Teenage Pregnancy in Indonesia:

Does media exposure matter?

Hario Megatsari1, Agung Dwi Laksono2, fsdgah3,

1
Faculty of Health Science, Muhammadiyah University of Jember, East Java, Indonesia.
2
National Institute of Health Research and Development, the Ministry of Health of the
Republic of Indonesia, Jakarta, Indonesia.
3
Faculty of Public Health

Corresponding Author:
Hario Megatsari
Email: hario.megatsari@fkm.unair.ac.id

Abstract

Background: Along with technological developments, health behavior is much influenced

by media exposure, including sexual behavior in teenage girls. The study aimed to analyze
the effect of media exposure on teenage pregnancy in Indonesia.
Methods: The study employs 2107 Indonesia Demographic and Health Survey as a material
of analysis. The analysis units were women aged < 20 years old. The study determines
samples by stratification and multistage random sampling methods to obtain a weighted
sample of 7,986. Apart from teenage pregnancy and media exposure, other variables analyzed
were a residence, age, marital, education, employment, and wealth. The final stage analysis
used binary logistic regression.
Results: The results show teenage yang reading newspaper/magazine memiliki kemungkinan
lebih tinggi untuk mengalami teenage pregnancy. Teenage yang listening to the radio
memiliki kemungkinan lebih rendah untuk mengalami teenage pregnancy. Meanwhile,
teenage yang watching television memiliki kemungkinan lebih tinggi untuk mengalami
teenage pregnancy in Indonesia. Moreover, teenage yang using the internet memiliki
kemungkinan lebih tinggi untuk mengalami teenage pregnancy. Besides, the type of
residence, age, marital status, education level, employment status, and wealth status, juga
ditemukan mempengaruhi kejadian teenage pregnancy in Indonesia.
Conclusion: The study concludes media exposure dapat mempengaruhi kejadian teenage
pregnancy in Indonesia.

Keywords: media exposure, teenage pregnancy, early marriage, maternal health, pregnancy
care.

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INTRODUCTION: setiap paragraf terdiri dari 3-4 kalimat. Referensi 1-2 artikel.
Paling lama artikelnya tahun 2017/2018

Paragraf 1  Konep ttg teenage pregnancy dalam kontes kespro

Paragraf 2  Konsep ttg media exposure, apa dan bgmn bentuknya
Paragraf 3  Dampak negatif dari teenage pregnancy
Paragraf 4  Permasalahan teenage pregnancy di Indonesia (data dan trend masalah yg ada)
Paragraf 5  Dampak negatif media exposure scr umum
Paragraf 6  Dampak negatif media exposure pada kontes kespro
Berdasarkan uraian latar belakang, maka penelitian ini bertujuan untuk menganalisis
pengaruh media exposure pada teenage pregnancy in Indonesia.

METHODS

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Data Source

The report used data from the 2017 Indonesian Demographic and Health Survey
(IDHS) as research material. The IDHS was a national survey part of international
Demographic and Health Survey (DHS) that operation by Inner City Fund. The research used
analysis unit women aged < 20 years old in Indonesia. The study determines samples by
stratification and multistage random sampling methods to obtain a weighted sample of 7,986.

Variables Definition

The dependent variable in this study was teenage pregnancy. Teenage pregnancy is a
pregnancy that occurs in adolescence (< 20 years old). Teenage pregnancy consists of two
categories: no teenage pregnancy (No) and teenage pregnancy (Yes).
The study defines media exposure as respondent's acknowledgment of exposure to
newspaper/magazine, radio, television, and internet media. The frequency of reading
newspaper/magazine, frequency of listening to the radio, frequency of watching television,
and frequency of using internet last month, consists of three categories: not at all, less than
once a week, and at least once a week.
Apart from media exposure, the study used six independent variables. The
independent consist of residence, age, marital status, education level, employment status, and
wealth status. The study defines age as the last birthday that has passed. The residence
consists of two types: urban and rural. Marital status consists of two categories: never in a
union/divorced/widowed and married/living with a partner.
Meanwhile, the study defines education level based on the last education certificate
has. Education level consists of four criteria: no education, primary, secondary, and higher.
Employment status consists of two categories: unemployed and employed.
Moreover, the research determines wealth status based on the wealth index. The
wealth index is calculated based on wealth (number and type of goods owned). The wealth
that counts are televisions to bicycles or cars, and housing characteristics, such as sources of
drinking water, toilet facilities, and the main building materials for the floor of the house.
This score is calculated using principal component analysis. The national wealth quintile is
compiled based on the household score for each person in the household and then divided by
distribution into the same five categories, each accounting for 20% of the population. The
wealth status consists of five levels: poorest, poorer, middle, richer, and richest (Wulandari et
al., 2019).

