Barriers to Modern Contraceptive Use by Female Workers in Indonesia's Urban Areas.

Background: Female workers in Indonesia are vulnerable, because they must work to earn a living while still being responsible for domestic problems. This study analyzes the barriers to the use of modern contraceptives by female workers in Indonesia's urban areas. Methods: This cross-sectional survey looked at 21,696 female workers. We used modern contraceptive use as a dependent variable, and age, education, wealth, known modern contraceptives, number of live births, ideal number of children, and insurance ownership as independent variables. In the final test, we employed binary logistic regression. Results: The results showed that women at all age categories were more likely than those aged 15-19 years not to use modern contraceptives, except those aged 35-39 years, who showed no difference. All other marital types were more likely to use modern contraceptives than married individuals. Rich female workers were 1.139 times more likely than poor workers not to use modern contraceptives (adjusted odds ratio [AOR], 1.139; 95% confidence interval [CI], 1.026-1.264). Female workers who did not know about modern contraceptives were 4.549 times more likely than those who did not to use modern contraceptives (AOR, 4.549; 95% CI, 1.037-19.953). Female workers with more than two children were 9.996 times more likely than those with two or fewer children not to use modern contraceptives (AOR, 9.996; 95% CI, 9.1890-10.875). Conclusion: This study identified five factors associated with the non-use of modern contraceptives by female workers in Indonesia's urban areas: young, unmarried, rich, did not know about modern contraceptives, and had more than two children.

Factors related to intrapartum/delivery care in Southeast Asia: A cross-sectional study in the Philippines and Indonesia.

Background: Policy encouraging healthcare intrapartum/delivery care is critical to accelerating the decline in maternal mortality. The study analyzes intrapartum/delivery care factors in Indonesia and the Philippines. Methods: The investigation included 15,346 Indonesian and 7992 Filipino women (ages 15 to 49 who delivered during the previous five years). Aside from the location of intrapartum/delivery care as a dependent variable, additional factors investigated included domicile, marital status, age, occupation, education, parity, wealth, and ANC-the conclusion of the study utilizing binary logistic regression. Results: Women in both countries predominantly do healthcare intrapartum/delivery care. Both countries' urban women are more likely to receive intrapartum/delivery care than rural women. The higher the amount of schooling, the greater the likelihood of receiving intrapartum/delivery care. The lower the parity, the higher the chance to do healthcare intrapartum/delivery care. The higher the wealth position, the greater the likelihood of receiving intrapartum/delivery care. Furthermore, women in both nations who had four or more antenatal visits were more likely to receive intrapartum/delivery care. Conclusion: The study concluded five factors related to healthcare intrapartum/delivery care in the Philippines: residence, education, parity, wealth, and ANC. Meanwhile, there are six factors related to healthcare intrapartum/delivery care in Indonesia: place, age, education, parity, wealth, and ANC.

Socioeconomic Differences of Intimate Partner Violence among Married Women in Indonesia: Does Poverty Matter?

Background: Society placed women living in the men's world as inferior. Poverty as a stressor for men has the opportunity to make women victims of violence from their partners. The study aimed to analyze the effects of poverty on the risk of intimate partner violence among married women in Indonesia. Materials and Methods: The samples used were married women aged 15-49 years old. The weighted sample size was 34,086 women. Besides intimate partner violence as the dependent variable, other variables analyzed as independent variables were wealth status, residence, age, education, employment, living with in-laws, and recent sexual activity. The study employs binary logistic regression to determine intimate partner violence risk in the final stage. Results: The results show the poorest married women were 1.382 times more likely than the richest married women to experience intimate partner violence. Married women with wealthy status in the lower category were 1.320 times more likely than the richest married women to experience intimate partner violence. Married women with a wealthy group in the middle class were 1.262 times more likely than the richest married women to experience intimate partner violence. Married women with wealthy status in the more decadent category were 1.132 times more likely than the richest married women to experience intimate partner violence. Conclusion: The study concluded that poverty was a risk factor for intimate partner violence among married women in Indonesia. The lower the socioeconomic status, the greater the risk of intimate partner violence.

