The Relationship of Husband's Knowledge, Attitude, and Support to Low Interest in Use of IUD Contraceptive Methods in Work Area Community Health Center Technical Implementation Unit Melak

Introduction : The use of contraceptives at the Melak Health Center is still dominated by short-term contraceptives, while the level of use of long-term contraceptive methods, especially the IUD is still low. Melak Health Center wheres has made efforts to increase interest in the use of IUDs such as providing counseling to WUS and cross-sectoral cooperation. Objective: The purpose of this study was to determine the relationship between knowledge, attitudes and husband's support for the low interest in using the IUD contraceptive method in the Technical Implementation Unit working area Malacca Health Center. Methods : This type of research is an analytic survey using a cross sectional design. Results : The characteristics of most wives are between 31-40 years old (48.8%), high school education (36.9%) and household members (47.6%). The research variables were mostly poor knowledge about IUD (64.3%), negative attitude towards IUD (54.8%), husband was less supportive (60.7%) and less interested in using the IUD contraceptive method (58.3%). Discussion : Knowledge is not good due to lack seeking information such as from mass media. Negative attitude is due to perception that IUD is less safe to prevent pregnancy, costs more and interferes with husband & wife relationships. Husbands are less supportive because they do not provide funds or do not deliver to IUD services. Conclusion : Husband's knowledge, attitude and support associated with low interest in using the IUD.


Introduction
Family planning aims to control the rate of population growth, meet public demand for quality family planning and reproductive health (KR) services, reduce maternal mortality (MMR) and infant mortality (IMR) as well as overcome reproductive health problems (Yuhedi and Kurniawati, 2016).
Contraceptive users in the world according to the World Health Organization (WHO) in 2015 out of 100 million women there were 75% users of hormonal contraceptives, while 25% used non-hormonal.In 2016 it reached 89%, then in 2017 in urban areas it reached 58% while in village reached 57% (Nirvana et al, 2018).
Indonesia is in the fourth position with the highest population in the world with 253.60 million people.This brings challenges in improving people's welfare, creating employment opportunities, eliminating poverty, improving the quality of education and health, improving infrastructure, and public services.The Indonesian government is taking action to deal with population problems through the strategy of implementing the family planning program based on the Medium-Term Development Plan, which is the increasing use of Long-Term Contraceptive Methods (MKJP) such as IUD (Intra Uterine Device), implants and sterilization.The target of achieving the Long-Term Contraceptive Method (MKJP) is 22.3%, but the achievement is only 17.8%.The use of contraceptives is still dominated by short-term contraceptives, especially injections reaching 31.15%,condoms 3.5% and pills 28.1%, while long-term reaching 25.56% with an IUD of only 3.9% (Pinamangun, 2018).
Factors that influence the interest in the use of contraception include predisposing factors (knowledge, attitudes, interests and other elements that exist in the individual), supporting factors, namely the availability of health facilities and strengthening factors such as midwife services and husband or couple support (Rahayu, 2018).The results of previous research conducted by Widyarni (2018) showed that it showed results that there was a relationship of knowledge to the use of IUD birth control and there was a relationship between attitudes towards the use of IUD birth control.Putri's research (2020) shows that there is a relationship between family instrumental social support and the interest of Su bur Age Women using IUD birth control.Santoso's research (2017) shows that knowledge and attitudes correlate with interest in IUD use.
Preliminary studies at the Melak Center for Public Health show that the selection of IUD as a contraceptive is still low.Even though the Melak Community Health Center has made efforts to increase interest in IUD use such as providing counseling to WUS in Novita Asmiranti, Andi Parellangi, Fara Imelda/KESANS The Relationship of Husband's Knowledge, Attitude, and Support to Low Interest in Use of IUD Contraceptive Methods in Work Area Community Health Center Technical Implementation Unit Melak its work area.Counseling is given to classes for pregnant women conducted by the Community Health Center using alternating sheets that are given 3 times to each pregnant woman every trimester.The efforts made also include increasing cross-sectoral cooperation in an effort to improve respondents' knowledge and attitudes about the advantages and disadvantages of using IUD birth control.
Initial interviews with 9 WUS people who used the IUD there were 5 people who were dissatisfied due to several things such as cramps or back pain for several days, there were spots between menstrual periods, irregular menstrual periods and cramps during menstruation.In addition, there are 4 WUS people who are satisfied with using the IUD because their husbands support the use of the IUD as a contraceptive that does not reduce the pleasure of sexual intercourse, the information provided by the midwife is detailed about the IUD so that they are interested in using the IUD because it can reduce the number of children in the long term.

