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Stud Fam Plann. 1988 May-Jun;19(3):162-8.

Husband's approval of contraceptive use in metropolitan Indonesia: program implications.

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School of Public Health, University of Indonesia, Jakarta.


Husband's approval of contraceptive use plays a decisive role in Indonesia. Despite this, no previous study of contraceptive use in Indonesia has evaluated the importance of husband's approval. Such evaluation is especially important in metropolitan areas where family planning programs have encountered more difficulty than those elsewhere in recruiting contraceptive users. Using data from the first Indonesia Contraceptive Prevalence Survey for metropolitan cities, husband's approval and other determinants of contraceptive use among fecund women were evaluated. The levels of contraceptive use varied among cities, ranging from 34.2 percent in Ujung Pandang to 56.5 percent in Semarang. For all cities, however, husband's approval was the most important determinant, followed by number of living children and wife's education. Among women who desire to have no more children, 17.4 percent and 27.8 percent of contraceptive nonuse in Medan and Jakarta, respectively, was attributable to husband's disapproval. Because most of the family planning programs in Indonesia are designed to serve primarily women, the finding of husband's approval as the most important determinant has important program implications.


Women in the 5 largest cities in Indonesia were interviewed as part of the Indonesian Contraceptive Prevalence Survey in 1983, and data were analyzed to determine the effect of husband's approval on contraceptive use. Sample groups ranged from 1748 women in Medan to 1980 women in Jakarta. 2 analyses were performed: the relationship between husband's approval to 10 independent variables, and the unmet need for contraception as a result of husband's approval and other variables. Contraceptive use ranged from 34.2% in Ujung Pandang to 56.3% in Semarang. In all cities, husband's approval was the most important determinant, followed by number of living children and by wife's education. The effect of husband's approval was much more influential, 31.9 to 41.8%, for women with 2 or more children, than for those with fewer children. The percentage of unmet need for contraception among women without husband's approval was striking: from 86.9 to 93.3% in various cities. Expressed as attributable risk, at most 27.8% of contraceptive nonuse in Jakarta could be reversed with husband's approval. Indonesia is a Muslim country where husbands make decisions about family life and their consultation is required by law for contraceptive prescription. It was observed that in the city of Medan, the proportion of nonuse with husband's disapproval was lowest, reflecting ethnicity and the larger Christian population.

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