6 Summary of The Roadmap To Accelerate Achievement of The Mdgs in Indonesia 201011181327281 20110812135234 0

Summary of the Roadmap to Accelerate Achievement of the MDGs in Indonesia
Foreword
Ten years ago, at the General Assembly of the United Na ons held in New York in September 2000, Heads of State and representa ves from 189 countries adopted the Millennium Declara on to conrm the global concern for the welfare of the people of the world. The objec ves of the Declara on, the Millennium Development Goals (MDGs), place people as the main focus of development and ar culate a set of interrelated goals as the agenda for development and global partnership. Each goal has been translated into one or more targets with measurable indicators. In Indonesia and other developing countries, the MDGs are used as a reference in formula ng policies, strategies, and development programs. The Indonesian government has mainstreamed the MDGs in all phases of development, from planning and budge ng to implementa on. This approach has been outlined in the Na onal Long-Term Development Plan 2005-2025, the Na onal Medium-Term Development Plans, 2005-2009 and 2010-2014, Annual Work Plans and budget documents. Based on the na onal development strategy that is pro-growth, pro-jobs, pro-poor, and pro-environment, alloca ons of public funding at the central and regional levels have been increased annually to support the achievement of the MDG targets. In addi on, produc ve partnerships between the Government, civil society organiza ons and the private sector have made a vital contribu on towards accelera ng the achievement of the MDGs. A er the economic crisis in 1997/1998 Indonesia implemented a series of reforms in various elds which provided a strong founda on for the Indonesian people to return to a period of high and sustainable economic growth. Economic growth and the strengthening of democracy and social ins tu ons during the past ten years have supported the achievement of the MDGs. Indonesia has already been successful in achieving several MDG targets. For example, in terms of poverty reduc on, the propor on of the popula on living on less than USD 1 per day has been reduced from 20.6 percent in 1990 to 5.9 percent in 2008. For several other MDG targets signicant progress has been achieved, and we are condent that other MDG targets will be realized by 2015. Special a en on will be given to several MDG targets, including the reduc on of maternal mortality and increasing the ra o of forest cover so that those targets can be achieved by 2015. This year, 2010, is a very important moment for Indonesia to again make a commitment to the global declara on on the MDGs. Indonesia will work harder to con nue to improve the welfare and quality of life of the people of Indonesia and to achieve the MDG targets on me. To that end, the Government of Indonesia has formulated the Roadmap to Accelerate Achievement of the MDGs. This Roadmap includes details concerning the present situa on, challenges faced, as well as na onal development policies and strategies. Various approaches that need to be implemented to accelerate the achievement of the MDG targets are also iden ed in this
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Roadmap. The informa on presented in this publica on is expected to contribute to a be er understanding concerning the challenges faced and the steps that must be taken to achieve all the MDG targets in Indonesia. At the same me, the Government of Indonesia con nues to build an environment that allows all components of society, including civil society organiza ons, and the private sector to par cipate produc vely in a community-based, grass-roots movement to benet all Indonesians. Success in achieving the MDGs is highly dependent upon good governance, produc ve partnerships among all components of society, and implementa on of a comprehensive approach to achieve an inclusive pa ern of growth while improving public services and empowering communi es in all regions. Akhirul kalam, we thank and express gra tude to all those who have contributed to the prepara on of this Roadmap. We hope that what we have produced will be useful for the na on.
Prof. Dr. Armida S. Alisjahbana, SE, MA Minister for Na onal Development Planning/ Head of the Na onal Development Planning Agency (BAPPENAS)
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Acknowledgement
The Na onal Roadmap to Accelerate Achievement of the Millennium Development Goals (MDGs) in Indonesia from 2010 to 2015 has been prepared by a Team consis ng of a Steering Commi ee and a Technical Team / Working Group responsible to the Minister of Na onal Development Planning / Head of BAPPENAS. The membership of the Team is presented in Appendix 4 of the Roadmap. To all members of the Prepara on Team we extend our gra tude and thanks for their hard work and dedica on which have contributed to the comple on of the Roadmap. Apprecia on and thanks are specically extended to: Prof. DR. Nila Moeloek, as the Special Envoy of the President for the MDGs, who has guided the formula on process of this document. Dr. Ir. Lukita Dinarsyah Tuwo, MA and Dra. Nina Sardjunani, MA who have coordinated the prepara on while also maintaining quality assurance for the substance of this Roadmap. Dr. Ir. Rr. Endah Murniningtyas, MSc; Dr. Ir. Tauk Hana MUP; Dr. Ir. Subandi, MSc; Dr. Arum Atmawikarta, SKM, MPH; Dr. Ir. Edi Eendi Tedjakusuma, MA; Dra. Tu Riya , MA; Ir. Wahyuningsih Daraja , MSc; Dra. Rahma Iryan , MT; Dr. Rd. Siliwan , MPIA; Dadang Rizki Ratman, SH, MPA; Ir. Budi Hidayat, M.Eng.Sc; Ir. Wet Hernowo, MA; Ir. Mon y Girianna, MSc, MCP, Ph.D.; Dr. Ir. Sri Yan , MPM, Ir. Adi Wismana Suryabrata, MIA; Ir. Rahmana Yahya Hidayat, MSc; Woro Srihastu Sulistyaningrum, ST, MIDS; Mahatmi Saronto Parwitasari, ST, MSIE; Ir. Yosi Tresna Diani, MPM; Dr. Ir. Arif Haryana, MSc; Randy R. Wrihatnolo, MADM; Emmy Soeparmijatun, SH, MPM; Drs. Mohammad Sjuhdi Rasjid; Dr. Sanjoyo, M. Ec; Fithriyah, SE, MPA, Ph.D.; Benny Azwir, ST, MM; Imam Subek , MPS, MPH; Sularsono, SP, ME; Ahmad Tauk, S. Kom, MAP; Dr. Hadiat, MA; Tri Goddess Virgiyan , ST, MEM; Dr. Hygiawa Nur Rahayu, ST, MSc; Ir. Tommy Hermawan, MA; Ir. Nugroho Tri Utomo, MRPL Hamzah Riza, SE, MA; Erwin Dimas, SE, DEA, Msi; Maliki, ST, MSIE, PhD; S. Happy Hardjo, M. Ec; Drs. Wynandin Imawan, MSc, and Dr. Wendy Hartanto, MA who have contributed in providing data, informa on and prepara on of the manuscript.
Our thanks are also extended to our development partners from the Asian Development Bank (ADB) and the Australian Agency for Interna onal Development (AusAid), for their support in the prepara on of this Roadmap, especially to Alan S. Prouty, MSc; Prof. Dr. Ir. H. Hidayat Syarief, MS; Rooswan Soeharno, dr, MARS; Hjalte S.A. Sederlof, Ph.Lic (Econ.), MSc; and Sap a Novadiana, and to all others who contributed to the prepara on of this document but that cannot be men oned individually.
May the Roadmap be used by all interested par es both within government and the concerned stakeholders in eorts to accelerate the achievement of the Millennium Development Goals by 2015.
Jakarta, August 2010 Minister for the Na onal Development Planning / Head of the Na onal Development Planning Agency (BAPPENAS)
Prof. Dr. Armida S. Alisjahbana, SE, MA
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Table of Contents
FOREWORD ...................................................................................................................... ACKNOWLEDGEMENT ..................................................................................................... TABLE OF CONTENTS ........................................................................................................ LIST OF FIGURES ............................................................................................................... LIST OF MAPS ................................................................................................................... LIST OF TABLES ................................................................................................................. LIST OF ABBREVIATIONS .................................................................................................. INTRODUCTION................................................................................................................ SUMMARY BY GOAL ........................................................................................................ OVERVIEW OF STATUS OF MDG TARGETS ....................................................................... GOAL 1: ERADICATE EXTREME POVERTY AND HUNGER ................................................. Target 1A: Halve, between 1990 and 2015, the propor on of people whose income is less than USD 1.00 (PPP) a day ........ Target 1B: Achieve full and produc ve employment and decent work for all, including women and young people ........... Target 1C: Halve, between 1990 and 2015, the propor on of people who suer from hunger .............................................. GOAL 2: ACHIEVE UNIVERSAL PRIMARY EDUCATION ..................................................... Target 2A: Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling ....... GOAL 3: PROMOTE GENDER EQUALITY AND EMPOWER WOMEN ................................ Target 3A: Eliminate gender disparity in primary and secondary educa on, preferably by 2005, and in all levels of educa on no later than 2015....................................................................... GOAL 4: REDUCE CHILD MORTALITY RATE ...................................................................... Target 4A: Reduce by two-thirds, between 1990 and 2015, the under-ve mortality rate ...................................................... GOAL 5: IMPROVE MATERNAL HEALTH ........................................................................... Target 5A: Reduce by three-quarters, between 1990 and 2015, the Maternal Mortality Ra o ....................................................... Target 5B: Achieve, by 2015, universal access to reproduc ve health.......... iii v vii ix xi xi xiii 1 9 15 23 25 39 43 49 51 59
61 69 71 78 79 79
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GOAL 6: COMBAT HIV/AIDS, MALARIA AND OTHER DISEASES ....................................... Target 6A: Have halted by 2015 and begun to reverse the spread of HIV/AIDS ....................................................................................... Target 6B: Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it ..............................................................
91 93 93
Target 6C: Have halted by 2015 and begun to reverse the incidence of Malaria and other major diseases ........................................... 101 GOAL 7: ENSURE ENVIRONMENTAL SUSTAINABILITY ..................................................... 111 Target 7A: Integra ng the principles of sustainable development in na onal policies and programs and reversing the loss of environmental resources ............................................................. 113 Target 7B: Reduce biodiversity loss, achieving, by 2010, a signicant reduc on in the rate of loss ......................................................... 120 Target 7C: Halve, by 2015, the propor on of people without sustainable access to safe drinking water and basic sanita on ...................... 122 Target 7D: By 2020, to have achieved a signicant improvement in the lives of at least 100 million slum dwellers ............................. 129 GOAL 8: DEVELOP A GLOBAL PARTNERSHIP FOR DEVELOPMENT .................................. 133 Target 8A: Develop further an open, rule-based, predictable, non-discriminatory trading and nancial systems ....................... 136 Target 8D: Deal comprehensively with the debt problems of developing countries through na onal and interna onal measures in order to make debt sustainable in the long term......................... 141 Target 8F: In coopera on with the private sector, make available the benets of new technologies, especially informa on and communica ons ........................................................................... 144
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List of Figures
Figure 1.1. Figure 1.2. Figure 1.3. Figure 1.4. Figure 1.5. Figure 1.6. Figure 1.7. Figure 1.8. Figure 1.9. Figure 1.10. Progress in reducing extreme poverty (USD1.00/capita/day) as compared to the MDG target ................................................................. Long-term trends in poverty reduc on in Indonesia measured using the indicator for Na onal Poverty Line and the target for 2015 .................. The na onal trend in Indonesia of the Poverty Gap Index, 2002 to 2010........................................................................................... The percentages of the popula on below the na onal poverty line by major geographical region of Indonesia (2010) .......................... Percentages of popula on below the na onal poverty line by province of Indonesia, 2010 ................................................................... The distribu on of Indonesias poor by urban and rural se ng (1990-2010) ............................................................................................ The growth rate of labor produc vity (in percentages) for the agriculture, industry and the service sector ........................................... Employment to Popula on Ra o for urban and rural areas and for the na onal level .................................................................................... The propor on of vulnerable workers to total workers, 1990-2009 ...... Trend in the prevalence of underweight children under ve years of age (1989-2007) using the WHO 2005 standard and the MDG Target for this indicator in 2015.............................................................. The prevalence of underweight children under ve years of age by province (2007) .................................................................................. Trends in the average calorie consump on for rural and urban households (2002-2009) ......................................................................... Trend in the desirable dietary pa ern (PPH) score of food consump on for rural and urban households, 2002-2007 ..................... Trends for Net Enrolment Ra os for primary and junior secondary educa on levels (including Madrasah) ................................................... Net Enrolment Rate for primary school including Madrasah by province, 2009 ................................................................................... Gender Parity Index (GPI) of Net Enrolment Rates (NER) senior secondary schools by province, 2009 ..................................................... Average monthly wages (Rp 000) of male and female workers in non-agricultural sectors ...................................................................... Na onal trend Infant and Child Mortality per 1,000 live births ............. Propor on of one-year-old children immunized against measles, by province 2007 .................................................................................... Na onal trends and projec ons for the Maternal Mortality Ra o 1991-2025............................................................................................... Percentage of births assisted by skilled provider, by provinces , 2009 ........................................................................................................ 25
26 27 27 28 29 40 41
43 44 45 46 52 52 62 63 72 73 80 80
Figure 1.11. Figure 1.12. Figure 1.13. Figure 2.1. Figure 2.2. Figure 3.1. Figure 3.2. Figure 4.1. Figure 4.2. Figure 5.1. Figure 5.2.
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Figure 5.3. Figure 5.4. Figure 6.1. Figure 6.2. Figure 6.3. Figure 6.4. Figure 6.5.
Figure 6.6.
Figure 6.7. Figure 6.8. Figure 6.9. Figure 7.1. Figure 7.2. Figure 7.3. Figure 7.4. Figure 7.5.
Figure 7.6.
Figure 7.7. Figure 7.8. Figure 7.9. Figure 8.1. Figure 8.2. Figure 8.3. Figure 8.4. Figure 8.5.
First and fourth antenatal visits, in Indonesia 1991- 2008 ..................... 81 Unmet needs, Indonesia 1991-2007 ...................................................... 82 AIDS cases per 100,000 popula on in Indonesia, 1989-2009................. 94 Number of AIDS cases in Indonesia, by province, 2009......................... 94 Distribu on of HIV Infec ons, by popula on group, 2009 ..................... 95 Cumula ve percentage on AIDS cases by age group, 2009 .................... 95 Percentage of unmarried women and men age 15-24 who have ever had sex, who use condom at last sex, according to background characteris c, 2007............................................................. 96 Propor on of men and woemn aged 15-24 with correct of comprehensive knowledge about AIDS, by back ground characteris c, Indonesia 2007 ....................................................................................... 97 Coverage of ART interven ons in Indonesia, 20062009 ....................... 97 Annual Parasites Incidence of Malaria, Indonesia 1990-2009 ................ 101 The Na onal Case Detec on Rate (CDR) and Success Rate (SR) of TB (%) 1995-2009 ............................................................................... 106 The percentage of forest cover of the total land area of Indonesia from 1990 to 2008 .................................................................................. 113 Total energy use of various types for the years 1990-2008 (equivalent to Barrels of Oil (BOE) in millions) ....................................... 114 Ozone Deple ng Substance Consump on in Indonesia from 1992 to 2008 ................................................................................................... 114 Propor on of households with access to propoer (improved) drinkingwater, 1993-2009....................................................................... 122 The propor on of households that have access to improved drinking water in urban and rural and total according to the provinces, in 1993-2009 ................................................................... 123 The propor on of households that have access to adequate sanita on in rural, urban and rural and urban total, the year 1993-2009 ................................................................................ 123 Proporsi households that have access to adequate sanita on in rural, urban and total rural and urban, by province, year 2009 ....................... 124 The propor on of urban households living in slums, 1993 and 2009 .... 129 The propor on of urban slum households by province, 2009 ............... 130 The trends for imports, exports, GDP growth and the ra o of imports plus exports to GDP as the MDG indicator for economic openness .............. 137 Loan to Deposit Ra o (LDR in percent) of commercial and rural credit banks, 2000 - 2009................................................................................. 138 The trend of foreign debt to GDP and the Debt Service Ra o (DSR) during 1996-2009............................................................................................... 141 Percentage of popula on in Indonesia owning xed-line telephones or cellular telephones during 2004-2009 .................................................... 145 Percentage of households owning personal computers and having access to the internet by province (2009) .............................................................. 146
List of Maps
Map 1.1. Map 3.1. Percentages of popula on below the na onal poverty line by province of Indonesia, 2010 .................................................................................. The average wages of female workers as percentages of the average wages of male workers by province in August 2009 ............................... 28 64
List of Tables
Table 1.1. Table 1.2. Table 1.3. Table 2.1. Table 2.2. Table 3.1. Table 4.1. Table 5.1. Table 5.2. Table 6.1. Table 6.2. Table 6.3. Table 7.1. Table 7.2. Table 7.3. Table 7.4. Annual Implementa on Targets Specied in the Na onal Medium-Term Development Plan to Reduce Poverty .................................................... 32 Underweight Prevalence Among Children Under Five Years of Age by Rural and Urban Areas of Indonesia (2007)............................................ 44 Outputs and Targets Specied in the Na onal Medium-Term Development Plan (RPJMN 2010-2104) ................................................. 48 Number and Propor on of Teachers by Academic Qualica ons and School Levels for Indonesia (2009)* ....................................................... 54 Program Priori es, Outputs and Indicators 2010-2014 .......................... 57 Priority, Output and Performance Indicators in Educa on, Poli cs, and Labor, 2010-2014 ............................................................................. 67 Priori es, Outputs, and Targets to Improve the Quality of Child Health Services, 20102014 ............................................................................. 76 Priori es, Outputs, and Targets to Improve the Quality of Maternal and Reproduc ve Health Services, 2010-2014 .............................................. 87 Priori es, Outputs, and Targets for Popula on and Family Planning Programs, 2010-2014............................................................................. 88 Priori es, Outputs and Targets of HIV/AIDS Mi ga on Program, 2010-2014............................................................................................... 100 Priori es, Outputs and Targets in Malaria Control Program, 2010-2014............................................................................................... 105 Priori es, Outputs and Targets in Reducing Morbidity and Mortality Rate Related to TB, 2010-2014 ....................................................................... 109 Annual Implementa on Targets from the Na onal Medium-Term Development Plan to Improve Natural Resource Management ............ 116 Selected Annual Implementa on Targets in the Na onal Medium-Term Development Plan to Achieve Sustainable Use of Energy Resources ... 119 Priori es, Outputs, and Targets for Improvment of the Access to Drinking Water and Improved Sanita on, 2010-2014 .......................................... 128 Implementa on Targets to Reduce the Propor on of the Popula on Living in Slums ........................................................................................ 131
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List of Abbreviations
ACFTA ACSM ACT ADB ADP AEC AFTA AIDS AKFTA ANC APEC APL ART ASEAN BAPPENAS BCC BCG BEONC BLT BOE BOK BOS BPK BPLHD BPS BSM BSNP BWA CAIRNS CBE CCS CDM CDR CEACR CEONC The ASEAN-China Free Trade Agreement Advocacy, Communica on and Social Mobiliza on Artemisinin-based combina on therapy Asian Development Bank Annual Development Plan ASEAN Economic Community ASEAN Free Trade Area Acquired Immuno-defeciency Syndrome The ASEAN Korea Free Trade Agreement Antenatal Care The Asia Pacic Economic Coopera on Forum Areal Penggunaan Lain (areas for other uses) An retroviral Therapy The Associa on of Southeast Asian Na ons Kementerian Negara Perencanaan Pembangunan Nasional (The Na onal Development Planning Agency) Behavioral Change Communica on Bacillus Calme e-Gurin Basic Emergency Obstetric-Neonatal Care Bantuan Langsung Tunai (Direct Cash Assistance Program) Barrels of Oil Equivalent Biaya Operasional Kesehatan (subsidy for opera onal cost for health facili es) Bantuan Operasional Sekolah (School Opera onal Assistance) Badan Pemeriksa Keuangan (Supreme Audit Authority) Badan Pengelolaan Lingkungan Hidup Daerah (Local Environmental Management Agency) Badan Pusat Sta s k (Central Bureau of Sta s cs) Beasiswa Miskin (Scholarship for Poor Children) Board of Na onal Educa on Standards Broadband Wireless Access Coali on of Agricultural Expor ng Na ons Lobbying for Agricultural Trade Liberaliza on Compulsory Basic Educa on Carbon Capture and Storage Clean Development Mechanism Case Detec on Rate Commi ee of Experts on the Applica on of Conven ons and Recommenda ons Comprehensive Emergency Obstetric-Neonatal Care
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CEPT CFCs CH4 CITES CLMV CLTS CO2 CPR CSO DAK Desa Siaga DOTS DPD DPR DPRD DPT 3 DRA DSR DSS ECED EFA FMU FSW G-20 G-33 GATT GDP GER GHG GMP GPI HCFC HDR HIS HIV HL HP
The Common Eec ve Preferen al Tari Chlorouorocarbons Methane Conven on on Interna onal Trade in Endangered Species of Wild Flora and Fauna Cambodia, Laos, Myanmar and Vietnam Community-Led Total Sanita on Carbon Dioxide Contracep ve Prevalence Rate Civil Society Organiza on Dana Alokasi Khusus (Special Alloca on Funds) Alert Village: a village that has resources capability and readiness to overcome health problems and to reach a healthy village) Directly Observed Treatment Short-Course Dewan Perwakilan Daerah (Regional Representa ve Council) Dewan Perwakilan Rakyat (House of Representa ves) Dewan Perwakilan Rakyat Daerah (Regional House of Representa ves) Trivalent vaccines against three infec ous diseases in humans: diphtheria, pertussis (whooping cough) and tetanus Demand-Responsive Approach Debt Service Ra o Dengue Shock Syndrome Early Childhood Educa on and Development Educa on for All Forest Management Unit Female Sex Worker The group of 20 is a forum for 20 industrialized and developing countries to discuss key issues of the global economy Chair of the coali on of developing countries suppor ng exibility to undertake limited market openings on agricultural issues General Agreement on Trade and Taris Gross Domes c Product Gross Enrolment Rate Green House Gasses Growth Monitoring Prac ce Gender Parity Index Hydrochlorouorocarbon Human Development Report Health Informa on System Human Immuno-deciency Virus Hutan Lindung (Protected Forest) Hutan Produksi (Produc on Forest)
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HPK HPT ICCSR ICCTF ICT IDHS IDU IEC IJEPA ILO IMCI IMF IMR INHERENT IPCC IPPA IPTP IRS ITN IUCN IUD Jamkesmas KAP KPA KPU KSA KUR LDR LG LJK LKBB LLIN LMIC LMVD LPG LPTK LULUCF MA MARP MDGs MDR-TB
Hutan Produksi yang bisa dikonversi (forest areas which can be converted to non-forest uses) Hutan Produksi Terbatas (Limited Produc on Forests) Indonesia Climate Change Sectoral Roadmap Indonesia Climate Change Trust Fund Informa on and Communica on Technology Indonesia Demographic Health Survey Injec ng Drug Users Informa on, Educa on and Communica ons Indonesia-Japan Economic Partnership Agreement Interna onal Labor Organiza on Integrated Management of Childhood Illness Interna onal Monetary Fund Infant Mortality Rate Indonesia Higher Educa on Network Intergovernmental Panel on Climate Change Interna onal Planned Parenthood Associa on Intermi ent Preven ve Treatment for Pregnant women Indoor Residual Spraying Insec cide-Treated Nets Interna onal Union for Conserva on of Nature Intra-Uterine Device Jaminan Kesehatan Masyarakat (Na onal Health Security Program) Knowledge, A tudes and Prac ce Kawasan Pelestarian Alam (Nature Conserva on Area) Komisi Pemilihan Umum (General Elec ons Commission) Kawasan Suaka Alam (Nature Reserve Area) Kredit Usaha Rakyat (People-Based Small Business Loan Program) Loan Deposit Ra o Local Government Lembaga Jasa Keuangan (nancial service ins tu on) Lembaga Keuangan Bukan Bank (non-bank nancial ins tu on) Long-Las ng Insec cidal Nets Lower Middle Income Country Lembaga Modal Ventura Dasar Liquid Petroleum Gas Lembaga Pendidikan Tenaga Kependidikan (Teacher Training Ins tute) Land Use, Land Use Change and Forestry Madrasah Aliyah Most at Risk Popula on Millennium Development Goals Mul drug-Resistant TB
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MDTFs MI MMR MMT MNCH MOH MONE MORA MSME MSS MT MTEF NAMA 11 NCCC NER NFE NGHGI NIN NMTDP NO NPL NTP OBF ODP ODS ORS ORT PAKEM PAUD PFM PHBS PISA PISEW PKH PKK PLHIV PLWHA PMTCT PNC PNPM
Mul -Donor Trust Funds Madrasah Ib daiyah Maternal Mortality Ra o Methadone Maintenance Therapy Maternal, Neonatal and Child Health Ministry of Health Ministry of Na onal Educa on Ministry of Religious Aairs Micro, Small and Medium Enterprise Minimum Service Standards Madrasah Tsanawiyah Medium-Term Expenditure Framework A coali on of developing countries seeking exibility to limit market opennings in trade of industrial goods Na onal Council for Climate Change Net Enrollment Rate Non-formal Educa on The Na onal Greenhouse Gases Inventory Na onal Iden ca on Number Na onal Medium-Term Development Plan Nitrogen Oxide Non-Performing Loans Na onal TB Program Oil-Based Fuels Ozone Deple ng Poten al Ozone Deple ng Substances Oral Rehydra on Solu ons Oral Rehydra on Therapy Pembelajaran Ak f, Krea f, Efek f dan Menyenangkan (Ac ve, Crea ve, Eec ve and Fun Learning) Pendidikan Anak Usia Dini (Early Childhood Educa on) Public Finance Management Perilaku Hidup Bersih Sehat (clean and healthy behavior) Program for Interna onal Student Assessment Program Infrastruktur Sosial Ekonomi Wilayah Program Keluarga Harapan (Family Hope Program) Pembinaan Kesejahteraan Keluarga (Family Welfare Movement) People Living with HIV People Living with HIV/AIDS Preven ng Mother to Child Transmission Postnatal Care Program Nasional Pemberdayaan Masyarakat (Na onal Program for
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Posyandu PPLS PPP PSTN PT Puskesmas RANMAPI RASKIN RBM RDA REDD Riskesdas RPJPN RPJMN Sakernas SBM SD SDKI SKRT SMA SMP SPM SPR SR SRH STI Susenas TB TBA TFR TIMSS UNDP UNFCCC UNICEF
Community Empowerment) Pos Pelayanan Terpadu (Integrated Health Post, a community-based basic health monitoring and services at village level) Pendataan Program Layanan Sosial (Social Service Program Survey) Purchasing Power Parity Public Switched Telephone Network Perguruan Tinggi (Higher Educa on) Pusat Kesehatan Masyarakat (Primary Health Center) Rencana Aksi Nasional untuk Menghadapi Perubahan Iklim (Na onal Ac on Plan on Mi ga on and Adapta on to Climate Change) Beras Miskin (Rice for the Poor Program) Roll Back Malaria Recommended Dietary Allowance Reducing Emissions from Deforesta on and Degrada on Riset Kesehatan Dasar (basic health research, conducted by MOH-RI) Rencana Pembangunan Jangka Panjang Nasional (Na onal Long-Term Development Plan) Rencana Pembangunan Jangka Menengah Nasional (Na onal Medium-Term Development Plan) Survei Tenagakerja Nasional (Na onal Labour Force Survey), conducted by the Central Bureau of Sta s cs School-Based Management Sekolah Dasar (Primary School) Survei Demogra dan Kesehatan Indonesia (Indonesian Demography and Health Survey) Survei Kesehatan Rumah Tangga (Household Health Survey) Sekolah Menengah Atas (Senior High School) Sekolah Menengah Pertama (Junior High School) Standar Pelayanan Minimum (Minimun Service Standard) School Par cipa on Rate Success Rate Sexual and Reproduc ve Health Sexually-Transmi ed Infec on Survei Sosial Ekonomi Nasional (Na onal Socio-Economic Survey), conducted by Central Bureau of Sta s cs Tuberculosis Tradi onal Birth A endant Total Fer lity Rate Third Interna onal Mathema cs Science Study United Na ons Development Programme United Na ons Framework Conven on on Climate Change United Na ons Childrens Fund
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UNSD VCT WAN WB WBG WHO WiMAX WTO
United Na ons Sta s cs Division Voluntary Counseling and Tes ng Wide Area Network World Bank World Bank Group World Health Organiza on Worldwide Interoperability for Microwave Access World Trade Organiza on
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Introduction
Introduction
In September 2000, at the Millennium Summit of the United Na ons (UN), 189 member states agreed to adopt the Millennium Declara on which was then translated into a prac cal framework, the Millennium Development Goals (MDGs). The MDGs place human development as the focus of development and establish a set of measurable indicators of progress to be achieved by 2015. There now remain ve years for developing member states of the UN to achieve the eight MDGs related to poverty reduc on, a ainment of universal basic educa on, gender equality, improving maternal and child health, reduc on in the prevalence of communicable diseases, environmental sustainability, and global coopera on. The MDGs are based on global partnership and developed countries also have stressed their agreement to fully support these eorts. The MDGs have been an important considera on in preparing na onal development planning documents. The Indonesian government has mainstreamed the MDGs in the Na onal Long-Term Development Plan (RPJPN 2005-2025), the Na onal Medium-Term Development Plans (RPJMN 2005-2009 and 2010-2014), and Na onal Annual Development Plans (RKP) as well as the State Budget documents.
National Development Priorities

