The Relationship Between Service Readiness and Injection
Contraceptive Acceptor Motivation in Compliance with Revisits at
the Beginning of the COVID-19 Pandemic
Wulan Tertiana S.
a
, Ni Kadek Neza Dwiyanti
b
and Ni Wayan Sri Rahayuni
c
Bachelor of Midwifery Program, Faculty of Health, Institute of Technology and Health Bali, Bali, Indonesia
Keywords: Service Readiness, Injection Contraceptive Acceptor Motivation, Revisits, COVID-19 Pandemic.
Abstract: The COVID-19 pandemic has impacted the continuity of health services, especially contraceptive service
facilities. The purpose of this study was to examine the relationship between service readiness and injection
contraceptive acceptor motivation in compliance with revisits at the beginning of the COVID-19 pandemic.
This was an observational analytical study with a cross sectional design. The results of the study found that
of the 82 respondents in five contraceptive service facilities, as many as 61 (74.4%) respondents said
contraceptive service facilities were prepared in providing contraceptive services, as many as 71 (86.6%)
respondents had high motivation, and as many as 72 (87.8%) respondents were compliant in revisiting in the
early days of the COVID-19 pandemic. In conclusion, there was a relationship between preparedness of
services in providing injectable contraceptive services and high motivation to re-inject according to a
predetermined schedule.
1 INTRODUCTION
The increasing population is one of the global
problems that have arisen throughout the world. A
large population that is unaccompanied by adequate
quality will have an impact on development, causing
difficulties for the government in increasing
economic growth and national development. The
Central Bureau of Statistics found that one problem
that occurs in Indonesia is the relatively high
population growth. The results of the 2020 population
census found that the total population in Indonesia
was 270.20 million people. This number has
increased by 32.56 million compared to the results of
the 2010 population census with a population growth
rate of 1.25%. The growth rate is determined by birth
and death. However, with improvements in health
services, the number of deaths decreased, while the
number of births increased, causing a population
explosion.
According to the World Health Organization, the
contraceptive use has increased, especially in Asia,
a
https://orcid.org/0000-0003-3568-1232
b
https://orcid.org/0000-0002-0715-2811
c
https://orcid.org/0000-0003-3042-8799
from 60.9% to 61.6%. High population growth will
hamper the development pace, meaning efforts to
reduce the number of births need to be increased. The
government has carried out several programs, one of
which is the family planning (KB) program. The
population and family planning agency (BKKBN)
seeks to reduce the rate of population growth with
family planning methods or the use of contraceptives.
Coronavirus disease 2019 (COVID-19) is an
infectious disease caused by severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2) which
causes inflammation of the pulmonary organs.
COVID-19 transmission occurs through contact with
droplets in the respiratory tract of sufferers. COVID-
19 symptoms vary, but include runny nose, cough,
sore throat, headache, muscle aches, loss of sense of
smell, and so on (Huang et al., 2020).
The International Professional Practices
Framework (IPPF) found that during the COVID-19
pandemic, health service activities were not optimal.
The COVID-19 pandemic has also impacted family
planning services. This happened due to limited
116
S., W., Dwiyanti, N. and Rahayuni, N.
The Relationship Between Service Readiness and Injection Contraceptive Acceptor Motivation in Compliance with Revisits at the Beginning of the COVID-19 Pandemic.
DOI: 10.5220/0012023900003576
In Proceedings of the 2nd Bali Biennial International Conference on Health Sciences (Bali BICHS 2022), pages 116-123
ISBN: 978-989-758-625-5
Copyright
c
2023 by SCITEPRESS – Science and Technology Publications, Lda. Under CC license (CC BY-NC-ND 4.0)
supplies of birth control equipment as all health
service resources were concentrated on supporting
the handling of COVID-19 (Nanda et al., 2020).
In addition, health services, especially family
planning services during the COVID-19 pandemic,
experienced obstacles due to limited access for the
community, especially among couples of
childbearing age (PUS) to health facilities. This was
done to reduce the spread of the COVID-19 virus.
