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Country Profiles, Indonesia.Population Council, New York, N.Y.Apr 7112p.The Population Council, 245 Park Avenue, New York,New York 10017 (Free)

EDRS Price MF-$0.65 HC-$3.29*Biographies, Demography, *Developing Nations,*Family Planning, National Programs, PopulationDistribution, Populaticn Growth, *Population Trends,Social Sciences

A profile of Indonesia is sketched in this paper.Emphasis is placed on the nature, scope, and accomplishments ofpopulation activities in the country. Topics and sub-topics include:location and description of the country; population - size, growthpatterns, age structure, urban/rural distribution, ethnic andreligious composition, migration, literacy, economic status, futuretrends; population growth and social and economic development -relationship to national income, relationship to size of the laborforce, relationship to agriculture, relationship to social welfareexpenditures; population policies - direct, indirect, relevant laws;history of population concerns; population programs - objectives,organization, operations, research and evaluation; and assistancefrom international agencies. Summary statements indicate that thefamily planning movement is in a transitional phase from a restrictedvolunteer program to one with significant governmental support.Cooperation of related population/family planning agencies isoccurring and pilot projects and program plans have been initiatedfor a national five-year program of family planning services. A mapof the country is drawn. (BL)

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I 3E1 U.S. DEPARTMENT OF HEALTH. EDUCATION& WELFARE

OFFICE OF EDUCATIONTHIS DOCUMENT HAS BEEN REPRODUCEDEXACTLY AS RECEIVED FROM THE PERSON ORORGANIZATION ORIGINATING IT POINTS OFVIEW OR OPINIONS STATE() DO NOT NECES-SARILY REPRESENT OFFICIAL OFFICE OF EDU-CATION POSITION OR POLICY

Country Profiles

INDONESIATHIS profile was prepared by Mrs. N. Soewondo and Mrs. 0. Djoewariof the Indonesian Planned Parenthood Association, with the assistance ofBrooks Ryder, M.D., of the Ford Foundation, Djakarta.

Location and DescriptionStretching across the equator be-tween Asia and Australia, and sepa-rating the Pacific and Indian Oceans,Indonesia occupies most of the MalayArchipelago. Five large land massesdominate the more than 3,000 islandsmaking up the archipelago: Sumatra,Java, Kalimantan (Borneo), Sula-wesi (Celebes), and West Irian (West-ern New Guinea). Although Indo-nesia covers an area roughly 1,100miles from north to south and 2,800miles east to west, the total land areais only 735,269 square miles, corre-sponding to the area in the states eastof the Mississippi River in the UnitedStates. Kalimantan, alone, is almostas large as France.

Indonesia's topography is one ofmarked contrasts. A major mountainrange extends through the largerislands of Sumatra, Java, and Bali.West Irian with its forest-coveredslopes and high mountain plateaushas a snow-capped peak not far fromthe equator. More than a hundredactive or recently active volcanoes arefound in Indonesia. Particularly onthe central islands, volcanic ash hasenriched the soil, permitting intensiveagricultural development which sup-ports unusually high population den-sities. There are broad plains andlevel, frequently swampy lands alongthe coastal fringes. The outer islandsare forest-covered and sparsely popu-lated or uninhabited; while the cen-tral islands of Java, Madura, and

Bali are characterized by intensiveagricultural activity, with terraced,irrigated rice paddies and plantationsof tea, rubber, and teak.

The archipelago has a tropicalmarine climate with high tempera-tures, high humidity, and a moderateto heavy seasonal rainfall. Much ofnorthern and western Indonesia, withtwo-thirds of the total land area, hasa tropical rain forest climate. Cli-matic variations occur dependingupon elevation above sea level, dis-tance from the coast, and prevailingwinds.

In the early seventeenth century,the Dutch East India Companyinitiated a program of trade andacquisition of territory in the islandsthat presently constitute Indonesia.The territory became a colony of theNetherlands, the Dutch East Indies,in 1798.

In the early stages of colonialism,Indonesia did not respond to effortsto enforce an export economy on thevillage structures. The modern co-lonial period, beginning in 1870, wascharacterized by land reforms andmeasures to encourage free enter-prise. Economic gains during thisperiod, however, were offset by popu-lation growth. The standard of livingdid not increase, while the populationmore than doubled between 1880 and1940.

A nationalist movement developedin the twentieth century. One of thefirst reforms it produced was the

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JUN 1 4 1971

A PUBLICATION OF

THEPOPULATIONCOUNCIL

April 1971

People's Council in 1918. Though thiscouncil gained in power over the fol-lowing years, it did not approachautonomy. Independence became pos-sible only when the territory wasoccupied by Japan in World War II.Japan, when faced with defeat in thewar, encouraged Indonesia to claimindependence, which it did in late1945. Dutch attempts at negotiationto regain control of Indonesia re-sulted in a United Nations Commis-sion which, on 27 December 1949,transferred to the United States ofIndonesia sovereign rights over theterritory formerly known as theDutch East Indies, with the exceptionof West Irian (Western New Guinea),the distribution of which was leftopen to further negotiation. In 1963,West Irian became part of Indonesia.

PopulationSIZE

Total population. Indonesia's popu-lation, estimated at 118,000,000 in1970, is exceeded only by those ofChina, India, the Soviet Union, theUnited States, and Pakistan. Thefirst national Census, taken in 1961,recorded 97,018,829 inhabitants, in-cluding an estimated 700,000 residentin West Irian. Marked regional vari-ations in population density occur.The central islands of Java, Madura,and Bali, with less than 7 percent ofthe land area, contain two-thirds ofthe population. Java has a populationdensity of 1,250 persons per squaremile, making it one of the mostdensely populated large areas of theworld. The outer islands, on the otherhand, are sparsely populated: Kali-mantan and West Irian, for example,

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while comprising together more thanhalf of the land area of the archi-pelago, contain only 4 and 1 percentof its population, respectively.

During the nineteenth centuryIndonesia, particularly the island ofJava, experienced one of the mostrapid population growth rates in theworld. In 1815, when the first Censuswas taken in Java, the population was5 million; a little more than a centurylater it was already in excess of 40million. From 1930 on it continued togrow, reaching 63 million in 1961.Keyfitz, allowing for possible under-reporting in 1815, believes that "theincrease of Java and Madura was ten-fold in a century and a half."' Haw-kins concludes that the population ofJava more than doubled from 1815 to1845; increased by two-thirds during

Nathan Keyfitz, "Population Dynamicsin Indonesia: Focus on Research," presentedat the Seventeenth Annual Meeting of theAssociation of Asian Studies, San Francisco,2-4 April 1965 (photo-offset).

the next quarter century and againfrom 1870 to 1900; and increased byalmost 50 percent from 1900 to 1930,and by more than that in the next 31years.2

The Censuses of 1930 and 1961,which were, perhaps, of different de-grees of reliability, enumerated 60,-727,000 and 97,019,000 inhabitants,respectively. Some estimates place theannual growth rate at 1.54 percent inthe 1920s and 1.63 percent in the1930s. The growth rate dropped to0.92 percent in the 1940s but roseagain to 2.13 percent in the 1950s.The drop in the 1940s reflects thehigh mortality and low birth ratesduring the war and revolutionaryperiod.

Current estimates place the growthrate at about 2.6 percent. While pre-

Everett D. Hawkins, "IndonesiaPopu-lation Booms," AID/University of WisconsinResearch Project on Economic Interdepend-ence in South East Asia, Research Paper 24,April 1968.

