Contraceptive Use in East Timorese Ex-Refugee Women in Indonesia: Determinants and Barriers

Maria Paula Marla Nahak, Maria Lupita Nena Meo, Maria Getrida Simon


Background: Poor access to contraceptive services is a global health problem, especially in the marginal community order. Refugee camps and areas with weak community order are the groups with the lowest prevalence of contra­ceptive use. This study aimed to determine the factors affecting contraceptive use in East Timorese ex-refugee women.

Subjects and Method: This was a cross-sectional study conducted at 3 ex-refugee settlements in Noelbaki village, Kupang, East Nusa Tenggara, Indonesia, from April to May 2019. A total of 76 women of reproductive age were selected by fixed disease sampling. The depen­dent variable was contraceptive use. The inde­pendent variables were education, family in­come, accessibility, and sociocultural. The data were collected by a set of questionnaire and analyzed by a multiple logistic regression.

Results: The likelihood of contraceptive use increased with high education (OR= 7.05; 95% CI= 1.16 to 42.76; p= 0.034), family income (OR= 9.36; 95% CI= 0.88 to 99.01; p= 0.063), good accessibility (OR= 27.53; 95% CI= 2.62 to 288.88; p=0.006), and supportive sociocultural (OR= 14.15; 95% CI= 2.14 to 83.63; p= 0.006).

Conclusion: The likelihood of contraceptive use increases with high education, high family income, good accessibility, and supportive sociocultural

Keywords: contraceptive, reproductive age, ex-refugee women

Correspondence: Maria Paula Marla Nahak. Nursing Study Pro­gram, Universitas Citra Bangsa, Kupang, East Nusa Tenggara, Indonesia. Email: marlanahak­ Mobile: +6282328282282.

Journal of Maternal and Child Health (2020), 05(04): 365-375

Full Text:



Ackerson K, Zielinski R (2017). Factors influencing use of family planning in women living in crisis affected areas of Sub-Saharan Africa: A review of the literature. Midwifery. 54: 35–60.

Adebowale SA, Adeoye IA, Palamuleni ME (2013). Contraceptive use among Nigerian women with no fertility intention: Interaction amid potential causative factors. Etude de La Population Africaine. 27(2): 127–139.

Adeyemi AS, Olugbenga-Bello AI, Adeoye O, Salawu M, Aderinoye A, Agbaje M (2016). Contraceptive prevalence and determinants among women of reproductive age group in Ogbomoso, Oyo State, Nigeria. Open Access Journal of Contraception, 33.

Agbemenu K, Auerbach S, Murshid NS, Shelton J, Amutah-Onukagha N (2019). Reproductive health outcomes in African refugee women: A comparative study. Journal of Women’s Health, 28(6): 785–793.

Alspaugh A, Barroso J, Reibel M, Phillips S (2019). Women’s contraceptive perceptions, beliefs, and attitudes: An integrative review of qualitative research. Journal of Midwifery and Women’s Health, 65(1): 64–84.

Bell AV, Gifford K, Rashid H, McDuffie MJ, Knight EK (2020). “Power of mom”: A mixed methods investigation of mothers’ influence on women’s contraceptive attitudes and behaviors. Maternal and Child Health Journal, 24(3): 291–298.

Bishwajit G, Yaya S (2018). Domestic violence: a hidden barrier to contraceptive use among women in Nigeria. Open Access Journal of Contraception. 9: 21–28.

Cavallaro FL, Benova L, Owolabi OO, Ali M (2019). A systematic review of the effectiveness of counselling strategies for modern contraceptive methods: What works and what doesn’t? BMJ Sexual and Reproductive Health. 7: 1–16.

Dadi D, Bogale D, Minda Z, Megersa S (2020). Decision-making power of married women on family planning use and associated factors in Dinsho Woreda, South East Ethiopia. Open Access Journal of Contraception. 11: 15–23.

Dehlendorf C, Reed R, Fox E, Seidman D, Hall C, Steinauer J (2018). Ensuring our research reflects our values: The role of family planning research in advancing reproductive autonomy. Contraception, 98(1).

Dhosa DD, Ratumakin PA (2019). Ekonomi politik redistribusi tanah, dinamika kelas dan perjuangan pengungsi Timor Timur di Timor Barat Indonesia. Jurnal Pendidikan Dan Kebudayaan Missio. 11(1): 1–17. Retrieved from

Finlay JE, James E (2017). Barriers to contraceptive use: Examination of contraceptive laws and contraceptive use in Sub-Saharan Africa. Journal of Contraceptive Studies, 02(02): 1–10.

Gagnon AJ, Merry L, Robinson C (2002). A systematic review of refugee women’s reproductive health. Refuge - Canada’s Periodical on Refugees. 21(1): 6–17.

Gebresilassie YH, Woldu GT (2018). Explaining unmet need for family planning in rural Tigrai, Ethiopia. Journal of Contraceptive Studies. 03(02): 1–7.

Government of South Australia and World Health Organization (2017). Progressing the Sustainable Development Goals through Health in All Policies: Case Studies from Around the World. In Government of South Australia.

Haider T, Sharma M (2012). Barriers to family planning and contraception uptake in Sub-Saharan Africa: A systematic review. International Quarterly of Community Health Education. 33(4): 403–413.