Based on the current condi on of the Indonesian na on, taking into account the challenges to be faced over the next 20 years, and the resource endowment of Indonesia, the Na onal Development Vision for the years 2005-2025 year has been dened to be: an Indonesia that is self-reliant, advanced, prosperous and just. To achieve this vision, eight missions related Na onal Development are to be achieved: 1. Realiza on of a society that has strong moral values that are ethical, cultured, and based on the philosophy of Pancasila, 2. Crea on of a compe ve na on, 3. Crea on of a democra c society based on the rule of law, 4. Crea on of an Indonesia that is safe, peaceful and united; 5. Achievement of an equitable and just pa ern of development; 6. Crea on of a green and sustainable Indonesia; 7. Realiza on of Indonesia as an independent island na on, advanced, powerful, and based on na onal interests, and 8. Enabling Indonesia to play an important role in the interna onal community.
The strategies to be implemented to accomplish this vision and missions have been translated into stages of ve-year periods that are presented in Na onal Medium-Term Development Plan documents (RPJMN). The ve-year development phases are summarized as follows: 1. the rst Na onal Medium-Term Development Plan (2005-2009) was formulated to reorganize and develop all regions of Indonesia and to create Indonesia as a safe and peaceful, just and democra c na on while increasing the welfare of the people; 2. the second Na onal Medium-Term Development Plan (2010-2014) aims to consolidate the restructuring of Indonesia in all elds with an emphasis on improving the quality of human resources, including development of science and technology, and the strengthening of economic compe veness; 3. the third Na onal Medium-Term Development Plan (2015-2019) will further strengthen overall development in various elds by emphasizing the achievement of compe veness of the economy based on compara ve advantages of natural and human resources and the expanding capacity of science and technology; and 4. the fourth Na onal Medium-Term Development Plan (2020-2025) will create a selfreliant Indonesian society, progressive, fair, and prosperous through the accelera on of development in various elds built on a solid economic structure and based on compe ve advantages in various elds supported by qualied and compe ve human resources. The current Na onal Medium-Term Plan will be implemented during 2010 to 2014. The Na onal Development Vision during this period has been dened as follows: The realiza on of Indonesia as a prosperous, democra c, and just na on. This vision has been translated into three Na onal Development Missions which are to: (i) con nue developing towards a prosperous Indonesia, (ii) strengthen the pillars of democracy, and (iii) improve the jus ce system in all sectors. The Vision and Missions of Na onal Development 2010-2014 have been formulated and translated into opera onal terms in a number of na onal priori es in the following thema c areas: (i) reform of the bureaucracy and governance; (ii) educa on; (iii) health; (iv) poverty reduc on; (v) food security; (vi) infrastructure; (vii) investment and improving the business climate; (vii) energy; (ix) the natural environment and disasters; (x) border areas, remote areas and post-conict areas; and (xi) culture, crea vity, and technological innova on. In addi on to these eleven na onal priori es, eorts to achieve the Vision and Mission of the Na onal Development will also be carried out through achievement of other na onal priori es in the poli cal, legal, and security areas and in the elds of the economy and peoples welfare.
Development of Indonesia After the Global Crisis and Achievement of the MDG Targets
During the past ve years, while the na on has not yet fully recovered from the economic crisis of 1997/1998, Indonesia has faced signicant global challenges. Some of the most important have been the uctua on of oil prices, rising food prices, global climate change and the global nancial crisis of 2007/2008. The global economic crisis has resulted in a world economic recession which has inuenced the performance of the domes c economy. The growth rate of GDP dropped to 4 to 5 percent as compared with the growth rate of the economy prior to the crisis, which amounted to 7-8 percent. With rising food prices, lower middle income households and the poor have been forced to expend a greater share of their incomes on food. Extreme weather events have increased; high rainfall has resulted in crop failures and damage to crops, shermen have been unable to go to sea and public health has been nega vely aected. In this unfavorable global environment, Indonesia con nues to organize and develop in all elds. The various crises and global challenges men oned above have provided the lesson that globaliza on has two dierent sides which provide both opportuni es and challenges. A na on must be fully prepared in all elds to address the global crises and challenges. Posi ve economic growth and strengthening of democra c ins tu ons during the last ten years have strengthened the posi on of the na on to accelerate the achievement of the MDGs. Currently, Indonesia is the third most populous democracy of the world and has been able to strengthen the economy to achieve the status of a middle-income country. The Indonesian na on has also worked consistently over the last decade to achieve the MDG targets. Although there are s ll many challenges and problems in the implementa on of development in Indonesia, the Government remains determined to fulll the commitment to achieve the MDG targets on me. Alloca on of funds in na onal and local budgets in Indonesia has increased from year to year to support the achievement of the MDGs. This has been done to accelerate the achievement of na onal goals. Se ng measurable targets related to the MDGs that can be monitored and evaluated has proven to be eec ve in increasing the eciency of resource alloca on. In turn, evalua on of the progress in achievement of the MDGs has been useful in adjus ng plans to be more responsive to the needs of poor and vulnerable groups. In reviewing trends in the achievement of the MDG targets, the current status can be grouped into three categories of achievement: (a) targets which have already been achieved, (b) targets for which signicant progress has been achieved, and (c) targets that s ll require great eort to be achieved. The MDG targets that have already been achieved include: MDG 1 - The level of extreme poverty, that is the propor on of people living with per
capita income of less than USD 1 per day, has declined from 20.6 percent in 1990 to 5.9 percent in 2008. MDG 3 - The targets for gender equality in all levels of educa on are expected to be achieved. In 2009, the Gender Parity Index (GPI) at primary schools including madrasah ib daiyah (SD/MI) was 99.7 percent while at the junior secondary schools including madrasah tsanawiyah (SMP/MTs) and senior secondary educa on including madrasah aliyah (SM/MA) the GPI was 101.99 percent. The ra o of literate women to men in the age group of 15-24 years has reached 99.85 percent. MDG 6 - An increase in detec on of tuberculosis cases has been achieved, from 20.0 percent in 2000 to 73.1 percent in 2009 as compared to the MDG target of 70.0 percent. There has also been a decrease the prevalence of tuberculosis from 443 cases per 100,000 popula on in 1990 to 244 cases per 100,000 popula on in 2009.
The MDG targets for which signicant progress has been demonstrated include: MDG 1 - The prevalence of infant malnutri on has been reduced by nearly half, from 31 percent in 1989 to 18.4 percent in 2007. It is expected that the MDG target of 15.5 percent will be achieved by 2015. MDG 2 The par cipa on rate for primary educa on is close to 100 percent and the literacy rate of the popula on was more than 99.47 percent in 2009. MDG 3 The par cipa on ra o of females to males in SMA / MA / Paket C and higher educa on in 2009 was 96.16 and 102.95. Thus it is expected that the target of 100 will be achieved by 2015. MDG 4 The number of deaths in children under the age of ve years has decreased from 97 per 1,000 births in 1991 to 44 per 1,000 births in 2007. It is expected that the target of 32 per 1,000 births will be achieved by 2015. MDG 8 - Indonesia has been successful in developing trade and nancial systems that are open, rule-based, predictable and non-discriminatory - as evidenced by the posi ve trends in indicators related to trade and the na onal banking system. At the same me, signicant progress has been made in reducing the foreign debt ra o to GDP from 24.6 percent in 1996 to 10.9 percent in 2009. The Debt Service Ra o has also been reduced from 51 percent in 1996 to 22 percent in 2009.
The MDG targets where a posi ve trend has been demonstrated but which s ll require special eorts to achieve the targets by 2015 include the following: MDG 1 - Indonesia has raised its targets for poverty reduc on and will give special a en on to reducing poverty levels as measured against the na onal poverty line from 13.33 percent (2010).
MDG 5 - Maternal mortality has been reduced from 390 in 1991 to 228 per 100,000 live births in 2007. Special eorts are required to achieve the target of 102 per 100,000 live births by 2015. MDG 6 The number of people living with HIV / AIDS has increased, par cularly in high risk groups, including injec ng drug users and sex workers. The rate of increase is also high in some areas where awareness about this disease is low. MDG 7 - Indonesia has high levels of greenhouse gas emissions, but is commi ed to increasing forest cover, elimina ng illegal logging and implemen ng a policy framework to reduce carbon dioxide emissions by at least 26 percent over the next 20 years. At present, only 47.73 percent of households have sustainable access to improved water supply, and 51.19 percent of households have access to improved sanita on. Special a en on is required to achieve the MDG targets for Goal 7 by 2015.
The success of Indonesias development has been recognized globally and has received various awards. Progress in developing the na onal economy over the past ve years has reduced the gap between Indonesia and the developed countries. Developed countries who are members of the Organiza on of Economic Coopera on and Development (OECD) recognize and appreciate Indonesias development progress. Therefore, Indonesia along with China, India, Brazil and South Africa were invited to enter the group of enhanced engagement countries or states with an increasingly enhanced engagement with developed countries. Indonesia has also joined the G-20, i.e. the twenty countries that control 85 percent of Gross Domes c Product (GDP) of the world, which has a very important and decisive role in shaping global economic policy.
New Initiatives Moving Forward

Success in achieving the MDGs in Indonesia depends on the achievement of good governance, produc ve partnerships at all levels of society and the implementa on of a comprehensive approach to achieving pro-poor growth, improving public services, improving coordina on among stakeholders, expanding partnerships, increasing the alloca on of resources, and developing decentralized approaches to reducing dispari es while empowering communi es in all regions of Indonesia. In planning to achieve the MDGs, the size, growth and distribu on of the popula on is one important considera on. Accelera ng the achievement of the MDGs and all related targets requires that popula on problems are addressed in a comprehensive and integrated approach, including expanding access to reproduc ve health services and family planning while protec ng reproduc ve rights. The Indonesian popula on is 237.5 million people (2010 Popula on Census - Preliminary results, BPS), having more than doubled since 1971. Although
the popula on growth rate decreased from 1.97 per cent per annum during 1980-1990 to 1.49 per cent per annum in the period 1990-2000, and to a 1.30 per cent per annum rate in 2005, the total popula on of Indonesia in 2015 is expected to be approximately 247.6 million people (Indonesian Popula on Projec on 2005-2025). Of this amount, approximately 60.2 percent will be in Java which has an area of only 7 percent of the total land area of Indonesia. In addi on, no less than 80 percent of industries are concentrated in Java. The Government is commi ed to maintaining a socio-economic environment and culture where all ci zens, civil society organiza ons and the private sector can par cipate produc vely in improving the welfare of all Indonesians. In eorts to accelerate the achievement of the MDGs, the role of communi es, including community organiza ons, and especially womens groups, have contributed signicantly, especially in educa on, health, the supply of clean water and the living environment. In the future, grass-roots organiza ons will con nue to be given a en on to speed up achievement of the MDGs and increase the welfare of the people on a sustainable basis. Steps to accelerate the achievement of the MDGs during the next ve years as mandated by Presiden al Instruc on No. 3 of 2010 concerning Equitable Development Programming include the following: The Roadmap to Accelerate Achievement of the MDGs will be distributed as a reference for stakeholders in working to speed up a ainment of the MDGs throughout Indonesia. Provincial governments will prepare Regional Ac on Plans to Accelerate Achievement of the MDGs and these will be used is used as a reference in improving planning and coordina on of eorts to reduce poverty and improve peoples welfare. Alloca on of funds by the central, provincial and district governments will con nue to be increased to support the intensica on and expansion of programs to achieve the MDGs. A funding mechanism will be prepared to provide incen ves to local governments that perform well in achieving the MDGs. Support for the expansion of social services in disadvantaged areas and remote areas will be increased. Partnerships between the Government and private enterprises (Public - Private Partnerships or PPP) will be developed in the social sectors, especially educa on and health, to expand sources of funding to support achievement of the MDGs. Mechanisms to expand Corporate Social Responsibility (CSR) ini a ves will be strengthened to support the achievement of the MDGs. Enhanced coopera on with creditor countries will be sought for the conversion of debt (debt swap) for achieving the MDGs.
Summary by Goal
Summary of the Status of Achievement of the MDGs in Indonesia
MDG 1: ERADICATE EXTREME POVERTY AND HUNGER
Indonesia has achieved the target of halving the incidence of extreme poverty as measured by the indicator of USD 1.00 per capita per day. Progress is also being made to further reduce poverty as measured against the na onal poverty line from the current rate of 13.33 percent (2010) to the targeted rate of 8-10 percent by 2014. The prevalence of undernourished children under ve years of age decreased from 31.1 percent in 1989 to 18.4 percent in 2007 and Indonesia is on track to achieve the MDG target of 15.50 percent in 2015. Priori es for the future to reduce poverty are to expand employment opportuni es, improve suppor ng infrastructure and strengthen the agricultural sector. Special a en on will be given to: (i) expanding credit facili es for micro, small and medium enterprises (MSMEs); (ii) empowering disadvantaged communi es in all regions of the na on to be er access and use resources to improve their welfare; (iii) improving access of the poor to social services; and (iv) improving the provision of social protec on to the poorest of the poor.
MDG 2: ACHIEVE UNIVERSAL PRIMARY EDUCATION
Indonesia is on track to achieve the MDG target for primary educa on and literacy. The country aims to go beyond the MDG educa on target for primary educa on by expanding the target to junior secondary educa on (SMP and madrasah tsanawiyah-MTs, grades 7 to 9) to the universal basic educa on targets. In 2008/09 gross enrolment rate (GER) at primary educa on level (SD/MI) was 116.77 percent and the ne enrolment rate (NER) was 95.23 percent. At primary educa on level, disparity in educa on par cipa on among provinces has been signicantly reduced with NER above 90 percent in almost all provinces. The main challenge in acelera ng the achievment of MDG educa on target is improving equal access of children, girls and boys, to quality basic educa on. Government policies and programs to address this challenge: (i) expansion of equitable access to basic educa on par cularly for the poor; (ii) improvement of the quality, eciency, and eec veness of educa on; and (iii) strengthening governance and accountability of educa on services. The policy to allocate minimal 20 percent of government budget to the educa on sector will be con nued to accelerate the achievement of universal junior secondary educa on by 2015.
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MDG 3: PROMOTE GENDER EQUALITY AND EMPOWER WOMEN
Progress has been achieved in increasing the propor on of females in primary, junior secondary schools, senior high schools and ins tu ons of higher educa on. The ra o of NER for women to men at primary educa on and junior secondary educa on levels was 99.73 and 101.99 respec vely, and literacy among females aged 15-24 years has already reached 99.35. As a result, Indonesia is on track to achieve the educa on-related targets for gender equality by 2015. In the workforce, the share of female wage employment in the nonagricultural sector has increased. In poli cs, the number of women in the Indonesian parliament increased to 17.9 percent in 2009. Priori es for the future are to: (i) improve the role of women in development; (ii) improve protec on for women against all forms of abuse; and (iii) mainstream gender equality in all policies and programs while building greater public awareness on issues of gender.
MDG 4: REDUCE CHILD MORTALITY
The infant mortality rate in Indonesia has shown a signicant decline from 68 in 1991 to 34 per 1,000 live births in 2007. With this rate, the target of 23 per 1,000 live births in 2015 is expected to be achieved. Likewise, the child mortality target is expected to be achieved. However, regional dispari es remain as constraints to achieve the targets, reec ng the discrepancy in accessing health services, par cularly in underserved and remote areas. The future priori es are to strengthen health systems and improve access to health services especially for the poor and remote areas.
MDG 5: IMPROVE MATERNAL HEALTH
Of all the MDGs, the lowest rate of global achievement has been recorded in the improvement of maternal health. In Indonesia, the maternal mortality ra o (MMR) has gradually been reduced from 390 in 1991 to 228 per 100,000 live births in 2007. Extra hard work will be needed to achieve the MDG target by 2015 of 102 per 100,000 live births. Even though the rates for antenatal care and births a ended by skilled health personnel are rela vely high, several factors such as high risk pregnancy and abor on are considered to be constraints that require special a en on. Cri cal measures to reduce maternal mortality are improving the contracep ve prevalence rate
12
and reducing the unmet need through expanding access and improving quality of family planning and reproduc ve health services. For the future, priori es to improve maternal health will be focused on expanding be er quality health care and comprehensive obstetric care, improving family planning services and provision of informa on, educa on and communica on (IEC) messages to the community.
MDG 6: COMBAT HIV/AIDS, MALARIA AND OTHER DISEASES
In Indonesia, the HIV/AIDS prevalence rate has increased, especially among high risk groups, i.e. injec ng drug users and sex workers. The number of HIV/AIDS cases reported in Indonesia more than doubled between 2004 and 2005. The incidence of malaria per 1,000 popula on decreased from 4.68 in 1990 to 1.85 in 2009. Meanwhile, in TB control, the case detec on rate and successfully treated TB cases have already reached the 2015 targets. The communicable disease control approaches are focusing on preven ve measures and mainstreaming into the na onal health system. Beyond that, communicable disease control eorts must involve all stakeholders and strengthen health promo on ac vi es to increase public awareness.
MDG 7: ENSURE ENVIRONMENTAL SUSTAINABILITY
Indonesia has a high rate of greenhouse gas emission, but has worked to increase forest cover, eliminate illegal logging and is commi ed to implemen ng a comprehensive policy framework to reduce carbon dioxide emissions over the next 20 years. The propor on of households with access to improved sources of drinking water increased from 37.73 percent in 1993 to 47.71 percent in 2009. At the same me, the propor on of households with access to improved sanita on facili es increased from 24.81 percent in 1993 to 51.19 percent in 2009. Accelera on of achievement of the targets for improving access to improved water and sanita on facili es will be con nued with increased support. A en on will be given to investments on water and sanita on systems to serve growing urban popula ons. In rural areas, communi es are expected to play a larger role, with communi es taking responsibility for opera on and management of infrastructure with advisory support from local authori es. The role and detailed responsibili es of local governments in natural resource management and water supply /sanita on will be be er delineated and their skills enhanced.
13
MDG 8: BUILDING GLOBAL PARTNERSHIP FOR DEVELOPMENT
Indonesia is an ac ve par cipant in a wide variety of interna onal forums and is commi ed to con nuing to build successful partnerships with mul lateral organiza ons, bilateral partners and representa ves of the private sector to achieve a pro-poor pa ern of economic growth. Indonesia has beneted from close collabora on with the interna onal donor community and interna onal nance ins tu ons. The Jakarta Commitment was signed with 26 development partners in 2009 to provide a roadmap for all concerned to improve coopera on and management of development assistance in Indonesia. Indonesia has commited to reducing interna onal borrowing as a percentage of GDP and this is demonstrated by the reduc on of foreign debt to GDP from 24.6 percent in 1996 to 10.9 percent in 2009. Indonesias debt service ra o has also con nued to decline from 51 percent in 1996 to 22 percent in 2009. The private sector has made major investments in informa on and communica ons technology and access to cellular telephones, telephone land lines and internet communica ons has increased drama cally over the past ve years. In 2009 some 82.41 percent of the popula on had access to cellular telephones.
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Overview of the Status of Achievement of the MDG Targets

Indicator Baseline Current MDG Target 2015 Status Source
Goal 1. Eradicate Extreme Poverty and Hunger Target 1A: Halve, between 1990 and 2015, the propor on of people whose income is less than USD 1.0 (PPP) a day 1.1 Propor on of popula on below USD 1.00 (PPP) per day Poverty gap ra o (incidence x depth of poverty) 20.60% (1990) 2.70% (1990) 5.90% (2008) 10.30%
World Bank and BPS BPS, Susenas
1.2
2.21% (2010)
Reduce
Target 1B: Achieve full and produc ve employment and decent work for all, including women and young people 1.4 Growth rate of GDP per person employed Employment-topopula on (over 15 years of age) Propor on of own-account and contribu ng family workers in total employment Prevalence of underweight children under-ve years of age Prevalence of severe underweight children under-ve years of age Prevalence of moderate underweight children under-ve years of age 3.52% (1990) 65% (1990) 2.24% (2009) 62% (2009) BPS, Sakernas Decrease PDB Na onal and Sakernas
1.5
1.7
71% (1990)
64% (2009)
Target 1C: Halve, between 1990 and 2015, the propor on of people who suer from hunger 1.8 31.0% (1989)* 18.4% (2007)** 15.5%
* BPS, Susenas ** Ministry of Health Riskesdas, 2007
1.8a
7.2% (1989)*
5.4% (2007)**
3.6%
1.8b
23.8% (1989)*
13.0% (2007)**
11.9%
Status:
Already achieved On-track Need special a
en on
15
Con nued: Overview of the Status of Achievement of the MDG Targets
Indicator
Propor on of populaon below minimum level of dietary energy consump on: 1.9 1400 kcal/capita/day 2000 kcal/capita/day
Baseline
Current
MDG Target 2015
Status
Source
17.00% (1990) 64.21% (1990) 14.47% (2009) 61.86% (2009) 8.50% 35.32% BPS, Susenas
Goal 2: Achieve Universal Primary Educa on Target 2A: Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete full course of primary schooling 2.1 Net Enrolment Ra o (NER) in primary educa on Propor on of pupils star ng grade 1 who complete primary school. Literacy rate of populaon aged 15-24 year, women and men 88.70% (1992)** 62.00% (1990)* 95.23% (2009)* 93.00% (2008)** 99.47% (2009) Female: 99.40% Male: 99.55% 100.00%
* MONE **BPS, Susenas * BPS, MONE ** BPS, Susenas
2.2
100.00%
2.3
96.60% (1990)
100.00%
BPS, Susenas
Goal 3: Promote Gender Equality and Empower Women Target 3A: Eliminate gender disparity in primary and secondary educa on, preferably by 2005, and in all levels of educa on no later than 2015 3.1 Ra os of girls to boys in primary, secondary and ter ary educa on - Ra o of girls to boys in primary schools - Ra o of girls to boys in junior high schools - Ra o of girls to boys in senior high schools - Ra o of girls to boys in higher educa on 3.1a Literacy ra o of women to men in the 15-24 year age group 100.27 (1993) 99.86 (1993) 93.67 (1993) 74.06 (1993) 98.44 (1993) 99.73 (2009) 101.99 (2009) 96.16 (2009) 102.95 (2009) 99.85 (2009) 100.00 100.00 100.00 100.00 100.00

BPS, Sakernas
Status:
en on
16
Indicator
Share of women in wage employment in the non-agricultural sector Propor on of seats held by women in na onal parliament
Baseline
29.24% (1990) 12.50% (1990)
Current
33.45% (2009) 17.90% (2009)
MDG Target 2015

Decrease
Status
Source
BPS, Sakernas
3.2
3.3
Decrease
KPU
Goal 4: Reduce Child Mortality Target 4A: Reduce by two-thirds, between 1990 and 2015, the under-ve mortality rate 4.1 4.2 4.2a Under-ve mortality rate per 1,000 live births Infant mortality rate per 1,000 live births Neonatal mortality rate per 1,000 live births Propor on of oneyear-old children immunized against measles 97 (1991) 68 (1991) 32 (1991) 44.5% (1991) 44 (2007) 34 (2007) 19 (2007) 67.0% (2007) 32 23 Decrease

BPS, IDHS 1991, 2007
4.3
Decrease
Goal 5: Improve Maternal Health Target 5A: Reduce by three-quarters, between 1990 and 2015, the Maternal Mortality Ra o 5.1 Maternal Mortality Ra o (per 100,000 live births) Propor on of births a ended by skilled health personnel (%) Current contracep ve use among married women 15-49 years old, any method Current contracep ve use among married women 15-49 years old, modern method 390 (1991) 40.70% (1992) 228 (2007) 77.34% (2009) 102 BPS, IDHS 1991, 2007 BPS, Susenas 1992-2009
5.2
Increase
Target 5B: Achieve, by 2015, universal access to reproduc ve health 5.3 49.7% (1991) 61.4% (2007) Increase
BPS, IDHS 1991, 2007
5.3a
47.1% (1991)
57.4% (2007)
Increase
Status:
en on
17
Indicator
5.4 Adolescent birth rate (per 1000 women aged 15-19) Antenatal care coverage (at least one visit and at least four visists) - 1 visit: - 4 visits: 5.6 Unmet need for family planning
Baseline
67 (1991)
Current
35 (2007)
MDG Target 2015

Decrease
Status
Source
5.5
75.0% 56.0% (1991) 12.7% (1991)
93.3% Increase 81.5% (2007) 9.1% (2007) Decrease
BPS, IDHS 1991, 2007
Goal 6: Combat HIV/AIDS, Malaria and Other Diseases Target 6A: Have halted by 2015 and begun to reverse the spread of HIV/AIDS 6.1 HIV/AIDS Prevalence among total popula on (percent) Condom use at last high-risk sex Propor on of popula on aged 15-24 years with comprehensive correct knowledge of HIV/AIDS 6.3 Female: 9.5% Male: 14.7% (2007) Female: 2.6% Male: 1.4% (2007) 0.2% (2009) Female: 10.3% Male: 18.4% (2007) Decrease MOH es mated 2006 BPS, IYARHS 2002/2003 & 2007
6.2
12.8% (2002/3)
Increase
- Married
Increase
BPS, IDHS 2007
- Unmarried
Increase
BPS, SKRRI 2007
Target 6B: Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it Propor on of popula on with advanced HIV infec on with access to an retroviral drugs 38.4% (2009) MOH, 2010 as per 30 November 2009
6.5
Increase
Status:
en on
18
Indicator
Baseline
Current
MDG Target 2015
Status
Source
Target 6C: Have halted by 2015 and begun to reverse the incidence of Malaria and other major diseases 6.6 Incidence and death rates associated with Malaria (per 1,000) Incidence rate associated with Malaria (per 1,000): 6.6a - incidence of Malaria in Jawa & Bali - Incidence of Malaria outside Jawa & Bali 6.7 Propor on of children under 5 sleeping under insec cidetreated bednets Incidence, prevalence and death rates associated with Tuberculosis Incidence rates associated with Tuberculosis (all cases/100,000 pop/ year) Prevalence rate of Tuberculosis (per 100,000) Death rate of Tuberculosis (per 100,000) Propor on of Tuberculosis cases detected and cured under directly observed treatment short courses Propor on of Tuberculosis cases detected under directly observed treatment short course (DOTS) Propor on of Tuberculosis cases cured under DOTS * TB Global WHO Report, 2009 343 (1990) 228 (2009) Stop, began to reduce 4.68 (1990) 0.17 (1990) 24.10 (1990) 1.85 (2009) 0.16 (2008) 17.77 (2008) 3.3% Rural: 4.5% Urban: 1.6% -2007 Decrease Decrease Decrease
MOH 2009 API, MOH 2008 AMI, MOH 2008 BPS, IDHS 2007
Increase
6.9
6.9a

TB Global WHO Report, 2009
6.9b
443 (1990) 92 (1990)
244 (2009) 39 (2009)
6.9c
6.10
6.10a
20.0% (2000)*
73.1% (2009)**
70.0%
6.10b
87.0% (2000)*
91.0% (2009)**
85.0%
** MOH Report-2009
Status:
en on
19
Indicator
Baseline
Current
MDG Target 2015
Status
Source
Goal 7: Ensure Environmental Sustainability Target 7A: Integrate the principles of sustainable development into country policies and programs and reverse the loss of environmental resources The ra o of actual forest cover to total land area based on the review of satellite imagery and aerial photographic surveys Carbon dioxide (CO2) emissions Primary energy consump on (per capita) Energy Intensity
7.1
59.70% (1990)
52.43% (2008)
Increase
Ministry of Forestry
7.2
1,416,074 1,711,626 Gg Gg CO2e CO2e (2008) (2000) 2.64 BOE (1991) 5.28 BOE/ USD 1,000 (1990) 0.98 (1991) 3.5% (2000) 8,332.7 metric tons (1992) 66.08% (1998) 4.3 BOE (2008) 2.1 BOE/ USD 1,000 (2008) 1.6 (2008) 3.45% (2008) 0 CFCs (2009)
Reduce at least 26% by 2020 Reduce
Ministry of Environment
7.2a
7.2b.
Decrease
Ministry of Energy and Natural Resources
7.2c 7.2d
Energy Elas city Energy mix for renewable energy Total consump on of ozone deple ng substances (ODS) in metric tons Propor on of sh stocks within safe biological limits The ra o of terrestrial areas protected to maintain biological diversity to total terrestrial area The ra o of marine protected areas to total territorial marine area
Decrease 0 CFCs while reducing HCFCs Ministry of Environment Ministry of Marine Aairs & Fisheries Ministry of Forestry *Ministry of Forestry / **Ministry of Marine Aairs & Fisheries
7.3
7.4
91.83% (2008)
not exceed
7.5
26.40% (1990)
26.40% (2008)
Increase
7.6
0.14% (1990)*
4.35% (2009)**
Increase
Status:
en on
20
Indicator
Baseline
Current
MDG Target 2015
Status
Source
Target 7C: Halve, by 2015, the propor on of households without sustainable access to safe drinking water and basic sanita on Propor on of households with sustainable access to an improved water source, urban and rural Urban Rural Propor on of households with sustainable access to basic sanita on, urban and rural Urban Rural
7.8
37.73% (1993)
47.71% (2009)
68.87%
7.8a 7.8b
50.58% (1993) 31.61% (1993) 24.81% (1993) 53.64% (1993) 11.10% (1993)
49.82% (2009) 45.72% (2009) 51. 19% (2009) 69.51% (2009) 33.96% (2009)
75.29% 65.81%

BPS, Susenas
7.9
62.41%
7.9a 7.9b
76.82% 55.55%
Target 7D: By 2020, to have achieved a signicant improvement in the lives of at least 100 million slum dwellers 7.1 Propor on of urban popula on living in slums 20.75% (1993) 12.12% (2009) BPS, Susenas
Goal 8: Develop a Global Partnership for Development Target 8A: Develop further an open, rule-based, predictable, non-discriminatory trading and nancial systems 7.1 Propor on of urban popula on living in slums Propor on of urban popula on living in slums Propor on of urban popula on living in slums 20.75% (1993) 20.75% (1993) 20.75% (1993) 12.12% (2009) 12.12% (2009) 12.12% (2009) -
BPS & The World Bank
7.1
BI Economic Report 2008, 2009
7.1
Target 8D: Deal comprehensively with the debt problems of developing countries through na onal and interna onal measures in order to make debt sustainable in the long term 8.12 8.12a
Status:
Ra o of Interna onal Debt to GDP Debt Service Ra o (DSR)
24.59% (1996) 51.00% (1996)
10.89% (2009) 22.00% (2009)

en on
Reduce Reduce
Ministry of Finance BI Annual Report 2009
21
Indicator
Baseline
Current
MDG Target 2015
Status
Source
Target 8F: In coopera on with the private sector, make available the benets of new technologies, especially informa on and communica ons Propor on of popula on with xed-line telephones (teledensity in popula on) Propor on of popula on with cellular phones Propor on of households with access to internet Propor on of households with personal computers 4.02% (2004)
8.14
3.65% (2009)
Increase
Minister of Communica on and Informa cs 2010
8.15
14.79% (2004) -
82.41% (2009) 11.51% (2009) 8.32% (2009)
100.00%

BPS, Susenas 2009 BPS, Susenas 2009
8.16
50.00%
8.16a
Increase
Status:
en on
22
Coming Home from the Field
Goal 1: Eradicate Extreme Poverty and Hunger
24
Target 1A: Halve, between 1990 and 2015, the proportion of people whose income is less than USD 1.00 (PPP) a day
Current Status
The incidence of extreme poverty (using the measurement of USD 1.00 purchasing power parity per capita per day) has been reduced in Indonesia from 20.6 percent in 1990 to 5.9 percent in 2008, and Indonesia has already achieved and exceeded Target 1 for reduc on of extreme poverty. Figure 1.1 presents the trend for the declining percentages of the popula on es mated to have levels of consump on below USD 1.00 (PPP) per capita per day as measured by World Bank/BPS annually from 1990 to 2008. The declining trend is expected to be sustained to 2015 and beyond.
25
20
Figure 1.1: Progress in Reducing Extreme Poverty (USD1.00/capita/day) as Compared to the MDG Target
14.8 12.0
Percentage
15
9.9 7.8
20.6
9.9
9.2
Target: 10.3
7.2 7.4 8.5 6.0 6.7 2006 2007 6.6 5.9 2008 2009
10
0
1990 1993 1996 1998 1999 2000 2001 2002 2003 2004 2005 2010 2011 2012 2013 2014 2015
Source: BPS, Susenas, The World Bank 2008.
25
Using the prevailing na onal poverty line, the incidence of poverty has generally trended downwards during the period 1976 to 1996 (Figure 1.2). The economic crisis in 1997/8 resulted in a drama c increase in the number of Indonesians below the poverty line. The incidence of poverty more than doubled to 24.2 percent in 1998 when a nega ve GDP growth rate was recorded and prices increased drama cally. Since 1999, the na onal poverty rate had been reduced to 13.33 percent (2010) as the na onal economy has recovered and as ini a ves to reduce the incidence of poverty proved to be eec ve in bene ng the poor. Although the percentage of the popula on living below the poverty line in 2010 had been reduced, the total number of people living below the na onal poverty line was s ll high, amoun ng to 31.02 million people. At the same me it is important to note that the decline of the poverty rate from March 2009 to March 2010 is only 0.82 percent and that was less than during the previous year (2008/2009) when the decline of the poverty rate was 1.27 percent. As a result it is necessary to take steps to increase the rate of poverty reduc on.
Figure 1.2: Long-Term Trends in Poverty Reduc on in Indonesia Measured Using the Na onal Poverty Line
60 50 40
40.1 33.3 54.2
49.5 42.3 40.6
47.2
48.0
38.7
37.9
38.4
37.3
39.3
36.1
35.0
35.1
37.2
35.0
32.5 14.2
30.0
27.2
28.6
24.2
21.6
23.4
20 10 0
26.9
22.5
30
25.9
19.1
18.4
18.2
17.4
17.4
16.7
17.8
16.0
16.6
15.1
13.7
15.4
11.3
1998*
1976
1978
1980
1981
1984
1987
1990
1993
1996
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
Source: BPS, Susenas, several years.
Number of poor popula on (milliions)
Na onal Poverty Line (percentage)
The Poverty Gap Index is an indicator which measures the gap between the average income of the poor and the na onal poverty line. During the period 2002-2010 the trend for this indicator was generally downward, although there was a signicant increase in 2006 reec ng increases in the na onal price of fuel and other basic consumer goods. A er 2006 there has been a posi ve downward trend reec ng the impact of the measures to stablize prices and mi gate the impact of price increases on the poor (see Figure 1.3). In 2009 the average Poverty Gap Index for all areas was 2.5, and in 2010 there was a further decline to 2.2. The Poverty Gap Index measured for rural areas (3.05) was signicantly higher than for urban areas (1.91) and the highest levels were found in the rural areas of the provinces of Papua Barat (12.52), Papua (11.51), Maluku (6.94), Gorontalo (6.26), Aceh (4.87), Sulawesi Tengah (4.8), Yogyakarta (4.74), and Nusa Tenggara Timur (4.47). The total number of poor is large and the distribu on of the poor among the provinces and islands of Indonesia is uneven. Of the 31.02 million people living below the na onal poverty line in 2010, the largest share (55.83 percent) are resident on the island of Jawa. Sumatera
26
2010
13.3
31.0
ranks second in terms of percentage of the popula on living below the poverty line (21.44 percent) while Bali/ Nusa Tenggara and Sulawesi are the geographical regions with the third and fourth largest shares of people living below the poverty line (Figure 1.4).
Figure 1.3. The Na onal Trend in Indonesia of the Poverty Gap Index, 2002 to 2010
3.4
Poverty Gap Ra o
3.1 3.0 2.9 2.9 3.0 2.8 2.5 2.2
2002
2003
2004
2005
2006
2007
2008
2009
2010
Source: BPS, Susenas.
Sulawesi 7.6% Kalimantan 3.3% Bali & Nusa Tenggara 7.1%
Maluku 1.5%
Papua 3.3% Sumatera 21.4%
Figure 1.4. The Percentages of the Popula on Below the Na onal Poverty Line by Major Geographical Region of Indonesia (2010)
Jawa 55.8%
Source: BPS, Susenas 2010.
There remain signicant dispari es in the incidence of poverty among the 33 provinces of Indonesia. Poverty rates in 17 provinces are below the na onal average, while in 16 provinces they are above the na onal average (see Figure 1.5). The provinces where the incidence of poverty is more than double the na onal average of 13.33 percent include Papua (36.80 percent), Papua Barat (34.88 percent) and Maluku (27.74 percent). In Sumatera the incidence of poverty is s ll higher than the na onal average in the provinces of Aceh, Sumatera Selatan, Bengkulu and Lampung. On the islands of Jawa and Bali, the provinces of Jawa Tengah, Yogyakarta and Jawa Timur also have an incidence of poverty that is higher than the na onal average. On the island
27
of Sulawesi, the provinces of Sulawesi Tengah, Sulawesi Tenggara and Gorontalo also have poverty rates higher than the na onal rate while the same is true for the provinces of Nusa Tenggara Barat (NTB) and Nusa Tenggara Timur (NTT). The three provinces with the lowest incidence of poverty in 2010 were Jakarta (3.48 percent), Kalimantan Selatan (5.21 percent) and Bali (4.88 percent). The geographical distribu on of the incidence of poverty by province is presented in Map 1.1.
Figure 1.5 Percentages of Popula on Below the Na onal Poverty Line by Province of Indonesia, 2010
Percentage 34.9 36.8 DKI Jakarta Bali Kalimantan Selatan Bangka Belitung Kalimantan Tengah Banten Kalimantan Timur Kepulauan Riau Jambi Riau Kalimantan Barat Sulawesi Utara Maluku Utara Sumatera Barat Jawa Barat Sumatera Utara Sulawesi Selatan INDONESIA Sulawesi Barat Jawa Timur Sumatera Selatan Jawa Tengah DI Yogyakarta Sulawesi Tenggara Sulawesi Tengah Bengkulu Lampung Aceh Nusa Tenggara Barat Nusa Tenggara Timur Gorontalo Maluku Papua Barat Papua
Na onal Average 40 35 30 25 20 15 10 5 -
Map 1.1. Percentages of Popula on Below the Na onal Poverty Line by Province of Indonesia, 2010
The poverty rate is signicantly higher in rural areas than in urban centers in Indonesia. The poverty rate in rural areas of Indonesia was 16.56 percent in 2010 compared to 9.87 percent in urban areas (Figure 1.6).
28
3.5 4.9 5.2 6.5 6.8 7.2 7.7 8.1 8.3 8.7 9.0 9.1 9.4 9.5 11.3 11.3 11.6 13.3 13.6 15.3 15.5 16.6 16.8 17.1 18.1 18.3 18.9 21.0 21.6 23.0 23.2
27.7
25.7
26.0
30
22.4
21.1
25
19.8 16.8
21.8
20.2
20.1
20.0
20.4
Figure 1.6. Percentages of Urban and Rural Popula ons below the Na onal Poverty Line (1990-2010)
18.9 17.4 10.7 2009 16.6 2010 9.9
20
21.9
Percentage
15
14.3
13.8
19.1
14.6
24.8 14.5
13.5
13.6
13.4
13.5
11.7
1990 1993 1996 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
9.8
11.7
10
12.3
12.5
Source: BPS, Susenas Several Years
Urban
Rural
Challenges
A major challenge is to reduce the propor on of the na onal popula on living below the na onal poverty line while also reducing dispari es in the incidence of poverty among provinces and districts. The government is faced with the challenge of maintaining a high growth rate of GDP in order to expand employment opportuni es for the poor. To break the cycle of poverty there is a need to further strengthen the provision of educa on and health services and social protec on. Decentraliza on has brought new challenges to both central and local government authori es in Indonesia to coordinate programs to reduce poverty and to u lize scal resources eec vely to promote inclusive growth, empower the poor and improve public services.
Policies and Strategies

