Factors That Influenced the Use of Family Planning (KB) in Padang

Hulu District of Tebing Tinggi 2018

Namora Lumongga Lubis

and Hasnida

Department of Public Health, Universitas Sumatera Utara, Jalan Universitas No. 21 Medan,

Indonesia

Department of Psychology, Universitas Sumatera Utara, Jalan Dr. Mansyur No.7 Medan, Indonesia

Keywords: Use of Male Family Planning, Possible Factors, Strengthening Factors.

Abstract: As developing country, Indonesia still has to struggle with various problem. One of the main problems

faced by Indonesia today is the growing number of populations. The purpose of this research is to analyze

the factors that influence the male use of family planning in Padang Hulu sub-district, Tebing Tinggi 2018.

This research is using analytical observational with case control study design. The sample of this study

consisted of 60 cases group and 60 control group. The case group sample was the male family planning

acceptor and the control group sample including the male non family planning. Based on multivariate

results that age and support of wives are predicators of male family planning. It is suggested for health

workers to improve the promotion of vasectomy services, through the provision of education, knowledge

and the use of family planning vasectomy in the form of counseling and family approach concerning the

importance of family planning vasectomy and for men family acceptor is expected to be role model to his

peers so that the other men would participate in family planning, especially vasectomy.

1 INTRODUCTION

Indonesia is one of the developing countries with

various problems. One of the problems deals with

Indonesia in recent time is the high rate of

population growth. Therefore, the government

continues to strive to reduce the rate of growth with

the family planning program of Badan

Kependudukan dan Keluarga Berencana Nasional

(BKKBN). Although socialization activities have

been conducted to the community, the number of

MKET program participants is still low (BKKBN,

2011).

Male participation rates in contraceptive use in

Indonesia Indonesia are still very low at only 2.1%

family planning and they generally use condoms.

The percentage is lower compared to other

countries, such as Iran 12%, Tunisia 16%, Malaysia

9-11%, even the percentage in the United Stated

reached up to 32%. Based on BKKBN 2012 the

participation of male using contraception is only

1.3% consist consist of condom user (0.9%) and

vasectomy (0.4%). Therefore, the socialization of

family planning programs among men should be

improved (Mardiya cited in Ernawati, 2016). Factor

that influence the choice of contraception in male is

the support of wife (Musdalifah, 2013). To increase

the percentage of male participation in family

planning, the socialization should be improved

(Mardiya, 2012). One of the most influencing

factors for male using contraception is wife support

(Musdalifah, 2013). The communication between

spouse will help men to choose the most appropriate

contraception. Furthermore, the information

obtained from health worker can greatly affect male

use of contraception (Musdalifah, 2013).

The ease and availability of service family

planning facilities has a positive impact on the use

of contraception. Men became less motivated to use

contraception due to the low accessibility of

information about family planning (Suprihastuti,

2013). According to (Hasibuan, 2014) the cause of

husband’s less participation in family planning is

the limitation of knowledge about reproductive

health and paradigm associated with patriarchy in

which the role of husband is greater than women.

Based on the research showed that wife support

associated with husband’s involvement in family

1386

Lubis, N. and Hasnida, .

Factors That Inﬂuenced the Use of Family Planning (KB) in Padang Hulu District of Tebing Tinggi 2018.

DOI: 10.5220/0010076213861391

In Proceedings of the International Conference of Science, Technology, Engineering, Environmental and Ramiﬁcation Researches (ICOSTEERR 2018) - Research in Industry 4.0, pages

1386-1391

ISBN: 978-989-758-449-7

planning (condom and vasectomy) in Bantul

Regency (Budisantoso, 2009). Male participation in

the practice of modern family planning methods in

Indonesia is influenced by socio-demography that

includes knowledge, wife's age, husband's

education, number of surviving children and

attitudes toward family planning programs (Rustam,

2006).

Tebing Tinggi, is one of the cities in North

Sumatera which inhabited by 147,771 people with a

total of 23,550 couples with reproductive age.

Active family planning participants in 2013 reached

up to 17,450 people which consist of 200 males

using vasectomy (1.15%) and 610 males using

condom (3.50%) at the group age of 30-45 years

old. The largest coverage of family planning

acceptors was found in Rambutan sub-district

consist of 52 people (1.23%) from the total 5,578

reproductive couples. In Bajenis sub-district there

were 49 people (1.23%) from the total of 5.081

reproductive couples, Tebing Tinggi Kota 48 people

(1.85%) from the total of 3,539 couples, Padang

Hilir sub-district is 33 people (0,97%) from 4,697

couples, and Padang Hulu sub-district is 18 people

(0,51%) from 4,655 couples (BKKBN, 2013).