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cise data are lacking, there is evidencethat the growth rate in the regionsoutside of Java is higher than that onthe central island. The increase inpopulation between 1930 and 1961 isestimated to have been 91 percent forSumatra, 89 percent for Kalimantan,and 67 percent for Sulawesi; while forJava as a whole the rate was only 51percent, and in the central province ofJava it reached a low of 34 percent.Similarly, the child-woman ratiosyielded by the 1961 census data showonly 734 children aged 4 and underfor every 1,000 women aged 15-44 forJava, but 901 for the island ofSumatra, which has 16 percent of thepopulation of the country.

Number and size of households. Inthe early 1960s there were an esti-mated 18,000,000 households with anaverage family size of five.

Total number of women of reproduc-tive age and average age at marriage.The 1961 Census recorded 23,530,000women of reproductive age. The

mean age at marriage was 24.3 yearsfor males and 19.2 years for females.By the age of 30, 87 perce:C6 ofJavanese women in rural areas weremarried as compared with 82 percentof women from urban areas. Ofwomen aged 15-19, 45 percent inrural areas were married as against 25percent in urban areas. Present fer-tility rates reflect the low mean agesat marriage, the high proportions ofmarried women, and the large cohortof individuals in the age group 5-9 atthe time of the 1961 Census.

GROWTH PATTERNS

Reports of births and deaths through-out Indonesia are far too incompleteto compile accurate fertility and mor-tality rates for the country as awhole. Evidence from sample surveysand other estimates places the crudebirth rate between 43 and 45 perthousand, with Java and Madurapossibly showing a rate a few pointslower than the outer islands. Crudedeath rates, estimated to have beenaround 21 per thousand at the timeof the last census, are continuing adownward trend, and are now be-lieved to be 17-19 per thousand.While significant changes in fertilityare unlikely in the next decade, it ishighly probable that the mortalitydecline will continue, with a conse-quent rise in the rate of naturalincrease.

Demographers are unwilling, on thebasis of the limited data available, toselect a single figure for Indonesia'scurrent rate of natural increase; esti-mates range from 2.6 to 2.9 percentwith the frequently cited figure of 2.8being used by planners in severalministries and planning groups.

AGE STRUCTURE

The population Census of 1961 re-vealed a relatively small 10-19 agegroup, reflecting perhaps the conse-quences of the war occupation, mal-nutrition, and civil disorders. By con-trast, the large population aged 9 andunder reflects a resurgence in thebirth rate and a decline in infant andchild mortality. There is a significantexcess of females over males in mostage groups, particularly in Java. Thesex ratio is slightly higher in citiesthan in rural areas, suggesting the

movement of young male workersfrom the countryside to cities,

Of the total population, 42.1 per-cent are in the 14 and under agegroup and 2.0 percent in the agegroup over 65, making the depend-ency ratio (the number of persons ofdependent age per 100 persons ofworking age) 79. tt

URBAN-RURAL DISTRIBUTION

The Census of 1961 recorded that 16percent of the population of the coun-try lived in 229 urban units; in 1920and 1930 the comparable figures wereonly 6 percent and 8 percent. Thesize of the urban population con-tinues to grow at a very fast rate,having increased by 232 percent dur-ing the period 1930-1961. The in-crease in urban dwellers was greatestin the largest cities. For instance,while the five cities having 100,000 ormore persons in 1920 accounted foronly 31 percent of the urban popula-tion, by 1961 the number of suchcities had risen to 23; these held two-thirds of the total urban population.

In the outer islands, both the gen-eral population and the urban popula-tion are growing at a faster rate thanin Java. While in 1920 more than 80percent of the urban population ofthe nation lived in Java, by 1961 thispercentage had dropped to 67. Thegrowth rates of urban population be-tween 1920 and 1961 for Java, Kali-mantan, Sumatra, and Sulawesi were,respectively, in percents, 185, 283,387, and 543.

The six largest cities of Indo-nesia, by order of rank in 1961,were Djakarta (2,973,052), Surabaja(1,007,945), Bandung (972,5661, Sema-rang (503,153), Medan (479,098), andPalembang (474,971); all but the lasttwo of these cities are situated inJava. Djakarta, the national capital,with a population of almost 5,000,000today, accounts for more than 20 per-cent of the urban (and 3 percent ofthe total) population of Indonesia.Since 1930 the population of thismetropolis has been increasing at anaverage rate of 148 percent perdecade. Only about half of the in-habitants of Djakarta in 1961 wereborn in that city and of those bornthere about half were infants andsmall children, a fact that indicatesthe magnitude of the immigrationfrom areas outside the city. Only two

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other large cities of Indonesia (Medanand Bandung) and three others in thewhole of Asia (Karachi, Dacca, andNew Delhi) have witnessed growthrates comparable to Djakarta's inrecent times.

ETHNIC AND RELIGIOUS COMPOSITION

The majority of the inhabitants ofIndonesia belong to the group termed"Malaysian race" made up of about25 principal ethnic groups.

The main alien minority is ofChinese descent and is estimated tocontain between 3 and 4 millionpersons concentrated in the areas ofIndonesia nearest Singapore: WestKalimantan, East Sumatra, Dja-karta, and Central Java. Some of theoldest settlements of the Chinese arefound in West Kalimantan where theworkers are primarily engaged inagriculture and forestry. However,most Indonesian Chinese, exclu:ive ofthose engaged in market gardeningaround Djakarta, are traders, shop-keepers, or skilled craftsmen. Theheav demand for skilled and un-skilled laborers and traders broughtlarge numbers of Chinese into thecountry during the nineteenth cen-tury; nonetheless, place of birth dataof 1930 disclose that about 62 percentof all Chinese were locally born, andof these 67 percent had locally bornfathers.

The European population of Indo-nesia, while economically and politi-cally strong in 1930, numbered only240,417 (0.4 percent of the total popu-lation); it was essentially an urbanelement with a heavy concentration(80 percent) on the island of Java.Arabs numbered 71,000 in 1930 andwere mostly in Java; 80 percent hadbeen born in Indonesia. There were30,000 Indians enumerated in 1930,almost two-thirds of whom lived inthe outer islands.

It is estimated that the breakdownby religion of the population of Indo-nesia is as follows: Muslim, 85 per-cent; Protestant, 7 percent; RomanCatholic, 3 percent; Hindu/Buddhist,2 percent; and other, 3 percent.

MIGRATION

Many proposals have been developedcalling for the movement of largenumbers of people from densely popu-lated Java to some of the outer

islands, both as a solution to Java'spopulation problem and as a meansof increasing the rate of developmentof Sumatra and other outer islands.One proposal, advanced in the late1950s, held that an annual transfer of160,000 families over a 30-year periodwould neutralize Java's natural popu-lation increase.

Such measures have not to datebeen notably successful. During thecolonial period, fewer than 60,000persons moved from Java even whenthe program was strongest, in the1930s; and, after Independence, dur-ing the 1950s, fewer than 25,000 per-sons moved annually. In 1960, theyear of the largest number of trans-migrations since Independence (11,439families, comprising 46,096 individu-als), the population of Java increasedby over a million and a half. Whileefforts to encourage migration fromJava to the outer islands were beingmade, a "spontaneous" migration inthe opposite direction was occurringthat may well have operated to givea net migration inwards. It is nowgenerally acknowledged that trans-migration, while it may expedite therate of development of the outerislands, is unlikely to have a majorinfluence on the problems of popula-tion density in Java itself.

