Indrayani, Khonita Hikmala Fatma, & Bony Wiem Lestari
Hal. 27-36
FACTORS AFFECTING VASECTOMY CONTRACEPTION FAKTOR-FAKTOR YANG MEMPENGARUHI PEMILIHAN KONTRASEPSI VASEKTOMI Indrayani1, Khonita Hikmala Fatma1, Bony Wiem Lestari2 1Akademi
Kebidanan Dewi Sartika, Jl. Terusan Kopo KM 12,8 Katapang, Bandung, Telp./Faks.+6225880535 Epidemiologi dan Biostatistik Fakultas Kedokteran Universitas Padjadjaran, Jl. Raya BandungSumedang km 21, Bandung, Telp./Faks. (022) 7795594 Corespondence address:
[email protected]
2Departemen
ABSTRACT Background: The low participation of men in family planning is influenced by many factors, including demographic factors, social structure factors, family factors, and the availability of health resources. There are many other factors that influence the selection of contraceptive vasectomy is not yet known. Objective: To know factors affecting vasectomy contraception in Kiarapedes, Purwakarta regency. Method: The study design used was mixed methods approaches and strategies embedded concurrent. Quantitative data were collected by questionnaire. The gathering of qualitative in-depth interviews were conducted in the respondent, the respondent's wife and PLKB selected using an interview guide. The data has been collected and analyzed, for a quantitative method using descriptive analysis of the characteristics of respondents. For qualitative methods, information from research subjects are recorded in the form of transcripts, then given coding and grouped into categories and themes. Result: Based on data collected from 53 respondents found the majority of respondents were in the age group 41-50 years (39.6%), most of the respondents had a number of children >3 people (75.5%), the majority of respondents had elementary (90, 6%), all Muslim respondents (100%), most of the income ≥ minimum wage (75.5%) of all respondents have the support of his wife (100%), and most respondents receive information from field officers (73.6% ). Response acceptors of stigma related to religious factors, sexual, and psychological medical treatment while the reasons respondents chose vasectomy because of factors such as family, economy and role model. Conclusion: Modeling is another factor that can influence a man's decision to undergo a vasectomy in the village Kiarapedes. Keywords: Family planning, vasectomy
INTISARI Latar belakang: Rendahnya partisipasi pria dalam keluarga berencana dipengaruhi oleh banyak faktor, di antaranya faktor demografi, faktor struktur sosial, faktor pasangan, dan faktor ketersediaan sumber daya kesehatan. Masih banyak faktor lain yang mempengaruhi pemilihan kontrasepsi vasektomi yang belum diketahui. Tujuan: Untuk mengetahui factor-faktor yang mempengaruhi pria dalam pemilihan vasektomi di Kiarapedes, Kabupaten Purwakarta. Metode: Rancangan penelitian yang digunakan adalah mixed methods dengan strategi concurrent embedded. Data kuantitatif dikumpulkan dengan kuesioner. Untuk pengumpulan data kualitatif dilakukan wawancara mendalam pada responden, istri responden dan PLKB yang terpilih dengan menggunakan panduan wawancara. Data yang sudah dikumpulkan kemudian dianalisis, untuk metode kuantitatif menggunakan analisis deskriptif terhadap karakteristik responden. Untuk metode kualitatif, informasi dari subjek penelitian dicatat dalam bentuk transkrip, kemudian diberi koding dan dikelompokkan menjadi kategori serta tema. Hasil: Berdasarkan data yang terkumpul dari 53 responden didapatkan sebagian besar responden berada pada kelompok umur 41-50 tahun (39,6%); sebagian besar responden memiliki jumlah anak >3 orang (75,5%); mayoritas responden berpendidikan SD (90,6%); seluruh responden beragama Islam (100%); sebagian besar berpenghasilan ≥ UMR (75,5%); seluruh responden mendapatkan dukungan dari istri (100%); dan sebagian besar responden mendapatkan informasi dari PLKB (73,6%). Tanggapan akseptor terhadap stigma berkaitan dengan faktor agama, seksual, tindakan medis dan psikologi sedangkan alasan responden memilih vasektomi diantaranya karena faktor pasangan, ekonomi dan panutan. Simpulan: Panutan merupakan faktor lain yang dapat memengaruhi keputusan pria untuk menjalani vasektomi di Desa Kiarapedes. Kata kunci: Faktor, keluarga berencana, vasektomi
Jurnal Ilmu Kebidanan, Volume 1, Nomor 1, Maret 2013 27
Indrayani, Khonita Hikmala Fatma, & Bony Wiem Lestari
INTRODUCTION
Hal. 27-36
problems resulting from vasectomy. We
Indonesia is the 5th most populous
aimed to explore the characteristics of
country in the region of the Association of
vasectomy clients and identify factors which
South East Asian Nations (ASEAN), and
may influence the selection of vasectomy in
was ranked the 8th most populous in the
men.
