Family planning survives Indonesian crisis

Family planning survives Indonesian crisis

Peter Janssen, Deutsche Presse-Agentur, Jakarta

Karinee, 30, the wife of a fisherman in Kalibaru, a coastal village in North Jakarta, already has three children and doesn't want more.

She received a free contraceptive implant from the government five years ago and recently showed up at the Kalibaru health clinic hoping to receive another one.

"If I can't get the implant I will get injections," said Karinee, swinging her five-year-old son on her hip. "We have no money but I will pay for the injections somehow if I don't get them for free."

That's the kind of spirit that has saved Indonesia from a population explosion during the past five years of economic and political turmoil, when many predicted the government's family planning program was heading for disaster.

Indonesia's population has increased from 75 million in 1945 to some 215 million by 2002. The government got serious about birth control in the mid-1970s, when it set up the National Family Planning Coordinating Board (BKKBN).

Over two decades, the BKKBN succeeded in lowering the country's total fertility rate (TFI - number of children per couple) from 4.7 in 1980 to 2.3 in the year 2000.

Many demographers were surprised when Indonesia's fertility rate didn't increase after the country was hit by a combo economic and political crisis in 1997-98, effectively slashing the BKKBN budget by 60 percent in U.S dollar terms.

The crisis doubled the number of Indonesia's very poor from 22 million, or 11 percent of the population in 1996, to 49.5 million, or 24 percent of the population in 1998. Last year, the number living below the poverty line was 37.7 million, or 18 percent.

While demographers are still awaiting fertility figures for 2001, the results for 1998 to 2000 were encouraging.

Experts attribute the good performance to two factors.

"First of all, it was because we had been successful in creating demand for contraceptives, so they have become a basic necessity among the people," said BKKBN deputy for family planning Siswanto Agus Wilopo.

The second factor was donor assistance. Prior to 1997, the BKKBN only relied on international aid for 15 percent of its contraceptive supply. Between 1998 to 2001, the percentage has reserved to 85 percent.

That donor assistance is now drying up, partly because many donors feel the private sector is doing an adequate job supplying the market with contraceptives, and partly because of concerns about the "leakage" in the BKKBN's pipeline to the poor.

"The donors are saying we don't want to put any more commodities into the system until you show us that these commodities are really going to the poor," said one international health researcher.

Health experts estimate that nearly 70 percent of the contraceptives - chiefly injections and pills - currently on the Indonesian market are already supplied by the private sector, and at prices similar to government subsidized commodities.

Since 1998, the BKKBN has focused only on the poorest population, for many of whom contraceptives have become a household necessity.

"Men fight to have their household budget for cigarettes while women want it for contraceptives," said Sri Moertiningsih Adioetomo, deputy coordinating minister for people's welfare.

"The idea of birth control has been institutionalized. It's already in the hearts of the women, not necessarily the men," she told Deutsche Presse-Agentur.

While the family planning message has sunk in after two decades of government indoctrination under the autocratic rule of former President Suharto, the program is now facing numerous challenges im the so-called reform era.

Not least of these is the comparatively mixed message from the government. Vice President Hamzah Haz, who has three wives and 15 children, last year muddied the waters when he publicly opined that the budget for education was more important than for family planning.

President Megawati Sukarnoputri, the country's first female head of state, has said precious little about family planning and definitely steers clears of controversial topics such as unwanted pregnancies and abortion, still a taboo for most Moslems.

"I am worried about the political commitment, in the sense of making family planning a priority," said BKKBN's Wilopo.

BKKBN is seeking a bigger budget for contraceptives to meet demands while it decentralize its operation by year-end 2003.

"My concern is that the bupati (district chiefs) don't realize the importance of family planning," said Wilopo. There is a fear that when the districts take charge of their own development budgets they will be inclined to spend more on infrastructure than on social services, such as family planning.

International health experts, however, seem optimistic that good sense will prevail.

"We keep looking for an explosion and it doesn't happen because Indonesian couples aren't letting it happen," said Gary Lewis, Johns Hopkins' family planning program director in Jakarta. "In some ways I trust the people more than I do the government program."