Keinginan Penerapan Program Keluarga Berencana (KB) pada Remaja untuk Masa Mendatang di Provinsi Bengkulu

Background: The government seeks to improve the quality of life of adolescents through coaching related to the generation planning program in order to provide understanding and strengthen family planning in the future, including participation in the Family Planning (KB) program. Objective: This study aims to determine the factors related to the desire of adolescents in implementing family planning programs in the future in Bengkulu Province. Methods: Cross sectional research design with secondary data from the Family Performance and Accountability Survey (SKAP) in 2019. The research sample was 341 unmarried adolescents aged 10-24 years in Bengkulu Province with data analysis using the chi square test. Results: The results of statistical tests showed three variables were significantly associated with desire of adolescent in implementing the family planning in the future namely knowledge (p=0.005), place of residence (p=0.000) and sources of information (p=0.009). Meanwhile, the variables of age (p-value 1.686) and level of education (p-value 0.277) are not significantly associated. Conclusion: place of residence, access to information and knowledge of adolescents about various contraceptive methods are factors related to the desire of adolescents in implementing family planning programs in the future. It is recommended that there be periodic assistance from the National Population and Family Planning Agency (BKKBN) to optimize the role of the Youth Counseling Information Center (PIK-R) in schools in order to provide motivation to adolescents in planning their future families.

KONTRASEPSI VASEKTOMI PRIA: PERSPEKTIF TEOLOGI ETIKA TERAPAN

<em>The Covid-19 pandemic that began in early 2020 has had serious impacts on various aspects of life globally, nationally and locally, including family planning program services in Indonesia. BKKBN, for example, carries out various policies to increase participation in family planning programs to maintain community welfare by anticipating the baby boom during the Covid-19 pandemic. Based on the results of the survey conducted, the interest of men to participate in becoming MOP contraceptive acceptors began to increase. This is certainly a progress where the awareness of men to participate in family planning programs is increasing. The increase in participants occurred because of ‘correct’ knowledge about family planning programs. Before the Covid-19 pandemic, many men and their families did not have adequate knowledge about vasectomy as a method of contraception. Consequently, this caused limited accessibility to contraceptive services and acceptance among men. The main objective of this paper is therefore to provide complete and clear information to men regarding the benefits, impacts and perspectives of applied ethical theology on the use of the vasectomy method of contraception. Methodologically, this study uses a qualitative method by collecting several journals and books related to the formulation of the problem and looking for possible equations to answer this research problem. The expected results are therefore a wider recognition of the important role of health workers, culture, and experienced family planning cadres, as well as a provision of knowledge and direction in socializing the vasectomy method, including understanding the theologically ethical perspectives of vasectomy as a method of contraception.</em> <br /> <br /><strong>Key words:</strong> Covid-19, Ethical Theological Perspectives, Family Planning Program, Men, Vasectomy.

The aggregate effect of implementation strength of family planning programs on modern contraceptive use at the health systems level in rural Malawi

To explore the association between the strength of implementation of family planning (FP) programs on the use of modern contraceptives. Specifically, how strongly these programs are being implemented across a health facility’s catchment area in Malawi and the odds of a woman in that catchment area is using modern contraceptives. This information can be used to assess whether the combined impact of multiple large-scale FP programs is leading to change in the health outcomes they aim to improve. We used data from the 2017 Implementation Strength Assessment (ISA) that quantified how much of family planning programs at the health facility and community health worker levels were being implemented across every district of Malawi. We used a summary measure developed in a previous study that employs quantitative methods to combine data across FP domains and health system levels. We tested the association of this summary measure for implementation strength with household data from the 2015 Malawi Demographic Health Survey (DHS). We found that areas with stronger implementation of FP programs had higher odds of women using modern contraceptives compared with areas with weaker implementation. The association of ISA with use of modern contraception was different by education, marital status, and geography. After controlling for these factors, we found that the adjusted odds of using a modern contraceptive was three times higher in catchment areas with high implementation strength compared to those with lower strength. Metrics that summarize how strongly FP programs are being implemented were used to show a statistically significantly positive relationship between increasing implementation strength and higher rates of modern contraceptive use. Decisionmakers at the various levels of health authority can use this type of summary measure to better understand the combined impact of their diverse FP programming and inform future programmatic and policy decisions. The findings also reinforce the idea that having a well-supported and supplied cadre of community health workers supplementing FP provision at the health facility can be an important health systems mechanism, especially in rural settings and to target youth populations.

