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Breastfeeding is an easy way to reduce morbidity and mortality in infants and childrens. The delay in giving the first breast milk can be caused by the chosen method of birth such as vaginal or cesarean delivery. This study was conducted in a cross sectional and quantitative approach using the 2017 IDHS data to determine the relationship between cesarean delivery and Early Breastfeeding Initiation (EBFI) in DKI Jakarta Province. The sample used was women of childbearing age 15-49 years during the survey in DKI Jakarta Province who had their last child born in the last 2 years as many as 236 respondents. Univariate, bivariate statistical analysis was performed using chi-square (95% CI) and multivariate analysis with multiple logistic regression tests. The results of the analysis showed that mothers who gave birth by cesarean had 0.52 times [95% CI 0.27-1.01] times lower risk of having an EBFI than mothers who gave birth vaginally. Multivariate analysis in this study showed that mothers who delivered by cesarean had 0.54 times lower risk [95% CI 0.18-1.61] of having an EBFI compared to mothers who gave birth vaginally after controlled by variables such as education level, age, and economic status. It is concluded that policy making and providing interventions on how to implement and the importance of early breastfeeding initiation need to be carried out on mothers who have low levels of education, age under 35 years, low economic status, and who plan to give birth by cesarean delivery method.
Tingginya Angka Kematian Ibu (AKI) menjadi salah satu isu prioritas kesehatan di Indonesia. Penggunaan kontrasepsi modern pascasalin merupakan strategi efektif untuk menekan AKI dengan mengatur jarak kehamilan. Namun, cakupannya belum merata, dengan disparitas signifikan antarprovinsi. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berhubungan dengan penggunaan kontrasepsi modern pascasalin di Provinsi Jawa Timur dan Sumatera Utara.
Penelitian ini menggunakan desain potong lintang (cross-sectional) dengan analisis data sekunder dari Survei Kesehatan Indonesia (SKI) 2023. Sampel terdiri dari wanita usia subur (15-49 tahun) yang telah melahirkan. Analisis data dilakukan menggunakan regresi logistik multivariabel. Hasil penelitian menunjukkan proporsi penggunaan kontrasepsi modern pascasalin di Jawa Timur (79,2%) lebih tinggi secara signifikan dibandingkan Sumatera Utara (50,5%). Faktor determinan di Sumatera Utara adalah umur, status pekerjaan, dan konseling KB. Di Jawa Timur, faktor yang berhubungan adalah daerah tempat tinggal, status ekonomi, paritas, dan konseling KB. Konseling KB pascasalin menjadi satu-satunya faktor yang berhubungan signifikan di kedua provinsi. Kesimpulannya, terdapat perbedaan determinan dalam penggunaan kontrasepsi modern pascasalin antara kedua provinsi, yang menyoroti pentingnya intervensi spesifik sesuai konteks wilayah. Penguatan layanan konseling menjadi kunci strategis untuk meningkatkan cakupan secara nasional.
The high Maternal Mortality Rate (MMR) is a priority health issue in Indonesia. The use of modern postpartum contraception is an effective strategy to reduce MMR by managing pregnancy spacing. However, its coverage is uneven, with significant disparities between provinces. This study aims to analyze the factors associated with the use of modern postpartum contraception in East Java and North Sumatra provinces. This study employed a cross-sectional design using secondary data analysis from the 2023 Indonesian Health Survey (SKI). The sample consisted of women of childbearing age (15-49 years) who had previously given birth. Data were analyzed using multivariate logistic regression. The results showed that the proportion of modern postpartum contraceptive use in East Java (79.2%) was significantly higher than in North Sumatra (50.5%). The determining factors in North Sumatra were age, employment status, and family planning counseling. In East Java, the associated factors were area of residence, economic status, parity, and family planning counseling. Counseling was the only factor significantly associated in both provinces. In conclusion, there are different determinants for the use of modern postpartum contraception between the two provinces, highlighting the importance of region-specific interventions. Strengthening counseling services is a strategic key to increasing coverage nationally.
Latar Belakang: KB memiliki sejarah keberhasilan dalam meningkatkan pemakaian kontrasepsi modern dalam waktu relatif pendek, yaitu dari 10% di awal dekade 1970-an menjadi sekitar 60% di awal 2000-an. Namun, pada kurun waktu tersebut hingga 2017 terjadi pergeseran dominasi metode kontrasepsi yang digunakan oleh perempuan usia subur berstatus kawin, yaitu dari penggunaan metode kontrasepsi yang beragam menjadi dominasi Non MKJP, khususnya suntik KB.
Metode: Analisis data sekunder dilakukan dengan menggunakan data SKI tahun 2023. Uji chi-square dan regresi logistik dengan interval kepercayaan 95% digunakan dalam penelitian ini untuk menggambarkan kekuatan hubungan antar variabel.
Hasil: Cakupan penggunaan MKJP pada perempuan usia subur berstatus kawin di Indonesia dalam penelitian ini mencapai 28,8%. Hasil analisis multivariabel menunjukkan bahwa variabel yang memiliki hubungan secara statistik antara lain adalah usia, pendidikan responden, status pekerjaan responden, paritas, status ekonomi, wilayah administratif, pendidikan pasangan, dan konseling KB.
Kesimpulan: Semakin tingginya tingkat pendidikan yang ditempuh oleh seorang perempuan, semakin tinggi juga peluang yang dimilikinya untuk menggunakan MKJP. Hal ini disebabkan karena dengan tingkat pendidikan tersebut perempuan akan cenderung lebih mudah memahami informasi dan manfaat MKJP, serta memiliki kapasitas lebih besar dalam pengambilan keputusan terkait kontrasepsi. Oleh karenanya, peningkatan akses dan kualitas informasi dapat menjadi salah satu strategi yang dapat mendorong penggunaan MKJP secara lebih luas.a
Background: The family planning program has a history of success in increasing the use of modern contraceptives within a relatively short period, rising from 10% in the early 1970s to around 60% in the early 2000s. However, during that period up to 2017, there was a shift in the dominant contraceptive methods used by women of reproductive age—from a variety of methods to a dominance of non-long-acting and permanent methods (non-LARCs), particularly injectable contraceptives. Method: The proportion of long-acting reversible contraceptive (LARC) use among women of reproductive age in Indonesia in this study reached 28.8%. The multivariable analysis showed that several variables were statistically associated with LARC use, including age, respondent’s education, respondent’s employment status, parity, economic status, administrative region, partner’s education, and FP counseling. Results: Women with a secondary education level are more likely to use long-acting reversible contraceptive (LARCs). This is because, at this level of education, women tend to better understand information regarding the benefits of LARCs and have greater capacity in making decisions related to contraception. Therefore, improving access to and the quality of information may serve as an effective strategy to promote broader use of LARCs. Conclusion: The higher the level of education attained by a woman, the greater her likelihood of using long-acting reversible contraceptive (LARCs). This is because women at this education level tend to understand information about the benefits of LARCs more easily and have greater capacity in making decisions related to contraception. Therefore, improving access to and the quality of information can be an effective strategy to encourage wider use of LARCs.
