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Afterthoughts

Indonesia: A Family Planning Model for the Philippines?

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The facts are clear.

In terms of key economic and social indicators, the Philippines was ahead of Indonesia, Thailand, and Vietnam 40 years ago.  Today, we are behind and face the dismal prospect of falling even farther behind in the next few years.  And a major part of the reason is that in contrast to the Philippines, the three carried out successful population management programs.  As a result, all three are now enjoying the dividends of effective family planning: rapid economic growth, decreasing poverty, and a better quality of life.

We did not take the population challenge seriously.  Our neighbors did.

Fertility Fall Precedes Economic Growth

Indonesia is perhaps the clearest case of the causal relationship of population management to economic growth and poverty reduction.  As Peter Miller, a leading family planning analyst with experience in Indonesia, told me, “family planning clearly preceded economic growth in Vietnam, Thailand, and Indonesia, but it is in Indonesia that the case is most clearly seen.”

Miller recalls going from an assignment in Bohol to Surabaya in Indonesia in 1975.  Compared to Bohol then, Surabaya was desperately poor, with “the children lining the streets showing signs of severe malnutrition.”  But what he found significant is that in contrast to Bohol, family planning was widely practiced. Surabaya was a microcosm of Indonesia during this period of widespread poverty, where the key program to promote economic growth was the vigorous family planning program pushed by the Suharto government.

The demographic transition in the West was marked by economic growth followed by a fall in the fertility rate.  In contrast, Indonesia’s economic takeoff was preceded by a fall in the fertility rates.  The Total Fertility Rate (TFR), or average number of children expected in a woman’s lifetime, dropped from 5.6 in 1965-70 to 5.2 in 1970-75 to 4.7 in 1975-80 to 4.11 in 1980-85.  This left Indonesia well positioned for its golden period of economic growth in 1985 to 1995, when per capita income grew by 70 per cent.

A low population growth rate translates into a higher gross domestic product (GDP) per capita, and this translates into higher incomes, higher savings, and higher investments.  Effective population management interacted with economic growth to trigger a virtuous circle that made a central contribution to reducing the percentage of the population living in poverty from 40 per cent in the late seventies to around 11 per cent in the mid-nineties, or an overall reduction of almost 75 per cent in two decades!

Ingredients of a Success Story

What accounted for the success of program?

One very important ingredient was national leadership.  There were many things wrong with Suharto, and the man was responsible for countless human rights violations, but one of the things the dictator apparently got right was that any possibility of development would be choked by unrestrained population growth.  As Jose Ferraris, the United Nations Population Fund (UNFPA) representative in Indonesia, put it, “Suharto had vision. He saw things thirty years down the road, and he provided the high-level political will.”

Second, the population program became a mass movement. “It began as a top-down movement, but it soon became a bottom-up movement,” says Ferraris. Innovative organizing at the village level sustained the momentum of the program, and central to this process was a charismatic individual named Haryono Suyono, who was described as a “cross” between Juan Flavier, the dynamic Filipino civil society figure, and Meechai Viraidya, a central figure in the history of family planning in Thailand.  Highly motivated field workers promoted the idea of “small, healthy, prosperous and happy family.”  Signs proclaiming “Two Children are Enough” were planted everywhere, and blue chromatic circles were imprinted on houses whose residents were practicing contraception.

Third, the program was integrated into income-support programs.  One of the major reasons for successful expansion of village family planning groups in Indonesia was the ability of National Family Coordinating Board (BKKBN) to come up with innovations to make these groups more attractive to village women that served as incentives for women to limit births.  Making micro-credit available was one such initiative, analyst Ashok Barnwal claims, “The BKKBN provided funds with low interest rates to the groups for micro-credit purposes…requiring family planning use for a specific period of time before they could have access to these low interest loans. This worked like an incentive to use the family planning methods. This intervention also helped in strengthening the government-society link.”