Family planning providers and contraceptive users in Rwanda employ strategies to prevent discontinuation

Background In Rwanda, nearly a third of contraceptive users discontinue within the first year of use. Family planning programs often focus more on recruitment of new users as opposed to maintaining use among current users. A focus on sustaining users and minimizing discontinuation is imperative for long-term family planning program success. This study explores the efforts providers and contraceptive users in Rwanda employ to prevent one of the greatest challenges to family planning programs: contraceptive discontinuation. Methods This was a qualitative study conducted in Rwanda between February and July 2018. It included eight focus group discussions with 88 family planning providers and 32 in-depth interviews with experienced modern contraceptive users. Data were collected in two districts with the highest (Musanze) and lowest (Nyamasheke) rates of contraceptive use. Data were analyzed using thematic content approach. Results Family planning providers in this study used the following strategies to prevent discontinuation: counseling new users on the potential for side effects and switching, reminding clients about appointments for resupply, as well as supporting dissatisfied users by providing counseling, medicine for side effects, and discussing options for switching methods. Users, on the other hand, employed the following strategies to prevent discontinuation: having an understanding that experiences of side effects vary by individuals, supporting peers to sustain use, persisting with use despite experiences of side effects, and switching methods. Conclusions The strategies used by family planning providers and users in Rwanda to prevent discontinuation suggest the possibility of long-term sustained use of contraception in the country. Harnessing and supporting such strategies could contribute to sustaining or improving further contraceptive use in the country.

Peningkatan Pengetahuan Wanita Usia Subur Tentang Efek Penggunaan Kontrasepsi Progestin Terhadap Kesehatan Organ Reproduksi

ABSTRAK Pemerintah menggalakan program Keluarga Berencana (KB) untuk mengendalikan pertumbuhan penduduk. Salah satu program KB adalah dengan penggunaan kontrasepsi. Metode kontrasepsi yang saat ini yang paling banyak digunakan oleh Wanita Usia Subur (WUS) adalah suntikan Depo Medroxy Progesterone Acetate (DMPA) yang berisi hormon progesteron. DMPA memiliki efek samping yang merugikan organ reproduksi untuk penggunaan jangka panjang. Tujuan kegiatan pengabdian dilakukan untuk meningkatkan pengetahuan wanita usia subur tentang efek samping penggunaan kontrasepsi hormonal DMPA jangka panjang pada organ reproduksi. Metode pelaksanaan adalah dengan edukasi peningkatan pengetahuan tentang kontrasepsi DMPA dengan sasaran wanita usia subur akseptor KB DMPA sebanyak 60 orang. Hasil kegiatan diperoleh bahwa mayoritas pengetahuan wanita usia subur pada kategori kurang pada saat pretest sebanyak 41 orang (68,33%) dan pada saat posttest mayoritas berada pada kategori baik sebanyak 53 orang (88,33%). Adanya peningkatan pengetahuan setelah dilakukan edukasi tentang penggunaan kontrasepsi DMPA dan efek samping yang ditimbulkan akibat penggunaan jangka panjang terhadap kesehatan organ reproduksi. Kata Kunci : Depo Medroxy Progesterone Acetate (DMPA), Wanita Usia Subur, Kontrasepsi, Keluarga Berencana ABSTRACT The government is promoting the Family Planning (KB) program to control population growth. One of the family planning programs is the use of contraception. The method of contraception currently most widely used by women of reproductive age is the injection of Depo Medroxy Progesterone Acetate (DMPA) which contains the progesterone hormone. DMPA has adverse side effects on reproductive organs for long-term use. The purpose of this service is to increase the knowledge of women of reproductive age about the side effects of long-term use of DMPA hormonal contraceptives on the reproductive organs. The method of implementation is education to increase knowledge about DMPA contraception with the target of women of reproductive age DMPA to acceptors as many as 60 people. The results of the activity showed that the majority of knowledge of women of reproductive age were in the lack knowledge at the time of the pretest as many as 41 people (68.33%) and at the time of the posttest the majority were in the good knowledge category as many as 53 people (88.33%). There is an increase in knowledge after education about the use of DMPA contraceptives and the side effects caused by long-term use on the health of the reproductive organs. Keywords: Depo Medroxy Progesterone Acetate (DMPA), women of reproductive age, Contraception, Family Planning

GAMBARAN KEJADIAN SUB INVOLUSI UTERI PADA IBU NIFAS DI POLINDES BUGIH II WILAYAH KERJA PUSKESMAS KOWEL

The postpartum period is the period that begins after the placenta comes out and ends when the uterine organs return to their original state (before pregnancy). One of the complications that can occur during the puerperium is uterine subinvolution, where the uterus fails to follow the normal pattern of involution as it should. So that the process of uterine shrinkage is hampered. Based on data obtained at Polindes BugihII in 2014 out of 10 postpartum mothers at 2-6 weeks, 7 (70%) postpartum mothers had uterine subinvolution and 3 (30%) did not. The purpose of this study was to describe the incidence of uterine subinvolution in postpartum mothers at Polindes Bugih II. This research design is descriptive. The total population in this study were 30 postpartum mothers, while the sampling used probability sampling with saturated sampling technique. The variable in this study was the incidence of uterine subinvolution in postpartum mothers. The research instrument used the MCH handbook, then analyzed using univariate analysis. The results of the study were almost entirely (76.67%) mothers did not experience uterine subinvolution, namely as many as 23 people. The solution that can be done to overcome this incident is to encourage the mother to move and breastfeed her baby as often as possible, because this will affect the hypothalamus and cause contractions. So that from these contractions will result in uterine involution and expenditure of Lochea running normally. It is also recommended for multiparous mothers to participate in family planning programs.

