Factors Associated with Long-Term Contraceptive Use in Women of Reproductive Age in Surakarta, Central Java

Abstract

Background: Family planning services have been defined as educational, comprehensive medical or social activities which enable individuals, including minors, to determine freely the number and spacing of their children and to select the means by which this may be achieved. Family planning allows people to attain their desired number of children and determine the spacing of pregnancy. Long-term contraceptive methods (such as IUD) are more effective, safe, with fewer contraindications than others contraceptive method. However, according to the National Population and Family Planning Board (BKKBN), the prevalence of long-term contraceptive users was only 18% in 2015. This study aimed to investigate the factors associated with long-term contraceptive use in women of reproductive age in Surakarta, Central Java, using Theory of Planned Behavior. Subjects and Method: This was a case-control study conducted in Surakarta, from January to February 2018. A sample of 210 women of reproductive age was selected for this study by fixed disease sampling. The dependent variable was long-term contraceptive use. The independent variables were age, parity, education, employment status, knowledge, attitude, subjective norm, perceived behavior control, husband support, family income, and health counseling. The data was collected by questionnaire and analyzed by path analysis. Results: The use of long-term contraceptive was associated with positive attitude (b= 3.49; 95% CI= 1.88 to 5.11; p< 0.001), supportive subjective norm (b= 2.91; 95% CI= 1.10 to 4.73; p= 0.002), strong perceived behavior control (b= 3.09; 95% CI= 1.29 to 4.88; p= 0.001), and strong husband support (b= 2.68; 95% CI= 1.04 to 4.33; p= 0.001). The use of long-term contraceptive was indirectly associated with knowledge, health counseling, and education level. Conclusion: Long-term contraceptive use is associated with positive attitude, supportive subjective norm, strong perceived behavior control, and strong husband support. It is indirectly associated with knowledge, health counseling, and education level. Keywords: long-term contraceptive, Theory of Planned Behavior, path analysis