Factors That Influence The Couples Of Childbearing Age On Selection Of Iud Contraception

The low use of IUD


Introduction
Population problems today are very important which receive serious attention and discussion from interested people and population experts. The National Family Planning Movement has been successful in encouraging improvements as well as communities in building small families that are increasingly independent. there are regions where family planning activities are already high, while other regions are still low in using the Long-Term Contraception Method (MKJP) (MOH, 2014). The low use of IUD (Intrauterine devicecontraception is)due to ignorance of acceptors about the advantages of the method. Ignorance of acceptors about the advantages of IUD contraceptive methods due to incomplete information from family planning services (Muhajirah, 2014). In general, people prefer non-MKJP contraceptives such as birth control pills and injections, and MKJP family planning methods such as Intra Uterine Devices (IUD), Implants, Male Operative Medicine (MOP), and Women's Operative Medicine (MOW) are less desirable.
WHO data in 2010 shows that more than 150 million women use an IUD. Nearly 40% of them are in China. Only 6% in developed countries and 0.5% in sub-Saharan Africa. IUD users in Indonesia account for 22.6% of all users of the contraceptive method. The results of the 2012 Indonesian Demographic and Health Survey (IDHS), the use of new contraceptives reached 62% (58% using modern contraception) and 4 percent using traditional contraception. The community still uses a lot of short-term contraception, even though the short-term contraceptive device has a high risk of failure. Copper or hormone-coated IUDs do not cause side effects such as pelvic inflammatory disease (PRP) or do not have the risk of smelling effects related to contraceptive methods (Widrianto, 2018). Saragih's research results showed that the majority of respondents aged over 35 years (61.7%), had high school education (61.7%), had 1-2 children (51.1%), had insufficient knowledge about IUDs (80, 9%) stated that side effects were one of the factors that caused respondents not to use an IUD (59.6%).
Ginting's research shows that the dominant factor associated with contraceptive use is good mother's knowledge of contraception, but 48.5% of them have children ≥3 people (Ginting, 2010).
The results of the preliminary study in the Lakea Kec Lakea Community Health Center Working Area in Buol Regency found that there were 1774 EFAs in 2017, and 30 IUD participants, MOW (Women Operative Medical) 14 KB participants, MOP (Male Operative Medical) 9 KB participants, and IUDs. and PIL 607, injecting 953 KB participants. The results of the preliminary study in the last 2 months (November and December 2017) were obtained on average PUS who visited the Lakea Community Health Center Working Area in Lakea, Buol District, as many as 33 EFAs. The results of the PUS preliminary study used an IUD and were obtained, 5 of which had sufficient knowledge about the benefits and use of IUDs, and 4 of them had good family support that was proven by families to find information and support to get the best family planning.
IUDs are small contraceptive devices, there are homonal and non hormonal, often in the form of 'T', containing copper or levonorgestrel, which is inserted into the uterus. This tool is one form of reversible longterm contraception which is the most effective birth control method. The advantage of using an IUD is the effective prevention of pregnancy for at least 10 years, does not interfere with sex with a partner, is not affected by drugs, can be fertile again after the IUD is issued, does not affect the amount and quality of breast milk, can prevent pregnancy outside the womb. IUD side effects are pain, menstrual disorders, uterine perforation, loose spirals, pelvic inflammation, cysts, and hormonal effects (BKKBN, 2013). IUD contraindications that have never given birth, an estimate of pregnancy, internal uterine abnormalities such as: abnormal bleeding from the genitals, bleeding in the cervix, and uterine cancer, unknown vaginal bleeding, suffering from genital infections (vaginitis, cervicitis) ), the last three months have experienced or often Factors that influence EFA in IUD family planning include age, knowledge, and family support. Age of family planning participants influenced the choice of contraception due to experience in using contraception and also supported by information during previous pregnancies, the age of family planning participants was dominant at the age of 20-40 years after they had children. Knowledge plays an important role because knowledge is one of the factors in decision making for family planning use. Knowledge is the result of knowing what happens after people do sensing a particular object and is a very important domain for the formation of one's actions. The level of sufficient knowledge about IUD contraception which includes understanding, benefits, side effects, the right time for the installation and myth of KB is the basis for married couples so that more and more people are expected to choose the IUD method (BKKBN, 2013). The family has a family role that has an important role and has the right to support or not support what is done by the wife so that family support in the use of IUD contraceptive methods is very necessary. With the presence of family support regarding contraception used by wives, the use of IUDs can continue which is an attempt to reduce fertility. Often the absence of a husband's involvement results in a lack of information a husband has regarding reproductive health, especially contraception (BKKBN, 2013). Muhajirah argued that married couples motivated to use contraception were caused by various factors including age, education, knowledge, number of children and the cultural and economic conditions of the community. The use of contraception in married women in the age group 15-19 years and 45-49 years is lower than those aged 20-44 years. EFA tends to use modern short-term contraceptives such as injections and birth control pills, while older people tend to use long-term contraception such as IUD (Intra Uterine Device) and female sterilization (BKKBN, 2013). Factors that influence EFA women in the use of IUD family planning are factors of mother's knowledge, age, maternal attitude factor, husband's participation factor and family planning service factor (Nasution, 2010). The questionnaire in the study was tested for validity using Pearson test and reliability using alpha crombac test, before being used to measure the variables studied. Based on the background above, the researcher is interested in researching Factors Affecting Pus on Contraceptive Selection of IUDs in the Work Area of Lakea Health Center in Lakea, Buol District.

Method
design used in the study wasanalytic cross-sectional. The population is all fertile age couples. The sample size is 32 respondents using Simple Random sampling technique. Independent variables of the study were age, knowledge, and family support. The dependent variable is the selection of an IUD. Data were collected using a questionnaire, then the data were analyzed usingtest logic regression, with a significance level of α ≤ 0.05.

