Determinants of subdermal contraceptive use among women of reproductive age: A Cross-Sectional Study

Dahniar; Uliarta Marbun; Lili Purnama Sari; Irnawati; Arisna Kadir

doi:10.35816/jiksh.v15i1.211

Authors

Dahniar Department of Midwifery, STIKES Nani Hasanuddin, South Sulawesi https://orcid.org/0009-0001-5942-3062
Uliarta Marbun Department of Midwifery, STIKES Nani Hasanuddin, South Sulawesi https://orcid.org/0000-0002-5251-448X
Lili Purnama Sari Department of Midwifery, STIKES Nani Hasanuddin, South Sulawesi https://orcid.org/0000-0001-6171-8110
Irnawati Department of Midwifery, STIKES Nani Hasanuddin, South Sulawesi
Arisna Kadir Department of Midwifery, STIKES Nani Hasanuddin, South Sulawesi https://orcid.org/0000-0003-0063-7397

DOI:

https://doi.org/10.35816/jiksh.v15i1.211

Keywords:

Contraceptive Agents, Family Planning Services, Health Knowledge, Attitudes, Practice; Logistic Models, Women’s Health

Abstract

Introduction: Family planning is a key global public health strategy to reduce maternal morbidity and mortality. The World Health Organization (WHO) reports that millions of women of reproductive age worldwide still have unmet needs for modern contraception, contributing to preventable maternal deaths and adverse reproductive outcomes. Although long-acting reversible contraceptives such as subdermal implants are highly effective (failure rate <1%), their utilization remains lower than short-term methods in many low- and middle-income countries, including Indonesia. Understanding the determinants of implant use is essential to strengthening family planning programs at the primary health care level. Objective: To analyze factors associated with the use of subdermal contraceptives (Alat Kontrasepsi Bawah Kulit/AKBK) among women of reproductive age at Puskesmas Pattingalloang.

Research Methodology: An analytic cross-sectional study was conducted among 50 women of reproductive age, selected by simple random sampling, between December 2024 and January 2025. Data were collected using validated structured questionnaires. Descriptive statistics, chi-square tests, and multivariate logistic regression were performed using SPSS version 26. Statistical significance was set at α = 0.05.

Results: Good information exposure (AOR = 9.12; 95% CI: 1.78–46.76; p = 0.008), good husband’s support (AOR = 7.45; 95% CI: 1.56–35.58; p = 0.012), good knowledge (AOR = 6.74; 95% CI: 1.38–32.94; p = 0.019), and age 20–30 years (AOR = 5.21; 95% CI: 1.02–26.60; p = 0.047) were independently associated with AKBK use. Parity, education level, and duration of contraceptive use were not significantly associated.

Conclusion: Cognitive and relational determinants play a central role in subdermal contraceptive uptake. Strengthening structured counseling, improving information dissemination, and implementing couple-centered family planning interventions are recommended to enhance long-acting contraceptive utilization and improve maternal health outcomes

References

Ahmed, M. S. and Yunus, F. M. (2021) ‘Factors associated with knowledge and use of the emergency contraceptive pill among ever-married women of reproductive age in Bangladesh: findings from a nationwide cross-sectional survey’, The European Journal of Contraception & Reproductive Health Care, 26(3), pp. 195–201. doi: https://dx.doi.org/10.1080/13625187.2020.1850675.

Ames, J. L. et al. (2024) ‘Reproductive healthcare in adolescents with autism and other developmental disabilities’, American Journal of Obstetrics and Gynecology, 230(5), pp. 546.e1-546.e14. doi: https://doi.org/10.1016/j.ajog.2024.01.005.

Beraki, G. G. et al. (2023) ‘Factors associated with men’s involvement in antenatal care visits in Asmara, Eritrea: community-based survey’, Plos one, 18(10), p. e0287643. doi: https://dx.doi.org/10.1371/journal.pone.0287643.

Black, K. I., Vromman, M. and French, R. S. (2025) ‘Common myths and misconceptions surrounding hormonal contraception’, Best Practice & Research Clinical Obstetrics & Gynaecology, 98, p. 102573. doi: https://doi.org/10.1016/j.bpobgyn.2024.102573.

Costa, F. O. et al. (2022) ‘Association between cumulative smoking exposure, span since smoking cessation, and peri-implantitis: a cross-sectional study’, Clinical Oral Investigations, 26(7), pp. 4835–4846. doi: https://dx.doi.org/10.1007/s00784-022-04451-8.

Cucinella, L., Tiranini, L. and Nappi, R. E. (2024) ‘Sexual health and contraception in the menopause journey’, Best Practice & Research Clinical Endocrinology & Metabolism, 38(1), p. 101822. doi: https://doi.org/10.1016/j.beem.2023.101822.

Flynn, J. (2025) ‘Contraceptive access and infant health outcomes’, Journal of Health Economics, 104, p. 103081. doi: https://doi.org/10.1016/j.jhealeco.2025.103081.

Habib, L. A. et al. (2022) ‘Medical comorbidities and orbital implant exposure’, Acta Ophthalmologica, 100(3), pp. e813–e819. doi: https://dx.doi.org/10.1111/aos.14973.

Hairuddin, K., Yulis, D. M. and Suprapto, S. (2026) ‘Study of Socio-cultural Support for Stunting in Children of Biak Regency’, Journal of Public Health Sciences, 5(01), pp. 30–46. doi: https://doi.org/10.56741/IISTR.jphs.001299.

