An Assessment of Recent Levels and Trends in Longterm Contraceptive Method Use in Indonesia by Siti Fathonah and Andrew Kantner. East-West Center Working Papers, Population and Health Series, No. 96. December 1997. 30 pp.

Abstract

Between 1991 and 1994, the proportion of currently married women using contraception in Indonesia increased from 50 to 55 percent. Most of this increase was in the use of short-term methods, however, especially pills and injectables. Long-term methods appropriate for limiting births registered very modest gains, especially vasectomy and tubectomy, and IUD use actually declined from 13 to 10 percent.

Using data from the 1991 and 1994 Indonesia Demographic and Health Survey (IDHS), this paper identifies factors that may be inhibiting the growth of long-term method use. Results show that the use of long-term methods declined in two regions of the country (Java-Bali and Outer Java-Bali I), in rural areas, among women with higher levels of education, and among women with four or more children. The analysis suggests that family planning information, education, and communication (FP-IEC) activities had a modest effect in promoting the use of long-term methods, most notably the use of implants. Recent contact with family planning field workers, however, was associated with lower use of long-term methods.

IUD discontinuation rates are low (15 percent) after one year of use but rise to 36 percent after three years and 47 percent after five years. Implant discontinuation rates are fairly low after one year (4 percent) and three years (14 percent) of use, but rise to 31 percent after five years. Most women who discontinue IUD use switch to a temporary method or stop using contraception altogether. Since many of these women do not wish to become pregnant, this group should receive priority attention from service providers. Most women who discontinue implant use do not begin using another method. Clearly, better follow-up and counseling services are needed for long-term method users who switch to short-term methods or stop using contraception.