Operationalizing Human Rights in Sexual and Reproductive Health and Rights Programming: An Example from a Global Family Planning Partnership

The International Conference on Population and Development (ICPD), which has guided programming on sexual reproductive health and rights (SRHR) for 25 years, reinforced that governments have a role to play in addressing population issues but in ways that respect human rights and address social and gender inequities. The shift at ICPD was partly in response to excesses that had occurred in some family planning programs, resulting in human rights abuses. The 2012 London Summit on Family Planning refocused attention on family planning as a crucial component of SRHR and, in part due to significant pushback on the announcement of a goal of reaching an additional 120 million women and girls with contraception by 2020 in the world’s poorest countries, ignited work to ensure that programming to achieve this ambitious goal would be grounded in respecting, protecting, and fulfilling human rights. This attention to human rights has been maintained in Family Planning 2030 (FP2030), the follow on to Family Planning 2020 (FP2020). While challenges remain, particularly in light of pushback on reproductive rights, widespread work over the past decade to identify human rights principles and standards related to family planning, integrate them into programming, strengthen accountability, and incorporate rights into monitoring and evaluation has improved family planning programs.

A SUPPORT OF THE HUSBAND DURING THE PROCESS OF LABOR AND THE PUERPERIUM IN KUPANG DISTRICT

Husband's support during pregnancy, childbirth and the puerperium is needed by both mother and baby. Husband's support makes mothers less stressed, needs are met, mothers feel comfortable emotionally. The purpose study was to determine the husband's support during labor and childbirth. The research method is qualitative exploration with a phenomenological approach. The research was conducted in Oelbiteno Village with the informants were 10 husbands of mothers who gave birth. Data collection by direct interview and via telephone. Data processing and analysis techniques are interpretative phenomenological analysis with content analysis. Results showed husband's support for his wife during childbirth is physical support (massaging the wife's back, feeding and drinking); emotional (feeling what the wife is facing, helping her during childbirth); informational (information about nutritious food); advocacy (planning a safe labor for the wife, preparing clothes for mothers and babies, KTP, KK, JKN). Husband's support during the puerperium period is physical support (caring for the baby, delivering the wife and control baby); emotional (encouraging to provide exclusive breastfeeding); informational (information about wife and child health, nutritious food); advocacy (planning family planning programs).

Family Welfare Expenditure, Contraceptive Use, Sources and Method-Mix in India

Making universal access to sexual and reproductive health care a reality, and thus building momentum for comprehensive family planning by 2030, is key for achieving sustainable development goals. However, in the last decade, India has been retreating from progress achieved in access to family planning. Family planning progress for a large country such as India is critical for achieving sustainable developmental goals. Against this backdrop, the paper investigated the question of how far family welfare expenditure affects contraceptive use, sources of contraceptive methods, and method-mix using triangulation of micro and macro data analyses. Our findings suggest that, except for female sterilizations, modern methods of contraception do not show a positive relationship with family welfare expenditure. Notwithstanding a rise in overall family welfare expenditure, spending on core family planning programs stagnates. State-wise and socio-economic heterogeneity in source-mix and method-mix continued to influence contraceptive access in India. Method-mix continued to skew towards female sterilization. Public sector access is helpful only for promoting female sterilization. Thus, the source-mix for modern contraceptives presents a clear public-private divide. Over time, access to all contraceptive methods by public sources declined while the private sector has failed to fill the gap. In conclusion, this study identified a need for revitalizing family planning programs to promote spacing methods in relatively lower-performing states and socio-economic groups to increase overall contraceptive access and use in India through the rise in core family planning expenditure.

Barriers to vasectomy acceptance and uptake in Nigeria: a review of the literature

There is growing support of male involvement in reproductive health and the integration of voluntary vasectomy services into national family planning programs in lower resource contexts; yet, the prevalence of women of reproductive age who rely on vasectomy in African countries such as Nigeria, is less than 1 percent. We conducted this review to gain a broader understanding of current sociocultural and health systems’ conditions that need to be addressed to expand the integration and acceptability of vasectomy as an option for family planning in Nigeria. To explore this, we scoped existing literature on vasectomy in Nigeria between 2009 to 2021. Findings reveal that there is a strong awareness of vasectomy among men in Nigeria. Yet, several factors prevent men from having the same confidence in vasectomy as they have in female biomedical methods. Three significant themes emerged: 1) fear; 2) religious and cultural beliefs, which overlapped with fear; and 3) access to health providers and health facilities. These findings have implications for future family planning policies, strategies and programmes in the country.