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Introduction Family planning activities in Indonesia were initiated in 1957 by a private organization working under the auspices of the International Planned Parenthood Federation (IPPF). It provided family planning services and advices, as well as maternal and child care. In Bucharest, Rumania, during the World Population Conference, Government of Indonesia ratified the United Nations Declaration on Population. Following that fatification, in 1968, government established a National Family Planning Institute, which was reorganized as the National Family Planning Coordinating Board (NFPCB) two years later. NFPCB is a non-departemental body and the chairman report directly to the President. Family planning programs were not initiated simultaneously throughout the country. In the First Five-Year Development Plan (Repelita) which covered the period 1969/70 to 1973/74, program began in the six provinces which are DKI Jakarta, West Java, Central Java, Yogyakarta, East Java, and Bali. In the Second Five-Year Development Plan (1974/75 to 1978/79), the family planning program was expanded to the provinces of Aceh, North Sumatra, West Sumatra, South Sumatra, Lampung, West Nusa Tenggara, West Kalimantan, South Kalimantan, North Sulawesi, and South Sulawesi. In the development of programs, these provinces are classified as the Outer Java-Bali I Region. In the Third of Repelita (1979/80 to 1983/84), family planning programs were further expanded to include the remaining 11 provinces which are grouped as the Outer Java-Bali II Region. The successful of family planning program in Indonesia is reflected in the level of fertility. Table-1 show that the TFR has declined steadily since the late of 1960s. The overall fertility rate for the period 1991-94 (2.9 children per woman) was half of that reported for the period 1967-70 (5.6 children per woman). Results from the 1994 IDHS (Indonesia Demographic and Health Survey) indicate that the pattern of fertility by age group is the same as in the past, except that the peak in fertility has shifted from age 20-24 to age 25-29. Fertility has declined in all age groups in Indonesia. Table-1 :Age Specific and Cumulative Fertility Rates from Selected Sources, Indonesia 1971-1994 Regarding the differences of social and economic development also achievement of family planning program, , it is known that level of fertility differs accross the country. Based on IDHS 1994, TFR in Indonesia vary from 1.79 in Yogyakarta to 4.69 in East Timor. Furthermore, Java-Bali region consistently approach the lowest fertility in the contry. Among the six provinces in Java-Bali, two provinces which were Yogyakarta and Jakarta have reached fertility level less than two children per woman. Two others provinces which were Bali and East Java are approaching the level of two children per woman. West Java continues to have the highest fertility in the Java-Bali region. IDHS also found that fertility level in outer Java-Bali II region was still above 3 children per woman except in Central Kalimantan. The rate for this province may be underestimated. However, in the recent time, fertility in Outer Java-Bali II declined rapidly, narrowing the difference in fertility between this region and other region. This is true since fertility rate in Outer Java-Bali II still high and it was quite easy to reduce. Fertility Trend in East Java Province Analyzing fertility trend in East Java could not be separated with others provinces in Java Bali since the family planning programs in this region were initiated at the same time and also this region have quite similar social, economic and political development. Figure-1 show fertility trend in Java-Bali region from 1971 to 1994. Yogyakarta consistently shows the lowest fertility rate and West Java the highest. Until the mid of 1970s, fertility rate in Bali was second highest after West Java. However, a rapid decline in the early 1980s brough the rate in Bali to a level lower that that of all other provinces in the regions except Yogyakarta. The 1994 IDHS presents slightly different results. The fertility rate for Bali is slightly higher than the rate for Jakarta, shifting its position to the third lowest. Figure-1 Fertility in Java-Bali region has contiued to decline, except in East Java where fertility increased slightly from 2.1 children per woman (1991 IDHS) to 2.2 children per woman (1994 IDHS). However, these figures should not be interpreted as indicating that fertility in East Java has actually increased in the recent past since the change (0.09 children per woman) is so small. Within the East Java province, the difference in fertility level was not too extreem. Based on study done by State Ministry for