2 RESEARCH METHOD

Based on its purpose, this study is an analytic

observational study with case control method.

Analytical observational case control study is a

design to determine the relationship between

variables by comparing case group and control

group based on their status (Murthi, 2003). The

sample were consisted of 60 control groups and 60

case groups. Data were analyzed using simplex

logistic regression and multiple logistic regression

test.

3 RESULTS AND DISCUSSION

3.1 Univariate Analysis

Description of the respondents in the study showed

that the most of respondents in the case group had

entrepreneurial jobs it consists of cases of 38 people

(63.3%). Based on the research, the muslim

respondents in the case group consist of 55

respondents (85%). And there were 58 muslims

(96.77%) in control group. The majority of

respondent were Javanese consist of 28 people

(46.7%) from case group and 35 people (53.8%)

from control group. 47 people (78.3%) from case

group had 1-2 children and in control group there

were 52 respondents (86.7%) had (> 3) more 3

children.

48 respondents (80%) respondents in case group

55 respondents (91,7%) in control group had

income 1-2 million. 27 respondents (61,7%) wives

in the case group were within in control group

above 35 years. 43 respondents (71.7%) in control

group were within the age group above 35 years (>

35). 32 of respondent (53.3%) from the case group

and 40 respondents (66.7%) from control group had

more than 12 years the length of marriage.

3.2 Bivariate Analysis

3.2.1 Simple Logistic Regression Test

Results

The analysis results of simple logistic showed that

there is a significant influence between age to male

KB use. The results of analysis using simple logistic

regression test showed that there is no significant

influence between education on the use of family

palnning in men. The results of analysis using

simple logistic regression test showed that there is

no significant influence between knowledge on the

use of family palnning in men. The results of

analysis using simple logistic regression test showed

that there is no significant influence between the

availability on the use of family palnning in men.

The results of analysis using simple logistic

regression test showed that there is no significant

influence between the support of wife to the use of

family planning. The results of analysis using

simple logistic test showed that there is no

significant influence between culture on male family

usage.

Thus, based on bivariate analysis using simple

logistic regression test, age variable and wife

support have p value <0, 25 so it can be including in

multivariate analysis model and conducted by

multiple logistic regression test with “enter”

method.

3.3 Multivariate Analysis Results

Based on the results of multiple logistic regression

test showed that risk factors influencing the use of

contraceptive in men in Padang Hulu sub-district of

Tebing Tinggi after being adjusted with other

variables were p = 0,034, OR = 2,384 95% CI

(1,068-5,320), wife support p = 0,042; OR = 2,428

95% CI (1,033-5,708).

Factors That Inﬂuenced the Use of Family Planning (KB) in Padang Hulu District of Tebing Tinggi 2018

1387

Therefore, the most dominant variable affecting

the use of contraceptive in men after multiple

logistic regression test on multivariate analysis is

the wife support variable p = 0,034; OR = 2,428;

95% CI (1,033-5,709) which means that men who

received wife support 2.4 times estimated men

using KB vasectomy compared with men who do

not have the support of the wife.

3.3.1 The Relationship between Age and

Contraceptive Use in Men

The result bivariate analysis shows that there is

significant influence between age with the use of

famili planning in men with p value = 0,014. The

result of multivariate analysis also showed that age

had significant effect on male KB use p = 0,034; OR

= 2,384 95% CI 1,068-5,320. This means that men

> 40 years old are 2.3 times more likely than men to

use vasectomy contraception compared with men

aged ≤ 40 years. Age can affect the one’s psychic,

young age often cause tension, confusion, anxiety

and fear that can affect one’s behavior

(Notoatmodjo, 2011). The results of this study is in

line with the previous research that there is a

spesific relationship between age and men’s

paricipant in family planning (Rozi, 2017). The

results are also accordance with the research

conducted by (Butto and Mburu, 2015) showing the

significant relationship between respondent’s age

and their participants in family planning.

3.3.2 The Relationship between Education

with the Contraceptive Use in Men

Based on the results of simple logistic regression,

that there is no influence between education on

contraceptive use in men. This is evidenced from the

calculation of simple logistic regression test can be

seen that the value p = 0.999 which means greater

than α = 0.05, then H

accepted.

