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WORKING PAPER
Members:
MEDICAL FACULTY
PATTIMURA UNIVERSITY
AMBON MALUKU
1
FAMILY PLANNING
WORKING PAPER
Members:
MEDICAL FACULTY
PATTIMURA UNIVERSITY
AMBON MALUKU
2
FOREWORD
For that, we don't forget to say thank you to all parties especially:
Which in this case has contributed in the form of material and thought so
that the preparation of this paper runs smoothly. Hopefully this paper can be
useful for all parties, especially for the readers and compilers of this paper.
Group
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TABLE OF CONTENS
TITLE OF PAGE..................................................................................................2
FOREWORD........................................................................................................ 3
TABLE OF CONTENS....................................................................................... 4
CHAPTER I
1.1 Background.......................................................................................................5
1.2 Formulation of the problem...............................................................................6
1.3 Purpose...............................................................................................................6
CHAPTER II
2.1 Definition of the Family Planning.....................................................................7
2.2 The Condition of the Family Planning..............................................................8
CHAPTER III
3.1 Content of Poster 1..........................................................................................16
3.2 Content of Poster 2..........................................................................................18
3.3 Content of Poster 3..........................................................................................18
3.4 Medical Term of The Poster...........................................................................19
CHAPTER IV
4.1 Conslution........................................................................................................24
4.2 Sugestion..........................................................................................................24
BIBLIOGRAPHY
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CHAPTER I
INTRODUCTION
1.1 Background
The International Conference on Population and Development (ICPD) at
Kairopadat 1994 stated that the Family Planning (KB) program needs to cover
reproductive health and reproductive rights by placing consumers as
individuals who have the right to achieve their reproductive goals. The most
basic reproductive rights are the rights of each individual and partner to
determine when to give birth, how many children and the distance of children
born, and efforts to realize these rights through the use of contraception.
Everyone has the right to choose a method of contraception that is safe,
effective, affordable and acceptable (Prawirohardjo et al., 2006). Regarding
the ICPD's objectives, the London Summit on Family Planning 2012 resulted
in a Family Planning 2020 (FP2020) commitment that wanted to fight for all
women to get access to contraception in 2020. Another commitment is to
increase 120 million women in the poorest countries in the world to use
modern contraception for years 2020 and ensure that every individual gets
access to reproductive health services for free in 2030 (Cohen, 2012). In 2015,
64 percent of women of childbearing age in the world had used contraception
(UN, 2015). The use of all methods of contraception in women in Indonesia in
2012 was 62 percent and 58 percent in the use of modern contraception (BPS,
2013). Modern use of contraception has increased in 2015 by 59 percent
(National Population and Family Planning Board of Indonesia (BKKBN) et
al., 2015). The most dominant contraceptive methods used throughout the
world in 2015 are the pill (15 countries), injections (10 countries), IUD (7
countries). Other contraceptive methods such as female sterilization, chakra,
and traditional I PA methods are only used in some countries (UN, 2015). In
Indonesia, in 2012 the most widely used contraceptive methods were pills and
injections each by 14 percent.
Age increases the risk of several diseases and therefore requires a balance
of benefits and new risks regarding the use of contraceptive methods.
Increasing age can increase the risk associated with the use of combination
pills (Baldwin and Jensen, 2013). And women over 35 who don't want to have
children need safe and effective contraception until menopause because this
group will experience increased morbidity and mortality if they are pregnant,
whereas women who smoke should avoid these combination pills. Because
epidemiological studies have reported an increase in myocardial infarction and
an increase in cardiovascular mortality in combination pill users who smoke
and are over 35 years old.
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The family planning program has a very strategic, comprehensive and
fundamental meaning in realizing healthy and prosperous Indonesian people
and has become the responsibility of the central government in synergy with
the district / city government to realize the development of quality human
resources in accordance with RI Law article 78 paragraph 2 .Based on the
description above, researchers are interested in conducting research on family
planning.
