Article

Komunitas: International Journal of Anomalies in Family Planning Indonesian Society and Culture 10(1) (2018): 86-91 DOI:10.15294/komunitas.v9i1.9634 in Central , © 2018 State University, Indonesia p-ISSN 2086 - 5465 | e-ISSN 2460-7320 http://journal.unnes.ac.id/nju/index.php/komunitas UNNES JOURNALS

Saratri Wilonoyudho1, Sucihatiningsih Dian Wisika Prajanti2

1,2Universitas Negeri Semarang, Indonesia

Received: 4 April 2018; Accepted: 18 December 2018; Published: 30 March 2018

Abstract This study was aimed at uncovering the anomalies in the implementation of the Population, Family Plan- ning and Family Development Program in province. Qualitative-naturalistic approach was em- ployed. The results of the study about the population and family planning in Central Java Province is showed an alarming rate of TFR (Total Fertility Rate) indicator of 2.3 to 2.5. In addition, the public mind set about the ideal number of children in a family also increased from the TFR indicator of 2.6 to 2.8. This mindset would hinder family planning program. To overcome the anomalies, BKKBN Central Java Province made various strategic efforts. The high rate of CPR (Contraseptive Prevalence Rate) which was not followed by the low rate of TFR was assumed to be related to the active family planning participants were not using long term contraception method, leaving them vulnerable to drop out. Therefore, an increase in long term contracep- tion method, would be a top priority in the population and family planning program in Central Java. In the “anomaly” of having high CPR numbers but low TFR, operational strategy required to be conducted was to increase the Educational, Information, Communication (EIC) Program, especially for the younger generation, because young age marriage was prevalent in those areas.

Keywords anomaly; population; family planning and family development program; program management; strategic solutions

INTRODUCTION Contraceptive Prevalence Rate (CPR). An example is which has The background of this study is a phenome- CPR 71.8 % (high) and TFR 3.0 (high). Some non in Central Java Province showing how regencies/cities which belonged to quadrant varied the problems and achievement and II showed low CPR, but high TFR. Quad- the results of family planning programs in rant III had low CPR, but the low TFR, Pe- the regency / city were. According to BK- kalongan City with CPR 50.8 % (low) and KBN-Badan Kependudukan dan Keluarga TFR 2.0 (low). Quadrant IV had high CPR Berencana Nasional/National Board of Po- and low TFR. pulation and Family Planning Central Java One important indicator in populati- Province in 2015 there were “anomalies” or on and family planning program is the decli- deviations from one regency / city to anot- Corresponding author her. In regencies grouped in quadrant I the- Jl. Sekaran Raya, Sekaran, Gn. Pati, Semarang City, re were pretty “strange” anomalies, in which Central Java 50229 Indonesia Email the number of Total Fertility Rate (TFR) [email protected] was very high, while they achieved the high Komunitas: International Journal of Indonesian Society and Culture 10 (1) (2018): 86-91 87 ning birthrate and is commonly measured Bruce (1990) suggests an increase in by the Total Fertility Rate (TFR). The decline the quality of service, with six of the follo- in TFR has become an important indica- wing elements, namely: choice of contra- tor. The control quantity of the population ception method, information given to users, would be considered successful if the there skill personnel, relationships between the is a decline of TFR. client - the officer, the mechanism of repea- Five-year data issued by BPS-Statis- ted contact and continuity, accuracy constel- tics Indonesia (2004,2008,2013) showed lation of the service. Hermalin and Entwisle that the rate of TFR in Central Java Province (1985) also corroborate that a service mana- has increased 2.1 in 2003, and then rose to gement consisting of six components. Those 2.3 in 2007 and increased to 2.5 in 2012 res- six components cover the scope of services pectively. If the TFR was 2.5, then the Cent- provided by on-site service, particularly for ral Java Province would have faced problems the specific contraception methods, and the because of high population density. The quality of service, which includes the ele- population of Central Java was 32,382,657 in ments such as the waiting period, training 2010, with density of 995 people per / km 2 . and skills of staff, privacy and decency by Approximately 14 percent of the Indonesian the client, and the length of operation. population inhabited Central Java (BPS-Sta- Basu (2007) in India finds that the me- tistics Indonesia, 2011). asured success of family planning policy in The increasing use of contraceptives the developing world rests on increases in should be used as one of the tools to reduce the ‘modern’ methods of contraception. By the number of TFR. The use of contracep- extension, ‘traditional’ methods of contra- tives is usually measured by the percenta- ception are equated with traditional men- ge of Contraceptive Prevalence Rate (CPR), talities and insufficient motivation to cont- which is the percentage of active fami- rol fertility. In other side, Adioetomo (1993) ly planning coverage than the amount of examines socio-economic characteristics of reproductive age couples in a certain area at women and contraceptive use can be seen as a certain time. The percentage of women of individual factors that influence their state- reproductive age using (or whose partner is ment of Ideal Family Size, but factors such using) a contraceptive method at a particu- as a bureaucratic commitment to reducing lar time (BKKBN only counts modern met- fertility and the cultural milieu also play an hods). important role in Javanese women’s formu- lation of Ideal Family Size. Luo and Zhuoyan Mao (2014) showed Literature Review that attitudes towards fertility, subjective According to the theory, the population norms, and perceived behaviour control all growth can be reduced if fertility can be contribute significantly to the discrepancy controlled and unwanted fertility can be between fertility intention and behaviour. reduced. The survey data from 40 develo- The result shows that, given the situation of ping countries showed that 21% of births fer- being qualified to have two children accor- tility was not wanted (Bongaarts, W Parker ding to the government’s birth control po- Mauldin, and James F Phillips, 1990). The licy, when faced with the choice of whether anomaly of family planning program can to have a second child or not, people tend to also be sourced from recording errors. Ac- make their decisions rationally. In addition, cording to Nortman and G. Lewis (1984), the formation of a concrete birth plan is a statistics showed that there were many sig- major driving force for fertility translating nificant mismatches between the high pro- intention into action. portions of couples who declared not wan- ting to have more children on one hand. On Research Methods the other hand, the low proportion of their This study was aimed at analysing the fac- contraceptive practice. tors that contribute to the making family

