Contraceptive Method Choice Among Married Women in West Java Province, Indonesia By. Rina Gustiana Email : r_busidho@yahoo.co.id

Introduction 21% of Indonesia’s population living in West Java Province Population growth increase rapidly TFR stagnant at 2.6 from 2002/2003 – 2007 Contraceptive use still dominated by short-term contraceptive

Introduction Short-term contraceptive use increase the probability of contraceptive discontinuation and unintended pregnancy (Hubacher et al, 2008; Harbinson and Adetunji, 2009) Broadening contraceptive choice is one of effort to prevented unwanted pregnancy There is need to acknowledge policy makers regarding factors affected contraceptive choice

Paper Objectives Find out women’s preference of contraceptive method Examine factors affected contraceptive choice among married women

Data Source & Respondents Data source : 2007 Indonesian Demographic and Health Survey (IDHS) Respondents : 973 un-pregnant married women in reproductive ages (15-49)

Method Choice Determinats Bulatao (1989) Contraceptive Goal Contraceptive Competence Contraceptive Evaluation Contraceptive Access

Analysis Methods Descriptive Analysis Chi-square Multivariate Analysis Multinomial Regression

Responden Characteristics Results Responden Characteristics Characteristics % Age 30-39 42.5 Live in urban area 53.5 Primary education 45.8 Not working 28.7 Live within rich household 31.7 Had more than 3 children 65.6 Discuss FP with husband 22.8 Characteristics % Contraceptive use 61.0 - Pill 31.1 - Injection 52.8 - Condom 2.6 - IUD 8.3 - Implant 2.1 - Female Sterilization 2.5 - Male Sterilization 0.5

Respondents Characteristics Results Respondents Characteristics Characteristics % Heard FP from: Television 34.0 Radio 12.3 - News Paper 15.8 Visited by FP officers 3.8 Source of Contraceptive: Public 76.5 - Private 11.4 - Other 12.1 FP message through TV seem to be more effective affected every member of household Majority of women tend to obtain contraceptives from public sources because it were more accessible and with lower cost

Results Contraceptive goal Correlates of Method Choice Variables Contraceptive Method Choice Chi-square Short-term Long-term Permanent Contraceptive Goal Age   82.428 *** 15-29 94.1 5.9 30-39 87.7 10.6 1.7 40-49 71.2 17.6 11.2 Number of Living Children 23.225 No Children 81.7 11.7 6.6 1-2 100 3+ 88.6 10 1.4 * significant at 0.05 level ** significant at 0.01 level *** significant at 0.001 level

Contraceptive Competence Correlates of Method Choice Variables Contraceptive Method Choice Chi-square Short-term Long-term Permanent Contraceptive Competence   Highest Education Level 31.491 *** No education 92 4 Primary 90.8 6.7 2.5 Secondary 84.9 11.9 3.2 Higher 68.1 26.4 5.5 Heard Family Planning from Media Heard FP from TV 4.375 No 87.9 9.8 2.3 Yes 84 11.5 4.5 Heard FP from Radio 3.156 87.2 10 2.8 81.7 13.3 5 Heard FP from Newspaper 27.316 89 8.5 73.4 10.4 16.2 Visited by Family Planning Field Officers 2.23 86.9 10.1 3 78.4 5.4 Discussion FP with husband 0.314 86.6 10.5 2.9 86.5

Technical and Culture Correlates of Method Choice Variables Use of Modern Contraceptive Chi-square Short-term Long-term Permanent Technical and culture influence   Decision maker for using contraceptive 34.173 *** Mainly Respondent 92.3 6.8 0.9 Mainly Partner 71 12.9 16.1 Joint decision 83.7 12.5 3.8 Religion 14.865 ** Other 53.3 33.3 13.4 Islam 87.1 10.4 2.5 * significant at 0.05 level ** significant at 0.01 level *** significant at 0.001 level

Contraceptive Access Correlates of Method Choice Variables Use of Modern Contraceptive Chi-square Short-term Long-term Permanent Accessibility   Source of Contraceptive 144.13 *** Other 98.3 0.8 0.9 Public 54.1 28.8 17.1 Private 89.5 9.1 1.4 Place of residence 11.31 * Urban 83.1 13.1 3.8 Rural 90.5 7.3 2.2 Wealth Index 26.254 ** Poorest 94.7 4 1.3 Poorer 91.7 7.4 Middle 92.1 5.3 2.6 Richer 86 10.8 3.2 Richest 79.5 15.9 4.6 Working Status 0.862 No 87.3 9.9 2.8 Yes 85.2 11.2 3.6 * significant at 0.05 level ** significant at 0.01 level *** significant at 0.001 level

Factors Effected Contraceptive Method Choice Multinomial Regression Results Variables Method Choices Short-term Contraceptives vs Long-term Contraceptives Short-term Contraceptives vs Permanent Contraceptives Contraceptive Goal   Age 30-39 0.69 ** 21.1 40-49 1.53 *** 23.05 Number of Living Children 1-2 -36.6 -14.1 3+ 0.16 -0.85 Contraceptive Competence Highest Education Level Primary 1.5 1.28 Secondary 1.94 Higher 2.8 * 2.02 Heard Family Planning from Media Heard FP from TV -0.42 0.67 Heard FP from Radio 0.06 -0.1 Heard FP from Newspaper 0.63 0.38 Visited by Family Planning Field Officers 0.47 0.48 Discussion FP with husband -0.34 0.24

Factors Effected Contraceptive Method Choice Technical and culture influence Decision maker for using contraceptive   Mainly Partner 0.91 3.5 Joint decision 0.75 ** 1.62 Religion Islam -1.38 * -3.02 Accessibility Source of Contraceptive Public 4.33 *** 3.77 Private 2.48 0.39 Place of residence Urban 0.33 0.51 Wealth Index Poorer 1 0.38 Middle 0.2 0.87 Richer 1.01 1.4 Richest 0.98 1.52 Respondents currently working -0.21 -0.32

Conclussions Despite of the success of West Java Province governments in encourage women to practice contraception, the large proportion of short-term contraceptive use is still being a problem contraceptive method choice largely affected by women’s contraceptive goal and competence, technique on how they use contraceptive, cultural environment and accessibility toward contraceptive methods and services.

Conclussions The results suggest: Increasing long-term and permanent contraceptives method would be more effective when contraceptive campaign targeting both husband and wife and for both highly educated and less educated women Husband-wife communication recommendation need to be integrated into pre-service counseling material. Long-term and permanent contraceptives services should be spread out into more private and public hospitals and clinics with lower cost intensive Behavior Communication Change (BCC) and advocacy through religion leaders should be increased