Indonesia may see baby boom<\/p>\n
By Stevie Emilia<\/p>\n
JAKARTA (JP): The crippling economic crisis is threatening the
\nstate's successful family planing program as prices of
\ncontraceptives have soared nearly five-fold, observers warn.<\/p>\n
Many fear the crisis will trigger a baby boom over the next
\nseveral years as more and more families struggle to cover the
\ncosts of their daily necessities.<\/p>\n
Since its introduction in 1969, the family planning program's
\nsuccess in slowing down the country's population growth has been
\ninternationally recognized.<\/p>\n
Annual population growth fell from 2.32 percent recorded in
\nthe 1970s to 1.66 percent in the first half of the 1990s. Had the
\ngrowth rate continued at its 1970 level, Indonesia's population
\nwould have exceeded 200 million in 1991 instead of in 1997.<\/p>\n
The most serious threat to the program's success is the
\nskyrocketing prices of birth control devices, of which 80 percent
\nof their raw materials are imported.<\/p>\n
Ida, a mother of two and one of many participants in the
\nprogram, deeply feels the pinch of the crisis. She was compelled
\nto switch from using an intravenous contraceptive to the pill
\nthree months ago.<\/p>\n
\"I only pay a mere Rp 1,000 at a community health center for
\nthe pills, but for the injection I had to pay Rp 9,000,\" the 29-
\nyear-old housewife in Central Jakarta said.<\/p>\n
At first, she was reluctant to make the switch. \"I like the
\ninjection method better because I only had to do it once in three
\nmonths. But it's getting expensive.\"<\/p>\n
A pack of contraceptive pills effectively covers a 28-day
\nperiod, while one injection protects for a three-month period.
\nBut doctors have warned that the pill is only effective if the
\nwoman is disciplined in taking it every day.<\/p>\n
Ida is only one of many of the 25.6 million active
\nparticipants in the program -- out of over 33.7 million couples
\nin the country -- who has had to switch their birth control
\nmethod due to economic circumstances.<\/p>\n
A survey conducted by the University of Indonesia's School of
\nMedicine between July 1997 and July 1998 in Pisangan Baru
\nsubdistrict, East Jakarta, found that out of 98 family planning
\nparticipants surveyed, 26 had changed their contraceptives, while
\nseven had been forced to quit the program. The remaining 65 had
\nnot changed their contraceptive.<\/p>\n
Of the 26 who had switched to a new method, 69 percent said
\nthey had done it because of the original method's side-effects,
\n19 percent because of financial reasons and the remaining 12
\npercent due to other reasons.<\/p>\n
The seven who dropped out of the program cited, among others,
\nside-effects, financial problems and wanting more children.<\/p>\n
\"But I believe many of the participants changed their
\ncontraceptive because of economic pressures but just won't admit
\nit,\" Corrie Wawolumaya, the university's lecturer on research
\nmethodology and one of the students' tutors on the survey, told
\nThe Jakarta Post.<\/p>\n
The survey also found that many family planning participants
\nnow preferred taking the pill instead of an injection.<\/p>\n
\"The switch from injection to pill is a set-back to the family
\nplanning program because it's hard to monitor women using pills.