LITERACY

Efforts to reduce illiteracy in Indo-nesia are achieving results: accordingto the Census of 1930, only 6.4 per-cent of the population were literate;while according to the 1961 Census,40 percent of the total populationwere able to read and write. Furtherfindings of the 1961 Census were asfollows: 46.7 percent of the peopleaged 10 and over were able to readand write; the highest literacy rate(72.1 percent) was in the 10-14 agegroup; 22.5 million persons, or about35 percent of the population aged 10and over, had had three or more yearsof primary school; more than 50 per-cent of the population aged 10 to 29had had at least elementary schooleducation, while only 14.5 percent ofthe population in the age group 45-54and less than 10 percent of thoseaged 55 and over had had this mucheducation. In 1961, 54.8 percent ofthe primary-school age group were inschool. For all age groups the level ofeducation of the population was

higher in urban areas than in ruralareas.

In 1970 it is estimated that about50 percent of the population was liter-ate. Those aged 10-29 years have ahigher percentage of literacy thanthose aged 30 and over. About one-half the children of elementary schoolage are now in school, and over206,000 students are in institutions ofhigher learning.

When the children born during thebaby boom of the 1950s began toreach school age, many new schoolswere built and many new teacherstrained. The exceptionally large baseof the educational pyramid suggeststhat continuing pressures to expandwill be placed on the educationalsystem, not only in the primarygrades, but also in secondary schools,vocational schools, and universities.As the population grows and the pres-sures on educa ional resources i ncrease,the system m y only with difficulty beable to maintain progress in increas-ing the proportions of the younger agegroups attending schools, withoutlowering educational standards, eventhough absolute numbers of studentsin school may show an increase.Analyses of the demographic pictureshow clearly that a lowered birth ratewould help to reduce the pressures onthe educational system, enabling it toincrease the average level of educa-tion and to improve educationalstandards.

ECONOMIC STATUS

According to the 1961 Census, 80 per-cent of males aged 10 years and overbelonged to the labor forcedefinedas those persons actually employedfor at least two months during the sixmonths preceding the Census andthose who, although not employed,were seeking employment; 4.8 percentof the labor force was classified asbeing unemployed. Of females, 30 per-cent of those 10 years of age and overbelonged to the labor force, of whom 7percent were unemployed. However, itis noteworthy that the majority ofwomen, particularly in rural areas,are both home-house keepers and alsoengage in other forms of economicactivity.

Almost 10 percent of persons 10years of age and over are students,while 30.5 percent are classified ashome- or house-workers.

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Comparison of urban and ruraldata shows that a larger percentage ofthe population (55.4 percent) is in thelabor force in rural areas than inurban areas (47.1 percen,), a phe-nomenon resulting from the fact thatin rural areas relatively more personsare engaged in economic activities atyounger ages, while, at the same time,the retirement age is higher.

For the country as a whole, about72 percent of employed persons areengaged in agriculture and less than 6percent in manufacturing. Trade ac-counts for less than 7 percent andservices 9.5 percent. The percentageof all persons employed in all non-agricultural pursuits, exclusive oftrade and services, amounts to only10 percent.

FUTURE TRENDSProjections as to the future size ofIndonesia's population depend uponwhich of the estimates of currentbirth rate is chosen and upon sub-jective impressions as to the rate ofdecline of the death rate.

Various projections have been madebased upon different assumptions re-garding the speed at which thesevital rates will change. The highestprojection, assuming a continued highbirth rate and a rapid mortality de-cline, would lead to a population of158 million in 1980, 167 percent ofthat of 1960; lower projections antici-pate a population of 150 million by1980. Within the ranges of thesealternate projections one can reason-ably predict that the population ofIndonesia will double within 25 years.

Population Growth and Socialand Economic Development

RELATIONSHIP TO NATIONAL INCOME

Economic development from 1950 to1970 has not kept pace with the rateof population growth. After a slowrise in the 1950s, per capita incomedeclined from 1958 to 1968. A com-monly quoted figure places the cur-rent average per capita income inIndonesia at approximately $85.00per year. It is apparent that the in-crease in GNP is not paralleled by anincrease in average per capita annualincome because of a rapidly increasingpopulation.

RELATIONSHIP TO SIZE OF THELABOR FORCE

For the purpose of the 1961 Censusthe labor force was held to consist ofpersons 10 years old and over whowere actually at work for at least twomonths during the six months pre-ceding the Census and those who werenot at work but were seeking work.In 1961 there were 64 million persons10 years old and over, of whom 34.6million persons, or 54.1 percent, be-longed to the labor force. Almost 1.5million-5.4 percent of the laborforcewere classified as unemployed.

Further findings of the 1961 Cen-sus, relating to the sex of employedpersons, are as follows. Out of 31.3million males aged 10 and over, 25million, or almost 80 percent, be-longed to the labor force; and 1.2 mil-lion males, or 5 percent of the malelabor force, were classified as being un-employed. In the case of females, onlyabout 30 percent, that is, 6 millionout of a total of 32.6 million aged 10and over, belonged to the labor force.Of this number 7 percent were un-employed. Thus, the number offemales belonging to the labor forcewas less than half of the number ofmales. However, it should be pointedout that, particularly in the ruralareas, the majority of females arehome-houseworkers and are at thesame time engaged in economic ac-tivity. It is imperative ,to take thispoint into account in drawing infer-ences from the Census returns concern-ing the female labor force.

The percentage of the population10 years and over belonging to thelabor force is higher in the rural areas(55 percent) than in the urban areas(47 percent). This phenomenon, whichis found in the case of both males andfemales, is due to the fact that in therural areas there are relatively, morepersons engaged in economic activi-ties at younger ages and the with-drawal from the labor force starts atlater ages. Unemployment is morethan 50 percent higher in the urbanareas than in the rural areas. Thisdifference arises partly because inurban centers overt unemployment ismore easily discernible and also muchmore immediately felt by the personsconcerned. Both in urban and inrural areas the percentage of unem-ployed females is higher than that ofmales.

RELATIONSHIP TO AGRICULTURE

About 72 percent of the 33.1 millionemployed persons of both sexes areengaged in agriculture and less than6 percent in manufacturing. Tradeaccounts for less than 7 percent andservices for less than 15 percent of thelabor force. Those persons employedin all other nonagricultural pursuitsamount to only 10 percent of thetotal labor force.

Of all the islands Java has thelowest percentage of persons engagedin agriculture (68 percent), and thehighest percentage of persons em-ployed in manufaL airing, (i.e., '7 ascompared with 3 for Sumatra).

RELATIONSHIP TO SOCIAL WELFAREEXPENDITURES

The rapid rate of population growthin Indonesia is felt most severely inthe already densely-packed CentralIslands of Java, Madura and Bali.While growth rates in the OuterIslands are also high, some govern-ment officials entertain the belief thatthese areas, less densely populatedbut rich in natural resources, wouldbe enhanced by a larger populationbase. However, in all sections of thecountry, both in the Central Islandsand in the Outer, population growthalready threatens to negate theplanned expansion of educationalfacilities, medical services and welfareprograms, and to strain the capacityof the government to provide ade-quate numbers of qualified teachers,physicians, engineers, and other pro-fessional personnel.

Indonesia's Five - Year - Develop-ment Plan allocates about 16 percent ofestimated development resources inthe public sector to the social field,comprising health and family plan-ning, education and culture, religion,and social welfare. Within this alloca-tion, education and culture have themajor share and are expected to ab-sorb close to 60 percent of the allo-cated resources. Actual expenditureson these social programs during 1969/1970 amounted to less than 10 pnr-cent of the total public sector develop-ment budget.

Since independence, Indonesia hasplaced a high value on mass educa-tion and is striving to provide educa-tion and the benefi ts of literacy for all ofits population. Approximately 80 per-

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cent of children receive two years ofprimary education but less than halfof them finish the sixth grade. Therewere about 13.5 million studentsactually enrolled at all educationallevels in 1961 and 17.4 million in 1967.Total educational enrollment, hasbeen projected to reach 34.7 millionin 1981 at the present populationgrowth rate. The government's goal isto achieve universal primary educa-tion as early as possible.

