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ABSTRAK Latar Belakang Masalah: Angka penggunaan kontrasepsi berbagai cara/metode cenderung meningkat dalam beberapa tahun belakangan. Namun peningkatan tersebut juga diikuti dengan stagnansi angka berhenti pakai (drop out) nya. Tujuan: Mendapatkan faktor-faktor yang paling mempengaruhi kejadian berhenti pakai kontrasepsi pada PUS 10-49 tahun pada tahun 2010. Metode: Penelitian belah lintang menggunakan data Riskesdas 2010. Populasi dalam penelitian ini adalah Pasangan Usia Subur (PUS) dengan status kawin yang berusia 10-49 tahun. Sampel yakni semua pasangan usia subur usia 10-49 tahun dengan status kawin yang pernah menggunakan dan masih menggunakan kontrasepsi di Indonesia. Analisa menggunakan Regresi Logistik Ganda dengan mempertimbangkan disain penarikan sampel (menggunakan primary sampling unit/PSU dan weight/pembobotan). Analisa menggunakan program STATA versi 10 untuk survey dan SPSS versi 15. Hasil: Proporsi berhenti pakai pada PUS 10-49 tahun yang berstatus kawin sebesar 32%. Jika dibandingkan antar kawasan di Indonesia, proporsi berhenti pakai tertinggi berada di Luar Jawa Bali II yakni sebesar 33,6%, yang diikuti kawasan Luar Jawa Bali I (32,9%) dan Jawa Bali (30,5%). Alasan terbanyak berhenti pakai penggunaan kontrasepsi adalah sudah tidak memerlukan lagi (31%), ingin punya anak (26%), takut efek samping (14%) dan tidak menginginkan lagi (10%). Berdasarkan analisa multivariate umur istri > 35 tahun memiliki odds ratio 2 kali lebih besar terjadi kejadian berhenti pakai kontrasepsi dibandingkan umur istri 21-35 tahun (OR adj 2,150; 95%CI= 2,041 – 2,265). Selain umur istri, PUS yang memiliki jumlah anak 0-1 anak memiliki odds ratio hampir 1,5 kali lebih besar terjadi kejadian berhenti pakai kontrasepsi dibandingkan dengan PUS dengan jumlah anak 3 orang atau lebih. Selain itu, PUS yang memiliki komposisi jenis kelamin anak tidak lengkap (perempuan atau laki-laki saja) memiliki odds 1,5 kali lebih besar terjadi kejadian berhenti pakai kontrasepsi dibandingkan PUS yang memiliki komposisi anak lengkap (OR adj 1,517; 95%CI= 1,447 – 1,591). Kesimpulan: Faktor yang paling menentukan kejadian berhenti pakai kontrasepsi adalah umur istri, jumlah anak dan komposisi anak yang telah dimiliki PUS setelah dikontrol dengan faktor pendidikan suami & istri, wilayah tinggal, pengeluaran RT perkapita, riwayat menstruasi istri dan pengetahuan kesehatan suami & istri. Kata Kunci: Berhenti pakai, Kontrasepsi, PUS
ABSTRACT Background : Trends of prevalence contraceptive rates is increasing in the last few years. However,the discontinuation of contraceptives prevalence is still stagnant. Goals : To obtain factors influencing discontinuation of contraceptives in couples of childbearing age 10-49 years. Methode : Population this research are women of childbearing age 10-49 years who are married. Sample in this research are all couples of childbearing age of 10-49 years who had ever used contraception and using contraception. The data was analysed using statistic test of logistic regression multivariate use SPSS version 15. And STATA version 10. The analysed used primary sampling unit and weight to adjust based on survey design. Result : Proportion of discontinuation of contraceptives in women of childbearing age 10-49 years is 32%. In comparison between regions, the highest prevalence of discontinuation of contraceptives is on outer Jawa Bali II (33,6%) than outer Jawa Bali I (32,9%) and Jawa Bali (30,5%). The most frequent reason of discontinuation of contraceptives are : do not need contraceptives (31%), want to have child (26%), fear of side effects (14%) and do not want anymore (10%). Based on the multivariate analysis show odds ratio of discontinuation of contraceptives is twice as higher among married women age above 35 years compare to the younger group (OR adjusted 2,150;95% CI=2,041-2,265). The odds ratio of discontinuation of contraceptives is also higher among couples who have less children (0-1 child) compare to those who has 3 or more children (OR adjusted 1,486;95% CI=1,373-1,568). Couples who have children in the same sex have higher discontinuation of contraceptives than couples who have both male and female children (OR adjusted 1,398;95% CI=1,333-,466). Conclution : The main contributing factors of discontinuation of contraceptives are age of wife, number of children and sex composition of children with the control variables education of husband and wife, living area, household expenditure per capita, wife’s menstrual history, and wife and husband’s health knowledge. Keywords : discontinuity, contraception, couples of childbearing age
ABSTRAK Nama : Marthalia Desy Arisiyanti Program Studi : Ilmu Kesehatan Masyarakat Judul : Determinan Pemilihan Metode Kontrasepsi Pada Wanita Pekerja Informal di Indonesia (Analisis Data Sekunder Susenas 2016) Pembimbing : Dr. Pujiyanto, SKM, M.Kes Kesulitan ekonomi dan tuntutan biaya kehidupan yang semakin tinggi, telah mendorong sebagian besar kaum wanita untuk ikut berperan dalam meningkatkan pendapatan keluarganya. Peran sektor informal menjadi penting, karena kemampuan sektor informal dalam menyerap tenaga kerja dan tidak menuntut keterampilan yang tinggi. Seperti diketahui para pekerja informal ini terkadang tidak memiliki jaminan kesehatan yang dapat membantu mereka mendapatkan pelayanan kesehatan sehingga bisa berdampak terhadap kesehatan mereka. Kesehatan reproduksi para wanita tersebut sangat penting untuk dijaga dan diperhatikan. Salah satu cara untuk menjaga kesehatan reproduksi para wanita pekerja informal tersebut agar bisa lebih baik dan terjaga adalah dengan penggunaan alat kontrasepsi. Penelitian ini bertujuan untuk menganalisis determinan apa saja yang berpengaruh terhadap pemilihan