Elly Burhaini Faizal, Jakarta – Poor women in urban areas are reluctant to accept contraceptives offered to them for free, hampering efforts to slow the country's population growth.
Few were even aware of the importance of using contraceptives, National Family Planning Board (BKKBN) deputy chairman Julianto Witjaksono said.
"Poor people are somewhat reluctant to seek contraceptives, saying that they have no money to get contraceptives at care centers," he said at a media briefing. In fact, he said, contraceptives for low-income families were free of charge.
"I think they have a particular way of thinking that we find hard to change," Julianto said, adding many considered children as investments.
Elvi Royyana, 43, a midwife from an East Jakarta community health center (Puskesmas), said it was not easy to encourage people to use contraceptives, especially long-term ones such as implants or intra-uterine devices (IUD).
"Many people are reluctant to use IUDs, saying that it will cause severe bleeding and affect their sexual pleasure – which is totally wrong," she told The Jakarta Post.
Of the 192 patients who received contraceptives at the Puskesmas, just five had the implanted types and 15 received IUDs. The rest chose contraceptive injections.
According to the 2007 Indonesia Demography and Health Survey (SDKI), fertility rates are greatly differ between the poor and wealthy.
Julianto said that uncontrolled population growth could place a greater economic burden on poor families, which would eventually produce social problems. As of last September, 10.95 million of the country's 29.89 million poor people lived in cities, Central Statistics Agency (BPS) data states.
Recent BKKBN research shows that urban poor people in Indonesia have an average of three to six children. In Semarang, Central Java, the number of children born to some families even reached up to 10 people. With such huge numbers of children, parents bear a heavy burden in raising their children.
"In West Nusa Tenggara (NTB), for example, many children dropped out of elementary schools and are working only as construction laborers or half-unemployed workers in their adulthood," BKKBN researchers concluded in the study, which took place in the three provinces with highest number of poor people: Central Java, NTB and Gorontalo.
The BKKBN's acceptors-management director, Wicaksono, said many poor people had trouble just traveling to receive contraceptives.
"Even if contraceptive care is available in community health centers, many urban poor people face difficulties to reach the available care. They must spend a lot of money to transport them to care centers," he said.
In 2012, the BKKBN rolled out family planning programs in urban slum and poor areas in cities of 10 provinces, comprising Banten, Central Java, DKI Jakarta, East Java, East Kalimantan, Maluku, South Kalimantan, South Sulawesi, West Java, and West Kalimantan.
The program allows poor people to receive better access to family planning and contraceptives in hospitals, maternity clinics, community health centers, private clinics and even from a mobile team. People in slums, the homeless and those without identity cards are eligible.