Population/NFPCB in 1994, the highest TFR in East Java was found in Gresik (3.25 children per woman) and the lowest was found in Surabaya (1.9 children per woman). The successful to control the fertility aspect in East Java due to the systematic and well design in family planning program that was design by central and local government. Since the family planning program was launched by government in 1972, East Java was becoming one of the first target area of the programs. Besides as one of the first target area, the succesful to run the family planning program in this province is considered as a national barometer. That way after more than 30 years, almost all young marriage couple are knowing and considering the motto of 'small and happy family norm'. Furthermore, based on 1994 IDHS data, the prevalence of family planning use in East Java has increased from 32 percent in 1976 to 55 percent in 1991 then to 55.9 percent in 1994. This level of prevalence was slightly higher than the national level (54.7 percent) but it was lower than the Java-Bali region (58.4 percent). The other aspect of fertility that also important to analyze is teenage fertility (age 15-19 years old). This topic is important because teenage mothers and their children are at increased risk of social and health problems. Births to teenage mothers usually follow an early marriage. Because women who marry at an early age often come from poor families with low education and health status, their children are more prone to illness and to higher mortality during childhood than other children. Based on Demographic and Health Survey (DHS-94), teenage fertility in East Java relatively high compared to other provinces in Java and Bali (see Table-2). Unfortunately, regarding the sample size, data on teenaage fertility in city of Surabaya is not possible to be founded. However, assuming that pattern in every province is the same, the teenage fertility in this city seem relatively higher than other cities in Java and Bali regions except cities in West Java. Table-2 : Teenage Pregnancy and Motherhood 1994 (in Percentage) Family Planning in Surabaya City General Information Level of fertility in city of Surabaya in particular and East Java in general is known as one of the lowest in Indonesia and it has reached the replecement level. In 1994, Crude Birth Rate (CBR) was 17.96 and this number is the lowest in East Java that was 23.6. Meanwhile Total Fertility Rate (TFR) in 1990 was estimated 1.9. The average number of person per household also has declined from 4.88 persons in 1980 to 4.65 persons in 1990. The figure of Age Specific Fertility Rate (ASFR) in this city was not different than the national figure or East Java where the highest fertility rate found during the age of 20-24 and 25-29. The fertility level in this city is estimated still continue to decreasing in the future. Like other places in Indonesia, family planning plays the important role on declining fertility level in Surabaya. Local government announced that in 1994 the prevalence of family planning user was 67.41 percent and it was much higher than the national level that was 54.7 percent of all married women at the same time. The number of married women 15-49 years old was approximately 438 thousand people and the number of women are using family planning method was 295 thousand. Among the active family planning user, injection was the most populer method compared to other methods. 36.3 percent of family planning user, use injection method followed by IUD. The least populer family planning method among the user was implant and condom (see table-3). Table-3 :Family Planning Methods in 1994 (%) Study Design This study is designed to explore the characteristics of family planning user including reason to use family planning method. Special purpose of study is to explore perception among male migrants on family planning. The study is located in 4 (four) sub-districts which are (1) Rungkut as a representative of East part of Surabaya; (2) Karang Pilang sub-district as a representative of south part; (3) Semampir sub-district as a representative of north part; and (4) Tandes sub-district as a representative of West part. In each sub-district, purposively was chosen one village ("kelurahan"), and in each villages was chosen one hamlet ("Dusun/RW"). The respondent are women who are living in the chosen hamlets. From each hamlet 30 female respondents and 30 male respondents were interviewed, so the total number of sample from 4 sub-districts was 120 female respondents and 120 male respondents. The criteria of female respondents are age of 15-49 years, married and living with husband, and born either in or outside the city. Meanwhile the criteria of male respondents are age of 15-49 years