Unmarried Women and Unintended Pregnancy: An Indonesian Cross-Sectional Study.

Background: Indonesia has moral norms consider pregnancy among unmarried women a disgrace. The study analyzes the factors influencing unintended pregnancies among unmarried women in Indonesia. Material and Methods: The study examined 1,050 women. The author analyzed unintended pregnancy and six other variables (residence, age, education, employment, wealth, and parity). Multivariate analysis used binary logistic regression. Results: 15.5% of unmarried women in Indonesia have experienced an unintended pregnancy. Women living in urban areas are more likely to experience unintended pregnancies than women in rural areas. The 15-19 have the highest chance of experiencing an unintended pregnancy. Education is a protective factor from unintended pregnancy. Employed women are 1.938 times more likely than unemployed. Poverty is a risk factor for experiencing an unintended pregnancy. Multiparous is 4.095 times more likely than primiparous. Conclusion: The study identified six variables that affect unintended pregnancy among unmarried women in Indonesia: residence, age, education, employment, wealth, and parity.

The choice of delivery place in Indonesia: Does home residential status matter?

Background: To care for their health needs, women in Indonesia who live with their parents or in-laws frequently lose their independence, including the choice of delivery place. Aim: The study aimed to analyze the effect of home residential status on the choice of delivery place in Indonesia. Methods: The study design was a cross-sectional study. The study employed secondary data from 2017 Indonesian Demographic and Health Survey (IDHS). The research included 15,357 women aged 15-49 with live births in the last five years. Meanwhile, the study used place of delivery as an outcome variable and home residential status as an exposure variable. Moreover, the research employed nine control variables: type of residence, age group, education level, employment status, marital status, parity, wealth status, health insurance, and antenatal care visits-the final analysis using binary logistic regression. Findings: The result shows that women with home residential status in the alone category were 1.248 times more likely than those in the joint category to choose to give birth to healthcare facilities (AOR 1.248; 95% CI 1.143-1.361). In addition to home residential status, the study also found seven control variables to have a relationship with the choice of place of delivery. The seven control variables were the type of residence, age group, education level, parity, wealth status, health insurance, and antenatal care. Conclusion: The study concluded that home residential status affects the choice of delivery place in Indonesia.

Policy to Decrease Low Birth Weight in Indonesia: Who Should Be the Target?

The study aimed to analyze the target of the policy to decrease low birth weight (LBW) in Indonesia. This cross-sectional study used a sample of live births in last five years preceding the survey of birth weight. Data collection took place from July to September 2017. The weighted sample size was 17,848 participants. The variables analyzed included residence, age, marital status, education, employment, parity, and wealth. The study employed binary logistic regression in the final stage to determine the target of policy regarding LBW. The results showed that women in urban areas were 1.200 times more likely to deliver babies with LBW than women in rural areas. All age groups were less likely to deliver babies with LBW than those aged 45-49. The study also found all marital statuses had a lower likelihood of providing babies with LBW than those who had never been in a marriage. Women of all education levels had a greater risk of giving birth to babies with LBW than women with higher education levels. Unemployed women had 1.033 times more chances of delivering babies with LBW than employed women. Primiparous women were 1.132 times more likely to give birth to babies with LBW than multiparous women. Overall, the women in all wealth status categories had a higher probability of delivering babies with LBW than the wealthiest groups. The study concluded that policymakers should target women who live in urban areas, are old, have never been married, have low education, and are unemployed, primiparous, and poor to decrease LBW cases in Indonesia.

Does Husband's Education Level Matter to Antenatal Care Visits? A Study on Poor Households in Indonesia.

