Jakarta – Decentralization has been blamed for the downfall of the national family planning program during the reform era.
Activists and officials say that the program, a success during the Soeharto regime, has been damaged by a lack of awareness on the part of local administrations and shifting priorities in national development programs.
"The government has to put the reproductive health program, including family planning back, at the top of its priorities, otherwise the country will face an unrestrained expansion of population in the future," said Inne Silviane, executive director of the Indonesian Planned Parenthood Association (PKBI).
Under the regional autonomy system, the National Family Planning Coordinating Agency (BKKBN) has little power, as many regency administrations have merged the office with other institutions. There is also less funding for the family planning program, which has been blamed for the recent baby boom.
Data from the Central Bureau of Statistics shows that the country's total population has continued to increase in recent years, from 179.4 million in 1990 to 205.8 million in 2002. The number reached 219 million in 2005. Experts have predicted the number could soar to 298 million people by 2050.
The birth rate declined from 5.6 percent in 1970 to 3.02 percent in 1991, and to 2.6 percent over the past few years, but that rate represents the birth of more than 4.2 million infants annually.
The government was also asked to be aware of the real population growth/birth rate minus the mortality rate, which according to the BPS reaches up to 3.2 million people, or 1.4 percent, per year.
"The threat of soaring population numbers has to be the government's main concern because the population problem goes beyond the number. If population control doesn't happen in tandem with economic development, this could lead to various problems, not excluding poor health, limited education and poverty," said BKKBN deputy chairman for family planning and reproductive health Siswanto Agus Wilopo.
He said that it was good that the government had finally increased the budget for reproductive health services, including for the family planning program.
"We'll receive up to Rp 1 trillion (US$110 million) for the program, making us optimistic the family planning campaign will be revitalized next year," said Siswanto. Over the past few years, the BKKBN has received between Rp 500 billion and Rp 600 billion.
He explained that since family planning problems were rooted in a combination of lack of education and information, advocacy and campaigns about quality family planning should be a priority for the government, especially for low income groups and people in rural areas.
They needed to understand how family planning related to reproductive health and not only learn about using contraceptives, Siswanto added.
Data shows that the number of contraceptive users among fertile couples has reached more than 60 percent of the population since 2002, but the contraceptive rate among poor families reached only 52.4 percent, which means this population segments makes the greatest contribution to the millions of babies born every year in the country.
These people suffer the most due to poor access to family planning, both in terms of information and service. Their lack of understanding of contraception is among the reasons for unwanted pregnancies and other problems related to reproductive health, including the alarming mortality rate of 307 deaths per 100,000 births in the country, the highest in Southeast Asia.
Inne of the PKBI said that despite its weakened authority at the regency level, BKKBN still had bargaining power at the provincial level.
"I understand that every region has its own priorities for development, however continuous advocacy and support from the central government will drive them to place more of a focus on reproductive health, particularly in the family planning program," she said.