Data Analysis

In the initial stage, the analysis carried out a co-linearity test to confirm the absence of
multicollinearity symptoms between independent variables. Hereinafter, the analysis carried
out a bivariate test by the chi-square for categorical variables and T-test for continue variable.
In the final stage, the study used a multivariate test by binary logistic regression to determine
the predictors and calculate the odds ratio. All stages of analysis using SPSS 22 software.

Procedure

The National Institute for Health Research and Development of the Ministry of Health
of the Republic of Indonesia passed the ethical test of the 2017 IDHS. Inner City Fund

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International has permitted the author to use the 2017 IDHS data for this study through its
website: https://dhsprogram.com/data/new-user-registration.cfm.

RESULTS

Table 1 shows the results of co-linearity tests. Hasil analisis memperlihatkan bahwa
nilai tolerance seluruh variabel lebih besar dari 0.10. Sementara nilai VIF untuk seluruh
variabel kurang dari 10.00. Maka mengacu pada dasar pengambilan keputusan dalam uji
multikolonearitas dapat disimpulkan bahwa tidak terjadi gejala multikolinearitas dalam
model regresi.

Table 1. Results for co-linearity test (n=7,986)

Collinearity Statistics
Variables
Tolerance VIF
Frequency of reading newspaper or magazine 0.857 1.167
Frequency of listening to radio 0.895 1.117
Frequency of watching television 0.973 1.028
Frequency of using internet last month 0.721 1.387
Type of residence 0.793 1.261
Age 0.781 1.281
Marital status 0.789 1.268
Education level 0.770 1.299
Employment status 0.910 1.098
Wealth status 0.685 1.461
Dependent Variable: Teenage pregnancy

Figure 1 shows distribution map of teenage pregnancy by province in Indonesia in

2017. Based on the figure, teenage pregnancy cenderung lebih tinggi di Eastern Indonesia.
Tepatnya pada region Papua, yang terdiri dari Papua Province and West Papua Province.

Figure 1. Distribution map of teenage pregnancy by province in Indonesia in 2017

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 Tabel 2 menampilkan hasil analisis bivariate antara kejadian teenaga pregnancy
dengan variabel lain yang dianalisis. Based on frequency of reading newspaper or magazine,
teenage yang not reading at all mendominasi di kedua kategori teenage pregnancy. Fenomena
yang sama juga didapati pada variabel frequency of listening to a radio. Teenage yang not
listening to the radio mendominasi di kedua kategori teenage pregnancy.
Table 2. The Results of Bivariate Analysis (n=7,986)
Teenage Pregnancy
Characteristics P
No Yes
Frequency of reading newspaper or magazine *** 0.000
- Not at all 47.1% 59.3%
- Less than once a week 41.0% 37.8%
- At least once a week 11.9% 2.8%
Frequency of listening to a radio *** 0.000
- Not at all 53.0% 59.9%
- Less than once a week 32.5% 26.8%
- At least once a week 14.5% 13.3%
Frequency of watching television *** 0.000
- Not at all 3.0% 3.0%
- Less than once a week 15.0% 11.0%
- At least once a week 82.1% 86.0%
Frequency of using internet last month *** 0.000
- Not at all 16.8% 43.7%
- Less than once a week 4.5% 11.1%
- At least once a week 15.5% 16.8%
- Almost every day 63.2% 28.4%
Type of residence *** 0.000
- Urban 54.0% 30.6%
- Rural 46.0% 69.4%
Age (mean) 16.88 17.94 *** 0.000
Marital status *** 0.000
- Never in union/Divorced/Widowed 92.7% 1.5%
- Married/Living with partner 7.3% 98.5%
Education level *** 0.000
- No education 0.3% 0.7%
- Primary 5.4% 24.6%
- Secondary 84.7% 73.3%
- Higher 9.6% 1.4%
Employment status *** 0.000
- Unemployed 76.9% 75.4%
- Employed 23.1% 24.6%
Wealth status *** 0.000
- Poorest 17.9% 27.7%
- Poorer 20.0% 33.1%
- Middle 20.4% 15.1%
- Richer 19.6% 21.8%
- Richest 22.1% 2.3%
Note: ∗p < 0.05; ∗∗p < 0.01; ∗∗∗p < 0.001.

