Samosir Omas Bulan, Kiting Ayke Soraya, Aninditya Flora
Lembaga Demografi, Faculty of Economics and Business, Universitas Indonesia, Depok, Indonesia.
J Prev Med Public Health. 2020 Mar;53(2):117-125. doi: 10.3961/jpmph.19.300. Epub 2020 Feb 12.
This study investigated the role of information and communication technology and women's empowerment in contraceptive discontinuation in Indonesia.
The study used data from the 2017 Indonesia Demographic and Health Survey and monthly contraceptive calendar data. A Gompertz proportional hazards model was used for analysis.
The 12-month contraceptive discontinuation rate was higher among women who had used the Internet in the past year, women who were mobile phone owners, and women who reported having fully participated in household decision-making than among their counterparts. These factors significantly impacted the risk of contraceptive discontinuation in Indonesia, even after controlling for contraceptive method, age, parity, contraceptive intent, education, work status, place of residence, and wealth status.
After adjustment for the control variables, a higher risk of contraceptive discontinuation was associated with having used the Internet in the past year, owning a mobile phone, and not participating in household decision-making. Higher contraceptive discontinuation risk was also associated with using contraceptive pills, older age, lower parity, intent of spacing births, more education, current unemployment, and rural residence, and the risk was also significantly higher for those in the lowest household wealth quintile than for those in the fourth household wealth quintile. The association of contraceptive discontinuation with the use of modern information and communication technology and relatively disempowerment in household decision-making may imply that information regarding family planning and contraception should be conveyed via social media as part of setting up an eHealth system. This must include a strong communication strategy to empower and educate women in contraceptive decision-making.
本研究调查了信息通信技术和妇女赋权在印度尼西亚避孕措施停用方面所起的作用。
该研究使用了2017年印度尼西亚人口与健康调查的数据以及月度避孕日历数据。采用冈珀茨比例风险模型进行分析。
在过去一年中使用过互联网的女性、拥有手机的女性以及报告完全参与家庭决策的女性中,12个月的避孕措施停用率高于其相应的对照人群。即使在控制了避孕方法、年龄、生育次数、避孕意图、教育程度、工作状况、居住地点和财富状况之后,这些因素仍对印度尼西亚避孕措施停用的风险产生显著影响。
在对控制变量进行调整之后,过去一年使用过互联网、拥有手机以及未参与家庭决策与更高的避孕措施停用风险相关。更高的避孕措施停用风险还与使用避孕药、年龄较大、生育次数较少、生育间隔意图、受教育程度较高、当前失业以及居住在农村有关,并且家庭财富处于最低五分位数的人群的风险显著高于处于第四家庭财富五分位数的人群。避孕措施停用与现代信息通信技术的使用以及在家庭决策中相对缺乏权力之间的关联可能意味着,作为建立电子健康系统的一部分,有关计划生育和避孕的信息应通过社交媒体进行传播。这必须包括一项强有力的沟通策略,以增强妇女在避孕决策方面的能力并对其进行教育。