Learning from Indonesia

JAKARTA—The last time I was in this city was 17 years ago, taking part in a regional meeting in preparation for the 1995 International Conference on Women.

Driving in from the airport, what I did notice was a city more spread out, with even more high-rise buildings and shopping malls than I remember.

I am in this city to take part in the fourth seminar of Women’s Edition, a gathering of women journalists organized by the US-based NGO Population Reference Bureau. We meet twice a year to acquaint ourselves with issues of population and family planning. This is the first time the group is meeting in Asia. We had previously gathered in Washington, DC, in Ethiopia and in Senegal, and I am so happy we are now in “my” part of the world. While my companions from the United States, Africa and other parts of Asia (India, Pakistan, Nepal, Cambodia) had to contend with visas on arrival, not to mention a lengthy tiring trip across the world, I breezed through immigration and had a stress-free travel through Singapore.

But not having set foot in Indonesia for more than a decade (save a brief visit to Bali a few years back), I also look on this trip as a voyage of discovery, or re-discovery. We travel to another province, Surabaya, two days from now, and I look forward to discovering a bit of the Indonesian countryside.

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As part of our background briefings, we were given an article discussing the development and sustainability of Indonesia’s family planning program.

The author—Elizabeth Leahy Madsen of Washington, DC’s Wilson Center—describes the article series as tracking “the process of building political commitment in countries whose governments have made strong investments in family planning.”

Indeed, while reading the article, I couldn’t help but feel a twinge of envy for the success of Indonesia’s program, this even if the country still faces daunting challenges in terms of human development, being the world’s fourth most populous nation.

Indonesia, said Madsen, is “classified among the pioneers of family planning in the developing world and has been described as a ‘world leader’ and ‘one of the developing world’s best’.”

Madsen ascribes Indonesia’s success to an “extensive community outreach program combined with a centralized government that made family planning a priority.” “A priority,” those words echoed in my mind as I read the story. The Philippines borrowed a page from the Indonesian game book when it embarked on a national family planning program in the 1970s, establishing a grassroots community-based approach, among others, but national leadership support—expressed among other ways by funding and logistics—waxed and waned according to the personal beliefs of the sitting president, and his or her relations to pressure groups, including the Catholic Church.

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As Madsen tells it, the family planning program of Indonesia faced a daunting challenge when it started, with President Sukarno ruling out “any government support for family planning.” In the 1950s, a Demographic and Health Survey report put the rate of contraceptive use among married women as “essentially zero.”

But with the departure from office of Sukarno (after he was overthrown in a bloody military coup where an estimated half-a-million people were killed), Suharto took over and pursued a program of economic development. Although he had personal reservations about a family planning program, “believing that Indonesians would oppose family planning on religious grounds,” he was convinced otherwise.

Gen. Ali Sadikin, then governor of Jakarta, was outspoken in his support and, according to an Australian scholar-demographer, “quickly (learned) demographic lessons in his attempts to renovate a city with poor housing, schooling, transport and basic services.”

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Sadikin’s key intervention was to support the Indonesian Planned Parenthood Association, a nongovernment organization which had a network of clinics but lacked the funding to meet the great demand for its services. More important was a 1967 meeting between government officials and Muslim, Protestant, Catholic and Hindu leaders. The resulting document: a pamphlet called “Views of Religion on Family Planning” proved to be “a tipping point when national consensus around the morality of birth control was turning from strongly negative to strongly positive.”

By late 1968, writes Madsen, efforts to scale up family planning efforts from a pilot program in Jakarta to the national level reached fruition with the founding of the National Family Planning Coordinating Board (BKKBN in Indonesian).

The BKKBN’s core program centered on community-level activities, “ensuring that family planning services and awareness-generating activities were reaching people around the country through multiple channels.” Among those taking part in promoting BKKBN’s programs and messages were youth, women’s and religious groups, employers, and schools, “with high-level support reiterated regularly by the president.”

The result was a national consensus on the need for family planning and, although BKKBN’s program was observed to have reached a “plateau” in recent years due to differing priorities by the administration of President Susilo Bambang Yudhoyono, the figures are impressive. Today, writes Madsen, “80 percent of all births are intended, and unmet need for family planning—the share of married women who wish to delay or prevent pregnancy but are not using contraception—stands at 9 percent, 2 percentage points below the average for Southeast Asia and all developing countries.”

Learning how Indonesia achieved this, and sustains the effort, is one lesson I hope to take away from this trip.

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