The addition of new COVID-19 cases showed a
tendency for cases to increase from time to time. An
increase in transmission occurred among health
workers, even leading to death. The COVID-19
pandemic that occurred also caused several other
impacts, such as limited access to health services,
decreased group activities, and decreased operational
mechanisms in the health line which might affect
service readiness and family planning membership
(Munawar, 2020).
Injectable contraception is a method of
contraception to prevent pregnancy by injecting KB
acceptors. The factors that influence the lack of
adherence to injectable contraception are the mothers’
level of knowledge, attitude, husband's support, and
other supporting factors. Positive attitudes about
family planning, for example, good knowledge, will
result in acceptor compliance in undergoing injection-
based family planning programs. Family planning
services must be improved to achieve the goal of a
healthy, prosperous family. The COVID-19 pandemic
in Indonesia has had an impact on health, especially
women's reproductive health services. Reproductive
health services cannot be postponed, including
services for pregnant women, childbirth, postpartum,
infants, as well as family planning services. At the
beginning of the pandemic, most acceptors
experienced changes in reproductive health
examinations (Mandira et al., 2020).
The pandemic conditions demanded
comprehensive efforts in case management and efforts
to break the chain of transmission. Judging from the
escalation of cases and the expansion of affected areas,
the government issued Government Regulation
Number 21 of 2020 concerning Large-Scale Social
Restrictions (PSBB) in the framework of accelerating
the handling of COVID-19 and Presidential Decree
Number 11 of 2020 concerning Establishing a Public
Health Emergency for COVID-19.
The focus of handling the COVID-19 pandemic is
efforts to break the chain of transmission by
empowering the community to voluntarily and
obediently carry out government recommendations
such as wearing masks, washing hands diligently with
soap and running water, staying at home, and social
distancing if you need to leave the house. Limited
access to health facilities and family planning service
providers who do not have the necessary facilities to
prevent COVID-19 transmission has had an impact
on family planning services (Suprayitno et al., 2020).
Research by Natalia (2014) on the Relationship
between Knowledge and Compliance of Mothers
Using Contraceptive Injections Depo Medroxy
Progesterone Acetate (DMPA) in the Work Area of
the Ranotana Weru Health Center, Kec. Wanea
Manado found that the higher or better a person's
knowledge, the better their compliance in making
visits. This research was conducted on DMPA
injectable contraception users. As much as 70% of
respondents (42 respondents) were in the good
knowledge category and 30% (18 respondents) in the
lesser knowledge category. As for compliance with
repeat visits by respondents using the DMPA
injection contraception, 61.7% (37 respondents) were
in the compliant category, and 38.3% (23
respondents) were in the non-compliant category. The
study found that there was a relationship between
knowledge and mothers’ adherence in using the
DMPA injection contraception (p = 0.000 <0.05).
This is in line with research conducted by Noriani
(2019) concerning the Relationship between
Knowledge and Motivation of 3-Month Injecting KB
Acceptors and Compliance with Repeat Visits at
BPM Koriawati. Based on the results of the study, it
was found that out of 19 respondents, 52.6% (10
respondents) had high motivation, 63.2% (12
respondents) had high knowledge, and 63.2% (12
respondents) had compliance in making repeat visits.
The study found that there was a relationship between
knowledge about the use of three-month family
planning injection contraception and increased
awareness to carry out re-injections according to a
predetermined schedule (Natalia et al., 2014).