The Central Government's expen-ditures on education, including bothrecurrent and capital expendituresduring the past years, were of theorder of 43-44 billion rupiah,3 or 13percent of total Central Governmentexpenditures. It has been estimatedthat with a lower birth rate the pro-jected increase in the number ofschool age children would be reduced,freeing government resources for pri-mary and secondary education to theextent of at least 15 billion rupiah be-tween 1976 and 1994a figure whichmay be compared to the 12.6 millionneeded to maintain the present levelof primary education. Similarly, sav-ings of the order of 2 billion rupiahsbetween 1981 and 1994 are projectedin the field of secondary education iffamily planning programs are suc-cessfully carried out.

In the health sector, a Master Planhas been formulated calling for theintegration of curative and preventivehealth services at all levels, the re-habilitation of essential facilities, andthe further development of healthservices. Over the coming four years,the main emphasis will be on train-ing; the continuing integration ofhealth services, with activitiez, ofseparate health centers and poly-clinics gradually being absorbed intomultipurpose public health centers;and the strengthening of communi-cable disease control activities.

Approximately 6.2 billion rupiahsis planned for these objectives duringthe period 1971-1974 by the Govern-ment ..11 Indonesia. The cost of healthand medical facilities can be expectedto rise in direct proportion to the rateof population growth. Some observerspredict that expenditures on a suc-cessful family planning program couldbe, at least partially, offset by savings

3 One Indonesian rupiah = US$0.0027.

in the cost of the government's healthprogram that would come about witha decrease in the population growthrate.

Population PoliciesDIRECT

In 1967 President Suharto signed theDeclaration on Population which hadbeen drawn up on Human RightsDay, 10 December 1966 by UnitedNations Secretary-General U Thant.It affirmed the belief of the signa-tories that "the population problemmust be recognized as a principalelement in long-range national plan-ning if governments are to achievetheir economic goals and fulfill theaspirations of their people; . . . thatthe opportunity to decide the numberand spacing of children is a basichuman right; . . . that lasting andmeaningful peace will depend to aconsiderable measure upon how thechallenge of population growth ismet." In his Independence Day ad-dress to Parliament on 10 August1969, President Suharto made astrong appeal for increased activity inthe field of family planning, empha-sizing that the program should bestarted now lest the gains in produc-tion be cancelled out by the greaterincrease in population.

Despite present support for familyplanning, the Government of Indo-nesia maintains a number of pro-natalist policies. Government officialsand employees receive, in addition totheir basic salaries, certain allow-ances and benefits that may have anindirect influence upon family size.Government workers receive salarystipends amounting to 5 percent ofthe basic salary for the wife of theworker plus 2 percent for each child,with no upper limit to the number ofchildren eligible for this benefit. Eachfamily also receives a rice ration (orits equivalent in money) amountingto 10 kilos of rice for the wife andfor each child.

Female employees of the govern-ment are eligible for maternity leavewith full pay amounting to a monthand a half before delivery and anothermonth and a half during the post-partum period. These provisions areauthorized in the Labour Act and inthe regulations of the Civil ServiceAct. While the disadvantages of theseprovisions vis-a-vis population growth

are recognized by a few governmentalleaders and those directing the familyplanning movement, it seems un-likely that changes will be recom-mended in the foreseeable future.

INDIRECT

Family units. Outside the cities andtowns, the Indonesian people live indifferent genealogical or territorialunits. Three types of genealogical orfamily units (clans) can be clearlydistinguished, namely the patrilineal,matrilineal, and parental family units.In patrilineal communities the socialgroup is based on descent along themale line from one common maleancestor. In matrilineal communities,the female line determines the mem-bership in the family group, while inparental communities, male and fe-male lines determine the relationshipequally. In some territorial or villagecommunities the inhabitants are notbound by kinship, although traces ofa system of kinship may still be foundin individual communities. The jointfamily system is found predominatelyin rural communities, whereas inurban areas the independent familyunit system prevails. The patrilinealsystem occurs mainly in the centralpart of North Sumatra (Bataklands)and South Sumatra (Lampongs), inBali, the Moluccas, and Timor. Thematrilineal system is common inWest Sumatra (Minangkabau); whilethe parental system occurs through-out Indonesia, exerting a great influ-ence on the position of women in thefamily and the number of childrendesired by the family.

In patrilineal communities thepreference for sons contributes to ahigher birth rate, since women will goon having children until one or moresons are born. In these communitiesthe husband may take a second wifeor divorce his wife if she does not givehim a son. In the Bataklands a bless-.ing given by the elders to a youngcouple at the time of the weddingruns as follows: "May you bear 17sons and 16 daughters." In the matri-lineal communities of Minangkabau,daughters are the preferred offspring,but the failure to have daughters doesnot lead to divorce or polygamy. Inparental communities boys and girlsare equally valued, but in communi-ties with a strong Muslim influence itis preferred to have at least one son.

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Warren's orgct niza t ion s. A largenumber of Indonesian women aremembers of one or more women'sorganizations. Thirty-nine of themost important women's organiza-tions are affiliated in the KongresWanita Indonesia (Kowani) withbranches throughout the country.The affiliates of the Kowani consist ofpolitical as well as nonpoliticalwomen's organizations: sister organi-zations of the main Islamic partiesand social Islamic women's organiza-tions; a sister organization of theNationalist Party; the ChristianWomen's Association; the various or-ganizations of the Armed Forces; theUniversity Women's Association; andmany others. Many of the govern-ment departments and companiesalso have women's organizations forwomen workers and wives of workers.These women's organizations play animportant role in supporting thefamily planning program; they or-ganize talks about family planningfor their members and set up familyplanning clinics. In a congress held18-20 February 1970 in Djakarta, theKowani decided to give full supportto family planning by including it inits program and urging its member or-ganizations to include it in their ownplans of action.

RELEVANT LAWS

Marriage regulations. With regardto marriage law, different regulationsdating from the Dutch colonial periodprevail for the various groups of Indo-nesian citizens. The marriage law ofIndonesian citizens of European orChinese ancestry as regulated in theCivil Code is based on monogamy, andstipulates that the minimum age ofmarriage is 18 for men and 15 forwomen. Special marriage regulationsfor Indonesian Christians also arebased on monogamy and stipulatethat the minimum age of marriage is18 for men and 15 for women. Themarriage law for thnse who profess theMuslim religion, the majority of Indo-nesians, is regulated by custom andMuslim religious law in which nominimum age of marriage is stipu-lated. Since 1968 two Bills of Mar-riage have been discvssed in Parlia-ment that call for a minimum age ofmarriage of 18 for men and 15 forwomen. Since child marriages are notprohibited ant! still occur in the rural

areas, the passage and enforcement ofthe proposed Marriage Bills could, ifimplemented and followed, have aninfluence on the mean age of marriageand consequently on the birth rate.The Marriage Bill for IndonesianMuslims also includes provisions re-lating to polygamy, which is nowlegal under certain conditions.

Legal provisions. In the Penal Codedating from the Dutch colonial times,Article 534 prohibits the dissemina-tion of information about contracep-tive methods. Although the AttorneyGeneral has declared that nobodyworking in the family planning fieldwill be prosecuted under this law, thearticle does impede somewhat theeffective implementation of the gov-ernment program, as the giving ofinformation on family planning isstill technically illegal.

The Second National Conference ofthe Indonesian Planned ParenthoodAssociation held in 1970 in Jogja-karta has appealed to the governmentto repeal this provision of the PenalCode.

