Socioeconomic inequalities and determinants of postpartum family planning utilization among Millennial and Generation Z women in Indonesia.

BACKGROUND

Postpartum family planning (PPFP) within 12 months after childbirth is crucial to prevent unintended pregnancies and ensure healthy birth spacing for better maternal and child health outcomes. As Millennials and Generation Z dominate the reproductive-age population, understanding how generational identity intersects with socioeconomic factors is critical to designing equitable reproductive health interventions.

OBJECTIVE

To assess socioeconomic inequality and identify key determinants of PPFP utilization among Millennial and Generation Z women in Indonesia.

METHODS

We conducted a cross-sectional analysis using data from the 2023 Indonesia Health Survey, a nationally representative dataset. The sample included women aged 15-49 who had given birth in the past five years. Respondents were grouped into two cohorts: Millennials (born 1981-1996) and Generation Z (born 1997-2012). Logistic regression identified determinants of PPFP use, while socioeconomic inequality was assessed using the concentration index and decomposition analysis.

RESULTS

Among Millennial women, PPFP utilization was significantly associated with maternal and partner education, employment status, household wealth, parity, pregnancy intention, delivery-related factors, and access to maternal health services. In contrast, among Generation Z women, PPFP utilization was mainly associated with partner's education, employment status, household wealth, delivery complications, and service access, while parity and pregnancy intention were not significant. Socioeconomic inequality in PPFP use was more pronounced among Millennials (CI = -0.069, p<0.001) than Generation Z (CI = -0.024, p=0.313).

CONCLUSIONS

Generational differences were associated with differences in PPFP determinants and equity patterns, underscoring the potential value of generation-sensitive approaches to promote more equitable access.