Communication Strategy on Family Planning Campaign by the Field Officer for Family Planning Campaign in North Sumatera

Communication strategy on family planning campaign is the interpretation of knowledge, attitude and practice theory (KAP theory) that commonly used in many health campaign programs in developing countries and advanced countries in the world. This theory can also be applied to other programs such as agriculture, family planning, commercial, and society capacity building. The aims of this research are to describe and analyse communication strategy on family planning campaign by the field officer, and also to find out all factors that can be the obstacle on family planning program in Sumatera Utara province, especially in Sibolga City. The long-term goal of this research is to find out the best method that can be done by the government in order to get people's support. It can only be achieved if the program is transparent, clearly stated and on the perfect target. The population of the research are the field officer for family planning campaign (10 persons) and also the citizen of Sibolga City (10 persons plus their husband/wife). Purposive sampling technique was selecting all informants. Observation, interview and Focus Group Discussion were also being held in order to get the best result. Several results were shown: it showed (especially using injection and implant method) among productive age couples is increasing. Nias people in Sibolga City are the most fragile community where many of them are not able to perform family planning due to lack of information because of the language problem. Another problem in Sibolga City is that many of the family planning acceptors using short-term contraception methods such as pill, condom and injection rather than long-term contraception methods such as IUD, implant or vasectomy/tubectomy. BKKBN in Sibolga City still needs to improve many aspects of doing communication strategy on family planning campaign by the field officer for family planning campaign, especially in the low-income productive age couples where the birth rate number is still high.


Introduction
The Republic of Indonesia is the fourth world most populous country. People's republic of China, India and United States of America are the big three. In average, Indonesian citizen increasing around 270.833 newborn babies every month. Badan Pusat Statistik stated that there are two newborn babies every 1 second in Indonesia. The high fertility rate is causing problems for Indonesia. That was the main reason the government launched the family planning program to solve the problem. Several problems in Indonesian family are: 1) rapid fertility rate; 2) people's migration to town/city; 3) low-quality people (Pahlupi, 2012). Increasing fertility rate without control could create another problem in the social and economic sector and give negative impact on development in Indonesia. The need of housing facility, health facility, education facility and other facilities will also be growing higher. This is another hard problem for the government to solve to create a happy and healthy family with a better income in Indonesia.
Indonesian government through Badan Kependudukan dan Keluarga Berencana Nasional (BKKBN), initiating Program Keluarga Berencana (family planning program) in order to control the fertility rate number among Indonesian citizens. This program aims to reduce fertility rate number with the using of contraception such as a pill, condom, injection, intrauterine device (IUD), implant, women medical operation (tubectomy) and men medical operation (vasectomy). All of this contraception method is given freely by the government and can be found at Pusat Kesehatan Masyarakat (Puskesmas), family planning clinic and centre of family planning services all over Indonesia. For the vasectomy and tubectomy, methods can only be doing in the hospital or certified health services clinic with a health expert and the medical operation supporting devices in it.
Family planning program primary target are productive age couple who wish to control the number and the range of birth of their children to create a quality family. Family planning program also aims to reduce the number of unwanted pregnancy and the number of death among mother while delivering their babies. According to Law of the Republic of Indonesia number 52 (fifty-two) in the year 2009 about Population Increasing and Family Development, the aims of family planning program is to increase the quality of life and wealth in Indonesian family. Family planning program is under the coordination of National Family Planning Coordination Board (Badan Koordinasi Keluarga Berencana Nasional or BKKBN). One of most effective ways conducting family planning program in the society is through communication campaign. The family planning program campaign will succeed if the message is delivered by the communicator to the communicant so they can have a mutual understanding. By doing communication campaign, Petugas Lapangan Keluarga Berencana (PLKB or family planning campaign field officer) are also expected to gain more participation from productive age couple of using appropriate contraception methods according to their needs and their own health experiences. Family planning campaign field officer is expected to become their counsellor for new family planning acceptor, helping them to choose the right method so they can gain the most satisfying experiences of using family planning methods.
A research conducted by Riza Pahlupi, Asep Suryana and Agus Setiaman in 2012 in their article "The relations between family planning program campaign with the attitude changes of Garut Regency society" found that the good family planning program campaign with the support of media, content, method, right time and right place will create positive impact towards attitude changes among productive age couple and decrease resistance against family planning program. Based on the data that we already received from Data Department of Family Planning Board and Women Empowerment of Sibolga City, Sibolga City is one of the smallest (only 10.77 km2) and most populous in Sumatera Utara province. Sibolga city consists of 4 sub-district and 17 villages and 82.112 inhabitants, with 12.123 productive age couple (BKKBN Sibolga, 2015). Based on the previous situation, we decided to make a research about the communication strategy on family planning campaign by the family planning campaign field officer in Sibolga City, Sumatera Utara province.
Summarizing, the research questions that the study aspires to answer are: 1. How is the communication campaign strategy that is being done by the family planning campaign field officer so far in Sibolga City? 2. What is the best way that can be done by the family planning campaign field officer to grow attention and action from the society about the importance of family planning program? 3. What lessons will be learned from analyzing factors that could become obstacles on the communication campaign strategy by the family planning campaign field officer?
The goals of the research are: 1. To find out, describe and analyze family planning campaign communication strategy that is being done by the family planning campaign field officer in Sibolga city;