Indonesia is commi ed to reducing poverty in all regions, districts and villages. A mul dimensional approach will con nue to be applied, one that includes ac ons to achieve a sustained period of pro-poor growth, to create employment opportuni es, to empower communi es and to improve delivery of basic social services to all communi es. The government is commi ed to establishing a more conducive environment for all stakeholders to work to reduce poverty and achieve the na onal goals of development. It is expected that
29
the incidence of poverty as measured by the na onal poverty line will be reduced to 8 to 10 percent by 2014 in accordance with the Na onal Medium-Term Development Plan (20102014). The Na onal Team for Accelera ng Poverty Reduc on, led by the Vice President and senior cabinet ocials, will take the lead in improving coordina on of implementa on of all policies and programs to reduce the incidence of poverty. Cabinet members to be directly involved include the Coordina ng Minister for Peoples Welfare, the Coordina ng Minister for Economic Aairs, the Minister of Health, the Minister of Na onal Educa on, the Minister of Social Aairs, the Minister of Finance, the Minister for Coopera ves and SMEs and the Minister of Na onal Development Planning (BAPPENAS). The na onal priori es iden ed to reduce poverty and achieve the target for poverty are grouped into three policy areas: 1. Policies to achieve a sustained period of pro-poor growth will provide the founda on to provide produc ve employment for the poor. It is expected that growth of GDP will reach 6.3 to 6.8 percent during 2011 to 2013 and increase to 7 percent in 2014. 2. Arma ve ac ons to empower the poor and break the cycle of poverty will be implemented in three clusters of programs: First - Strengthening Social Services and Social Protec on (Cluster 1). Government support to strengthen the provision of health and educa on services will be expanded through the Na onal Health Security Program (Jamkesmas), the Family Hope Program (PKH) and provision of Scholarships for the Children from Poor Households. Second - Support will be expanded to empower communi es to reduce their poverty through PNPM Mandiri (Cluster 2). The government will increase support for the PNPM Mandiri Program to Rupiah 12.1 trillion per year and coverage will be expanded to include all 78,000 villages in Indonesia. Third - Facili es to increase the capacity of MSMEs and coopera ves will be expanded through (i.) entrepreneurship and capacity building on business management; (ii.) provision of informa on services and business consultancy; and through expansion of the PeopleBased Small Business Loan Program (KUR) (Cluster 3). KUR will be expanded to channel funds through local micronance ins tu ons to increase access of medium and small scale enterprises and coopera ves to credit. Bank guarantees will con nue to be provided in the form of Penyertaan Modal Negara (PMN) by Perum Jamkrindo and PT Askrindo. 3. Increasing eec veness of poverty reduc on programs: a. Priority will be given to improving coordina on of policies and programs to reduce poverty. Increased coordina on across programs within the three clusters is key for eec ve poverty reduc on. Therefore, coordina on of all poverty allevia on policies will be intensied through the establishment of the Na onal Team for Accelera ng Poverty Reduc on under the oce of the Vice President in accordance with Presiden al Decree 15/2010 concerning the Accelera on of Poverty Reduc on.
30
b.
c. d.
This eort will be supported by enhancing capacity and func ons of various technical ministries and government oces at the na onal, provincial and district levels. The coordina on of poverty reduc on will also be conducted at provincial and district levels by the Provincial and District Coordina ng Teams for Poverty Reduc on. Concerted eorts for poverty allevia on will also involve private sector partnerships through CSR and other types of funding such as zikat, infaq and sodaqoh. The above eorts will be supported by implementa on of an accurate monitoring and evalua on system to achieve greater eec veness in programming to alleviate poverty. Building local capacity to plan, implement, monitor and evaluate poverty reduc on programs, will be given special a en on in those provinces and districts with the highest incidence of poverty. Fiscal policies and instruments will be adjusted to be er support local government in gh ng poverty and providing services at the community level. Targe ng of the poor and near poor in poverty reduc on programs will be carried out in a systema c manner at the local level using the latest database on the poor. To maintain the accuracy of targe ng of these groups, it is planned that the Survey for Social Protec on Program will be implemented every three years.
In order to implement the policies to reduce poverty as presented above and to achieve the targets for poverty reduc on in 2015, the government has prepared and will implement the Na onal Medium-Term Development Plan (2010-2014) which denes programs and ac vi es with specic targets as presented below in Table 1.1.
31
Table 1.1. Annual Implementa on Targets Specied in the Na onal Medium-Term Development Plan to Reduce Poverty
Prioritas
Guidance and Development of Health Security
Output/Indicator
Percentage of the popula on (including all the poor people) who have health security The number of primary health centers providing basic health services for the poor The percentage of hospitals that serve poor pa ents / JAMKESMAS program par cipants
2010
2011
2012
2013
2014
Formulated nancing and health insurance policy
59%
70.30%
84.40%
94.50%
100%
Increased basic health services for the poor (JAMKESMAS) Basic Health Services for the Poor (Jamkesmas)
8,481
8,608
8,737
8,868
9,000
Increased referral of the poor for health services at hospitals Health Referral Services for the Poor (Jamkesmas)
75
80
85
90
95
Increased guidance, par cipa on and self-reliance of family planning acceptors Number of new family planning acceptors (KPS and KS-I) (poor and other vulnerable groups) to receive coaching and free contracep ves through 23,500 government and private family planning clinics (millions) The number of ac ve poor family planning par cipants (KPS and KS-I) and other vulnerable groups to receive coaching and contracep ves free through the 23,500 government and private family planning clinics (millions) Total number of PUS group members of produc ve age who become members of KB Mandiri Groups
3.75
3.80
3.89
3.97
4.05
Development of policy and guidance to family planning equality
11.9
12.2
12.5
12.8
13.1
Increased guidance and self reliance of family planning acceptors (Pre-S and KS-1)
22,000
44,000
66,000
88,000
110,000
Source: RPJMN 2010-2014
32
Prioritas
Output/Indicator
Total number of working partners who provide capital assistance and business guidance to economic working groups Total number of working partners to become facilitators for working groups Number of primary school students from poor households to receive scholarships Number of junior high school students from poor households to receive scholarships
2010
2011
2012
2013
2014
Table 1.1 Con nued
Increasing selfreliance of family planning acceptors (Pre-S and KS-1)
34
34
34
34
34
Provision of educa on subsidies/ scholarships for students from elementary schools Provision of lementary School Scholarships
2,767,282
3,916,220
3,640,780
3,370,200
3,103,210
Provision of Junior Secondary School Scholarships
The achievement of expanded and equitable access to junior high schools in all districts and ci es
966,064
1,395,100
1,346,020
1,275,840
1,195,700
Provision of High School Scholarships
The achievement of expanded and equitable access to quality high school educa on in all districts and ci es The number of high school students from poor households to receive scholarships
378,783
501,898
614,396
714,653
800,000
Provision of Voca onal Educa on Scholarships
The achievement of expanded and equitable access to quality voca onal educa on in all districts and ci es The number of vocaonal school students from poor households to receive scholarships
305,535
390,476
475,417
560,358
645,298
Ins tu onal Service Delivery Ac vi es
Expanding the availability and equitable access and quality of PT interna onal compe The number of poor students receiving scholarships 65,000 67,000 67,000 69,000
veness 70 ,000
Provision of scholarships for students from poor households (MI, MTs, and MA) Number of students from poor households to receive scholarships (MI) The number of students from poor households to receive scholarships (MT) The number of students from poor households receive scholarships (MA) 640,000 640,000 640,000 640,000 640,000
Providing Scholarships for Qualied Madrasah Educa on
540,000
540,000
540,000
540,000
540,000
320,000
320,000
320,000
320,000
320,000
33
Table 1.1. Con nued
Prioritas
Provision of Scholarships for Islamic Higher Educa on
Output/Indicator
2010
2011
2012
2013
2014
Increased availability of scholarships for students from poor households The number of students from poor households targetd to receive scholarships (PTA ) Total number of the poorest households to receive condi onal cash assistance (PKH) Total recipient households (15 kg per household per 12 months) Implementa on of the redistribu on of land (hectares)
59,538
59,538
59,538
59,538
59,538
Implementa on of condi onal cash aid to benet the poorest households (PKH); Condi onal Cash Transfers (PKH)
816,000
1,116,000
1,516,000
1,404,000
1,170,000
The provision of rice to poor households Provision of Subsidized Rice for the Poor (RASKIN) Annual targets will be determined based on surveys of need,
17,5 million
The realiza on of the land redistribu on Provincial Land Management 210,000 210,000 210,000 210,000 210,000
Increasing the availability of temporary employment for the unemployed and development of community infrastructure Development and Expansion of Employment Opportuni es The number of unemployed people to have temporary jobs Number of districts / ci es to implement temporary employment crea on for the unemployed 24,000 people 90,000 people 90,000 people 90,000 people 90,000 people
231 districts/ ci es
- Facilita on of child workers to return to school or receive skills training - Reduc on of the number of children working in worst forms of child labor The number of child workers withdrawn from the worst forms of child labor; The percentage of child workers withdrawn from the worst form of child labor who return to school and / or acquire skills training.
Increased Worker Protec on for Women and the Elimina on of Child Labour
3,000
4,300
5,600
6,900
8,400
100%
100%
100%
100%
100%
34
Prioritas
Improving Urban Community SelfReliance (PNPM Urban)
Output/Indicator
2010
2011
2012
2013
2014
Table 1.1. Con nued
Empowering communi es and accelera ng reduc on of poverty and unemployment in urban neighborhoods / sub-districts (PNPM Urban). The number of eighborhoods/ villages which benet from facilita on to empower 8,500 villages in 1,094 ubdistricts 7,482 villages in 805 subdistricts 4,968 villages in 460 subdistricts 552 villages in 460 subdistricts 482 villages in 460 subdistricts
Empowering communi es to accelerate reduc on of poverty and unemployment in districts and rural villages / (PNPM Perdesaan). The target areas of applica on of PNPMMP and strengthening PNPM Coverage areas of post-disaster reconstruc on and rehabilita on in crisis districts: Nias and Nias Selatan 4,791 subdistricts 4,940 subdistricts 4,943 subdistricts 4,946 subdistricts 4,949 subdistricts
Improving Rural Community Self-Reliance (PNPM-MP)
2 districts / 9 subdistricts
Regula ons, Guidance, Control and Opera on of Se lement Development (RISE)
Number of subdistricts served by the suppor ng infrastructure and socio-economic ac vi es.
237
237
237
237
237
Accelera ng poverty reduc on through infrastructure development and community empowerment (RIS PNPM + PPIP) Number of villages improved through development of infrastructure
3.9
2.45
1,237
1,237
1,226
Regula ons, Guidance, Control, Financing, and Management of Sanita on Improvement Supervision, Financing and Development of Water Supply Systema
210 districts/ ci es (SANIMAS) Target areas for infrastructure development and waste water facili es with on-site systems (district / city) Number of villages facilitated 30 districts/ ci es system on-site 35 districts/ ci es system on-site 40 districts/ ci es system on-site 45 districts/ ci es system on-site 50 districts/ ci es system on-site
4.650 villages (PAMSIMAS) 1,472 1,165 500 700 813
35
Table 1.2 Con nued
Prioritas
Output/Indicator
2010
2011
2012
2013
2014
Increased empowerment and self reliance of two million micro enterprises in coastal se lements, opera ng in 300 districts/ ci es supported by one unit BLU The number of groups of micro-enterprises in coastal areas and small islands are bankable Business Services and Community Empowerment Development of micro tools LKM Rural Community Empowerment Funding / PNPM MK Facilitators Micro Business Groups 100 units 120 districts/ ci es 480 people 800,000 businesses 100 units 120 districts/ ci es 480 people 800,000 businesses 100 units 120 districts/ ci es 480 people 800,000 businesses 100 units 120 districts/ ci es 480 people 800,000 businesses 100 units 120 districts/ ci es 480 people 800,000 businesses
Increasing realiza on of the lending program (KKP-E and KUR) commercial nancing, Islamic nancing, development of rural agricultural business centers, and development of farmer groups PUAP Realiza on of lending for agriculture (CTF-E, and KUR) Realiza on of distribu on of Sharia nancing and commercial nancing for agricultural sector Total number of agricultural business centers in rural areas Total number of farmer groups PUAP (units) Policy Development, Ins tu onal Strengthening, Coordina on and Facilita on of Local Governments in Less Developed Regions (P2DTK/SPADA) PNPM Improvement of Tourism Sector PNPM Mandiri Support the Peoples Business Credit Guarantee Cooperaon (KUR) 1,5 trillion Rupiah 2 trillion Rupiah 2 trillion Rupiah 2 trillion Rupiah 2,5 trillion Rupiah
Rural Agribusiness Development (PUAP) and Strengthening of Rural Economic Ins tu ons through LM3
4 trillion Rupiah
5 trillion Rupiah
6 trillion Rupiah
7 trillion Rupiah
8 trillion Rupiah
200
200
200
200
200
10,000
10,000
10,000
10,000
10,000
Increasing socio-economic recovery and growth in less developed regions
The number of districts, subdistricts and villages targeted in less developed regions
51 districts, 186 subdistricts, 4,596 villages
80 districts **)
80 districts **)
80 districts **)
80 districts **)
Increased number of tourist villages through PNPM tourism ini a ves Number of tourism villages 200 450 550 450 350
Budget available to guarantee Peoples Business Credit (KUR) Percentage of budget available to guarantee KUR 100% 100% 100% 100% 100%
36
Prioritas
Policy Coordina on Peoples Business Credit (KUR)
Output/Indicator
Percentage of policy recommenda ons to be implemented
2010
2011
2012
2013
2014
Table 1.1. Con nued
Increasing peoples business credit policy coordina on (KUR) 60% 65% 70% 75% 80%
Increased coverage of credit / bank nancing for coopera ves and SMEs Coopera on involving nancing from banks and nancial ins tu ons / other nancing. The expansion of credit services / nancing banks for coopera ves and SMEs, which supported the development of synergies and coopera on with nancial ins tu ons Regional Credit Guarantee Ins tu ons (LPKD) doing co-guarantee with the na onal insurance agency The number of coopera ves that can access credit / nancing banks through linkages Number of MFIs (coopera ves and rural banks), which work closely with the bank nancing Number of Regional Credit Guarantee Ins tu ons Increasing the role of nonbank nancial ins tu ons, such as KSP / KJKS, a venture capital, factoring, leasing companies, pawnshops in support of nance for coopera ves and SMEs, coupled with the development of informa on networks
5 MOU
5 MOU
5 MOU
5 MOU
5 MOU
7 Prov.
8 Prov.
9 Prov.
10 Prov.
10 Prov.
100
100
100
100
100
100
100
100
100
100
The increased capacity and coverage of non-bank nancial ins tu ons to provide nancing to coopera ves and SMEs
Number of non-bank nancial ins tu on established
100 KSP/ KJKS 1 LMVD
37
Table 1.1. Con nued
Prioritas
Output/Indicator
The number of MFIs that are registered and accredited in accordance with the law of the MFI The number of MFIs that par cipate in management training Total HR management sta KSP/ KJKS cer ed Total LDP KJK and reinforced TUK Number of managers/ heads of branch KJK which included training and cer ca on of competencies for MFIs
2010
2011
2012
2013
2014
Increased ins tu onal capacity of MFIs. Improved ins tu onal capacity and quality of services micronance ins tu ons (MFIs), including the accredita on and cer ca on service for MFIs, including MFIs incorporated under the law of the oopera ve
100 MFIs
100 MFIs
100 MFIs
100 MFIs
100 MFIs
Increasing the capacity and quality of services micronance ins tu ons (MFIs). 1,000 managers MFIs 1,200 people 2 Unit 1,000 managers MFIs 1,200 people 2 Unit 1,000 managers MFIs 1,200 people 2 Unit 1,000 managers MFIs 1,200 people 2 Unit
1,200 people -
900 people
900 people
900 people
900 people
900 people
Source: Na onal Medium-Term Development Plan 2010-2014
Revitalizing the educa on system, training and coopera ve extension for members and managers of coopera ves, as well as poten al coopera ve members and cadres
System of educa on, training and coopera ve educa on for members and managers of coopera ves, as well as poten al coopera ve members and cadres of the more eec ve The number of par cipants increase public understanding of coopera ves among the strategic groups. The number of par cipants increased understanding of educa on and training of coopera ves and human resources in coopera ves
1,000 people
1,000 people
1,000 people
1,000 people
1,000 people
1,750 people
1,750 people
1,750 people
1,750 people
38
Target 1B: Achieve full and productive employment and decent work for all, including women and young people
Current Status
Since the 1970s employment condi ons in Indonesia have been inuenced by the demographic transi on of the popula on structure and two economic crises that occurred in 1997/1998 and 2007/2008. The demographic transi on, from a popula on structure dominated by the younger genera on in the 1970s to the current structure dominated by those of middle age, has resulted in a rapid increase in the working popula on. In 1971, the working age popula on amounted to 63.34 million whereas it is es mated to have reached 171.02 million in 2010. The development of various indicators for "the crea on of full and produc ve employment opportuni es and provision of decent jobs for all, including women and young people" is detailed as follows: The growth of gross domes c product (GDP) per worker during the 1990-2009 period has varied signicantly, with an average annual growth of about 2.53 percent. Growth of GDP per worker in the period before the crisis of 1997/1998 (during 1990-1995) was rela vely high, amoun ng to 5.42 percent as compared to the period a er the crisis period (1997/1998 - 2008). A er the crisis, the growth rate of labor produc vity showed a tendency to decline, averaging 3.36 percent per year during the past 10 years. The lower growth rate of "post crisis" labor produc vity was partly due to the dwindling capital accumula on per worker during the post crisis period. In the industrial sector the highest growth rate occurred in 1995, amoun ng to 18.68 percent and the lowest in 2001, amoun ng to -0.05 percent. In the same year (1995), the agricultural sector also experienced the highest growth rate of 12.15 per cent, and the lowest in 1998 amounted to -12.91 percent (see Figure 1.8). The ra o of the employed to working age popula on in the 1990-2009 period experienced a rela vely small, but quite dynamic change. The strong economic growth during the 19901997 and 2004-2008 period resulted in the employment growth rate exceeding the rate of workforce growth. The employment opportuni es created during this me were able to absorb new members of the workforce entering the labor market. Meanwhile, at the me of the economic crisis, job opportuni es were s ll created even though they were mainly in the informal sector (Figure 1.8). The last two decades have seen a diminishing ra o of employment to the working age popula on, from 65 percent to 62 percent. The growth of the working age popula on has been higher than the growth of the workforce, indica ng that there is a higher preference
39
among students to con nue their schooling to higher levels of educa on rather than to nd a job.
Figure 1.7. The Growth Rate of Labor Produc vity (in Percentages) for the Agriculture, Industry and the Service Sector, 1990-2009
25%
The growth rate of labor produc vity (%)
20% 15% 10% 5% 0% -5% -10% -15% -20%
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
Source: BPS, Extracted from Sakernas and Indonesia Sta s cs in years 1990, 1993, 1996, 1999-2009
Agriculture
Industry
Services
Total
Improvements in the quality of job opportuni es have resulted in a reduc on in the propor on of self-employed workers and family workers (generally in the informal sector) to total employment. The employment ra o in the sector has decreased from 71 percent in 1990 to 64 percent in 2009 (Figure 1.9).
80%
Figure 1.8. Employment to Popula on Ra o for Urban and Rural Areas and for the Na onal Level
70% 60% 50% 40% 30% 20% 10% 0%
Source: BPS, Sakernas, 1990-2009
EPR Urban
EPR Rural
EPR Total
The declining ra o of workers who work in the informal sector is made possible by the growth of wage employment and increasing worker produc vity. This source of
40
2009
employment grew by 1.9 percent per annum during the period 2008-2009. Produc vity of workers has increased signicantly over the last several years.
90% 80% 70% 60% 50% 40% 30% 20% 10% 0%
1990 1991 1992 1993 1996 1997 1998 1999 2000 2001 2002 2003 2004 Nop-05 Agust-06 Agust-07 Agust-08 Agust-09
Figure 1.9. The Propor on of Vulnerable Workers to Total Workers, 1990-2009
Male
Female
Urban
Rural
Total
Source: BPS, Sakernas (1990-2009).
Challenges
First: Expanding formal employment opportuni es. Investment recovery that has not met expecta ons may well be a constraint to achievement of a higher economic growth rate. Contribu ng factors to the weak investment climate have been well documented and include, among others, slow investment recovery in infrastructure provision, legal and bureaucra c issues as well as uncertainty in property ownership. Uncertainty in industrial rela ons, including the provisions of severance payment due to layo as well as on contract and outsourced workers, has aected the compe veness of several key labor-intensive industries, although this is not the sole, deciding factor. Second: Narrowing the wage gap between workers at the same level. Current changes in wages are determined by the increasing price level rather than improvements in produc vity. Produc vity has not yet become the main determinant in wage calcula on. Ideally, the components for determining the Regional Minimum Wage (UMR) should not only include ina on factors, but also produc vity and achievement of job outputs. Third: Accelera ng workers transi on from lower produc vity jobs to higher produc vity jobs. This entails moving labor surplus out of the tradi onal or informal sector into more produc ve jobs which provide higher wages. Worker transi on from tradi onal sectors with low produc vity encourages wage increment, improves workers output as well as narrows the gap in wage and labor produc vity. Should the growth in the formal sector slow down, it will result in more workers entering the informal sector so that workers in the informal sector (including their families) will be in a state of greater uncertainty.
41
Policies and Strategis

Crea ng as many employment opportuni es as possible by promo ng investment and business expansion. The government will con nue to promote the crea on of job opportuni es in the formal sector by promo ng investment growth and business expansion. This policy con nues to be implemented so that the economy will grow and develop. Improving the investment climate is one of the governments na onal priori es, both for urban and rural areas. Improving the environment and mechanisms of industrial rela ons to promote employment and business opportuni es. Through a process of nego a on and delibera on and bipar te discussions, workers and employers can resolve issues rela ng to their respec ve needs and interests. The government will be more ac ve in working to create more conducive industrial rela ons and to encourage collec ve bargaining between workers and employers. Crea ng employment opportuni es through government programs. This policy aims to assist the unemployed who do not have access to economic ac vi es. Unemployment is not only found in urban areas, but also in areas that have been le behind in terms of economic development. Improving the quality of workers. The competence of Indonesian workers is s ll perceived as an obstacle for business development. The low level of competence is a constraint to the improvement of na onal economic security. Indonesia's compe veness and produc vity s ll lag behind other Southeast Asian countries. One eort to be taken to improve labor produc vity will be to improve worker skills. Improving the produc vity of agricultural workers. The government will give a en on to workers in the agricultural sector through improving agricultural sector produc vity. This will be done through various ac vi es, including: (a) extending the scope of agricultural sector management by intensifying research to expand agricultural ac vi es, thus increasing agricultural output and added value; and (b) providing workers with knowledge and skills, through educa on, training and agricultural extension. In me, knowledge and skills improvement will have an impact on the enhancement of agricultural produc vity. Developing social security and empowering workers. Strategies for providing workers with social security will be implemented, including development of social security programs that provide workers with the greatest possible benets. For informal workers, there is a need to protect workers from their working environment and the dispropor onate use of their labor. Assistance will also be provided to workers in the form of training to improve skills to help them increase their produc vity and, thus, their welfare.
42
Implemen ng key employment regula ons. The ILO Declara on on the Principles and Fundamental Rights in the Workplace mandates the implementa on and enforcement of basic labor standards.
Target 1C: Halve, between 1990 and 2015, the proportion of people who suffer from hunger
Current Status
The nutri onal level of the popula on has improved over me, as indicated by the decline in the prevalence of underweight children under ve years of age. Indonesia has made good progress in improving nutri on outcomes over the past two decades. The prevalence of underweight children under ve years of age, who are moderately and severely underweight, decreased from 31.0 percent in 1989 to 21.6 percent in 2000. A slight rise was seen between 2000 and 2005, reaching 24.5 percent in 2005. However in 2007 it decreased to 18.4 percent (Riskesdas 2007) and progress on this indicator is considered to be on track to achieve the MDG target of 15.5 percent by 2015 (Figure 1.10). In the Na onal Medium Term Development Plan (RPJMN 2010-2014) the Government has set the new target for this indicator to be less than 15.0 percent in 2014.
40
31.0
29.8 27.7 26.1 22.8 21.6 21.8 23.2 23.2 24.5 18.4
30
Target MDG 2015
Figure 1.10. Trend in the Prevalence of Underweight Children Under Five Years of Age (1989-2007) Using the WHO 2005 Standard and the MDG Target for this Indicator in 2015
Percentage
20
15.5
10
23.8 7.2 21.7 8.1 15.4 12.3 14.8 11.3 13.9 8,9 13.2 8.4 15.0 6.8 14.6 8.6 14.5 8.7 14.8 9.7 13.0 5.4
0
1989 1992 1995 1998 1999 2000 2001 2002 2003 2005 2007 2015
Source: BPS, Susenas 1989 to 2005 and MOH, Riskesdas 2007.
Moderate
Severe
Malnourished
Dispari es in the prevalence of underweight children under ve years of age remain a problem. Even though the na onal MDG target for the prevalence of underweight children under ve years of age is expected to be achieved, dispari es exist in nutri onal
43
status among provinces, between rural and urban areas, and among socio-economic groups. Riskesdas 2007 indicated that the prevalence of underweight children under ve years of age ranged from 10.9 percent (DI Yogyakarta) to 33.6 percent (Nusa Tenggara Timur). In addi on to Nusa Tenggara Timur, provinces with the prevalence of underweight children under ve above 25 percent include: Maluku (27.8 percent), Sulawesi Tengah (27.6 percent), Kalimantan Selatan (26.6 percent), and Aceh (26.5 percent) (Figure 1.11).
Figure 1.11. The Prevalence of Underweight Children Under Five Years of Age by Province (2007)
Percentage
33.6
40
10.9 11.4 12.4 12.9 15.0 15.8 16.0 16.6 16.7 17.4 17.5 17.6 18.2 18.3 18.4 18.9 19.3 20.2 21.2 21.4 22.5 22.7 22.7 22.8 23.2 24.2 24.8 25.4 25.4 26.5 26.6 27.6 27.8
35 30 25 20 15 10 5 0
TARGET 2015
15.5 11.9
3.6
DI Yogyakarta Bali Kepulauan Riau DKI Jakarta Jawa Barat Sulawesi Utara Jawa Tengah Banten Bengkulu Jawa Timur Lampung Sulawesi Selatan Sumatera Selatan Bangka Belitung INDONESIA Jambi Kalimantan Timur Sumatera Barat Papua Riau Kalimantan Barat Sulawesi Tenggara Sumatera Utara Maluku Utara Papua Barat Kalimantan Tengah Nusa Tenggara Barat Gorontalo Sulawesi Barat Aceh Kalimantan Selatan Sulawesi Tengah Maluku Nusa Tenggara Timur
Source: MOH, Riskesdas 2007
Severely Underweight
Moderately Underweight
Total Underweight
Moreover, disparity between rural and urban areas remains. The prevalence of underweight children under ve years of age in rural areas in 2007 was 20.4 percent, while in urban areas it was 15.9 percent, which indicates achievement of the MDG target (Table 1.2). Data in Table 1.2 also indicates that the prevalence of severely underweight children under ve years of age was 5.4 percent na onally while in rural areas it was 6.4 percent and in urban areas 4.2 percent. The data indicates that the MDG target of 3.3 percent is not yet achieved in rural and urban areas. Riskesdas 2007 showed that the lower the household income the higher the prevalence of underweight of children under ve years of age.
Table 1.2. Underweight Prevalence Among Children Under Five Years of Age by Rural and Urban Areas of Indonesia (2007)
Source: MOH, Riskesdas 2007
Region
Rural Urban Indonesia
Severely Underweight
6.4 4.2 5.4
Moderately Underweight
14 11.7 13
Total Underweight
20.4 15.9 18.4
The propor on of the popula on with a daily kcal intake of less than 2,000 calories is s ll high. Based on the average daily dietary energy consump on intake per capita, there has been a signicant improvement in reducing undernourishment in Indonesia. The Susenas 2002-2008 data showed that the average dietary calorie intake in 2002 was
44
1,986 kcal per capita per day which was below the minimum requirement of 2,000 kcal per capita per day. In 2008, it increased to 2.038 kcal per capita per day (Figure 1.12). The data conrm that food consump on improvement par cularly among the poor is urgently needed. Moreover, poor people in par cular consume unsafe food which adversely aects their health and nutri onal status.
2,050 2,040 2,030 2,020
Kcal/capita/day
2,038
Figure 1.12. Trends in the Average Calorie Consump on for Rural and Urban Households (2002-2008)
2,015 2,007
2,010 2,000 1,990 1,980 1,970 1,960 1,950 2002 1,986

