Salah satu penyebab belum optimalnya pencapaian angka penggunaan kontrasepsi di Indonesia adalah kejadian unmet need Keluarga Berencana (KB) yang belum sepenuhnya dapat diatasi. Penanganan unmet need KB tidak hanya memerlukan pengukuran besaran angkanya, tetapi juga pemahaman mengenai faktor-faktor penyebabnya. Penelitian ini bertujuan mengetahui pengaruh determinan pemanfaatan pelayanan keluarga berencana terhadap kejadian unmet need di Indonesia sebagai landasan rekomendasi program yang efektif. Penelitian ini menggunakan data sekunder SDKI 2017 dengan desain cross sectional dengan responden sebanyak 33.635 yang merupakan wanita kawin usia 14-59 tahun. Hasil penelitian terkait distribusi responden menunjukkan bahwa paling banyak responden mendapat kualitas pelayanan KB rendah, termasuk dalam kategori umur tua, pendidikan rendah, indeks kekayaan tinggi, jumlah anak masih hidup 0-2 anak, bekerja, pendidikan suami rendah, tempat tinggal perkotaan, memiliki otonomi rendah, memiliki permasalahan akses terhadap pelayanan kesehatan rendah, dan memiliki jumlah anak ideal ≥ 3 anak. Kejadian unmet need di Indonesia sebesar 11,68%, terdiri dari unmet need spacing (4,86%) dan unmet need limiting (6,82%). Hasil analisis GSEM menunjukkan bahwa variabel kualitas pelayanan KB, status sosio ekonomi demografi, dan jumlah anak ideal berpengaruh signifikan terhadap kejadian unmet need pada analisis Indonesia, daerah unmet need tinggi, maupun daerah unmet need rendah. Variabel otonomi wanita berpengaruh signifikan terhadap kejadian unmet need pada analisis Indonesia dan daerah unmet need rendah, dan permasalahan akses berpengaruh signifikan terhadap kejadian unmet need pada daerah unmet need rendah. Dapat disimpulkan bahwa terdapat pengaruh signifikan determinan pemanfaatan pelayanan keluarga berencana terhadap kejadian unmet need di Indonesia. Diperlukan peningkatan terhadap kualitas pelayanan KB, memberikan perhatian lebih terhadap wanita status sosio ekonomi rendah, otonomi wanita rendah, permasalahan akses tinggi, dan wanita dengan jumlah anak ideal ≥ 3 anak. KB Pasca-Persalinan merupakan cara paling efektif dalam menurunkan kejadian unmet need KB. Pemanfaatan media massa dalam pemberian informasi KB khususnya terkait efek samping metode dapat ditingkatkan serta dapat disesuaikan dengan kecenderungan tayangan yang saat ini digemari oleh masyarakat Indonesia. Diperlukan pula peningkatan peran aktif petugas kesehatan dalam memberikan konseling KB yang terintegrasi dalam pelayanan kesehatan Ibu dan Anak.
One of the causes of the non-optimal achievement of contraceptive use rates in Indonesia is the incidence of unmet need for family planning (FP) which has not been fully resolved. Handling the unmet need for family planning requires not only measuring the magnitude of the number, but also an understanding of the factors causing it. This study aims to determine the effect of the determinants of family planning services utilization on the incidence of unmet need in Indonesia as the basis for effective program recommendations. This study uses secondary data from the 2017 IDHS using a cross sectional design with 33,635 respondents who are married women aged 14-59 years. The results of the study related to the distribution of respondents showed that most of the respondents received low-quality family planning services, including in the category of advanced age, low education, high wealth index, number of children still living 0-2 children, working, low husband's education, urban residence, low autonomy, low access to health services, and the ideal number of children is 3 children. The incidence of unmet need in Indonesia is 11.68%, consisting of unmet need spacing (4.86%) and unmet need limiting (6.82%). The results of the GSEM analysis show that the variables of quality of family planning services, socioeconomic status, demographics, and the number of ideal children affect the incidence of unmet need in Indonesia, also in areas of high unmet need and low unmet need. The variable of women's autonomy has a significant effect on the incidence of unmet need in Indonesia and regions with low unmet need, and access problems has a significant effect on the incidence of unmet need in regions with low unmet need. It can be concluded that there is a significant effect on the determinants of family planning services utilization on the incidence of unmet need in Indonesia. It is necessary to improve the quality of family planning services, pay more attention to women with low socio-economic status, low women's autonomy, high access problems, and women with the ideal number of children 3 children. Post-partum family planning is the most effective way to reduce the incidence of unmet need for family planning. The use of mass media in providing family planning information, especially regarding the side effects of the method, can be increased and adapted to the current trend of broadcasts favored by the people of Indonesia. It is also necessary to increase the active role of health workers in providing integrated family planning counseling in maternal and child health services. |
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