Methods
This type of research is an analytical survey using a cross-sectional design analyzing variable data collected at one point in time.Most of the wives between 31-40 years old were 41 people (48.8%), the wife's education after high school was 31 people (36.9%) and the wife's job as an IRT was 40 people (47.6%).

Knowledge
Table 2 Attitudes towards IUD in couples of childbearing ages in the working area of the Technical Implementation Unit of the Melak Community Health Center, mostly negative amounted to 46 people (54.8%), while positive amounted to 38 people (45.2%).

4.
Husband Support Husband's support for IUD in couples of childbearing ages in the work area of the Melak Community Health Center Technical Implementation Unit, was mostly less supportive of 51 people (60.7%), while supporting was 33 people (39.3%).

5.
Interest in the Use of IUD Contraceptive Methods The results of the statistical test obtained a p value of 0.021 < α: 0.05 meaning that there is a relationship of knowledge to the low interest in the use of the IUD contraceptive method.

7.
Relationship of attitudes to the low interest in the use of IUD contraceptive methods The results of the statistical test obtained a p value of 0.002 < α: 0.05 meaning that there is a relationship of husband support for the low interest in the use of IUD contraceptive methods in the work area of the Technical Implementation Unit of the Melak Community Health Center.

The relationship of knowledge to the low interest in the use of IUD contraceptive methods
Based on the results of the study, it is known that couples of childbearing ages have good knowledge who are interested in using the IUD contraceptive method totaling 18 people (21.4%) and less interested in 12 people (14.3%).Then couples of childbearing ages have poor knowledge who are less interested in using the IUD contraceptive method totaling 37 people (44%) and interested in 17 people (20.2%).Based on the results of statistical tests, the results of p value 0.021 < α: 0.05 mean that there is a relationship of knowledge to the low interest in the use of IUD contraceptive methods in the work area of the Technical Implementation Unit of the Melak Community Health Center.
The results of this study are in accordance with Widyami's research (2018) showing that there is a knowledge relationship to the use of IUD birth control in the Working Area of the Paramasan Community Health Center, Banjar Regency (Widyarni & Dhewi, 2018).Likewise, Santoso's research (2017) shows that knowledge is correlated with interest in the use of MKJP in Ende Regency (Santoso & Surya, 2017) (Santoso & Surya, 2017) Notoadmodjo (2017) suggests that a person's knowledge is usually influenced from experiences that come from various sources, for example: mass media, posters, close relatives and so on.This knowledge can form certain beliefs so that a person behaves like that belief.Knowledge is influenced by the level of education, information and experience.The level of education possessed by these respondents helps them to be able to understand the information they receive about family planning, both its purpose and purpose (Notoatmodjo, 2007) Novita Asmiranti, Andi Parellangi, Fara Imelda/KESANS The Relationship of Husband's Knowledge, Attitude, and Support to Low Interest in Use of IUD Contraceptive Methods in Work Area Community Health Center Technical Implementation Unit Melak Researchers as Total that there is a knowledge relationship to the low interest in the use of IUD contraceptive methods in the working area of the Technical Implementation Unit Melak Community Health Center.This knowledge can form certain beliefs so that a person behaves like those beliefs.Related to this study shows that the level of knowledge is one of the factors related to the low interest in the use of IUD contraceptive methods in the technical implementation unit work area.Melak Community Health Center.A well-informed person will participate more in the birth control program.The obstacle that affects the lack of knowledge is that counseling about IUD birth control is often not all PUS in the Technical Implementation Unit work area.The Melak Community Health Center followed.This is because of the busy work of taking care of the house and which takes up too much of their time so that they pay less attention to family planning problems.