Abortion. According to the PenalCode abortion is illegal. No attemptshave been made to legalize it or tomodify this part of the Code in anyway. Little or no information isavailable relating to the prevalence ofabortion in Indonesian society.

History of Population ConcernsIn 1953 a small group of concernedprivate citizens in Indonesia began topromote family planning. Their ef-forts culminated in the organizationof the Indonesian Planned Parent-hood Association (IPPA) four yearslater. The early efforts of the familyplanning movement were restricted toproviding information about the aimsand purposes of family planning, in-viting the opinions of religious leaderson the subject, and offering servicesin a few clinics. The political climateduring these years was hostile to theconcept of family planning, with theresult that the program developed asone that offered clinical services witha minimum of publicity and fanfare.During these early years of the pro-gram, the Pathfinder Fund gave as-sistance and helpful guidance; severalvisits to Indonesia by Pathfinderrepresentatives were made. By 1963seminars on family planning were

conducted in seven different localitiesin Java and Bali; the IPPA estab-lished eight branches on Java, Su-matra, and Bali, with a central head-quarters in Djakarta. Training oppor-tunities in Indonesia and funds forattendance at international confer-ences were made available to phy-sicians by the Population CounLil andthe International Planned Parent-hood Federation (IPPF).

The political and social turmoil ofthe mid-1960s in Indonesia was re-flected in the work of the voluntaryassociation. Contacts between thecentral group and the provincialbranches and clinics were weakenedor broken altogether, and relation-ships with supporting institutions atthe international level were disrupted.

Following the change in adminis-tration and political leadership in thecountry after the abortive coup inSeptember 1965, the family planningmovement began to emerge from theatmosphere under which the subjecthad been almost taboo. In February1967 a National Conference on Fam-ily Planning was held by the IPPAwithrepresentatives from the voluntaryassociation and government officialsand social leaders. From the speeches ofthe Ministers of Health and of Man-power, the Governor of the City ofDjakarta, and the Secretary Generalof the Department of Social Affairs,it was evident that the new govern-ment supported the concept of familyplanning. Most encouraging was theassurance of the Coordinating Minis-ter of People's Welfare that familyplanning would be included in thegovernment's program.

Subsequently, the IPPA became amember of the IPPF and expandedits activities considerably. Its pro-gram, which had, until around 1967,been supported almost entirely byfunds generated by the sale of contra-ceptives (donated to the voluntaryassociation) and contraceptive serv-ices, began to receive financial andtechnical support from the IPPF andthe Ford Foundation.

The increasing acceptance of theconcept of family planning amongsocial and governmental leaders andthe development of a program reach-ing throughout the country haveoccurred in the last three years, andespecially since the IndependenceDay speech of the then Acting Presi-

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dent Suharlo, 16 August 1967, inwhich he said:

Looking far into the future, we shouldcourageously face the fact that the in-crease in the rate of population will notbe in balance with the rate of availablefood supplies, whether produced at homeor imported. We should, therefore, payserious attention to efforts in birth con-trol with the idea of planned parenthoodwhich can be justified by the ethics ofReligion and the ethics of Pantjasilathe five pillars or five principles on

which the Republic of Indonesia isbased: belief in God, nationalism, hu-manism, democracy, social justice]. Thisis a principal problem related to the fateof our future generations. So it should bedone thoroughly and according to plan.

Population Programs

OBJECTIVES

The long-range target of the nationalfamily planning program in Indo-nesia will be to bring about a reduc-tion of the birth rate and a conse-quent lowering of the populationgrowth rate. The more immediatetarget during the next few years willbe to build up the supporting infra-structure through the strengtheningof clinic services, the training of per-sonnel, and a large-scale public edu-cation program.

The National Planning Board(BAPPENAS) and the Ministry ofHealth have formulated objectivesthat call for a slowing of the growthrate, but to date most policy state-ments and planning documents cite asthe primary goal of the family plan-ning movement the benefits that willaccrue to the health and welfare ofmothers and children. Family plan-ning is an integral and importantpart of the government's Five-YearDevelopment Plan. In reference tofamily planning, the plan addressesitself to two principal. objectives:

(1) To improve the health and wel-fare conditions of mothers, chil-dren, the family, and the nation.

(2) To raise the level of the people'sliving standard by decreasing therate of birth so that the popula-tion increase will not exceed theability to step up the grossnational product.

ORGANIZATION

The organizational pattern of thenational program is currently under_

going revision. The National FamilyPlanning Institute of Indonesia, cre-ated in October 1968 by the StateMinister of People's Welfare, is nowin the process of being superseded bya Coordinating Body for FamilyPlanning. Both of these institutionsare described in the paragraphs thatfollow.

The National Family Planning In-stitute was "primarily obligated tocreate the social welfare of the familyin particular, and the people andnaion in general" by: (a) coordinat-ing family planning programs andactivities, (b) making recommenda-tions to the government about thenational program, (c) promoting co-operative arrangements between In-donesia and other countries h thefield of family planning, (d) develop-ing family planning on a voluntarybasis and with a broad approach, in-cluding marriage ,ounseling and thetreatment of sterility.

The Institute was made up of anAdvisory Board of 40 members work-ing through a Central Plenary Execu-tive Board of 17 members concernedwith the formulation of broad policymatters, approval of budgets, and or-ganization of financial resources, bothdomestic and foreign. Pending theappointment of an executive officercharged with the implementation ofthe decisions of the Board, the Cen-tral Plenary Board combined bothpolicy-making and executive func-tions. A central headquarters staff wasappointed and the organization ofprovincial and district bodies withmembership representative of suchfields as health, education, informa-tion, and voluntary agencies wasinitiated.

On 22 January 1970, by a Presi-dential Order, the National FamilyPlanning Institute was superseded bya new Coordinating Body for FamilyPlanning in which the policy-makingand executive responsibilities promiseto be more clearly delimited. TheCoordinating Body has a single execu-tive officer appointed by the Presi-dent, two deputies, and a central staffgrouped into six ko eight functionalbureaus. The Coordinating Body willcoordinate the work of the severalministries, institutions, and agenciesthat conduct activities in the field offamily planning.

The Ministry of Health, working

under the general guidance of, and asa major operating unit of, the familyplanning program, is expected to beassigned responsibility for three mainfunctional parts of the national pro-gram: (1) services in clinics and hos-pitals of the Ministry of Health, (2)the provision of supplies and logisticalsupport for all family planning clinicsin the country, and (3) record keepingand the collection and analysis ofmost of the service statistics from thegovernment clinics,

The Indonesian Planned Parent-hood Association until recently hadalmost sole responsibility for all as-pects of the family planning programthroughout the country, operatingthrough a network of local branchesstaffed by volunteers and making useof clinical facilities and staff of gov-ernmental health and maternal andchild health (MCH) services. As thenational program grows and develops,former elements of the program of thevoluntary association are being turnedover to the Coordinating Body andto the Ministry of Health. It appearslikely that in the coming years theassociation will be given responsibil-ity for training some categories offamily planning workers, for much ofthe public information program, andfor some types of research andevaluation.

Other groups, such as the ArmedForces, consisting of the Army, Navy,Police, and Air Force, as well as cer-tain of the religious and social groups,are in process of organizing familyplanning activities that will be co-ordinated by the governmental Co-ordinating Body.

