FERTILITY ANB FANILY PLANNINu:

PR0SPECT ANB CBALLENuES F0R

S0STAINABLE FERTILITY BECLINE
Sri Hoertininqsib AJioetomo
IJ
1hls paper argued LhaL Lhere ls subsLanLlal poLenLlal for furLher ferLlllLy decllne ln
lndonesla 8ecause much of Lhe ferLlllLy decllne can be aLLrlbuLed Lo Lhe lndoneslan famlly
plannlng program lnlLlaLed ln Lhe early 1970s (Pull Pull and Slngarlmbun 1977 Warwlck
1986 AdloeLomo klLlng and Salman 1990) LfforLs Lo leglLlmaLe Lhe concepL of ferLlllLy
conLrol followed by Lhe dlsLrlbuLlon of conLracepLlves and famlly plannlng servlces and Lhe
promoLlon of a small famllyslze norn of Lwo or Lhree chlldren have made Lhe lndoneslan
people famlly plannlngllLeraLe nowadays mosL women are able Lo name a number of
modern conLracepLlve meLhods asa well as lndlcaLe where Lhey maybe obLalned 1hls ls
congruenL wlLh Lhe lncreased raLe of conLracepLlve use from flrLually zero before Lhe 1960s
Lo abouL half of marrled couples ln 1994 (C8S et ol 1993) values of small famlly slze have
developed
LducaLed mlddleclass women wanLed Lo llmlL famlly slzes because of growlng soclal
economlc asplraLlons (Subandrlo 1963 Pull 1973) and lowerclass rural women wanLed Lo
sLop chlld bearlng because of Lhe healLh and economlc burden presenLed by frequenL
pregnancles 8uL because means for ferLlllLy conLrol were unavalble and Lhe ldea of blrLh
conLrol was noL soclally accepLed Lhe adopLlon of effecLlve means of conLracepLlon was
llmlLed neverLheless durlng Lhe 1930s and early 1960s small groups of women and
dedlcaLed medlcal personnel sLarLed Lo provlde famlly plannlng servlces orlenLed Lo
lmprovlng moLhers and chlldren's healLh (Pull Pull and Slngarlmbun 1977) 1hls provlded
Lhe foundaLlon for lmplemenLaLlon of a naLlonal famlly plannlng program Lo accommodaLe
Lhe growlng demand for ferLlllLy conLrol among women and changed Lhe people percepLlon
from 'famlly slze ls noL maLLer for cholce Lo 'numeracy' abouL preferred famlly slze
(AdloeLomo 1993)
Cn Lhe basls of Lhe above Lrends and experlences Lhe shape of conLlnued ferLlllLy
LranslLlon depend on governmenL 8kk8n and publlc awareness ln Lhe early days Lhe
lndonesla famlly plannlng program was characLerlzed by hlgh governmenL subsldy for
conLracepLlve servlces Lo cllenLs lncreaslngly new and conLlnulng accepLors are paylng for
Lhe supply and Lhe provlslon of servlces slnce governmenL alone can noL afford Lo provlde
free and subsldlzed conLracepLlon Lo all couples 1herefore efforLs Lo lncrease selfrellance
ln famlly plannlng are belng encouraged 1hen ln 1989 a pollcy of MooJltl (selfrellanL l)
was lnlLlaLed ad promoLed 1he ldea ls Lo encourage Lhose who have capaclLy and
wllllngness Lo pay for conLracepLlves Lo use prlvaLe sources Lo obLaln famlly plannlng
servlces 1he prlvaLe secLor ln Lhls case conslsL of Lhe prlvaLe hosplLal prlvaLe cllnlcs prlvaLe
docLors prlvaLe mldwlves pharmacles and drugsLore or volunLary communlLy groups
A comparlson of women who obLalned famlly plannlng servlces free of charge wlLh
Lhose who pald for Lhe servlces found LhaL rural women havlng lower educaLlon and lower
economlc sLaLus and worklng ln agrlculLure are less llkely Lo pay for servlces Lhan urban
women who has flnlshed prlmary school and llve ln beLLer houses ?ounger women aged
less Lhan 30 years old havlng noL more Lhan Lwo chlldren showed very hlgh selfrellance
Lhey were Lwlce as llkely Lo pay for servlces 1hls paLLern relnforces Lhe beLLer prospecLs for
prlvaLlzaLlon when Lhe older generaLlon are replaced by Lhe younger more urbane more
educaLed and more economlcally secure cohorL of women (AdloeLomo CanlarLo and
PldayaL 1996)
8uL noL every women used Lhls faclllLy wheLher wlLh subsldles or pay by herself 1he
reason glven by nonusers were malnly deslre Lo have chlldren buL a subsLanLlal percenLage
of women sLaLed LhaL Lhey were noL uslng conLracepLlon because of dlsapproval or
rellglous reasons or lack knowledge 1hls caLegory women can be consldered as Lhe hardLo
reach or harLoserve
ln summary sLudles on quallLy of care have found LhaL quallLy of famlly plannlng
servlces ln lndonesla ls far from saLlsfacLory (Wlbowo 1994 8alnLung et ol 1993 AdloeLomo
1996) ln parL because Lhe quallLy of healLh servlces ls so quesLlonable SLandard operaLlonal
procedures are noL properly followed commlLmenL and responslblllLles of provlders are
lnadequaLe and faclllLles and equlpmenL are such low sLandard LhaL Lhey preclude
aLLalnmenL of good quallLy of servlces Whlle Lhese provlderperspecLlve lndlcaLors are
lmporLanL lndlcaLors of quallLy of care ln famlly plannlng ln Lerms of cllenLs saLlsfacLlon
need Lo be developed Lo glve more dlscernlng lndlcaLors of quallLy of care

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8uL ln Lhls global era we can see many people use conLracepLlve especlally ln young
famllles We are no need Lo worry because of unconLrolled populaLlon growLh So glad Lo
found LhaL lndonesla sLlll have ferLlllLy raLes ln hlgh level lL [usL Lhe opposlLe wlLh !apan or
neLherland who have Lhe llLLle ferLlllLy raLe
1he hlgh ferLlllLy raLe ls noL a blg problem lf we can compensaLed lL wlLh good
progress ln every secLor CovernmenL should make more [obs and used Lhe domesLlc
workers So lL can help Lhem Lo provlde Lhelr famlly and lmprove Lhe economlc sLandard
1he amaLeur people can use Lhls paper Lo learn abouL challenges ln famlly plannlng
Powever as a sLudenL we can use Lhls paper Lo solve some problem based on Lhe Lheorles
1hls paper examlnes wheLher currenL ferLlllLy levels and Lrends and famlly plannlng
lnsLlLuLlons provlde Lhe basls for conLlnulng ferLlllLy decllne lnLo Lhe 21
sL
cenLury

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DEMUCRAPHICS )URNAL REVIEW

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