Conforming to (Nurliana and Subiyatun, 2011)

states that there is no relationship between husband

education with the use of contraceptives in the

hamlet Tekik Bangunharjo Bangunkerto Turi

Sleman, which proved the value with the value p =

0.185 (p> 0.05). In contrast to research indicating

that of 291 husbands in Sumber Agung Jetis Bantul,

most husbands were educated at junior high school

150 (51.5%), and the least husband who had high

education was 14 (0.5%). From the results of

analysis, it can be said most of the husband educated

junior high. The results of this study revealed there

is an influence between educational factors on the

use of male contraceptive methods (Setyaningrum

and Melina, 2017).

Less educated people will be more likely to

respond new ideas with emotion. Because the new

things might be shocking the people or change what

they have done in the past. The level of education

not only affects the willingness to use family

planning, but also the selection of a method.

3.3.3 The Relationship between Knowledge with

the Contraceptive Use in Men

Based on the results of simple logistic regression

test, that there is no influence between knowledge

on contraceptive use in men. This is evidenced from

the calculation of simple logistic regression test can

be seen that the value p = 1,000 which means

greater than α = 0.05, then Ho accepted.

Knowledge and attitude associated with

husband’s participation in family planning in

Yogyakarta, husbands’ knowledge about family

planning can be influenced by geography location,

the respondents live closer to the city has the better

knowledge about family planning than that of

respondents who live in the village, because the

geography location close to the city can facilitate

more information about family planning to society

(Tourisia, 2012)

There was a very significant relationship

between knowledge and contraception use in men

(Islam, 2013). Because an educated man will have

the knowledge of modern contraceptive and sexual

transmitted disease.

The statement above is in contrast to the

previous research results, it was found that 32.9%

(94 people) of reproductive age in Surakarta was

using contraceptives while another 67.1% (192

people) did not use contraception (Setiyani and Ayu,

2012). There were still many reproductive couples

who do not use contraception. Based on the results

of this study found, there is no significant

relationship between the level of knowledge of

contraceptive use. The higher the level of husbands'

knowledge of male family planning, the higher the

status of contraceptive use in men.

It is accordance with the situation in the District

of Padang Hulu Tebing Tinggi, it was found that

there is no relationship of knowledge to the use of

contraception in men. Although the study was not

statically significant but in terms of OR values,

knowledge about contraception has a tendency of

1.000 times to affect men in using contraception.

ICOSTEERR 2018 - International Conference of Science, Technology, Engineering, Environmental and Ramiﬁcation Researches

1388

3.3.4 The Relationship between Knowledge with

the Contraceptive Use in Men

Based on the results of simple logistic regression

analysis, there is no influence between the

availability of male family planning services to the

use of contraception in men. This is revealed from

the calculation of simple logistic regression test can

be seen that the value p = 0.650 which means greater

than α = 0.05, then Ho accepted.

This is in line with (Butto and Mburu, 2015)

which revealed that there was no relationship

between the availability of family planning services

and the involvement of men in contraceptive use, as

access to family planning services and the

involvement in family planning services by men

may also be affected by the types of health workers

who offer the service.

Availability of service facilities was a positive

impact on the use of contraceptive devices. The

accessibility of men to information on family

planning is low because of the limited information

on the role of men in family planning and KR; and

male accessibility to low contraceptive services

(Muhatiah, 2016).

This result of this study is contradicting with

previous research states, that factors that cause male

family planning participation in various areas tend

to be low are: First, information access is very

limited. Men's knowledge of contraception, such as

type, side effects, effectiveness, mode of use, where

to get contraceptives, benefits and others is still very

low. Second, access to services is still limited

(Sutinah, 2017).

In accordance with the situation in the District of

Padang Hulu Kota Tebing Tinggi, it was found that

there was no relationship between the availability of

male contraceptive services with the use of

contraception in men. Although this study was not

statistically significant but in terms of OR values,

the availability of male family planning services has

a tendency of 1.526 times to affect men in using

contraception.