South East Asia Region (SEARO).
1-2
The
growth of population in Indonesia is 5 years faster than projected by the Central Bureau
RESEARCH METHODS In this study, we used a mixed methods
of Statistics (BPS).3 The uncontrolled growth
using
of Indonesian population will cause many
Concurrent embedded was done through
problems.1,4 Family Planning programme
quantitative and qualitative data collection at
(KB)
the same time. Quantitative data were
is
one
attempt
from
Indonesian
government to control its population growth. The low participation of men in family
concurrent
embedded
approach.
collected by questionnaire. For qualitative data, the information was collected through
planning is influenced by many factors,
in-depth
including demographic factors (age, number
respondents
of children and sex of the child), social
Obtained information from qualitative study
structure
science,
used to support the quantitative data and
religion, socio-economic status and level of
explore other factors that influence the
well-being), factor family (wife’s health and
selection of vasectomy. Data collection was
wife support), and the availability of health
conducted
resources (health insurance, access to
Purwakarta District in October 2012.
factors
(education,
interviews using
in
among an
the
interview
Kiarapedes
selected guide.
Village,
information, distance to health facilities and
Subjects were vasectomy clients that met
health workers). Research showed that
inclusion criteria and agreed to become
there is a relationship between knowledge
respondents.
and wife support with male participation in
(informed consent). The inclusion criteria
family planning. In addition, education and
are: vasectomy clients, age more than 30
knowledge also affect the decision making in
years, residing in the Kiarapedes Village.
the selection of contraception methods.5-7
We excluded men who become vasectomy
There are many other factors that
clients
to fill out the consent form
because
of
his
wife’s
health
influence the selection of vasectomy which
condition. Before data collection, all subjects
are not yet known. It is important to identify
receive complete explanation about this
such factors, because they may affect male
study. Those who were agreed then fill in the
in choosing vasectomy. It is also beneficial
written consent. For quantitative research,
for health and family planning field workers,
we collected 53 subjects using simple
so they can provide services that meet the
random sampling technique. The data was
client’s
further analyzed using descriptive statistics.
needs
and
anticipate
possible
Jurnal Ilmu Kebidanan, Volume 1, Nomor 1, Maret 2013 28
Indrayani, Khonita Hikmala Fatma, & Bony Wiem Lestari
Meanwhile, qualitative data were written into transcripts and by doing peer briefing we classified
the
information
into
certain
categories and themes. RESULTS AND DISCUSSION We collected data from 53 respondents. The
result
showed
that
majority
of
respondents were in the age group of 41-50 years (39.6%), most respondents had a number of children> 3 people (75.5%), those with elementary education level (90.6 %); they have Moslem religion (100%), most of the income ≥ minimum wage (75.5%), all respondents have the support of his wife (100%),
and
most
of
them
received
information from field officers (73.6%). Most respondents were in the age group of 41-50 years (39.6%), this is in accordance with the theory and research stating that age
Hal. 27-36
Table 1 Subject Characteristics towards The Choosing of Vasectomy Vasectomy acceptor (n = 53) f %
Variable
Age 31-40 years 41-50 years 51-60 years 61-70 years 71-80 years Number of children 1 2 >3 Level education Elementary school Junior high school Senior high school Higher education Religion Islam Non-muslim Socioeconomic status < UMR ≥ UMR Wife support Supportive Unsupportive Access to Information Health workers Field officers (PLKB) Cadre / community Friends Mass media
3 21 18 9 2
5.7 39.6 34 16.9 3.8
0 13 40
0 24.5 75.5
48 4 1 0
90.6 7.5 1.9 0
53 0
100 0
13 40
24.5 75.5
53 0
100 0
1 39 13 0 0
1.9 73.6 24.5 0 0
will affect an individual in the selection
the decisions of couples of childbearing age
methods of birth because of the increasing
in determining the choice of contraceptive
age of the increasing numbers of maturity,
use. Couples with large number of children’s
the maturity of thinking and act that makes it
living, generally prefer to use long-term
easier to get new information and gain
contraception in an attempt to limit the
experience.
