PEREMPUAN UNMET NEED DI KABUPATEN LOMBOK TIMUR (Studi Pengaruh Variabel Demografi, Sosial, Ekonomi, Sikap dan Akses pelayanan Terhadap Unmet Need Index Perdesaan dan Perkotaan)

LALU MAKRIPUDDIN, Prof. Drs. Kasto, MA,

2011 | Disertasi | S3 Kependudukan

Penelitian ini bertujuan mengkaji pengaruh variabel demografi, sosial, ekonomi, sikap dan akses pelayanan terhadap perempuan unmet need. Selain itu, juga mengkaji perbedaan perempuan unmet need menurut daerah tempat tinggal (perdesaan dan perkotaan). Penelitian dilakukan di Kabupaten Lombok Timur, menggunakan metode survai, didukung data kualitatif. Sampel responden sejumlah 310 dipilih secara sampling bertahap. Selain analisis deskriptif, dipergunakan analisis model persamaan struktural, untuk menguji ketepatan model. Selain itu, juga digunakan Z test, untuk mengetahui apakah ada beda antara perempuan unmet need perkotaan dan perdesaan. Model hubungan antara variabel penelitian, baik di perdesaan maupun perkotaan, sesuai (fit) dengan data empiris atau model dinyatakan fit. Model tersebut, menjelaskan: (1) Variabel demografi, sosial, ekonomi, sikap dan akses pelayanan berpengaruh negatif terhadap perempuan unmet need (unmet need index). (2) Nilai Zc sebesar 0,41 (>1,96), berarti rata-rata unmet need index, tidak menunjukkan perbedaan antara perdesaan-perkotaan, atau tidak ada perbedaan perempuan unmet need perdesaan dan perkotaan. Model menunjukkan pengaruh variabel demografi terhadap unmet need index, sebesar -0,15 di perdesaan, dan -0,27 di perkotaan. Pengaruh variabel sosial, di perdesaan sebesar -0,12, dan di perkotaan -0,23. Variabel sosial juga berpengaruh positif terhadap sikap responden, sebesar 0,87 di perdesaan dan 0,94 di perkotaan. Pengaruh variabel sikap terhadap unmet need index, sebesar -0,24 di perdesaan, dan -0,12 di perkotaan. Pengaruh variabel ekonomi terhadap unmet need index, di perdesaan sebesar -0,54, dan di perkotaan -0,73. Variabel ekonomi, juga berpengaruh positif terhadap akses pelayanan, di perdesaan sebesar 0,96, dan di perkotaan, sebesar 0,91. Pengaruh variabel akses pelayanan terhadap unmet need index, di perdesaan sebesar -0,36 dan perkotaan sebesar -0,14. Keberadaan perempuan unmet need, menunjukkan bahwa pelaksanaan program, belum mampu memenuhi seluruh permintaan masyarakat akan keluarga berencana. Upaya mengatasinya seyogyanya dengan cara komprehensif. Variabelvariabel yang berpengaruh, perlu diintervensi sehingga dapat menurunkan jumlah perempuan unmet need. Perempuan yang bersikap negatif cenderung untuk tidak menggunakan alat kontrasepsi. Sedangkan yang bersikap positif, tentu akan menggunakan alat kontrasepsi, namun faktor-faktor ekologis menghambatnya, seperti ketidakterjangkauan akses pelayanan. Perempuan unmet need umumnya berpendapatan rendah. Mengurangi beaya alat kontrasepsi harus menjadi prioritas, antara lain dengan menjamin ketersediaan alat kontrasepsi. Dukungan suami cukup baik terhadap penggunaan alat kontrasepsi. Walaupun demikian, masyarakat suku bangsa Sasak, masih memegang kuat ideologi patriarki. Peran suami sangat penting dalam pengambilan keputusan. Oleh karena itu, akses perempuan terhadap pendidikan perlu menjadi prioritas. Pendidikan dapat meningkatkan peran perempuan, dan mempengaruhi sikap perempuan terhadap penggunaan alat kontrasepsi, menjadi lebih positif.

The aims of this study is to examine the influences of demographic, social, economic, attitude and services-accesses variables on women with unmet-need. It also examine the differences of women with unmet need by area of residence (rural and urban). Research was conducted in East Lombok District, with a survey method, supported by qualitative data. Respondent samples consist of 310 that selected by multistage sampling. The analysis technique used in this study was descriptive analysis and structural equation modeling to test the accuracy of the proposed model. In addition, Z-test calculation was also used for understanding whether there was a difference between women with unmet need in rural and urban areas. Related model among variables, both in rural and urban areas, according to (fit) with empirical data or model declared fit. The model explains: (1) demographic, social, economic, attitudes and services-accesses variables, negatively influence on women with unmet need (unmet need index). (2) The value of Zc as 0,41 (< 1.96), means the average unmet need index, showed no difference between the rural-urban, or no difference women with unmet need of rural and urban areas. The model shows that demographic variable influence on women with unmet need as -0.15 at rural and -0.27 at urban. The influence of social variables, as -0.12 at rural, and -0.23 at urban. Social variables also has positive influence on the attitude, as 0.87 in rural and 0.94 in urban areas. Influence of attitudes variable on women with unmet need, as -0.24 at rural, and -0.12 at urban areas. The influence of economic variables, as -0.54 at rural, and -0.73 at urban areas. Economic variables, also influence positively on services-access variable, at rural areas as -0.96, and at urban areas, as -0.91. Influence of access-services variable on unmet needs of women, at rural areas as -0.36 and -0.14 at urban areas. The existence of women with unmet need, showing that the implementation of programs, has not been able to meet the public demand for family planning. Efforts to overcome them should be a comprehensive manner. The variables that influence, need to intervene so as to reduce the number of women with unmet need in the future. Women who are negative tend to not use contraceptives. While a positive attitude, it would be using contraception, but the ecological factors discourage it, as no reasons of services-access. Women with unmet need are generally low income. Reducing the cost of contraceptives should be a priority, including by ensuring availability of contraceptives. Husband supporting to women for use contraceptives. Nevertheless, ethnic Sasak people, still hold patriarchal ideology. Husband very important role in decision-making. Therefore, women's access to education should be a priority. Education can improve women's role, and influence women's attitudes toward the use of contraceptives, became more positive.

Kata Kunci : Unmet need, demografi, sosial, ekonomi, sikap, akses pelayanan, alat kontrasepsi.