A fourth reason was an active government effort to recruit religious leaders to support the process.  The role of the ulamas or Muslim leaders trained in Islamic doctrine and laws was critical in convincing Indonesia’s majority Muslim population, so the BKKBN initiated a sustained dialogue with them.  The decisive outcome of this effort was the ulamas’ issuing of a fatwa, or religious opinion, supporting the use of contraceptive methods except for vasectomy.  As a result, about 90 per cent of the Muslim community now supports family planning, according to Eddy Hasmi, head of BKKBN’s Center for International Training and Collaboration.

The family planning leaders were aware of possible problems with the minority Catholic community, so, as they did with the Muslim leaders, they placed a special effort on a constructive dialogue with the Catholic hierarchy.  According to Hasmi, the Church in Indonesia supports family planning, and though it does not endorse the use of contraceptives, it does not actively oppose it.   According to UNFPA’s Ferraris, there is dialogue between the State and the Catholic Church, and the process has been made easier by the “relative independence of the Indonesian Catholic Church.” The attitude of the Indonesian Church is that family planning is a matter of moral choice by the individual, and this moral choice can only be exercised “if it is based on information.”  The liberal attitude of the Indonesian Catholic hierarchy is evident in its approving the distribution of a government family planning booklet titled “Building a Prosperous and Responsible Family: the Catholic Perspective,” which has 11 pages that describe in detail the different methods of artificial contraception.

Still, despite the relatively tolerant attitude of the Indonesian Church, the TFR in East Nusa Tenggara, where Catholics form the majority, is 3.7 – the highest in the country – while the national rate is 2.3.   The proportion of sexually active women of reproductive age who want to practice family planning but do not have access to family planning supplies or methods is over 15 per cent in the province, much higher than the national figure of 9 per cent.  Its relatively poor performance in family planning is perhaps not unrelated to the fact that East Nusa Tenggara is also a depressed region, where the unemployment rate in its most populated part, West Timor, reaches as high as 80 per cent.

Losing and Recovering Direction

For a decade after the Asian financial crisis in 1998, Indonesia entered a period of economic crisis and political instability, and the family planning programs saw some scaling down in emphasis and budget-wise.  However, the habits of contraceptive use to limit family size held: from 1997 to 2003, TFR decreased from 2.8 to 2.4, and to 2.3 in 2007.

Nonetheless, the deemphasis on the program might have had some negative consequences.  The current high incidence of abortion, which was estimated in 2010 at about 1.2 million, could have something to do with the fact that “access to and the quality of family planning counseling and other services deteriorated owing to neglect,” according to Eddy Hasmi, who says a number of micro-studies pointed in this direction. There is also the sense that with country’s population reaching 241 million in 2011, the 1.3 per cent population growth is still uncomfortably high and adds a cohort of people “nearly the size of Singapore” each year, as one government publication puts it.

Worried about such trends, President Susilo Bambang Yudhoyono has refocused government attention on and sought to increase government resources for family planning during his second term.

Indonesia’s Window of Opportunity

Today, Indonesia is said to be on the threshold of its “window of opportunity,” with a “dependency ratio” – that is, the ratio of people age 0-14 and age 65 and above to the working age population of 15 to 64 years – moving from 51.9 in 2005 to 48.8 in 2010 to 44.7 in 2020 to 44.0 in 2030.   The members of the labor force entering the work force during this period are also said to be of a better quality from the perspective of skills than earlier cohorts owing to their being born to smaller families, a condition that has helped equip them with higher educational attainments, better health, and modern values.

The entry of this new cohort into the labor force has coincided with the unfolding of a new, sustained boom in the Indonesian economy that saw Indonesia grow by 4.9 per cent during the lowest point of the current global economic crisis in 2009, even as other economies were plunged into recession.  According to the World Economic Forum, “Among Indonesia’s strengths, the macroeconomic environment stands out…Fast growth and sound fiscal management have put the country on a strong fiscal footing.  The debt burden has been drastically reduced, and Indonesia’s credit rating has been upgraded.” It points out that “as one of the world’s 20 largest economies, Indonesia boasts a large pool of potential consumers, as well as a rapidly growing middle class, of great interest to both local and foreign investors.”  A strength that the report should have underlined as well is Indonesia’s having successfully surmounted the population problem.