UNNES JOURNALS 88 Saratri Wilonoyudho, Sucihatiningsih D.W.P, Anomalies in Family Planning in Central Java, Indonesia planning anomaly in Central Java Provin- the highest poverty rate in Central Java Pro- ce, as well as to provide strategic solutions vince (22.2%) and the low average length to address these problems. This study emp- of time spent in school at 6.56 years. Con- loyed an integrated approach of qualitative sequently, only 58 percent of family plan- and quantitative, such as the results of sur- ning was , which is paid at a private clinic vey and BPS-Statistics Indonesia, BKKBN (BPS-Statistics Indonesia, 2015); In other data. Researchers also used focus group dis- side, the absence of local communities to cussions and in-depth interviews. The site of run the family planning program, and the the study was located in early marriage age (women under 19 years, and City in Central Java Provin- and men under 21 years old) was still preva- ce of Indonesia. lent. Base on BKKBN (2015), in Wonosobo Regency, the first married age (mean : 19, 4 Anomaly in Wonosobo years old; median : 19 years old), the first age The results of the study in Wonosobo Re- of pregnancy (mean : 20,3 years old; median gency, Central Java Province, showed a uni- : 20 years old), and the first age childbirth que thing which was the high CPR with high (mean : 21 years old; median : 21 years old). TFR. The high TFR in Central Java was an However until now, what happened aggregate of a number of TFR in the regen- was it did not count for a couple who was cy/city, and some problem could be identi- considered not in need of contraception at fied from these following sources: the time of the study, even though they pre- First, the regency does not have suf- vent or delay births in the future according ficient human resources, both quality and to Westoff and Pebley (in Nortman D. and quantity, as demographers, population sta- G. Lewis, 1984). Identifying pregnant wo- tisticians, health workers, special clinic for men accurately was also a challenging task family planning.The results of the inter- to do especially on the early stage of preg- views and observations in the field (in Wo- nancy, and there is an abortion caused by nosobo Regency) revealed that the number urgent condition. Therefore, it could be that of family planning officers was reduced to pregnant more than is recorded (when given only 72 people to serve 265 villages, and they contraceptives). For women who breastfeed currently serves 8,000 households. It cer- are also not be free from the risk of preg- tainly made it difficult to serve each of them nancy (McCann 1981). excellently, especially those experiencing problems using contraception. Family planning program in Wonoso- Case Studies in Pe- bo Regency that Education, Information and kalongan Communication (EIC) Program were carried out incidentally and also “integrated” other The results of the study in Pekalongan City activities at the event at the village level / Central Java Province showed a unique thing districts / countries like community activi- which was the low CPR with low TFR. From ties. When EIC was implemented, brochures the study, the phenomenon was caused by were distributed on family planning to be the voluntary abstinence. Davis and Bla- read by people individually. The only prob- ke (1956) corroborated that the voluntary lem was the low budget to make the brochu- abstinence among the variables contributes re which was only Rp.20 million (1,200 US to the reduction in fertility. The theory of dollars) per year. decline in fertility by Jain (1989) argues that Second, the reproduction beha- that the continuity and effectiveness of a viour in Wonosobo Regency was influenced method must be approved by the public be- by several factors, including the difficulty in fore it can lower the TFR. The second cause accessing qualified service of family -plan of Pekalongan City case was the migrati- ning program. In addition to the limited use on behavior. The results of interviews with of contraceptives especially in rural areas, couples who did not use modern contra- ception revealed that they practiced family

