'Decentralization affects family planning program'
Dewi Santoso, The Jakarta Post, Jakarta
The National Family Planning Board (BKKBN) has expressed concern about the future of the family planning program after a transfer of the responsibility to regional governments next year.
In its statement released on Thursday, the board said there was uncertainty in the division of labor and coordination among the central, provincial, regental, and municipal governments regarding the implementation and financing of the program. It also questioned how the central and provincial government would maintain its technical, financial, and logistical support for the program.
A survey conducted by BKKBN in 2002 found less than 10 percent of government health clinics followed the manual on prevention of infection which may result from the use of contraceptives. It also discovered that the quality of counseling in the family planning program was poor and that 20 percent of government clinics had never been supervised.
Another survey revealed that not a single clinic was equipped to perform sterilizations in West Java.
The low quality of the services in the family planning program can endanger clients' lives, lower public trust in the program, lead to drop outs, it said.
The Indonesia Demographic and Health Survey (SDKI) revealed that nationwide, the Contraceptive Prevalence Rate (CPR) among fertile couples increased to 60.3 percent in 2003, from 57.4 percent in 1997. As a result, the fertility rate decreased to 2.6 from 2.8. This means that two to three children were born to one woman.
Current BKKBN data recorded 27 million fertile couples.
Funded by the World Bank and the U.S. Agency for International Development (USAID), the SDKI was conducted by Macro International Corporation, taking samples in the provinces of Bangka Belitung, Banten, and Gorontalo from October 2002 until April 2003.
However, previous data from the 2002 survey showed that the CPR figure varied from one province to another. Some provinces, such as Central Java and East Java, and North Sulawesi, equaled European countries at 69 percent, while other provinces like East Nusa Tenggara, West Sulawesi and North Sulawesi the rate was estimated at between 29 and 35 percent, way below the average world figure of 40 percent.
These disparities in regional data proved that the government needed extra efforts in promoting the use of contraceptives in provinces with low CPR, BKKBN said.
With the current population of 215 million, the CPR figure of 60.3 percent must be maintained, if not improved, as a 0.5 percent decrease each year may increase the population to 265 million in 2015 and adversely affect the country's political and economic stability.
"Thus, we are now trying to actively start promoting the family planning program by providing information on the importance of the use of contraceptives, as it can help decrease the fertility rate," BKKBN chairperson Sumarjati Arjoso said.
Sumarjati further said that now, the BKKBN was focusing on long-term contraception methods, such as the intrauterine device (IUD), implants and tubal litigation.
She hoped the program would raise the CPR to 75 percent in 2015.