Repeat visits by family planning participants (old
acceptors) and/or visits by new participants (new
acceptors) are efforts to obtain contraceptive services
aimed at preventing pregnancy. The use of
contraception is not only for couples of reproductive
age (PUS) who plan to space births, but also for those
who intend to delay pregnancy and/or end pregnancy
or fertility. Visits by old acceptors or new acceptors
require leaving the house and meeting with health
workers to get contraceptive services. Meanwhile, the
spread of the virus, which was very fast and difficult
to detect, caused many couples who wished to have
family planning to delay going to health facilities in
fear of contracting COVID-19. The technical
instructions from primary healthcare center services
during the COVID-19 pandemic towards couples of
The Relationship Between Service Readiness and Injection Contraceptive Acceptor Motivation in Compliance with Revisits at the
Beginning of the COVID-19 Pandemic
117
reproductive age consisted of 1) family planning
services at primary healthcare centers can be provided
by appointment to acceptors who have complaints,
IUD/implant acceptors that have expired, or injection
acceptors who arrive on schedule; 2) family planning
services for IUD/implant/injection acceptors that
cannot be controlled by health workers are carried out
in coordination with PLKB and cadres to ask for help
in giving condoms; 3) family planning services for
birth control pill acceptors are carried out in
coordination with birth control clinicians and cadres
to ask for assistance in administering birth control
pills; 4) provision of communication, information,
and educational materials (IEC) as well as counseling
related to reproductive health and family planning can
be carried out using online media or telephone
consultations; 5) all couples were encouraged to
postpone pregnancy while continuing to use
contraception in the COVID-19 pandemic by
increasing the delivery of information/IEC to the
public. The issuance of these technical guidelines
caused discomfort in the community because it
required an adaptation and acceptance stage.
Basically, individuals needed time to adapt until they
reached the acceptance stage, and then there was a
change in behavior by complying with existing rules,
especially in family planning services (RI, 2020).
The pandemic, as is currently happening, has had
several effects, especially on the family planning
program, namely 1) a decrease in family planning
participants due to limited access to services and
pattern changes; 2) a decrease in activity in activity
groups (BKB, BKR, BKL, PIK –R, and UPPKS); and
3) reduction of rational operating mechanisms in field
lines including KB Village (BKKBN, 2020).
Ultimately, this will affect family planning services
and membership.
Based on a preliminary survey conducted in Bali
Sadhar Utara, Kec. Banjit, Kab. Way Kanan,
Lampung, Indonesia obtained information that
contraceptive service visits by acceptors had
decreased at the start of the COVID-19 pandemic.
Based on this background, this study intended to
conduct research on "The Relationship Between
Service Readiness and Injection Contraceptive
Acceptor Motivation in Compliance with Revisits at
the Beginning of the COVID-19 Pandemic".
Based on the background, the formulation of the
problem in this study can be summarized as "what is
the relationship between service readiness and
injection contraceptive acceptor motivation in
compliance with revisits at the beginning of the
COVID-19 pandemic?". The purpose of this study
was to determine the relationship between service
readiness and injection contraceptive acceptor
motivation in compliance with revisits at the
beginning of the COVID-19 pandemic.
2 MATERIAL AND METHOD
This study was conducted using the correlation
analysis method to determine repeat visits by
injection contraceptive acceptors at the beginning of
the COVID-19 pandemic. The research was
conducted in North Bali Sadhar, Kec. Banjit, Kab.
Way Kanan, Lampung, Indonesia from March to
April 2020. The population in this study were
injection family planning acceptors who made repeat
visits. The sample in this study consisted of 82
women who revisited for injectable contraceptives
from March to April 2022, selected using total
sampling.
The data were collected by distributing
questionnaires to injection family planning acceptors
who made repeat visits to five healthcare facilities.
Data were collected using a questionnaire packaged
on Google Forms and distributed via WhatsApp
(WA). Respondents filled out questions or statements
and then submitted. Data in the form of responses to
the Google Form were processed using frequency
distribution, and then analyzed quantitatively using
tables. The data were analyzed using the Chi-square
test.
3 STATISTICS
Statistical analysis was performed using SPSS
Statistics for Windows (Version 23, IBM enterprise).
The independent variable in this study was service
readiness in the early days of the COVID-19
pandemic, while the dependent variable in this study
was the motivation of injection contraceptive
acceptors in complying with repeat visits. The data
analysis used in this study was the Chi-square test.
The Chi-square alternative test stated that if the
expectation value was below 5, it was more than 20%.
A p-value of less than 0.05 was considered
significant.
4 RESULTS
Based on research conducted at five PMB Bali Sadhar
Utara in March to April 2020 involving 82
respondents regarding the relationship between
Bali BICHS 2022 - The Bali Biennial International Conference on Health Sciences
118
service readiness and injection contraceptive acceptor
motivation in compliance with revisit at the beginning
of the COVID-19 pandemic, the results are presented
in the following table:
Table 1: Respondents’ Characteristics.