In
associated
with
is
also
number of children, whereas on couples with
productivity.
The
small number of living children prefer to
results showed that the age may influence
choose short-term use of contraceptives to
the decision to undergo vasectomy. We
extend child birth spacing.10 Other studies
found higher proportion of vasectomy clients
have
were at the age ≥ 31 years, compared with
relationship between the number of children
men 3 people (75.5%). This is
mination of number of children held by each
consistent with research showing that the
couple depending on the family itself and the
number of children living owned will affect
child welfare conditions would influence the
Jurnal Ilmu Kebidanan, Volume 1, Nomor 1, Maret 2013 29
Indrayani, Khonita Hikmala Fatma, & Bony Wiem Lestari
Hal. 27-36
decision of couples of childbearing age in
various health products and innovations
determining participation in family planning.
such as contraceptives greatly influenced by
The
majority
of
respondents
had
the level of education. The higher the
elementary education level (90.6%). This is
education, the easier it is for someone to
not in accordance with the theory and the
accept an innovation particularly in the areas
results of previous research which stated
of health and more likely to wear a tool / way
that education is one of the factors that can
of modern family planning.6,15
influence the knowledge and attitudes about contraceptive
methods.
education
is
one
of
The problem of family planning is not just
factors
that
demographic and clinical problem but also
determine
a
person’s
knowledge
and
socio-cultural issues and religion, even
perception. Someone who is well educated
regulated in the Act (Act) No.10 of 1992
will have broader vision and more receptive
which states that the implementation of birth
to ideas and new ways of life. Highly
control, is done in a way that can be
educated individuals would respond more
accounted for in terms of health, ethical and
rational than those with less educated, more
religious affiliation of the related population.6,
creative and more open to reform efforts.
16
Someone who is well educated are generally
the support of society, including religious
more able to adjust to social changes. The
leaders. Despite initially being challenged,
higher the education the more increasing
eventually family planning programs are
proportion of those who know and use
supported by religious leaders with the
contraceptives to limit the number of their
understanding that family planning is not
children.13
one’s
against religion and is one of the efforts in
will
the setting of population to fight poverty,
contraceptive
ignorance, backwardness of the community
the
Education
knowledge influence
of
and the
The
will
one’s choice
level
In this study, all subjects are Moslem.
affect
knowledge of
Family planning program needs to have
methods. Knowledge concerning the rumors
in
in the community about vasectomy, it also
development.6,14
contributes to the low participation of men in doing vasectomy.14
order
to
support
the
nation
In Islam, there are groups that do not support family planning. They reason that
It is adviseable, educated people find it
The Qur’an does not allow the use of
easier to accept an inovasi. Education for
contraceptives because they are considered
acceptor
the
to be killing a baby, but there are also
choice of contraception and will indirectly
scholars who allow family planning program
affect the continuity of use. The results
(KB) to an agreement that allowed by
stated that education has an effect on
Shari’a (Islamic laws) which is an effort of
reproductive
of
arrangement or spacing births or temporary
contraceptives. Utilization of the public on
pregnancy prevention based on spousal
candidates
can
behavior
influence
and
use
Jurnal Ilmu Kebidanan, Volume 1, Nomor 1, Maret 2013 30
Indrayani, Khonita Hikmala Fatma, & Bony Wiem Lestari
Hal. 27-36
agreement because certain circumstances
can be either positive or negative depending
for the family benefit (beneficiaries). This is
on the knowledge, beliefs, attitudes and
in line with the purpose of family planning,
actions of peers.