Results
The results of the study found respondents' characteristics and displayed in the frequency distribution table below: The results of the study found that most of the respondents aged 20-35 years were 18 respondents (48.6%). The results of the study showed that most of the respondents had high school education as many as 19 respondents (59.4%). The results of the study showed that at most 19 respondents did not work (59.4%). The results of the study showed that most respondents had sufficient knowledge as many as 15 respondents (46.9%). The results of the study showed that more than half of the respondents had an assessment of moderate family support by 15 respondents (46.9%). The results of the study showed that at most 22 respondents used in addition to the IUD (22%). The results of the study showed that most respondents used other than IUD with knowledge enough 12 respondents (37.5%). The results of the study showed that most respondents used other than IUDs with moderate family support 13 respondents (40.6%). p-ISSN: 2667-1609  The results of the study showed that most respondents had sufficient knowledge with Sufficient family support as many as 12 respondents (37.5%). The results of the study were obtained that most respondents have ages 20-35 years with good knowledge as many as 9 respondents (28.1%). The results of the study were obtained that most respondents have ages 20-35 years with moderate family support of 10 respondents (31.3%). tatistical test on this new study used regression, logistics the test results listed in the table above. The results of the statistical test in this study indicate that, the significance value p value of the of the wald test is 0.039, which means that each variable has a partial effect. The results of the next statistical test found that p <a with a value of <0.05, this can be seen in Overall Statistics with a significance value of (p) 0.005 which means that there are variables that affect the selection of IUD KB, and when viewed (p) for each independent variable, the age variable has a value (p) of 0.004, knowledge has a value (p) of 0.002, the family support variable has a value (p) of 0.001. Which means that age, knowledge and family support factors influence fertile couples on IUD contraceptive selection in the Lakea Community Health Center Working Area in Lakea, Buol District. And the most influential is the factor of family support for fertile couples on IUD contraceptive selection in the Lakea

Discussion
The results of the study found that more than half of the respondents used as many as 22 respondents (22%), and at least used in addition to the IUD as many as 10 respondents (31.3%). The results of the next statistical test found that p <a with a value of <0.05, this can be seen in Overall Statistics with a significance value of (p) 0.005 which means that there are variables that affect the selection of IUD KB, and when viewed (p) for each independent variable, the age variable has a value (p) of 0.004, knowledge has a value (p) of 0.002, the family support variable has a value (p) of 0.001. Which means that age, knowledge and family support factors influence fertile couples on IUD contraceptive selection in the Lakea Community Health Center Working Area in Lakea, Buol District. And the most influential is the factor of family support for fertile couples on IUD contraceptive selection in the Lakea Community Health Center Working Area in Lakea, Buol District.
Fertile Age Couples (PUS) are married couples whose wives are between the ages of 15 and 49 (Kurniawati, 2014). Family planning has a broad connotation. In this term additional consideration is given to physical, social, psychological, economic and religious factors that govern family attitudes while influencing family decisions in determining family size, distance between children, and selection and use of pregnancy control methods. EFA who is a family planning participant is a child of fertile age whose husband / wife is using or using one of the tools or methods of modern contraception in the year of the family data collection. (BKKBN, 2013). Factors that influence EFA in the selection of IUD family planning include age, the age of family planning participants is dominant at the age of 20-40 years after they have children. The age of a person is getting higher, it is expected that the information and experience of pregnancy and pregnancy planning will be better, according to the results of cross tabulation, many respondents have good knowledge on respondents aged 20-35 years. The current information is easily accessible and easy to access so knowledge can be easily received and obtained.
Based on the results of the study found knowledge affects the selection of IUDs. Most respondents have high school education. knowledge is the result of knowing what happens after people have sensed a particular object and is a very important domain for the formation of one's actions (Notoatmodjo, 2013). An adequate level of knowledge about IUD contraception which includes understanding, benefits, side effects, the right time for the installation and myths of family planning is the basis for married couples so that more and more people are expected to choose the IUD method.
The results showed that age, knowledge and family support factors influence fertile couples on IUD contraceptive selection in the Lakea Community Health Center Working Area in Lakea, Buol District. Family support has a family role that has an important role and has the right to support or not support what is done by the wife so that family support in using IUD contraceptive methods is very necessary. With the presence of family support regarding contraception used by wives, the use of IUDs can continue which is an attempt to reduce fertility. In accordance with what was disclosed by Fitriani (2015) who stated that the selection of IUDs was determined, one of which was family support and the age of concepts. Often the absence of a husband's involvement results in a lack of information a husband has regarding reproductive health, especially contraception (BKKBN, 2013 (Nasution, 2010). EFA tends to use contraceptives other than IUDs because there are many choices in determining suitable family planning according to EFA conditions. There are EFAs who have insufficient knowledge and choose IUD family planning, this is probably due to information or following a partner of previous fertile age who is a neighbor or relative of the respondent. EFA is expected before deciding in the use of contraception, it must look for information about contraception that is in accordance with the conditions and can be discussed with the family in deciding. Couples of childbearing age must be able to increase their knowledge, support their families so that family quality will improve and can prevent unplanned pregnancies, and ultimately family quality will increase.

Conclusion
1. The results of the study found that most of the respondents aged 20-35 years were 18 respondents (48.6%). 2. The results of the study found that most respondents had sufficient knowledge as many as 15 respondents (46.9%). 3. The results of the study found that more than half of the respondents had an assessment of moderate family support of 15 respondents (46.9%). 4. The results of the study showed that most respondents used in addition to the IUD as many as 22 respondents (22%).