This document presents a manuscript proposal examining the roles of family planning services in women's contraceptive choice in Indonesia. The study aims to assess the level of mismatch between intended and actual contraceptive use and examine how the source and type of family planning services influence any mismatch. If approved, the study would analyze existing survey data using descriptive statistics, bivariate correlations and logistic regression to model the relationship between services and contraceptive mismatch, controlling for demographic factors. Key topics to be further developed include limitations, results, discussion, conclusions and recommendations.

1. Manuscript Proposal
(working document)
“Roles of Services in Women’s
Contraceptive Choice”
Melania Hidayat
Presented in Students Seminar - FKMUI
2 Sept 2014

2. Background
• The skewed CS method mix in Indonesia is
suspected to be providers’ driven.
• Some analysis indicates the miss match use of CS
• Concerns of unmet need for types of CS
according to:
– Intention of use.
– Demographic characteristics.
– Physical Condition
IMPROVING CONTRACEPTIVE METHOD MIX IN INDONESIA

3. Background ………
• Risks of unmet need
– Side effects
– High discontinuation of use
– Not meeting the clients’ rights
– Influence (inhibit) FP programme achievements
• Complex mechanism of decision to CS use is well
understood.
• Hypothesis:
“Services” is suspected to have strong forces that drives the
miss match use
IMPROVING CONTRACEPTIVE METHOD MIX IN INDONESIA

4. Objectives
• To examine the roles of Services towards the
miss match of CS use
– Assess the level of miss match CS use
– Examine the roles of source (place) of services
towards the miss match of CS use
– Examine the roles of types of providers towards
the miss match of CS use
IMPROVING CONTRACEPTIVE METHOD MIX IN INDONESIA

5. Key Literature Review
• Met Need and Unmet need
– Concepts and definitions
– Consequences of not meeting the needs
• Frameworks / determinants for CS use / decision to use
IMPROVING CONTRACEPTIVE METHOD MIX IN INDONESIA
• Services
– Concept and definition of services for FP
– Determinants for quality services
• Guides (global/national) for CS use
• Review of other relevant Studies:
 designs, methodologies and analysis

6. Conceptual Framework
1. Rogers, EM , 1983: Diffusion of Innovations
 A model of stages in the innovation-decision process)
2. Green & Kreuter, 2005:
 Teori Precede-Proceed ttg pemanfaatan yankes
3. Bertrand, Magnani &Rutenberg, 1994
 Teori permintaan KB dan dampaknya thd fertilitas
4. Davis & Blake, 1956
Teori determinant fertilitas
IMPROVING CONTRACEPTIVE METHOD MIX IN INDONESIA

7. Conceptual Framework
Individual Level
Backgr Knwldg Attititude Decision
Environ CS Use
ment:
•Sosio
culture
•Decent
SDPs/providers
Attitude
raluizati
Knwldg
Backgr
Advise
on
& skills
Logistics
•Coord
with
MOH
•Political
Institutional level
will
Policy Progr structure Inputs
IMPROVING CONTRACEPTIVE METHOD MIX IN INDONESIA

8. Study /research framework
IMPROVING CONTRACEPTIVE METHOD MIX IN INDONESIA
Services
CS
miss match
Demogr:
-Age
-Child
Financial
Advise
Geogr

9. OD
Variable OD Q Measurement
Dependent
IMPROVING CONTRACEPTIVE METHOD MIX IN INDONESIA
CS
miss match
Assessment of CS use according
to intention of use
D25
D28
1. Y (Match)
2. N (Not Match)
Criteria Intention of Use
Spacing Limiting
Match Pill, Inj,
IUD, Implant, Streril IUD, Implant, Streril
Miss match
Steril
Pill, Inj

10. Variable OD Q Measurement
Independent
1. Services Place from where the CS service
is obtained
D29 1. Hosp
2. Pusk
3. Polindes
4. Others
2. Age Years of age * A4 1. 15-34
2. 35 – 49
3. Child # living Chldren ** B02 1. ≤ 2
2. 3-4
3. ≥ 5
4. Advise Who make the decision to
chose the CS method
D34 1. Self
2. Together
3. Others
5. Financial Clients perception of fee for
services
D50 1. Afford
2. Expensive
3. Free
IMPROVING CONTRACEPTIVE METHOD MIX IN INDONESIA
7. Geogr Clients’ perception of distance
to service
D30 1. Close
2. Near
3. Far

11. Methodology
• Secondary data analysis of data gathered by the
ICMM study in 2013.
• ICMM study design:
 quantitative, cross sectional
• Population:
 Ever married WRA in 6 districts who use CS.
IMPROVING CONTRACEPTIVE METHOD MIX IN INDONESIA

12. Proposed Analysis
1. Descriptive / Uni-variate
– Distribution / frequencies of all variables
– Scheme of CS use
2. Bi-variate
– Correlation of all independent variables with dependent
variable
3. Multivariate
– Logistic regression to observe probability (OR) of
“services” to affect “CS miss match use”
– Log istic regression modeling to show interaction of
“Service” with other independent variables towards “CS
miss match use”
IMPROVING CONTRACEPTIVE METHOD MIX IN INDONESIA

13. Scheme of CS Use*
WRA
Infecund Fecund – not pregnant
Want child Do not
Pregnant
IMPROVING CONTRACEPTIVE METHOD MIX IN INDONESIA
want child
Not
use CS
Use CS
Want now Want later
Use LAPM Use pill, Inj
Not
use CS
Use CS
Use steril Use ipil, inj IUD, Impl

14. Chapters/topics
to be further included
1. Study limitation
2. Results
3. Discussions
4. Conclusion and Recommendation
5. References
6. Acknowledgement
IMPROVING CONTRACEPTIVE METHOD MIX IN INDONESIA

15. IMPROVING CONTRACEPTIVE METHOD MIX IN INDONESIA