MIDWIFERY AND NURSING RESEARCH (MANR) JOURNAL Vol.

6 Issue 2 Year 2024

http://ejournal.poltekkes-smg.ac.id/ojs/index.php/MANR
57
p-ISSN: 2685-2020 ; e-ISSN: 2685-2012

The Role of Task Force SUP IVA on IVA Examination Behavior

Yunni Ratnawati1 Siti Chunaeni2 Siti Rofi’ah3

Email: uknow.2610.yr@gmail.com

ABSTRACT

Background : The total number of women aged 30-50 years in Temanggung Regency who underwent IVA
(Visual Acetic Acid Inspection) examination for early diagnosis of cervical cancer was reported to be 2,127,
which accounts for 1.1% of the total population of 114,035 women in that age group. The proportion of
WUS who conduct VIA examinations is still well below the established aim of 10% (Dinkes Temanggung,
2022). This study seeks to ascertain the impact of the SUP IVA (Husband cares about IVA examination)
Task Force on the conduct of IVA examinations in Women of Childbearing Age (WUS).
Methods : This type of research uses quasi-experiments with postest only with control group design. The
population in this study was all men who had wives aged 30-50 years in Coyo, Dayohan, and Jekaton
Hamlets of Wonosari Village who had not done IVA examination totaling 197 people. With the slovin
formula, a sample of 130 respondents was obtained, namely 65 respondents became the intervention
group and 65 respondents became the control group. The sampling technique uses purposive sampling.
The statistical test of this study used the Chi Square test.
Result : The group that received counseling from the SUP IVA Task Force, as many as 11 people (16.9%)
carried out IVA examinations. The group that received counseling for female IVA cadres, as many as 6
people (9.2%) carried out IVA examinations. Chi Square's statistical test shows that the role of the SUP
IVA Task Force does not have a significant effect on IVA inspection behavior in WUS (p value = 0,298).
Conclusion: There is no influence on the role of Task Force SUP IVA on IVA examination behavior. Provide
input to health workers to involve the role of the husband in the behavior of IVA examination in WUS.

Keywords : Task Force on the role of husbands, cadres, WUS, IVA

1Bulu Public Health Center, Temanggung, Indonesia

Wolodono, Bulu, Temanggung, Jawa Tengah, Indonesia
2,3Department of Midwifery, Poltekkes Kemenkes Semarang, Indonesia

Jl. Perintis Kemerdekaan, Magelang, Jawa Tengah, Indonesia

Received: March 31, 2024; Revised: September 25, 2024; Accepted: September 25, 2024

