The Utilization of Long-Acting Reversible Contraception and Associated Factors Among Women in Indonesia

Abstract

Long-acting reversible contraceptives (LARCs), consist of IUD and implats, were effective and efficient methods in preventing the pregnancy. However, the used of these methods in Indonesia was still low. This study sought to explore LARC utilization trends and the factors influencing LARC used among reproductive women in Indonesia. This research analyzed data from the Indonesia Demographic and Health Survey 2017. Respondents in this study were women who currently used modern contraceptive methods. A total of 20,409 women who used modern methods were included in the analysis. Descriptive analysis was performed using chi-square and percentages. Logistic regression with complex sample design was used to determine the associated factors in LARC utilization. Among women in reproductive age who currently used modern contraception, IUDs and implants were viewed particularly unfavorably which only 16.5% of women used LARC. Findings highlighted that higher LARC use among reproductive age women in Indonesia correlated with higher parity, older women, higher education, working women, desire to limit the pregnancy in the future and more visited by fieldworkers in the last 12 months. This study underscored that even though only 4% of respondents were visited by fieldworkers, the utilize of LARC was higher among women who visited by fieldworkers. This study suggests that communication skills among fieldworker need to be enhanced to do counselling and work closely with the community member.

Low Use of Long-Acting Reversible Contraceptives in Tanzania: Evidence from the Tanzania Demographic and Health Survey

“…This advantage demonstrates the need for more effective and long-term contraceptive options even in the less formally educated women. These findings are similar to observations in Malawi, Zimbabwe [ 11 ], Indonesia [ 13 ], and most other low and middle countries [ 27 ]. While education level impacted the overall use of contraceptives in Ghana, Zambia, and Madagascar, it did not impact the choice of the method used [ 28 ].…”

“…This may be because most women marry at an early age (median age: 19.2 years in Tanzania) [ 18 ], typically conceiving immediately after marriage and thus ruling out the need for LARCs in their teenage years. A similar relationship was observed in other sub-Saharan nations [ 11 ], Nigeria [ 9 ], the USA [ 10 , 24 ], and Indonesia [ 13 ]. Interestingly, women in Zambia aged below 25 years did not use LARCs [ 25 ].…”

“…Similarly, adaptable programs successfully improved the uptake of LARCs within Malawi and Zimbabwe [ 11 ]. However, the use of LARCs was not influenced by the wealth index in Indonesia [ 13 ]; however, Nigeria demonstrated opposite results, with a greater uptake in lower wealth index communities than their counterparts [ 30 ]. This is possibly due to the greater emphasis on promoting LARC use in rural communities, where extensive campaigns have taken place, than in urban areas, where most individuals pay for services that may have otherwise hindered their use.…”

“…Maternal age was determined to be a factor, with teenagers less likely to use contraceptives than older women [ 9 , 10 , 11 ]. Excluding a select population in the USA [ 12 ], a higher educational status has also been linked to greater use of LARCs [ 11 , 13 , 14 ]; empowering women via education, therefore, seems to be a stronger mode of improving the use of contraceptives [ 14 , 15 ]. Lastly, a couple’s desire for more children bidirectionally affected the use of LARCs, with some positive [ 16 ] and some negative correlations associated with its use [ 11 , 17 ].…”

Options of Long-Term Contraceptive Methods in Married Women in South Sulawesi (Analysis of Idhs 2017)

“…A study by Gayatri (2020) explains about analyzing women throughout Indonesia using the 2017 IDHS data, which showed that women who were visited by field workers had a higher chance of using long-term reversible contraceptive methods than women who were not visited. However, the proportion of women visited by the field workers was less than 4%.…”