Lessons for the Philippines

So what lessons can the Philippines learn from Indonesia?

Definitely, the most relevant is a strong commitment on the part of the national government that is sustained over time.

Second, family planning cannot simply be left to the government but must be supported by organizing at the grassroots, community level.

Third, incentives can facilitate commitment to family planning.  The Aquino administration might, for instance, provide more generous benefits in health insurance, housing, and other government programs to low-income families that practice effective family planning.

Finally, the program’s progress can be accelerated if it enjoys the support of a country’s religious leadership.  In Indonesia, the support of the ulamas in the Muslim community has been a big plus for the program.  Unfortunately, the Catholic hierarchy in the Philippines will not be swayed from its opposition to family planning.  Thus, it might be necessary to mobilize lay Catholic leaders as well as priests who believe in the program – of which there are many – to neutralize the opposition of the bishops.

The Indonesian experience shows the value of political will, innovativeness, participation, and dialogue in family planning.  It is one that the Philippines will do well to study and replicate, with sensitivity, of course, to our particular national circumstances.

* Walden Bello represents Akbayan (Citizens’ Action Party) in the House of Representative and serves as a senior analyst in the Bangkok-based research institute Focus on the Global South.  He recently visited Indonesia, Thailand, and Vietnam to investigate the family planning programs in these countries.


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Tags: family planning , Indonesia , Population

  • Anonymous

    Good governance and correct economic policies are what we need to attain high economic growth.  Should we accept our government policy to increase GDP mathematically by reducing population, solve classroom shortage magically by having 2 or 3 shifts or lessen the poverty level statistically by raising the threshold.
    There is no substitute to employment when we talk about economic growth and improving the citizen’s welfare.

    • Anonymous

      I agree…

  • Anonymous

    family planning is really needed specially the poor. to improve their quality of life. i hope our religious leaders see that too

    • Stefan Handoyo

      Dear Joseph, for you Filipinos to improve the quality of life of the poor you don’t have to give them them condom or contraceptive pills, even more to kill their unborn babies.  But they need a good and affordable access to the quality health care services that the government must provide, good hospitals affordable to the poor, dedicate medical officials to help the poor, affordable medicines, and you can think of other medical needs.

      Greetings from Jakarta.

  • Stefan Handoyo

    I am surprised with this article which Mr. Walden Bello seems to know Indonesia more than the Indonesians themselves.  I am being an Indonesian and also an Indonesian economist deal and know first hand day-in and day-out on how terrible the damage that has been done to the Indonesian families, especially the poor, on the propaganda of family planning (in Indonesia: Keluarga Berencana) is.  High rate of abortion, the breakdown of the family institution, free sex among the youth, and increasing rate of divorce just to mention few.  Thanks to the FAILURE of more than 30 years of Indonesia family planning program, because if not we Indonesians will not be as prosper as we are now with 240 million people which attract many wealthy foreign investors and companies. We may not enjoy an income per capita of $3,500 now because our market will not be attractive for businesses. More sadly, I will not be able to see the beauty of this world if my mother took contraceptive pill, because I am the youngest of 7 children.  Moreover, if that family planning was successful, there might be less Indonesians than Filipinos in the next 10 years.  I can tell my dear Filipino friends that the “bigger your population is, the sexier your economy is.”  Therefore, Mr. Bello I can tell you that you are misguided if you think that Filipinos must learn a lesson from Indonesian family planning.  The only relevant lesson that you Filipino must learn from Indonesians, if any, is to keep your population as young as possible for the longest possible time, generation to generation, naturally and educate them well that they may be very innovative, productive and entrepreneurial. As a business economist, I can tell you that a healthy and young population, an effective government free of corruption and better management of natural (agricultural) resources are what make your economy growing and keep going. Mr. Bello,I beg you to please do not advice Filipinos to follow the wrong path of Indonesian family planning, because in the process you might plant a “demographic tim bomb” rather than reaping “demographic dividend.” You still need more great leaders, like Aquino, Magsaysay, Diosdado Macapagal and Fidel Ramos whom who knows will only be born from large families.