Background. Cancer is one of the due to cancer. Based on data (Central Java
health problems whose incidence tends to Health Office in 2021), the number of cervical
increase in the community, both in the world cancer patients increased by 57.9% from the
and in Indonesia (Ministry of Health, 2015a). previous year, reaching 2,444 cases.
Types of cancer in Indonesia that require Based on the health profile of
public health efforts or interventions through Temanggung Regency in 2022, the number of
national prevention programs are breast women aged 30-50 years in Temanggung
cancer and cervical cancer (Ministry of Health, Regency who underwent IVA (Visual Acetic
2015b). One of the measures for early Acid Inspection) examination for early
detection of cervical cancer is with IVA. diagnosis of cervical cancer was reported to
However, awareness of IVA examination is be 2,127 people or 1.1% of the total
still low. This can be due to a lack of population of 114,035 women at that age.
motivation or support for women of Group. The proportion of WUS conducting
childbearing age and access to information IVA examinations is still far below the target
obtained (Sholikah, 2023). set at 10% (Dinkes Temanggung, 2022).
According to data (Indonesia Health The 2022 Puskesmas Bulu
Profile in 2021), cervical cancer ranks second Performance Assessment Report shows that
after breast cancer, with 36,633 cases out of 7,171 women aged 30-50 years, only
(17.2%) of the total number of cancer patients 109 people (1.52%) underwent IVA tests, far
in Indonesia. This number has a high mortality from the target of 10%. Meanwhile, in
rate of 21,003 deaths (19.1%) of all deaths Wonosari village, only 2 people carried out
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IVA examinations during the January- motivational factors aimed at improving family
December 2022 period (Puskesmas Bulu, and community health. These cadres have the
2022). capacity to identify health needs and barriers,
Low early detection is one of the causes understand the resources available in the
of the high incidence of cervical cancer. community, and collaborate effectively with
Timely identification is the most effective community leaders, government officials, and
measure to prevent delays in cervical cancer health workers to encourage independent
treatment. Various methods are used for early community involvement in health services
identification of cervical cancer, including the (Rasyid, 2021).
use of IVA examination or also called visual Puskesmas Bulu seeks to provide
inspection of acetic acid. IVA test is a information on Early Detection of Cervical
macroscopic examination of the entire cervix Cancer through IVA Examination targeting
using undiluted acetic acid/vinegar, without only married women. However, the results
the help of an enlargement device (Santosa, have not shown any improvement in
2020). Because it is simple and affordable, compliance with the VIA examination. The
this examination has been included as a findings of a preliminary investigation
program in the Decree of the Minister of conducted by researchers through interviews
Health of the Republic of Indonesia No. with 10 husbands whose wives were aged
796/MENKES/SK/VII/2010 which provides between 30 and 50 years in Coyo, Dukuh, and
technical guidelines for cervical and breast Jekaton Hamlets, Wonosari Village, Bulu
disease control. (Ministry of Health, 2017). District in March 2023, revealed that the ten
The lack of motivation of women of couples (100%) had never undergone an IVA
childbearing age (WUS) for IVA examination examination before. The husbands cited three
is one of the factors causing the low IVA main reasons: first, 10 people (100%) had
examination. The role of the husband as a never been told about IVA screenings;
motivator is a form of encouragement or second, 10 husbands were embarrassed to
support that the husband gives to his wife to seek information about IVA from midwives
do an action (Maryani, 2023). External and health cadres in the village; and third, the
sources of support and motivation are ten husbands (100%) stated that they
provided by Task Force SUP IVA, which preferred to obtain information from male
carries out the function of husband support. A cadres rather than female cadres.
husband's support becomes a moral and The results of the analysis (Widayanti et
material encouragement and inspiration for al., 2017), showed that there was no biavriat
his wife (Mardjan, 2016). The purpose of the significant relationship between the level of
IVA Task Force Cares for Husbands of husband support and the behavior of
Women of Childbearing Age (WUS) is to be undergoing IVA examination (p = 0.719).
actively involved in efforts to prevent and treat Meanwhile, the results of the study
cervical cancer. The goal is to ensure that (Cendraiswati, 2021), showed a significant
couples are willing to undergo IVA (Visual relationship (p = 0.001, sig < 0.05) between
Acetic Acid Inspection) examination the level of husband support and the behavior
(Dartiwen, 2022). Husband's participation can of women of childbearing age in early
be done by participating in health education detection of cervical cancer. A contingency
which is carried out with the concept of peer coefficient value of 0.342 indicates a
group. Peer group education aims to improve moderate relationship.
one's knowledge and skills to prevent various Based on the description provided,
problems (Indah, 2022). researchers wanted to know the impact of Task
Cadres are carefully selected and Force SUP IVA on IVA Examination Behavior
appointed community members to improve at WUS.
health conditions and raise public awareness Methods. This study uses a quasi-
of the importance of maintaining health experimental research design, which is an
through collaborative involvement in many experiment that includes treatment, impact
community initiatives, including posyandu assessment, and experimental units, to
programs. (Isnawati, 2019). The emergence determine the impact of the therapy (Henny
of cadres who are empowered by the Syapitri et al, 2021). This study used Only With
community can be caused by various
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p-ISSN: 2685-2020 ; e-ISSN: 2685-2012

