Contraceptive use and maternal mortality in Indonesia: a community-level ecological analysis

Aryanty, Riznawaty Imma; Romadlona, Nohan Arum; Besral, Besral; Panggabean, Elvi Debora P.; Utomo, Budi; Makalew, Richard; Magnani, Robert J.

doi:10.1186/s12978-020-01022-6

Cited by 21 publications

(18 citation statements)

References 13 publications

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“…The national MCH program on the other hand has struggled mightily as indicated by a maternal mortality ratio of 305 per 100,000 live births in 2015 [ 27 ] that is not commensurate with a country that the World Bank had “graduated” to upper-middle income status prior to a COVID-19 pandemic-related setback. A recent community-level ecological study [ 50 ] found that maternal mortality ratios were strongly associated with the proportion of households that were classified as poor but only weak (at best) associations with local health system infrastructure/resource indicators (i.e., numbers of hospitals, community health centers, physicians, nurses, and midwives), a strong indication of program ineffectiveness.…”

Section: Discussionmentioning

confidence: 99%

How well are Indonesia’s urban poor being provided access to quality reproductive health services?

et al. 2022

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Accommodating the needs of Indonesia’s rapidly growing urban population is essential to reaching national reproductive health goals and international commitments. As in other rapidly urbanizing low- and middle-income countries, satisfying the needs of Indonesia’s urban poor is both a high priority and a significant challenge. In this study, we assessed both how being from urban poor or near-poor households affects the quantity and quality of family planning and maternal health services received and the extent to which differentials had narrowed during the 2012–2017 period. This time interval is significant due to the introduction of a national social health insurance scheme in 2014, establishing the foundation for universal health care in the country. Data from the 2012 and 2017 Indonesian Demographic and Health Surveys were analyzed using logistic and multinomial logit regression. Poverty status was measured in terms of urban household wealth quintiles. For family planning, although urban poor and near-poor women made different method choices than non-poor women, no substantial 2017 differences in contraceptive prevalence, unmet need for family planning or informed choice were observed. However, urban poor women and to a lesser extent near-poor women systematically lagged non-poor urban women in both the quantity and quality of maternal health services received in connection with recent pregnancies. Significant maternal health service gains were observed for all urban women during the study reference period, with gains for poor and near poor urban women exceeding those for non-poor on several indicators. While the deployment of pro-poor interventions such as the national social health insurance scheme is likely to have contributed to these results, evidence suggesting that the scheme may not be influencing consumer health-seeking behaviors as had been anticipated along with continued limitations in public health sector supply-side readiness resulting in service quality issues suggest that more will have to be done.

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Section: Discussionmentioning

confidence: 99%

How well are Indonesia’s urban poor being provided access to quality reproductive health services?

et al. 2022

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“…Improving the demand for family planning information among adolescents should be stressed in the country's population policies as key priority strategy to reduce fertility further. Increasing access to family planning information is essential and has been shown to have a signi cant impact on decision making to use contraception, postponing of marriage and limiting the number of children, thus reducing fertility (43,44). Health education on limiting family size through family planning programming will surely assist in changing reproductive behavior of adolescents, but it will only be effective if adolescents will embrace the advantages of having smaller families.…”

Section: Discussionmentioning

confidence: 99%

Perceived Ideal Number of Children Among Adolescents in Sub-Saharan Africa: Does Exposure to Family Planning Messages Matter?

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Lemba

Simona

et al. 2022

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BackgroundEven though evidence shows that fertility transition has begun almost everywhere in sub–Saharan Africa, the decline has been slower than in other parts of the world. Researchshows that there is a positive relationship between fertility levels and desired family size. Therefore, many countries in the region are implementing family planning education campaigns targeting at influencing reproductive behaviour of women. Thus,this studyaimed at examiningthe extent to which exposure to family planning communication is associated withdesired family size in adolescencein sub-Saharan Africa.MethodsThis study used data extracted fromthe most recent Demographic and Health Survey datasets for 28 countries in sub-Saharan Africa. Analyses were conducted on a pooled weighted sample of 87,950female adolescents’ aged 15-19 yearscaptured in respective country surveys. Multivariate logistic regression models were fitted in Stata version 16 software to examine the effects of exposure to family planning communication on adolescents desired family size.ResultsFindings show that regardless of the country,exposure to family planning communication among adolescentshad a significant effect on desire for fewer children. Average ideal family size among adolescents who had exposure to family planning communication was (3.8 children compared to 4.5 children;p<0.001) among those with no exposure.Marital status, wealth status, education level,contraceptive use and employment status were also significantly associated with adolescents’desiredfamily size.Country level differences were observed regarding desired family size among adolescents. Adolescents from West Africa Countries had higher desired family size.ConclusionExposure to family planning communication has shown the potential to influence adolescents’ fertility behavior in the region. Desire for large family size is predominantly high among adolescents from West and Central African countries. Suggesting that high fertility remains a social concern in these regions. Furthermore, the study found sub-regional variations in determinants ofdesired family size among adolescents. Calling for the need to scale-up family planning education programmes especially in West and Central Africa countries.

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“…Globally, contraceptives remain an important public health intervention for preventing unintended pregnancies and related maternal mortality and morbidity [ 1 – 4 ]. Despite these benefits, studies show low use of contraceptives across sub-Saharan Africa (SSA) including Ghana, where the modern contraceptive prevalence rate is about 25% [ 5 ], a figure slightly lower than the regional (SSA) average.…”

Section: Introductionmentioning

confidence: 99%

“…This influence is partly strengthened by ideologies of masculinity, gender roles and beliefs existing in both patrilineal and matrilineal societies which allow men control over women’s sexual and reproductive decisions and health [ 23 , 24 ]. Studies on covert use of contraceptives are a sobering reminder of the power dynamics in sexual unions [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Partner support and women's contraceptive use: insight from urban poor communities in Accra, Ghana

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Background Despite the benefits associated with contraceptive use, there is a low prevalence of contraceptive use in sub-Saharan Africa and Ghana. Previous studies have partly and consistently attributed the low prevalence of contraceptive use to partner opposition. However, little is known about the influence of men in contraceptive related choices of their partners, particularly within the context of urban poverty. This study examines the influences of partners on women’s contraceptive choices. Methods The study utilized a cross-sectional household survey data of 1578 currently married women and women in a union of reproductive ages 16–44 years. Women who were pregnant and those trying to be pregnant were excluded from the analysis. The dependent variables for the study were current use of any contraceptive method, types of contraceptive methods and types of modern contraceptive methods. The independent variable for the study was a woman’s report of partner support in contraceptive related choices. A binary logistic regression model was used to examine the associations between partner support in contraceptive related choices and contraceptive use of women. Results The results of the study show that partner support of contraceptive related choices has a significant influence on contraceptive use of women. Women who indicated support from their partners were more likely to be current users of any contraceptive method, yet were less likely to use modern contraceptive methods. Conclusion The study highlights the need to involve men in family planning programs and research, as well as educating them on the various contraceptive modern methods and the side effects.

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Contraceptive use and maternal mortality in Indonesia: a community-level ecological analysis

Cited by 21 publications

References 13 publications

How well are Indonesia’s urban poor being provided access to quality reproductive health services?

How well are Indonesia’s urban poor being provided access to quality reproductive health services?

Perceived Ideal Number of Children Among Adolescents in Sub-Saharan Africa: Does Exposure to Family Planning Messages Matter?

Partner support and women's contraceptive use: insight from urban poor communities in Accra, Ghana

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