1.2 Formulation of The Problem
1.2.1 What the content of poster 1?
1.2.2 What the content of poster 2?
1.2.3 What the content of poster 3?
1.2.4 What the some and meaning of medical term in the poster?
1.3 Purpose
1.3.1 To understand of content in poster 1.
1.3.2 To understand of content in poster 2.
1.3.3 To understand of content in poster 3.
1.3.4 To understand the some and meaning of medical term in the poster.
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CHAPTER 2
LITERATURE REVIEW
Family planning is credited primarily for its role in bringing down the
birth ratesglobally and particularly in developing countries. From 1950 to 2000,
the global fertility has fallen by about half - from five children per woman in
1950-1955 to 2.7 children in 2000-2005 (United Nations, 2005a). However, less
well recognized is the contribution of family planning to the major social change
around the world whereby couples are empowered in regulating their fertility
instead of considering it as a matter of God's will or destiny. Family planning also
has an impact on reproductive health and development, an aspect that is often
glossed over.
Family planning is known to have been practiced for centuries long before
the advent of modern methods of contraception. The earlier methods used by men
and women to regulate their fertility included coitus interrupts (withdrawal of the
penis from the vagina prior to ejaculation), abstinence (abstaining from sex
altogether or around the time of ovulation), herbs and amulets (Planned
Parenthood Federation of America, 2006). The condom appeared in the 17th
century. Modern methods of family planning have a more recent history since
about 1960 when both the oral contraceptive pill and the intrauterine device
became available.
The public health relevance of family planning is enormous. In the
absence of family planning, the level of childbearing will be high resulting in a
greater demand for obstetric and infant/child health services. In such situations
maternal morbidity and mortality will be high. Shorter spacing between births,
because of non-use of family planning methods, is linked with increased risk of
fetal death, low birth-weight, prematurity and of infant and child death. It is
estimated that about one million of the 11 million deaths of children younger than
age five years could be averted annually if there were no inter-birth intervals of
less than two years (Cleland et al., 2006). A highernumber of unintended
pregnancies may occur due to non-use of family planning methods. Many of these
may be terminated unsafely where induced abortion is legally restricted, causing
grave danger to the lives of women and a drain on national health services in
dealing with complications of unsafe abortion. It is therefore rightly stated that
"family planning saves lives".
The social and economic implications of family planning are no less
significant. Family planning provides opportunities to women to pursue studies
and engage in productive activities. In countries with high levels of family
planning use and consequently lowered fertility, savings made in addressing
maternal and child ill-health can be invested in social and economic development
and improving the quality of life of people. The most obvious examples of
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economic prosperity and development, partially as a result of lowered fertility,
include China, Republic of Korea, Singapore and Thailand.
Such major public health and social achievements have recently been
overshadowed by the lack of or lukewarm support for family planning. The
continued preoccupation of the world community with the prevention and
management of the HIV/AIDS epidemic has resulted in the neglect of the growing
demand for family planning. In the era of sexual and reproductive health and
rights, the focus on reproductive health has also raised questions about the place
that family planning holds. These new challenges may impact on the advance of
contraceptive revolution and on the benefits yielded by it.
The main objective of this chapter is to document the progress made in
family planning,globally and by region, to highlight the relevant issues and to
explore linkages toreproductive health. Family planning continues to be central to
achieving reproductive health goals of reducing child mortality, improving
maternal health and combating HIV/AIDS. The provision of quality family
planning would meet most of reproductive health needs and hence the focus of
this chapter. Data sources are first indicated, followed by definitions and
discussion of the key concepts. The chapter then discusses the various aspects of
levels and trends in family planning and the role of family planning in
reproductive health. The conclusions highlight key findings and lists emerging
issues and challenges in family planning and reproductive health.
2.2 The Condition Of Family Planning
2.2.1 The History Of Family Planning Indonesia
In Indonesia, family planning is called Keluarga Berencana (KB),
Keluarga Berencana was established as a government program on June 26, 1970,
together with the formation of a national family planning coordinating body.
