Determinan "Unmet Need" pelayanan Keluarga Berencana di Kabupaten Sampang

NURINDRAYANTO, Wahyu Utomo, Prof.dr. Mohammad Hakimi, Sp.OG(K).,Ph.D

2006 | Tesis | S2 Ilmu Kesehatan Masyarakat (Kes. Ibu dan Anak-Ke

Latar Belakang . Angka kematian ibu di Indonesia masih tinggi sekitar 390 per 100.000 kelahiran hidup. Angka itu masih jauh dari sasaran Millenium Development Goal (MDG), 124 per 100.000 kelahiran hidup yang harus dicapai tahun 2010. Kasus Aborsi yang tidak aman, yang sebenarnya dapat dicegah dengan pelayanan kontrasepsi yang memadai, menyumbang 11 % dari angka kematian ibu tersebut. Sementara contraceptive prevalence rate di Indonesia baru mencapai 54,2 % dan angka unmet need mencapai 9 %. Menurut data evaluasi Safe Motherhood : Partnership and Family Approach (SMP-FA) tahun 2002 di Kabupaten Sampang contraseptive prevalence rate-nya dibawah rata-rata nasional yaitu 44,3 %, sedangkan angka unmet need pelayanan Keluarga Berencana mencapai 11, 3 %, jauh dari target intervensi yang 6,5% Tujuan. Penelitian ini bertujuan untuk mengetahui determinan unmet need pelayanan keluarga berencana di kabupaten Sampang Metode Penelitian. Penelitian ini merupakan penelitian observasional dengan rancangan cross-sectional study, menggunakan data hasil survey evaluasi Safe Motherhood-Partnership and Family Approach (SMP-FA) tahun 2002. Jumlah sample penelitian 178 wanita kawin usia 15 – 49 tahun. Lokasi penelitian ini adalah Kabupaten Sampang. Analisa data kuantitatif akan menggunakan uji chi-square dan uji regresi logistik. Hasil Penelitian. Wanita kawin yang tidak sekolah berpeluang 6 kali lebih besar (OR=5,86, CI 95%=1,29-26,41) untuk mengalami unmet need for spacing dibandingkan wanita kawin yang berpendidikan SD. Wanita kawin yang berpengetahuan KB kurang berpeluang 8 kali lebih besar (OR=7,77, CI 95%=1,51-40,01) dibandingkan wanita kawin yang berpengetahuan cukup. Ekspose media terbukti memiliki hubungan bermakna dengan unmet need for spacing maupun unmet need for limiting. Wanita kawin yang jarang terekspose media massa berpeluang 8 kali (OR=8,76, CI 95%=1,48-51,70) untuk mengalami unmet need for limiting dibandingkan dengan wanita yang terekspose media massa setiap hari. Komunikasi dalam keluarga terbukti berkorelasi positif dengan unmet need for spacing (OR=8,04, 95%CI=1.93- 33,55). Kesimpulan : Hasil penelitian menunjukan bahwa pendidikan, pengetahuan tentang kontrasepsi, komunikasi keluarga dan ekspose media massa merupakan prediktor unmet need for spacing. Sementara prediktor untuk unmet need for limiting adalah ekspose media massa.

Background : Despite five years Safe Motherhood : A Partnership and Family Approach Intervention Project, contraceptive prevalence rate in Sampang District remains lower than national level. Contraceptive prevalence rate in Sampang District is 44,3% compared to national level 58,6%. Meanwhile, the level of unmet need for family planning in Sampang District is 11,8%, that is, higher than national level 9%. Objective : This study is aims to identify determinant unmet need for family planning in Sampang District, East Java. Method : We used the 2002 Safe Motherhood : A Partnership and Family Approach (SMP-FA) Evaluation Survey to analyze determinant unmet need family planning of 178 sample married women, aged 15 to 49 years old in Sampang District. Main outcome measures in this cross-sectional study were whether education, contraceptive knowledge, mass media exposure, and spousal communication variable would be a good predictor for unmet need family planning. Results : Married women with no education are significantly more likely to have unmet need for spacing than married women who have a primary education (OR=5,86, CI 95%=1,29-26,41). Married women who have poor knowledge about contraception are eight times as likely to have unmet need for spacing as married women who have better knowledge about contraceptive (OR=7,77, CI 95%=1,51-40,01). Meanwhile, mass media exposure is a significant determinant for both unmet need spacing and unmet need for limiting. Married women who have less exposure is more likely to have unmet need for limiting than married women who have mass media exposure every day (OR=8,76, CI 95%=1,48-51,70). Spousal communication is a significant determinant of unmet need for spacing. Conclusion : This study show that married women education, knowledge about contraception, and spousal communication are a good predictor for unmet need for spacing. Mass media exposure is a good predictor for both unmet need for spacing and unmet need for limiting.

Kata Kunci : Kesehatan Ibu,Pelayanan KB,Unmet Need, Determinant, unmet need, family planning, sampang district