The provincial level is importantbecause several of the provinces inJava have populations commensuratein size with those of many independ-ent countries (East Java, alone for ex-ample, claims 29,000,000 inhabitants).The Coordinating Body is in the proc-ess of appointing provincial repre-sentatives, who will be responsiblefor coordinating programs and proj-ects at the provincial level, and forencouraging and stimulating newfamily planning activities. The pro-vincial governors are to be assignedfinal responsibility for provincial ac-tivities in the field of family planning,an arrangement that promises to en-courage a cooperative approachamong such key provincial depart-

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ments as those of health, education,social welfare, finance, and informa-tion, and among voluntary agencies.The chief health inspector of theMinistry of Health is most commonlythe delegate of the governor in carry-ing out these functions. In effect,there will be created, in each province,a smaller coordinating body that willreflect the duties and functions of thenational coordinating body at thecentral level.

The National Coordinating Bodyhas received the report of a missionorganized by the United NationsWorld Health Organization and theWorld Bank Group, prepared at therequest of the Government of Indo-nesia. The recommendations of themission are currently under reviewand are expected to serve as a majorcornerstone to the Five-Year Na-tional Family Planning Program soonto be presented to the government bythe National Coordinating Body.Both documents propose a target of6,000,000 new acceptors over the five-year period.

OPERATIONS

Character of the program. A funda-mental operational decision, initiatedby the voluntary association andadopted by the national agency, wasto utilize existing health facilities andhealth personnel in the developmentof the family planning service pro-gram. About 2,700 MCH centers andabout the same number of midwivesare available in the initial programareas.

Another policy advanced in earlydiscussions about the probable growthof the national program now receivesless official attention: it was proposedthat the program be initiated in themajor provincial capital cities, ex-panded subsequently to other urbanareas, and finally extended to ruralareas. Currently, planners are con-cerned with a simultaneous expan-sion in both urban and rural areas.

As of early 1970 almost 400 familyplanning clinics offer services in Min-istry of Health facilities, in the clinicsand hospitals of the Armed Forces,and in clinics operated by other agen-cies. A typical clinic is located in orbeside an existing MCH clinic and isopen one or two mornings per week.It is staffed by a physician and a

nurse-midwife, assisted by one ormore aaxiliary workers. Contracep-tive services and advice in the typicalclinic are provided by the clinic staffin the clinic setting; home visits togive information, to recruit potentialnew acceptors, or to follow up on pa-tient:. who have visited the clinic arenot functions of the clinic staffmember.

In a few pilot areas, family plan-ning field workers have been attachedto clinics. They are responsible formeeting potential clients outside theclinic, and utilizing home visits, smallgroup discussions, or talks to organ-ized groups to convey informationabout the benefits of family planningand to stimulate referrals to clinicfacilities. In early 1970 there wereroughly 150 such field workers, few ofwhom had been employed for as longas one year. Plans are being discussedto recruit, train, and employ a largecadre of field workers over the com-ing years. A target of 15,000-20,000over a five-year period has been ad-vanced by some planning groups.Such a large number of workers willprove to be one of the most costlyelements of the program over the longterm; therefore, careful evaluation ofthe present field worker program andthe organization of additional demon-stration projects are anticipated asprobable early next steps.

During 1969 the logistical supportsystem for Java, Bali, and Madurawas transferred from the voluntaryassociation to the Ministry of Health.All contraceptive supplies and relatedmaterials, such as sets of medical in-struments for IUD insertions, areconsigned to the Ministry of Health;enter the Ministry's supply channels;pass through its central warehousesto provincial warehouses; and are de-livered to the clinics themselves. Asof early 1970, this supply pipeline waswell stocked with over 300,000 IUDs,1,700,000 cycles of orals, and signifi-cant quantities of condoms and foamtablets. The IPPA continues to beresponsible for providing supplies tothe outer islan's.

While no official schedule of recom-mended fees to be charged to patientshas yet been made mandatory for theclinics, typical charges range from100-150 rupiahs (US 25-35 cents)for an IUD insertion, 100 rupiahs(25 cents) for a cycle of pills, and a

rupiah or two for each condom orfoam tablet. Patients who are unableto pay these modest fees may receivetheir supplies at a reduced price or atno cost whatsoever. The practiceat most clinics of charging a smallregistration fee and service chargesfor follow-up visits means that theabove figures do not reflect thesometimes large hidden costs to thepa Lien Is.

A postpartum program was initi-ated in 1969 in five large hospitals inDjakarta and Bandung as part of thePopulation Council's InternationalPostpartum Program. Other post-partum activities of a more modestscope are being introduced in othermaternity hospitals in several prov-inces as a result of the success of thedemonstration project.

Training programs. Training offamily planning workers is carriedout in the National Training Center(NTC) for Family Planning, locatedin Djakarta, and in six ProvincialTraining Centers (PTCs) located inthe six provincial capitals of Java andBali. All centers are conducted by andoperated through the IndonesianPlanned Parenthood Association.Each has the capacity to train 300workers per year, making a total out-put of 2,100 for the seven centers inthe course of a twelve-month period.The National Training Center trainsthe staffs who work in the PTCs andarranges special training courses forgovernment officials, opinion leaders,and others whose position requirestheir understani, ing of, and supportfor, the family planning movement;the NTC also trains some workerswho will be responsible for clinic ac-tivities. It sets training standards andrecommends curricula for use by thePTCs.

The PTCs chiefly train physicians,nurses, midwives, and others whowill have clinic responsibilities. Train-ing programs for physicians usuallyare of two weeks' duration; eachphysician trainee is expected to per-form five IUD insertions as part of histraining; nevertheless, limited clini-cal material makes this target un-attainable in some areas. Paramedi-cal workers receive two weeks oftraining. In the nine-month periodAprilDecember 1069, 1,600 familyplanning workers were trained underthis program, and the annual target

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of 2,100 was achieved by the end ofthe fiscal year in April 1970.

Orientation courses for other healthand social welfare personnel are givenby the respective ministries either inspecial workshops, during regular up-grading or refresher courses, or aspart of basic training programs.These courses are usually of two tothree days' duration and are designedto give a general understanding ofthe program and its benefits; theseworkers are not trained for specificfamily planning tasks, but are ex-pected to help support the programin the course of their regular profes-sional duties.

Other family planning workershave been trained at the RegionalTraining Center of IPPF in Singa-pore (23 in 1969), and in 1969 an ad-ditional 109 workers attended formalprograms of instruction or madeshort observational tours to seefamily planning programs in othercountries.

Information and education. Theprogram of information and educationof the public in matters relating tofamily planning was severely limitedduring the 1950s and 1960s, with theresult that the service program hasoutpaced the information program.The Indonesian Planned ParenthoodAssociation for many years main-tained a speakers' bureau whose goalwas to reach opinion leaders and gov-ernmental authorities through talksto women's organizations, nationalconferences, and programs for otherorganized groups. The volunteers ofthe association also employed news-paper, radio, and television. A limitednumber of pamphlets and posters wasprepared and distributed through thelocal IPPA branches. Currently, sev-eral demonstration areas are experi-menting with a program in whichfamily planning field workers developa face-to-face communications ap-proach through home visits and smallgroup meetings at the communitylevel.

The trend in Indonesia is toward acomprehensive information programthat will incorporate both the massmedia (radio, newspapers, television)and the face-to-face approach (per-sonal critact, small L,rroup discus-sions) and utilize a multifaceted mix-ture of teaching aids. Projected planscall for a marked intensification of

all informational activities throughthe several ministries and voluntaryagencies operating under the guidanceof the National Coordinating Body.

Methods. The four contraceptivemethods employed in the nationalprogram are the IUD, oral contra-ceptives, condoms, and foam tablets.A cafeteria approach is publiclyavowed but in practice most physi-cians and clinic workers directly orindirectly advocate the IUD or thepill.