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 According to frequency of watching television, teenage yang watching television At
least once a week mendominasi di kedua kategori teenage pregnancy. Meanwhile, based on
frequency of using internet last month, unpregnant teenage mendominasi kategori using
internet almost every day. On the other hand, pregnant teenage mendominasi kategori not
using internet at all.
Based on the type of residence, unpregnant teenage dominan tinggal di wilayah urban.
Meanwhile, pregnant teenage dominan tinggal di wilayah rural. As well, pregnant teenage
memiliki rata-rata umur yang sedikit lebih tua dibanding unpregnant teenage. Moreover,
based on marital status, unpregnant teenage mendominasi kategori teenage yang never in
union, divorced, or widowed. Meanwhile, pregnant teenage mendominasi kategori married
teenage or living with partner.
Tabel 2 menginformasikan bahwa based on education level, kedua kategori teenage
pregnancy mendominasi kategori secondary education. Kedua kategori teenage pregnancy
juga ditemukan mendominasi enemployed teenage. Finally, based on wealth status,
unpregnant teenage mendominasi the richest categori. In reverse, pregnant teenage
mendominasi poorer category
Tabel 3 menampilkan hasil binary logistic regression of teenage pregnancy in
Indonesia. Analisis pada tahap final ini mempergunakan “teenage pregnancy=No” sebagai
referensi. Hasil analisis menunjukkan bahwa seluruh media exposure type menunjukkan hasil
yang signifikan berkaitan dengan teenage pregnancy in Indonesia.

Table 3. The results of binary logistic regression of teenage pregnancy in Indonesia (n=7,986)
Teenage Pregnancy
Predictors
P AOR LB UB
Freq. of reading newspaper/magazine: Not at all - - - -
Freq. of reading newspaper/magazine: Less than *** 0.000 1.859 1.858 1.860
once a week
Freq. of reading newspaper/magazine: At least *** 0.000 1.041 1.040 1.042
once a week
Freq. of listening to a radio: Not at all - - - -
Freq. of listening to a radio: Less than once a *** 0.000 0.907 0.907 0.908
week
Freq. of listening to a radio: At least once a week *** 0.000 0.799 0.799 0.800
Freq. of watching television: Not at all - - - -
Freq. of watching television: Less than once a *** 0.000 1.679 1.677 1.681
week
Freq. of watching television: At least once a week *** 0.000 1.779 1.777 1.781
Freq. of using internet: Not at all - - - -
Freq. of using internet: Less than once a week *** 0.000 2.639 2.637 2.641
Freq. of using internet: At least once a week *** 0.000 1.064 1.063 1.064
Freq. of using internet: Almost every day *** 0.000 1.073 1.072 1.073
Residence: Urban - - - -
Residence: Rural *** 0.000 1.359 1.358 1.359
Age (mean) *** 0.000 0.962 0.961 0.962
Marital: Never in union/Divorced/Widowed - - - -
Marital: Married/Living with partner *** 0.000 1014.028 1012.698 1015.359
Education: No education - - - -
Education: Primary *** 0.000 0.501 0.499 0.502
Education: Secondary *** 0.000 0.522 0.521 0.524
Education: Higher *** 0.000 0.603 0.601 0.604

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 Employment: Unemployed - - - -
Employment: Employed *** 0.000 0.935 0.935 0.936
Wealth: Poorest - - - -
Wealth: Poorer *** 0.000 1.423 1.423 1.424
Wealth: Middle *** 0.000 0.815 0.814 0.815
Wealth: Richer *** 0.000 2.582 2.581 2.584
Wealth: Richest *** 0.000 0.397 0.396 0.397
Note: ∗ p < 0.05; ∗∗ p < 0.01; ∗∗∗ p < 0.001.

