References
Use of intrauterine devices/implants and injectables under the universal health coverage scheme in Indonesia
Abstract
Background/Aims
Family planning services are crucial for improving maternal and child health, reducing unintended pregnancies and enhancing wellbeing. Indonesia's universal health coverage programme has increased access to these services, but use varies widely. This study explored the use of intrauterine devices/implants and injectables under the universal health coverage programme using a national dataset from 2021.
Methods
This cross-sectional study was conducted using secondary data from the Indonesian Social Health Insurance Administration. The sample included 7855 married couples aged 15–49 years. Binary logistic regression was used to analyse factors influencing use of intrauterine devices/implants and injectables.
Results
Most users (60.2%) were premium assistance beneficiaries who received government subsidies for healthcare services. Informal workers (who did not receive subsidies) (P<0.001), those aged 21–35 years (P<0.001) and those registered with network providers (P<0.001) were more likely to use injectables.
Conclusions
Optimising universal health coverage for family planning services and enhancing promotional efforts are essential to encourage engagement across all universal health coverage members.
Implications for practice
Tailoring Indonesia's family planning services to account for demographic needs could improve equitable access and increase contraceptive uptake.
Family planning has significantly improved millions of lives by empowering individuals to decide if and when to have children. Longer intervals between births contribute to better health outcomes for both mothers and children, while smaller families tend to experience greater economic prosperity (Wijanarko and Wisana, 2019). Despite these benefits, in 2022 it was reported that approximately 257 million women globally wished to prevent or delay pregnancy, but did not use modern contraceptive methods (United Nations Population Fund, 2022).
Intrauterine devices, implants and injectable contraceptives are regarded as the most effective and reliable forms of contraception, as they do not require daily administration, in contrast to methods such as oral contraceptives (Fernandez, 2017). Intrauterine devices and implants provide contraceptive protection for several years, while injectable methods offer protection for up to 3 onths (Baker and Creinin, 2022). Long-acting reversible contraceptives function by releasing hormones or using copper to prevent fertilisation, making them an optimal choice for those seeking a long-term, low-maintenance approach to family planning (Bahamondes and Bahamondes, 2021; Martínez Pérez et al, 2023).
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