    Sapto

    • http://pulse.yahoo.com/_OHOD5EA75DBBUH53UKLRXRK764 Mang Teban

      Pak Sapto:
      I thank you profoundly for sharing your personal and professional thoughts to expose the folly that Rep. Walden Bello has been spreading about Soeharto’s family planning program that wreaked havoc in your country’s society.

      Now, the truth has come out about what the dictator did to Indonesian families. Your comment lent credence to my persistent opposition to the RH bill.
      Syukur kepada Allah!

      • Guest

        Mang Teban, can you re-post your first post about Suharto’s family planning program in Indonesia?
        Your first post can’t be read. Something is superimposed on your post so it’s unreadable. Maybe if you post it as a reply here it might turn out OK. I noticed when I’m posting this reply to your post above your first post appears clearly. When I cancel this , the superimposition on your post reappears. Does somebody in Inquirer not like your first post to be read?

      • http://pulse.yahoo.com/_OHOD5EA75DBBUH53UKLRXRK764 Mang Teban

        Rep. Walden Bello;For some unexplained reason, my earlier comments were not posted.I
        shall try again because your article is your second attempt to advance
        the RH bill using the Suharto’s  model of economic program for
        Indonesia. Okay, I will simply lay down the facts.Suharto’s
        program was to provide access to economic opportunities for farm workers
        so that food production in the agricultural sector will prosper. He had
        mostly the women to work in the farmlands and the men to the army.
        Suharto as a dictator for 36 years had the military establishment
        controlling natural resources and, to his credit, distributed lands to
        be tilled by the village folks. It was a genuine agrarian reform. But,
        while the women had their husbands away to occupy East Timor, a former
        Portuguese colony, for a long time on tour duty, Suharto supplemented
        his economic agenda by compelling the women to take contraceptives and
        had several women on tubal ligation. The men in uniform committed sexual
        abuses on the women of occupied East Timor. Rape was prevalent and
        massacres of males in East Timor was permitted.Suharto did not
        pursue family planning to make what Indonesia is today, economically
        speaking. It was purely and primarily agrarian reform coupled with
        increased awareness for nationalism by banning any other second
        language. Today, Indonesians are beginning to realize the importance of
        second language, especially English. Today likewise, some Islamic sects
        perform female circumcision and prostitution has spread. President
        Susilo is facing social problems among the youth who have access to
        “safe sex” and promiscuity is causing nightmares to parents. Abortion
        and divorce have created deep concern from religious leaders of
        different faiths. While Indonesia is predominantly Islamic that many
        people think that it is the most conservative religion, it does not
        appear to be because the citizens got the wrong education about family
        planning.

    • Guest

      Thank you, Mr. Handoyo. I myself, took Mr. Bello’s so-called “facts” about Indonesia’s family planning “success” as gospel truth until your comment that it was a FAILURE. Can you elaborate on the FAILURE of family planning in Indonesia?–Pinoy Papist