Characteristics Fre
q
uenc
y
Percent
Age
< 20 years 4 4.89
20
–
35 years 55 67.07
> 35
y
ears 23 28.04
Educational Level
Basic Education 8 9.75
Secondary
Education
64 78.04
Tertiar
y
Education 10 12.21
Parit
y
Primiparas 66 80.48
Multiparas 14 17.07
Grande
Multiparas
2 2.45
Total 82 100
Table 1 shows that respondents were mostly 20-
35 years old, with 55 in this age range (67.07%), 23
aged over 35 years (28.04%), and four aged below 20
years (4.89%). In the table of educational
characteristics, most of the respondents went through
secondary education, amounting to 64 (78.04%)
respondents, while 10 had undergone tertiary
education (12.21%), and eight had completed basic
education (9.75%). Meanwhile, in terms of parity, 66
respondents were primiparas (80.48%), 14 multiparas
(17.07%), and two grande multiparas (2.45%).
Table 2: Service Readiness in the Early Period of the
COVID-19 Pandemic.
Service Readiness Fre
q
uenc
y
Percent
Read
y
61 74.4
Not Read
y
21 25.6
Total 82 100
In Table 2, it was found that service readiness
during the early days of the COVID-19 pandemic was
mostly in the ready category with 61 respondents
(74.4%), while the remaining 21 (25.6%) were not
ready.
Table 3: Injection Contraceptive Acceptor Motivation.
Acce
p
tor Motivation Fre
q
uenc
y
Percent
Hi
g
h 71 86.6
Low 11 13.4
Total 82 100
In Table 3, it was found that injection
contraceptive acceptors were mostly highly
motivated with as many as 71 reports (86.6%), while
the remaining 11 had low motivation (13.4%).
Table 4: Visit Compliance.
Visit Com
p
liance Fre
q
uenc
y
Percent
Compliant 72 87.8
Not Compliant 10 12.2
Total 82 100
Table 4 shows that the compliant proportion in
conducting visits amounted to 72 respondents
(87.8%), while 10 did not comply (12.2%).
Table 5: Visit Compliance*Acceptor Motivation
Crosstabulation.
Acceptor Motivation
TotalHigh Low
Visit
Compliance
Compliant Count 71 1 72
% within
Compliant
98.6% 1.4% 100%
Not
Compliant
Count 0 10 10
% within
Not
Compliant
0.0% 100% 100%
Total Count 71 11 82
% within
Visit
Compliance
86.6% 13.4% 100%
Table 5 shows the distribution of repeat visit
adherence against respondent motivation. From the
research results, it was found that 98.6% of
respondents who obeyed in making repeat visits had
high motivation to do so, while respondents who were
disobedient in making repeat visits had low
motivation
.
Table 6: Visit Compliance*Service Readiness
Crosstabulation.
Service Readiness
Total
Ready Not
Ready
Visit
Compliance
Compliant Count 61 11 72
% within
Compliant
84.7% 15.3% 100%
Not
Compliant
Count 0 10 10
% within
Not
Compliant
0.0% 100% 100%
Total Count 61 21 82
% within
Visit
Compliance
74.4% 25.6% 100%
Table 6 shows the distribution of repeat visit
adherence against service readiness. From the results
of the study, it was found that 84.7% of contraceptive
service facilities had good readiness to provide
services at the start of the COVID-19 pandemic.
Meanwhile, the remaining contraceptive service
The Relationship Between Service Readiness and Injection Contraceptive Acceptor Motivation in Compliance with Revisits at the
Beginning of the COVID-19 Pandemic
119
facilities lacked preparedness in providing services at
the start of the COVID-19 pandemic.
5 DISCUSSION
The study results are in accordance with the opinion
of Nurjanah (2015), who stated that education is a
process of the changing attitudes and behaviour of a
person or group as well as efforts to mature humans
through teaching and training; thus, the higher a
person's level of education, the more knowledge is
obtained. A person tends to apply their previous
experience to solve the problems they face. The
respondents’ experiences cause them to have good
analytical and synthesis skills. The better the analysis
and synthesis abilities a person has, the better their
level of knowledge (Nurjanah & Puspitaningrum,
2015).