Control Group Design. Both experimental study, it can be concluded that the awareness
groups in this design received the same to do the IVA test is still low.
treatment and neither group underwent pre-test Lack of motivation among women of
prior to the study. Measurements are carried childbearing age (WUS) to undergo IVA tests is
out post-treatment. one of the causes of the low frequency of IVA
This study focuses on the role of Task examinations. The husband's duties as a
Force SUP IVA as an independent variable. motivator include providing encouragement or
The dependent variable in this study was the support to the wife to inspire her to take action.
behavior of the WUS IVA examination. The This assistance can be provided by enabling
study population consisted of 197 married men, the couple to meet their requirements while
aged 30-50 years, domiciled in Coyo, undergoing an Individual Voluntary
Dayohan, and Jekaton Hamlets of Wonosari Arrangement (IVA) assessment (Maryani,
Village. These people have not undergone IVA 2023). The lack of WUS knowledge about early
examination. A sample size of 130 respondents detection of cervical cancer is caused by the
was obtained based on calculations using the low involvement of mothers in seeking
formula of Isaac and Michael. Purposive information on the topic. Access to information
Sampling approach is used for the sampling facilitates the achievement of changes in health
process. behavior, especially the application of early
The research was conducted in Coyo, detection of cervical cancer through IVA
Dayohan, and Jekaton Villages, Wonosari examination. In addition, certain women who
Villages, Puskesmas Bulu area in December undergo cervical cancer screening may also
2023. The instruments of this research are experience feelings of embarrassment
leaflets on IVA examination, IVA examination (Sholikah, 2023).
register book. External sources of support and
Analisa univariate pada penelitian ini motivation are provided by Task Force SUP
menggunakan frekuensi dan persentase. The IVA, which plays a role in providing assistance.
bivariate analysis conducted in this study The support of a husband provides
encouragement and incentives both morally
involved comparing two separate groups using
and materially for his wife (Mardjan, 2016). The
the Chi Square test. Interpretation of the results purpose of the IVA Caring for Husbands of
shows p value = 0.298 > 0.05. This shows that Women of Childbearing Age (WUS) is to play
there is no significant difference in IVA an active role in efforts to prevent and control
examination behavior between the group that cervical cancer. The aim is to encourage wives
received counseling from the SUP IVA Task to be willing to undergo IVA (Visual Acetic Acid
Force and the group that received counseling Examination) examination (Dartiwen, 2022).
Husbands can participate by conducting health
from female IVA cadres.
education activities carried out through a peer
Result and Discussion. group framework. Peer group education seeks
IVA Examination Behavior in Groups to improve individual knowledge and abilities to
Receiving Counseling from Task Force SUP reduce various problems (Indah, 2022). The
IVA SUP IVA Task Force consisting of WUS
Table 1. Data on the Frequency Distribution of IVA
husbands aged 30-50 years who are targeted
Examination Behavior in the Group
Receiving Counseling from the SUP IVA by IVA is expected to have a greater capacity
Task Force in motivating and facilitating the improvement
No IVA Examination F (%) of the husband's role so as to encourage WUS
1 Did not do 54 83,1 to undergo IVA examination.
2 Do 11 16,9 As in the study (Cendraiswati, 2021), the
Total 65 100,0 findings of this study show a significant
relationship between the level of support
Based on table 4.1 shows that of women provided by husbands and the behavior of
of childbearing age (WUS) who received women of childbearing age in early detection of
counseling from the SUP IVA Task Force, as cervical cancer. The analysis showed a p-value
many as 11 respondents (16.9%) underwent of 0.001 (sig < 0.05) and a contingency
IVA examination. Based on the results of the coefficient value of 0.342 (in the range of 0.26-
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0.50), indicating a moderate degree of The data analysis test using the Chi
relationship. Square Test obtained a p value of 0.298 (p >
0.05) which showed that there was no
IVA Examination Behavior in Groups with statistically significant difference in IVA
Counseling for Women IVA Cadres examination behavior between the group who
Table 2. Frequency Distribution of IVA Examination received counseling from the SUP IVA Task
Behavior in the Group Receiving Force and the group who received counseling.
Counseling for Female IVA Cadres from female IVA cadres.
No IVA Examination F (%) However, based on descriptive analysis,
1 Did not do 59 90,8 it is known that the maternal cadre counseling
2 Do 6 9,2
group and not IVA is more than IVA, which is
Total 65 100,0
52.2% compared to 35.3%. Meanwhile, in the
counseling group in the SUP IVA and IVA Task
Based on table 4.2, it shows that Women
Force, there were more than those without IVA,
of Childbearing Age (WUS) in the group who
namely 64.7% compared to 47.8%. Thus, there
received counseling for female IVA cadres as
is a tendency for IVA examination behavior to
many as 6 respondents (9.2%) carried out IVA
be carried out in groups that receive counseling
examination. Based on the results of the study,
by the SUP IVA Task Force rather than groups
it can be concluded that the number of women
that receive counseling for female IVA cadres.
who carry out IVA examinations with the
Based on the researcher's assumptions
assistance of female IVA cadres is still low.
in this study, factors that affect women's low
The role of a cadre, as defined by
awareness to do IVA examinations include lack
(Isnawati, 2019), is that cadres have the power
of support from husbands, low levels of
to overcome all health problems faced by the
knowledge and women's fear or anxiety about
community. Public health cadres work within
IVA examinations.
the health system and not in isolation, thus
Research (Purnamasari, 2023) states
fulfilling their duties as active participants. This
that there is a relationship of husband support
research aims to increase knowledge about
to the wife's behavior in the IVA examination
WUS, thus encouraging the application of the
which is shown by a p value = 0.010 < 0.05.
VIA test.
Research (Dewi et al., 2019) stated that there
Research (Nuraini et al., 2023) states that
was a relationship between the knowledge of
awareness of IVA examinations cannot be
women of childbearing age about cervical
separated from the role of cadres. The level of
cancer and participation in the visual inspection
knowledge and communication in providing
examination of acetic acid which was shown
information about cervical Ca and IVA
with a p value = 0.028 < 0.05. Research (Isnaini
examination affects women's awareness to do
et al., 2020) stated that there was a relationship
IVA examinations.
between the level of anxiety about cervical
cancer and the participation of women of
Differences in IVA Examination Behavior in
childbearing age (WUS) in conducting visual
Groups Receiving Counseling from the SUP
inspections of acetic acid (IVA) in the Sibela
IVA Task Force and Groups Receiving
Health Center Working Area, which was shown
Counseling for Women IVA Cadres
by a p value = 0.000 < 0.05.
Table 3. Differences in IVA Examination Behavior in
Groups Receiving Counseling from the SUP The research findings showed that there
IVA Task Force and Groups Receiving was no statistically significant disparity in IVA
Counseling for Women IVA Cadres examination behavior between the group that
IVA Examination received counseling from the SUP IVA Task
Mentoring Tidak Total p Force and the group that received counseling
Periksa
Group Periksa value from female IVA cadres. However, there is a
f % f % f %
tendency for IVA assessment to be carried out
SUP IVA
Task 54 47,8 11 64,7 65 50 in cohorts that receive guidance from the SUP
Force 0,298 IVA Task Force, compared to cohorts that
Women's
59 52,2 6 35,3 65 50 receive guidance from female IVA cadres. The
IVA Cadre lack of motivation of women of childbearing age
Sum 113 86,9 17 13,1 130 100
(WUS) to undergo IVA tests is one of the
causes of the low frequency of these
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examinations. The absence of spousal support =dartiwen buku ajar

