HUBUNGAN KESENJANGAN PILIHAN FERTILITAS DAN RELASI KUASA SUAMI ISTRI DENGAN UNMET NEED KELUARGA BERENCANA (KB): ANALISIS DATA SDKI 2007

Nurul Fitriyah, dr. Siswanto Agus Wilopo, SU., M.Sc., Sc.D.

2011 | Tesis | S2 Kesehatan Masyarakat/KIA

Latar Belakang: Di Indonesia, pencapaian Contraceptive Prevalence Rate (CPR) terus meningkat, namun tidak disertai dengan penurunan unmet need KB. Adanya kesenjangan pilihan fertilitas dan relasi kuasa suami istri dimungkinkan menjadi penyebab unmet need KB. Tujuan: Mengkaji hubungan kesenjangan pilihan fertilitas dan relasi kuasa suami istri dengan unmet need KB di Indonesia. Metode: Penelitian survei dengan rancangan cross sectional ini menggunakan data SDKI 2007. Subjek penelitian adalah pasangan menikah monogami, terdiri dari pria kawin usia 15-54 tahun dan wanita kawin usia 15-49 tahun. Digunakan uji statistik chi-square dan regresi logistik dengan Confidence Interval (CI) 95% dan p<0,05. Hasil: Dari 7.464 pasangan suami istri ditemukan unmet need KB suami sebesar 5,5%, unmet need KB istri sebesar 8,1% dan unmet need KB pasangan sebesar 9,8%. Prevalensi unmet need KB suami, unmet need KB istri dan unmet need KB pasangan lebih besar pada pilihan fertilitas suami. Faktor-faktor yang berhubungan dengan unmet need KB suami kaitannya dengan pilihan fertilitas suami (OR=1,4; CI95%=1,04-2,01) adalah umur, kesenjangan pendidikan, persepsi sikap pasangan, diskusi istri dan kesenjangan pengetahuan. Sedangkan unmet need KB suami kaitannya dengan suami yang dominan memutuskan keputusan rumah tangga berhubungan signifikan (OR=1,5; CI95%=1,08-2,06) dengan jumlah anak hidup, persepsi pasangan,diskusi istri dan kesenangan pengetahuan. Unmet need KB istri berhubungan signifikan dengan pilihan fertilitas suami(OR=1,4; CI95%=1,08-1,90), suami dominan memutuskan urusan rumah tangga (OR=1,4;CI95%=1,03-1,83), umur pasangan, jumlah anak masih hidup, kesenjangan pekerjaan, persepsi istri dan kesenjgnan pengetahuan. Unmet need KB pasangan berhubungan signifikan dengan pilihan fertilitas suami (OR=1,3; CI95%=1,02-1,72), suami dominan memutuskan (OR=1,3;CI95%=1,01-1,69) yang dipengaruhi faktor umur pasangan, jumlah anak hidup, persepsi istri, diskusi pasangan dan kesenjangan pengetahuan. Kesimpulan: Pilihan fertilitas suami dan suami yang dominan memutuskan lebih banyak ditemukan dan lebih berpeluang menyebabkan unmet need KB baik pada suami, istri dan pasangan.

Background: In Indonesia the achievement of Contraceptive Prevalence Rate (CPR) is increasing and, unfortunately, so is unmet need for contraception. Differences in fertility preferences and husband-wife power relations are supposed to be the causes of unmet need for contraception. Objective: To analyze the relationship between differences in fertility preferences and husband-wife power relations and unmet need for contraception in Indonesia. Method: This survey study with cross-sectional study design used 2007 IDHS data. Subjects were monogamous couples, consisting of married men and women aged 15-54 years and 15-49 years, respectively. Chisquare statistical test and logistic regression test were used with Confidence Interval (CI) 95% and p<0.05. Result: Of 7464 couples, it was found that husbands’, wives’, and couples’ unmet need for contraception was 5.5%, 8.1%, and 9.8%, respectively. The prevalence of husbands’, wives’, and couples’ unmet need for contraception was greater in husbands’ fertility preferences. Factors related to husbands’ unmet need for contraception in regard to husbands’ fertility preferences (OR=1.4; CI 95%=1.04-2.01) were age, educational gap, spousal’s perception, wife’s discussion, and knowledge gap. Husbands’ unmet for contraception in regard to husbands’ dominance in decision making was significantly related to (OR=1.5; CI 95%=1.08-2.06) number of live children, spousal perception, wives’ discussion, and knowledge gap. Wives’ unmet need for contraception was significantly related to husbands’ fertility preferences (OR=1.4; CI 95%=1.08-1.90), husbands’ dominance in decision making (OR=1.4; CI 95%=1.03-1.83), spousal age, number of live children, occupational gap, wives’ perception, and knowledge gap. In addition, couples’ unmet need for contraception was significantly related to husbands’ fertility preferences (OR=1.3; CI 95%=1.02-1.72) and husbands’ dominance in decision making (OR=1.3; CI 95%=1.01-1.69), affected by factors of spousal age, number of live children, wives’ perception, spousal discussion, and knowledge gap. Conclusion: Husbands’ fertility preferences and husbands’ dominance in decision making were likely to be greater and to have more chances of causing husbands’, wives’, and couples’ unmet need for contraception.

Kata Kunci : Unmet need KB , pilihan fertilitas, relasi kuasa