Perceptions of Contraception and Patterns of Switching Contraceptive Methods Among Family-planning Acceptors in West Nusa Tenggara, Indonesia

OBJECTIVES

The perceptions of family-planning (FP) acceptors regarding contraception influence the reasons for which they choose to switch their method of contraception. The objective of this study was to analyze the perceptions of contraception and rationales for switching contraceptive methods among female FP acceptors in West Nusa Tenggara, Indonesia.

METHODS

This study involved the analysis of secondary data from the Improve Contraceptive Method Mix study, which was conducted in 2013 by the Center for Health Research, University of Indonesia. The design of the study was cross-sectional. We performed 3 stages of sampling using the cluster technique and selected 4819 women who were FP acceptors in West Nusa Tenggara Province, Indonesia as the subjects of this study. The data were analyzed using multiple logistic regression.

RESULTS

The predominant pattern of switching contraceptive methods was switching from one non-long-term method of contraception to another. Only 31.0% of the acceptors reported a rational pattern of switching contraceptive methods given their age, number of children, and FP motivations. Perceptions of the side effects of contraceptive methods, the ease of contraceptive use, and the cost of the contraceptives were significantly associated (at the level of α=0.05) with rational patterns of switching contraceptive methods.

CONCLUSIONS

Perceptions among FP-accepting women were found to play an important role in their patterns of switching contraceptive methods. Hence, fostering a better understanding of contraception through high-quality counseling is needed to improve perceptions and thereby to encourage rational, effective, and efficient contraceptive use.

Physician-patient interaction satisfaction and its influence on medication adherence and type-2 diabetic control in a primary care setting

INTRODUCTION

Medication adherence has been found to be an important determinant in achieving glycaemic control in Type 2 Diabetes (T2DM) patients. In other patient populations, physician-patient interaction satisfaction was found to influence medication adherence. It is then important to identify if this is also a factor amongst T2DM patients on insulin as poor adherence was associated with increased all-cause mortality.

METHODS

This was a cross sectional study involving 197 T2DM patients on insulin from two government primary health clinics in Gombak. Physician-patient interaction satisfaction was assessed using Skala Kepuasan Interaksi Perubatan (SKIP-11) consisting of 3 subdomains (Distress Relief, Rapport and Interaction Outcome). Medication adherence level was measured using a single item selfreport question. Data analysis for descriptive, inferential and multivariate analysis statistics were performed.

RESULTS

The mean age of the study participants was 57.12 (SD: 9.27). Majority were Malay, female, unemployed with mean BMI of 27.5. Majority reported full adherence (62.9%). High scores in the Interaction Outcome subdomain was associated with better adherence. Factors associated with high scores in this subdomain included patient education level, number of oral hypoglycaemic agent and type of insulin regime taken. This study also found that high scores in the Interaction Outcome domain is associated with lower HbA1c (p<0.05).

CONCLUSION

Physician-patient interaction satisfaction is an important factor in achieving better medication adherence which also leads to better glycaemic control in this group of patients. There is a need to identify strategies to improve satisfaction in this domain to improve patient adherence.

Changing Knowledge and Practices of Mothers on Newborn Care through Mother Class: An Intervention Study in Indonesia

Poor knowledge and practices of newborn care may contribute to high neonatal mortality. This study aims to analyze the effect of prenatal education, namely 'mother class', on knowledge and practices of newborn care among mothers in Tangerang Selatan District, Indonesia. An intervention study with a quasi-experimental design was conducted. Using a questionnaire, 427 mothers were interviewed: an intervention group (n = 214) that attended mother class and a control group (n = 213) that had not. A home visit followed the intervention to assess newborn care practices. Mother class used Maternal and Child Health Handbook as the main reference material. Attending mother class significantly increased knowledge of breastfeeding initiation and hepatitis B immunization (p < 0.05). Mothers in the intervention group had the likelihood of practicing good newborn care compared with the control group (odds ratio: 1.812; 95% confidence interval: 1.235-2.660). Mother class improves knowledge and newborn care practices and strengthens interactions between mothers and health care providers.