UNNES JOURNALS Komunitas: International Journal of Indonesian Society and Culture 10 (1) (2018): 86-91 89 planning through the voluntary abstinen- revealed that the Mayor of Pekalongan City ce. Her husband migrated outside the city and Regional Parliament member strongly and only return once in three months. supported this program. Regional Regula- BPS-Statistics Indonesia (2011) data tion on the Acceleration of the Family Wel- showed that the number of people who are fare Development and Regional Regulation risen migrants in Central Java continued to on Rural Area Institution were issued to sup- increase over time. The results of data sho- port the family planning program. The fam- wed that 5, 396, 419 people or 2.5 percent of ily planning program also received a promi- the population was an inter-provincial risen nent place by the empowering of Educational migrants. These facts showed that fertili- Information Communication (IEC) by giv- ty decline may be associated with changes ing money in the amount of Rp. 500. 000 in the economic behaviour of childbearing (50 .00 US $) for anyone who had vasecto- age couples. Spoorenberg (2009) adds that my. The results of the study in Thailand was in Mongolia, as a consequence of the tran- corroborated by Kalwij (2016) arguing that sition to democracy and a market economy, the institutional approach to empower local Mongolia experienced an impressive ferti- communities becomes the main factor. lity reduction. In the same cases, Shava- Those couples who have just used con- zi and Peter McDonald (2006) corroborates traceptives receive transport money in the that by a socio-political history of Iran in the amount of Rp 50. 000, 00 (3.00 US $) and years 1970-2000, conclude with some specu- groceries. The Rural Area Institution was the lations linking specific socio-economic and institution to decentralize authority. There political changes to the demographic chan- were about 80 activities were transferred to ge (continued low fertility) in Iran. the Rural Area Institution, because the com- BKKBN (2015) data that in 2013, 73.9% munity was considered able to run those ac- citizens in Pekalongan City carried out in- tivities. dependent family planning at their own The role of the government is impor- expense through private clinics, and only tant, because the results showed that con- 12.5% joined free family planning program sumption of food and nutrition is almost from government clinics. Only unfortuna- close to the recommended nutrition ade- tely only 13% of them used long term cont- quacy standard. The variables of household raception method, while the rest used non– head age, family size and income are posi- long term contraception method which are tively and significantly correlated to energy prone of dropping out. Therefore, it is sug- and protein consumption adequacy of the gested that people are willing to switch to family, while the factor of household head long term contraception method. education was unrelated (Suandi and Dama- The results of this study yanti, 2016). This demographic investment also showed that independence in family was a form of creativity from the local gov- planning in Pekalongan City can be caused ernment to “work” on potential family plan- by the number of poor people in this city ning clients. Freedman (1975) argues that to which was “only” 9.47%. Moreover, most reduce fertility, intermediate variables that of Pekalongan City citizens work in the in- have been given by Davis and Blake (1956) dustrial sector and the percentage of wo- must be expanded and be preceded by seri- men working was about 42.12%. This figure ous study. On the other hand, Lapham and is quite large. As a consequence, it affects Mauldin (1972) suggest political commit- the bustle of a mother and is also expected ment and adequate budgetary allocations. to affect the perception of the number of In addition to a vigorous campaign through children they have. mass media. The low TFR in Pekalongan City was also associated with high political commit- ment of family planning program develop- Conclusion ment. The results of focus group discussions From the results of the study and the