Background: Involvement in antenatal care (ANC) is one of the husband's responsibilities for his wife's health. Objective: This study analyzed the contribution of the husband's education level to his involvement in ANC visits among poor households. Methods: The study employed secondary data from the 2017 Indonesian Demographic and Health Survey. The study analyzed 6429 respondents. The analysis units were poor women aged 15-49 years, had a husband, and had ever been pregnant for the past 5 years. Besides husband's education, other independent variables analyzed were residence, husband's age and occupation, and wife's parity. The analysis used a binary logistic regression test in the final step. Results: Husbands with a primary education record were 1.381 times more likely to participate in ANC visits than those without education. Husbands who had secondary education were 2.339 times more likely to get involved in ANC visits than those without education records. Moreover, husbands who had higher education were 3.376 times more likely to be engaged in ANC visits than those without education records. Conclusions: The study concludes that better education levels will be more likely to motivate husbands to get involved in ANC visits.

The Determinants of Four or More Antenatal Care Visits Among Working Women in Indonesia.

This study aimed to analyze the determinants of four or more antenatal care (ANC) visits among working women in Indonesia. The researchers extracted data from the Indonesian Demographic and Health Survey 2017 and obtained a sample size of 8239 working women aged between 15 and 49 years. Women's residence, age, marital status, education level, parity, economic status, and health insurance were selected as the independent variables. Binary logistic regression was used for the analysis. Older working women, married working women, educated working women, those in higher economic status, and those with health insurance were more likely to complete four or more of their ANC visits. The more children the working women had, the less likely they would complete their ANC visits. In conclusion, age, marital status, education, parity, economic status, and health insurance are the determinants for completing ANC visits among working women in Indonesia. At the same time, place of residence does not affect the frequency of ANC visits.

The Barrier to Contraceptive Use among Multiparous Women in Indonesia.

BACKGROUND: The lack of perception related to the risk of pregnancy and contraceptive use's side effects is the main reason for not using contraceptives. OBJECTIVE: This study aimed to analyze barriers to contraceptive use among multiparous women in Indonesia. METHODS: This study employed the 2017 Indonesia Demographic and Health Survey. The analysis unit was multiparous women aged 15-49 years old, and the sample was 25,543 women. The contraceptive use was the dependent variable, while the independent variables analyzed were residence, age, education, employment, wealth, and insurance. The study used a binary logistic regression to determine the barriers. RESULTS: Women in urban areas were 1.100 times more likely not to use contraceptives than women in rural areas. All categories of age group are more likely to use contraception than the 45-49 age group. Multiparous women who had low education had a higher possibility of not using contraceptives. Unemployed multiparous women were 1.008 times more likely not to use contraceptives than employed multiparous women. In terms of wealth status, women with all wealth status tended not to use contraceptives than the richest. CONCLUSIONS: Multiparous women in Indonesia had five barriers to not using contraceptives. These included living in urban, being at younger ages, having no education, being unemployed, and having low wealth status.

The determinant of health insurance ownership among pregnant women in Indonesia.

BACKGROUND: Health insurance ownership is one indicator of the readiness of pregnant women for the delivery process. The study aimed to analyze the determinants of health insurance ownership among pregnant women in Indonesia. METHODS: The study population was pregnant women in Indonesia. The study involved 2542 pregnant women in Indonesia. The variables analyzed included type of place of residence, age group, education level, employment status, marital status, parity, wealth status, and know the danger signs of pregnancy. In the final step, the study employed binary logistic regression to explain the relationship between health insurance ownership and predictor variables. RESULTS: The results show that pregnant women with higher education were 3.349 times more likely than no education pregnant women to have health insurance. Pregnant women with wealth status in the middle category were 0.679 times the poorest pregnant women to have health insurance. Meanwhile, the richest pregnant women had 1.358 times more chances than the poorest pregnant women to have health insurance. Grande multiparous pregnant women were 1.544 times more likely than primiparous pregnant women to have health insurance. Pregnant women who know the danger signs of pregnancy were 1.416 times more likely than pregnant women who don't see the danger signs of pregnancy to have health insurance. CONCLUSIONS: The study concluded that four variables, including education level, wealth status, parity, and knowledge of the danger signs of pregnancy, were significant determinants of health insurance ownership in Indonesia.

Determinants of Breast Cancer Screening Practice among Women in Indonesia: A Nationwide Study.

