RI under threat of 'lost generation'

Wednesday, December 14, 2005
Hera Diani, The Jakarta Post, Jakarta

Her name, Sasih, in Sundanese means 'month'. Over the past 14 years, Sasih, 33, has given birth to five children -- two boys and three girls -- with the youngest being barely two years old.
Along with husband Kadmira, a bajaj driver, the family of seven occupies a two-meter by two-meter rented room in a slum corner of Pejompongan, Central Jakarta.
Sasih said that having five children was a headache, financially and emotionally. Kadmira only earns Rp 30,000 daily, while she gets at most Rp 40,000 from selling steamed corn at a nearby low-income apartment complex.
Most of her pregnancies were unplanned, she said, and she had not used contraception.
"I took pills but they made me nauseous and dizzy. I tried injected contraceptive, but I bled the whole month. So, I stopped both," she told The Jakarta Post on Monday.
Jamu herbal drinks were ineffective, while Sasih did not dare to try an intra-uterine device (IUD), despite a doctor's recommendation that this was the most effective, long-term contraceptive.
"I think I'm going to try an implant. But it costs Rp 75,000," she said.
As the world's fourth most populous nation, Indonesia has long struggled to reduce its birth rate. Back in the period of the Soeharto regime, family planning was forced by the government, with the slogan "two children are enough".
It was later criticized, however, for not respecting women's reproductive rights.
The total fertility rate indeed declined from 5.6 in the 1970s to 3.02 in 1991 and 2.6 in 2003.
Yet, couples like Sasih and Kadmira, who live in poverty, continue to have more than three children.
It raises concern over the increase in the 36.1 million people currently living in poverty, which may result in a lost generation.
The head of the National Family Planning Coordination Board (BKKBN), Sumarjati Arjoso, said contraceptive users among poor families only numbered 52.4 percent, while among the non-poor population the rate was 62.4 percent. The unwanted pregnancy rate, meanwhile, was 17 percent.
"It's not in line with the program of making pregnancy safer," Sumarjati said, pointing to the alarming mortality rate of 307 deaths per 100,000 births, which was the highest in Southeast Asia.
She said the problems of family planning were rooted in a combination of lack of education and information, as well as geography and even corruption.
"Over 90 percent of people understand the concept of family planning and contraception, but (the understanding is) still superficial," she told reporters on Monday on the sidelines of a national meeting on family planning.
Most poor families prefer pills and injections, even though the longevity of these contraceptives was short -- unlike IUDs that can be used for up to 10 years -- and this factor increased the risk of unwanted pregnancy.
Implants are effective within three years, but are quite expensive. And male contraceptives seem to be out of the question in this strongly patriarchal society.
The quality of services have yet to be standardized, Sumarjati said, with infrastructure in many regions, particularly in rural areas, not available or inadequate.
Nor are many health offices informed that civil servants' health insurance (ASKES) also includes contraceptives. Worse still, contraceptives are supposed to be free, but many health workers charge for them, as confirmed by Sasih, who had to pay Rp 15,000 for injected contraceptive while pills cost Rp 5,000 per strip.
"Contraceptives are not the same as medicines for illness. When people get sick, they will pay to be cured. But when you have to pay to get contraceptives, people will back out," Sumarjati said.

Labels: social affairs

Posted by hera at Wednesday, December 14, 2005 12:42 AM | Permalinks