For almost 25 years, Luiza Tecla Suarez (52) has worked as a midwife at the Camplong Community Health Center, Kupang Regency, East Nusa Tenggara. Throughout her long career, she had never attended any training, especially regarding Family Planning (FP). “And I only attended that training in early 2024, organized by the IPAS Indonesia Foundation,” Midwife Tecla recalled.
During that training, she was introduced to the KLOP Wheel, an acronym for the Circle Diagram and Application of Medical Eligibility Criteria in Contraceptive Use. The KLOP Wheel is a tool designed to help select the appropriate contraceptive method based on health conditions. This tool is a modification of the Medical Eligibility Criteria for Contraceptive Use (MEC) issued by the World Health Organization.
Visual Representation of Roda KLOP
“After we attended the training, and after counseling prospective family planning acceptors, they are the ones who make the decision. Then, for screening acceptors using contraceptives, we use the KLOP Wheel. The KLOP Wheel was also facilitated by IPAS Indonesia to determine a definitive diagnosis of whether the mother can or cannot [choose a contraceptive method],” Midwife Tecla added.
With the help of that tool, she can provide contraceptive methods that are appropriate for the person’s health condition. “For example, in the past, if there was a pregnant woman with high blood pressure, we would immediately not serve her. But after the KLOP Wheel was introduced, we use the KLOP Wheel to determine whether the mother is eligible to use a contraceptive method or not,” she added.
In addition to simplifying the provision of contraceptive method options, Midwife Tecla stated that Roda KLOP can also expedite insertion. “Furthermore, regarding technique, the insertion technique is faster because we use a checklist within Roda KLOP. Also, the technique for implant insertion and removal is faster because of the techniques taught during the training we attended,” she explained.
A similar experience was also shared by Midwife Yanti from the Sulamu Community Health Center, Kupang Regency. She stated that Roda KLOP assists in providing appropriate contraception, especially for women with certain medical conditions.
“After attending the training, we use Roda KLOP. We can then recommend contraception to patients who are eligible, as there is a diagnosis. If there are patients with risks, we consult with the doctor who provided us with the training directly via WhatsApp,” Midwife Yanti explained.
She once consulted with the doctor, who was also a family planning training facilitator, regarding a patient with a goiter on her neck. “For example, yesterday I saw a patient with a goiter who asked if she could have an implant inserted or not, because it is hormonal family planning. The doctor replied to use the checklist [in Roda KLOP],” she recalled.
Midwife Yanti added that with the counseling process and the use of Roda KLOP, many women are beginning to understand which contraceptive methods are suitable for them. “As a result, they themselves come to choose their contraceptive method,” she emphasized.
Despite women beginning to assert their right to family planning, society still faces several challenges. Among these are numerous myths related to contraceptive methods. Furthermore, many women still do not use family planning if they have not yet had a son, due to family demands.
“However, things have now changed; some mothers come for family planning without their husbands’ knowledge because they now understand it is their right as women,” Midwife Yanti added.
Meanwhile, Midwife Tecla emphasized that the uneven distribution of midwives’ ability to provide family planning services also remains a challenge. This is because some villages in Kupang Regency are not areas included in the TAKENUSA program (Joint Determination for Women of Nusa Tenggara).
“So that all midwives can be exposed to knowledge, and if we are well-equipped with that knowledge, then we can effectively face the challenges I mentioned above,” she concluded.