3.3.5 The Relationship between Wife Support

with Contraceptive Use in Men

Based on the results of simple logistic regression,

there is a relationship between the wife support with

the use of contraception in men. It is revealed from

the result of simple logistic regression test with the

value p = 0.017 which means smaller than α = 0.05,

then H

is accepted. The result of multivariate

analysis was dominant influential factor which

showed that wife support had significant effect on

contraception use in men p = 0,042; OR = 2,428

95% CI 1.033-5,709 This means that men who get

wife support 2.4 times more the estimate of men

willing to use vasectomy contraception in men than

men who do not have the support of the wife.

This is conforming to previous research stated,

that the support of wife to the contraception use is a

positive attribute of the wife to family planning, if

couples have a positive attitude toward family

planning then they tend to use contraception (BPS

and Macro International, 2007), (Rozi, 2017). Other

research also stated that there is a relationship

between the support of the wife and the participation

of the husband in the family planning program

(Kharisto and Shofiyah 2016).

The support of the family refers to support that

is considered useful. Support of wife is one factor

that is very influential on positive behavior. The role

of family support itself is divided into the formal

role of explicit role, such as the role of husband or

wife and the role of information, such as direct

assistance from the family (Wahyuni, 2013).

Wives support is strongly influenced by

husband's motivation for contraceptive use. Thus, in

taking contraceptive options, there is an approval

between husband and wife have a role as a partner

of reproduction. The more support of wife receives,

the higher motivation husband gets for contraceptive

use, and vice versa (Istiqomah, 2012). This is in

accordance with (Friedman, cited in Sirait & Reni,

2012) that the wife helps the individual (husband) in

building self-esteem and competence. Kind of

support given in the form of awards to the husband,

positive responses and provide feedback on the use

of male contraceptives.

The results showed OR = 2,428 which means

that men whose wives support for the use of

contraception have 2.428 greater possibility than

men whose wives do not support the use of

contraception.

3.3.6 The Relationship between Culture with

Contraceptive Use in Men

Based on the results of simple logistic regression

test, there is no influence between the culture on the

use of contraception in men. This is revealed from

the simple logistic regression test showed that the

value p = 0.855 which means greater than α = 0.05,

then Ho is accepted.

A study states that, there is no socio-cultural

relation on family planning men’s acceptor with

men's participation in family planning (Ernawati,

2016). In some studies, cultural standards are

identified as barriers to male involvement in

Factors That Inﬂuenced the Use of Family Planning (KB) in Padang Hulu District of Tebing Tinggi 2018

1389

participating family planning programs. All

respondents believe that the reasons for involving

men in family planning programs include that men

play a dominant role in family decision-making.

Another reason expressed by the majority of

participants are that men are the head of the family

and give much influence to women's decisions

(Bayray, 2012). Men often assume that family

planning services are designed and provided for

women, so men are embarrassed to join the family

planning program (Cleland, 2011).

In contrast to other research, which states that

respondents who are positive social culture as much

as 86% participate actively in the vasectomy

program (Rizkitama and Imdrawati, 2015).This is

different from the situation in Padang Hulu

Subdistrict, Tebing Tinggi in 2018, found that there

is no connection between culture and contraceptive

use in men. Although this study was not statistically

significant but in terms of OR values, cultures had a

tendency of 0.935 times to influence men in using

contraception.

4 CONCLUSIONS AND

SUGGESTIONS

Based on the results of research on the use of factors

that affect the use of male Family Planning

(Keluarga Berencana) in Padang Hulu District

Tebing Tinggi in 2018, the conclusions are stated as

follows:

a. There is an effect between age on the use of

family planning in men

b. There is no effect between education on the use

of family planning in men

c. There is no effect of knowledge on the use of

family planning in men

d. There is no effect between the availability of

male contraceptive service on male family

planning use

e. There is an effect of wife support on the use of

family planning

f. There is no cultural influence on male birth

control

g. Based on multivariate test results, the dominant

variable affecting the use of male KB is the

support of the wife

A. For Researcher

It is expected that the reseacher can make the results

of this research as the study material of science

development to increase the information about the

benefit of using Family Planning (KB) in men and

help to apply the form of counseling about the use

of contraception in men so that the increase of

population every year can be controlled in

accordance with the hope of BKKBN program.

B. For Family Planning Field Officer

It is expected that the promotion of vasectomy

services is enhanced, through the provision of

education, knowledge and the benefits of using

vasectomy in the form of counseling and family

approaches regarding to the importance of family

planning in this case vasectomy.

C. For the male KB acceptor

The men are expected to be precendent by

approaching, so that other men would participate in

family planning, especially vasectomy.

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