old, permanent migrant that has lived in the city at least 5 years. Background Characteristics of Female Respondents Several background characteristics that influence the level of fertility among women is discussed. Table-4 indicate place of birth of respondents. Information on place of birth is important since people who born and growing up in rural areas tend to have more children compared to people who born and growing up in urban areas. About 47.5 percent of respondents born in rural areas while 63 respondents or 52.5 percent of them were born in urban areas. However, the total married women respondents dominated by those who were born in urban areas. Furthermore, table-4 also indicates that 64 percent of women who were born in rural areas are migrant while only 36 percent of them who born in urban areas. All ofnon migrant women are coming from urban areas. Table-4: Percentage Distribution of Married Women by Place of Birth, Surabaya 1996 The acceptance of family planning idea begin with the age of first marriage, since it is the time when a family start. Based on this indicator, female migrant as well as the non-migrant had a high rate to marry at the ages under 20 years, that was 57.5 percent or more than a half of the whole respondents. Nevertheles, female migrants had a higher rate of young age of marriage than the non-migrants, with the difference for about 14 percent. It seemed, the fact was caused by majoring rural place of birth of the female migrants(see table-5). Table-5: Percentage Distribution of Married
Women by Age of First Marriage Fertility Situation Calculation from raw
data found that there were 60 children ever born among non migrants
compared to 169 children ever born among migrants. Furthermore, from 60
children ever born among non migrants there were 60 children who were
still living. Among the migrants, from 169 children ever born, there
were 160 children who were still living. This implies two condition (1)
level of fertility among migrants was higher than level of fertility
among non migrants; (2) level of child survival among migrants was
lower than level of child survival among non migrants. This
differential primary was caused by the place of birth of respondent
where all of non migrants born in urban areas while 65 percent of
migrants born in rural areas. Table-6: Distribution of
Married Women by Number of Children Ever Born and Number of Living
Children
From the trend of having
more children, female non-migrants had higher proportion to stop birth.
In other word, they didn't want to have more children (48.4 percent),
while the migrants was 41.9 percent (see table-7). It coincided
with the high rate of contraceptive use among the non-migrant, which
was 77.4 percent, while the migrants only 71.9 percent. It is true
since many of migrants respondents came from rural areas, so the number
of expected children was higher than non migrants that all of them born
and growning up in urban areas. Table-7: Distribution of
Married Women by Number of Children Wanted More
Fertility situation in
Surabaya city is slightly better than others places in East Java. it is
showing in table-8 where mean
of children ever born and mean of living children in Surabaya almost
for all age structure was lower than in East Java in general. For
example mean of children ever born in Surabaya from women 30-34 years
old in 1996 was 2.4 while in East Java in 1994 was 2.43. Other example
is mean of living children in Surabaya from women age 30-34 was 2.23
while in East Java was 2.17. However, we have to be careful to
summarize this comparation since both survey were taken in different
time and sample size. Table-8: Distribution of
Married Women by Mean of Children Ever Born and Mean of Living Children
to Age Group Surabaya-1996 and East Java (%)
Family Planning Acceptance Among Women The percentage of women using contraceptive that found from this survey was 88 respondents or 73.3 percent (see table-9). This was quite high since teh government announcement that the prevalence of contraceptive use in Surabaya in 1994 was 67.1 percent. This over estimated may be related to the sample size in this survey. About 15 percent of women reapondents were never use any method of contraceptive. Among them who never use any method of contraceptive were respondents of 15 year old (10 respondents). Table-9: Distribution of
Married Women by Contraceptive Use (%)
Further analysis show that among
the respondents 1.7 percent against the family planning and 118
respondents or 98.3 feel that family planning is necessary. If we
compare table-10 and table-9, it is clear that prevalence of family
planning use was still under the what respondents feel about family
planning. This is a potensial market for family planning programs.