According to the 2013 World Population Sheet, Indonesia is the 5th in the
world with an estimated total population of 249 million. Among ASEAN
countries, Indonesia with the largest area of the country remains the country with
the most population, far above the other member countries. With a Fertilization
Number (TFR) of 2.6, Indonesia is still above the ASEAN TFR average of 2.4
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2.2.2 The Condition Of Family Planning In Indonesia
In accordance with RI Law No. 36/2009 on Health, article 78 states that the
government is responsible and guarantees the availability of personnel, service
facilities, tools and medicines in providing quality family planning services that
are safe and affordable by the community.
a. Contraceptive method
b. Health facility
Puskesmas as primary health care facilities are expected to provide the largest
contribution in providing family planning services in the community. However,
since 1997 there has been a shift in the use of contraceptive service facilities by
family planning participants from government services to private services, as
shown in the results of the 1997, 2003 and 2007 IDHS. The tendency for the use
of private service facilities for contraceptive services has consistently increased
from 42% to 63% and then 69%, while in government service facilities it declined
from 43%, to 28% and then 22%. The results of the 2010 Basic Health Research
(Riskesdas) showed that the highest number of people receiving family planning
services in the private sector was the Independent Practice Midwife, which was
52.5%. Government service facilities such as hospitals, puskesmas, pustu and
poskesdes or polindes are used by around 23.9% of family planning participants.
As a result of the Health Facility Research (Rifaskes) 2011, MCH / KB service
activities have been carried out in 97.5% of puskesmas. MCH and KB services
include 6 (six) mandatory health center services, so each health center should
provide these services. However, there are still puskesmas that have not provided
MCH and family planning services, as in Papua Province there are 18.4% of
puskesmas that have not provided MCH and family planning services, West
Papua 5.8%, and Maluku 3.1%. It was also found that 32.6% of the puskesmas
had a special family planning clinic. The highest percentage of puskesmas with a
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special family planning clinic was in DKI Jakarta (66.4%) and the lowest was in
Southeast Sulawesi (12.9%). In urban areas around 43.2% of puskesmas have a
special family planning clinic while in rural areas around 29%. Even though
97.5% of the puskesmas have implemented MCH / KB services, the puskesmas
whose staff received new family planning training was 58% and only 32.2% of
the puskesmas had sufficient resources in the family planning program. The
adequacy of these resources includes service competency, availability of officers
at the puskesmas, availability of guidelines and Standard Operating Procedures
(SPO), and technical guidance.
In the chart above, we can see that the ratio of Non Long-Term Contraception
Method and Long-Term Contraception Method usage is getting higher every year,
or the use of non Long-Term Contraception Method contraception is greater than
the use of Long-Term Contraception Method contraception. Whereas Non Long-
Term Contraception Method Couple Years Protection (CYP) ranging from 1-3
months provides a great opportunity to discontinue using contraception (20-40%).
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Meanwhile CYP from Long-Term Contraception Method which ranges from
3-5 years provides a chance for high survival, but the number of users of this
method is lacking. This might be because the use of this method requires more
complex actions and professional skills of health professionals
Based on the table above we can see that the IUD, which is one of the Long-
Term Contraception Method , causes the least amount of complaints compared to
pills, injections and implants.
2.2.2.3 Impact
a. Knowledge about to use familiy palnning
Family planning methods can be divided into modern and traditional
methods. The modern methods of family planning are sterilization, pills, IUDs,
injections, implants, KB, condoms, intravenous / diaphragm, emergency
contraception and the Lactation Amenorrhoea Method (MAL). Whereas the
traditional method, for example, abstinence periodically and intercourse was
interrupted.
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Knowledge of Family Planning in a Modern Way By age
In the graph above, it can be seen that injections and pills are the most
modern method of family planning that is most known by people in all age
groups, including those at high risk over 35 years. Both types of contraception are
considered less effective in preventing pregnancy. Types of contraception that are
effective for preventing pregnancy for high-risk women are MKJP such as IUDs,
female sterilizers and male sterilizers
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Knowledge of Family Planning in a Modern Way Based on Education
At every level of education, whether those not in school, not graduating from
elementary school, graduating from elementary school, not completing high
school +, or graduating from high school +, the best known methods are injection
and pill. While what is less known, at every level of education is also almost the
same, namely MAL, emergency contraception, and diaphragm. In the picture
above we can also see that those who know about pills, injections and implants
tend to be the same at each level of education, except for those who are not in
school. Whereas sterilization, IUD, and other methods tend to be increasingly
known as education increases.
