pemerintah, rasio faskes KB swasta, rasio penyuluh KB dengan nilai adjusted R square sebesar 46,06%. Kemiskinan berpengaruh dalam meningkatkan unmet need KB di 43 Kabupaten/Kota (76,8%) di Pulau Kalimantan, Indonesia selama 2018-2021. Non cakupan JKN berpengaruh dalam meningkatkan unmet need KB di 35 Kabupaten/kota (62,5%) di Pulau Kalimantan, Indonesia selama 2018-2021. Rasio praktik bidan mandiri, rasio faskes KB pemerintah dan rasio faskes KB swasta berpengaruh terhadap unmet need KB tetapi belum dapat menurunkan unmet need KB di Pulau Kalimantan, Indonesia selama 2018- 2021. Rasio penyuluh KB berpengaruh dalam menurunkan unmet need KB di 22 Kabupaten/kota (39,3%) di Pulau Kalimantan, Indonesia selama 2018-2021. Berdasarkan hasil penelitian tersebut direkomendasikan kepada SKPD-KB di Kabupaten/kota untuk memprioritaskan program KB pada penduduk miskin dalam menurunkan unmet need KB dengan mendekatkan program KB seperti pelayanan KB dan penyuluhan KB khususnya pada Kabupaten/kota yang konsisten tergolong kemiskinan tertinggi selama 2018-2021, yaitu Kapuas Hulu, Melawi, Kayong Utara, Paser, Kutai Barat, Kutai Timur, Mahakam Ulu dan Bulungan. ......Unmet need for family planning in Indonesia has not yet reached the target, especially on the island of Kalimantan. Reducing the unmet need for family planning can prevent maternal deaths. Decentralization requires local governments to create health policies such as family planning programs. Spatio-temporal analysis is needed to investigate unmet need for family planning which is useful for monitoring family planning programs. The aim of this research is to determine the spatial patterns and factors that influence the unmet need for family planning in 2018-2021 at the district/city level on the island of Kalimantan, Indonesia. Ecological studies were carried out in 56 districts/cities on Kalimantan Island in 2018-2021. Aggregate data is used and comes from the BKKBN Contraception Control and Services Report, the Central Statistics Agency (BPS) Publication Book and the Social Security Council's Integrated Information System Website. Data analysis using Geographically Temporal Weighted Regression. Poverty has an influence in increasing the unmet need for family planning in 43 districts/cities (76.8%) on Kalimantan Island, Indonesia during 2018-2021. Non-coverage of JKN has an influence in increasing the unmet need for family planning in 35 regencies/cities (62.5%) on Kalimantan Island, Indonesia during 2018-2021. The ratio of independent midwife practices, the ratio of government family planning health facilities and the ratio of private family planning health facilities have an influence on the unmet need for family planning but have not been able to reduce the unmet need for family planning on the island of Kalimantan, Indonesia during 2018-2021. The ratio of family planning instructors has an influence in reducing the unmet need for family planning in 22 districts/cities (39.3%) on Kalimantan Island, Indonesia during 2018-2021. Based on the results, it is recommended for SKPD-KB in districts/cities to prioritize family planning programs for the poor in reducing the unmet need for family planning by bringing family planning programs closer together such as family planning services and family planning counseling, especially in districts/cities which consistently have the highest poverty level during 2018-2021 namely Kapuas Hulu, Melawi, North Kayong, Paser, West Kutai, East Kutai, Mahakam Ulu and Bulungan.

