The recent population census found that Indonesia has
experienced rapid population growth, and this will likely continue from what
some have attributed to the stagnation of its family planning programme.
The Jakarta Post's Elly
Burhaini Faisal talked to Terence H. Hull, a professor of demography from the
Australian Demographic and Social Research Institute (ADSRI) at the Australian
National University (ANU), about the challenges facing the country's family
planning programme. Below are the excerpts.
Question: Despite the ongoing family planning programme,
population growth in Indonesia has been rapid, at about 1.49 percent per year.
Why?
Answer: In 2000, there were
millions of people who were not included in the census. In 2010, there were
also millions of people not included, but fewer. So it was much better coverage
in the 2010 census, and indicated the rate of growth between the figures
published in 2000 and in 2010 was 1.49 percent. But the real population growth
rate was much lower because you can't just look at the number published in
2010. You have to adjust both ends. When you do the adjustment it might be 1.3
percent, 1.36 percent or 1.38 percent.
The current level of population
growth doesn't make any difference, anyway. Does it make any difference to you
if the population today is 245 million people, 250 million, or even 255
million? The degree of gridlock on the roads is just the same. You only care
about those numbers because you're interested in what is going to happen with
the future of this country. If those numbers indicate that the people who are
missed by the census are also missed by all social programmes, such as health
and education programmes, then I would be very concerned that government
officials do not want to recognise them.
Do you think the National Demography and Family Planning
Agency (BKKBN) is still relevant?
It's important to ensure that
every woman in Indonesia has full choice of all methods of contraception.
During the last 15 years, the proportion of women using injecting contraceptive
methods has increased phenomenally and has overwhelmed all other methods. The
family planning programme is in trouble. It needs new direction. It needs new
energy to offer good services.
When people talk about
population explosion, however, they often don't talk about services. What they
talk about is just making women do something, whereas we have to make sure that
impoverished women do not reproduce so much. We have to give women good
services.
If we want to revitalise family planning, what should the
BKKBN do?
There are two dimensions
regarding this issue. In one dimension, you can talk revitalising bureaucracy
and government organisation. What is important is to ensure that in all 520
regencies and municipalities, there's someone who is concerned and studying
about population, as well as developing policies that are good. I don't see
those units working very well. Within that hierarchy, you only need one or two
people in a regency to work on demography, rather than what is happening now: a
bureaucracy of 50 or 100 people. The idea of someone actually working as an
autonomous analyst has not been established here. So, you really have to decide
what kind of picture, bureaucratically speaking, should the BKKBN be looking
for? My own view is, you should look for a very lean, but very strong
analytical capacity at the central level and at local levels.
The second dimension is the
revitalisation of the services themselves and what kind of thing you expect. I
would expect the proportion of women who obtain their contraceptives from
private sources to be lower than 70 percent, which is what it is now. Contraceptive
services in many countries are given free of charge but that is no longer the
case in Indonesia, and many women in Indonesia needing contraceptives are
low-income.
What do you think is the biggest obstacle affecting
contraceptive delivery?
In Indonesia, the problem lies
in the fact that midwives in villages used to be government employees. They had
short-term contracts, or PTT. The short-term contract spans from two to three
years; it can be extended to six years but there are no more contracts after
that. People who were government employees but then became private
practitioners are effectively running their own private services. They do not
get much financial benefit from pills, and even less from condoms. They do get
paid for injections, however. Every injection is money. If you go for an
injection covering three months, and then you change to one month, the midwives
can receive three times as much money. So, midwives have changed the
contraceptive profile of Indonesian women. Indonesian women used to have
choices of all contraceptives, including IUD and implants, and they also had
better opportunities to apply for sterilisation than nowadays. Someone should
undertake very serious analysis as to what is the most efficient way to ensure
that contraceptives are available everywhere.
Some experts urge the
government to recentralise the family planning programme as regional autonomy
has been blamed for stagnation in the family planning programme. What's your
comment?
Regional autonomy is another
challenge facing the family planning programme. You have to ensure that local
people and governments are committed to family planning. And right now, there
are a lot of places where the commitment is not there. A lot of local
governments, even though they have been democratically elected by local people,
have not delivered good quality services to their own people. There's been a
priority for the government to control women's fertility, but there has never
been a priority for women to be empowered to control their own fertility.
I've just become frustrated
looking at the waste of time and money and good people who should be able to do
good things. However, the question of whether local governments have the
commitment to family planning, or whether you should ignore their role and go
back to a central-command economy, it's ridiculous because the command economy
was not committed to women's rights. The command structure in the 1970-1980s
was all about controlling population explosion but not about serving women.
Jakarta Post
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