The picture above presents the TFR results of the 1991 IDHS, 1994, 1997,
2002-2003, 2007 and 2012. There has been a decline from 3 children per woman
in the 1991 IDHS to 2.6 children in the 2002-2003 IDHS. This TFR rate has been
stagnant in the last 3 periods of IDHS monitoring (2002, 2007, 2012). To achieve
the 2014 RPJMN target of 2.36 and the 2015 MDG target of 2.11, it seems that
more serious efforts are needed.
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b. CPR and TFR 1991-2012
In the graph that contains the CPR and TFR above we can see that even though
the CPR rate continues to increase from the period during 1991-2012, but the TFR in the
same year period only slightly decreased namely 3 in 1991 and only declined to 2.6 in
2012.
ASFR for ages 15-19 years describes the number of pregnancies in adolescents
aged 15-19 years. SDKI results 2012, ASFR for ages 15-19 years is 48 per 1,000 women
aged 15-19 years while the target is expected in 2015 were 30 per 1,000 women aged 15-
19 years.
In the picture above it can be seen that the drop-out rate for the non-MKJP
method (pills and injections) higher than the MKJP method (implant and IUD).
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e. Contraceptive Prevalence Rate (CPR)
CPR 1991-2012
In the picture above, we can see that the Family Participation Rate (CPR) increase is
very small, only 0.5% in the last 5 years, both in all methods of family planning and in
the modern way. The 2014 RPJMN targets for the modern way are 60.1% and MDG 2015
by 65%, but the 2012 achievements are only 57.9%.
f. Unmet Need
Unmet Need in 1991 and 2012
The number of people who need family planning services but don't get it (unmet
need) is still high, only dropped by 0.6% in the last 5 years, even when compared to the
achievements of 10 years ago it only fell by 0.1% (because this number had increased in
2007).
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CHAPTER 3
CONTENT
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Contraception Method is an effective contraceptive device that can work for a
sufficiently long period of at least 3 years including IUD (Intra-Uterine Device),
Implant, Tubectomy , while Short-term Contraception Method is a contraceptive
method that has effectiveness in a period of months or days (pills, injections,
condoms).The choice of contraception for women must weigh a variety of factors,
including their health status, the potential side effects of a method, the
consequences for an unwanted pregnancy, the size of the desired family, family
income, and partner.
Side effects have a role in the choice of contraception. A side effect is an
adverse or undesirable impact or effect, which arises as a result of a treatment or
other intervention in this case the use of . Long-Term Contraception Method and
Short-term Contraception Method contraceptives. Various contraception both
Long-Term Contraception Method and Short-term Contraception Method many
side effects including can trigger acne, weight gain which is a scourge for some
women, cause irregular menstrual patterns, amenorrhea, spotting bleeding,
contraceptive contraception, pain during intercourse, vaginal discharge, infection,
hair loss, nausea, vomiting, changes in libido, dizziness / headaches, and
prolonged fertility.
Sometimes it is not surprising that complications arise. Complications are
the events of new or old Family Planning (KB) participants who experience health
problems leading to pathological conditions as a result of the process of action /
administration / installation of contraceptive devices and drugs used (Directorate
General of Nutrition and Maternal and Child Health, 2012).
Improvement of Family Planning (KB) services must be done so that the
Family Planning (KB) program can run as expected by the government and the
public to avoid various adverse rumors about Family Planning (KB) by providing
appropriate information to potential contraceptive users. In order to achieve this
goal, the wisdom is to categorize the three phases to reach the target, which is
delaying phase, spacing phase, and stopping or ending pregnancy. First, the
delaying phase is shown for Fertile Pairs who have a wife aged <20 years.
Second, the sparse phase in which the period of the wife aged 20-30 years which
is the best age to conceive and give birth. Third, the phase of stopping or ending a
pregnancy where in this period the wife's age is over 30 years.
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3.2 Content of poster 2
This poster explains about women who can be more effective than
needed families. The point here is that everything can start from ourselves,
because by not using the disaster family program we can avoid what is written on
the poster, that is without artificial hormones, without pharmaceutical companies,
without menstrual suppression and also without side effects.
