SUSTAINABILITY OF IUD UTILIZATION FROM LAW AND INSTITUTIONAL DIMENSIONS: A MULTI-DIMENSIONAL SCALING APPROACH IN PEKANBARU CITY

Abstract

Sustainable contraceptive practices are essential for controlling population growth and reducing environmental pressure. Despite its advantages, the utilization of non-hormonal Intrauterine Devices (IUDs) in Indonesia remains low. This study analyzed the sustainability of IUD utilization from legal and institutional perspectives in Pekanbaru City, Riau Province, Indonesia. A quantitative approach was employed through interviews with 99 family planning acceptors and 4 informants, supported by observations and document reviews. The sustainability assessment used the Multi-Dimensional Scaling (MDS) method with RAPSGreenC analysis, adapted from RAPFISH, to evaluate eleven attributes across the legal–institutional dimensions. The sustainability index of IUD utilization was 67.6, indicating a moderately sustainable status. Six main leverage factors were identified: funding support, availability of field officers, availability of health personnel, collaboration with related sectors, the role of non-formal institutions, and monitoring and evaluation mechanisms. These factors significantly influence institutional capacity and service continuity. Strengthening cross-sector collaboration and adaptive monitoring systems is recommended to enhance policy implementation and ensure the long-term sustainability of family planning programs.