is an external factor that initiates the lack of IVA asuhan&pg=PR3&printsec=frontcover
examination behavior in women undergoing Dinkes Temanggung. (2022). Laporan
uterine sonography. The husband's job as a Triwulan ke Empat Dinas Kesehatan
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action. This assistance can be provided by Berbagai Perspektif (D. Nurjanah (ed.); 1st
giving the ability to the wife to meet her needs ed.). Syiah Kuala University Press.
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The lack of WUS knowledge regarding early Kader Kesehatan Jiwa di Masyarakat (1st
detection of cervical cancer is caused by the ed.). Yayasan Ahmar Cendekia Indonesia.
limited involvement of mothers in seeking https://www.google.co.id/books/edition/Ko
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facilitates the implementation of early diagnosis wa/6k-
of cervical cancer through IVA examination, 9DwAAQBAJ?hl=id&gbpv=1&dq=konsep
thus encouraging changes in health behavior. pembentukan kader kesehatan jiwa
In addition, certain women who undergo masyarakat&pg=PA12&printsec=frontcove
cervical cancer screening may experience fear r
and embarrassment (Sholikah, 2023). The aim Kemenkes. (2015a). Pedoman Nasional
of the study was to provide health workers with Program Paliatif Kanker.
valuable insights into how couples can play a Kemenkes. (2015b). Peraturan Menteri
more active role in encouraging WUS to take Kesehatan Republik Indonesia Nomor 34
VUS tests. To increase the involvement of Tahun 2015 Tentang Penanggulangan
husbands, it is necessary to increase the Kaker Payudara dan Kanker Leher Rahim.
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encourage wives to conduct IVA assessments. Kesehatan RI nomor
Conclusion and Suggestions. The HK.01.07/Menkes/14/2017 Tentang
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many as 6 people (9.2%) carried out IVA (ed.); 1st ed.). Abrori Institute.
examinations. There was no difference in IVA Maryani, S. (2023). Asuhan Kesehatan
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Acknowledgements I would like to N_KELUARGA/cYfXEAAAQBAJ?hl=id&gb
thank my supervisor for his guidance during the pv=1&dq=peran suami dalam kesehatan
preparation of this thesis. I would also like to reproduksi&pg=PA117&printsec=frontcove
thank my family for their moral and material r
support, as well as to my fellow students of the Purwaningsih, S. S. (2015). Prosiding PKWG
Magelang Midwifery Applied Bachelor Study Seminar Series : Kebijakan Kesehatan dan
Program, IBI Temanggung Cooperation Level Pelibatan Komunitas dalam Menurunkan
Transfer Class of the Ministry of Health AKI atau AKB di Indonesia (K. U. Noer
Semarang who have given encouragement. (ed.); 1st ed.). Pusat Kajian Wanita dan
Gender Universitas Indonesia.
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