Relationship of attitudes to the low interest in the use of IUD contraceptive methods
Based on the results of the study, it is known that couples of childbearing ages have a positive attitude who are interested in using the IUD contraceptive method totaling 22 people (26.2%) and less interested in 16 people (19%).Then couples of childbearing ages had negative attitudes who were less interested in using the IUD contraceptive method totaling 33 people (39.3%) and interested in 13 people (15.5%).Based on the results of statistical tests, a p value of 0.012 < α: 0.05 was obtained, meaning that there was a relationship between attitudes towards the low interest in the use of IUD contraceptive methods in the work area of the Technical Implementation Unit of the Melak Community Health Center.
The results of this study are in accordance with Widyami's research (2018) showing that there is a relationship between attitudes towards the use of IUD birth control in the Working Area of the Paramasan Community Health Center, Banjar Regency.Likewise, Santoso's research (2017) shows that attitudes correlate with interest in the use of MKJP in Ende Regency (Santoso & Surya, 2017) According to Azwar (2018) stated that the husband's attitude is negative to participate in the use of contraception but the husband wants to take the wife to a health care facility for control or remind the wife to birth control.Based on the factors that influence the husband's behavior so that he does not use contraception is the experience of a husband whose wife has used contraceptives, namely a feeling of discomfort when the wife uses IUD contraceptives such as unpleasant or dissatisfied when using IUD contraceptives.Although respondents already know and behave that participating in the use of contraception can help the wife but if there is no intention or encouragement in the person of each individual, there will be no positive behavior towards the use of contraception (Azwar, 2007) Researchers total that there is an attitude relationship to the low interest in the use of IUD contraceptive methods in the working area of the Technical Implementation Unit of the Melak Community Health Center.This is because respondents who think the IUD Novita Asmiranti, Andi Parellangi, Fara Imelda/KESANS The Relationship of Husband's Knowledge, Attitude, and Support to Low Interest in Use of IUD Contraceptive Methods in Work Area Community Health Center Technical Implementation Unit Melak is less a man and effective in preventing pregnancy, IUD installation costs more than short-term contraceptives and also fears risks such as being able to interfere with the comfort of having a conjugal relationship, causing respondents not to participate in using contraceptives.IUD.Although respondents are positive or supportive in the use of IUD contraceptives, if there is no intention or encouragement in each individual's person, there will be no positive behavior towards the use of contraception.

The relationship of husband support to the low interest in the use of IUD contraceptive methods
Based on the results of the study, it is known that couples of childbearing ages whose husbands support so that they are interested in using the IUD contraceptive method are 21 people (25%) and less interested in 12 people (14.3%).Then couples of childbearing ages whose husbands were less supportive so they were less interested in using the IUD contraceptive method were 37 people (44%) and interested in 14 people (16.7%).Based on the results of statistical tests, the results of p value 0.002 < α: 0.05 mean that there is a relationship of husband support for the low interest in the use of IUD contraceptive methods in the work area of the Technical Implementation Unit of the Melak Community Health Center.
The results of this study are in accordance with Putri's research (2020) showing that there is a relationship between family instrumental social support and the interest of Couples of Childbearing Age using MKJP in RW 5 Sidotopo Village (Putri & Widati, 2020) Support is a beneficial state for the individual obtained from others who can be trusted so that one will know that there are others who pay attention to, value and love him (Cohen andSyme 1996 in Prasetyawati, 2011).Husband support in this study is the support given by husbands to wives to use IUD contraceptives.In implementing Family Planning, the support of the husband is indispensable.As is known in Indonesia, the husband's decision to allow the wife is an important guideline for the wife to use contraceptives.If the husband does not allow or does not support, few wives dare to keep the contraceptives installed.This is in accordance with the opinion of Sadli (2010), in terms of birth control, the wife still has to get the husband's consent if she wants to use contraception or choose certain contraceptives.
Husband support is very influential in making decisions whether to use or not and what methods to use.Support from the husband in the use of contraceptives is very necessary because without the support of the husband a sense of comfort in using contraceptives, especially IUD will not be obtained, the contraceptive method cannot be forced by married couples to jointly choose the best contraceptive method, cooperate with each other in use (Indrawati and Mahmudah, 2015).
Based on the description above, the researchers that there is a relationship of husband support for the low interest in the use of IUD contraceptive methods in the work area of the Technical Implementation Unit of the Melak Community Health Center.This is because husbands who lack support such as not providing funds or not delivering wives Novita Asmiranti, Andi Parellangi, Fara Imelda/KESANS The Relationship of Husband's Knowledge, Attitude, and Support to Low Interest in Use of IUD Contraceptive Methods in Work Area Community Health Center Technical Implementation Unit Melak to get IUD birth control services make wives less interested in using IUD birth control.Therefore, a husband who supports his wife using long-term contraceptives such as an IUD can be an impetus for a woman to participate in a government program.Husband support in this study is the support given by husbands to wives to use IUD contraceptives.Husband support is indispensable.As is known in Indonesia, the husband's decision to allow the wife is an important guideline for the wife to use contraceptives.If the husband does not allow or does not support, few wives dare to keep the contraceptives installed.