BACKGROUND: Breast cancer remains the leading cause of death for women globally, including in Indonesia. Breast cancer screening plays a vital role in reducing deaths caused by breast cancer. However, breast cancer screening rate is still low and studies on determinants for breast cancer screening is limited in Indonesia. This study aimed to identify the determinants of breast cancer screening among women in Indonesia. METHODS: This population-based study was conducted among 827 women who lived in either rural and urban areas, using a stratified sampling design where were based on province and locality combinations. Data were analysed using a binary logistic regression model to assess the associations between independent and dependent variables. RESULTS: As many as 827 women with an average age of 29.91 (± 11.14) years old participated in this study. The overall breast cancer screening among women was 18.74%. Knowledge of breast cancer risk factors, signs, and symptoms (adj.OR = 1.75, 95%CI: 1.20 - 2.56), age of 35 to 39 years old (adj.OR. = 1.52, 95% CI: 1.02 - 2.26), and household income of ≥6,000,000 IDR (≥457 USD) (adj.OR. = 5.19, 95%CI: 1.43-18.84) were associated with breast cancer screening attendance. In contrast, Christian women had a significantly lower breast cancer screening rate that women from other religions (adj. OR. = 0.45, 95%CI: 0.24 - 0.85). CONCLUSION: The overall breast cancer screening attendance was poor among Indonesian women population. Age, household income, religion, and knowledge of breast cancer risk factors were identified as the determinant factors for breast cancer screening.

The association between recent sexual activity and the use of modern contraceptive methods among married/cohabiting women in Indonesia.

Background: Modern contraceptive methods are considered more reliable for preventing and spacing pregnancy than traditional methods in sexual activity. The study aimed to analyze the association between recent sexual activity and the use of modern contraceptive methods among married/cohabiting women in Indonesia. Design: The samples used were married/cohabiting women aged 15-49 years old. The sample size was 34,467 women. The variables analyzed included modern contraceptive use, recent sexual activity, age groups, marital status, education level, and wealth status. Analysis using multinomial logistic regression. Results: It was found that women who were sexually not active last 4 weeks had the likely to use modern contraceptive non-LARC (long-acting reversible contraceptives) 0.416 times compared to women who were sexually active last 4 weeks. Women who were sexually active last 4 weeks were more likely to use modern contraceptive LARC 0.535 times than women who were sexually active last 4 weeks. The results of this analysis inform that women who are sexually active last 4 weeks have a higher possibility to use modern contraceptives, both non-LARC and LARC types. Conclusions: Based on the results of the research analysis it could be concluded that recent sexual activity was associated with modern contraceptive use among married/cohabiting women in Indonesia.

Breast cancer stigma among Indonesian women: a case study of breast cancer patients.

BACKGROUND: The stigma experienced by cancer patients stems from the association of cancer with death, as cancer is the most feared disease worldwide, especially among cancer patients and their families. The stigma regarding breast cancer screening behaviour has not been critically evaluated and is poorly understood; therefore, we aimed to analyse the stigmatization of breast cancer patients in Indonesia to reduce the morbidity and mortality of breast cancer. METHODS: A qualitative study using a focus group discussion (FGD) and in-depth interviews with thematic analysis was conducted. RESULTS: One informant experienced breast pain and kept the referral letter, in which the medical doctor advised medical treatment, to herself for 3 months due to her embarrassment. A traditional healing practice known as 'kerokan', which involves scraping of the skin, and consumption of a traditional drink were used by most informants to decrease their breast pain. Finally, most informants were diagnosed with an advanced stage of cancer when they returned to the health care facility. In addition, financial difficulties were noted as barriers to breast cancer screening in Indonesia. CONCLUSIONS: Feelings of fear and shame when diagnosed with breast cancer were reported by the informants in this study. Alternative treatment known as 'kerokan' was the first treatment sought for breast cancer symptoms due to financial difficulties among breast cancer patients. Informants were diagnosed with an advanced stage of cancer after they returned to the health care facility. A better understanding of early breast cancer symptoms could motivate women to seek out breast cancer treatment.