Socio-cultural sustainability of non-hormonal IUD use and women’s active living in Pekanbaru, Indonesia

Introduction: Family planning is widely recognized as a key component of women’s health and social well-being, particularly in urban contexts where socio-cultural conditions shape access to and continuity of contraceptive use. Non-hormonal intrauterine devices (IUDs) are long-acting and reversible contraceptive methods; however, their utilization remains relatively low in Pekanbaru City, Indonesia, where socio-cultural factors continue to influence contraceptive choices. Objective: This study aims to assess the socio-cultural sustainability of non-hormonal IUD use among family planning acceptors in Pekanbaru City. Methodology: A quantitative cross-sectional study with an exploratory analytical approach was conducted in 2025, which involved 99 women registered as family planning acceptors in Tuah Madani and Sail districts. Data were collected using structured questionnaires and analyzed using Multidimensional Scaling (MDS) to generate a socio-cultural sustainability index. Root Mean Square (RMS) analysis was applied to examine attribute sensitivity, and the model strength was assessed by using a Monte Carlo simulation. Results: The socio-cultural sustainability index reached 58.1, which indicated a moderately sustainable condition. Religious norms and knowledge-related attributes demonstrated higher sensitivity within the sustainability configuration, while socio-demographic, relational, and service-related attributes showed moderate sensitivity. Attributes related to attitudes toward environmental impact and exposure to rumors exhibited lower sensitivity. The model demonstrated good stability (stress = 0.14; R² = 0.95). Conclusion: The sustainability of non-hormonal IUD use in Pekanbaru City is formed by the interaction of multiple socio-cultural attributes. Strengthening culturally sensitive communication, improving access to accurate contraceptive information, and enhancing spousal and community engagement may support more sustainable family planning practices.