Abstract
Background: In the last two decades, unmet need for family planning in Indonesia remains stagnant, and contraceptive discontinuation has increased. These two indicators describe the risk of unwanted pregnancy in a population. Therefore, this study aims to develop an accurate calculation of the unmet need for family planning in Indonesia. Method: The study uses 2017 IDHS data to compare unmet need at survey-time and five years preceding the survey, measured by contraceptive calendar data that measured history of contraceptive use within five years preceding the survey. Unmet need at five years preceding the survey is measured by calculating the proportion of months not using contraceptive to the duration of months exposed to pregnancy in a period of 69 months. The study population is married women in Indonesia, with a sample size of 35,681. Results: Unmet need with contraceptive calendar calculation is higher than unmet need at survey-time. A difference of 3% concerns an additional of nearly 1.6 million unwanted pregnancies. This study proves that the high number of contraceptive discontinuations is directly proportional to higher unmet need with contraceptive calendar calculation. Conclusion: In Indonesia, with a relatively high contraceptive discontinuation rate, the calculation of unmet need using the calendar method is more precise than at survey-time method. The study results suggest the use of unmet need calendar for countries with high contraceptive discontinuation rate and provision of primary health care that is responsive to a potential unwanted pregnancy.
Highlights
Unmet need for family planning refers to those who are fecund and sexually active, but are not using any method of contraception, and report a desire to delay or limit childbearing
The perspective of the family planning program has been oriented towards reproductive health and measured by the unmet need indicator to assess the risk of unwanted pregnancy which has an impact on maternal mortality.[6]
Unmet need of family planning is a crucial measure to assess the achievement of family planning programmes
Summary
Unmet need for family planning refers to those who are fecund and sexually active, but are not using any method of contraception, and report a desire to delay or limit childbearing. In the last two decades, unmet need for family planning in Indonesia remains stagnant, and contraceptive discontinuation has increased These two indicators describe the risk of unwanted pregnancy in a population. This study aims to develop an accurate calculation of the unmet need for family planning in Indonesia. This study proves that the high number of contraceptive discontinuations is directly proportional to higher unmet need with contraceptive calendar calculation. Conclusion: In Indonesia, with a relatively high contraceptive discontinuation rate, the calculation of unmet need using the calendar method is more precise than at survey-time method. The study results suggest the use of unmet need calendar for countries with high contraceptive discontinuation rate and provision of primary health care that is responsive to a potential unwanted pregnancy
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