In 1969 over 50,000 new acceptorschose the following methods duringtheir first visits to family planningclinics: IUD, 26,400; oral contracep-tive, 15,000; other, about 9,000. Thehigher proportion accepting the IUDin 1969 reflects not only the prefer-ence of patients and a probable biasof family planning workers towardthis method, but also the tenuoussupply situation of oral contracep-tives in the first half of the year;many clinicians were reluctant tostart new clients on the pill untilthere was reasonable assurance thatthe supply channels could supportlarge numbers of pill acceptors. Bythe latter half of 1969, when theavailability of continuing stocks wasassured, the ratio of pill to IUD usersprobably increased, although thedata are not reliable.

The relatively low number of ac-ceptors of traditional methods prob-ably reflects the predilection of clinicstaff toward recommending loops andpills; it may also reflect a preferencefor loops and pills on the part of pro-gram administrators and clients them-selves.

A few small studies were made ofthe injectable Depo Provera4 insome of the larger teaching hospitals.Reported results of these studies sug-gest that the method could quicklygain popular favor; however, the com-mercial sale of injectables is not yetofficially sanctioned for contraceptiveuse.

An estimated 65,800 IUDs havebeen inserted in the period 1 Janu-ary 1967-30 June 1970; this figure,however, contains a serious degree ofunderreporting, since only data sub-mitted to IPPA are recorded. Com-parable figures for orals and conven-

4 An injectable progestagen of long (threeto six months') duration and effectiveness.

tionals during the same period are30,900 and 19,300.

IUDs are provided by the Popula-tion Council at no cost. The Lippesloop is the only IUD distributed bythe national program, although theM-loop is being tried in a few clinics;and two Indonesian physicians havefor several decades been insertingtheir own specially designed andlocally manufactured devices.

Personnel. The National FamilyPlanning Institute, at the time its ac-tivities were taken over by the Co-ordinating Body, was made up of anAdvisory Board of about 20 membersand a Plenary Committee of another15 supported by a staff of 50 personsat the central level and 30 in the pro-vincial structure. While most of thelower level staff such as clerks,drivers, and messengers (totalling,perhaps 25) were employed full time,most of the professional staff servedon a part-time basis.

The new Coordinating Body is ex-pected to have more full-time staffmembers, organized under an execu-tive officer (the chairman), two depu-ties, and six bureau chiefs. With themain function of coordinating thework of the several family planningagencies, the Coordinating Body mayemerge as a small group, workingthrough other units and utilizing thecontract method in stimulating spe-cific projects.

The Indonesian Planned Parent-hood Association operates through anexecutive secretary, a deputy, a fieldcoordinator, and an office manager,plus an office staff of 20 full-timeworkers and a cadre of part-timevolunteers.

At the provincial level, the Na-tional Family Planning Institute has,typically, five employees and the Pro-vincial Chapter of the voluntary asso-ciation has two or three.

Clinic staff, such as physicians,nurses, and midwives, are usuallysalaried government employees in theMinistry of Health with responsi-bility for other aspects of the healthservices programs. Fees collectedfrom patients are distributed on amonthly basis to clinic workers as aform of incentive payment in manyclinics, while other incentive pay-ments are made to field workers forreferrals. One or more mornings aweek may be devoted to family plan-

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ning clinic activities. Since approxi-mately 400 clinics were operating inearly 1970, one can reasonably as-sume that about 400 physicians and800 other workers were engaged, parttime, in family planning activities.

RESEARCH AND EVALUAfPION

The Indonesian Planned ParenthoodAssociation for many years has as-sumed responsibility fki)r collectingand tabulating data on acceptors ofcontraception who attend the familyplanning clinics of the Association.During the present transitional pe-riod, as the Ministry of klealth takesover the major share of i!he responsi-bility for clinical services in the na-tional program and as the NationalCoordinating Body prephres itself tosupervise the service statistics activi-ties, the responsibility for collectingand tabulating these reports is di-vided between the Association andthe Ministry. Clinics at the presenttime continue to send monthly ac-tivity reports to the central officeswhere simple tabulations are madeabout numbers of new and old ac-ceptors by method of choice. Severalrecord and report forms have beendeveloped, but not all clinics areusing them.

It is planned to review and revisethe record-keeping syFitern, to trainclinic workers in its t4e, and to de-velop the tabulation and analysis ofthe results at both the provincial andthe central level. It ids likewise ex-pected that full responsibility for theservice statistics program will be as-sumed by the National CoordinatingBody. The United Nations EconomicCommission for Asia and the FarEast (ECAFE) has offered technicalassistance and financia:I support in le-viewing the present sIstem, assistingin its revision, and training personnelin its use.

The National Family Planning In-stitute (LKBN) ha& established asmall research bureau! at the nationallevel. Under the new family planningcoordinating body, the bureau willstimulate, sponsor, an0 coordinate allresearch and evaluatichi activities con-ducted by the several agencies withfamily planning programs. The re-search bureau will identify areas re-quiring research and; evaluative ap-proaches, will seek to interest indi-viduals and institutions in studying

these problems; and will arrangeprobably through contractual agree-mentsfor the necessary funding. AResearch Review Panel will meetperiodically to study and commentupon research proposals; to assignpriorities to the types of researchneeded; and to receive reports on re-search completed.

A national sample survey (NSS)was initiated by the Central Bureauof Statistics in 1963. The nationalsample in principle covered the entirecountry and all strata and categoriesof population. It involved a sample ofsome 40,000 households. Data ondemographic characteristics, employ-ment and unemployment, and con-sumption expenditure were collected.The third round of this survey wascompleted in late 1967. Results arenot yet available.

In July 1967 a survey was con-ducted in urban Djakarta by thestaff and students of the Social Sci-ence Department of the University ofIndonesia. The survey showed that amajority of the 2,000 respondentswere favorably inclined toward fam-ily planning. A large number of re-spondents, however, had no knowl-edge of the subject. This study demon-strated the feasibility of conductingfurther surveys on fertility and familyplanning in Indonesia and stimulatedthe approval of the more definitiveknowledge, attitude, and practice(KAP) study described below.

A KAP survey was undertaken byIPPA in 1967 with Ford Foundationtechnical assistance and financial sup-port. The total sample consisted of2,246 respondents, approximately halfof whom were male and half female,all drawn from the age group 15-49and classified as "ever married." Themain findings of the study may besummarized as follows: The level ofknowledge about family planning inthe sample studied is extremely low;there is evidence of strong positiveattitudes toward family planning witha high level of desire to obtain moreinformation; contraception is prac-ticed by only a small fraction of thesample population and the methodsthat are being used are generally in-effective. A crude birth rate of 46.7and a total fertility rate of 57.7 wasderived from this study for 1966-1967.

The School of Public Health has

undertaken an evaluation of threefamily planning clinics in two sectionsof Djakarta, has studied the effective-ness of the three clinimobile unitsused in the family planning move-ment, and has made an evaluation ofthe family planning exhibit at theDjakarta Fair.

Bekasi, a rural area outside Dja-karta, is the site of a pilot study andservice area where a "before-and-after" evaluation conducted by theIPPA has been under way since 1967.However, problems of transport andcommunications and difficulties in theorganization of the service and infor-mational program have hindered theproject; illustrative of the problemsinvolved in the development of thisproject is the fact that Bekasi has apopulation of 800,000 and until re-cently was served by only two phy-sicians.

Limited clinical research has beenconducted in Indonesia for severalyears. Studies of IUDs were under-taken by the Department of Obstet-rics and Gynecology at the Universityof Indonesia Faculty of Medicine.This group is continuing to evaluateseveral of the newer IUDs and oralcontraceptives along with small stud-ies of Depo Provera and Deladroxateinjectables. The Department of Ob-stetrics and Gynecology at the Uni-versity of Padjadjaran Medical Schoolin Bandung is also conducting studieson the safety and effectiveness oforal, IUD, and injectable contracep-tives.