which is to maintain the health of mothers
Research showed that the low number of
and children, support other population and
man in the doing family planning is largely
development programs to be part of human
due to familial factors, among others, the
rights.6
wife did not give any support.23 Other study
For income, 75.5% of subjects have salary
above
wage.
relationship between the attitude of the wife
Socioeconomic status of a family is of great
towards men participation in family planning.
influence on the selection of contraception,
18,22-24
because
to
the
minimum
results indicate that there is a significant
necessary
Most of respondents got information from
contraceptive services, participants must
field officers (73.6%). Providing information
provide funding. that
there
is
obtain 19
the
Research results suggest
that
a
associated
relationship
between
is
clear,
complete,
with
the
and
Family
correct Planning
economic status with the selection of
Program is extremely important. The family
contraception. This is because they think
planning goals, how the family planning
that in choosing of contraception should
program
indeed be seen from the capacity of their
consequences or side effects and so on,
ability to purchase contraceptives so that the
including the risk of complications and side
use of contraception is not considered
effects of contraceptive failure must be
6
will
be
adressed,
and
the
burdensome for its users. Another study
clearly understood by clients.
stated that there were strong influences
family planning information should not be
between economic status/income level on
hidden,
the use of vasectomy.15,18
choose the appropriate type of contraception
thus
potential
Therefore,
participants
can
All subjects received full support from
(informed choice).25 Attention to the quality
their wife (100%). The support has a positive
of service delivery, such as education,
effect, both physical, mental and social life.
counseling and skills in providing vasectomy
Social support is felt when a person is
contraceptive
experiencing confusion/stress. The support given by closest people will be very
service,
will
acceptance and use of vasectomy. Sources
of
information
increase 16
from
health
significant as a driving force for reducing
professionals is a very important factor to
stress, with support, will further decrease
increase male participation in vasectomy,
stress levels suffered.
19-20
Wife response
which delivery is supported by media
against vasectomy action to be performed
campaign through printable material and
by their husbands is a form of support of the
electronic devices.14 The new information on
wife towards her husband. Wife response
something that will provide foundation for the
Jurnal Ilmu Kebidanan, Volume 1, Nomor 1, Maret 2013 31
Indrayani, Khonita Hikmala Fatma, & Bony Wiem Lestari
emergence
of
new
cognitive
attitude.
Hal. 27-36
Factors medical treatment
Affective messages that are strong enough
As expressed by the informants, as follows:
will provide a basis for assessing affective
“Some say vasectomy is similar with castration, but for me they are different... castration tends to be a massive operation ....” (Informant 1st)
something that would formation of toward certain attitudes.27 There is a relationship between
subject’s
the
information
with
the
perception
of
Psychological factors
selection
of
As expressed by the informants, as follows:
contraceptive family planning. Someone who previously had received family planning
“Some says that vasectomy was creepy ... lots of terror of surgery .... hahahaha ... but it turns out to be just fine...” (Informant 4th)
information before, generally will not have Our
difficulty in selecting contraception.6
results
confirmed
that
clients
response’s to stigma was related to religious QUALITATIVE DATA ANALYSIS
factors, sexual, psychological and medical
Qualitative data analysis was performed
treatment. There are opinions from religious
to confirm the results from quantitative data
point of view that vasectomy is equated with
analysis. In-depth interviews was conducted
murder, in fact, there are the pros and cons
on 6 vasectomy clients and their wives also
of vasectomy by scholars, there is a permit
1
Village
to use vasectomy and some that do not
Purwakarta District. We classified the results
allow for vasectomy is haraam (forbidden)
into: responses to stigma of vasectomy and
similar to killing.
field
officer
in
Kiarapedes
the reasons of choosing vasectomy among their clients.
