Indonesia's family planning story: success and challenge

Popul Bull. 1977 Nov;32(6):1-52.

Abstract

PIP: A historical overview and descriptions of family planning programs in Indonesia are presented. 85 million of the 135 million inhabitants of the Indonesian archipelago are concentrated on the island of Java, which comprises about 7% of the Indonesian land mass. The Dutch colonial government preferred a policy ("transmigration") which advocated the redistribution of population from Java to the other islands to relieve overpopulation. This policy was also advocated by President Sukarno after the Indonesian Revolution of 1940. The need for family planning was recognized by small groups, and official policy supported national family planning programs to replace transmigration programs only after Sukarno became president in 1966. The focus of the program was on Java and Bali, the 2 most populous islands. Local clinics became the locus for birth control efforts. Fieldworkers affiliated with the clinics were given the job of advocating birth control use door-to-door. Fieldworkers "incentive programs," area "target" (quota) programs, and "special drives" were organized to create new contraceptive "acceptors." A data reporting system and a research program increase the effectiveness of the family planning drive by ascertaining trends in contraceptive use which can determine where and how money and effort can best be applied. "Village Contraception Distribution Centers" bring the contraceptive means closer to the people than do the clinics. Figures from the years 1969-1977 show the great increase in acceptance of contraceptives by the inhabitants of the Java-Bali area. Steps are now being taken to alleviate the large monthly variations in the number of (often temporary) acceptors caused by the "target programs" and "special drives." The average acceptor is 27-years-old, has 2.6 children, has not finished primary school, and has a husband of low social status. Bali has shown the greatest success in family planning. It is a small island with a highly developed system of local clinics. The strong community structures on Bali encourage birth control use. Bali, which is predominantly Hindi, is more receptive to the IUD than Java, which is predominantly Muslim. In East Java, the authoritarian bureaucracy makes efficient use of its money. Central Java is making slow but steady progress in family planning. In West Java, fieldworkers are teamed with paramedics; there, door-to-door contraceptive supply was more effective than the clinic system. In many areas traditional methods, i.e., herbs, massage, total abstinence for long periods of time, etc., were favored. More educated women often do not use contraceptives for fear of side effects. The need for family planning on the outer Indonesian islands is not as great, but programs are being set under way. These programs are the beginning of an attempt to alleviate problems that could be encountered if Indonesia's population growth continues unchecked.

MeSH terms

  • Age Factors*
  • Ambulatory Care Facilities*
  • Asia
  • Asia, Southeastern
  • Birth Rate
  • Community Health Workers
  • Contraception Behavior*
  • Contraception*
  • Cost-Benefit Analysis
  • Data Collection*
  • Delivery of Health Care*
  • Demography
  • Developing Countries
  • Economics
  • Education*
  • Evaluation Studies as Topic*
  • Family Characteristics
  • Family Planning Services
  • Fertility
  • Goals
  • Health
  • Health Facilities
  • Health Personnel*
  • Health Planning*
  • Indonesia
  • Infant Mortality
  • Marital Status
  • Marriage
  • Mortality*
  • Motivation*
  • Organization and Administration
  • Parity*
  • Patient Acceptance of Health Care*
  • Population
  • Population Characteristics
  • Population Dynamics
  • Population Growth*
  • Program Evaluation*
  • Public Policy*
  • Research
  • Social Change*
  • Social Class*
  • Socioeconomic Factors
  • Statistics as Topic