Motivation that exists in a person is a person's
personality that encourages the individual's desire to
carry out certain activities in order to achieve their
goals. Motivation refers to encouragement and effort
to achieve a goal or satisfy one's life needs. A person's
behaviour in complying with every recommendation
from a health professional is influenced by several
factors, including level of knowledge, educational
level, socioeconomic factors, and culture. Besides
that, health facilities, the physical environment, and
intervention or support from health workers also
support and strengthen the formation of one's
behaviour (Suhartatik et al., 2022).
Based on the results of the study, there was a
relationship between service readiness and injection
contraceptive acceptors’ motivation with adherence
to repeat visits at the beginning of the COVID-19
pandemic. Service readiness and acceptor motivation
greatly influenced the success of the family planning
program. In addition, education and reproductive age
were also very influential. The higher a person's
education, the better their knowledge was; conversely
the lower a person's education, the less knowledge
they had.
The tables show that there is a relationship
between service readiness and injection contraceptive
acceptors’ motivation with adherence to repeat visits
at the beginning of the COVID-19 pandemic. This
means that the more prepared contraceptive service
facilities were, the higher a person's motivation was
in complying with making repeat visits according to
schedule at the start of the COVID-19 pandemic.
Compliance was closely related to one's knowledge
or cognition, which is a very important domain in the
formation of one's motivation or actions. There are
three factors that influence behavioral change,
namely predisposing factors, enabling factors, and
reinforcing factors.
This study’s results are in line with research
conducted by Wulan (2022) regarding participation in
the family planning program during the COVID-19
pandemic. The research found that most of the
reproductive age couples in Bali during the COVID-
19 pandemic used injectable contraceptives. Data
obtained from January to April 2020 found that the
non-MKJP method was the most widely used
contraceptive method in Bali at the start of the
COVID-19 pandemic. The non-MKJP method was
chosen because the method was classified as
practical.
This is in line with Bakri’s (2019) research
concerning “Factors Associated with the Selection of
Contraceptive Methods in Women of Reproductive
Age”. Family planning acceptors who had good
knowledge preferred the non-MKJP type of
contraception method. This is because injection
contraception is considered safer, more practical and
has a high effectiveness of 99%. Apart from that,
injection contraception also has another advantage,
namely it does not affect milk production, hence, it is
very good for breastfeeding mothers.
Another study was also conducted by Wulan
(2022) regarding “Education of Family Planning
Programs for Women of Reproductive Age as an
Effort to Suppress Baby Booms during the COVID-
19 Pandemic”. This study found that most women of
childbearing age had insufficient knowledge, with 10
people (1.4%) having sufficient knowledge and 715
having good knowledge (98.6%) about family
planning programs for women of childbearing age.
Providing education about family planning programs
to women of childbearing age as an effort to suppress
baby booms during the COVID-19 pandemic has had
a significant effect on the level of knowledge of
women of childbearing age.
Another study was done by Herowati in 2019
concerning the “Relationship Between Reproductive
Ability, Child Ownership, Place of Residence,
Education and Working Status in Married Women
and Use of Hormonal Contraception”. In this study, it
was found that injectable contraception was more
attractive to family planning acceptors because the
method was considered the easiest. This method is
done by injecting hormonal substances into the body,
meaning that acceptors do not need to visit healthcare
facilities repeatedly (Herowati & Sugiharto, 2019).
Education and socialization for couples of
childbearing age (PUS) about the benefits and
importance of the MKJP method, especially at the
Bali BICHS 2022 - The Bali Biennial International Conference on Health Sciences
120
start of the COVID-19 pandemic, needs to be
improved. Health workers such as doctors and
midwives who had been trained had an important role
or significant influence in increasing knowledge and
understanding of family planning acceptors regarding
participation in MKJP contraception (Huang et al.,
2020; Ramlan et al., 2020)
The decline can be attributed to many family
planning service facilities closing at the start of the
COVID-19 pandemic. During the COVID-19
pandemic, medical personnel were more focused on
handling COVID-19 cases, while family planning
services were not classified as emergencies. Research
conducted by Lindberg (2020) found that access to
health service facilities was very limited and many
residents avoided looking for available service
facilities because of fears that they would be
contaminated with COVID-19. This is in line with
research conducted by Benson (2020). This study
found that one in three women (33%) reported that,
because of the pandemic, they had to postpone or
cancel visits to healthcare providers.