The stigma of vasectomy is associated with sexual factors, vasectomy is considered to make men become impotent. This is not
Responses to stigma
true
Stigma circulating in the community about vasectomy mostly related to religious, sexual,
medical
and
psychological
measures.
on
medical
perspectives
because
vasectomy procedure just cut the continuity of the vas deferens spermatozoa from testicular functioning channel, then there is a block of spermatozoa distribution through
Religious factors
the channel. The process of spermato-
As expressed by the informants, as follows: “Once there are scholars who say that vasectomy is haram (forbidden). It kills but in my opinion vasectomy does not kill, rather it protects... so ... " (Informant 6th)
genesis which takes between 70-90 days still can continue. Blockage of the vas deferens does not affect intersitiel tissue of the testis, so that the Leydig cells produce
Sexual factor
testosterone remained normal. Because
As expressed by the informants, as follows: “Some say... if you do vasectomy, it reduces your power...oh wait..no sweat... but in my experience such thing not happen” (Informant 1st)
testosterone production is not disrupted, the libido remain unchanged.28 Vasectomy also does not cause men to be impotent because
Jurnal Ilmu Kebidanan, Volume 1, Nomor 1, Maret 2013 32
Indrayani, Khonita Hikmala Fatma, & Bony Wiem Lestari
the nerves and blood vessels that play a role
Hal. 27-36
The Reasons of Choosing Vasectomy
in the process of erection are in the penis
Some factors which can explains why
shaft, while the action is only done around
vasectomy clients chose vasectomy are the
vasectomy scrotal / testis, away from nerves
condition from their spouses, economic
for erection that vasectomy will not at all
reason and the existence of role model.
interfere with the ability of the penis to
Spouse condition
erect.29 In addition, vasectomy does not
As expressed by informants, as follows:
affect the function of the accessory glands
“... Because long time ago my wive gave birth here, there’s such interference when my wife should be taken to the hospital ...because a lot of symptoms ... so it’s better if me as his husband is vasectomised” (Informant 2rd)
thus cement production still persists and vasectomised men can ejaculate.28 Vasectomy is different from castration. The act of castration is an act of throwing
Economic reason
away testicles for virility throw. Meanwhile,
As expressed by informants, as follows:
the act of vasectomy is the cutting/tying the
“Because I don’t want to have another baby, just 2 kids it’s enough for me, I don’t want to have another child, it is troublesome, for the cost and the sake of my children’s future” (Informant 5th)
left and right vas deferens, so that seminal fluid released during ejaculation no longer contain sperm. Vasectomy action takes a short operation about 10-15 minutes and requires no general anesthesia (anesthetic) just under local anesthesia only, so it is relatively safer.30-31 Anxiety is an unpleasant emotional state, which is characterized by subjective feelings such as tension, anxiety, worry, and also characterized by active central nervous system. Anxiety is generally vague, has no known cause, so the anxiety becomes an individual defense.32 The fear experienced by the people about vasectomy was caused by things that are uncertain. Our study revealed that most of clients claimed not to feel fear as rumored in the community. It is the attitude of the provider that can help clients to eliminate fear. The study results conducted by Santiso, et al
33
stated that 97
% of vasectomy clients felt satisfied with the action of vasectomy and did not regret it.
The existence of role model As expressed by informants, as follows: “My husband thinks .. there are already many people done vasectomy, Mr. Koko did it also... sometimes I’m thinking myself, Mr Koko choose to have vasectomy, but I don’t... so I finally decide to also have it” (Informant 5th)
In this study, we showed that reasons of choosing vasectomy among its clients are driven by the condition from their spouses, economic reason and the existence of role model. Economic factor indirectly influences the selection of family planning methods. When a family has large numbers of children, it may increase the family budget to meet the needs of clothing, food, housing and education as well. It agrees with the study results18,34 which states that there is a significant relationship between the level of income towards the use of vasectomy. Since vasectomy is a permanent birth control
Jurnal Ilmu Kebidanan, Volume 1, Nomor 1, Maret 2013 33
Indrayani, Khonita Hikmala Fatma, & Bony Wiem Lestari
Hal. 27-36
method then it is cost-effective. It requires
References
only one action that will be more economical
1.
Kemenkes
RI.
