The Status of Family Planning

in Indonesia Today:

A Story of Success and Fragmentation

UNFPA and ICOMP Regional Consultation on Family Planning

in Asia and the Pacific: Addressing the Challenges

Bangkok, 8-10 December 2010

Adrian C. Hayes

Australian Demographic and Social Research Institute (ADSRI)

The Australian National Universityadrian.hayes@anu.edu.au

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1. Introduction

The International Conference on Population and Development (ICPD) in Cairo (1994) adopted a Programme of Action with an ambitious goal:

“All countries should take steps to meet family-planning needs of their populations as soon as possible and should, in all cases by the year 2015, seek to provide universal access to a full range of safe and reliable family-planning methods and to related reproductive health services which are not against the law”(UN 1994: para 7.16).

Can the national FP program of Indonesia meet this goal?

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2. Past Achievements in FP/RH

The national FP program in Indonesia was

widely proclaimed an impressive success

during 1970-1995.

By the mid-1990s the practice of FP was

broadly accepted as a social norm, and fertility

had declined to around 2.7 births per woman.

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Total fertility rate (TFR), countries of SE Asia, 1950-2010

4Source: Data from UN (2009).

Reasons for success

Program factors

• Establishing BKKBN in 1970

• Outreach and field workers

• Program innovations

• Commitment from President Soeharto

Non-program factors

• Political-administrative apparatus put in place by the New Order government

• Social and economic development

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3. Current Issues in the National

Program

The program’s performance has been noticeably less

impressive during the last 15 years.

There are significant issues regarding:

1.CPR;

2.unmet need;

3.contraceptive mix;

4.access to services for unmarrieds; and

5.source of supply.

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Contraceptive prevalence rate, Indonesia, 1987-2007

7Source: Data from Indonesia Demographic and Health Survey (1987, 1991, 1994, 1997, 2002/03, 2007).

Met need (MN) and unmet need (UN) for FP among currently

married women (15-49), Indonesia, 1987 - 2007

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Source: IDHS.

Contraceptive mix among currently married women using

contraception, Indonesia, 1987 - 2007

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Source: IDHS.

Marital status of women by age, Indonesia, 1990, 2000

10Source: Indonesia Population Census.

Source of supply for married women practicing modern

contraception, Indonesia, 1991-2007

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Source: IDHS.

4. Understanding the Current

Situation

The status of BKKBN has been seriously “tested” by recent developments, including:

1.changing demographics in Indonesia;

2.the changing international agenda; and

3.political reforms and decentralization.

As a result the national FP program is increasingly seen as “behind the curve” by RH advocates

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Cairo and the changing international

agenda

“Cairo was truly a watershed. Some have already seen it as the end of the family planning movement, an event celebrated by many feminists and women’s rights activists as a paradigm shift and equally regretted by traditional population advocates, including many demographers and others concerned about high fertility rates, as abandonment of a decades-long commitment to population stabilization.”

Steven W. Sinding (2007)

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Political reforms and decentralization

• Background: 1999, 2004 Decentralization Laws

• BKKBN’s adjustment to decentralization

• Issue: Making the national FP program more responsive to

local needs

• ‘Platforms’ for good governance: Civil service reform and

public demand for good governance

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5. Recommendations

If the national FP program is to be

revitalized and responsive to the evolving

needs and aspirations of Indonesian

citizens this will require significant

structural change in the current

institutional arrangements.

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Recommendation 1

Can Indonesia’s national FP program make

meeting all remaining unmet need for services

by 2015 its central focus?

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Recommendation 2

Can primary responsibility for FP policy be

transferred to the Ministry of Health within the

next few years?

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Recommendation 3

Can a new vision and mission be developed for BKKBN which satisfies three requirements:

a. it is centered on an holistic (inter-sectoral) vision of population policy and its role in development;

b. it is acceptable to other parts of the government; and

c. it gives BKKBN an important and exciting future?

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6. General Conclusion

While we all embrace Cairo today we still

need to clarify precisely what we stand for

as a result.

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The Cairo Programme of Action

promotes two goals

Goal A : Providing “universal access to a full range of safe and reliable

family-planning methods and to related reproductive health services.” This

is a challenge for the health sector; the PoA articulates it well and lists

concrete steps to achieve it.

Goal B: Integrating “population concerns into development strategies … with

the goal of meeting the needs, and improving the quality of life, of present

and future generations.” This is an inter-sectoral challenge; the PoA does

little to clarify this goal and provides little guidance on how to achieve it.

In many countries (including Indonesia) A and B are confused both

intellectually and in the organization of government. A and B need to

be kept quite distinct, without denying that there are some

relationships between them.

The common tendency to support one at the expense of the other should

also be resisted.

Note: Quoted phrases are from ICPD. 20