During the COVID-19 pandemic, the BKKBN
has made various efforts to increase family planning
membership. This effort came in the form of family
planning extension workers/field officers assisting
couples of reproductive age virtually by promoting
family planning after childbirth and miscarriages to
avoid forcing couples to return to healthcare facilities
(Ramlan et al., 2020). In addition, these officers
identified recovered COVID-19 patients, who were
then given motivation and could be accepted in
society. Other efforts made were the creation of vlogs
and virtual-based media involving the millennial
generation as an effort to increase family planning
participation (Mandira et al., 2020).
Repeat visits by injection contraceptive acceptors
at the start of the COVID-19 pandemic continued, but
some anxiety occurred during the visits. Family
planning repeat visits are determined by several
things, including access to health workers or officers,
as well as the contraceptive availability. The WHO
declared COVID-19 a global health emergency. The
Indonesian government has declared ait as a non-
natural national disaster. In facing the outbreak, the
Large-Scale Social Restrictions (PSBB) policy was
implemented to prevent COVID-19 transmission.
This has had an impact on the continuity of health
services in the community, including contraceptive
and reproductive health services. Government
policies have implemented social distancing, physical
distancing, and working from home as efforts to
prevent COVID-19 transmission. The COVID-19
pandemic has made it difficult for family planning
acceptors to receive family planning services (Amin
et al., 2022).
Injection contraceptive services at the beginning
of the COVID-19 period were hampered due to
limited family planning equipment supplies as all
health service resources were concentrated on
supporting the handling of the pandemic. The
lockdown measures taken globally in response to
COVID-19 brought major disruptions to the
contraceptive supply chain. Major contraceptive
manufacturers in Asia have had to stop production or
operate at reduced capacity. Personnel and funds for
sexual and reproductive health services in various
countries have been diverted to handling COVID-19.
This causes women and girls to be unable to access
contraception and other sexual and reproductive
healthcare.
The provision of sexual and reproductive health
services has also been affected by infection
prevention measures, the use of personal protective
equipment (PPE), and including access to health
workers. Even though contraception is available and
continues to be provided through clinics or
pharmacies, the impact of COVID-19 on the lives of
women and girls has limited access to contraceptive
services. Quarantine measures and mobility
restrictions will affect the ability of women and girls
to seek contraceptive services.
Financial insecurity and additional parenting
burdens caused by lockdown measures will be a
further obstacle. If women, girls, and marginalized
communities are unable to access contraceptive
services in this crisis, there will be an increase in
unwanted and forced pregnancies, an increase in
sexually transmitted infections, including HIV, and
ultimately, a sharp increase in unsafe abortions. The
impact on the lives of women and girls now, and after
this crisis, will be dire (Aly et al., 2020; Nanda et al.,
2020).
Access to healthcare facilities is very limited and
people are starting to avoid going to health facilities
because of fears of contracting COVID-19. One in
three women (33%) reported that due to the
pandemic, they had to postpone or cancel visits to
healthcare providers (Benson et al., 2020; Lindberg et
al., 2020).
This condition has also occurred in DIY, where
since the COVID-19 pandemic, the number of active
family planning participants has decreased. The
decrease in active family planning participants in
March to April 2020 for the injection and pill
contraceptive types amounted to 0.5 and 0.4 percent,
respectively. The number of new family planning
participants also showed a decline in March and April
The Relationship Between Service Readiness and Injection Contraceptive Acceptor Motivation in Compliance with Revisits at the
Beginning of the COVID-19 Pandemic
121
2020, and there was a tendency to decrease in the
number of new family planning participants in all
districts/cities. More new family planning
participants in DIY used non-MKJP contraception
(58.91% in April 2020). Meanwhile, unmet needs for
family planning tended to continue to increase, from
10.2% in January 2020 to around 10.36% in April
2020. The number of new family planning
participants appeared to have decreased in March-
April 2020 along with the increase in the number of
positive COVID-19 cases in DIY (Witono &
Parwodiwiyono, 2020).