Hodgson EJ, Collier C, Hayes L, Curry LA, Fraenkel L (2013). Family planning and contraceptive decision-making by economically disadvantaged, African-American women. Contraception. 88(2): 289–296.

IAWG (2018). Inter-agency field manual on reproductive health in humanitarian settings. Available at

Jain A, Reichenbach L, Ehsan I, Rob U (2017). “Side effects affected my daily activities a lot”: a qualitative exploration of the impact of contraceptive side effects in Bangladesh. Open Access Journal of Contraception. 8: 45–52.

Kabagenyi A, Habaasa G, Rutaremwa G (2016). Low contraceptive use among young females in Uganda: Does birth history and age at birth have an influence? Analysis of 2011 Demographic and Health Survey. J Contracept Study. 1(1): 4.

Lowe P, Griffiths F, Sidhu R (2007). “I got pregnant, I was so like … crying inside …”: experiences of women of Pakistani ancestry seeking contraception in the UK. Diversity in Health and Social Care, 4: 69–76. Retrieved from

Mahumud RA, Hossain G, Sarkar AR, Islam N, Hossain R, Aik S, Khan J (2015). Prevalence and associated factors of contraceptive discontinuation and switching among Bangladeshi married women of reproductive age. Open Access J Contracept. 13.

Meo MLN, Nahak MPM (2020). Problem kesehatan reproduksi perempuan usia subur eks pengungsi Timor Timur. Jurnal Kesehatan Reproduksi, 7(1): 18–25.

Merki-Feld GS, Caetano C, Porz TC, Bitzer J (2018). Are there unmet needs in contraceptive counselling and choice? Findings of the European TANCO Study. Eur J Contracept Reprod Health Care. 23(3): 183–193.

Nakirijja DS, Xuili X, Kayiso MI (2018). Socio-economic determinants of access to and utilization of contraception among rural women in Uganda: The Case of Wakiso District. Health Science Journal, 12(6): 1–20.

Pazol K, Zapata LB, Tregear SJ, Mautone-Smith N, Gavin LE (2016). Impact of contraceptive education on contraceptive knowledge and decision making: A systematic review. Physiology & Behavior, 176(1): 139–148.

Pleasants E, Koffi TB, Weidert K, McCoy SI, Prata N (2019). Are women in Lomé getting their desired methods of contraception? Understanding provider bias from restrictions to choice. Open Access J Contracept. 10: 79–88.

Rada C (2014). Family planning in Romania: A cross-sectional study of knowledge, practice and attitudes. International Journal of Collaborative Research on Internal Medicine & Public Health, 6(9): 260–275.

Richards NK, Crockett E, Morley CP, Levandowski BA (2020). Young women’s reproductive health conversations: Roles of maternal figures and clinical practices. PLoS ONE, 15(1): 1–11.

Richardson E, Allison K, Gesink D, Berry A (2016). Barriers to accessing and using contraception in highland Guatemala: the development of a family planning self-efficacy scale. Open Access J Contracept. 77–87.

Sinai, I, Nyenwa J, Oguntunde O (2018). Programmatic implications of unmet need for contraception among men and young married women in northern Nigeria. Open Access J Contracept. 9: 81–90.

Tanabe M, Myers A, Bhandari P, Cornier N, Doraiswamy S, Krause S (2017). Family planning in refugee settings: findings and actions from a multi-country study. Conflict and Health. 1–12.

Thapa P, Pokharel N, Shrestha M (2018). Knowledge, attitude and practices of contraception among the married women of reproductive age group in selected wards of Dharan Sub-Metropolitan City. J Contracept Studies, 03(03): 1–8.

Tran NT, Yameogo WME, Gaffield ME, Langwana F, Kiarie J, Kulimba M, Seni K (2018). Postpartum family-planning barriers and catalysts in Burkina Faso and the Democratic Republic of Congo: a multiperspective study. Open Access J Contracept. 9: 63–74.

UNDESA. (2017). World Family Planning. United Nations, 1–43. Available at

United Nations Fund for Population Activities. (2016). Universal access to reproductive health: Progress and challenges. UNFPA, January. Available at

United Nations High Commisioner for Refugees. (2019). Contraception and family planning in refugee settings. UNHCR. Available at

Wado YD (2017). Women’s autonomy and reproductive health-care-seeking behavior in Ethiopia. Women and Health, 58(7): 729–743. https://doi.-org/10.1080/03630242.2017.1353573

World Health Organization (2016). Selected practice recommendations for contraceptive use. Third Edition. Available at;jsessionid=AFA5066-F3AA385411DA48E888430D7CE?sequence=1.

World Health Organization (2018a). Family planning: A global handbook for providers. 2018 Edition. Available at

World Health Organization (2018b). Family planning/ Contraception. 1–8. Available at

World Health Organization (2019). Contraception. World Health Organization. Available at

Wyatt KD, Anderson RT, Creedon D, Montori VM, Bachman J, Erwin P, LeBlanc A (2014). Women’s values in contraceptive choice: A systematic review of relevant attributes included in decision aids. BMC Women’s Health, 14(1): 1–18.

Yesgat YM, Gebremeskel F, Estifanous W, Gizachew Y, Jemal S, Atnafu N, Nuriye K (2020). Utilization of family planning methods and associated factors among reproductive-age women with disability in Arba Minch Town, Southern Ethiopia. Open Access J

Contracept. 11: 25–32.


  • There are currently no refbacks.