The results of binary logistic regression of teenage pregnancy in Indonesia show

teenage yang reading newspaper/magazines less than once a week memiliki kemungkinan
1.859 kali dibanding teenage yang not reading newspaper/magazines at all untuk mengalami
teenage pregnancy (AOR 1.859; 95% CI 1.858-1.860). In addition, teenage yang reading
newspaper/magazines at least once a week memiliki kemungkinan 1.041 kali dibanding
teenage yang not reading newspaper/magazines at all untuk mengalami teenage pregnancy
(AOR 1.041; 95% CI 1.040-1.042). Hasil analisis ini menunjukkan bahwa teenage yang
reading newspaper/magazine memiliki kemungkinan lebih tinggi untuk mengalami teenage
pregnancy.
Based on frequency of listening to the radio, teenage yang listening to the radio less
than once a week memiliki kemungkinan 0.907 kali dibanding teenage yang not listening to
the radio at all untuk mengalami teenage pregnancy (AOR 0.907; 95% CI 0.907-0.908).
Meanwhile, teenage yang listening to the radio at least once a week memiliki kemungkinan
0.799 kali dibanding teenage yang not listening to the radio at all untuk mengalami teenage
pregnancy (AOR 0.799; 95% CI 0.799-0.800). The research result informs teenage yang
listening to the radio memiliki kemungkinan lebih rendah untuk mengalami teenage
pregnancy.
According to frequency of watching television, teenage yang watching television less
than once a week memiliki kemungkinan 1.679 kali dibanding teenage yang not watching
television at all untuk mengalami teenage pregnancy (AOR 1.679; 95% CI 1.677-1.681).
Forward, teenage yang watching television at least once a week memiliki kemungkinan 1.779
kali dibanding teenage yang not watching television at all untuk mengalami teenage
pregnancy (AOR 1.779; 95% CI 1.777-1.781). Informasi ini menunjukkan bahwa teenage
yang watching television memiliki kemungkinan lebih tinggi untuk mengalami teenage
pregnancy in Indonesia.
Table 3 shows teenage yang using the internet less than once a week memiliki
kemungkinan 2.639 kali dibanding teenage yang not using the internet at all untuk mengalami
teenage pregnancy (AOR 2.639; 95% CI 2.637-2.641). Meanwhile, teenage yang using the
internet at least once a week memiliki kemungkinan 1.064 kali dibanding teenage yang not
using the internet at all untuk mengalami teenage pregnancy (AOR 1.064; 95% CI 1.063-
1.604). Moreover, teenage yang using the internet almost every day memiliki kemungkinan
1.073 kali dibanding teenage yang not using the internet at all untuk mengalami teenage
pregnancy (AOR 1.073; 95% CI 1.072-1.073). Hasil penelitian ini menunjukkan bahwa
teenage yang using the internet memiliki kemungkinan lebih tinggi untuk mengalami teenage
pregnancy.
Selain media exposure, enam variabel independen lain yang dianalisis juga
menunjukkan hasil yang signifikan berhubungan dengan teenage pregnancy in Indonesia.

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Keenam variabel tersebut adalah the type of residence, age, marital status, education level,
employment status, and wealth status.
Based on the type of residence, teenage yang tinggal di wilayah rural memiliki
kemungkinan 1.359 kali dibandingkan teenage yang tinggal di wilayah urban untuk
mengalami teenage pregnancy (AOR 1.359; 95% CI 1.358-1.359). On the other hand, age
and marital status juga ditemukan signifikan mempengaruhi kejadian teenage pregnancy in
Indonesia. Married teenage or teenage yang living with partner memiliki kemungkinan
1014.028 kali dibanding teenage yang never in union, or divorced, or widowed, untuk
mengalami teenage pregnancy (AOR 1014.028; 95% CI 1012.698-1015.359).
According to education level, teenage dengan primary education memiliki
kemungkinan 0.501 kali dibanding no education teenage untuk mengalami teenage pregnancy
(AOR 0.501; 95% CI 0.499-0.502). Meanwhile, teenage dengan secondary education
memiliki kemungkinan 0.522 kali dibanding no education teenage untuk mengalami teenage
pregnancy (AOR 0.522; 95% CI 0.521-0.524). Moreover, teenage dengan higher education
memiliki kemungkinan 0.603 kali dibanding no education teenage untuk mengalami teenage
pregnancy (AOR 0.603; 95% CI 0.601-0.604). The analysis result shows bahwa semakin baik
education level seorang teenage, semakin kecil kemungkinan untuk mengalami teenage
pregnancy di Indonesia.
On the other side, based on employment status, employed teenage memiliki
kemungkinan 0.935 kali dibanding unemployed teenage untuk mengalami teenage pregnancy
(AOR 0.935; 95% CI 0.935-0.936). Informasi ini menunjukkan bahwa unemployed
merupakan faktor risiko bagi teenage in Indonesia untuk mengalami teenage pregnancy.
Finally, based on wealth status, teenage dengan wealth status kategori poorer and
richer memiliki kemungkinan lebih tinggi untuk mengalami teenage pregnancy. Whereas,
teenage dengan wealth status kategori middle and the richest memiliki kemungkinan lebih
rendah untuk mengalami teenage pregnancy in Indonesia.