The BKKBN estimated that the increase in the
number of unplanned pregnancies during the
COVID-19 pandemic reached 420 thousand. The
results of a survey conducted by DKT Indonesia
together with independent research institutions to
measure the effect of the pandemic on contraceptive
consumption patterns, especially the injection and pill
contraceptive methods in the DKI Jakarta area and its
surroundings, found that: (1) 26% of midwives said
that the COVID-19 pandemic had an impact on their
clinic income, while 56% of midwives stated that the
pandemic had no impact on their clinical practice
activities. (2) The number of family planning
injection services in the majority of Independent
Midwife Practices (PMB) has not changed. A small
number of respondents who experienced a decline in
injection services said that this was influenced by
reduced consumer purchasing power, and because
their acceptors were afraid to come to the clinic. (3)
The pattern of demand for injecting contraceptive
services decreased during the PSBB determination
period, but has started to increase in the last one to
two months. In general, there was no drastic change
in method recommendation patterns. (4) Respondents
felt that the pandemic has provided benefits for the
pharmacy business, especially in the product segment
to increase vitality and endurance. Meanwhile, 34%
of respondents stated that there was a decline in sales
during the PSBB period. (5) As many as 40% of
respondents said contraception was one of the most
sought-after items in pharmacies during the
pandemic. (6) There was an increase in the frequency
of sexual activity, especially in the younger age
group. (7) It was necessary to anticipate a decrease in
family planning participation due to reduced
purchasing power, as well as distribution and service
patterns that can reduce the risk of COVID-19
transmission, both for acceptors and for service
providers, including pharmacists (Suprayitno et al.,
2020).
In this pandemic, it is hoped that couples of
childbearing ages, especially those with 4 Too (4T),
postpone their pregnancies first and health workers
will continue to monitor them in using contraception.
When facing the COVID-19 pandemic, midwife
services, especially women's reproductive health
services, were still being carried out by applying the
principles of infection control prevention and
physical distancing.
The family planning service guidelines state that
the messages that must be conveyed to the
community are: (1) Postpone pregnancy until the
pandemic conditions are over. (2) Family planning
acceptors should not come to health workers, except
for those who have complaints, with the condition
that they agree with the health officer first. (3) For
acceptors of IUD/implant contraception that have
expired, if it is not possible to come to the health
worker, they can use condoms which can be obtained
by contacting PLKB officers or cadres by phone. If
unavailable, they can use traditional methods
(periodic abstinence or interruption of intercourse).
(4) For injection contraceptive acceptors, they are
expected to come to the health worker according to
schedule by making an appointment beforehand. If
this is not possible, they can use condoms which can
be obtained by contacting PLKB officers or cadres by
phone. If unavailable, they can use traditional
methods (periodic abstinence or interruption of
intercourse). (5) For contraceptive pill users, it is
hoped that they can contact PLKB officers, cadres, or
health workers via telephone to get birth control pills.
(6) Mothers who have given birth should immediately
use birth control postpartum (KBPP). (7)
Communication, information, and education (IEC)
materials, as well as the implementation of
counselling related to family planning can be
obtained online or via telephone consultation.
6 CONCLUSION
In conclusion, there was a relationship between
preparedness of services in providing injectable
contraceptive services and high motivation to re-
inject according to a predetermined schedule. Thus,
the more prepared the contraceptive service facility in
providing services and the higher acceptors of
injectable contraceptives’ motivation, the higher their
compliance in revisiting. It is best to maximize in-
depth socialization regarding family planning
guidelines during the COVID-19 pandemic to
encourage acceptors to follow the recommendations
written in the family planning guidelines.
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122
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The Relationship Between Service Readiness and Injection Contraceptive Acceptor Motivation in Compliance with Revisits at the
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