Profil
Kesehatan
and practical than other family planning
Indonesia. In: Kemenkes RI, editor.
methods. As a government programme,
Jakarta: Kemenkes RI; 2011.
vasectomy is provided free of charge to
2.
Baskara
UD.
intensify male participation in family planning
kependudukan
so
penghematan
they
can
become
clients
without
considering operating costs.
Manfaat dan
program
KB
terhadap
ekonomi
demi
kemakmuran masyarakat Jawa Barat.
Another reason from the subjects of
Diakses tanggal 18 Juni 2012 melalui.
choosing vasectomy is the existence of role
http://jabarbkkbngoid/rubrik/529/.
models. Role model is one element of
Barat: BKKBN Jawa Barat; 2011.
experience that can be seen by other people
3.
Jawa
BPS RI. Laju pertumbuhan penduduk.
that the use of family planning is harmless
Diakses tanggal 18 Juni 2012 melalui.
and
not
like
community
so
the it
rumors serves
existing
in
http://sp2010bpsgoid/indexphp. Jakarta:
examples
or
BPS; 2010.
evidence. Exemplary role or models have a
4.
Bappenas. Laporan pencapaian tujuan
major influence in the formation of a simple
pembangunan milenium di Indonesia.
personal
In:
example
that
requires
an
assessment of whether or not the behavior is dangerous before deciding to do so.
Bappenas,
editor.
Jakarta:
Bappenas; 2010. 5.
BPPKK RI. laporan riset kesehatan dasar. In: Kemenkes RI, editor. Jakarta:
Conclusion
Kemenkes RI; 2010.
Vasectomy
is
a
safe
method
of
6.
Kusumaningrum R. Faktor-faktor yang
contraception for men. Other factors that
mempengaruhi
influence the choice of vasectomy in addition
kontrasepsi
to age, number of children, education,
pasangan
religion, socio-economic, wife support and
UNDIP; 2009.
access to information is the existence of role
7.
pemilihan
yang usia
jenis
digunakan subur.
pada
Semarang:
Budisantoso SI. Partisipasi pria dalam
model. There is a need for efforts to
keluarga berencana di kecamatan Jetis
increase
kabupaten Bantul. Promosi kesehatan
the
promotion
of
male
contraceptive methods through education and
counseling.
Appropriate
health
Indonesia. Agustus 2009;4(2). 8.
Kurnia
RA,
A
DI.
Pengetahuaan
education about vasectomy should be given
kontrasepsi
vasektomi
to reduce vasectomy stigma within the
ditinjau dari umur,
community.
pekerjaan.
Falkutas
masyarakat
universitas
pada
suami
pendidikan dan kesehatan airlangga
Surabaya. 2008.
Jurnal Ilmu Kebidanan, Volume 1, Nomor 1, Maret 2013 34
Indrayani, Khonita Hikmala Fatma, & Bony Wiem Lestari
9.
Ekarini SMB. Analisis faktor-faktor yang berpengaruh terhadap partisipasi pria dalam
keluarga
berencana
di
Hal. 27-36
16. UU RI. UU RI No 20 tentang Sistem pendidikan nasional. Jakarta2003. 17. Saifuddin AB. Buku panduan praktis
Kecamatan Selo Kabupaten Boyolali.
pelayanan
Semarang:
YBPSP,
Universitas
Diponegoro;
2008.
kontrasepsi.
Jakarta:
JNPK-KR/POGI,
BKKBN,
DEPKES, JHPIEGO; 2003.
10. Singarimbun M. Kelangsungan hidup
18. Simanullang
R.
Pengaruh
faktor
anak,berbagai teori, pendekatan dan
predisposisi, pemungkin dan penguat
kebijaksanaan.
peserta
Yogyakarta:
UGM;
1996.
pria
terhadap
penggunaan vasektomi di kecamatan
11. Nafidah A. Survey cepat gambaran beberapa faktor suami yang berkaitan dengan
pemilihan
kecamatan
vasektomi
Pulosari
di
kabupaten
Pemalang bulan Juli - Oktober 2007. Semarang: UNDIP; 2007.
pria dengan keikutsertaan penggunaan vasektomi
Medan: USU; 2011. 19. Sarafino
EP.