\nOther devices necessitate doctors' care, which makes it easier to
\nmonitor,\" Corrie said.<\/p>\n
Price controls<\/p>\n
Former chairman of the Indonesia Planned Parenthood
\nAssociation (PKBI), Kartono Mohamad, warns that if the prices of
\nbirth control devices remain high, more and more participants
\nwill be unable to afford buying them anymore.<\/p>\n
\"People face too many problems already and if they have to
\nmake a choice between buying food and birth control devices, they
\nwill certainly prioritize food,\" Kartono told the Post.<\/p>\n
PKBI, a non-profit organization, has played an important role
\nin educating the public about population growth since it was set
\nup in 1957.<\/p>\n
Kartono said that unlike those using implants and intra-
\nuterine devices (IUD), which need to be replaced only after three
\nyears to 10 years, pill and injection users are the most affected
\nby the hike in the prices of contraceptives.<\/p>\n
\"They feel the impact most because they have to buy pills or
\ninjections regularly,\" said the former chairman of the Indonesian
\nMedical Association.<\/p>\n
Data at the National Family Planning Board (BKKBN) in February
\nand March shows the use of IUD dropped 3.93 percent, while those
\nusing injections decreased 6.28 percent, pills 7.31 percent and
\nvaginal contraceptive devices 11.4 percent.<\/p>\n
According to BKKBN's 1998 family survey report, 40.01 percent
\nof active family planning participants use the injection method,
\n28.07 percent use the pill and 17.78 percent use IUDs. The rest
\nlook to other methods, such as condoms, vasectomy, tubectomy and
\ntraditional methods.<\/p>\n
Kartono urges the government to do more to provide birth
\ncontrol devices which can be produced locally.<\/p>\n
\"The manufacturers are complaining they can no longer produce
\nbirth control devices because the raw materials are getting too
\nexpensive,\" he said.<\/p>\n
The government can promote the use of long-term birth control
\ndevices, such as implants and IUDs, to prevent a decline in the
\nnumber of participants due to the crisis.<\/p>\n
If nothing is done to control birth control prices in two
\nyears, he warned that it might result in a baby boom within the
\nnext five years.<\/p>\n
The fear of a baby boom has also been voiced by State Minister
\nof Population and BKKBN chairman Ida Bagus Oka.<\/p>\n
Kartono predicted that a baby boom might come out of the
\nmiddle class, who think they still can afford raising children.<\/p>\n
For people in the low-income bracket who suffer most from the
\ncrisis, a lucky few might be able to receive a permanent form of
\nbirth control, such as a vasectomy or sterilization, while others
\nmight have to resort to the worst option: abortion.<\/p>\n
\"So, high contraceptive prices might not only lead to a baby
\nboom, but it might also raise the number of abortions and at the
\nsame time, increase the maternal mortality rate. That's what we
\nfear most,\" Kartono said.<\/p>\n
The government has managed to lower the maternal mortality
\nrate from 390 per 100,000 births in 1994 to 295 per 100,000
\nbirths today.<\/p>\n
Supply<\/p>\n
BKKBN's deputy for family planning, A. Muchyi M.M., brushes
\naside the possible impact of high contraceptive prices.<\/p>\n
\"In my opinion, there might be an increase in births. But a
\nbaby boom sounds too pessimistic. We still have enough of a
\nsupply of contraceptives to last at least until March 1999,\" he
\ntold the Post.<\/p>\n
But he revealed that there would be a slight change in the
\nprogram's long-term targets. Earlier, the program was expected to
\nlead to a \"balanced growth\" by 2005, or 2010 at the latest.<\/p>\n
\"Instead of reaching a balanced growth by the year 2005, or
\n2010, experts project that we will reach a balanced growth by
\n2008, or 2013 at the latest,\" Muchyi said.<\/p>\n
The latter prediction, he said, was made based on the result
\nof a health and demography survey in 1997. The survey recorded a
\ntotal fertility rate of 2.79, or 0.2 point higher than targeted.<\/p>\n
\"It's impossible to reduce the 0.2 point rate in a short time,
\nthat's why the experts changed the projection,\" Muchyi said.<\/p>\n
With the program, the country's population was expected to
\nstabilize at 350 million people by the middle of 21st century.<\/p>\n
BKKBN, he said, was still studying about those dropping out of
\nthe programs, adding that dropping out meant the women wanted to
\nhave children or were already pregnant.<\/p>\n
\"We will also examine whether there are participants who quit
\nthe programs because of high contraceptive prices,\" Muchyi said.<\/p>\n
But BKKBN does not close its eyes to the high birth control
\nprices. \"We know it's difficult to lower the price of
\ncontraceptives because most of raw materials are still being
\nimported.\"<\/p>\n
For instance, he said, an implant, which was earlier sold at
\nRp 75,000, was now sold at Rp 365,000 each.<\/p>\n
The sale of contraceptives is subsidized by the government and
\nefforts are made to supply free contraceptives to seven million
\nlow-income participants.<\/p>\n
BKKBN's data from February and March show an apparent rise in
\nthe number of people relying on vasectomy, tubal ligation,
\nimplants and condoms.<\/p>\n
The data showed a 10.15 percent rise in those performing
\nvasectomies, a 35.64 percent rise in tubal ligation, a 61.4
\npercent rise in those using implants and a 0.42 percent increase
\nin the reported use of condoms.<\/p>",
"url": "https:\/\/jawawa.id\/newsitem\/indonesia-may-see-baby-boom-1447893297",
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