ALASAN DAN DETERMINAN UNMET NEED KELUARGA BERENCANA PADA WANITA USIA SUBUR DI INDONESIA: A MIXED METHODS APPROACH

NANIK SRI WAHYUNI, Prof. dr. Siswanto Agus Wilopo, SU, M.Sc, Sc.D.; Dr. dr. Eugenius Phyowai, SpOG(K)

2018 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar Belakang: Program keluarga berencana di Indonesia telah berjalan lebih dari 4 dekade, namun angka unmet need masih belum mencapai target yang ditetapkan dalam Rencana Pembangunan Jangka Menengah Nasional tahun 20152019 yaitu sebesar 9,91%. Tujuan: Penelitian ini bertujuan untuk mengetahui alasan unmet need keluarga berencana dan determinannya di Indonesia. Metode: Penelitian mix methods dengan desain studi sequential explanatory. Menggunakan data survei PMA2020 tahun 2015 di Indonesia dan indepth interview di Kota Balikpapan Provinsi Kalimantan Timur. Pengumpulan data kualitatif dilakukan pada bulan April 2018. Responden adalah wanita usia subur. Besar sampel dalam penelitian kuantitatif adalah 875 orang dan penelitian kuantitatif 11 orang/ tercapai saturasi data di lapangan. Karakteristik WUS disajikan secara deskriptif menggunakan statistik inferensial. Pengaruh determinan karakteristik demografi pada unmet need dianalisis dengan uji chi square. Untuk analisis multivariabel menggunakan regresi logistik dan menghitung kekuatan hubungan dengan Odds Ratio (OR). Seluruh perhitungan menggunakan tingkat kepercayaan (CI) 95% dan signifikansi <0,05. Hasil: Alasan takut terhadap gangguan kesehatan akibat kontrasepsi meningkatkan terjadinya unmet need. Proporsi alasan takut terhadap gangguan kesehatan akibat kontrasepsi sebesar 48,1%, dimana 60% diantaranya adalah WUS dengan unmet need limiting. Peluang terjadinya unmet need limiting pada WUS dengan alasan gangguan kesehatan akibat kontrasepsi sebesar 2,27 kali setelah mengontrol variable individu lainnya. Hasil wawancara pada penelitian kualitatif memberikan informasi baru tentang alasan tetap menggunakan kontrasepsi meskipun takut terhadap gangguan kesehatan akibat kontrasepai. Integrasi penelitian membuktikan bahwa hasil kualitatif mendukung hasil kuantitatif. Kesimpulan: Alasan takut terhadap gangguan kesehatan akibat kontrasepsi terjadi pada WUS unmet need maupun WUS yang mengunakan kontrasepsi. Determinan lain terjadinya unmet need diantaranya adalah faktor usia, paritas, keinginan memiliki anak, dan variabel tempat tinggal.

Background: Family planning program in Indonesia has been running more than four decades, but the unmet need has not reached the targets set in the National Medium Term Development Plan for the year 2015-2019 is 9.91%. Objective: This study aims to determine the reasons of unmet need for the family planning and its determinant in Indonesia. Method: Research mixed methods with sequential explanatory study design, using the PMA2020 survey results in 2015 in Indonesia and indepth interview in Balikpapan City East Kalimantan Province. Qualitative data collection was conducted during the April 2018. Respondents in this study were women of childbearing age. The sample size in quantitative research was 875 people and qualitative research was 11 people is limited until saturation of data is reached in the field. Women characteristics are presented descriptively using inferential statistics. The determinant effect of demographic characteristics on unmet need was analyzed by chi square test. For multivariable analysis use logistic regression and calculate strength of relationship with Odds Ratio (OR). All calculations use 95% confidence level (CI) and significance <0.05. Result: The reason for fear of health problems caused by contraception increases the unmet need family planning. The proportion of reason is 48,1%, where 60% of them are women with unmet need limiting. Opportunities for unmet need limiting in women with health reasons due to contraception 2.27 times after controlling other individual variables. The results of interviews in qualitative research provide new information about the reasons to continue using contraception despite fear of health problems due to contraceptives. Research integration proves that qualitative results support quantitative results. Conclusions: The reason for fear of health problems caused by contraception occurs in WUS unmet need and WUS who use contraception. Determinants of unmet need include the factors of age, parity, desire to have children, and variable residence.

Kata Kunci : Unmet need, Keluarga Berencana, Kontrasepsi, Limiting, Spacing, Unmet need, Family Planning, Contraception, Limiting, Spacing