2005 2007 2008
The Government of Indonesia is commi ed to improving the nutri onal status of the popula on, par cularly the poor. To address the high prevalence of malnutri on among children, the government has implemented the Food and Nutri on Ac on Plan 2006-2010, with the following immediate objec ves: (i) improvement of family nutri on awareness (kadarzi) through community-based growth monitoring and counseling; (ii) preven on of nutri on-related diseases such as diarrhea, malaria, tuberculosis, and HIV/AIDS; (iii) promo on of healthy lifestyle behavior; and (iv) improvement of food for ca on. In its eorts to fulll the global accord, the government set up health sector policies in the Na onal Medium-Term Development Plan 2005-2009 which cover the community nutri on improvement program.
Challenges
Economic and socio-cultural factors aec ng low nutri onal status among children under ve years of age include: (i) lack of access to quality food, par cularly due to poverty; (ii) inappropriate child care due to low levels of educa on among mothers; and (iii) inadequate access to health, water and sanita on services. Moreover, lack of awareness and commitment of the government contributes to the existence of the malnutri on problem. Lack of access of the poor with low educa on to quality and safe food. The poor have low
45
capacity to acquire the required food intake, in terms of quan ty as well as quality. Lack of food intake and inappropriate caring pa ern result in malnutri on among chidren under ve years of age. Moreover, the unbalanced food consump on pa ern of Indonesians can lead to serious disease problems and even death. The quality of food consump on is s ll low. During the period 2002-2007, the quality of food consump on improved as indicated by an increase in the desirable dietary pa ern (PPH) score from 77.5 in 2002 to 83.6 in 2007. However, this gure is s ll far from the ideal PPH score of 100 in both rural and urban popula ons.
Figure 1.13. Trend in the Desirable Dietary Pa ern (PPH) Score of Food Consump on for Rural and Urban Households, 2002-2007
PPH Score 88.0 86.0 84.0 82.0 80.0 78.0 76.0 74.0 72.0 70.0
85.9 83.6 81.9 80.8 79.1 77.5 75.0 77.6 81.2
68.0 2002 2005 2007
Rural
Urban
Indonesia
The prac ce of exclusive breast feeding has declined. To minimize morbidity and mortality of children, the United Na ons Childrens Fund (UNICEF) and the World Health Organiza on (WHO) recommend that children be exclusively breas ed for at least six months a er birth. In 2007 only about 32 percent of children under six months were exclusively breas ed in Indonesia, and only 41 percent of children under four months old were exclusively breas ed. The role of the community in dealing with malnutri on has been declining. Community par cipa on in dealing with malnutri on, par c ularly among children under ve, has been undertaken in Integrated Health Posts (Posyandu). Un l the early 1990s, the na onwide system of Posyandus was the main mechanism for nutri on service delivery at the community level. However, the Posyandu ac vi es deteriorated under decentraliza on as indicated by huge varia ons of malnutri on rates among provinces. Lack of ins tu ons dealing with hunger eradica on programs. Nutri on policy development and program planning and management are inadequate in both capacity and ins tu onal linkages. A strong na onal intersectoral body for coordina ng and enforcing nutri on policies across sectors and across the levels of administra on does not exist.
46
Na onal food security ins tu ons are not eec ve in solving problems related to hunger and malnutri on.
Policies and Strategis

Policies and strategies to reduce the prevalence of underweight children under ve years of age to 15.5 percent in 2015 and to improve the propor on of the popula on consuming at least the minimum level of dietary energy consump on are as follows: 1. Increase access of the poor, par cularly children under ve years of age and pregnant women, to adequate nutri ous and safe food and other interven ons such as nutrient supplementa on. Develop specic pro-poor assistance interven ons to provinces and districts with high prevalence of malnutri on. Other strategies that will be developed include: (i) socializa on and advocacy on social and cultural behavior for healthy lifestyle, par cularly to promote exclusive breast-feeding and infant feeding prac ces; and (ii) investments in basic infrastructure (health, water, sanita on), par cularly in rural and urban slum areas. Strengthen community empowerment and revitalize Posyandus. Strengthen food and nutri on service delivery at the grassroots level through the following: (i) revitalize Posyandu to expand coverage of service delivery for food and nutri on, including reac va on of growth monitoring prac ce (GMP); (ii) provide linkages of nutri on to early child educa on program (PAUD); and (iii) develop nutri on programs through community-based ac vi es by empowering local community-based ins tu ons such as religious gatherings (kelompok pengajian) and womens organiza ons. Improve food security at the local level par cularly to reduce disparity among regions. Ensure food security at the local level by: (i) increasing agricultural produc vity; (ii) improving the eciency of food distribu on and handling systems; and (iii) developing a local-based food diversica on program through improvement of food produc on and post-harvest technology and advocacy of balanced diets. Strengthen ins tu ons at the central and dictrict levels that have a strong authority in formula ng policy and programs in food and nutri on. The problem of malnutri on and food insecurity is mul sectoral in nature, related to socio-cultural, economic, and poli cal issues. Policies and programs should be formulated holis cally and require an ins tu onal framework with a strong authority and capacity in synchronizing and coordina ng ac vi es in food and nutri on. Therefore, the ins tu onal framework for nutri on and food security at central and district levels will be strengthened.
2.
3.
4.
In the Na onal Medium-Term Development Plan 2010-2014, the Government set the new target of reducing undernourishment of children under ve years of age to be less than 15.0 percent. Ac ons to be carried out include: (i) expansion of exclusive breast-
47
feeding; (ii) complementary and supplementary feeding for children 6-24 months old; (iii) supplementary feeding for pregnant and lacta ng mothers; (iv) strengthening communitybased nutri on programs through Posyandu; (v) nutri on educa on and kadarzi; (vi) strengthening malnutri on mi ga on management in primary health centers (Puskesmas) and hospitals; and (v) strengthening the food and nutri on surveillance system. In line with the above policies and strategies, the Na onal Medium-Term Developement Plan 20102014 set up programs and targets to address malnutri on par cularly among children under ve years of age as listed in Table 1.3.
Table 1.3. Outputs and Targets Specied in the Na onal Medium-Term Development Plan (RPJMN 2010-2104)
Outputs/Indicators Percentage of severe undernourished children under 5 years ve years old receiving care Percentage of severe undernourished children 6-24 months old from poor households receiving MPASI (food supplement) Percentage 0-6 months old babies with exclusive breast feeding Coverage of Iodized salt Percentage of 6-59 month old children receiving vitamin A supplement Percentage of Puskemas implemen ng nutri onal status monitoring and providing care for the severely undernourished Percentage of districts implemen ng nutri on surveillance Percentage of children under 5 years old weighed for growth monitoring Percentage of children under 5 years old of poor households (GAKIN) receiving recovery food supplements (PMT pemulihan)
2010 100
2011 100
2012 100
2013 100
2014 100
100
100
100
100
100
65 75 75
67 78 78
70 80 80
75 83 83
100 85 85
100
100
100
100
100
100 65
100 70
100 75
100 80
100 85
100 100 60
100 100 65
100 100 70
100 100 75
100 100 80
Source: Na onal Medium-Term Development Plan (RPJMN 2010-2014), Ministry of Health Strategic Plan 2010-2014 and Presiden al Instruc on No. 3/2010.
MPASI buer stock for disaster areas Percentage of households with nutri onal awareness (keluarga sadar gizi)
48
Kindergarten and primary school students
Goal 2: Achieve Universal Primary Education
Target 2A: Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling
Current Status
Indonesia aims to go beyond the MDG educa on target for primary educa on by expanding the target to include junior secondary educa on (SMP and madrasah tsanawiyah-MTs, grades 7 to 9) in the universal basic educa on target. Access to Primary and Junior Secondary Educa on. The primary school (SD/MI) gross enrolment ra o (GER) achieved universal coverage by the early 1980s, and stayed high despite the nancial crisis of the late 1990s. In 2008/2009, the GER was 116.77 percent while the net enrolment ra o (NER) was 95.23 percent. At the junior secondary level (SMP/MT), the GER was 98.11 percent and the NER was 74.52 percent (Figure 2.1). At the primary school level, disparity in educa on par cipa on has been reduced. The Susenas 2009 indicated the NER of all other provinces were above 90 percent, except for Papua where the NER was measured to be 76.09 percent (Figure 2.2). The school drop-out rate has been decreasing. The propor on of pupils star ng grade 1 who complete primary school shows an increasing trend. Susenas data indicates that the percentage of children aged 16-18 years who completed primary educa on increased from 87.8 percent in 1995 to 93.0 percent in 2008. This gure indicates the decreasing trend in the dropout rate at primary schools, including madrasah.
51
Percentage
74.2
73.1
76.0
77.5
78.3
79.9
81.1
82.2
82.3
80
70.5
88.7
92.5
Figure 2.1. Trends for Net Enrolment Ra os (NER) for Primary and Junior Secondary Educa on Levels (Including Madrasah), 1992 - 2009
116.6 96.2 95.1
108.1
108.1
107.3
107.4
107.6
107.2
107.1
107.3
107.1
106.0
102.0
105.3
106.0
120
106.9
110.0
115.7
92.7
92.5
92.2
92.3
92.9
91.6
91.3
88.7
100
92.2
91.6
92.7
92.6
93.0
93.3
93.5
94.9
64.4
61.1
55.6
57.9
20
1992
42.0
1993
46.8
40
1994
50.1
1995
51.0
1996
54.6
1997
1998
57.0
1999
59.2
2000
60.2
2001
60.6
2002
61.7
2003
63.5
2004
65.2
2005
65.4
2006
66.5
60
65.7
2007
71.6
2008
72.3
Source: BPS, Susenas and MoNE Sta s cs.
NER - Primary School/MI NER - Junior Secondary School/MTs
GER - Primary School/MI GER - Junior Secondary School/MTs
Figure 2.2. Net Enrolment Rate for Primary School Including Madrasah by Province, 2009
Percentage
100 80 60 40 20 0
95.23
Bali
Banten
Aceh
Riau
Kali imantan Barat
2009
74.5
95.2
98.1
116.8
Nusa Te enggara Timur
Jambi
Bengkulu
DKI Jakarta
Maluku
Papua Barat
INDONESIA
Nusa Tenggara Barat
Jawa Barat
Lampung
S Sulawesi Utara
Maluku Utara
Kalim mantan Selatan
Kalim mantan Tengah
Kalim mantan Timur
Sul lawesi Tengah
Ba angka Belitung
Su umatera Utara
Su umatera Barat
DI Yogyakarta
Ke epulauan Riau
S Sulawesi Barat
Jawa Timur
wesi Sulaw Tenggara
Source: BPS, Susenas 2009 and MoNE Sta s cs 2008/2009.
The literacy rate of the Indonesian popula on aged 15-24 years is increasing. The Susenas data of 1992 to 2009 indicated that the literacy rate of the Indonesian popula on aged 15-24 years increased from 96.71 percent in 1992 to 99.47 percent in 2009. The literacy rate of the poorest group in the popula on rose signicantly from 92.9 percent in 1995 to 97.8 percent in 2006 for the 15-24 years age group (UNESCO, 2006). Progress in increasing the literacy rate has occurred largely due to improvements in the par cipa on rate of educa on and the propor on of students who have been able to complete their educa on at the primary level. Beyond access, the quality of educa on has been a concern of the government. Measured by interna onal standards, Indonesias educa onal quality is low compared to neighboring countries. The nine-year basic educa on graduates do not always have adequate skills relevant to the needs of the community or the labor market. Based on the Third Interna onal
52
Sum matera Selatan
Sul lawesi Selatan
Jawa Tengah
Gorontalo
Papua
Mathema cs Science Study (TIMSS 2003), Indonesian student performance ranked 34 out of 45 countries. In the 2006 Program for Interna onal Student Assessment (PISA), which examines how well students aged 15 years are prepared for life, the average score of reading ability of Indonesian students was 393, which was below the average of OECD countries (492), and Indonesia ranked 44 among 57 countries. In addi on, only 31 percent of children could complete more than the most basic reading tasks. This was due to lack of access to books and other reading materials.
Challenges
Improving equitable access of all children, boys and girls, to quality basic educa on is a major challenge to the achievement of the MDG educa on targets. Several cri cal factors have prevented Indonesia from achieving universal basic educa on. On the demand side, poverty is considered to be a major factor contribu ng to the low access to schooling. On the supply side, it includes: (i) insucient educa onal infrastructure, including teaching-learning materials and equipment; (ii) lack of highly qualied teachers, par cularly in remote, underserved areas; (iii) lack of relevant curriculum and the low quality of teaching learning process; and (iv) lack of funding for school opera ons. Moreover, the low quality of governance in educa on management contributes to low equitable access of all children to quality basic educa on. Reaching the unreached in improving equitable access of all children, boys and girls, to quality basic educa on is a major challenge in achieving the educa on MDG target. Poverty is a major factor contribu ng to low enrollment in basic educa on with lack of aordability being the reason for 70 percent of non-a endance at school (AIBEP 2008). The na onwide implementa on of the BOS program which was intended to support the government policy of free basic educa on contributed to improvement of school par cipa on by elimina ng cost barriers, especially in the poorest urban and rural areas. However, in reality, costs are s ll signicant and o en unaordable for poor parents, par cularly for daily travel, lunches, uniforms and books. In addi on, there is a challenge to develop the holis c and integrated ECED program and to improve the quality of non-formal educa on (NFE) programs par cularly to poor communi es. Moreover, there is a need to expand provision of an adequate infrastructure, books and teaching learning equipments for basic educa on. Improving the quality and equal distribu on of teachers in all regions to improve the quality of basic educa on. There is a strong correla on between teachers academic qualica ons, overall school eec veness, and improved learning outcomes. However, lack of qualied teachers, par cularly in remote and underserved areas, is a major challenge in improving equitable access to quality basic educa on in Indonesia (Table 2.1).
53
Table 2.1. Number and Propor on of Teachers by Academic Qualica ons and School Levels for Indonesia (2009)*
Number of Teachers Educa on Level Senior SS

119,984 374,728 29,083
Propor on (%) Total

223,422 1,497,659 502,915
Diploma 1-3
71,080 758,294 101,890
Dipl. 4 / S1
32,378 364,637 341,972
Diploma Dipl. Senior 1-3 4 / S1 SS

53.70 25.02 5.78 31.81 50.83 20.26 14.49 24.35 73.96
Total
100 100 100
PrePrimary (TK) Primary School (SD/MI) Junior Secondary School (SMP/ MT) Senior Secondary School (SMA/SMK/MA) TOTAL
Source: Directorate General of Quality Improvement of Teachers and Educa on Personnel, MONE, 2010. *not including madrasah teachers.
11,806 535,601
29,876 961,120
341,633 1,110,590
475,917 2,607,311
3.08 20.54
7.79 36.88
89.13 46.60
100 100
Developing be er nancing and a fund transfer mechanism to improve eciency, accountability, and equity in funding and to ensure the equitable access to quality basic educa on. In line with educa on reform plans to accelerate the pace of achieving MDG educa on targets, the government has drama cally increased public funding alloca ons for educa on. From 2001 to 2009, educa on spending as a propor on of GDP increased from 2.8 percent to 3.7 percent and as a propor on of public expenditures from 11.4 percent to 20 percent. However, transfer of resources from central government to district and to schools resulted in reduc on of local budget for educa on (subs tu on eect). Therefore, a challenge is to further develop be er nancing, and fund transfer mechanisms to improve eciency, accountability, and equity in funding to ensure the equitable access to quality basic educa on. Improving educa on management accountability and eciency in the decentralized system. Indonesias decision to decentralize government is transforming the nature and level of public service delivery, including in educa on. However, decentraliza on of educa on policy has not been fully implemented as intended. The transi on to decentraliza on has not yet included guidelines for monitoring and evalua on as well benchmarking on progress achieved by ins tu ons at all levels of government.

1. Priori es to Improve Equitable Access: a. Formulate and implement policy at na onal and local levels to accelerate provision of adequate infrastructure and teaching-learning facili es, par cularly in poor, underserved and remote areas, madrasah and pesantren. A en on will be given to concurrently ra onalizing and accelera ng provision of adequate school infrastructure
54
and teaching learning resources that meet minimum service standards (MSS). b. Ensure educa on nancing mechanisms are more pro-poor to address inequitable alloca on of funds and educa on resources. An arma ve policy for the poor is essen al to accelerate access to quality educa on services. This should include increasing the number of cost-based scholarships for poor students in primary and junior secondary schools in targeted areas with the lowest enrolment rates, and ensuring matching funds from revenue-rich districts. c. Strengthen the eec veness, eciency, and accountability in the implementa on of BOS. Capacity of local government and schools in managing the implementa on of BOS will be strengthened in order to raise the eec veness, eciency, and accountability of BOS. Moreover, community par cipa on will be increased in planning, monitoring, and evalua on of BOS by enhancing the capacity of school commi ees. d. Accelerate provision of holis c and integrated ECED services in rural and underserved areas. Districts will be encouraged or mandated to allocate a share of their budget to support an increase in holis c and integrated ECED services in underserved areas. Ins tu onal capacity at district, provincial, and central levels to improve planning and monitoring on program performance will be strengthened e. Accelerate provision of equivalency programs and enhance quality for school dropouts. Equivalency program (Packets A and B) will be be er targeted to reach poor and dropout students. Strategies may include: (i) increasing the ecient u liza on of formal school human resources, facili es and infrastructure for informal educa on; (ii) improving eciency and quality of services through enhancement of the curriculum and quality assurance of program implementa on to ensure equivalency to formal educa on; and (iii) improving coordina on of educa on equivalency programs between MoNE and the Ministry of Religious Aairs (MoRA). 2. Priori es to Improve Quality and Relevance: a. Accelerate improvements in pre-service and in-service teacher training provision. In order to increase learning quality, all teacher training ins tutes (Lembaga Pendidikan Tenaga Kependidikan/LPTKs) will review their courses with a view to improve prac cal classroom performance and apply best prac ces in linking teaching to improved student learning. b. Reform curriculum and improve teaching and learning quality. Curriculum reform will be conducted to develop and improve the curriculum and teaching-learning process to enable students to develop their intellectual, emo onal, spiritual, and social capaci es. More specically, the curriculum and teaching-learning process will be enhanced to build moral values and character. c. Improvement of training on school-based management (SBM) targeted to school principals and supervisors. The training will cover teacher support and
55
sta performance appraisal, monitoring and supervision, nancial planning and management, and community par cipa on. 3. Priori es to Strengthen Governance and Accountability: a. Improve local government capacity in managing basic educa on programs. District ins tu onal capacity will be strengthened through expanding coverage of capacity development programs in educa on management including analysis, planning and budge ng, monitoring and evalua on, as well as nancial management. b. Strengthen accountability in educa on resource management. The strategies will include: (i) evalua ng budget eciency and funding mechanisms; (ii) developing performance-based budge ng ed to quality standards and incen ve mechanisms; (iii) strengthening performance evalua on and quality assurance systems; (iv) strengthening management informa on systems; (iv) strengthening nancial repor ng systems, alongside eec ve mechanisms for ensuring mutual accountability between central and districts, and between schools and parents; (v) developing governance and accountability indicators and informa on systems at the district level; and (vi) improving the quality of informa on for educa on sector performance to ensure adherence to standards. c. Increase community par cipa on. Improvement of community par cipa on in educa on management will be conducted through: (i) advocacy to stakeholders for increased resource mobiliza on; (ii) promo on of public-private partnerships with explicit roles for parents and the community in school performance and school-based management; (iii) recogni on of civil society organiza ons as legi mate par cipants in the direc on of the educa on system through strengthening Provincial Educa on Councils and District Educa on Councils, and establishment of the Na onal Educa on Council to improve governance. In line with the above policies and strategies, the Na onal Medium-Term Development Plan 2010-2014 sets up program priori es as listed in Table 2.2:
56
Priori es Improving access and quality of primary educa o n (SD/MI)
Outputs/ Indicators Equitable access to quality primary educa on in all districts achieved/ NER of primary educa on Subsidy for students in SD/SDLB allocated and distributed/ Number of students in SD/SLB received BOS Subsidy for students in MI/Diniyah Ula allocated and distributed/ Number of students in MI/ Diniyah Ula received BOS Availability of curriculum and teachinglearning models/ Percentage of improved curriculum implemented
2010
2011
2012
2013
2014
Table 2.2. Program Priori es, Outputs and Indicators of the Educa on Sector, 2010-2014
95.2%
95.3%
95.7%
95.8%
96.0%
Provision of educa on subsidy for SD/SDLB
27,672,820
27,973,000
28,006,000
28,085,000
28,211,000
Provision of educa on subsidy for MI
3,555,803
3,626,919
3,681,322
3,736,543
3,791,591
Provision of quality and aordable text books
100%
Availability of qualied teachers Provision of and educa on teaching-learning personnel of SD/MI system and that equitable in all curriculum districts/ Percentage of SD/MI principals a ending the training Management and quality assurance system at DG of Primary and Secondary Management improved/ Involvement of community in duca on planning, implementa on, control, and nance through Educa on Council
10%
15%
25%
65%
100%
Improving quality and welfare of teacher and educa on personnel for primary educa on
15%
25%
45%
70%
90%
Improving Management Capacity for basic educa on
Improved
improved
Improved
Improved
Improved
Source: Na onal Medium-Term Development Plan 2010-2014.
57
58
SUPERNETS. One thousand women in the Atrium TP3 Surabaya, May 11, 2009 using the internet. This supernets event was held to commemorate Kar ni Day, Na onal Educa on Day and the 716th Anniversary of Surabaya
Goal 3: Promote Gender Equality and Empower Women
Target 3A: Eliminate gender disparity in primary and secondary education, preferably by 2005, and in all levels of education no later than 2015
Current Status
One of the human development goals of Indonesia is to achieve gender equality by building human resources without dieren a ng between men and women. Much eort has been undertaken to improve the quality of life and the role of women to enable them to be equal partners with men in development. In educa on, gender equality has improved signicantly. Measured by the Gender Parity Index (GPI) of the Net Enrolment Rate (NER) or the ra o of NER of females to males, gender equality in educa on has shown signicant progress. Using this indicator, the MDG target to achieve gender equality at all levels of educa on will be met. Susenas data from 1993 to 2009 shows that the NER of both girls and boys at primary schools including madrasah ib daiyah (SD/MI/Package A) was more than 90. During the same period, the NER at the junior secondary level including madrasah tsanawiyah (SMP/MT/Package B), and senior secondary educa on including madrasah aliyah (SM/MA/Package C) increased signicantly. Meanwhile, the GPI of NER for higher educa on uctuates with a tendency to rise signicantly. In 2009, the GPI at primary schools (SD/MI/Package A) was 99.73, while at the junior secondary educa on level (SMP/MT/Package B) it was 101.99, at the senior secondary educa on level (SM/MA/Package C) it was 96.16, and at all levels of higher educa on it was 102.95 (Susenas 2009). Susenas 2009 indicated that the NER of females to males was close to homogenous among provinces with the GPI ranging from 96.39 (Papua Barat) to 102.5 (Kepulauan Riau). However, dispari es s ll exist at the post pimary educa on level (Figure 3.1), where at the junior secondary level the GPI ranged from 89.54 (Papua) to 116.17 (Gorontalo) and at the senior secondary level
61
it ranged from 68.60 (Papua Barat) to 143.22 (Kepulauan Riau). In several provinces the GPI exceeded 110 which indicates that the NER of female students is much higher than that of males. At the junior secondary level, provinces with GPI higher than 110 include DI Yogyakarta, Nusa Tenggara Timur, and Gorontalo. At the senior secondary level, provinces with GPI of more than 110 include Sumatera Barat, Riau, Kepulauan Riau, Sumatera Selatan, Bangka Belitung, Nusa Tenggara Timur, and Sulawesi Barat (7 provinces), while provinces with GPI less than 90 include DKI Jakarta, Jawa Barat, Jawa Timur, Nusa Tenggara Barat, Papua, and Papua Barat (6 provinces). The gures indicate that disparity among provinces is s ll a major problem par cularly for senior and higher educa on levels.
Figure 3.1. Gender Parity Index (GPI) of Net Enrolment Rates (NER) Senior Secondary Schools by Province, 2009
180 160 140 120 100 80 60 40 20 Papua Barat DKI Jakarta Nusa Tenggara Barat Jawa Barat Jawa Timur Papua Bali Banten Lampung Maluku Utara DI Yogyakarta INDONESIA Sulawesi Selatan Jawa Tengah Kalimantan Tengah Sumatera Utara Kalimantan Selatan Kalimantan Barat Sulawesi Tenggara Aceh Sulawesi Tengah Bengkulu Maluku Gorontalo Kalimantan Timur Sulawesi Utara Jambi Riau Sumatera Selatan Bangka Belitung Sumatera Barat Nusa Tenggara Timur Sulawesi Barat Kepulauan Riau 0
The MDG target on the literacy ra o of females to males aged 15-24 years has been achieved. Progress in educa on par cipa on of both male and female contributed to improvement of the na onal GPI for literacy of the 15-24 year age group. In 2009 the GPI was almost 100, with female literacy rates at 99.4 percent and male literacy rates at 99.5 percent. In the employment sector, the female labor force par cipa on rate is lower than that of males. Based on the Na onal Labor Force Survey (Sakernas), the female labor force par cipa on rate has shown no signicant increase from 2004 to 2009, with an average rate of around 50 percent. This rate is signicantly lower than that of their male counterparts which averaged around 84 percent during the same period. The low labor par cipa on rate of females was due to most females chosing to work domes cally as housewives. For example in August 2009 around 31.8 million females chose to work as housewives while only 1.5 million males were recorded to be in this category. However, the open unemployment rate of females showed signicant progress, declining by 6 percent during 2005 to 2009, from 14.71 percent to 8.47 percent, while the open unemployment rate for males declined by only 1.6 percent, from 9.29 percent to 7.51 percent during the same period. Morover, the percentage of waged
62
women in non-agricultural sectors increased from 29.02 percent in 2004 to 3.45 percent in 2009 (Sakernas 2004-2009). While the wage levels of female workers have increased, wage discrimina on is s ll prevalent. Sakernas data showed that from 2004 to 2009, the average monthly wage of female workers categorized as employees increased from Rp 676,611 to Rp 1,098,364. In non-agricultural sectors, the average wage of female casual employees also increased from Rp 277,183 to Rp 396,115. Although the average wage of female workers has increased, the data shows that there is a wide wage disparity between females and males. The biggest gap was in casual employees in non-agriculture sectors where women receive only 54 percent of males wage. (Figure 3.2).
1,600 1,448 Average monthly wages (thousand Rp.) 1,400 1,255 1,200 1,000 800 600 400 200 2004 2005 2006 2007 2008 2009 915 677 540 930 689 609 824 715 593 633 396 732 1,166 1,083 974 893 1,098
Figure 3.2. Average Monthly Wages (Rp 000) of Male and Female Workers in Non-Agricultural Sectors
277
267
294
337
355
Male labour workers, white collars Female labour workers, white collars Male casual employee in non-agricultural sector Female casual employee in non-agricultural sector
Source: BPS, Sakernas 2004-2009.
Disparity in the average wage of female workers as percentages of the average wages of male workers exists among provinces. In Nusa Tenggara Barat, the wage of female worker was only 58 percent of the average male workers wage in 2009. In Sulawesi Utara the average wage of women is higher than that of males (Map 3.1). A quan able improvement has been recorded in the propor on of women in public ins tu ons (legisla ve, execu ve and judica ve). In poli cs, progress has been achieved as indicated by the issuance of a law that mandates a quota of 30 percent womens representa on in parliament. The quota for women legisla ve candidates as mandated by law was met by all poli cal par es in the 2009 general elec on. The result of the 2009 general elec on were that women have 17.9 percent of seats in the legisla ve branch, an increase from 11.3 percent in the period 2004-2009. The propor on of women in DPD has also increased from 19.8 percent in 2004 to 27.3 percent in 2009.
63
Map 3.1. The Average Wages of Female Workers as Percentages of the Average Wages of Male Workers by Province in August 2009
Source: BPS, Sakernas
In decision making, womens par cipa on in senior management posi ons of execu ve and judica ve ins tu ons is s ll low. In 2008, only 8.7 percent of senior (Echelon 1) posi ons and 7.1 percent of Echelon 2 posi ons were lled by women. The propor on of women out of the total number of state civil servants was 44.5 percent.1 At the provincial level, there is only one female Vice Governor while, at the district level, less than 10 women ll the posi on of Mayor or district head (Bupa ).2
Challenges
At the na onal level, gender equality and empowerment showed signicant progress, par cularly in par cipa on in educa on. However, dispari es among provinces at senior secondary and hgher educa on as well as in employment and poli cs are s ll a major challenge. In educa on, the challenge is not only improving the NER of females but also the NER of males depending on the situa on. The primary focus is to target children from poor families, par cularly those in remote and rural areas. Special a en on is, therefore, needed to achieve gender parity among geographically dis nct provinces which have diering characteris cs and cultural values. In employment, enforcing laws to ensure equal opportuni es without discrimina on for women and men in employment and in the job place is a major challenge. Moreover, strong coordina on among government ins tu ons at the central and provincial levels is required to ensure a synergy between na onal and regional laws, and also to implement comprehensive
1 2
State Civil Service Agency, Sta s cal Yearbook of Indonesia, 2008. Ministry of Home Aairs, 2009, www.depdagri.go.id
64
coordina on and monitoring to ensure enforcement of laws and regula ons on employment at the provincial and district levels. In poli cal ins tu ons, there is a need to ensure greater par cipa on of women in decisionmaking posi ons at the na onal, provincial, and district levels. Lack of adequate legal and poli cal literacy training contributes to the low par cipa on of women in poli cal ins tu ons. This is due to lack of planning related to gender issues.