      • Stefan Handoyo

        Dear Mang Teban, Pinoy Papist and all my dear Filipino friends who share with me that the neo-Malthusians who are now trying to tell you to use contraceptives under the disguise of “Reproductive Health” are misguided.  You should not use Indonesia’s family planning as a model at all due to its degrading social and economic consequences. The failure of the family planning in Indonesia can easily be seen through what is starting to happen now in society:  individualism, materialism, increasing number of juvenile delinquencies due to free sex, women prioritize their professional career more than having a family and bear children, abortions, declining family values, etc. The 35 years or so of million and million US$ disbursed by the Indonesian government to buy contraceptives and conduct nationwide campaign is a waste of money. Foreign and local pharmaceuticals companies and foreign population experts of UNFPA with exuberant salaries are the ones get financial benefits from the Indonesian big market for condoms and pills. The poor continues to suffer because they were only told to take the pills and use condom for their family to prosper, without any knowledge on how to make themselves economically productive to support their families’ needs.  Simply because there are not enough technical or training assistance from the government.  And these same poor people are now frustrated of the empty promises of family planning and are abandoning condoms and pills, and make massive urbanization to big cities like Jakarta and Surabaya. If you follow closely the English mass media in Jakarta right now, there are enough news about the government working very hard to revitalize family planning program but to no avail. The frustration of the Indonesian government towards the failure of family planning can be seen in the new slogan they use now. The previous family planning slogan was “2 children is enough – boy or girl is the same”; and not it reads: “2 children is better.”  But, the question is better than what? Is it better than not being able to buy televisions, cars, motorcycles or gadgets because you will spend more money with more than 2 childrens? Or, is it because better than you won’t be able to have enough money to send your 3rd, 4th, 5th child to school? Oh boy…, this is exactly what the responsibility of the government is, to provide good schools that are affordable enough. Imagine, assuming that those million of million $ that Suharto had spent for condoms and pills were spent to build schools, to produce more qualified teachers, to buy free books and computers for poor children, you can imagine what a multiplier effect it will do to the quality of education, improved quality of life, increased income, productive activities of these poor people, innovation and entrepreneurship, etc. When your government leaders opt to sign off agreement with UNFPA for Reproductive Health” program, it is a sign of the lukewarmness and laziness of your leaders to work harder to provide more schools, build bridges and farm-to-market roads, reform agricultural management, open many employment opportunities through better economic policies. Simply put, it is much easier to give condoms and kill the unborn babies than to build schools and feed the newly born babies with good food. If you allow me, I would love to change the title of Mr. Bello’s article into: “Indonesia: A Family Planning Tragedy for the Philippines.” This is a serious fight, but hopefully we fight a good fight for a good cause.

  • http://pulse.yahoo.com/_OHOD5EA75DBBUH53UKLRXRK764 Mang Teban

    Rep. Walden Bello;
    For some unexplained reason, my earlier comments were not posted.
    I shall try again because your article is your second attempt to advance the RH bill using the Suharto’s  model of economic program for Indonesia. Okay, I will simply lay down the facts.

    Suharto’s program was to provide access to economic opportunities for farm workers so that food production in the agricultural sector will prosper. He had mostly the women to work in the farmlands and the men to the army. Suharto as a dictator for 36 years had the military establishment controlling natural resources and, to his credit, distributed lands to be tilled by the village folks. It was a genuine agrarian reform. But, while the women had their husbands away to occupy East Timor, a former Portuguese colony, for a long time on tour duty, Suharto supplemented his economic agenda by compelling the women to take contraceptives and had several women on tubal ligation. The men in uniform committed sexual abuses on the women of occupied East Timor. Rape was prevalent and massacres of males in East Timor was permitted.

    Suharto did not pursue family planning to make what Indonesia is today, economically speaking. It was purely and primarily agrarian reform coupled with increased awareness for nationalism by banning any other second language. Today, Indonesians are beginning to realize the importance of second language, especially English. Today likewise, some Islamic sects perform female circumcision and prostitution has spread. President Susilo is facing social problems among the youth who have access to “safe sex” and promiscuity is causing nightmares to parents. Abortion and divorce have created deep concern from religious leaders of different faiths. While Indonesia is predominantly Islamic that many people think that it is the most conservative religion, it does not appear to be because the citizens got the wrong education about family planning.

    • Anonymous

      Mang Teban, can you re-post this somewhere here or as a reply to Stefan Handoyo?Something is superimposed on your post!

      • http://pulse.yahoo.com/_OHOD5EA75DBBUH53UKLRXRK764 Mang Teban

        Yes, the web designer of PDI needs to fix it..what I suggest is for you to click the sorting option to “Oldest first” at the box above for the first comments..you should be able to see it when the order of comments are changed. God bless you, Enrique!