Conclusion
The characteristics of couples of childbearing ages in the working area of the Technical Implementation Unit of the Melak Community Health Center are mostly wives between 31-40 years old totaling 41 people (48.8%), the education of wives who graduated from high school amounted to 31 people (36.9%) and the wife's work as IRT amounted to 40 people (47.6%).Knowledge of IUD in couples of childbearing ages in the working area of the Technical Implementation Unit of the Melak Community Health Center was mostly poor at 54 people (64.3%), while both were 30 people (35.7%).
Attitudes towards IUD in couples of childbearing ages in the working area of the Melak Community Health Center Technical Implementation Unit were mostly negative (44.8%), while positives amounted to 38 people (45.2%).Husband's support for IUD in couples of childbearing ages in the working area of the Melak Community Health Center Technical Implementation Unit was largely less supportive of 51 people (60.7%), while support amounted to 33 people (39.3%).The interest in the use of IUD contraceptive methods in the technical implementation unit of the Melak Community Health Center was mostly less interested, totaling 49 people (58.3%), while the interest was 35 people (41.7%).
There is a knowledge relationship to the low interest in the use of IUD contraceptive methods in the working area of the Melak Community Health Center Technical Implementation Unit (p value: 0.021 < α: 0.05).There is an attitude relationship to the low interest in the use of IUD contraceptive methods in the working area of the Melak Community Health Center Technical Implementation Unit (p value: 0.012 < α: 0.05).There is a relationship of husband support for the low interest in the use of IUD contraceptive methods in the working area of the Melak Community Health Center Technical Implementation Unit (p value: 0.002 < α: 0.05).

The Relationship of Husband's Knowledge, Attitude, and Support to Low Interest in Use of IUD Contraceptive Methods in Work Area Community Health Center Technical Implementation Unit Melak Results dan Discussion Results 1. Characteristics of Respondents Table 1. Characteristics of Respondents
The population of this study was couples of childbearing age who had birth control in the Technical Implementation Unit the Melak Community Health Center in 2021 totaled 1,481 people with a sample of 84 people based on the Lem show formula.This sampling technique uses purposive sampling, basedon the inclusion criteria for Couples of Childbearing Age who have birth control who visit the Technical Implementation Unit Melak Community Health Center or Posyandu or located in the work area of the Technical Implementation Unit Melak Community Health Center, suami accompanied the visiting wife and was willing to be a respondent.Data analysis using Chi-Square.

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Statistical distribution of knowledge about the IUDThe knowledge about IUD in couples of childbearing ages in the work area of the Technical Implementation Unit of the Melak Community Health Center, most of them were not good at 54 people (64.3%), while both were 30 people (35.7%).Novita Asmiranti, Andi Parellangi, Fara Imelda/KESANS The

Relationship of Husband's Knowledge, Attitude, and Support to Low Interest in Use of IUD Contraceptive Methods in Work Area Community Health Center Technical Implementation Unit Melak 3. AttitudeTable 3 .
Statistical distribution of attitudes towards the IUD

Table 4 .
Distribution of husband support statistics

Table 5 .
Statistical distribution of interest in the use of IUD contraceptive methods

Relationship of Husband's Knowledge, Attitude, and Support to Low Interest in Use of IUD Contraceptive Methods in Work Area Community Health Center Technical Implementation Unit Melak KESANS, Vol. 2, No. 4, 2023 200 6. The relationship of knowledge to the low interest in the use of IUD contraceptive methodsTable 6 .
The relationship of knowledge to the low interest in the use of IUD contraceptive methods * Chi Square Test Analysis p < α α = 0.05

Table 7
Relationship of attitudes to the low interest in the use of IUD contraceptive methodsThe results of the statistical test obtained a p value of 0.012 < α: 0.05 meaning that there is a relationship between attitudes towards the low interest in the use of IUD contraceptive methods in the work area of the Technical Implementation Unit of the Melak Community Health Center.Novita Asmiranti, Andi Parellangi, Fara Imelda/KESANS The

Relationship of Husband's Knowledge, Attitude, and Support to Low Interest in Use of IUD Contraceptive Methods in Work Area Community Health Center Technical Implementation Unit Melak KESANS, Vol. 2, No. 4, 2023 201 8. The relationship of husband support to the low interest in the use of IUD contraceptive methodsTable 8 .
Relationship of husband support to low interest in the use of IUD contraceptive methods

Relationship of Husband's Knowledge, Attitude, and Support to Low Interest in Use of IUD Contraceptive Methods in Work Area Community Health Center Technical Implementation Unit Melak
Novita Asmiranti, Andi Parellangi, Fara Imelda/KESANS The