To address the above challenges, policies on improving gender equality and womens empowerment will be carried out in all sectors and ins tu ons at both the na onal and local levels. The priori es iden ed to enhance gender equality are grouped into four areas: (i) educa on; (ii) employment; (iii) poli cs, and (iv) local governance processes. 1. Strategic steps to be carried out in educa on are as follows: a) Improve access and quality of educa on to reduce gender inequality among regions and among socio-economic groups; b) Improve access and quality of gender responsive non-formal educa on. Focus will be given to improve knowledge and life skills par culary in income genera ng ac vi es targeted to those who are unable to enroll in formal schooling. Strategies to address the challenges in employment are as follows: a) Priori ze the enforcement of exis ng laws, including synchronizing policies and employment regula ons at the na onal and regional levels, as well as company/ employers, to ensure that men and women are able to equally par cipate without discrimina on in the labor force; b) Strengthen coordina on between central and local government to ensure the enforcement of labor laws and regula ons. c) Strengthen labor inspec on through improving the number, capacity and competency of labor inspectors to ensure be er enforcement of core labor standards. d) Provide social protec on to women who work in the informal sector. The strategy will include provision of subsidies for the poor to join social insurance programs under the na onal social insurance scheme to the poor. e) Improve the quality of female workers and job seekers. The ac vi es will include improving the access of women to educa on and skills training, to improve capacity and skills of women workers in the elds where there is a need for workers. Strategies to ensure gender equality in poli cs include the followings: a) Improve partnerships with civil society organiza ons (CSO) to improve womens
2.
3.
65
b) c) d) 4.
par cipa on in poli cs; Design modules on voter educa on for womens groups, the poor, disabled, and elderly; Improve voter educa on concerning women legisla ve candidates; Improve poli cal educa on for female members of poli cal par es.
A strategy to implement gender mainstreaming in local governance processes will be carried out through developing a general guideline for local governments agencies to integrate a gender perspec ve into planning, implementa on, budge ng, monitoring, and evalua on processes of development policies, programs, and ac vi es at the local levels, both provincial and district levels.
To ensure achievement of the MDG targets for gender par cularly in educa on, employment, and poli cs, the Na onal Medium-Term Development Plan 2010-2014 has set the following targets, under the responsibilty of MONE, MORA, General Elec on Commission, MOHA, and MOLT.
66
Prioritas
Educa on
Output
Target 2010-2010 2010 2011 2012 2013 2014
Table 3.1. Priori es, Output and Performance Indicators in Educa on, Poli cs and Labor, 2010-2014
NER Ra o of female to male at general primary educa on (SD) NER Ra o of female to male at Islamic primary educa on (MI) Improve quality of life and role of women in development NER Ra o of female to male at general junior educa on (SMP) NER Ra o of female to male at Islamic junior educa on (MTs) GER Ra o of female to male at general senior educa on GER Ra o of female to male at Islamic general senior educa on (MA) GER Ra o of female to male at general higher educa on GER Ra o of female to male at general Islamic higher educa on Literacy ra o of female to male age 15-24 years Ra o of cer ed female teacher to male teacher in public school Ra on of cer ed female teacher to male teacher at madrasah Poli cs Number of partnership with NGO on par cipa on of women in poli cs Number of elec on educa on modules for poor, disabled, and elderly women Number of elec on educa on for women legisla ve candidates Number of women cadre of poli cal party trained in poli c educa on Labor Percentage of Improve protec on company that fullled work norm of of women against women and children abuse Number of labor controlers for women and children that improved their capacity
> 0,98 > 0,98 > 0,97 > 0,97 > 0,80
> 0,98 > 0,98 > 0,97 > 0,97 > 0,85
> 0,98 > 0,98 > 0,98 > 0,98 > 0,85
1 1 1 1 > 0,90
1 1 1 1 1
> 0,80
> 0,85
> 0,90
> 0,95
1,12 1.12 97.6 60% 50%
1,08 1.12 97.8 68% 60%
1.05 1.12 98.0 75% 70%
1.05 1.12 98.0 85% 80%
1.04 1.04 98.0 95% 85%
5 -
100 5 10 100
100 5 10 150
100 5 10 200
400 k) 25 k) 40 k) 500 k)
Note: k) cumula ve. Source: MTDP 2010-2014, Strategic Planning of MONE 2010-2014, Strategic Planning of MORA 2010-2014, Strategic Planning of General Elec on Comission 2010-2014, Strategic Planning of MOHA 2010-2014, and Strategic Planning of Ministry of Labor antdTransmigra on 2010-2014.
10%
20%
25%
30%
40%
120
150
180
240
990 k)
67
68
Lining up to get Vitamin A
Goal 4: Reduce Child Mortality Rate
Target 4A: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate
Current Status
The health of children in Indonesia has been improving steadily over me in response to be er health care, nutri on, water and sanita on access and improved environmental condi ons, as well as increased community awareness. This is shown by the declining rates of infant and child mortality over the past two decades. In 1991, the under-ve mortality rate was 97 deaths per 1,000 live births, by 2002/2003 it had dropped to 46, and it had fallen to 44 in 2007 (IDHS 2007). The signicant progress that has been achieved in reducing child mortality reects the con nuous expansion of coverage and improvements in the quality of health services, especially at the community level, including immuniza on, antenatal care, simple medical care, and promo on of clean and healthy behavior (PHBS). The decline of child mortality has been accompanied by a reduc on in infant mortality, from 68 deaths per 1,000 live births in 1991 to 34 in 2007 (IDHS). This trend shows that the decline of child mortality is faster than the decline in the rate of infant mortality. However, neonatal mortality has fallen more gradually from 32 in 1991 to 19 deaths per 1000 live births in 2007 (Figure 4.1). Neonatal, infant and under-ve mortality rates vary widely by region, as well as by social and economic status. Signicant dierences in child mortality among provinces are recorded, the highest rate was recorded in Sulawesi Barat (96), a rate that is more than four mes higher than the province with the lowest rate, i.e. DI Yogayakarta (22). Children of less educated mothers generally have higher mortality rates than those born to more educated mothers,
71
while children in richer households have lower mortality rates than those in poorer households. In addi on to the constraints of geography, transporta on, informa on access, availability of clean water and sanita on, and infrastructure contribute signicantly to decreasing child mortality.
Figure 4.1. Na onal Trend and Projec on of Child, Infant and Neonatal Mortality per 1,000 Live Births, 1991-2015
Per 1,000 live birth 120
100 97 81 80 68 60 57 58 46 40 32 30 46 35 26 20 19 44 34 RPJMN Target 2014 IMR: 24 Target MDGs 2015 IMR: 32 USMR: 23
20
0 1991 1995 1999 2003 2007 2011 2015
Source: BPS, IDHS several years.
Infant Mortality Neonatal Mortality Expon. (Under-5 Mortality)
Under-5 Mortality Expon. (Infant Mortality) Expon. (Neonatal Mortality)
Most of child, infant and neonatal mortality causes are preventable. Two eec ve preven ve measures to ght child, infant and neonatal morbidity and mortality are immediate and exclusive breas eeding and immuniza on. In addi on to these, skilled a endance at birth, access to emergency obstetric and neonatal care (BEONC/CEONC); access to, safe water and good sanita on; management of diarrhea, pneumonia, and malaria; appropriate feeding prac ces; and access to care could signicantly reduce child mortality. It is proven that increasing the immuniza on rate can reduce the number of child deaths. Immuniza on against measles has a direct impact on child mortality, and it is proven that an increase of three percentage points in the immuniza on rate reduces the number of deaths of children under-ve years of age caused by measles by one per thousand live births (UNSD 2009, ADB)1. Data from the IDHS 2007 indicates that there are 18 provinces with lower coverage of immuniza on against measles than the na onal average (67 percent). The provinces with the lowest coverage were North Sumatra (36.6 percent), Aceh (40.9 percent), and Papua (49.9 percent), while the province with the highest coverage was DIY, with 94.8 percent coverage (Figure 4.2). In order to achieve universal coverage of immuniza on against measles in areas that have
Based on sta s c regression of immuniza on against measles by UNSD-ADB, 2009.
72
100 80
Percent coverage
60 40 20 0
Sumatera Utara Aceh Papua Maluku Maluku Utara Papua Barat Sulawesi Tengah Kalimantan Selatan Jambi Sulawesi Barat Sumatera Selatan Lampung Nusa Tenggara Timur Riau Bangka Belitung Kalimantan Barat Gorontalo Sulawesi Selatan INDONESIA Sumatera Barat DKI Jakarta Sulawesi Tenggara Jawa Tengah Jawa Timur Jawa Barat Banten Kepulauan Riau Nusa Tenggara Barat Kalimantan Tengah Kalimantan Timur Bengkulu Sulawesi Utara Bali DI Yogyakarta
36.6 40.9 49.0 50.2 50.8 51.0 51.5 57.8 58.0 58.0 58.8 59.2 60.5 61.9 64.6 64.9 65.9 66.6 67.0 67.4 69.8 71.8 72.3 74.0 74.2 74.6 76.8 77.1 77.6 78.3 79.2 80.9 85.5 94.8
Figure 4.2. Propor on of One-Year-Old Children Immunized Against Measles, by Province 2007
Source: BPS, IDHS 2007.
not achieved the coverage target, Back Log Figh ng (BLF) ac ons, - that is increased coverage of unvaccinated children aged 12-36 months will be conducted for those who have not been vaccinated un l they reach their rst birthday. In 2008, Indonesia started a campaign to immunize all one-year-old children against measles, providing a second measles vaccina on to children in school. Another interven on, called the Measles Crash Program, will carry out a vaccina on campaign covering all children aged 6-59 months, irrespec ve of their vaccina on status, in the areas where coverage targets have not been reached during three consecu ve years. Coverage of immuniza on against measles for children aged 12-23 months will be surveyed to assess coverage of measles immuniza on for infants (<12 months) from previous years programs. While immuniza on coverage has increased, coverage for some other types of immuniza on has regressed. Over the 2002-2005 period, coverage by some key immuniza on programs against Tuberculosis, Diphtheria, Pertusis and Tetanus and Hepa s has increased by 6, 17 and 7 percent, respec vely; reaching 82 percent, 88 percent and 72 percent of children. That is, however, counterbalanced by drops in polio and measles immuniza ons from 74 and 76 percent respec vely, to 70 percent. Full immuniza on coverage is s ll below 50 percent.
Challenges
While progress in improving child (and infant) mortality has been good, Indonesia s ll faces important challenges in all key policy and program areas aec ng child health. These include: maintaining and scaling-up eorts in immuniza on coverage; ensuring early detec on and
73
prompt treatment of sick children (IMCI2); improving nutri on outcomes; promo ng family ac on and community prac ces; and controlling for environmental risk factors (access to clean water and sanita on) About 20 percent of births had no access to proper health services, while at the same me most babies born in Indonesia are at high risk (Riskesdas 2007). It is reported also that 35 - 60 percent of children have no access to proper health services when ill and 40 percent were unprotected from preventable diseases, while about 30 - 45 percent live in high risk environments; only about 30 percent of mothers apply good health prac ces. Risk factors for infant and child mortality are strongly related to environmental health clean water, basic sanita on and low levels of indoor pollu on. The 2007 Riskesdas report found that 65 percent of infants and children have access to clean water and 71 percent to basic sanita on. Some 54 percent of households use pollu ng solid fuels in the household. The risk factors of child and infant mortality are highly correlated with environmental health. To maintain the necessary momentum in pursuing key interven ons, key challenges lie in the areas of: (i) program monitoring, synchroniza on of eec ve evidence-based interven ons with universal coverage, integra on of such interven ons into results-based sector planning and budge ng; without which expansion and even maintenance of achievements in immuniza on coverage will slow down; (ii) management, sta training, funding and grassroots promo on of IMCI; (iii) cost-eec ve, feasible and adaptable nutri on interven ons, implemented by well-trained and properly resourced health care providers; and (iv) designing informa on and behavior change programs that promote the role of the family (i.e. early ini a on of breas eeding, hand washing, etc).

While current policy correctly focuses on building up and expanding core interven ons, par cular emphasis needs to be placed on the following policy areas: immuniza on, IMCI, child nutri on program, strengthening the role of the family, enhancing access to health facili es. To achieve the national target for immunization against measles of 93 percent by 2014, ensuring adequate resources availability and defining clear roles between central and local government are crucially needed in program implementation. Central government will strengthen its roles in policy making, setting norms and standards, procurement of vaccines and equipment, and the design of disease surveillance.
IMCI Integrated Management of Childhood Illness
74
Strategies to address the key IMCI concerns are as follows: (i ) focus on IMCI training for health workers; (ii) strengthen management structures at the central and district levels; reduce sta turnover; increase funding for IMCI; coordinate with other child health programs and eliminate conic ng regula ons; and improve supervision at facility levels; (iii) ensure that essen al drugs are available for IMCI; (iv) implement IMCI at the household and community levels to improve care-seeking prac ces and health services u liza on; and (v) provision of counseling for mothers and caregivers on how to care for child and infants. Strategies to address the key nutritional concerns so as to achieve the national target to reduce stunting in under-five children from 36.8 percent to 32 percent by 20143 are as follows: (i) emphasize exclusive breast-feeding and appropriate complementary feeding; adequate nutri onal care during illness and severe malnutri on, and adequate micronutrient intake; (ii) promote child growth aimed at providing basic informa on for households and communi es about feeding, childcare and health care seeking; (iii) introduce communication for behavior change (BCC); (iv) pursue micronutrient interventions, increased dietary intake, food for ca on and direct supplementa on; and (v) pursue food supplementation strategies. Strategies at the family level relate to the following: (i) protec on of children in malariaendemic areas with insec cide-treated nets; (ii) ensure that children complete a full course of immuniza ons (hepa s, BCG, diphtheria, tetanus, pertussis, oral polio vaccine, and measles) before their rst birthday; (iii) recognize when sick children need treatment outside the home and then seek care from appropriate providers; (iv) feed and oer more uids, including breast milk, to children when they are sick; (v) give sick children appropriate home treatment for infec on; and (vi) follow health workers advice about treatment, follow-up, and referral. Strategy at the community and household levels includes: increasing clean and healthy life behavior (PHBS) prac ces at the household level from 50 percent to 70 percent by 2014 (RPJMN 2010-2014), through BCC and IEC. Strengthening Newborn care and Maternal Health, through: (i) support for implementa on of the newborn and child survival strategy emphasizing focused pregnancy and delivery care, essen al care for all newborns (including immediate and exclusive breas eeding, warmth, and clean cord care), infec on detec on and treatment, and special care for low birth weight newborns; (ii) support focusing on the essen al obstetric and neonatal care approach to preven on/early treatment of complica ons during pregnancy, delivery and the newborn period; (iii) quality improvement to promote hygiene and training for community health workers in clean delivery prac ces; and (iv) vaccina ons and support for iron supplementa on to prevent anemia during pregnancy. .
The Na onal Medium Term Development Plan 2010-2014.
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Strengthening and improving health facili es, by introducing strategies to promote primary health care and revitalize Posyandus, enable Basic and Comprehensive Emergency Obstetric and Neonatal Care (BEONC and CEONC); ensure adequate opera ng costs for hospitals and primary health centers, through BOK (Biaya Operasional Kesehatan). Mobiliza on of community par cipa on through Posyandu ac vi es that include: monitoring the nutri onal status of infants and toddlers each month through observa on of their body weight, complete basic immuniza on and other health services that are provided at the Posyandu. Policy advocacy will be targeted to provinces with lower levels of achievement on the indicators for MDG 4, through: (i) improved resource alloca on taking into account absorp ve capacity; (ii) increased provision of public funding for health in order to reduce nancial risks, especially for the poor; (iii) development of monitoring instruments; (iv) improved advocacy and capacity building of health personnel; and (v) addressing strategic needs of health workers in remote areas, underserved, border and island areas. To support the aforemen oned strategies and leverage their impact, cross sectoral approaches will be considered, linking service delivery, communicable diseases control, distribu on mechanisms, surveillance and IEC technologies with ac ons in water and sanita on, environmental pollu on, educa on, gender and women empowerment, and social protec on programs. To ensure progress, na onal targets for newborn, infant and child care have been set out in the Na onal Medium-Term Development Plan as presented in the following table:
Table 4.1. Priori es, Outputs, and Targets to Improve the Quality of Child Health Services, 20102014
Priority
Outputs
Coverage of Neonatal rst visit Coverage of Complete Neonatal Visits Coverage of Treatment on Neonatal Complica on
2010
84% 80% 60% 84% 78% 80% 80%
2011
86% 82% 65% 85% 80% 82% 85%
2012
88% 84% 70% 86% 81% 85% 88%
2013
89% 86% 75% 87% 83% 88% 90%
2014
90% 88% 80% 90% 85% 90% 92%
Improve the quality of child health care:
Coverage of Health Services for Infants Coverage of Health Services for Under-ve Children Coverage of one-year-old children fully immunized Coverage of one-year-old children immunized against measles
Source: The Na onal Medium-Term Development Plan 2010-2014 and Inpres no. 3/2010.
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Antenatal care at Puskesmas (primary health center) in Praya, NTT
Goal 5: Improve Maternal Health
Target 5A: Reduce by three-quarters, between 1990 and 2015, the Maternal Mortality Ratio Target 5B: Achieve, by 2015, universal access to reproductive health
Current Status
Indonesias Maternal Mortality Ratio (MMR) remains high. With current trends, the MMR has been falling gradually, but extra efforts are required to achieve the target of 102 deaths per 100,000 live births by 2015. While maternal mortality gures tend to vary by source, IDHS 2007 places the MMR at 228 maternal deaths per 100,000 live births for the period 2004-2007. Compared to 307 per 100,000 live births for the period 19982002 and 390 deaths per 100,000 live births in 1991 (IDHS), the number reects a gradual decline of MMR (Figure 5.1). It is es mated by WHO that 15-20 percent of pregnant women in both developed and developing countries will experience high risk and/or complica ons during pregnancy or at birth. Key areas of intervention that influence the MMR include appropriate antenatal care, births attendance by skilled health personnel, proper care of high-risk pregnancies, family planning to avoid early pregnancies, high risk abortions and post abortion care, and programs aimed at behavior change (raising awareness) among women of reproductive age. The most eec ve way to reduce maternal mortality is to have births a ended by a skilled health provider. Currently, 77.34 percent of births are assisted by a skilled health provider
79
(Susenas 2009), compared with 72.5 percent in 2007 (IDHS 2007) and 66.7 percent in 2002 (IDHS 2002/03). The MoH target for 2010 is 90 percent.
Figure 5.1. Na onal Trends and Projec ons for the Maternal Mortality Ra o 1991-2025
450 390 400 350 300 250 200 150 100 50 0 102
2015 (MDG)
334
307
228 226 118

2014 (NMTDP)
1991
1993
1995
1997
1999
2001
2003
2005
2007
2009
2011
2013
2015
2017
2019
2021
2023
IDHS
MDG Target
NMTDP
Linear (IDHS)
The disparity of births assisted by skilled health personnel among regions ranges from 98.14 percent in DKI Jakarta to 42.48 percent in Maluku, as shown by Figure 5.2.
Figure 5.2. Percentage of Births Assisted by Skilled Provider, by Provinces, 2009
100 90 80 70
Percentage
50 40 30 20 10 0
Ninety-three percent of women received antenatal care from a health professional during pregnancy (Figure 5.3). There are 81.5 percent of pregnant women who have at least four ANC contacts during pregnancy, but only 65.5 percent of pregnant women have complied with the recommended schedule of the minimum of four ANC visits. Even with rela vely high coverage,
80
Maluku Maluku Utara Sulawesi Barat Sulawesi Tenggara Papua Nusa Tenggara Timur Kalimantan Barat Papua Barat Sulawesi Tengah Gorontalo Kalimantan Tengah Banten Sulawesi Selatan Jawa Barat Jambi Nusa Tenggara Barat Kalimantan Selatan Lampung INDONESIA Sumatera Selatan Riau Sulawesi Utara Jawa Tengah Bengkulu Kalimantan Timur Bangka Belitung Aceh Jawa Timur Kepulauan Riau Sumatera Utara Sumatera Barat Bali DI Yogyakarta DKI Jakarta
42.5 47.2 47.5 48.7 49.1 49.9
60
59.1 60.4 62.5 63.2 63.6 68.9 69.5 70.2 70.5 71.3 76.0 76.4 77.3 78.7 82.7 82.8 84.3 85.2 85.2 85.4 85.9 86.3 87.5 88.7 88.9
96.2 96.9 98.1
2025
ANC s ll needs a en on, especially since MMR remains high. One aspect to be considered is quality of ANC services in ensuring early diagnosis and prompt treatment, beside an integrated and holis c approach of maternal health.
100 83.0 86.5 75.0 79.0 90 80 70 Percentage 60 50 40 30 20 10 0 1991 1994
1 visit
81.0
81.5
Figure 5.3. First and Fourth Antenatal Visits, in Indonesia 1991- 2007
65.5
64.0
93.1
56.0
63.7
93.3
1997
4 visits
2003
4 visits as recommended
2007
Con nuum of care is a cri cal element in the strategy to achieve maternal and child health targets. Regarding the pre-pregnancy period, contracep ve and reproduc ve health are the crucial issues to be improved. The contracep ve prevalence rate increased insignicantly in the last ve years. Na onally, the contracep ve prevalence rate (CPR) is rela vely low; 57.4 percent for modern methods and 61.4 percent for any method (IDHS 2007). During the period of 2002/03 to 2007, contracep ve use did not show signicant improvement, compared to the steady increase recorded in the period of 1991 to 2002/03. The contracep ve prevalence rate increased only by 1.1 percent for all methods and 0.7 percent for modern methods during the period 2002/03 to 2007, while in the period 1991 to 2002/03, the average increase in contracep ve use was 3.5 percent and 3.2 percent for all methods and modern methods, respec vely. The CPR varies among provinces, level of educa on, and wealth quin le. The lowest CPR for any method is in Maluku (34.1 percent), while the lowest for modern methods is in Papua (24.5 percent). The highest for any and modern methods are in Bengkulu, where the rates recorded are 74.0 percent and 70.4 percent, respec vely. In general, contracep ve use is high when the respondents level of educa on and wealth quin le are high. Disparity of CPR among provinces indicates the uneven coverage of family planning programs. The number of couples of reproduc ve age who want to space pregnancy or limit births, but do not use any contracep ves (unmet need1), has increased from 8.6 percent (IDHS 2002-
14 Unmet need is dened here as the percentage of currently married women who either do not want any more children or want to wait before having their next birth, but are not using any method of family planning. Women with an unmet need for spacing include pregnant women whose pregnancy was mis med; amenorrheic
81
2003) to 9.0 percent (4.3 percentage points are for spacing and 4.7 percentage points for limi ng) (IDHS 2007). These numbers have been nearly stagnant since 1997 (Figure 5.4).
Figure 5.4. Unmet Needs, Indonesia 1991-2007
14.0
% of married women aged 15-49
12.0 10.0 8.0 6.0 4.0
12.7 10.6 6.4 5.8 5.0 4.6 4.7 9.2 8.6 9. 0
6.3 2.0 4.8 4.2 4.0 4.3
Source: BPS, IDHS 1991, 1994, 1997, 2002/2003, 2007.
1991 1994
Spacing
1997
Limi ng Total
2002/3
2007
Unmet need varies greatly among provinces, regions and socio-economic status. The lowest unmet need is found in Bangka Belitung (3.2 percent) and the highest in Maluku (22.4 percent). Higher unmet need was found in rural areas (9.2 percent) as compared with urban areas (8.7 percent). In addi on, unmet need also tends to be inversely correlated with higher levels of educa on and welfare quin le: it is 11 percent for women with no educa on and 8 percent for women with higher educa on (secondary and above); while for women in the lowest quin le it is 13 percent and 8 percent for women in the highest quin le (Figure 5.16). This fact indicates that the more educated and prosperous the group, the more informa on and services of family planning and reproduc ve health have been accessed. The high unmet need is also caused by the concern about side eects and the inconvenience of using contracep ves, which reect the low quality of family planning services. IDHS 2007 shows that 60 percent of married women with 2 children, 75 percent of married women with 3-4 living children, and 80 percent of married women with 5 or more live children, do not want more children, but are not using any contracep ve method. Moreover, 12.3 percent women aged 15-19 are not willing to use any contracep ve because of side eects, 10.1 percent because of health problems and 3.1 percent because their husbands forbid them to do so.
women whose last birth was mis med; and fecund women who are neither pregnant nor amenorrheic, who are not using any method of family planning, and who want to wait two or more years for their next birth. Also included in unmet need for spacing are fecund women who are not using any method of family planning and are unsure whether they want another child or who want another child but are unsure when to have the birth. Unmet need for limi ng refers to pregnant women whose pregnancy was unwanted; amenorrheic women whose last child was unwanted; and women who are neither pregnant nor amenorrheic, who are not using any method of family planning, and who want no more children. Measures of unmet need for family planning are used to evaluate the extent to which programs are mee ng the demand for services. Women who have been sterilized are considered to want no more children (IDHS 2007).
82
The CPR and unmet need contribute to the Total Fer lity Rate (TFR), in addi on to increasing maternal mortality, with an es mated 62 -163 per cent caused by unsafe abor on prac ces. Unmet need leads to unwanted and unintended pregnancies, which in turn lead to termina on of pregnancies. Since abor on is illegal in Indonesia, pregnant women seek unsafe abor on services. The need for family planning is further underlined by the high adolescent birth rate in Indonesia, especially in rural areas4. The TFR is currently 2.3 in Indonesia (IDHS 2007); a decrease from 0.33 in 1991. Furthermore, in some provinces, TFR is signicantly higher due to the high Adolescent Birth Rate, which is due to the low median age of the rst marriage of women. The Age Specic Fer lity Rate for individuals aged 15-19 has decreased from 67 births per 1,000 married women (IDHS 1991) to 35 births per 1,000 married women (IDHS 2007), while the disparity among provinces and regions and socio-economic is s ll the main challenge. The highest ASFR aged 15-19 is found in Sulawesi Tengah (92 births), while the lowest is in Yogyakarta (7 births). Furthermore, 16 provinces s ll have ASFR aged 15-19 above the na onal average. The high adolescent birth rate is caused by lack of access to quality reproduc ve health services and reliable informa on on sexual and reproduc ve health Adolescent fer lity raises both health and demographic concerns. From a health perspec ve, the risks for both mother and child increase, par cularly during the perinatal and neonatal period, which result in elevated infant and maternal mortality rates. Adolescent births risk reproduc ve health system injuries, as well as complica ons during pregnancy and childbirth. In addi on, babies born to teenage mothers are more prone to injury during birth, low birth weight, and s llbirth. Demographically, early child birth raises fer lity rates; delaying pregnancy broadens opportuni es for pursuing educa on and expanding access to employment opportuni es. Knowledge and awareness of youth and couples in reproduc ve age about family planning and reproduc ve health is s ll low. The Indonesia Youth and Adolescent Reproduc ve Health Survey (IYARHS, BPS) in 2007, revealed the presence of teenagers who approved of having intercourse before marriage. This risks increasing unwanted pregnancies and unsafe abor ons, and points to the need to promote be er understanding of adolescent reproduc ve health, as well as the provision of family planning and reproduc ve health services for couples in reproduc ve ages.
2 3 4
MDGs countdown, 2005, prole Indonesia Abor on in Indonesia Gu macher Ins tute, Policy Brief, 9/2008 Adolescent Birth Rate is counted using the ASFR aged 15-19 (number of birth by married women aged 15-19 years divided by number of married women aged 15-19)
83
Challenges
1. Limited access to quality health care facili es, especially for the poor in disadvantaged areas, remote, border and island areas area (DTPK). The current health care facili es are not preferred loca ons for giving birth due to limited access, cultural issues and lack of necessary facili es and materials, such as availability and quality of Basic Emergency of Obstetric and Neonatal Care (BEONC) and Comprehensive Emergency of Obstetric and Neonatal Care (CEONC), posyandu and blood transfusion units; as well as the lack of medical equipment, medicines and blood supplies that are crucial to handling obstetric emergencies, especially in remote and poor areas, where risks to pregnancy and child births are par cularly high. In addi on, the referral system is weak, from community to primary to referral facili es. This is exacerbated by geographic and transporta on barriers to access health facili es and health workers. 2. Limited availability of health personnel both in terms of quan ty, quality and their distribu on, especially midwives. Health workers are some mes inadequately trained;5 access to trained health personnel, especially midwives, is cri cal for a successful safe motherhood program. Due to the inadequate number and distribu on of midwives, and cultural factors, communi es come to depend on tradi onal birth a endants (TBAs) and o en dangerous tradi onal prac ces. 3. Lack of knowledge and awareness on the signicance of safe motherhood. Community mo va on and mobiliza on becomes a par cularly important tool in an environment of uncertain service provision, especially with the diversity of condi ons that exist in Indonesia. Some socio-economic indicators, such as aordability and educa on, are low, as well as cultural factors, which may constrain demand and contribute to the maternal deaths gure in Indonesia. 4. Low nutri onal and health status of pregnant women. The percentage of women of reproduc ve age (15-45 years old) who suer from chronic protein energy malnutri on is rela vely high, 13.6 percent (Riskesdas 2007). The low nutri onal status, in addi on to escala ng health risks for pregnant women, is one cause of high prevalence of low birth weight (LBW) among infants. The risk of maternal death is even greater for mothers with the 4 TOOes: (i) too many (children), (ii) too close (interval between pregnancies), (iii) too old, or (iv) too young (age of the mother). This risk is exacerbated when other underlying condi ons are present (anemia, infec ous diseases, etc.), which s ll are common problems in most of places in Indonesia.
The educa on and training programs with crash program approaches some mes poorly resulted with insuciently skilled health workers, especially when they have to work in dicult circumstances where in fact they are most needed.
84
5. Low rates of contracep ve use and high unmet need remain major challenges. The high IMR and MMR, mothers age at child birth (too old; too young), high abor on rates, and low contracep ve use are indicators of the weakness of family planning services which are an important driver in reducing maternal mortality. 6. The Maternal Mortality Ra o remains uncertain, as the system for recording causes of maternal deaths is not robust. The rate is currently obtained from a survey using a direct es ma on procedure drawing on the Indonesia Demographic and Health Survey (IDHS). This has been the case since 1994. The surveys collect informa on on the survivorship of all live births of the respondents natural mother (i.e., the respondents brothers and sisters). To obtain accurate death rates and causes of death, a complete vital sta s cs model should be compiled through registra on, or a popula on census with the cause of death recorded needs to be implemented immediately.