Lusiana Andriani Lubis, Haris Wijaya Communication Strategy on Family Planning Campaign by the Field Officer for Family Planning
Campaign in North Sumatera 55 2. To find out the best way that can be done by the family planning campaign field officer to grow attention and action from the society about the importance of family planning program; 3. To find out factors that could become obstacles on the communication campaign strategy by the family planning campaign field officer. The output of this research is to create a better family planning campaign communication strategy in Sibolga city.

Theory of Communication Strategy Campaign
A campaign can be defined as a tool for changing social, economic and political process to empower and strengthen the society's ability through a participated group of a learning process to make behaviour changes in every stakeholder (individual, group or institution).
A campaign is a communication process where an individual transmits certain symbols (usually verbal symbol) to influence communicant's behaviour. Communication campaign strategy's goal is always connected to change the attitude, opinion, behaviour, knowledge and skill of the communicant, directly or indirectly to the communicant to create a better way by following the suggestion, idea or innovation.
The usage of Knowledge, Attitude, Practice theory is simply because of in many developing countries this theory was used for many health campaign programs since it is one of the most suitable theories to use in this situation. The idea behind this theory is that in many real-life situations, a new attitude will appear in someone if a new knowledge stimulated their cognitive domain. Then there will be some responses in their attitude, and in many cases, the response is practising the new knowledge based on what they just realised.
To find out the communication strategy campaign, there are several things to notice; they are campaign method, content, media, skill and time. In communication strategy campaign, there are three approaches that can be used: 1) A personal approach such as house visiting, telephone and so on; 2) Group approach through meeting group because there will be some interaction and experiences sharing among the member of the group that can be stimulated their attitude and norms; 3) A mass approach through mass media.
According to Milikan and Hoopgood (in Kartasapoetra, 1994), the content of a campaign must have some impact towards the targeted people, and they must have certain values such as: 1. Profitable 2. Complementary 3. Simplicity 4. Compatibility 5. Availability In the campaign, there is some media or supporting media campaign that is used for years. Kartasapoetra (1994) mentions that basically, campaign media are divided into: 1) Living media; a certain people who has applied a new living style according to the content of the campaign. They can make a good sample of a media campaign. 2) Dead media; certain media that is used as a mediator between the communicator and the communicant such as a sample, model, brochure, poster, photo, leaflet, sheet, slide, film, filmstrip, video, movie-film and graphical symbol like diagram, scheme and map.
And last, time is also very important in communication strategy campaign. We must choose the right time and the right place according to our targeted society situation and condition to achieve

Lusiana Andriani Lubis, Haris Wijaya Communication Strategy on Family Planning Campaign by the Field Officer for Family Planning
Campaign in North Sumatera the best result of our campaign. Sometimes, we must coordinate with our society to set the right time and place to launch our campaign perfectly.

Research Method
The research method that is used in this research was a qualitative method. The qualitative method does not rely on the number of population and sample, but it is rather how to achieve the deepest information from the informant no matter how small the population and the sample number is. If the information is enough, we do not have to find another sample. In qualitative research, researcher plays an integral part of the data, which mean the researcher actively participated in choosing the suitable data for the research (Kriyantono, 2006: 57).

Population and Sample
The population of this research are the productive age couples in Sibolga city with a total number of 12.384 couple (Data from Data Department of Family Planning Board and Women Empowerment of Sibolga City, 2016).
The researcher was using a purposive sampling technique to choose the right sample for this research. By using this technique, researcher picks up some sample based on what we have determined before. The researcher also uses an in-depth interview with the chosen sample to gain all the data needed for this research.

Data Collecting Method
Data collecting method in this research were done in 3 ways: observation, interview and focus group discussion (FGD).

