Quality of Family Planning Care as Enabling Factor for Modern Contraceptive Use in Indonesia: Evidence from PMA2020 Survey
Abstract BackgroundThe utilization of modern family planning methods is a key pointer that mirrors universal access to reproductive health cares. Fulfilling unmet needs for modern contraceptives may decrease the level of maternal mortality by almost a third. This research employed the 2016 PMA2020 survey to assess multilevel variables related to modern family planning method use among women of reproductive age in Indonesia. MethodData from interviews of female and Service Delivery Point (SDP) of the 2016 Performance Monitoring and Accountability 2020 (PMA2020) survey were linked to generate a merged dataset comprising women’s individual, cluster and SDP factors (N=10,210). Multilevel analysis was done to assess the influence of contextual factors including a summary index of SDP quality FP care on woman’s modern family planning practice. Adjusted odds ratios and 95% CIs were analysed and interpreted.ResultsModern contraceptive prevalence among women of childbearing age was 42.3% in 2016. There was a considerable variation in the likelihood of modern method use across the 372 clusters/EAs. Age, education, marital status, parity, residency, region, woman’s FP decision autonomy, cluster’s average ideal number of children, percentage of females dissatisfied with FP, and percent of females visited by CHVs were significant factors for modern FP use after adjusting for multilevel characteristics. Quality of FP care was revealed to be a significant enabling factor for modern contraceptive use in Indonesia. ConclusionsModern contraceptive prevalence among females aged 15-49 years was relatively low in 2016. The findings indicate that an advancement in modern method use can be gained by improving quality of family planning care. Likewise, an enhancement in women’s FP decision autonomy and their level of education, decline in women’s ideal number of children and diminution of the dissatisfaction with family planning are all major concerns to be addressed. Family planning policies must tackle adverse cultural norms and inequities in quality of family planning care and women’s education that would produce welfares to women, children, and communities.