Considering that the decline in maternal mortality has been slow with complex problems faced in achieving the target for 2015, that is 102 per 100,000 live births, the following policies will ensure improvements: (a) increasing the frequency of antenatal6 contacts between skilled health personnel and pregnant women; (b) increasing the use of skilled health personnel in deliveries; (c) increasing access to emergency (basic and comprehensive) obstetric care for highrisk deliveries; and (d) increasing the percentage of deliveries in a health facility. Therefore, the future policies and strategies to be pursued are:7 1. improving facility-based and outreach services by improving quality and quan ty of puskesmas, BEONC, CEONC, Mother and Baby Friendly Hospitals (CEONC8) and posyandu revitaliza on; 2. increasing access to family planning services, by means of expanding the service network (coverage and access) and integra ng family planning with other reproduc ve health programs with a focus on the poor and underserved areas; 3. expanding the village midwife func on, including partnering with TBAs; and strengthening the community based care through TBA-midwife partnership, integrated health posts (posyandu), village health posts (poskesdes);
6 7 8
Antenatal care is a poten ally important way to connect a woman with the health system, which, if it is func oning, will be cri cal for saving her life in the event of a complica on. The eects of these policies are not narrowly focused on maternal health, but are systemic; that is they are key interven ons that accelerate achievement of the full range of health MDG targets. UN guidelines recommend a minimum of one comprehensive emergency obstetric care facility and four basic emergency obstetric care facili es per 500,000 popula on.
85
Con nuing family planning revitaliza on in order to control the popula on is one of the key features of policies to achieve universal access to reproduc ve health by 2015, and will be pursued through a series of strategies, including: 1. Supervising and building self reliance to par cipate in family planning by: . increasing par cipa on and self-reliance training for family planning through 23,500 government and private family planning clinics, by providing material support for the clinics, free contracep ve devices/drugs and free family planning services for the poor; improving knowledge, a tudes and behavior of teenagers related to adolescent reproduc ve health, HIV/AIDS, addic ve drugs use, life skills educa on and family life educa on for adolescents; improving human resources capacity in the family planning program at all levels, in the aforemen oned 23,500 clinics in order to assist and develop self-reliance in family planning. developing media communica ons and intensifying informa on, communica on and educa on for popula on control and family planning; improving knowledge, a tudes and behavior related to popula on control, family planning and reproduc ve health; improving commitment and par cipa on across sectors and local governments in popula on and family planning program implementa on; promo ng and strengthening partnerships with the private sector, NGOs, and communi es in family planning program implementa on.
2.
Improving promo on and community mobiliza on by: . . . .
Source: Na onal Medium-Term Development Plan 2010-2014 (RPJMN 2010-2014).
4. strengthening the referral system, to reduce the three delays and to save womens lives by giving adequate care on me; 5. reducing nancial barriers through: PKH (condi onal cash transfers), Jamkesmas (social health insurance for the poor), BOK (subsidy for non-salary opera ng cost for primary health facili es); 6. improve the con nuum of care, that includes integrated service delivery for mothers and children from pregnancy to delivery, the immediate postnatal period, and childhood; 7. increasing the availability of health workers (general prac oners, specialists, village midwives, paramedical sta) in term of quan ty, quality and distribu on; focusing to fulll needs in remote, underserved, border and islands areas, through pre-service and in-service training of key health personnel and implemen ng the contractual service provider scheme; 8. raising awareness about safe motherhood at the community and household level by strengthening public health educa on; 9. improving adequate micronutrient intake by pregnant women by ensuring adequate
86
nutri on intake; 10. providing an enabling environment to support management and stakeholders par cipa on in policy development and the planning process, and promote collabora on among programs and sectors as well as between public and private sector en es, including developing linkages with communi es to achieve synergies in advocacy and service delivery; 11. improving the informa on system, in par cular by: (i) introducing analy cal methods to measure maternal deaths drawing on diverse sources of varying quality; (ii) focusing on groups and areas most at risk of maternal death; and (iii) developing models for iden fying eec ve safe motherhood strategies; 12. strengthening coordina on mechanisms by dening modali es for sharing roles and responsibili es among central, provincial and district authori es and introducing be er program oversight and management through surveillance, monitoring, evalua on and nancing; while focusing targe ng of interven ons in poor and underserved areas. In addi on, building eec ve partnerships across programs and sectors to make use of synergies in service provision and advocacy; 13. addressing par cular issues related to decentraliza on and strengthening and sharpening the tasks in achieving health Minimum Services Standards (MSS), to ensure the achievement of health MDGs at all levels. In emphasizing the aforemen oned strategies, the Na onal Medium-Term Development Plan (2010-2014) has set annual targets as follows:
Table 5.1. Priori es, Outputs, and Targets to Improve the Quality of Maternal and Reproduc ve Health Services, 2010-2014
Priority
Outputs Percentage of deliveries assisted by skilled birth a endant (PN)
2010 84%
2011 86%
2012 88%
2013 89%
2014 90%
Improve quality of maternal and reproduc ve health services
Percentage of pregnant mothers with at least 4 ANC visits (K4) Percentage of health care services that provides standardized family planning services Number of puskesmas that implement standardized midwifery services based on guidelines
84%
86%
90%
93%
95%
10%
40%
75%
90%
100%
Improve expansion of nursing and midwifery services
70
140
210
280
350
87
Table 5.1. Con nued
Priority Improve support for management and implementa on of technical tasks in Nutri on and Health programs for Maternal-Child
Outputs Number of func oning Poskesdes (village health posts)
2010
2011
2012
2013
2014
70,000
72,000
74,000
76,000
78,000
Table 5.2. Priori es, Outputs, and Targets for Popula on and Family Planning Programs, 2010-2014
Priori es
Outputs Contracep ve Prevalence Rate/CPR (%) a. Number of new par cipants (in millions) b. Number of current users (in millions) c. Number of self-reliant users (in thousands) d. Percentage of current self-reliant users e. Percentage of new par cipants for long term contracep ve method f. Percentage of current users for long term contracep ve method g. Percentage of new male par cipants 1. Number of public and private clinic providing family planning service 2. Number of new poor (KPS/family within below prosperity level and KS-1/ prosperity level-1) and other vulnerable par cipants receiving guidance and free contracep ve from 23,500 public and private clinics (in millions) 3. Number of poor current users (KPS/ family within below prosperity level and KS-1/prosperity level-1) and other vulnerable par cipants receiving guidance and free contracep ve from 23,500 public and private clinics (in millions) 4. Number of public and private clinics receiving infrastructure support
2010 57.4 7.1 26.7 3.4 48.4 12.1 24.2 3.6 23,500
2011 7.2 27.5 3.4 49.6 12.5 25.1 4.0 23,500
2012 7.3 28.2 3.4 49.7 12.9 25.9 4.3 23,500
2013 7.5 29 3.5 50.9 13.2 26.7 4.6 23,500
2014 65 7.6 29.8 3.6 51 13.6 27.5 5.0 23,500
Popula on and Family Planning
3.75
3.8
3.89
3.97
4.05
Increasing guidance, par cipa on, and independence in ge ng family planning service from 23,500 public and private clinics
11.9
12.2
12.5
12.8
13.1
4,700 35
4,700 45
4,700 75
4,700 90
4,700 100
Improving human resources capacity of the family planning providers in 23,500 public and private clinics in promo ng guidance, par cipa on and independence in family planning
1. Percentage of trained family planning human resources in 23,500 public and private clinics 2. Percentage of family planning clinic providing family planning services based on the proper Standard Opera ng Procedure (SOP) (from the whole 23,500 public and private exis ng clinics)
20
35
50
70
85
88
1. Percentage of adolescence knowledge about: a. Adolescence reproduc ve health b. HIV/AIDS Promo ng adolescence knowledge, manner and a tude about planning family life among adolescence (PKBR) c. Planning family life 2. Number of PKBR trainer receiving training 3. Number of center of excellent PKBR (per province) 4. Number of adolescence/student Informa on and Counseling Center (PIK) established and guided 1. Percentage of Informa on, Educa on and Communica on (IEC) media and materials produced 2. Percentage of reproduc ve age couples, reproduc ve age women and adolescence obtaining informa on on popula on and family planning from printed and electronic media and outdoor media Number of trained family planning eld worker (Family Planning Field Workers/ PLKB; Family Planning Counselors/PKB): a. General Basic Training (LDU) b. Refreshing c. Technical Training 1,065 1,350 3,018 1,343 2,500 3,300 1,342 2,750 3,450 2,700 2,157 1,700 950 50 64 10 1 9,373 53 67 15 115 2 12,253 56 70 20 30 3 13,195 59 72 25 30 4 14,140 62 76 30 30 5 15,016
38
65
84
100
100
Promo ng peoples knowledge, manner and a tude toward popula on control and family planning
95
95
95
95
95
Improving NGO, private sector and community par cipa on in maintaining popula on and family planning program
89
90
Stop AIDS, Start Running.
Goal 6: Combat HIV/AIDS, Malaria and Other Diseases
92
Target 6A: Have halted by 2015 and begun to reverse the spread of HIV/AIDS Target 6B: Achieve, by 2010, universal access to treatment for HIV/ AIDS for all those who need it
Current Status
The number of new HIV infec ons has been increasing in Indonesia, although the percentage of HIV-infected individuals in Indonesia is s ll rela vely low at 0.17 percent of the popula on. During the period 1996 to 2006, the number of HIV cases increased by some 17.5 percent and it is es mated that some 193,000 people are currently living with HIV in Indonesia. Although in most parts of Indonesia the AIDS epidemic is generally concentrated among high-risk popula ons with an es mated na onal adult prevalence of 0.22% in 2008, two provinces, Papua and Papua Barat, are shi ing to a generalized epidemic with a prevalence of 2.4 percent among the general popula on aged 15 49 (IBBS, CDC MoH 2007). Cumula vely, the number of AIDS cases has tended to increase. In 2009 there were 19,973 cases, more than double the number compared with the 8,194 cases recorded in 2006 (Figure 6.1.). Cases of HIV and AIDS are found in all areas of Indonesia, but the number of cases varies by province (Figure 6.2). The provinces with the greatest number of AIDS cases are West Java (3,598 cases), East Java (3,227 cases), DKI Jakarta (2,828 cases), Papua (2,808 cases), and Bali (1,615 cases).
93
Figure 6.1.
AIDS Cases per 100,000 Popula on in Indonesia, 19892009
20,000 18,000 16,000 14,000 12,000 10,000 8,000 6,000 4,000 2,000 -
19,973 16,110
11,141
3,863
8,194
1,195
5,321 2,682 1,171

316
Source: MoH, DG of CDC and EH, 2009.
21
Source: MoH, DG of CDC and EH, 2009.
Modes of transmission are indicated in Figure 6.3. Heterosexual groups such as female sex workers (FSW) and transsexuals, together with their partners represent most reported new HIV cases (50.3 percent), followed by injec ng drug users (IDUs) at 39.3 percent and 3.3 percent from homosexuals (men having sex with men MSM), about 2.6 percent are perinatal infec ons resul ng from mother-to-child transmission, and blood transfusion transmission cause about 0.1 percent of cases. About 91 percent of AIDS cases have occurred in the reproduc ve age group (15-49 years of age). At current rates, HIV infec on in Indonesia would con nue increasing over the next decades as people increasingly engage in unprotected sex, and the spread of HIV through injec ng drug use accelerates. The projec on of this modeling (Figure 6.3.) es mates increasing HIV prevalence in the popula on aged 15-49 years from 0.21 percent in 2008 to 0.4 percent in 2014, which will increase the number of people with AIDS from some 404,600 people by the
94
Sulawesi Barat Gorontalo Maluku Utara Kalimantan Timur Sulawesi Tengah Kalimantan Tengah Sulawesi Tenggara Kalimantan Selatan Aceh Papua Barat Bengkulu Bangka Belitung Nusa Tenggara Barat Nusa Tenggara Timur Lampung Jambi Sulawesi Utara Maluku Sumatera Selatan DI Yogyakarta Banten Sumatera Barat Kepulauan Riau Riau Sumatera Utara Sulawesi Selatan Jawa Tengah Kalimantan Barat Bali Papua DKI Jakarta Jawa Timur Jawa Barat
10
11
12
21
27
43
58
91
117
119
138
144
165
173
192
219
290
318
330
333
475
485
591
717
794
1,615
Figure 6.2. Number of AIDS Cases in Indonesia, by Province, 2009
1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Number of AIDS Cases Cumula ve AIDS Cases
3,598
4,500 4,000 3,500 3,000 2,500 2,000 1,500 1,000 500 -
2,639
2,873
2,947
4,969
2,808
2,828
3,227
end of 2010 to some 813,720 by 20141 (), that in turn will result in the increased need for an retroviral therapy (ART) from 50,400 cases in 2010 to 86,800 cases in 2014.
Figure 6.3.
Blood Transfussion; 0,1% Perinatal; 2,6% MSM; 3,3% IDUs; 39,3%
Note : MSM=men who have sex with men; IDU=injec ng drug user.
Unknown; 4,4%
Distribu on of HIV Infec ons, by Popula on Group, 2009
Heterosex; 50,3%
Source: Surveillance reports, Na onal AIDS Programme, Ministry of Health, Indonesia.
Another related factor in HIV/AIDS transmission is the failure to use condom. In total, the percentage of young unmarried people repor ng condom use during their most recent sexual encounter is only about 18.4 percent of young unmarried men and 10.3 percent of young unmarried women (IDHS 2007).
60.0 50.0 Percentage (%) 40.0 30.3 30.0 20.0 10.0 1.0 <1 1-4 5-14 15-19 20-29 30-39 40-49 50-59 > 60 Unknown
Figure 6.4.
48.7
Cumula ve Percentage on AIDS Cases by Age Goup, 2009
8.9 1.2 0.6 3.1 2.5 0.5 3.2

Source: DG of CDC & EH Ministry of Health, 2009
Age Group
By residence, men in urban areas are more likely to use a condom during high-risk sex than men in rural areas. Dierent pa erns are found in women, where women in rural areas are more likely than those in urban areas to report condom use in their last high risk intercourse. Condom use is also posi vely correlated with level of educa on (Figure 6.5)
Mathema c modeling of the HIV epidemic in Indonesia, 2010-2025, NAC
95
Figure 6.5.
Percentage of Unmarried Women and Men Age 15-24 Who Have Ever Had Sex, Who Use Condom at Last Sex, According to Background Characteris c, 2007
15-19
Age
15.6 13.2 20.0 4.0 28.0 7.5 9.4 12.1 10.6 11.7 15.3 8.4 24.8 21.3 18.4 10.3
20-24
Residence
Urban Rural Less than completed primary
Men Women
Education
Completed primary Some secondary Secondary +
Source: BPS, IYARHS 2007.
Total
5.0
10.0
15.0
20.0
25.0
30.0
Knowledge about HIV and its preven on is an important prerequisite for adop ng healthy behaviors. While most youth (15-24 years of age) in the country are aware of HIV/AIDS, only 14.7 percent of married men and 9.5 percent of married women have comprehensive and correct knowledge about HIV. Among youth who are unmarried, only 1.4 percent of unmarried men and 2.6 percent of unmarried women have correct and comprehensive knowledge of AIDS (Figure 6.6); this falls far short of the 95 percent target set by the United Na ons and is the lowest in the region, less than 50 percent2 (Figure 6.7). There are also dispari es in knowledge among regions, residence (rural vs. urban), educa on and socio-economic status. Knowledge of married men and women in urban areas was higher than in rural areas. The higher the level of educa on, the higher the percentage of correct and comprehensive knowledge about AIDS. Likewise, with regard to socio-economic status, knowledge in the highest wealth quin le was 27.5 percent (married men) and 21.7 percent (married women). The equivalent numbers for the lowest quin le are 3.1 percent and 1.9 percent for married men and married women, respec vely.
In Indonesia, an retroviral therapy (ART) is available at 180 facili es, and is being oered to 38.4 percent3 of the total es mated cohort of eligible people living with HIV/AIDS (PLWHA) (calculated from MOH report 2010) as presented in Figure 6.7. This coverage increased from ART interven on coverage in 2006 by about 24.8 percent.
2 3
UNGASS, country reports: HIV / AIDS in the South-East Asia Region 2009.
The es mated number of eligible PLWHA for ART per year is based on cut of point of the result of CD4 <200/ mm3 is about 10 - 20% from the total PLWHA in that period, while the number of PLWHA is es mated based on the Asian Epidemic Model (AEM).
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2.1
Figure 6.6.
5.7 10.3 9.5 15.5 14.7 18.5
15-19
Age
1.6 2.8 1.2 2.2 1.4 2.6 0.6 1.6
20-24 15-24
Propor on of Men and Women Aged 15-24 with Correct of Comprehensive Knowledge about AIDS, by Background Characteris c, Indonesia 2007
Residence
Urban Rural no educa on Some primary
14.9 8.4
0.1 0.2
5.0 2.2 3.8
Married Men* Married Women* Unmarried Men 4.9 3.9 10.2 10.2 22.7 28.8 Unmarried Women
Educa on
2.2 1.1 2.2 2.0
Completed primary Some secondary Secondary + Lowest Highest
1.3 2.8
1.7 3.1 0.9 1.9 3.1 1.9
Quin le
21.7 9.1 12.7
27.5
Note: *) covering age group of 15-54 years old for married man, except when describing married men by age group. **) covering age group of 15-49 years old for married women, except when describing marreid women by age group
Total
1.4 2.6
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
Source: BPS, IDHS and IYARHS 2007.
Without eec ve preven on, the need for ART among the 15-49 age group is projected to increase three fold from 30,100 in 2008 to 86,800 in 2014 (Na onal AIDS Strategy Ac on Plan - NASAP 2010-2014). The number of children needing ART will also increase from 930 in 2008 to 2,660 in 2014 (MoH 2010). Without adequate interven ons, the trend and projected cases of the HIV epidemic in Indonesia is es mated to increase uncontrollably.
Figure 6.7.
Coverage of ART Interven ons in Indonesia, 20062009
Note: An retroviral treatment (ART) is given to individuals with advanced HIV infec on as per na onal treatment protocols.
Source: Country reports.
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Challenges
The basic challenge in HIV/AIDS is to halt and reverse the upward trend in the incidence/ prevalence of the infec on and the disease. This places the emphasis squarely on preven on strategies and infec on control. Some of the crucial challenges in AIDS mi ga on are: 1. Limited access to health services related to HIV/AIDS. Strengthening the health-care system is crucial in dealing with HIV/AIDS cases. The health-care system needs to be strengthened in dealing with HIV/AIDS cases in preven on, diagnosis, treatment, care, safe blood transfusions and universal precau ons, currently, voluntary counceling and tes ng (VCT) is not yet available in all regions. 2. The limited budget alloca ons and sustainability of funding in controlling HIV and AIDS. The availability and sustainability of funding remain major obstacles in tackling the HIV/ AIDS epidemic. 3. The weakness of inter-sectoral coordina on as well as monitoring and evalua on systems. While much eort has gone into se ng up good governance prac ces at the na onal level, coordina on within the Na onal Aids Commission (NAC) itself needs further improvement. Tackling the disease involves par cipa on by a number of sectors (health, educa on, the military, the penal system, transporta on, immigra on) and places great demands on eec ve coordina on of strategies and interven ons. 4. There are some constraints due to s gma and discrimina on of PLWHA in the community as well as the existence of gender inequali es and viola ons of human rights. Community values shape a tudes, and conserva ve a tudes may serve as a signicant barrier to addressing the HIV/AIDS epidemic. While behavioral change communica ons (BCC) and informa on, educa on and communica ons (IEC) programs are being pursued as part of the HIV/AIDS strategy, they may not be suciently eec ve nor well-targeted; and sociogeographically, they may not be keeping pace with the spread of the disease, as it spreads na onwide. 5. Limited facili es and human resources as well as limited availability of ART in term of quan ty and quality.

1. Improving access by strengthening public health services so that they have the necessary skills and resources to an cipate and respond to the epidemic, through: (i) improving the number and quality of health-care facili es in providing sustainable promo on, diagnosis, preven on, treatment and care; (ii) strengthening the ability to apply preven on, infec on and disease management protocols;4 and (iii) improving coverage of preven on, care and
Protocols would be for managing STIs, preven ng mother-to-child infec ons, harm reduc on for IDUs, HIV tes ng
98
2.
3.
4.
5.
treatment including ARV coverage; (iv) developing na onal guidelines for mainstreaming HIV/AIDS; and (v) adap ng them to specic situa ons (stage of epidemic, high-risk groups, capacity, resources); (vi) human resource planning that recognizes the increasing demands of the growing HIV/AIDS epidemic (management and provider skills). Enhancing community mobiliza on to improve HIV/AIDS preven on, care and treatment interven ons through: (i) providing IEC services on incurring HIV infec ons and preven ng transmission; (ii) undertaking community outreach that focuses on the most-at-risk popula ons and includes HIV tes ng, counseling, treatment and care services in drop-in centers and similar loca ons, including mobile units; while encouraging community ac on; (iii) social marke ng of condoms; (iv) assuaging prejudices among health workers, in the community, and among pa ents; and (v) crea ng an enabling and conducive environment to reduce s gma za on and discrimina on, gender inequity and human rights viola ons in implementa on of HIV/AIDS programs. Mobilizing addi onal nancial resources for a successful HIV/AIDS strategy, through: (i) integra ng HIV/AIDS into development programs both at the na onal level (nanced through the na onal budget/APBN) and local level (nanced through the local budget/ APBD); (ii) mobiliza on of addi onal nancial resources in controlling HIV/AIDS, and (iii ) development of public private partnerships (PPP). Improving cross-sectoral coordina on and good governance, by: (i) establishing a concerted system within government that synergizes various levels of organiza on and ins tu ons to contribute towards an integrated strategy; (ii) strengthening the role of Na onal and Local AIDS Commissions; (iii) strengthening cross-sectoral partnerships by escala ng the role of HIV/AIDS planning and budge ng forums; (iv) dening the respec ve roles of central, provincial and district health authori es in tackling the HIV/ AIDS pandemic; (v) formula ng na onal guidelines for BCC programs and IEC messages, subsequently tailored to the par cular environment; and (vi) pursuing an inclusive approach that promotes complementarity among government, nongovernment and private sector organiza ons, and maintaining an eec ve coordina ng mechanism (NAC). Strengthening informa on and monitoring and evalua on systems, through: (i) conduc ng health monitoring and analysis including, in par cular, second genera on surveillance; and (ii) providing informa on to policy makers on the socio-economic costs of HIV/AIDS and on scaling-up interven ons.
In underlining the strategies, the Na onal Medium-Term Plan (2010-2014) has set targets to control the spread of HIV/AIDS as follows:
and counseling, preven ng the progression of HIV to AIDS, and for the clinical management of treatment and care for people living with HIV.
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Table 6.1.
Priori es, Outputs and Targets of HIV/AIDS Mi ga on Program, 2010-2014
Priority
Outputs Prevalence of HIV Percentage of Popula on above 15 years have correct and comprehensive knowledge of HIV and AIDS The number of people aged 15 who received HIV counseling and tes ng
2010 0.2
2011 <0.5
2012 <0.5
2013 <0.5
2014 <0.5
65%
75%
85%
90%
95%
300,000
400,000
500,000
600,000
700,000
Reducing morbidity and mortality rates of communicable diseases (HIV/AIDS)
Percentage of districts that implement appropriate guidelines for preven on of HIV transmission Use of condoms in high-risk sex groups (based on the report by the user) Percentage of people living with AIDS(PLWHA) who receive an retroviral therapy (ART) Percentage of public hospitals provide referral service for people with HIV and AIDS (PLWHA)
50%
60%
70%
80%
100%
35% (f) 20% (m)
45% (f) 30% (m)
55% (f) 40% (m)
65% (f) 50% (m)
30%
35%
40%
45%
50%
Source: NMTDP 2010-2014, Inpres 3/2010 and MOH Strategic Plan 2010-2014.
60%
70%
80%
90%
100%
100
Target 6C: Have halted by 2015 and begun to reverse the incidence of Malaria and other major diseases
Current Status
Incidence and death rate associated with Malaria. Almost half the popula on lives in endemic areas, and some 35 percent of this popula on is malaria posi ve. The malaria incidence rate during the period of 2000-2009 shows that malaria cases tended to decline: in 2000, the incidence was at 3.62 cases per 1,000 popula on; by 2009, it had declined to 1.85 cases per 1,000 popula on.
4.68
5.50 5.00
Figure 6.8.
3.66 3.63 3.62 3.54 3.7
Posi ve per 1,000 popula on
3.45
3.74
4.50 4.00 3.50 3.00 2.50 2.00 1.50 1.00 0.50 0.00
1990
3.33
3.23
3.18
3.36
Annual Parasites Incidence of Malaria, Indonesia 1990-2009

2.89 2.47 2008 2009 1.85
2.85
2.83
1991
1992
1993
1994
1995
1996
1997
2.53
1998
1999
2000
2001
2002
3.81
2003
2004
2005
4.1 2006
2007
Source: Ministry of Health, 2010.
The na onal prevalence based on clinical diagnosis5 is 2.89 percent (Riskesdas 2007), with the rate varying between 0.2 percent and 26.1 percent among regions. There are 15 provinces where malaria prevalence is above the na onal average (Aceh, Sumatera Utara, Jambi, Bengkulu, Bangka Belitung, Nusa Tenggara Timur, Nusa Tenggara Barat, Kalimantan Tengah, Sulawesi Tengah, Gorontalo, Maluku, Maluku Utara, Papua Barat and Papua). The highest prevalence rates are to be found in eastern Indonesia, the highest being in the provinces of Papua Barat (26.1 percent), Papua (18.4 percent) and NTT (12.0 percent). Provinces in Jawa and Bali have the lowest (clinical) prevalence, about 0.5 percent. As a result, malaria in Jawa and Bali is hypo-endemic, and drug-resistant plasmodium vivax malaria predominates. In the outer islands, where the highest number of malaria cases are reported, treatment-suscep ble plasmodium falciparum and plasmodium vivax are equally common. Only some 20 percent of pa ents with symptoma c malaria seek treatment at public health facili es, making it dicult to es mate the actual malaria incidence among the popula on.
Based on diagnosis results by health professionals and respondent complaints.
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Today, malaria can be prevented, diagnosed and treated with a combina on of available tools. The primary preven ve tools are long-las ng insec cidal nets (LLINs), indoor residual spraying with insec cides (IRS), and intermi ent preven ve treatment for pregnant women (IPTP). Other vector control measures (for example, larviciding and environmental management) are also used. Case management (diagnosis and treatment) emphasizes prompt interven ons. Propor on of children under 5 sleeping under insec cide-treated bed nets. Some 30 percent of households own some type of mosquito net; but ownership of treated nets is very low only 4 percent of households have at least one ever-treated net (ITN), and 3.3 percent have legi mate ITNs6. Households in rural areas are more likely to have insec cide treated bed nets, virtually three mes that of urban households, 4.5 percent and 1.6 percent, respec vely. In preven on eorts, the use of insec cide treated bed nets is an important interven on. However, the use of ITN is almost non-existent. In general, while provision of an malarial medicines by public health services has increased over me, access to treatment, especially of ACT,7 is s ll inadequate on a na onal scale. Prompt malaria treatment (that is within 24 hours) occurs in some 48 percent of cases; and community awareness about mely treatment is important. Underlining the par cular circumstances that may have led to the posi ve results of the MOH study is the conclusion of the 2007 IDHS study that only 50 percent of communi es na onally were aware of essen al an malarial strategies. Financial factors become essen al in ensuring availability, distribu on and monitoring and evalua on of an malarial drugs.
Challenges
1. Ineec ve malaria preven ve ac ons. Insucient understanding of appropriate preven ve ac ons and the need to seek prompt care pose challenges to eec ve infec on control and disease management at the community level. It is mainly through interac ons between well-informed communi es at risk and health authori es that results can be accelerated. Appropriate IEC and BCC messages are a crucial element, and it will have the desired impact if messages are standardized and pay sucient a en on to the local epidemiology, geography and socio-economic condi ons.8 Other constraints may also be due to ineec ve implementa on of epidemiological surveillance, vector control and the limited supply of malaria-related informa on systems.
6 7 8
An insec cide-treated net (ITN) is 1) a factory-treated net that does not require any further treatment, or 2) a pretreated net obtained within the past 12 months, or 3) a net that has been soaked with insec cide within the past 12 months.
ACT: Artemisinin-based Combina on Therapy.

Larval control and environmental management measures (for example, management of salinity in aquaculture and coastal lagoons, rice eld draining) can work well only if the community that lives in, uses and manages the environment is involved.
102
2. Limited capacity at local level. The transfer of responsibility for implemen ng the malaria program may not have paid enough a en on to limited capaci es at local levels, with the program encountering bo lenecks at the service level. Health services may not be suciently equipped and staed to respond promptly to needs. Case management may suer from weak logis c planning at the facility level with interrup ons in the availability of drugs and the means to carry out diagnos c tests. In some instances, the workforce may not have the appropriate training, and there may be shortages of necessary technical exper se (for example, entomologists and monitoring and evalua on specialists). 3. Inadequate monitoring and evalua on system. Oversight capabili es remain limited; monitoring and evalua on ac vi es are insucient to allow good planning and budge ng for the na onal malaria program. 4. Expanding malaria preven on and treatment along the lines set out in the Roll Back Malaria (RBM) program will require addi onal physical, human, and nancial resources. Interna onal nancial contribu ons need to be balanced with the increment of domes c nancial resources. So far, domes c nancingthrough na onal and sub-na onal budgetshas been rela vely modest. Therefore, a nancial mobiliza on strategy for both interna onal and domes c funding will be expanded for medium and long term programs.

To accelerate eorts to achieve the MDG targets related to malaria, improving and strengthening the implementa on of universal coverage RBM strategy are crucially needed, through: 1. Developing strategies for social mobiliza on that focus on promo ng community awareness about preven on interven ons and in malaria control, through: (i) developing IEC and BCC messages that are designed with par cipa on by service providers and user representa ves, so that they are tailored to specic regional and community situa ons (that is client orienta on)9; (ii) developing social mobiliza on strategies that focus on increasing public awareness about malaria preven on eorts; (iii) increasing a en on to a strong malaria informa on system by collec ng adequate malaria-related morbidity and mortality data; (iv) strengthening monitoring progress at local levels and undertake local situa on analysis; (v) providing and promo ng the use of insec cide treated bed nets, especially in the high malaria endemic areas, (vi) improving vector control that is suitable to local condi ons; (vii) strengthening epidemiological surveillance and outbreak
The par cipa on of malaria cadres, community health workers, and TBAs in malaria control eorts are key parts of the response strategy.
103
control systems; (viii) developing cross-sectoral interven on models such as larvaciding and biological control; and (ix) developing a capacity to assess the ecacy of the malaria control eorts. 2. Strengthening health services in preven on, control and treatment. Health services have a central role in raising awareness, control and treatment. Some improvements are needed in: (i) promo ng preven on and control in the community; (ii) ensuring early detec on and care seeking; (iii) responding to the need for case management in a mely manner; (iii) strengthening of village malaria posts (posmaldes) to reduce mortality and morbidity associated with malaria, par cularly in remote areas; and (iv) integra ng malaria program with maternal and child health program interven ons. 3. Improving capacity of human resources. To be able to carry out the strategies, the human resources need to be equipped with the appropriate skills in: advocacy, malaria detec on and rapid treatment; supply chain management, and entomology. To ensure sustainability of control programs, technical assistance and targeted training programs will be provided to ensure increased capacity at all levels. 4. Improving management structures and governance that include strategies, work programs, and informa on systems that allow monitoring for be er planning and targe ng of malaria interven ons, through: (i) strengthening program oversight with well-designed monitoring and evalua on systems that draw on a good understanding of community dynamics, and allow the incorpora on of local dierences into strategic planning; (ii) developing opportuni es for collabora on between public agencies and exploring public-private synergies, especially in awareness raising; (iii) ensuring be er use of donor support by placing it in the context of comprehensive na onal strategic planning for malaria; and (iv) controlling drug quality and use, in par cular by strengthening partnerships with research and technical en es to conduct opera onal research on the eec veness of drugs, insec cides and preven ve tools. 5. Improving nancial support. Long-term and predictable funding will be needed to maintain the sustainability of the programs, through the private sector and the interna onal community. To accelerate reducing the morbidity and mortality rates of emerging communicable diseases, the Na onal Medium-Term Development Plan (2010-2014) has set out some crucial targets that also are specied in the Presiden al Instruc on No. 3/2010, concerning Equitable Development Programs, especially related to improve malaria case detec on.
104
Priority Reducing the morbidity rate and the mortality rate of Malaria and other communicable diseases
Outputs Malaria case detec on rate per 1,000 popula on Percentage of District/Municipality conduct vector mapping Percentage of Outbreak reported and tackled
2010 2 30 100
2011 1.75 40 100
2012 1.50 50 100
2013 1.25 60 100
2014 1 70 100
Table 6.2.
Priori es, Outputs and Targets in Malaria Control Program, 2010-2014
Source: NMTDP 2010-2014, Inpres No. 3/2010, MOH Strategic Plan 20102014
Target 6C: Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases (Tuberculosis)
Current Status
The na onal surveillance report on TB prevalence shows that the number of people infected by TB is declining (Figure 6.9). Case detec on now exceeds 70 percent,10 and treatment outcomes show a success rate of 91 percent (2006). Both exceed the MDG targets of 70 and 85 percent respec vely. The TB case detec on rate has increased rapidly from 30.6 percent in 2002 to 75.7 percent in 2006. The treatment success rate has been above 85 percent since 2000, and it reached 91 percent in 2005 - 2008. Indonesia was the rst high TB burdened country in the WHO South-East Asia Region to achieve the global targets for case detec on (70 percent) and treatment success (85 percent). This performance reects increased collabora on between sub-na onal oces and private health services, as well as community-based TB care providers; increased focus on capacity building in human resources in health services, be er logis cs and a stronger TB monitoring system. Although the achievement of TB case detec on and treatment success has been rela vely sa sfactory, there remains a need to face the high incidence of Mul drug-Resistant TB (MDR-TB), resul ng from inadequate treatment of TB. With an increasing threat of MDR-TB, more focus needs to be placed on measures that adhere to interna onal standards for TB care, to improve prescrip on prac ces, ensure drug quality, and avoid interrup ons in medica on cycles. In order to increase the eec veness of TB control, Indonesia has made progress by strengthening of the Directly Observed Treatment Short-Course (DOTS) program as a na onal policy.
10
Targets are 70 percent case detec on of smear-posi ve cases under DOTS, 85 percent treatment success, to ensure that the incidence rate con nues to fall through 2015, and to reduce incidence rates and halve 1990 prevalence and mortality rates by 2015. Es mates for 1990 are prevalence 443/100,000 popula on and mortality of 91/100,000 popula on/year.
105
Figure 6.9.
The Na onal Case Detec on Rate (CDR) and Success Rate (SR) of TB (%) 1995-2009
100 90 80 70 60 50 40 30 20 10 0
91 81 73,8 54 58
87
89,5 86 86,1 86,7
91
91
91
91
Percentage
75,7 68 54 37,6 69,8
72,8 73,1
1,4 4,6
7,5
12 19 20 21
30,6
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
Source: MoH-RI, Directorate CDC, DG of CDC&EH, 2009.
SR
CDR
Challenges
1. The low household and community awareness and behaviors that increase the risk of infec on, reduce demand for services and consequently lower eec veness of na onal strategies. Advocacy, communica on and social mobiliza on (ACSM) are being pursued as part of the TB strategy, but results are s ll modest and understanding of the issues remains weak, reec ng a combina on of the following factors: (i) ACSM11 coverage is s ll low and messages may not be eec ve; and (ii) access to services is limited. In addi on, partnerships between public and private en es need to be established, which will require strong commitments of stakeholders, including professional associa ons. 2. The high case detec on rate has not been followed by the availability of adequate health care services. Detec on and treatment services for TB are not yet rou nely delivered in all health services facili es (98 percent of Puskesmas do that rou nely, but only some 38 percent of hospitals, private health facili es and peniten aries do so, and only about 2-3 percent of private prac oners. Moreover, there is signicant varia on between regions. 3. Insucient TB control policies with appropriate local strategies. To be successful, eld-level implementa on needs to pay par cular a en on to strengthening of health services and dissemina on of informa on. Interven on guidelines and ACSM need to be ed to local circumstances. Poor awareness of the TB program, and a consequently
11
ACSM is s ll a new area in TB program strategy and much more guidance and technical support is necessary. Involvement of communi es in TB care is essen al. A survey of Knowledge, A tudes and Prac ce (KAP) conducted recently reported the following ndings: (i) knowing what is TB (76 percent) and knowing that TB can be totally cured (85 percent); (ii) s gma za on according to TB (keep TB a secret if a family member had TB) is low, about 13 percent; (iii) most of the community does not know that an -TB drugs are free and provided by local health facili es (only 19 percent knew). Only 16 percent of respondents could correctly iden fy the signs and symptoms of TB.
106
2009
weak commitment to it, currently characterize many situa ons at the local level and are reected in insucient resources being allocated to the TB program. The situa on may be par cularly challenging in remote areas where the combina on of poverty and TB can be more devasta ng. 4. Beyond distribu ng informa on about TB, the informa on base needs to be improved so that policy making can be based on facts. At the present me, implementa on of some components in the TB Strategyhealth systems strengthening, par cipa on of care providers, ACSM, research (is less well understood than DOTS expansion and TB/HIV and MDR-TB rela onships, because data on the former is limited). Some surveillance has been conducted, however, informa on is sparse and insucient to support strong policy making. 5. There is a shortage of nancial resources available to combat TB in Indonesia. In the absence of integrated planning and budge ng for TB ac vi es, including the produc on of informa on that can be used, and would be used, for results management, resource use is neither ecient nor eec ve. Funding so far has mainly come from donors. However, there is a need to increase mobiliza on of local resources, including through ini a ves that draw more a en on to TB, and by means of eciency improvements in current program spending.