Hakizimana, S. and Odjidja, E. N. (2021) ‘Beyond knowledge acquisition: factors influencing family planning utilization among women in conservative communities in Rural Burundi’, Reproductive Health, 18(1), p. 94. doi: https://dx.doi.org/10.1186/s12978-021-01150-7.

Hoopes, A. J., Timko, C. A. and Akers, A. Y. (2021) ‘What’s known and what’s next: contraceptive counseling and support for adolescents and young adult women’, Journal of Pediatric and Adolescent Gynecology, 34(4), pp. 484–490. doi: https://dx.doi.org/10.1016/j.jpag.2020.12.008.

Irma, I. et al. (2025) ‘Determinants of chronic energy deficiency (CED) in pregnant women in stunting’, Jurnal Ilmiah Kesehatan Sandi Husada, 14(1), pp. 201–210. doi: https://doi.org/10.35816/jiskh.v14i1.1282.

Jemberie, M. M., Zewdu, M. and Rade, B. K. (2024) ‘Husbands’ knowledge and involvement in sexual and reproductive health rights of women in Bahir Dar City, Northwest Ethiopia: a community-based study’, Frontiers in Public Health, 12, p. 1359756. doi: https://dx.doi.org/10.3389/fpubh.2024.1359756.

Kaak, K., Crebessa, R. and Zite, N. (2025) ‘Permanent Contraception: Epidemiology and Access’, Obstetrics and Gynecology Clinics of North America, 52(2), pp. 317–330. doi: https://doi.org/10.1016/j.ogc.2024.12.007.

Karim, S. I. et al. (2021) ‘Men’s knowledge, attitude, and barriers towards emergency contraception: A facility based cross-sectional study at King Saud University Medical City’, PloS one, 16(4), p. e0249292. doi: https://dx.doi.org/10.1371/journal.pone.0249292.

Kassim, M. and Ndumbaro, F. (2022) ‘Factors affecting family planning literacy among women of childbearing age in the rural Lake zone, Tanzania’, BMC public health, 22(1), p. 646. doi: https://dx.doi.org/10.1186/s12889-022-13103-1.

Kolozali, Ş. et al. (2024) ‘Explainable early prediction of gestational diabetes biomarkers by combining medical background and wearable devices: A pilot study with a cohort group in south africa’, IEEE Journal of Biomedical and Health Informatics, 28(4), pp. 1860–1871. doi: https://dx.doi.org/10.1109/JBHI.2024.3361505.

Lozano-Ortega, G. et al. (2025) ‘Medicaid reimbursement policies for long-acting reversible contraceptives immediately postpartum: A systematic literature review’, Public Health in Practice, 10, p. 100680. doi: https://doi.org/10.1016/j.puhip.2025.100680.

Maqsood, S. et al. (2021) ‘Determinants of overall knowledge and health behaviours in relation to hepatitis B and C among ever-married women in Pakistan: evidence based on Demographic and Health Survey 2017–18’, BMC Public Health, 21(1), p. 2328. doi: https://dx.doi.org/10.1186/s12889-021-12406-z.

McCoy, C. F. et al. (2026) ‘Advances in drug-releasing vaginal rings’, Journal of Drug Delivery Science and Technology, 115, p. 107813. doi: https://doi.org/10.1016/j.jddst.2025.107813.

Petropoulos, T. et al. (2024) ‘Fibromuscular Dysplasia: A Focused Review for the Cardiologist’, CJC Open, 6(11), pp. 1274–1288. doi: https://doi.org/10.1016/j.cjco.2024.07.014.

Sanhueza, A. et al. (2026) ‘Wealth-based inequalities in family planning and perinatal coverage among adolescent and young women: analyses of national surveys from Latin America and the Caribbean’, The Lancet Regional Health - Americas, 53, p. 101318. doi: https://doi.org/10.1016/j.lana.2025.101318.

Sarfraz, M. et al. (2023) ‘“The wife should do as her husband advises”: Understanding factors influencing contraceptive use decision making among married Pakistani couples—Qualitative study’, PLOS one, 18(2), p. e0277173. doi: https://dx.doi.org/10.1371/journal.pone.0277173.

Shardell, M., Chen, C. and McCoy, R. G. (2024) ‘Doubly robust causal modeling to evaluate device implantation’, JAMA internal medicine, 184(7), pp. 834–835. doi: https://dx.doi.org/10.1001/jamainternmed.2024.1181.

Smith, A. K., Bhullar, S. and Vash-Margita, A. (2026) ‘Endometriosis in adolescents: A state-of-the-art review’, Best Practice & Research Clinical Obstetrics & Gynaecology, 105, p. 102706. doi: https://doi.org/10.1016/j.bpobgyn.2026.102706.

Westerman, C. et al. (2024) ‘Predictors of sexual and reproductive health knowledge and utilization of services among adolescents in Ghana’s Adaklu district’, Ghana Medical Journal, 58(1), pp. 60–72. doi: https://dx.doi.org/10.4314/gmj.v58i1.9.

Zhao, Y. et al. (2025) ‘Stage-specific association between unintended pregnancy and perinatal depression and the modifying roles of socioeconomic status: A longitudinal cohort study in China’, Journal of Affective Disorders, 386, p. 119478. doi: https://dx.doi.org/10.1016/j.jad.2025.119478.