Abstrak :
Kecemasan akan kembalinya kesuburan pascaputus pakai kontrasepsi yang tidak pasti berdampak negatif pada penggunaan kontrasepsi di Indonesia. Banyak perempuan meyakini mitos kontrasepsi menyebabkan kemandulan termasuk Metode Kontrasepsi Jangka Panjang (MKJP) seperti yang ditunjukkan Survei Demografi dan Kesehatan Indonesia 2007, 2012 dan 2017 dimana tidak ada perempuan yang putus pakai MKJP sebelum mempunyai anak. Penelitian ini membuktikan mitos tersebut tidak benar, karena kesuburan dapat segera kembali sebelum satu tahun pascaputus pakai kontrasepsi. Analisis kesintasan digunakan dalam mengestimasi kembalinya kesuburan pascaputus pakai kontrasepsi. Metode kontrasepsi yang diteliti pada SDKI yaitu pil, suntikan, IUD dan implant yang digunakan selama 5 tahun sebelum 2007, 2012 dan 2017. Sebanyak 4573 episode (SDKI 2007), 5183 episode (SDKI 2012) and 5989 episode (SDKI 2017) dari perempuan yang putus pakai kontrasepsi karena ingin hamil diikuti secara retrospektif. Analisis data dalam penelitian ini menggunakan Stata IC 15.1. Perempuan pemakai IUD hamil lebih cepat dibandingkan mereka yang menggunakan implan, pil dan suntikan. Tingkat kehamilan kumulatif selama 1 tahun pascaputus pakai kontrasepsi adalah 72%-85% untuk IUD, 75%-81% untuk pil, 72%-76% untuk implan and 65%- 67% untuk suntikan. Tingkat kehamilan pada 2 tahun pascaputus pakai pada keempat kontrasepsi mencapai 82%-92%. Tingkat kehamilan meningkat pada perempuan usia muda. Terjadinya kehamilan tidak berhubungan dengan jumlah anak, penyakit menular seksual, pengetahuan tentang masa subur, tingkat kesejahteraan dan tempat tinggal. Penelitian ini tidak menunjukkan adanya gangguan kesuburan yang disebabkan oleh putus pakai kontrasepsi. Studi ini merekomendasikan untuk penguatan konseling pada pra dan pasca pelayanan KB, pengembangan materi KIE dan konseling yang komprehensif serta penguatan kapasitas tenaga kesehatan dan non kesehatan dalam konseling. ...... The fear that resumption of fertility after discontinuation of contraception are uncertain or inconclusive has a negative impact on utilization of contraceptive methods in Indonesia. Many women belief that contraceptive methods cause infertility including Long-Acting Reversible Contraceptive (LARC), as shown by the 2007, 2012 and 2017 Indonesia Demographic and Health Survey (IDHS) data that not even one woman would discontinue LARC before the first pregnancy. Therefore, this study presented evidence that this belief is not true, because it took less than one year to resume fertility after the discontinuation of contraceptive methods. A survival analysis was used to assess the time of fertility resumption after discontinuation of reversible contraceptive methods. Type of contraception analysed included pills, injectables, Intrauterine Devices (IUD) and implants within the last 5 years preceding the Indonesia Demographic and Health Survey 2007, 2012 and 2017. As many as 4573 episodes (IDHS 2007), 5183 episodes (IDHS 2012) and 5989 episodes (IDHS 2017) of women who discontinued the use of reversible contraceptive methods for the reason of planned pregnancy were followed retrospectively. Data analysis was performed using Stata IC 15.1. Women who had been using IUD achieved faster to become pregnant than ex-implant users, ex-pill users and ex-injectable users. The 1-year pregnancy rates following contraceptive removal were 72%-85% for IUD, 75%-81% for pills, 72%-76% for implants and 65%-67% for injectables. The 2-years pregnancy rates were 82%-92% for pills, injectables, implants and IUDs. The rate of pregnancy was increased in younger women. The long duration of contraceptive used had no impact on reducing pregnancy rates. Time to pregnancy was not related to women's parity, sexually transmitted diseases, knowledge of fertile window, women's wealth status and place of residence. The study did not show any impaired fertility caused by the reversible contraceptive discontinuation. It is recommended to strengthen pre and post service counseling, developing IEC material and strengthening the capacity of health and non-health workers in counseling.