Mee ng the challenges in TB preven on and control program depends on strengthening some strategies: 1. Expanding DOTS coverage through health services by: (i) expanding and intensifying ACSM and facilitate access;(ii) improving poli cal support and strengthening decentraliza on programs for eec ve implementa on of DOTS; (iii) intensifying involvement of private and public services, family and community as well as work environment in inuencing behavior, increasing awareness and promo ng passive case nding; (iv) expanding access to health care and free of charge medicines; (v) improving logis c and eec ve drugs management systems; (vi) improving ac ve promo on of TB control; (vii) improving eec ve communica on to people with TB, providers and stakeholders; and (viii) improving the evalua on and monitoring system and measuring the impact of treatment under DOTS. 2. Improving capacity and quality in the TB program by: (i) strengthening laboratory diagnos c capacity in all health care facili es; (ii) implemen ng the Interna onal Standards for TB Care (ISTC) to all services; (iii) improving partnerships involving government, NGOs and the private sector in an integrated movement for na onal TB mi ga on (Gerdunas TB); (iv) ensuring availability of adequate health personnel both in quan ty and quality; (v)
107
ensuring the availability and sustainability of drug supply; (vi) improving collabora on in TB/HIV programs, (vii) strengthening public health services in providing eec ve responses to the Stop TB program; (viii) promo ng community-based treatment, vector control and other locally based preven ve interven ons; (ix) outreach that applies appropriate remote area strategies; (x) expanding case detec on rate and coverage of TB treatment and care services in all health services; and (xi) providing standardized facili es and infrastructure for TB services. 3. Enforcing policies and regula ons to build eec ve sector leadership and governance by establishing strong poli cal commitment, strong surveillance, enforcement of regula ons, as well as cross-sectoral collabora on and a monitoring and evalua on system, and promo ng evidence-based planning and decision making. It will require: (i) further strengthening the capacity of the health system to prevent and control infec ous disease reviewing surveillance and case-repor ng systems and se ng up alert and response mechanisms to lower the case fatality rate; (ii) reviewing and adjus ng the design of case detec on, diagnos c, and treatment delivery schemes to local condi ons and resources; (iii) suppor ve advisory services that facilitate adop on of correct prac ces; (iv) periodic evalua on at na onal and local levels to increase accountability and mo va on to perform; (v) periodic surveys to iden fy special risks (emergence of MRD-TB or outbreaks in prisons or health facili es); (vi) drug quality control: (vii) public-private collabora ve arrangements; and (viii) establishing TB control capacity as a district level priority. 4. Strengthening the health informa on, monitoring and evalua on system, through: (i) expanding research related to TB; (ii) improving coverage of laboratory services; (iii) implemen ng surveillance to iden fy specic risks (such as the emergence of MDR TB); and (iv) increasing availability of an eec ve health informa on system, through periodic studies about eorts to improve provision of services, reduce delays in diagnosis, and implementa on of the DOTS. 5. Promo ng the alloca on of funds to nance the Stop TB program, through promo ng an appropriate alloca on of resources, both at the central level and among local authori es. The local commitment in alloca ng funds to local government budgets (APBD) to TB as part of MSS (Minimum Services Standards) as well as the MDGs is crucial since both are na onal and local priori es in health development. Therefore, strengthening policies and fostering local ownership are key strategies to ensure the sustainability of the TB Program by reducing dependency of the local level on central transfers and external funds, while strengthening partnerships with other sectors and the private sector. In order to accelerate the achievement of the targets in reducing the incidence and death rate related to TB, the Na onal Medium-Term Development Plan (2010-2014) sets targets for the following ac vi es and indicators as described in the table below:
108
Priority
Indicators Prevalence of TB per 100,000 popula on Propor on of Tuberculosis cases detected under directly observed treatment shortcourse (DOTS) Propor on of Tuberculosis cases cured under directly observed treatment short-course (DOTS)
2010 235 73
2011 231 75
2012 228 80
2013 226 85
2014 224 90
Table 6.3.
Priori es, Outputs and Targets in Reducing Morbidity and Mortality Rate Related to TB, 2010-2014
Reducing the morbidity and mortality rates of TB
85
86
87
87
88
Source: NMTDP 2010-2014, Inpres No. 3/2010.
109
110
Maintaining replanted mangrove trees
Goal 7: Ensure Environmental Sustainability
Target 7A: Integrating the principles of sustainable development in national policies and programs and reversing the loss of environmental resources
Current Status
The ra o of actual forest cover to the total land area based on the review of satellite imagery and aerial photographic surveys was 52.43 percent in 2008, a reduc on of forest cover as compared with the baseline year of 1990 when forest cover was 59.97 percent.
Figure 7.1.
The Percentage of Forest Cover of the Total Land Area of Indonesia from 1990 to 2008
Source: Ministry of Forestry (1990-2008).
Degrada on of Indonesias forests and reduc on in biodiversity occurred on a large scale prior to 2002 due to unsustainable forest management prac ces, illegal logging, forest res,
113
and conversion of forest lands to other uses. The rate of forest degrada on between 2000 and 2005 was es mated to be 1.089 million hectares per year, a reduc on as compared to 1.6 million hectares per year during 1985 - 1997 and 2.1 million hectares between 1997 and 2001.
Figure 7.2.
Total Energy Use of Various Types for the Years 1990-2008 (Equivalent to Barrels of Oil (BOE) in Millions)
Source: Ministry of Energy and Mineral Resources.
The ra o of energy use per GDP in Indonesia has tended to decline. This reects the increasing eciency in the use of energy. Nevertheless, the use of nonrenewable energy in Indonesia more than doubled between 1990 and 2008. Besides causing emissions that aect climate change, the availability of non-renewable energy is becoming more limited. This in turn increases the threat of an energy crisis in the future. The consump on of ozone deple ng substances (ODS) has been signicantly reduced in accordance with the Montreal Protocol. The Indonesian government ra ed the Montreal Protocol through Presiden al Decree No. 23 of 1992 on the Elimina on of the Consump on of
Figure 7.3.
Ozone Deple ng Substance Consump on in Indonesia from 1992 to 2008
10,000 9,000 Consump on in ODP tonnes 8,000 7,000 6,000 5,000 4,000 3,000 2,000 1,000 0 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Source: Ministry of Environment.
ODS was phased out (CFC, Halon, CTC, TCA, MBr) HCFCs
114
Ozone Deple ng Substances, and a regula on prohibi ng the importa on of ozone deple ng substances was enacted in 1998 and revised in 2006 by the Ministry of Trade. Although since 1998 the import of CFCs and goods related to the CFC has been ocially banned, there are s ll indica ons of illegal importa on and trade in ODS. As the largest archipelagic country in the world, control over the smuggling, illegal importa on and use of ODS is very dicult.
Challenges
Global warming is leading to climate change and having nega ve impacts on the environment. Indonesia is vulnerable to the nega ve impacts of climate change, and na onal ac ons are needed, both to mi gate global climate change and implement steps to empower the people of Indonesia to adapt to the nega ve impacts of climate change, including sea level rise, more variable rainfall pa erns that can cause oods and droughts, and other environmental changes. If appropriate steps are not taken, many regions in Indonesia will experience water supply shortages, declining crop yields, and reduced produc vity of coastal ecosystems. The government is working to increase forest cover through rehabilita on of 2.5 million hectares during 2010-2014. In addi on, ini a ves are being taken to reduce deforesta on and forest degrada on through preven on of illegal logging, forest res and encroachment on forest lands. Indonesia announced the target to reduce CO2 emissions by 26 percent from Business as Usual (BAU) condi ons in 2020 in the forum of the United Na ons Framework Conven on on Climate Change in Copenhagen in December 2009. The target will be increased up to 41 percent with interna onal assistance. Reduc on of global warming requires interna onal partnerships, and Indonesia is commi ed to cooperate ac vely with the world community in dealing with the important issues related to climate change.

In accordance with the Na onal Long-Term Development Plan (2005-2025) and the Na onal Medium-Term Development Plan (2010-2014), development policies will be directed to achieve a sustainable pa ern of natural resource use and environmental management. Na onal plans and policies will be focused on improving coordina on among the ins tu ons directly involved in environmental management, building capacity for these ins tu ons at all levels, and strengthening the enforcement of laws and regula ons governing environmental management in Indonesia. The steps that the government has already implemented include the following: To overcome
115
the rate of deforesta on, in 2008 the government increased the total area of protected forests and protected aqua c waters signicantly. Comba ng illegal logging is being carried out in various areas to maintain the forest cover and protect conserva on areas. The government has also launched a na onal movement of rehabilia on of forests and cri cal lands. In addi on, the government is socializing and providing scal and non-scal incen vies to promote energy saving measures and use of more ecient, environmentally friendly and renewable alterna ve energy sources. Through the ozone layer protec on program, the government has and will con nue to maintain the ban on the use of materials that have been legally banned. Law Number 30/2007 has mandated increased use of New and Renewable Energy as an eort to diversify, and implementa on of this law will become the responsibility of central and local governments. The government, for example, has already launched a 10,000 MW electricity program Phase II which has renewable energy as its main energy source, especially geothermal energy which comprises 39 percent. The policy framework and strategy have been translated into programs and ac vi es in the Na onal Medium Term Development Plan (RPJMN 2010-2014) as follows:
Table 7.1.
Annual Implementa on Targets from the Na onal Medium-Term Development Plan to Improve Natural Resource Management
Priori es
Output / Indicators
2010
2011
2012
2013
2014
Rehabilita on of cri cal lands and forest reclama on Implementa on of Forest and Land Rehabilita on Facilitate the rehabilita on of mangrove forests, peat and swamp areas (295 000 ha)
60,000 Ha
120,000 Ha
180,000 Ha
240,000 Ha
295,000 Ha
Reduced area of cri cal lands through rehabilita on and reclama on of forests Facilitate and implement forest rehabilita on in priority catchment areas Implementa on of Land Reclamaon and Forest Rehabilita on in Priority Watersheds Facilitate land rehabilita on in the priority catchment areas Facilitate development of the urban forest areas Facilitate rehabilita on of mangrove forests, peat and swamp areas
160,000 Ha
320,000 Ha
480,000 Ha
640,000 Ha
800,000 Ha
100,000 Ha
200,000 Ha
300,000 Ha
400,000 Ha
500,000 Ha
1,000 Ha
2,000 Ha
3,000 Ha
4,000 Ha
5,000 Ha
60,000 Ha
120,000 Ha
180,000 Ha
240,000 Ha
295,000 Ha
116
Con nued Table 7.1.

Priori es Output / Indicators 2010 2011 2012 2013 2014
Improved forest management through community empowerment Facilitate establishment of community forest management areas (HKM), covering 2 million ha. Facilitate 500 group / unit management business license HKM Facilitate 50 partnership units HKM Social Forestry Development Facilitate ins tu onal support food security in 32 provinces Facilitate community forest development partnership for industrial wood raw materials covering 250 000 ha Facilitate establishment and func oning of the center at 30 HHBK districts Targeted working area of 500,000 ha of village forests
400,000 ha
800,000 ha
1,200.000 ha
1,600.000 ha
2,000.000 ha
100 groups
200 groups
300 groups
400 groups
500 groups
10 Unit
20 Unit
30 Unit
40 Unit
50 Unit
4 Prov
8 Prov
16 Prov
22 Prov
32 Prov
50,000 ha
100,000 ha
150,000 ha
200,000 ha
250,000 ha
6 Districts
12 Districts
18 Districts
24 Districts
30 Districts
100,000 ha
200,000 ha
300,000 ha
400,000 ha
500,000 ha
Increased quality of conserva on policies and forest damage control and integrated land management with various ministries and ins tu ons including, with the Ministry of Forestry, BPN and Local Governments Number of conserva on policies nalized to control forest destruc on and land use issued (the criteria and guidelines) are coordinated among the concerned ins tu ons Conserva on and Improvement of Control of Forest and Land Degrada on Data on hotspots in eight provincial land and forest res that are desseminated to the concerned ministries and ins tu ons An implementa on mechanism for land and forest re preven on in eight provincial land and forest res are coordinated among the concerned ministries and ins tu ons
80%
80%
80%
80%
80%
117
Con nued Table 7.1.

Priori es Output / Indicators Detailed data on land and forest damage in 11 priority watersheds and and areas poten ally prone to landslides are coordinated among the concerned ministries and ins tu ons The data of land cover and land use change (landuse change) compiled through the Program Go Green Indonesia Number of provinces (ecosystem approach) that are monitored according to the data and the poten al for disaster % of conserva on policy recommenda ons and control of forest destruc on and land area of the provinces implemented are monitored each year 2010 2011 2012 2013 2014
80%
80%
80%
80%
80%
100%
100%
100%
100%
100%
10
15
20
25
30
50%
50%
50%
50%
50%
Management of the 20% area of coral reefs, seagrass, mangrove and 15 species of endangered aqua c biota Sea and freshwater conservaon areas and sustainably managed brackish areas Number of conserva on areas and protected aqua c biota species iden ed and mapped accurately 900 thousand Ha 900 thousand Ha 900 thousand Ha 900 thousand Ha 900 thousand Ha
Management and Conserva on Development Areas
9 areas / 3 types
9 areas / 3 types
9 areas / 3 types
9 areas / 3 types
9 areas / 3 types
Improved system blackout preven on, mi ga on, impacts to land and forest res Hotspots on the islands of Borneo, Sumatera, and Sulawesi reduced by 20% each year The area of forest re is reduced compared to 2008 condi ons
20%
36%
48.8%
59.2%
67.2%
Forest Fire Control
10%
20%
30%
40%
50%
Adequacy of policies, data and informa on to control land and forest res is integrated and coordinated with the concerned ministries and ins tu ons Conserva on and Improvement of Forest and Control of Land Degrada on Data on the distribu on of hotspots/ forest res in eight Provinces disseminated to the ministries/ departments, to monitor the success of the implementa on mechanisms for the preven on of forest res
80%
80%
80%
80%
80%
Implementa on of integrated watershed management in priority watersheds Integrated watershed management plan in 108 priority watersheds (DAS) Build a base line data on the 36 watershed management BPDAS Provision of data and maps of cri cal land in 36 BPDAS
22 DAS
44 DAS
66 DAS
88 DAS
100 DAS
Development of Watershed Management
7 BPDAS
14 BPDAS
21 BPDAS
28 BPDAS
36 BPDAS
7 BPDAS
14 BPDAS
21 BPDAS
28 BPDAS
36 BPDAS
118
Con nued Table 7.1.

Priori es Output / Indicators 2010 2011 2012 2013 2014
Availability of integrated water quality management policy tools among the concerned ministries and ins tuons % Se ng classica on of water at the district/ municipality level for 13 rivers in 119 priority districts and ci es, with coordina on across the concerned ministries, ins tu ons and local governments Management of Water Quality and Peat Areas Number of technical assistance to 119 water quality management districts / ci es in 13 watersheds coordinated with the concerned ministries / ins tu ons Number of technical assistance to 119 water quality management districts / ci es in 13 watersheds coordinated with the concerned ministries / ins tu ons
25%
25%
20%
20%
10%
20%
20%
20%
20%
20%
20%
20%
20%
20%
20%
The physical model for CO2 absorb on, perfec ng and tes ng produc on Technology for Control and Mi ga on of the Impacts of Global Warming Policy recommenda ons to reduce emissions and increase carbon sinks and pilot plant photobioreactor for CO2 absorb on
Priori es Increased use of renewable energy including geothermal energy to reach 2000 MW in 2012 and 5000 MW by 2014 the commencement of coal bed methane produc on to generate electricity in 2011 accompanied by the u liza on of solar energy poten al
Output / Indicators
2010
2011
2012
2013
2014
Table 7.2.
Selected Annual Implementa on Targets in the Na onal Medium-Term Development Plan to Achieve Sustainable Use of Energy Resources
Contribu on to achieving the target of 10,000 MW geothermal power plants in the phase II program Total installed capacity of geothermal power plants. Amoun ng to 5795 MW in year 2014
1,261
1,419
2,260
3,000
5,795
The realiza on of new renewable energy and energy conserva on op ons Lisdes (EBT) - PLTS 50 Wp - PLTMH (kW) - PLT Wind (kW) Managing the provision of EBT and Implementa on of Energy Conserva on - Biomass (MW) - The number of ocean energy feasibility studies - Number of Pilot Projects genera ng electricity from ocean energy resources DME 3.55 1.53 0 0 1 24.49 10.42 5.16 0.1 1 24.59 10.9 5.32 0.1 1 24.69 11.38 5.55 0.1 1 27.78 11.94 5.64 0.1 1
50
50
50
50
50
119
Target 7B: Reduce biodiversity loss, achieving, by 2010, a significant reduction in the rate of loss
Current Status
Indonesian biodiversity is threatened due to the u liza on of natural resources in unsustainable ways. Transfer of some ecosystems into areas to be used for industry, residences, transporta on and other uses has had a nega ve impact on biodiversity. The average rate of degrada on of forest ecosystems in the period 2000-2005 reached 1.09 million hectares per year. During the last 50 years, damage to coral reefs has increased from 10 percent to 50 percent. Between 1989 and 2000, the percentage with 50 percent live coral reef popula ons has declined from 36 percent to 29 percent. Reduc on of biodiversity has occurred, not only at the level of ecosystems, but also at the level of species and gene c diversity. Interna onal Union for Conserva on of Nature (IUCN) Red List data reports that 772 species of ora and fauna are threatened with ex nc on. Meanwhile, approximately 240 rare plant species have been declared endangered and some sh species are also threatened with ex nc on.
Challenges
Deprecia on of gene c diversity, par cularly species of wild animals and plants, is not well documented. Discussions on gene c erosion in the eld of agro-ecosystems may also be true for wild species. Since not all gene c erosion occurring in wild species is known, Indonesia may have lost "pearls" without a chance to know the value and benet lost.

The Indonesian government launched the Indonesian Biodiversity Ac on Plan (BAPI) in 1993 as a document to set priori es and investment in biodiversity conserva on and this plan was used in preparing the h and sixth Five Year Development Plans (un l 1999). BAPI aimed to preserve biodiversity through reduced degrada on of ecosystems, development of the database, and providing support to the management of sustainable natural resources. This document was published before the ra ca on of the United Na ons Conven on on Biological Diversity (UNCBD) through Law No. 5 / 1994.
120
Ten years later, BAPI was updated into the "Indonesia Biodiversity Strategy and Ac on Plan (IBSAP)". In order to address the various issues specied in the UNCBD and learning from the BAPI experience, IBSAP was built through a par cipatory process and addressed more current environmental problems. IBSAP iden ed a number of needs, ac ons, opportuni es, new challenges and obstacles in implemen ng biodiversity conserva on. Conserving biodiversity is one of the priori es in natural resources management as contained in the Na onal Medium-Term Development Plan (2010-2014). Eorts to conserve biodiversity and expand protec on of endangered species is illustrated with clear indicators and targets to be achieved, namely: 1. Improving biodiversity conserva on a) Biodiversity conserva on policy b) Monitor the implementa on of biodiversity conserva on c) Facilitate the development of Biodiversity Parks 2. Development and conserva on of essen al ecosystems a) Reduce conict and pressure on na onal parks and other conserva on areas b) Improving the management of essen al ecosystem c) Improved management of problems resul ng from encroachment of conserva on areas d) Recovery of conserva on areas 3. Inves ga on and security protec on forest a) Reduce forest crime b) Finaliza on of cases of crime in conserva on areas 4. Development of species and biodiversity conserva on gene cs a) Enhance biodiversity and endangered species popula ons b) Cap ve c) Interna onal and regional coopera on 5. Forest re control a) Reduce the number of hot spots b) Reduce the burned area c) Improving human resource capacity in controlling forest res 6. Environmental services and ecotourism development 7. Management and development of ecosystem and species conserva on in coastal zones and marine areas a) Improved management of ecosystems of coral reefs, mangroves, sea grass, etc. b) Iden ca on and mapping of marine conserva on areas and protected species
121
Target 7C: Halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation
Current Status
The propor on of Indonesian households with access to improved drinking water and sanita on has con nuously increased. However, the number of households who have sustainable access to improved water and sanita on has only reached 47.71 percent and 51.19 percent respec vely. Therefore, greater a en on is required to reach the MDG targets for access to improved drinking water (68.87 percent) and sanita on (62.41 percent) in 2015. DRINKING WATER Improved drinking water is dened as water from a protected water source located more than 10 meters from sewage and shielded from any other sources of contamina on. Access to improved sources of drinking water has been increased from 37.73 percent of households in 1993 to 47.71 percent in 2009 (Figure 7.4). Access to improved sources of drinking water tends to be higher for urban households as compared to those in rural areas. The rela vely low levels of access to improved drinking water supply reects the slow rate of development of drinking water infrastructure, par cularly in urban areas where development has not matched the growth rate of popula on. In addi on, many water supply facili es are not operated and maintained well. To achieve the MDG target by 2015, priority should be given to ini a ves to expand access to improved water supplies, both in rural and urban areas.
Figure 7.4.
Propor ons of Rural, Urban and all Households with Access to Improved Drinking Water Sources in Indonesia (1993-2009)
80
Urban+Rural:
59.5
75.3 % 68.9 %
58.2 57.3 56.8 55.6 54.6 54.1
70
53.8 54.9 52.7 53.0 50.6 51.5 51.7
50.2
Percentage
50 40
46.0
43.9
42.9
40.4
40.3
41.0
41.5
42.7
43.0
45.7
49.8
60
65.8 %
TARGET MDG
35.9
35.6
31.6
34.5
30.8
20 10
37.7 37.7 38.0 41.3 42.7 42.0 42.2 37.5 48.7 48.3 47.7 48.8 47.6 47.8 48.3 46.5
30.7
31.3
30
35.2
Notes: Data does not include Timor Timur.
0
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
TOTAL
URBAN
RURAL
122
47.7
Signicant dispari es among provinces remain in terms of access to improved drinking water. As shown in Figure 7.5, the provinces with the highest propor on of households with access to improved drinking water sources in 2009 were: DI Yogyakarta, Bali and Southeast Sulawesi. Banten, Aceh, and Bengkulu were the three provinces with the propor on of households with the lowest propor ons of households with access to improved drinking water sources.
90 80 70 60 50 40 30 20 10 0
Figure 7.5.
Percentages of Households with Access to Improved Drinking Water Sources by Urban and Rural Popula ons by Province (2009)
27.47 30.60 33.02 34.81 35.44 36.84 36.89 37.74 40.29 40.51 40.96 42.92 43.75 44.36 44.49 44.85 44.96 45.45 46.62 47.71 48.08 48.53 50.13 51.04 51.19 51.97 54.02 55.50 55.70 55.71 58.30 59.12 59.99 60.38
Percentage
Banten Aceh Bengkulu DKI Jakarta Papua Bangka Belitung Kalimantan Tengah Kepulauan Riau Lampung Jawa Barat Riau Sulawesi Barat Maluku Utara Sulawesi Tengah Sulawesi Utara Gorontalo Nusa Tenggara Barat Nusa Tenggara Timur Sumatera Barat INDONESIA Papua Barat Sumatera Selatan Sulawesi Selatan Sumatera Utara Jambi Kalimantan Selatan Kalimantan Barat Maluku Jawa Timur Kalimantan Timur Jawa Tengah Sulawesi Tenggara Bali DI Yogyakarta
TOTAL
URBAN
RURAL
SANITATION Improved sanita on is dened as facili es that are safe, hygienic, and comfortable and that can separate users and the surrounding environment from contact with human feces. The propor on of households in Indonesia with access to improved sanita on facili es more than doubled, from 24.81 percent in 1993 to 51.19 percent in 2009 (Figure 7.6). However, progress has s ll been slower than in other countries in the region with similar levels of economic development.
Figure 7.6.
100 90
66.7 69.5
MDGs TARGET
80
57.7 56.9 57.3 56.6 56.7 59.2
70
53.6
53.7
54.1
64.7
76.8 62.4 55.6
The propor on of households with access to adequate sanita on in rural, urban and total rural and urban, 1993-2009
51.1
51.2
49.4
45.0
35.6
35.6
38.1
50
27.5
24.8
20.7
22.5
20
17.3 17.4 12.2 11.1 9.6 12.1 14.2 15.6
10 0
17.3
18.0
20.6
28.6
31.4
34.0
30
21.9
25.2
27.5
28.9
40
32.6
32.7
34.3
35.0
44.2
48.6
60
51.2
Note: Data does not include Timor Timur
Source: BPS, Susenas 1993 2009.
URBAN
RURAL
TOTAL
123
Popula on growth is the main challenge faced in increasing access to improved sanita on, especially in urban areas where the popula on growth rate is higher than the na onal popula on growth rate. Looking at the trend of increasing access to improved sanita on over the years, Indonesia must give special a en on to expanding access to improved sanita on to achieve the MDG target in 2015.
Figure 7.7.
Propor ons of Households with Access to Improved Sanita on Facili es by Rural/ urban Areas by Province (2009)
100 90 80 70
Percentage
60 50 40 30
14.98 21.65 28.78 32.63 34.66 38.43 38.69 39.21 39.83 40.12 40.93 41.16 41.48 42.02 42.03 43.18 43.84 45.35 45.78 45.91 51.07 51.19 51.92 52.17 52.75 54.06 57.58 58.48 58.82 60.66 63.59 75.35 75.95
10 -
There is a wide gap between urban and rural areas in terms of access to improved sanita on, and this gap varies among provinces. Na onwide, 69.51 percent of urban popula ons have access to improved sanita on facili es compared to only 33.96 percent in rural areas. In terms of the gap in access to improved sanita on between rural and urban areas, there are 21 provinces with a larger gap than the na onal average, with the largest gap found in the provinces of Kepulauan Riau, Maluku Utara and Kalimantan Barat.
Challenges
The major challenges in increasing access to improved drinking water and sanita on include the following: 1. Incomplete and outdated regula ons that support the provision of drinking water and sanita on. A number of exis ng laws are not in accordance with current condi ons, for example, Act No. 5 of 1962 regarding Regional Companies has not been revised, making it dicult for Municipal Water Companies (PDAM) to encorporate. 2. The absence of a comprehensive policy across sectors in the provision of improved
124
Nusa Tenggara Timur Papua Kalimantan Tengah Papua Barat Bengkulu Lampung Maluku Sumatera Barat Nusa Tenggara Barat Kalimantan Barat Jambi Kalimantan Selatan Sumatera Selatan Sulawesi Tengah Aceh Maluku Utara Gorontalo Sulawesi Barat Kepulauan Riau Sulawesi Tenggara Jawa Timur INDONESIA Sumatera Utara Jawa Barat Riau Jawa Tengah Sulawesi Selatan Kalimantan Timur Banten Bangka Belitung Sulawesi Utara DI Yogyakarta Bali DKI Jakarta
TOTAL
URBAN
RURAL
80.37
20
drinking water and sanita on. Many ins tu ons and agencies are responsible for development of drinking water and sanita on, and there is a need for more intensive coordina on, especially at the level of program implementa on. 3. Declining quality and quan ty of drinking water. There are s ll many households that rely on non-piped drinking water sources of poor quality. At the same me there are many on-site sanita on systems which have not been established with adequate investment in infrastructure, storage, processing, and disposal of fecal waste, and this increases the likelihood of contamina on of water sources. 4. Lack of balance between popula on growth, especially in urban areas with development of infrastructure for improved drinking water and sanita on. The level of investment in the provision of piped water connec ons, especially in urban areas, is not in balance with the rate of urban popula on growth. Similarly, investments in the provision of water service connec ons, centralized municipal sewerage systems and communal scale systems have been less than adequate. 5. Community awareness of hygienic and healthy prac ces (PHBS) remains low. Unsanitary behavior is reected in the high incidence of diarrhea, which reached 411 per 1,000 inhabitants (MOH, Diarrhea Morbidity Survey, 2010). Hand washing with soap is s ll not common; some 47 percent of households s ll defecate in open areas, and although almost all households boil water for drinking, some 48 percent of their water s ll contains E.coli bacteria. 6. Limited number of providers to supply improved drinking water, including both Municipal Water Companies (PDAM) and non-PDAM (credible and professional), especially in urban areas. An audit completed in 2008 showed that only about 22 percent of publicly owned water companies are func oning properly. Determina on and se ng of taris does not meet the cost recovery principle (full-cost recovery), and about 55.51 percent of the PDAM are s ll applying an average tari below the cost of water produc on. 7. The capacity of local governments to manage the drinking water and sanita on sector is limited, although the provision and management of improved drinking water and sanita on has become the responsibility of the local governments. Planning and budge ng for the provision of improved drinking water and sanita on has not become a priority of local governments, and this is reected in the low budget alloca ons of regional governments in support of the development of infrastructure to provide improved drinking water and sanita on. 8. Investment in drinking water supply and sanita on systems is s ll inadequate, both from the government and the private sector. This results from a tendency to rely on central government funding. The low nancial performance of the municipal water
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supply companies also constrains op ons to seek alterna ve nancing. Funding from the private sector, either in the form of Public Private Partnerships (PPP) or Corporate Social Responsibility (CSR) has not yet been u lized on a large scale.