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Contents of the poster: So, From what we can see this poster shows that
girls in developing countries who have access to family planning have a greater
chance of having a sustainable future, compared to girls who do not have access to
family planning, girls who have access to family planning can empower and
determine her life, can get education, can decide how family income is spent, and
are able to provide clothing , food , educate and care for their children later,
because they are not trapped in a pregnancy cycle that they cannot control, not
suffers from frequent pregnancy pains, does not die as a result of complications
related to pregnancy, and does not experience death of their child during
childbirth or during infancy. So the point of this poster is actually to emphasize
that in developing countries, a girl must have access to family planning to make it
easier to realize a sustainable future.
3.4.1 Poster 1
The following is a brief explanation of the types of Long-term
Contraception Method
and Short-term Contraception Method.
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3.4.1.2 Short-term Contraception Method:
1. As a method of contraception.
4. Play a role in helping to shed the endometrial lining which can thicken
in women and which results in late menstruation.
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neurological due to seizures that continue to be repeated and can be
aggravated by the menstrual cycle.
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rates of amenorrhea over time. Therapy may be limited by side effects, most
commonly irregular, unscheduled bleeding. These therapies can benefit women’s
quality of life, and by stabilizing the hormonal milieu, potentially improve the
course of underlying medical conditions such as diabetes or a seizure disorder.
This review addresses situations in which menstrual suppression may be of
benefit, and lists options which have been successful in inducing medical
amenorrhea.
3.4.2.4 Side-effect
3.4.3 Poster 3
3.4.3.1 Pregnancy
Pregnancy is the term used to describe the period in which a fetus develops
inside a woman's womb or uterus. Pregnancy usually lasts about 40 weeks, or just
over 9 months, as measured from the last menstrual period to delivery.
3.4.3.2 Frequent Pregnancies
Pregnancy that occurs has a very short period of time.
3.4.3.3 Abortion
An abortion is a procedure to end a pregnancy. It uses medicine or surgery
to remove the embryo or fetus and placenta from the uterus. The procedure is
done by a licensed health care professional.
3.4.3.4 Unsafe Abortion
An unsafe abortion is the termination of a pregnancy by people lacking the
necessary skills, or in an environment lacking minimal medical standards, or both.
Unsafe abortion is preventable and yet remains a significant cause of maternal
morbidity and mortality in much of the developing world. Over the last decade,
the World Health Organization has developed a systematic approach to estimate
the regional and global incidence of unsafe abortion. Estimates based on figures
around the year 2000 indicate that 19 million unsafe abortions take place each
year, that is, approximately one in ten pregnancies ended in an unsafe abortion,
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giving a ratio of one unsafe abortion to about seven live births. Unsafe abortion is
a life-threatening procedure.
3.4.3.5 Complications Associated with Pregnancy
Complications associated with pregnancy are health problems that occur
during pregnancy. They can involve the mother’s health, the baby’s health, or
both. Example of complications associated with pregnancy are like High Blood
Pressure, Gestational Diabetes, Preterm Labor.etc
3.4.3.6 Childbirth
Childbirth or also known as labour and delivery, is the ending of pregnancy
where one or more babies leaves a woman's uterus by passing through the vagina
or by Caesarean section.
3.4.3.7 Infancy
Infancy in humans constitute the life span between birth and about two
years of age and, as such, is a small percentage of the average person's life
expectancy.
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CHAPTER IV
CLOSING
5.1 Conclusion
1. Family planning is known to have been practiced for centuries long before
the advent of modern methods of contraception.
2. The social and economic implications of family planning are no less
significant. Family planning provides opportunities to women to pursue
studies and engage in productive activities. In countries with high levels of
family planning use and consequently lowered fertility, savings made in
addressing maternal and child ill-health can be invested in social and
economic development and improving the quality of life of people.
3. Family planning methods can be divided into modern and traditional
methods. The modern methods of family planning are sterilization, pills,
IUDs, injections, implants, KB, condoms, intravenous / diaphragm,
emergency contraception and the Lactation Amenorrhoea Method (MAL).
Whereas the traditional method, for example, abstinence periodically and
intercourse was interrupted.
5.2 Sugestion
In the use of family planning, it must use appropriate procedures and the
procedures so that the benefits can be generated optimally and reduce the amount
of population density equally.
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BIBLIOGRAPHY
1. Shah I.(2010). Family Planning and Reproductive Health, 1:2-3.
https://www.eolss.net/Sample-Chapters/C04/E6-147-05.pdf
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