DISCUSSION
Hasil analisis menemukan bahwa teenage yang reading newspaper/magazine memiliki
kemungkinan lebih tinggi untuk mengalami teenage pregnancy.
Apa maknanya?
Bandingkan dengan studi lain yang sejenis

The research result informs teenage yang listening to the radio memiliki kemungkinan
lebih rendah untuk mengalami teenage pregnancy.
Apa maknanya?
Bandingkan dengan studi lain yang sejenis

Informasi hasil analisis juga menemukan bahwa teenage yang watching television
memiliki kemungkinan lebih tinggi untuk mengalami teenage pregnancy in Indonesia.
Apa maknanya?
Bandingkan dengan studi lain yang sejenis

Hasil penelitian menunjukkan bahwa teenage yang using the internet memiliki
kemungkinan lebih tinggi untuk mengalami teenage pregnancy.

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Apa maknanya?
Bandingkan dengan studi lain yang sejenis

Meanwhile, teenage yang tinggal di wilayah rural ditemukan memiliki kemungkinan

lebih tinggi dibandingkan teenage yang tinggal di wilayah urban untuk mengalami teenage
pregnancy.
Apa maknanya?
Bandingkan dengan studi lain yang sejenis

Moreover, age and marital status juga ditemukan signifikan mempengaruhi kejadian
teenage pregnancy in Indonesia.
Apa maknanya?
Bandingkan dengan studi lain yang sejenis

The analysis result shows bahwa semakin baik education level seorang teenage,
semakin kecil kemungkinan untuk mengalami teenage pregnancy di Indonesia. Semakin
tinggi education level seorang teenage memberi kemungkinan pemahaman yang lebih baik
pula atas risiko setiap tindakan yang akan diambil (Rohmah et al., 2020). Pendidikan yang
lebih baik juga membuat teenage memiliki kemandirian yang lebih untuk menentukan
nasibnya sendiri, misalnya untuk menolak early marriage (Kasiati and Isfentiani, 2020;
Talukder et al., 2020). Study sebelumnya menginformasikan bahwa pendidikan yang lebih
tinggi seringkali ditemukan sebagai determinant positif dari sikap atau perilaku kesehatan
yang lebih baik (Ipa et al., 2020; Megatsari et al., 2020; Wulandari and Laksono, 2020).

On the other hand, unemployed merupakan faktor risiko bagi teenage in Indonesia
untuk mengalami teenage pregnancy.
Apa maknanya?
Bandingkan dengan studi lain yang sejenis

Moreover, wealth status juga ditemukan mempengaruhi kejadian teenaga pregnancy

in Indonesia.
Apa maknanya?
Bandingkan dengan studi lain yang sejenis

Study Limitation

Indonesia adalah negeri yang kaya akan perbedaan latar budaya. Studi ini dilakukan
secara superfisial sesuai dengan data sekunder yang didapat dari hasil survey pihak ketiga.
Analisis dalam studi tidak memperhatikan faktor latar budaya yang pada studi-studi
sebelumnya terbukti dapat mempengaruhi kejadian teenage pregnancy di Indonesia
(Imanugraha, S. and Budisuari, 2016; Laksono, Soerachman and Angkasawati, 2016; Pratiwi
et al., 2019).

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CONCLUSION

Based on the research results, it concluded media exposure dapat mempengaruhi

kejadian teenage pregnancy in Indonesia. Teenage yang reading newspaper/magazine,
watching television, and using the internet, memiliki kemungkinan lebih tinggi untuk
mengalami teenage pregnancy in Indonesia. On the contrary, teenage yang listening to the
radio memiliki kemungkinan lebih rendah untuk mengalami teenage pregnancy in Indonesia.
On the other hand, enam variabel independen lain yang dianalisis juga menunjukkan
hasil yang signifikan berhubungan dengan teenage pregnancy in Indonesia. Keenam variabel
tersebut adalah the type of residence, age, marital status, education level, employment status,
and wealth status.

Acknowledgments
The author would like to thank the ICF International, who has agreed to allow the
2017 IDHS data to be analyzed in this article.

Conflict of Interests Statement

The authors declare that they have no competing interests

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