The direc on of policies and strategies to improve public access to improved drinking water and sanita on are as follows: 1. The Ministry of Public Works and municipal water u li es (PDAM) will work to increase public access to improved drinking water through the development and improvement of water systems, maintenance, development and improvement of transmission and distribu on networks, especially in urban areas. In rural areas, the development of drinking water systems will be community-based with support jointly by the Ministry of Public Works and the Ministry of Health. Alloca on of funding from Central Government will give priority to the poor. The central government will also encourage and facilitate the provision of drinking water for middle and higher income groups through improved service performance by the PDAM with support provided through technical assistance and nancing. In addi on, the government has allocated a special alloca on fund (DAK) for drinking water which is intended to op mize the exis ng infrastructure services of drinking water and also for the construc on of new systems in small towns, remote, coastal and rural areas. 2. To increase access of households to improved sanita on, the future policy of investment is aimed at improving the management of centralized wastewater systems and the provision of community-based sanita on with a focus on services for the poor. Investment will be focused on the development of centralized wastewater treatment systems on a city-scale basis (o-site), construc on of sewerage systems (on-site) and also the development and improvement sewage processing facili es (IPLT). To increase the pace in the provision of sanita on services, the government has launched the Program to Accelerate the Development of Sanita on (PPSP) 2010-2014 which stresses that sanita on is a concern of all par es, including the government, the private sector, donors, and the community. At the same me, DAK funding will be used to increase coverage of sanita on services in densely populated urban areas through the community-based sanita on approach (SANIMAS). Eorts will be made to increase public awareness about the importance of improved drinking water and sanita on, and the Ministry of Health will expand implementa on of the Community Based Total Sanita on (STBM) during 2010-2014 to eliminate the prac ces of defeca on in open space by the end of 2014. 3. Improving the regulatory framework at central level and regional levels to support provision of improved drinking water and sanita on, through the addi on, revision, and deregula on of the laws.
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4. Ensuring the availability of drinking water, through the control of ground water use by domes c and industrial users; protec on of ground and surface water from sources of domes c pollu on through increased coverage of sanita on services, as well as the applica on of technology and development of alterna ve water sources including water reclama on. 5. Increasing public awareness about the importance of healthy behavior, through communica on, informa on and educa on as well as improvement of drinking water and sanita on facili es in schools as part of eorts to improve the hygienic behavior of students and communi es. 6. Improving the planning system for development of drinking water and sanita on systems, through the prepara on of master plans for drinking water systems (RIS-SPAM) based on community based ini a ves; prepara on of City Sanita on Strategies (SSK), aligned with the RIS-SPAM, as well as monitoring and evalua ng of implementa on. 7. Improving the management of drinking water and sanita on through: (a) prepara on of business plans, implementa on of corpora za on, asset management and human resource capacity building, both for ins tu ons and communi es; (b) increasing coopera on among government agencies, between government and society, between government and the private sector, and among government, the private sector and the public; (c) improving the linkage between the management system applied by communi es with those of the government, and (d) op mizing the u liza on of nancial resources. 8. Increasing local investment spending to improve access to improved drinking water and basic sanita on that is focused on services for urban popula ons, especially the poor. 9. Improving the investment climate to s mulate ac ve par cipa on of the private sector and the community through Public Private Partnerships (PPP) and Corporate Social Responsibility (CSR), and also for the development and marke ng of appropriate technology for water supply systems and sanita on systems. The accelera on of the achievement of the MDGs by 2015, especially regarding the provision of improved drinking water and sanita on has been dened in the Na onal Medium-Term Development Plan, as presented in the following table:
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Table 7.3.
Annual Implementa on Targets to Improve Access to Improved Drinking Water Sources and Basic Sanita on 2010-2014.
Priori es
Outputs Percentage of households with access to improved drinking water source Percentage of drinking water quality that meets the requirements
2010
2011
2012
2013
2014
62
62.5
63
63.5
67
85
90
95
100
100
Improving surveillance and monitoring of environmental quality Percentage of popula on that have access to basic sanita on
64
67
69
72
75
Number of villages where Sanitasi Total Berbasis Masyarakat (STBM) will be implemented Number of urban areas facilitated to improve water sources Number of rural areas facilitated to improve water sources Number of areas with improved infrastructure developed for syistem o-site sewerage Number of areas with infrastructure development and waste water facili es with on-site sewerage systems
2,500
5,500
11,000
16,000
20,000
218 area 31 areas and 1,472 villages 9 districts/ ci es
244 areas 30 areas and 1,165 villages 11 districts/ ci es
Improve the development of drinkig water supply systems
260 areas 30 areas and 500 villages
315 areas 30 areas and 1,000 villages
360 areas 32 areas and 700 villages
11 districts/ ci es
11 11 districts/ districts/ ci es ci es
Source: Na onal Medium Term Development Plan ( RPJMN 20102014) and Inpres no.3/2010
Improve the development of sanita on infrastructure
30 districts/ ci es
35 districts/ ci es
40 districts/ ci es
50 55 districts/ districts/ ci es ci es
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Target 7D: By 2020, to have achieved a significant improvement in the lives of at least 100 million slum dwellers
Current Status
The propor on of households living in Figure 7.8. urban slums in Indonesia has declined The Propor on of Urban Households Living in Slums, by 8.63 percentage points from 1993. 1993 and 2009 Many ini a ves have been carried out to improve the welfare of urban households, but 12.12 percent of urban households are s ll found to be living in slums (see Figure 7.8). The Government of Indonesia has implemented many programs to improve the lives of slum dwellers, including: the Kampung Improvement Program (KIP), Source: BPS, Susenas. urban renewal, the Urban Poverty Project (UPP), the Community-Based Ini a ves for Housing and Local Development (CoBILD), and the Neighborhood Upgrading and Shelter Sector Program (NUSSP). In addi on, several ini a ves to empower those who live in urban slums are being implemented, including the Na onal Community Empowerment Program (PNPM Mandiri) with technical support from various na onal ministries. Signicant disparites are found among provinces in the propor on of the urban popula ons categorized as slum households. As seen in Figure 7.9, the provinces where with the highest percentage of slum households are found are Nusa Tenggara Timur, Papua and DKI Jakarta. The provinces with the lowest propor ons of slum households are DI Yogyakarta, Jawa Tengah and Kalimantan Barat. The lowest propor on of slum households for a province is 5.10 percent (DI Yogyakarta) while the highest propor on is 28.85 percent (Nusa Tenggara Timur).
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Figure 7.9.
The Propor on of Urban Slum Households by Province, 2009
Percentage
35
5.1 5.6 5.7 7.6 7.7 7.9 8.5 8.5 8.6 8.6 9.0 9.7 9.8 10.5 10.7 10.9 12.1 12.5 13.3 13.3 13.3 14.0 14.1 14.1 14.6 15.7 17.0 18.8 19.1 21.4 24.0 25.1 25.4 DI Yogyakarta Jawa Tengah Kalimantan Barat Maluku Utara Jambi Sumatera Utara Bangka Belitung Sumatera Barat Sulawesi Selatan Jawa Timur Kalimantan Selatan Kalimantan Timur Aceh Riau Sulawesi Tenggara Lampung INDONESIA Gorontalo Bali Kalimantan Tengah Bengkulu Sumatera Selatan Sulawesi Tengah Kepulauan Riau Jawa Barat Banten Sulawesi Utara Maluku Sulawesi Barat Papua Barat Nusa Tenggara Barat DKI Jakarta Papua Nusa Tenggara Timur
30 25 20 15 10 5 0
Source: BPS, Susenas.
Challenges
Aside from the regional dispari es, the major challenges in reducing the propor on of urban slum households in Indonesia are as follows: 1. Limited access of low-income households to land for housing in urban areas; 2. Limited access to housing nance; 3. Limited capacity of the government and the private sector to build aordable houses; 4. Limited provision of basic facili es for urban se lements; and 5. Previous programs have produced less than op mal results in improving the lives of slum dwellers.

The direc on of policies and strategies is to fulll the needs of the urban poor for adequate, safe and aordable housing. Several steps have been taken to improve the provision of decent and aordable housing for low-income communi es through development of public housing for rent, facilita on of development of new housing and improvement in the quality of selfhelp housing and the provision of infrastructure, facili es and u li es for self-help housing, as well as facilita ng the provision of land. Addi onal ini a ves will increase access of low income households to decent and aordable housing through a liquidity facility, and microcredit for housing and na onal housing savings. Other priori es are to improve the quality of residen al environments through the provision of infrastructure, basic facili es, and adequate public u li es, integrated with real estate development to realize ci es without slums.
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28.9
The Na onal Medium-Term Development Plan (2010-2014) has set priori es and targets to reduce the number of households living in urban slums in order to accelerate the achievement of this MDG, as shown in Table 7.2. Eorts to achieve these targets will be implemented by the Ministry of Public Works, the Ministry of Housing, provincial governments, district / city governments and urban communi es.
Table 7.4.
2013 30 30 5,200 15 2014 22 22 3,458 21 Implementa on Targets to Reduce the Propor on of the Popula on Living in Slums
Targets Priori es Indicators 2010 Prepara on of ac on plans on urban slums at district/ municipality level Regula ons, Guidance, Control and Opera on in the Development of Se lements Urban slum areas to be improved Units of apartment dwellings built up with suppor ng infrastructure Se lement infrastructure improved in low income residen al areas Facilita on and promo on of environmental planning for slum areas Facilita on and promo on of development of self-help housing Facilita on and promo on of selfhelp improvement of housing Facilita on and promo on of selfhelp infrastructure Number of slum areas facilitated 50 Number of self-help new housing construc on ini a ves Number of self-help improvement of exis ng housing ini a ves Number of ini a ves to facilitate and s mulate self-help improvement of infrastructure, facili es and u li es Number of mul -story low rent housing units built (Rusunawa) 100 150 175 180 95 95 3,960 104 2011 30 30 7,041 50 2012 30 30 7,041 50
7,500 7,500
12,500 12,500
16,250 16,250
7,500 7,500
6,250 6,250
7,500
12,500
16,250
7,500
6,250
Development of mul -story low rent housing units*
100
100
180
Source: Na onal Medium Term Development Plan 2010-2014. Note: *) Simplied Rental Housing Development es mated 30 percent for low-income communi es.
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132
G-20 Summit in Pi sburgh, September 24-25, 2009
Goal 8: Develop a Global Partnership for Development

Indonesia is ac vely engaged with the interna onal community in working to improve governance of interna onal trade, investment and transfer of technology to accelerate achievement of the MDGs. Indonesia works to achieve a more equitable and dynamic pa ern of global partnerships as a member of mul lateral ins tu ons, including the United Na ons, the World Trade Organiza on (WTO), the Associa on of Southeast Asian Na ons (ASEAN), the Interna onal Monetary Fund (IMF), the World Bank Group (WBG) and the Asian Development Bank (ADB). Indonesia also par cipates with the interna onal community in many interna onal and regional forums including the Group of Twenty (G-20) and the Asia Pacic Economic Coopera on Forum (APEC) to promote collabora on on issues related to economic development and trade between emerging economies and developed economies. Indonesia, along with other Sherpas from ten countries (Norway, Netherlands, UK, Australia, Brazil, Chile, Mozambique, Tanzania, Liberia and Senegal) have established a Network of Global Leaders for Global Campaign on Health MDGs (NGL 45) with the sole purpose of garnering interna onal support on one of the most neglected and cri cal social MDGs, child and maternal mortality. Indonesia has built a wide network of strong bilateral partnerships to promote equitable development and trade, including south-south and triangular coopera on. Indonesia is commi ed to achieving produc ve partnerships with the private sector while maintaining a conducive investment climate to increase domes c and foreign private investment. Public private partnerships are encouraged to promote economic growth and improve provision of public services. The goal of the government is to seek quality investments that create jobs and reduce social inequality. The United Na ons Conference on Trade and Development recently ranked Indonesia as one of the top ten most a rac ve des na ons for foreign direct investment globally. In nancing na onal development, the Government of Indonesia will con nue to rely on foreign grants and loans, although funding from interna onal sources is expected to decline as a propor on of the na onal budget. To support u liza on of foreign loans, the government will proceed with cau on and borrow from interna onal sources that provide the most favourable terms and condi ons while protec ng Indonesias interna onal posi on. To best accomplish this approach, the government works to strengthen interna onal partnerships and to improve the eec veness and eciency in u liza on of foreign grants and loans to support na onal development.
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Target 8A: Develop further an open, rule-based, predictable, non-discriminatory trading and financial system
Current Status
Star ng in the 1950s Indonesia par cipated in global discussions on the General Agreement on Trade and Taris (GATT) to improve the global trading system and was a founding member of the World Trade Organiza on (WTO) in January 1995. Indonesia has also par cipated in various interna onal nego a ng forums related to interna onal trade including: APEC; the CAIRNS Group; the G-33; the NAMA 11; and W52 Sponsors. Indonesia has par cipated in the Doha Development Round and remains commi ed to reaching an agreement to maintain condence in the mul lateral trading system. The agreement is expected to reduce threats of rising protec onism and to provide a s mulus to global recovery. At the same me Indonesia supports a Special Safeguard Mechanism to reduce the short term nega ve impacts of trade liberaliza on on those involved in the agricultural sector, especially the rural poor. Indonesia is one of the founding member states of ASEAN which established the ASEAN Free Trade Area (AFTA) in 1992. ASEAN is also moving toward the establishment of the ASEAN Economic Community (AEC) by the year 2015 and the goal of regional economic integra on. ASEAN has also reached out to enter into free trade agreements with other Asian na ons as well as na ons outside of Asia. The ASEAN-China Free Trade Agreement (ACFTA)1 and the ASEAN Korea Free Trade Agreement (AKFTA) are among the free trade agreements which have been entered into force. In addi on, ASEAN is now in the process of nego a ng other ASEAN FTA such as: the ASEAN-India FTA, ASEAN-Australia-New Zealand FTA and the ASEANEuropean Union FTA. Besides regional trade agreements, Indonesia has also entered into bilateral agreements for free trade with several other countries. The Indonesia-Japan Economic Partnership Agreement (IJEPA) was signed on 20 August 2007 as the rst Indonesian bilateral trade agreement, and it went into eect on 1 July 2008. The objec ve of this agreement is to strengthen bilateral economic rela ons, covering wide-ranging coopera on in investment, trade, and movement of individuals
ACFTA creates the worlds largest free-trade area in terms of the popula on of the na ons which are signatories to the agreement (1.9 billion) and the third largest in terms of GDP (USD 6.6 trillion) a er the European Union and the North American Free Trade Area.
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Indonesia has been successful in developing greater openness in trading with the global community. An improved regulatory framework for trade has yielded substan ve economic benets. Trade has increased substan ally since 1980 and has led to growth of the na onal economy and the expansion of employment opportuni es.
100%
Percentage (level of economic openness)
600
Figure 8.1.
The Trends for Imports, Exports, GDP Growth and the Ra o of Imports Plus Exports to GDP as the MDG Indicator for Economic Openness
90% 80% 70% 60% 50% 40% 30% 20% 10% 0%

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
500
400
Billion USD
300 37.9% 39.5% 200
100
Level of Economic Openness IMPORTS
EXPORTS GDP at Current Price (billion USD)
Sources: BPS and the World Bank, 2009.
The recent data for the indicator of economic openness reveals a long-term trend to greater openness in the management of the Indonesian economy. Comprehensive reforms in Indonesias banking sector have been ins tuted based on the dicult lessons learned from the economic crisis of 1997/1998, including strengthening of corporate and banking sector balance sheets and reduc on of bank vulnerabili es through higher capitaliza on and be er supervision. The indicator for banking for MDG 8 is the Loan to Deposit Ra o (LDR) for commercial banks and rural banks. The LDR for commercial banks has increased steadily from a level of 45.8 percent in 2000 to a rate of 72.8 percent in 2009. The deposits of rural banks also increased from Rp 8,868 billion in 2003 to Rp 28,001 billion in 2009 while the LDR for rural banks also increased signicantly from 101.3 percent in 2003 to 109.0 percent in 2009. The level of nonperforming loans (NPL) at commercial has been improved during the repor ng period while the NPL at rural banks is considered to have been maintained at a safe level.
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Figure 8.2.
Loan to Deposit Ra o (LDR in percent) of Commercial and Rural Credit Banks, 2000 - 2009
140 119.4 120 101.3 100 108.9 111.2 107.5 109.7 109.0
Percentage
80 61.8 60 45.8 40 20 0 2000 2001 2002 2003 2004 2005 45.0 49.1 53.7 64.7
77.2 64.7 69.2
72.8
2006
2007
2008
2009
Source: Bank Indonesia Economic Report 2009.
LDR Rural Banking
LDR Commercial Banking
Challenges
The fragility of the global recovery underlines the importance of s mulus packages and the need to maintain the certainty of open trade and a rule-based mul lateral trading system. A er eight years of nego a ons on the Doha Development Agreement, the challenge now is to conclude an agreement that will provide a strong founda on for global recovery and sustained growth. Among the factors in determining the logis cal performance of a na on on trade are the following: Eciency of the customs clearance process and border procedures; Quality of trade and transport-related infrastructure; Ease of arranging compe vely priced shipments; Competence and quality of logis cs services; Ability to track and trace consignments; and Frequency with which shipments reach the consignee within the scheduled or expected me. The Logis cs Performance Index (LPI) survey highlighted the need for Indonesia to take further ac on to improve border management, service sector performance (transport, logis cs and freight-forwarding services) and overall logis cs infrastructure, especially mari me ports. The survey iden ed the need to give special a en on to improve customs and especially quality and standards inspec ons agencies.2
World Bank, Connec ng to Compete in Indonesia, 2010.
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There is a need to control the intermedia on func on of the banking system. The low composi on of investment credit cannot be separated from the structure of deposits in banks which are short-term funds with a maturity of one to three months so that there is the poten al for funding mismatches in the long term. Secondly, the magnitude of the spread between lending and deposit interest rates is an cipated to be one cause of low investment lending in the banking industry. In terms of micronance, the performance of rural banks (Bank Perkreditan Rakyat - BPR) has improved. The advantages of rural banks compared to commercial banks are the services they provide to SMEs and low income people who priori ze in macy through direct services (door to door), and a personal approach with a en on to local culture. However, due to a lack of informa on about the businesses owned by their customers, there is a tendency for rural banks to focus on clients considered to be more bankable.

Various steps will be taken to further develop an open, rules-based, predictable, nondiscriminatory trading system, including the following: 1. Increase non oil and gas exports of products that are high value-added, natural resourcebased, and high demand. Therefore, development of Indonesian exports will be focused on agriculture and shery products, mining, foods, beverages, tex les, machinery, electrical equipment, chemicals, chemical products, footwear and leather products. 2. Encourage exports of crea ve products and services, par cularly of small and medium enterprises. 3. Encourage eorts of market diversica on to reduce export dependency on certain markets. 4. Emphasize eorts on expansion of market access, promo on and export facilita on in Africa and Asia. 5. Support u liza on of trade schemes and interna onal trade coopera on that are more benecial to na onal interests. 6. Improve trade ac vi es in border regions which are func on as the front gates for economic and trade ac vi es with neighboring countries. 7. Strengthen trade ins tu ons and foreign trade nancing that can induce eec veness of non-oil export development.
139
The Government of Indonesia will also con ne to work to maintain a healthy, stable and ecient banking system to be er support achievement of the goals of na onal development. The strategy to strenghten the performance and stability of the banking sector includes the following ini a ves: 1. Strengthen the regulatory framework and further improve supervision of commercial and rural banks; 2. Strengthen the quality of management and opera onal services of all banking ins tu ons; 3. Enhance eorts to protect the consumer and investors; 4. Accelerate strategic intermedia on and distribu on of public funds to increase access to nancial service ins tu ons (LJK) for low income groups through the following ini a ves: a. develop appropriate banking products and Islamic borrowing arrangements; b. diversica on of sources of development funding through non-bank nancial ins tu ons (LKBB); c. expand the scope of nancial services, especially nancial services to support micro, small and medium enterprises; and d. improve the suppor ng infrastructure of nancial services ins tu ons.
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Target 8D: Deal comprehensively with the debt problems of developing countries through national and international measures in order to make debt sustainable in the long term
Current Status
In the decade following the economic crisis of 1997/98 the Government of Indonesia ins tuted a comprehensive set of reforms to strengthen the na ons economic fundamentals, including a reduc on of interna onal debt and strengthening of the banking sector. These reforms have provided a strong founda on for the Government to implement policies to recover from the crisis and also to achieve growth with equity. Mul lateral and bilateral coopera on has assisted Indonesia to work towards achievement of the MDGs while a decade of sustained economic growth has enabled the Government to reduce dependency on interna onal borrowing to a sustainable level. The success of Indonesias economic reforms and improvements in the management of the na onal debt are reected in the reduc on of the debt to GDP ra o which had declined from a peak of 89 percent in 2000 to 30 percent in 2009. While the ra o of interna onal debt to GDP has been reduced from 24.59 percent in 1996 to only 10.89 percent in 2009 (see Figure 8.3).
Billion Rupiah
(% ) 120%
Debt Service Ra o
Figure 8.3.
The Trend of Foreign Debt to GDP and the Debt Service Ra o (DSR) During 1996-2009
6,000 5,000 4,000

60.0% 57.9%
Ra o of foreign debt to GDP
100% 80%
56.8%
3,000 2,000 1,000 0
50.7% 47.3% 37.9% 24.6%
60%
41.1% 39.4% 33.1% 34.1% 39.9% 41.9% 37.2% 40% 27.1% 24.8% 24.2% 21.9% 31.3% 29.0% 27.8% 19.2% 17.3% 22.4% 20% 16.8% 14.8% 14.7% 10.9%
0%
1996 DSR 1997 1998 1999 2000 2001 GDP Foreign Loans 2002 2003 2004 2005 2006 2007 2008 2009 Outstanding Debt Ra o of Debt to GDP Ra o of Foreign Debt to GDP
Source: Economic Report Indonesia, Bank Indonesia, 2008, Sta s cs of Foreign Debt, Ministry of Finance and Bank Indonesia, 2010, Ministry of Finance, 2009.
The ra o of debt service as a percentage of exports of goods and services or the na ons Debt Service Ra o (DSR) also declined during the same period, having reached a maximum in the crisis years of 60 percent. A level of 19.4 percent was recorded in 2007 and a level of
141
22 percent was recorded in 2009. Both these rates are about 50 percent of the MDG baseline gure of 51.0 percent in 1996 and reect the success of the Government in applying improved prac ces of debt management as well as prudent scal policies. The Government of Indonesia is a signatory to the Monterrey Consensus (2002) and the Paris Declara on on Aid Eec veness (2005), and is commi ed to the principles of aid eec veness. Indonesia was also an ac ve par cipant in the regional prepara ons for the Third High Level Forum on Aid Eec veness (2008). In 2009, the Government and 26 key interna onal development partners3 signed the Jakarta Commitment: Aid for Development Eec veness - Indonesias Road Map to 2014. The Jakarta Commitment supports Indonesias eorts to maximize the eec veness of its aid in suppor ng development and denes the policy direc on to achieve greater development eec veness to 2014 and beyond. The roadmap for aid eec veness sets out the strategic vision to which Indonesia, along with development partners, have commi ed. The agenda is based on the principles of the Paris Declara on and the Accra Agenda for Ac on. The program will work to: (i) increase the u lity of interna onal assistance in support of implementa on of the Na onal Medium-Term Development Plan; (ii) increase na onal ownership of development assistance; (iii) encourage and assist development partners to follow regula ons and mechanisms established by the Government; (iv) support inclusion of development assistance in the na onal budget (APBN); and (v) encourage development partners to adopt un ed systems.
Challenges
The main constraint facing Indonesia in addressing the challenges and achieving its planned development outcomes is to strengthen capacity to u lize all resources eec vely. Maintaining the current debt por olio is one of the focuses while working to achieve cost ecient and manageable risks within the dynamic of nancial markets. The Government has worked to increase eec veness in use of interna onal grants and loans in providing support to achievement of na onal development objec ves, but there is s ll room to improve aid eec veness. Various reviews of programs and projects funded by
Development partners signing the Jakarta Commitment include: the Asian Development Bank; the Government of Australia; the Government of Japan; the Government of the Netherlands; the Government of the Republic of Poland; the World Bank; the Austrian Embassy; lAgence Franaise de Dveloppement; the Canadian Interna onal Development Agency; the Department for Interna onal Development of the United Kingdom; the Delega on of the European Commission; the Embassy of Finland; the Embassy of France; the Embassy of the Federal Republic of Germany; the Embassy of Italy; Japan Interna onal Coopera on Agency; Korea Interna onal Coopera on Agency; the Royal Norwegian Embassy; the New Zealand Agency for Interna onal Development; the Embassy of Sweden; the United States Agency for Interna onal Development/Indonesia; the United Na ons System in Indonesia; the Islamic Development Bank; the Danish Interna onal Development Agency; and the Swiss Agency for Development and Coopera on.
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interna onal nance ins tu ons and the donor community have found that common challenges exist in increasing the eec veness of aid in Indonesia. These include the following: a. a low sense of ownership of loan and grant funded programs by those responsible for implementa on; b. procedures of the donors are not always fully aligned with those of the Government; c. programming of loans and grants are not always fully harmonized with Government planning and priori es; d. development programs are not always managed to achieve op mum results and the sense of mutual accountability is some mes less than required; and e. weaknesses exist in suppor ng management informa on systems as well as in the human resources assigned to manage informa on on development programs.

Priori es of the Government in the management of loans and grants from mul lateral and bilateral ins tu ons as well as commercial credit ins tu ons for the coming years are as follows: 1. Foreign loans and grants will be used to support achievement of the na onal priori es, goals and objec ves in accordance with the Na onal Medium-Term Development Plan (RPJMN 2010-2014) and in harmony with Indonesias commitment to achieve the MDGs; 2. Con nuous eorts will be made to reduce the ra o of interna onal debt to GDP while con nuing to maintain a situa on of nega ve net transfers; 3. Further improvements will be made in the regula ons and laws rela ng to interna onal loans and grants; 4. Increased na onal ownership for programs funded by interna onal loans and grants will be promoted as will applica on of improved na onal procedures for management of interna onal funding; 5. Improvements will be made in the ins tu onal coordina on mechanisms, transparency and accountability at all stages, from planning and implementa on to monitoring and evalua on; and 6. Strengthening na onal capacity to manage programming and u liza on of development funding eec vely will be priori zed. The Jakarta Commitment4 is based on the spirit of mutual respect, support and accountability and will be implemented to achieve greater benets in the achievement of Indonesias development objec ves, including the MDGs. It enjoins upon the Government and development partners to make available appropriate resources, knowledge and capacity to
Jakarta Commitment, Aid for Development Eec veness Indonesias Roadmap to 2014 (January, 2009).
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implement the Jakarta Commitment. The three main components of the Jakarta Commitment5 are as follows: Strengthening Country Ownership over Development; Building More Eec ve and Inclusive Partnerships for Development; and Delivering and Accoun ng for Development Results.
The Government has established a Secretariat for Aid for Development Eec veness (A4DES) to support implementa on of the Jakarta Commitment and to ensure that government ins tu ons have the capacity to take full ownership and to lead aid coordina on and management processes.
Target 8F: In cooperation with the private sector, make available the benefits of new technologies, especially information and communications
Current Status
The government is commited to expanding collabora on with the private sector to ensure that all Indonesians are able to benet from the opportuni es that Informa on Communica on Technologies (ICTs) oer in building an inclusive Informa on Society. Ongoing ini a ves include those to improve infrastructure for ICT, to build capacity of users of ICT, and to create an enabling regulatory/policy environment to achieve the goals agreed at the World Summit on the Informa on Society. Telecommunica ons in Indonesia have expanded rapidly in the period since the economic crisis. Figure 8.4 presents the rapid increase in the percentages of the popula on owning cellular telephones in recent years as compared to the rela ve decline in the use of xed line telephones (Public Switched Telephone Network PSTN). The expansion in the use of personal computers has grown at a slower rate than cellular telephones due to the rela vely high cost of their purchase and the need for a minimum level of competency to u lize them. Only 8.32 percent of Indonesian households owned personal computers in 2009, although the use of computers is common in businesses, civil society
The following is a summary adapted from the Jakarta Commitment, the complete text is available at the website of the Secretariat for Aid Eec veness in Jakarta: h p://www.a4des.org/
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organiza ons, government and in community-based organiza ons. Access to the internet has expanded rapidly since 1998 when it was es mated that only 512,000 Indonesians were able to u lize the internet. By 2009 the number of internet users had risen to 11.51 percent of the na onal households.
100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 2004 2005 2006 2007 2008 2009
Source: Ministry of Communica ons and Informa on Technology, 2010.
Figure 8.4.
Percentage of Popula on in Indonesia Owning FixedLine Telephones or Cellular Telephones During 2004-2009
Fixed Telephone
Cellular Phone
Challenges
One of the primary challenges for the future is to close the gap in access to ICT communica ons by improving the telecommunica ons infrastructure to provide broadband access throughout Indonesia. In a na on as large and diverse as Indonesia, ICT communica ons play a strategic role in trade, government and civil society. Most remote areas do not yet have access to modern ICT and the quality of access in many areas is basic. The exis ng na onal infrastructure in support of telecommunica ons has been based on a system of satellites, wireless access and land lines. Infrastructure and internet use is expanding rapidly in the major urban centers, but suppor ng infrastructure is far weaker in rural areas, especially in eastern Indonesia. As a result, there exist major dispari es in the use of telephones, computers and the internet among regions, with the lowest rates of use occurring in the remote eastern provinces (see Figure 8.5). Investment in ICT industries has exceeded expecta ons. With the increased investments in ICT industries, there is a need to build a more compe ve environment for the provision of ICT services as well as a more conducive environment for collabora on in all ICT industries, including those providing services for users, equipment manufacturers and user solu ons, so ware and device applica ons. Awareness and capacity to use ICT eec vely is developing rapidly including among SMEs, while capacity building is s ll required to increase the na onal e-literacy rate.
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Figure 8.5.
Percentage of Households Owning Personal Computers and Having Access to the Internet by Province (2009)
40 35 30
Percentage
25 20 15 10 5 0
Sulawesi Barat Nusa Tenggara Timur Lampung Sulawesi Tengah Nusa Tenggara Barat Kalimantan Barat Sulawesi Tenggara Maluku Utara Kalimantan Tengah Maluku Jambi Aceh Papua Barat Papua Sulawesi Selatan Sumatera Utara Jawa Tengah Sumatera Selatan Kalimantan Selatan Gorontalo Jawa Timur Bangka Belitung Sulawesi Utara INDONESIA Bengkulu Jawa Barat Sumatera Barat Riau Kepulauan Riau Bali Banten Kalimantan Timur DI Yogyakarta DKI Jakarta
Computer
Internet

The government is commi ed to the promo on of private sector investment to achieve the objec ves of na onal development, including achievement of the MDGs. In order to create a more conducive environment for investors, the government will work to strengthen the regulatory framework for investors and harmonize the regula ons of na onal and regional government on investment. The government will also expand direct collabora on with the private sector through public-private partnerships while suppor ng the development of special economic zones for specialized products. Corporate social responsibility will also be encouraged to contribute to the achievement of community objec ves. It is the governments objec ve to transform Indonesia into an informa on-based society driven by the free ow of informa on. At present the popula ons of the larger urban centers of Indonesia have far greater access to ICT, but government policy is to make informa on available to communi es in all areas, including remote and isolated regions. At the same me the government will con nue to cooperate with the private sector and the public in implemen ng four components of a comprehensive ICT blueprint for Indonesia: 1. Improvement of ICT Infrastructure: The Palapa Ring Program; Broadband Wireless Access (BWA) Deployment; 3G Implementa on; Transi on to Digital Television; Community Access Points (CAP).
146
2. ICT Industry Development which will include: implementa on of the Electronic Informa on and Transac ons Law; prepara on of government regula ons on the dessemina on of informa on and electronic transac ons (RPP PITE); improvement of the ICT Convergence Law; and crea on of an investment climate to promote private sector investment in ICT. 3. E-Government: Various decrees and regula ons of the government have been issued to support adop on of innova ve prac ces of e-government through public-private partnerships and coopera on between central and regional governments and private sector service providers. ICT will be used as an instrument to re-engineer the provision of public services to all Indonesians. The government is preparing an Electronic System at the central and regional levels of government to support a na onal system of e-government. It is planned that: E-services and e-procurement will be applied by all government agencies; The applica on of e-budge ng by government agencies will increase the transparency and eciency of government planning and budge ng; Implement e-government strategies focusing on applica ons aimed at innova ng and promo ng transparency in public administra ons and democra c processes, improving eciency and strengthening rela ons with ci zens; Develop na onal e-government ini a ves and services, at all levels, adapted to the needs of ci zens and business, to achieve a more ecient alloca on of resources and public goods; Support interna onal coopera on ini a ves in the eld of e-government, in order to enhance transparency, accountability and eciency at all levels of government; and The government will formulate a dra Na onal e-Government Master Plan in 2010 and each government ins tu on will be required to prepare a their own e-Government Master Plan. At the end of the current Na onal Medium Term Development Plan it is expected that the score of the na onal system of e-government will have reached 3.4. It is expected that online public services will be available for e-ci zen, e-procurement and e-licensing services by the end of 2014. 4. E-Educa on under the Ministry of Na onal Educa on: The na onal educa on network (www.Jardiknas.net) has been established to integrate ICT in learning, to improve the management of educa on, and to make use of ICT in research and development of educa on. Building capacity for ICT will be accomplished through a public-private partnership model to be developed in such a way that all the par es involved will benet. The development of human resources for ICT will be focused on the target groups within government, educa onal ins tu ons, businesses and communi es.
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Summary of the Roadmap to Accelerate Achievement of the MDGs in Indonesia

Summary of the Roadmap to Accelerate Achievement of the MDGs in Indonesia

Summary of the Roadmap to Accelerate Achievement of the MDGs in Indonesia

Summary of the Roadmap to Accelerate Achievement of the MDGs in Indonesia

Prof. Dr. Armida S. Alisjahbana, SE, MA

Summary of the Roadmap to Accelerate Achievement of the MDGs in Indonesia

Summary of the Roadmap to Accelerate Achievement of the MDGs in Indonesia

Summary of the Roadmap to Accelerate Achievement of the MDGs in Indonesia

Summary of the Roadmap to Accelerate Achievement of the MDGs in Indonesia

Summary of the Roadmap to Accelerate Achievement of the MDGs in Indonesia

Summary of the Roadmap to Accelerate Achievement of the MDGs in Indonesia

Summary of the Roadmap to Accelerate Achievement of the MDGs in Indonesia

Summary of the Roadmap to Accelerate Achievement of the MDGs in Indonesia

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* BPS, Susenas ** Ministry of Health Riskesdas, 2007

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