Two IUD retention rate surveysand one pill-continuance-use studyhave been undertaken by the Dja-karta municipal project with a grantfrom IPPA, and an IUD retentionrate study was done in Surabaja in1968.

The five hospitals participating inthe Population Council's Interna-tional Postpartum Programthree inDjakarta and two in Bandunghaveshown encouraging results as to theeffectiveness of this approach inIndonesia.

Several smaller action-cum-researchactivities sponsored by the Path-finder Fund have been initiated or areunder way. Most of these are con-cerned with studying techniques ofusing field workers, paid on a salariedor "incentive-payment" basis, to re-cruit new contraceptive clients.

The National Institute for Eco-nomic and Social Studies (LEKNAS)is studying problems of urbanizationin Djakarta and will be concerned, inpart, with studies of the effect ofreproductive practices on populationgrowth.

Research proposals in the generalfields of demography, service statis-tics. operational research, and socio-economic studies are projected for1971 and subsequent years. Fundswere earmarked for research andevaluation activities during 1970,totalling about $81,000 in the bud-gets of the IPPA and in the NationalFive-Year Development Budget.

Budget. Reflecting recent govern-mental decisions that recognize familyplanning as an important nationalgoal, budgetary resources available tothe family planning movement havebeen significantly increased. The fol-lowing comparison between the finan-cial resources provided in 1967 (thelast year when the Indonesian PlannedParenthood Association almost single-handedly supported all clinical andother services) and those available in1969 (when the national programbegan to get underway) is illustrative.

In 1967, IPPF financial assistanceto the IPPA was about $30,000, in-cluding donations of contraceptivesupplies. Operating expenses for localadministration and information andfor education and clinic activitieswere largely provided through thesale of contraceptives and contracep-tive services in family planningclinics. By 1969 available resourcesfrom all sources, domestic and foreign,exceeded $3,000,000 exclusive of theconsiderable indirect assistance givenby the Ministry of Health and re-lated institutions that provide clinicfacilities, personnel services, and lo-gistical support to the family planningprogram. Analyses have not yet beenprepared that show the allocation ofthese resources by functional cate-gories such as clinical services, lo-gistics, information activities, train-ing, and research and evaluation.

Assistance fromInternational Agencies

Foreign assistance during the year1969 was received from private insti-tutions, international agencies, andbilateral organizations. The privateinstitutions such as the International

Planned Parenthood Federation, FordFoundation, Population Council,Pathfinder Fund, Church World Serv-ice, and World Assembly of Youth,whose assistance was mainly chan-neled to the private organizationsconducting family planning activities,totaled approximately $688,000. In-ternational agencies such as theUnited Nations Educational, Scien-tific, and Cultural Organization(UNESCO), United Nations Chil-dren's Fund (UNICEF), United Na-tions Population Division, and theInternational Bank of Reconstructionand Development gave direct or in-direct assistance valued at $155,000,much of which was in the form ofsupport for basic health services andMCH programs not directly attribut-able to family planning but nonethe-less of considerable importance tothat program. Bilateral agencies suchas the U. S. Agency for InternationalDevelopment (AID) and the SwedishInternational Development Authority(SIDA), and countries like Japan andthe Netherlands provided or prom-ised support totalling $1,734,000.

When these contributions frominternational agencies are added tothe direct allocations made by theGovernment of Indonesia through itsnational and provincial programs andfrom the Special Capital Territory ofDjakarta (DCI) during 1969, a totalof about $3,271,978 is derived whichdoes not include the contributions-in-kind made by the Ministry of Healthand alitr local participating insti-tutions.

SummaryThe family planning movement ofIndonesia is currently passing througha transitional phase in which the pro-gram, formerly conducted almost en-tirely by a group of dedicated andinterested volunteers working undersevere governmental restrictions, isnow recognized and accepted as de-serving of significant governmentalsupport. The President of the Re-public has on several occasions pub-licly stated his support for the con-

cent of family planning and has calledfor the formation of a national insti-tute or body to coordinate, guide, andsupervise work in this field. In aPresidential Decree the President hasundertaken responsibility for the de-velopment of the national programand for the appointment of the chiefexecutive of the National Coordinat-ing Body for Family Planning.

Close cooperation has been main---od among the several agencies and

itions that have the potential:aking the most important con-

tributions to the movement, such asthe Indonesian Planned ParenthoodAssociation (IPPA), the NationalFamily Planning Institute (LKBN),the National Coordinating Body, theMinistry of Health, and the DjakartaFamily Planning Project. That thereis not only close contact betweenthese groups but even an interlockingand duplication of their top policy-forming and implementing arms sug-gests that institutional friction anddisagreement may be held to aminimum.

Indonesia, faced with a series ofgrave economic problems demandingimmediate attention, has not untilnow attached high priority to a na-tional family planning program de-signed to reduce the country's rapidrate of natural increase. Pilot projectsare under way and program planshave been developed for the initiationof a national five-year program thatwill probably serve to strengthen theinfrastructure of family planningservices over the coming period butthat is not likely to achieve a sig-nificant reduction in the growth rateas presently projected. Nevertheless,with the strong support of the na-tional planning agency and the gov-ernment, particularly through theappointment of a strong executiveofficer to direct and coordinate thenational program, the impressive re-sources of the country could bemobilized toward the development ofa program that would address itself toa reduction of the population growthrate within the coming years.

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THE POPULATION COUNCI L2l Park Avelino. New York, New York 10017

The l'opula lion Council is a foundation .4,0,lishod in 1952 for scientific training 111111 Study inpopolitlion mailers. It endeavors to advanceknowleage in the broad field of population byfostering research. training, and technical C1111-M11111(1011 111141 11SHIS11111120. in Lhc suciul 1111(1lnedical sciences.

11I/AECI, (11 TICUNTIMi;

John I). Rockefeller ord. ChairmanChairman of Ihr BoardThe llochefeller Poondoilon

Bernard BerelsonPresident, The Population Council

Country Profiles is a series of occasionalpapers issued by the Information Officeof the Population Council. Based on aninternationally comparable outline, eachProfile sets forth the nature, scope, andaccoinplishments of population activitiesin a specified country. Selected issues areavailable in French or Spanish.

Country Profiles published to date include:Chile, October 1970.Ghana, October 1970.Hong Kong, November 1969.Iran, December 1969.Jamaica, April 1971.Japan, March 1971.Korea, Republic of. April 1970.Malaysia, July 1970.Mauritius, September 1970.Pakistan, March 1970.The Philippines; June 1970.Sierra Leone, September 1969.Taiwan, February 1970.Thailand, May 1969.Turkey, January 1970.United Arab Republic, August 1969.

Other publications issued by the In-formation Office are:

Studies in Family Planning, a monthlybulletin containing articles on a widerange of' topics related to population andfamily planning. Available in French andSpanish, beginning with Volume 1, Num-ber 99, January 1970.

Reports on Population/Family Planning,a series of occasional papers, each pre-senting in depth the current experience,information, and evidence on a centraltopic related to population and familyplanning. Selected issues available inFrench and Spanish.

Current Publications in Population/Fam-ily Planning, a four-page abstract/bibliog-raphy issued every other month and con-sisting of titles deemed by the Councilstair to be of particular interest to admin-istrators and scholars in the field. Avail-able in English only.

These publications are issued withoutcharge. Persons wishing to receive any oralk of them should address their requestsM: Information Office, The PopulationCouncil. Bulk orders may be requested foreducational purposes.