How Much does Culture Affect the Decision to Use Long-Term Contraceptive Method? A New Evidence from Madiun, East Java, Using Social Cognitive Theory

Abstract

Background: Indonesia has experienced a dramatic increase in contraceptive use and an equally dramatic fertility decline over the last 30 years. Yet recent reductions in family planning funding, program decentralization and the diminishing role of the public sector as a service provider may lead to lower use among poor women. In order to control population growth the Indonesian Government has attempted to increase the utilization of the long-term contraceptive method. This study aimed to determine the effect of social, cultural, and other factors on the decision to use long-term contraceptive method in Madiun, East Java, using social cognitive theory. Subjects and Method: This was a case control study conducted in Madiun, East Java. A sample of 50 women of reproductive age who had used long term contraceptive method and 100 similar women who had not, was selected for this study by fixed disease sampling. The dependent variable was use of long-term contraceptive method. The independent variables were maternal education level, knowledge, attitude, culture, information access, and joint wife-husband decision making. The data were collected using a set of questionnaire and analyzed by path analysis in STATA 13. Results: Use of long-term contraceptive method increased by high maternal education level (b= 1.31; 95% CI= 0.13 to 2.50; p= 0.029), positive attitude (b= 2.45; 95% CI= 1.47 to 3.43); p<0.001), and joint decision making (b= 2.02; 95% CI= 0.91 to 3.13; p<0.001). Use of long-term contraceptive method was indirectly and positively affected by good knowledge, positive culture, and good information access. Conclusion: Use of long-term contraceptive method increases by high maternal education level, positive attitude, and joint decision making. Use of long-term contraceptive method is indirectly and positively affected by good knowledge, positive culture, and good information access. Keywords: use of long term contraceptive method, women of childbearing age, family planning, cultural factor