Society of Sibolga City
Observation and in-depth interview  Spradley (1980: 3) said, in-depth interview is focusing on learning by people and not study of people because the researcher is also part of the people. It took about two months for data collecting through the indepth interview for this research. After that, the researcher conducted FGD for family planning campaign field officer of Sibolga City.

Data Analyses Method
Data analyses for this research is in inductive narrative style, by using: a) making notes on every single thing that happened during research b) trying to understanding the situation through the informant's point of view c) giving more attention to the factors that relate one to another d) making specific analyses for every cases and every situation (Daymon, 2007: 162).

Lusiana Andriani Lubis, Haris Wijaya Communication Strategy on Family Planning Campaign by the Field Officer for Family Planning Campaign in North Sumatera
As the world fourth most populous country, Indonesia also has very high proportion productive age citizen. Until the year of 2030, this situation considers as a "demographic bonus" in Indonesia. Demographically, the number of productive age citizen should be a potential point for the development of this country. But to make it happen, we still need more effort from all institution, by providing at least four conditions: 1. Quality people 2. More job opportunity for the productive age citizen 3. Raising the account of saving in every family 4. Raising of the female worker in the working field If we are talking about sexual reproduction and the level of fertility among women in the family of Indonesia, family planning program by using contraception method (especially pill and injection) are the most favourite in the productive age couple family planning method. The use of long-term contraception method such as IUD and sterilization (vasectomy and tubectomy) is still very low comparing to short-term contraception method.
Unwanted pregnancy among short-term contraception method user is higher than the long-term contraception method user. 6 out of 100 injection user having unwanted pregnancy during their first year because they have to get injected every month to prevent unwanted pregnancy. While IUD could last longer (around eight years) and the risk of unwanted pregnancy during the first year is only 0,8 out of 100 users. This is one factor that is considered as the factor that makes Indonesian Total Fertility Rate (TFR) is still stagnant at 2,6. This indicates that in the national average, every productive age woman delivers 2,6 babies during her life.
One of the results of this research found out that the level of knowledge among Sibolga City citizen about family planning is already at the high level. Most of the married women at the age of 15-49 and married men at the age of 15-54, at least knew one contraception method.
The more educated the married women, the more they aware of using contraception to prevent unwanted pregnancy. The reason behind married women that did not use contraception are: health factor, side effect, lack of information, high cost (for independent family planning method) and also fertility reason (such as menopause and unable to have children) Family planning campaign field officer duty is to give information to all productive age couples in their area. Making routine scheduled for family planning campaign will help productive age couple to be more aware of any kind of contraception method that most suitable for their condition.

Sibolga City Description
Sibolga city is situated on the west coast of Sumatera Utara. The distance from Medan city as the capital city of Sumatera Utara province to Sibolga city is 344 kilometres. Sibolga city is only as wide as 1.077 hectares. Most Sibolga citizen is working as fishermen, while other works as a farmer, civil servant and another job. There are four sub-districts (Sibolga Utara sub-district, Sibolga Kota sub-district, Sibolga Sambas sub-district and Sibolga Selatan sub-district) and 16 political sub-districts administered by a village chief in Sibolga city (data from Badan Pertahanan Kota Sibolga). The research is only focused on Sibolga Kota sub-district because this is the most populated area and very rich of a cultural and social environment.
Until September 2016, there are 8.404 couples or equal to 67,86% productive age couples that joining the family planning program with injections and implant as the most favourite method among them. Based on the data of September 2016, there are still 3.980 or equal to 32,14% productive age couples that have not joined family planning program in Sibolga City. Here is the composition of them: a. Pregnant Productive Age Couples The number of pregnant productive age couples are 365 couples or equal to 2,95% from a total number of productive age couples in Sibolga city.
b. Productive Age Couples trying to have kids soon The number of productive age couples trying to have kids soon is 1.642 which equals to 13,26% from a total number of productive age couples in Sibolga city.
c. Unmeet Needs Productive Age Couples Unmeet needs is a productive age of couples that do not wish to join family planning program and do not want to have children anymore (989 couples or 7,99%) or postponed to have more children (984 couples or 7,95%) but have not been protected with contraception.
Based on the table above, the researcher decided to research Sibolga Kota sub-district, that consist of four villages: Kota Beringin Villages, Pasar Baru Villages, Pasar Belakang Villages and Pancuran Gerobak Villages. Previous information from family planning campaign field officer indicates that Pancuran Gerobak Villages and Pasar Belakang Villages have the most productive couple age, but they are not joining the family planning program. So, the researcher decided to focus on this two area to find out the reason behind this condition.