Indonesia: Population Policy Case Study 1

By Jenna Dodson

Population policies[1] of the late 20^th century played a central role in the global decline in fertility rates¹. These policies mobilized resources to enact policies aimed at reducing fertility by widening contraception provision and changing family-size norms. In the first of a series of Positive Population Policy Case Studies, The Overpopulation Team examines population policies in Indonesia, which implemented one of the most efficient and non-coercive family planning programs in history². In the thirty years of focused family planning efforts, fertility dropped 54%, from 5.6 in 1970 to 2.6 in 2000 (Figure 1).

Indonesia is the fourth most populous country in the world (264 million), and the capital city, Jakarta, the second most populous urban area in the world. Although a Muslim-majority country, Indonesia has six recognized religions and substantial ethnic, cultural and economic diversity. Like other East Asian countries, Indonesia viewed fertility reduction through family planning as an integral component of a comprehensive development strategy³. Family planning was first introduced in 1957 by the Indonesian Family Planning Association as part of a private institution⁴. Family planning activities became semi-governmental in 1968 and fully institutionalized in 1970 with the formation of the National Center for Coordination of Family Planning (Badan Koodinasi Keluarga Berentjana Nasional, BKKBN).

Just prior to the formation of the BKKBM, the government published a pamphlet titled, “Views of Religions on Family Planning,” which documented the general acceptance of family planning by four of Indonesia’s five official religions at the time – Islam, Hinduism, Protestant and Catholic Christianity¹. This government and religious backing provided the catalyst for social change that laid the foundation for fostering a common national outlook positive to family planning.

Government backing proved to be instrumental. Since the program was institutionalized, the BKKBM had ties to President Suharto, who gave the program strong backing. This meant program support from the governmental ministries, island administrations and endorsements from the private sector, including media, academia and Indonesia’s cultural and religious leaders². Print media such as posters, leaflets and magazine articles were used to disseminate information about the benefits of contraceptive use, technical information about contraceptive methods and nearest family planning clinics¹. A highly popular entertainment-education radio soap opera called “Butir Pasir Di Laut” (“Grains of Sand in the Sea”) promoted the value of family planning[2]. Population concepts and concerns were also included in school curricula¹. “Small family size” encouragements and references on “how to achieve this by using contraceptives” were included in texts and Indonesian and Javanese plays². The social acceptance of family planning methods into the culture ensured the compatibility of social and cultural norms with the technical, economic, and political dimensions of the policies².

Implementation was managed downward, and the program engaged clinical professionals, including academic, provincial and district-based gynecologists and obstetricians. BKKBN provided program guidelines, budgets, and supplies, but provincial offices were largely autonomous in the allocation of those resources². Using a wide array of inputs and activities, local officials tailored the program to local characteristics, targeting areas for activities that would be most productive. For example, communities characterized by very low levels of contraceptive prevalence were targeted for outreach by mobile family planning teams and community-based programs, while high-prevalence areas received programs intended to increase continuation³. Trained fieldworkers and community volunteers ensured the program reached remote, rural areas – particularly impressive for a country with over seventeen thousand islands, and contraceptive distribution was even undertaken by labor unions working in collaboration with the government¹.

Collaboration between the government and community was essential. The program emphasized institutions not normally associated with family planning in a way that was socially acceptable and socially invigorating³, allowing for increased engagement and broader reach. By the late 1990s, family planning had become universally accepted practice among almost all political, religious and social groups – virtually all Indonesian women knew how to obtain and use a number of contraceptive methods, were acting on that knowledge³. The program slowed following the 1997 economic crisis and accompanying political and financial upheaval, and was decentralized in 2004³. Fertility decline has since stalled near 2.5 (Figure 1).

Social changes associated with the national family planning program were complemented by indirect population policies, including a Compulsory Education Law in 1973[3] and a National Marriage Act in 1974[4]. At the start of the family planning program in 1970, 50% of girls aged 10 to 14 went to school, increasing to 92% by 2000³. Children with no younger children to care for reaped benefits in terms of free time, increased shares of family resources, and encouragement to study, leading to an increase in women’s participation in the formal workforce. These socioeconomic changes were mutually reinforcing: 75% of the fertility decline from 1982 to 1987 resulted from increased contraceptive use, induced through economic and educational opportunities for females⁵. While all socioeconomic changes had a role to play, increased contraceptive use was only possible due to Indonesia’s focused family planning efforts that promoted social acceptance and established systems for contraceptive availability.

Indonesia is committed to international family planning efforts, both past and present. Together with the United National Population Fund (UNFPA), International Planned Parenthood Federation, and Population Council, the Indonesian government organized the “Conference on Family Planning in the 80’s” in Jakarta. One of our TOP mentors, Carl Wahren, attended the conference and noted the active participation of former Indonesian president Suharto and first lady, Madam Tien.

Indonesia’s current president, Joko Widodo, also recognizes the need to revive the nation’s family planning program. To do this, leaders have identified ways to improve the program, such as addressing the mismatch between the desired type of contraceptives and used contraceptives, as well as the need to include both men and women in the program⁶. Indonesian, and other leaders around the world, should consider reincorporating past strategies that made Indonesia’s family planning effort so effective, including a combined cultural-religious approach, collaboration between government and society, and perhaps a revitalization of the campaign “Dua Anak Cukup.”

[1] Population policies. Almost invariably, the words population policies conjure up images of forced sterilizations and fears of a one-child policy. These two extreme cases are so deeply entrenched in our mind’s eye that they can completely overshadow any positive examples or positive outcomes of population policies – to the point that just the acknowledgement of positive cases seems to detract from the gravity of extreme policies’ consequences. It is important to recognize the human rights violations that occurred and learn from past experiences. It is also important to recognize our bias shaped by the media’s portrayal of population issues over the years, and be willing to learn from effective, positive programs that will better inform future policies.

[2] For over two decades, audiences closely followed the life of Dr. Syarief. A young doctor born and raised in village poverty whose parents scraped money together to send him to medical school, and who repays their sacrifices by serving his community. His first patient dies from the complications of her sixth closely spaced pregnancy, after which he begins his campaign to improve local family welfare through family planning¹⁰.

[3] Requiring a six year compulsory education for primary school age children (7-12 years). In 1994, compulsory education was extended to the 13-15 year old population.

[4] The National Marriage Act of 1974 imposed a minimum age for marriage, 16 for girls and 19 for boys. It also required that persons marrying under the age of 21 have parental consent.

References

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