  • Andres Magdiwang

    mr bello, you are correct, indeed-on the reverse relationship between fertility rate and economic growth.
    however, to the simple minded, we can not simply say> low fertility rate= increase economic growth, and then we will rant with the figures.
    i think this needs to be dissected in simpler terms for the simpple minds-which are many in the country if we will use educational attainment as a basis. LEES MOUTH TO FEED=LESS EXPENSES. LITTLE HOUSE WILL BE ENOUGH. MORE MONEY FOR OTHER NEEDS, i think will be more appropriate at the grass root level. and for hammering to the heads of those who see birth control as “evil”…
    and i say, NO MATTER WHAT THEY SAY, if the government will be strong on its effort and NOT lackluster as it is now, incentives can be given, and advocacy/education strengthened and sustained- we will not fail…

    • Anonymous

      your perception is good and acceptable, the RH Bill should not be forced into a family but, should be approved as an alternative for those who want to avail with it! let the family decide, and let the government support by giving free counseling & materials if requested! the RH Bill should not be an instrument of force & coercion to the citizens, let freedom ring for the family!

  • http://pulse.yahoo.com/_6WTWZBPWUKYVEPFT2A6VIHDQZI taytay

    more people means more taxes, more consumption, more market,more business, more workforce, more money, more savings, more people to take care of the old people and to pay the debts of the country.

  • http://pulse.yahoo.com/_6WTWZBPWUKYVEPFT2A6VIHDQZI taytay

    more people means more workers, more money, more taxpayers, more savings, more market, more consumption, more people to take care of the old, more people to pay the country’s debt.

  • Stefan Handoyo

    I am coming from a Moslem family in the biggest Moslem population country. Isn’t it that you Filipino Christians should know better than me that the basic foundation of family is to multiply and bear children and raise your children responsibly for the glory of God. I don’t mean to preach, but what seems to be a logical proposition from the “Reproductive Health” supporters is actually illogical to the institution and the very objective of marriage itself. Our marriage must be a channel of “conception” from God, NOT “contra-ception” from artificial gods. So go for “Marriage Health” rather than “Reproductive Health.”

  • http://pulse.yahoo.com/_DGL7P57NL7PTDLY5VMAPZ6XZ4U Bobby

    Proponents of the RH Bill promote the emotional contention, among others, that using artificial contraceptive methods will decrease maternal mortality.  But, the Magna Carta for Women Act laid the basis already for the proper care of pregnant mothers-to-be, birth giving mothers and post partum situations of mothers.  If there is any need to change here, amendments to the landmark law and related laws only needed to be introduced, and not allocate a budget augmented by hidden sources to be funded by taxpayer’s money!  The comments of Indonesian economist here S. Handoyo and other Muslim commenters should warn our legislators and this country that the model followed by pro-rh proponents are basically flawed.  We should be able to think out of the box, rather than follow a bad model!  In Sierra Leone, the New York Times (c/o today’s issue of the Manila Bulletin), maternal deaths are significantly improved by removing the enormous downpayment for hospital admission by mothers about to give birth. More Muslim Filipinos are in fact against the erosion of family values in the country.  Wise economic policies, implementation and management, fighting graft and corruption,  putting more money to education, provnding  the poor with opportunities, employment, training and livelihood would be the right solutions to banish “overpopulation fears” which the World Population Monitoring and the New York Times have dismissed as not likely to happen and a mere myth.  If there is a need for families to space the number of children, the Natural Family Planning Methods offers a wide range of choices according to preference, choice, information and suitability to couple circumstances. They are more safe, reliable and inexpensive when properly instructed to couples, respect the Natural Law and the command of Allah and the Christian God.  Let us not banish God from our family.  God be praised!

  • http://twitter.com/judefawley Jude Fawley

    RH bill is promising but the governance is less promising. E Barangay Captain nga namin may pitong anak. Paano nya ngayon e imulat sa community nya ang RH bill? Karamihan ng mga politicians bukod sa sarili nilang pamilya may mga anak rin sa mga kabit nila, mga anak sa labas. Maraming mga babae sa atin na may anak pero walang tatay, Ang dami sa ating mga public officials na may mga anak sa labas! Tapos sila ang magpapatupad ng family planning program? Maganda sana ang RH bill kaso nga lang ang governance pangit. Hindi naman ganyan ka stupid ang mga pobre sa atin. Nakikita nila ang hypocrisy ng nag go-govern sa kanila. E example nalang natin, mag conduct kayo ng survey ng mga city councillors at mayors sa atin na may mga anak sa labas, abay sabihin ko sa inyo, pagka dami-dami nyan.



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