Contraceptive Use among Married Adolescent Women in Indonesia

Abstract

Background:  About 13% of adolescent women in Indonesia are in marital union and 10% already have children or pregnancy.  The 2012 Indonesia Demographic and Health Survey (IDHS) revealed that maternal mortality rate (MMR) in Indonesia had increased to 359 women/100,000 live births from 228 women/100,000 live births in the previous survey (in 2007 IDHS). Births among adolescents are one of the contributors of maternal mortality. Maternal related risk in pregnancy is higher among adolescents than in adult women. The infant mortality rate (IMR) is also higher among babies whose mothers are less than 20 years old. Thus, contraceptive use among married adolescent women is important for their reproductive health. This study aimed to examine factors associated with modern contraceptive use among married adolescent women in Indonesia.

Methods: This study used secondary data from 2012 Indonesia Demographic and Health Survey (IDHS). The samples for this study were adolescent women aged 15-19 years old who currently married in the survey. Excluded those who were pregnant and infecund, and only one woman was selected per household randomly, 691 eligible samples were analyzed.

Results: More than half of married adolescent women already had children (64%), from low economic status (58%) and live in rural area (66%). The most popular contraceptive methods were injections and pill.  Women’s education and their awareness of contraceptive methods are individual factors which have positive associations with contraceptive use among married adolescent women in Indonesia (p≤0.01 and p≤0.001), while the highest use among those who were unemployed (p≤0.001). Have living child is also enabling factors for the use (p≤0.05). Contraceptive use increased among adolescent women who have a discussion about family planning with husband, relatives, or friends/neighbors, exposed to family planning information in media, obtaining family planning information from community leaders and health workers, have more duration of marriage, have more educated husbands, and have no difficulties with distance to reach health facilities (p≤0.05). The highest user was among women whose husbands aged 25-34 years old. In the multivariate analysis, women who have one or more living children are more likely to use contraceptive. The higher their husband’s education the more likely they use contraception. Women who have more awareness of contraceptive methods and who ever obtained family planning information from personal contact with community leaders and health workers were also more likely to use contraceptive than their counterparts.

Conclusions: To increase contraceptive use among married adolescent women, the study suggest the strategies can focus on women’s and their husband’s characteristics such as improve their education and knowledge and interventions such as spreading information through community leaders or health workers, mass media, peers and relatives. In addition, providing more health centers in the limited access areas is also needed.