metode kontrasepsi pada wanita pekerja informal di Indonesia tahun 2016. Penelitian ini menggunakan data sekunder Susenas tahun 2016. Analisis data diolah dengan menggunakan pemodelan probit-marginal effect. Hasil penelitian menunjukkan bahwa faktor sosial demografi (variabel pendidikan, umur, lokasi tempat tinggal, jumlah anak dan pendapatan per kapita) dan faktor lingkungan/pelayanan kesehatan (kepemilikan jaminan kesehatan dan akses internet) berpengaruh terhadap pemilihan metode kontrasepsi (non MKJP dan MKJP). Untuk karakteristik pengguna menurut pilihan metode kontrasepsi antara lain wanita pekerja informal pengguna kontrasepsi metode non MKJP cenderung memiliki pendidikan setingkat SMP, berumur < 20 tahun, berdomisili diwilayah pedesaan, memiliki jumlah anak 0 sampai dengan 2 orang, berada pada kuintil 3 (Q3) memiliki rata-rata pendapatan per kapita sebesar Rp627.080 dan tidak mempunyai jaminan kesehatan serta tidak rutin mengakses internet. Sedangkan wanita pekerja informal pengguna kontrasepsi metode MKJP cenderung memiliki pendidikan setingkat D1-S3, berumur 40 – 49 tahun, tinggal di daerah perkotaan, memiliki anak lebih dari 2 orang, berada pada kuintil 5 (Q5) memiliki rata-rata pendapatan per kapita sebesar Rp1.801.073 terdaftar sebagai peserta jaminan kesehatan swasta dan rutin mengakses internet. Kata kunci : kontrasepsi, probit, wanita pekerja informal
ABSTRACT Name : Marthalia Desy Arisiyanti Study Program : Public Health Title : Determinants of Contraceptive Methods Selection on Informal Women Worker in Indonesia (Secondary Data Analysis of Susenas 2016) Counsellor : Dr. Pujiyanto, SKM, M.Kes Economic difficulties and the increase of higher cost of living have encouraged most women to play a role in increasing their family income. The role of the informal sector becomes important, because the ability of the informal sector to absorb labor and not demanding high skills. As we all know that informal workers sometimes does not have health insurance that can help them easily access health care so that it can have an impact on their health. It is very important to maintain these women’s reproductive health in the best way. One way to maintain the reproductive health of these informal female workers in order to be better and safer is by the use of contraceptives. This study aims to analyze the determinants of any effect on the selection of contraceptives on informal female workers in Indonesia in 2016. This study uses secondary data Susenas 2016. Data analysis processed by using multinomial logistic regression modeling. The results showed that social demographic factors (education, age, residence, number of children and income per capita) and environmental factors/health services (ownership of health insurance and internet access) influenced the selection of contraceptive type (traditional, non MKJP and MKJP). For the characteristics of the users according to the choice of contraceptive methods, among others female informal workers of contraceptive methods users non MKJP tend to have junior high school education, aged <20 years, domiciled in rural areas, have the number of children 0 to 2 persons, are in quintile 3 (Q3) per capita income of Rp627,080 and doesn’t have health insurance and does not regularly access the internet. Whereas women informal workers using contraceptive methods of MKJP tend to have a D1-S3 level of education, aged 40-49 years, live in urban areas, have children more than 2 persons, are in quintile 5 (Q5) have an average per capita income of Rp1.801.073 registered as a private health insurance participant and regularly access the internet. Keywords : contraceptive, probit, informal female workers
West Papua Province ranks third in the highest cases of malaria in Indonesia. The number of positive malaria cases in 2020 totaled 254,050 cases, which increased in 2021 with 304,607 cases. There are several risk factors for the occurrence of malaria such as socio-demographic, environmental factors, and individual behavior in preventing the transmission of malaria. This study aims to assess the determinants of malaria incidence in West Papua Province, using the 2018 West Papua Province Riskesdas data source with a cross-sectional study design. This study used the cox regression statistical test on 2,602 samples in the province of West Papua, with statistical significance based on 95% confidence intervals. The results showed that the prevalence of malaria in West Papua Province was 37.2%. the highest proportion of malaria incidence was in males 42.5%, age 5 tahun 37.4%, last education SMP/SLTP 37.5%, work not at risk 37.8%, did not sleep using insecticide treated nets 41.2 %, not using repellents, not using mosquito coils 38.0%, using gauze on house ventilation 42.7%, destroying used containerized 39.5%, living in urban areas 46.5%, the type of main water facility used used for cooking, personal hygiene and washing purposes which were not at risk 38.3% and the type of main water facility used for drinking purposes which was not at risk 38.7%. The results showed that there was a significant relationship between gender (PR 1.295; 95% CI 1.141-1.469) and area type (PR 0.746; 95% CI 0.650-0.855). As well as factors that are considered related to the incidence of malaria, namely sleeping using insecticide-treated nets PR 1.102; 95% CI 0.965-1.258). The gender factor is the factor that most influences the incidence of malaria which gives a risk of 1.295 for the occurrence of malaria in men compared to women after controlling for the type of area and sleeping using insecticide-treated mosquito nets. It is necessary to promotion, education, monitoring and evalution of the use of insecticide-treated nets, especially in urban communities and at risk group (men).