UNNES JOURNALS 90 Saratri Wilonoyudho, Sucihatiningsih D.W.P, Anomalies in Family Planning in Central Java, Indonesia mapping, it can be concluded that: style of leadership, logistics, and trai- 1. Population and family planning issues ning. The aim of population policy was in Central Java Province do not only to increase public demands. If demand include technical issues, but also origi- increases, then even without any fami- nate from the public mindset about the ly planning program, the community ideal number of children which rose has carried out their own family plan- from 2.6 children to 2.8 children; ning program. In other words, the inc- 2. The high CPR with the low rate of TFR rease in supply (supply) will affect the was presumably caused by inaccurate demand (demand). data collection to the unrepresentative population. This problem was caused by the untrained data collectors, or because of psychological pressure to References achieve the target of new participants Adioetomo, S.M., 1993. “Construction of Small-Family which resulted in less accountability; Norm in Java”. Unpublished Ph.D thesis. Aus- 3. Another cause was the weak commit- tralian National University, Canberra Austra- lia. ment of the policy leading to the li- Basu, M.A., 2007. “Ultramodern Contraception : So- mited supply of contraception and the cial Class and Family Planning in India”. Asian declining number of family planning Population Studies,1, pp. 303-323 program member. The family planning BPS-Statistics Indonesia.2004.Demographic and Health Survey 2003 program receivedless support from BPS-Statistics Indonesia. 2008.Demographic and the stakeholders such as the media, Health Survey 2007 political parties, interest groups, and BPS-Statistics Indonesia. 2011. Population Census 2010 etc. The weak population strategy as a BPS-Statistics Indonesia. 2013.Demographic and result of the weak link between bure- Health Survey 2012 BPS-Statistics Indonesia. 2015.Central Java Province in aucratic and political system which is- Figures 2014. sued the population program and the BKKBN (Badan Kependudukan dan Keluarga Berenca- action.Therefore, it did not form the na Nasional/National Board of Population and norms of reproduction, and then to in- Family Planning Central Java Province). 2015. termediate variables and to the decline Family Data Collection in 2014 Bongaarts, J., W. P. Mauldin, and James F. P. 1990. in TFR. “The Demographic Impact of Family Planning Programs”. Studies in Familiy Planning, 21 (6), pp 299-310. Suggestions Bruce, J., 1990. “Fundamental Elements of the Quality of Care : A Simple From the conclusion above, the suggestions Framework.” Studies in Family Planning, 21. (2), pp. can be formulated as follows: 61 – 91. 1. To overcome the low TFR with the Davis, K. And J. Blake., 1956. “Social Struture and Fer- low CPR, improving human resour- tility : An Analytic Framework”, Economic De- ces quality should be carried out to be velopment and Cultural Change, 4, pp, 211-235. Freedman, R. 1975. The Sociology Human Fertility. Ir- able conduct research and simulations vington Publishers Inc. to produce: a needs analysis of contra- Hermalin, A. I. and Barbara E., 1985. “Future Direc- ception, analysis of unmet need (me- tions in Analysis of Contraceptive Availability.” asurement of unmet needs), because in International Population Conference, Flor- in the status quo, the unmet needs was ence, 3, pp. 445-456. Jain, A.K., 1989. “Fertility Reduction and the Quality of Family Planning only for legally married. Service”. Studies in Family Planning, 20 (1), pp 2. The high number of TFR must be fol- 1–16. lowed by public policy (population Kalwij, A., 2016. “The Effects of Setting Up a National policy) which is designed seriously Family Planning Program in Local Communi- ties on Women`s Contraceptive Experiences and systematically to influence the and Fertility in Rural Thailand”. Asian Popula- TFR as: demographic behaviour, hu- tion Studies, 12, pp. 156-176. man resources, and patterns of staff, Lapham R.J. and Mauldin, W P.,1972. “National Family UNNES JOURNALS Komunitas: International Journal of Indonesian Society and Culture 10 (1) (2018): 86-91 91

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