Singapura:
Health
psychology.
John Willey and Sons;
1990;5-9.
health. Florida: Academic Press Inc.; 1985.
kecamatan
21. BKKBN. Keluarga berencana kesehatan
Kebumen
reproduksi, gender dan pembangunan
bulan April-Mei tahun 2002. Yogyakarta:
kependudukan, edisi Revisi. Jakarta:
UGM; 2002.
BKKBN; 2006.
Karanganyar
di
Labuhan Deli Kabupaten Deli Serdang.
20. Cohen S, Syme SL. Social support and
12. Fitri IR. Kaitan beberapa karakteristik
metode
kontrasepsi
kabupaten
13. Purwoko. Penerimaan vasektomi dan sterilisasi
tuba.
Semarang:
UNDIP;
2000.
22. Jayasuria R, Owen N. Predictors of men's
acceptance
of
modern
contraceptive practice in rural Vietnam.
14. BKKBN. mempengaruhi
Faktor-faktor
yang
rendahnya
partisipasi
pria dalam KB. Diakses tanggal 3 Juni 2007
melalui.
Health sagepub.
education
and
behavior.
2005.
10
Februari
2007;32(6):738. 23. Khotima FN, Palarto B, Julianti HP.
http://wwwbkkbngoid/gemapria/info-
Hubungan pengetahuan dan sikap istri
detailphp?infid=79: BKKBN; 2007.
dengan
15. Setyaningsih RW. kehidupan
rumah
Persepsi tentang tangga
dengan
pemilihan
kontrasepsi
vasektomi pada pasangan usia subur. Semarang: UNDIP; 2011.
keikutsertaan vasektomi di kelurahan
24. Simanjuntak RS. Tingkat adopsi inovasi
Tlogosari Kulon kecamatan Pedurungan
KB pria di kalangan prajurit wilayah
Kota Semarang tahun 2007. Semarang:
Medan tahun 2007. Medan: USU; 2007.
UNDIP; 2007.
Jurnal Ilmu Kebidanan, Volume 1, Nomor 1, Maret 2013 35
Indrayani, Khonita Hikmala Fatma, & Bony Wiem Lestari
25. Desra
ER.
Faktor-faktor
yang
Hal. 27-36
30. BKKBN.
Panduan
pelaksanaan
mempengaruhi partisipasi pria dalam
KIP/konseling kontrasepsi pria. Jakarta:
vasektomi di kelurahan Namo Gajah
BKKBN; 2008.
kecamatan Medan Tuntungan. Medan: USU; 2011.
tanpa pisau. Jakarta: BKKBN; 2008.
26. Wulansari, Hartanto. Ragam metode kontrasepsi. Jakarta: EGC; 2006. 27. Winarso
HP.
31. BKKBN. Panduan pelayanan vasektomi
Sosiologi
32. Jersild
AT.
The
psychology
of
adolesence. New York: The MacMillan
komunikasi
Company; 1965.
massa. Jakarta: Prestasi Pustaka; 2005.
33. Santiso R, Pineda MA, Marroquin M,
28. Taher A, Rasyid N, Asri, Mu'ammar.
Bertrand JT. Vasectomy in Guatemala:
Buku acuan vasektomi tanpa pisau.
A follow-up study of five hundred
Jakarta:
acceptors.
Perkumpulan
Kontrasepsi
Mantap Indonesia (PKMI); 2003.
Diambil
Desember
pada
tanggal
2012,
http://gemapria.bkkbn.go.id/consult-
&
Soc
Bio.
1981;28(3-4):253-64.
29. BKKBN. Gema Pria Pusat Informasi KB Pria.
Biodem
13 dari:
34. Kurnia RA. Pengetahuan kontrasepsi vasektomi pada suami ditinjau dari umur,
pendidikan
dan
pekerjaan.
Surabaya: Universitas Airlangga; 2008.
detail.php?conid=1377. 2012.
Jurnal Ilmu Kebidanan, Volume 1, Nomor 1, Maret 2013 36