The use of long-acting and permanent contraceptive methods (LAPMs) among women who have completed childbearing in Indonesia: does informed choice matter?

Abstract

Objectives

This study examined factors associated with long-acting and permanent contraceptive methods use among married women who completed childbearing in Indonesia.

Methods

Data were extracted from the 2017 Indonesia Demographic and Health survey. Subjects of this study comprised 12,790 (weighted) married women aged 15–49 years who completed their childbearing and used modern contraceptive methods. Logistic regression adjusted for complex sample was used to assess factors associated with LAPMs use among women in Indonesia.

Results

Only 28% of the participants used long-acting and permanent contraceptive methods. Older women, higher number of living children, higher educational level, informed choice, and living in urban areas were associated with higher likelihood of adopting long-acting and permanent contraceptive methods. Women who received comprehensive counselling on contraceptive methods were more likely to adopt long-acting and permanent contraceptive methods compared with women who did not receive comprehensive counselling on contraceptive methods (AOR = 1.23; 95% CI: 1.07–1.41). Women who attained secondary (AOR = 1.31; 95% CI: 1.14–1.50) or higher (AOR = 2.36; 95% CI: 1.91–2.91) educational level were more likely to use long-acting and permanent contraceptive methods compared to women with primary education or less. The use of long-acting and permanent contraceptive methods was higher among women aged 35–49 (AOR = 1.41; 95% CI: 1.24–1.61) and women who have three or more living children (AOR = 1.75; 95% CI: 1.57–1.96) than their counterparts.

Conclusion

The use of long-acting and permanent contraceptive methods was still low, even though there were more than half of women completed childbearing. The informed choice had a key role in improving long-acting and permanent contraceptive methods uptake. Training programs on contraceptive counselling for health providers and improving couple’s awareness on the effectiveness of long-acting and permanent contraceptive methods were suggested to increase long-acting and permanent contraceptive methods adoption.

在印度尼西亚已完成生育的妇女中应用长效和永久性避孕方法：知情选择是否重要？ 摘要

目的：本研究调查了印度尼西亚已婚且完成生育的妇女应用长效和永久避孕方法的相关因素。

方法：数据来自2017年印度尼西亚的人口与健康调查。研究纳入12790名（加权）15∼49岁已婚妇女,她们已完成生育并应用现代避孕方法。对复杂样本进行Logistic回归调整以评估印度尼西亚妇女应用LAPMs的相关因素。

结果：只有28 %的参与者应用长效和永久性避孕方法。老年妇女、抚育子女多、受教育程度较高、知情选择和居住在城市地区与应用长效和永久避孕方法的可能性较高有关。与未接受避孕方法全面咨询的妇女相比,接受避孕方法全面咨询的妇女更可能应用长效和永久性避孕方法( AOR = 1.23 ; 95 % CI : 1.07 - 1.41 )。中等( AOR = 1.31 ; 95 % CI : 1.14 - 1.50 )或以上( AOR = 2.36 ; 95 % CI : 1.91 - 2.91 )教育程度的妇女比初等教育或以下的妇女更容易应用长效和永久避孕方法。35 ∼ 49岁妇女( AOR = 1.41 ; 95 % CI : 1.24 - 1.61 )和抚育3个或3个以上子女的妇女( AOR = 1.75 ; 95 % CI : 1.57 - 1.96 )应用长效和永久性避孕方法的比例高于其他人。

结论：尽管有一半以上的妇女完成了生育,但长效和永久性避孕方法的应用率仍然较低。知情选择对提高长效和永久性避孕方法应用有关键作用。建议医务人员进行避孕咨询培训,提高夫妇对长效和永久避孕方法有效性的认识,以增加长效和永久避孕方法的应用。

Keywords:

• Contraceptives
• counselling
• informed choice
• long-acting
• permanent methods

Disclosure statement

No potential conflict of interest was reported by the author(s).