Table-10: Distribution of Married Women by Receiving Idea of Family Planning (%) Injection was the most popular method of contraceptive that used among respondents. Around 46 percent of respondents in this survey claim that they were using unjection for their fertility regulation. The next popular method was oral pill (26.1 percent). Meanwhile, the least popular method of contraceptive in this survey was condom that only used among 1.1 percent of respondents. This distribution was slightly similar between female migrants and female non migrants (see table-11). The finding in this survey was not too different than the government report in 1994 (see also table-3). Table-11:
Distribution of Married Women by Method of Contraceptive Used
Moreover, survey also found that 45 percent of female respondents had ever heard about abortion for fertility regulations (see table-12). This knowledge was higher among non migrants compared to among migrants (data not shown here). This is true since all of non migrants in this survey born and growing up in urban areas. However, there was no information regarding the percentage of respondents who ever used abortion for their fertility regulations. Table-12:
Distribution of Married Women by Knowledge of Abortion
The next table (table-13) provides the important information regarding the family planning programs acceptance. There are two important information from next table which are (1) there are still many respondents who already had at least two children are not using any contraceptive method. The reason for not using is because they still want to have more children. Only few of them said not possible to canceive it; (2) the percentage of women who wanted to stop birth but not using any contraceptive also high, as well as those who had never used anyone, resectively for 42.9 and 27.8 percent. The first information is becoming field of family planning campaign. It reflects that the market of family planning campaign is still wide. The second refer to the unmeet need among the clients. If government could provide more supporting system on family planning among the unmeet need clients, there is a high possiblity they will use the contraceptive. Table-13:
Distribution Women Using Contraceptive by Number of Living Children and
Number of Children Wanted More
Family Planning Perception Among Male Migrants This study also provides the information regarding the family planning perception among male migrants. Several background characteristics such as age of first marriage, number of children ever born, number of living children and number of children wanted more. Respondents in this analysis were married male migrants which were 96 personse from 120 male respondents. Table-14 shows the age of first marriage among the male migrants. Mostly male migrants married at the 20 to 29 years old. The age of first amrriage among the male migrants in city of Surabaya relatively higher than the national level which is 21.3 years old in urban area. Since migration will influence the late of marriage, finding in this survey is not quite surprised. Table-14:
Percentage Distribution of Male Migrants by Age of First Marriage
Among married male migrants, about 40 percent had one living children and almost 20 percent had not had any children. Furthermore, most of male migrants only want one or two more children and this situation will support the family planning program (see table-15). Table-15:
Percentage Distribution of Male Migrant by Number of Children Ever
Born, Number of Living Children and Number of Children Wanted more
Table-16 provides the information about Family Planning perception among migrants through the percentage of using method of contraceptive. The migrants who their family was using contraceptive reached for about 61.5 percent. It was lower than the rate for the whole population (eligible couple) in the city, which was about 74.8 percent. The phenomena might have relation with the high propotion whom just had one or had not had any children. Among migrants whom their family were using contraceptive found that injection was teh most popular method (47.5 percent), and followed by oral pill (28.8 percent) and norplant (10.2 percent). This research found that method of contraceptive among male migrants is quite similar with method of contraceptive among female. Table-16:
Percentage Distribution of Male Migrants by Contraceptive Use
Cross tabulation analysis was done to see the depth of family planning concept perceived by the migrants. The cross tabulation between the duration of marriage and the number of living children proved that migrants with two children had minimally 3 years duration of marriage. It means the migrant had already perceivef the concept of birth spacing. Otherwise, considering the concept of birth limit, which they were encouraged to have only two children, a lot of them have broken it to have 3,4 or more children. This condition particularly happened among those who had six or more years length time of marriage. Furthermore, the tabulation between contraceptive use and number of living children found that there were a lot of the migrants who ahd two or more children but was not using any contraceptive method. It inferred that the concept of limiting at two children had not had internalized entirely. Because the most of the reasons for not using was want to have more children (see table-17). Table-17:
Percentage of Distribution of Male Migrant Based on Number of Living
Children, by Duration of Marriage and Wife's Contraceptive Use.
As mentioned above that the main reason for not usind contraceptive was want to have more children. No one of the migrants said that not using caused by lack of facilities or not possible to conceive it. It means they already had enough knowledge and concept of family planning. The condition have to be investigated more deeply, since a lot of them who want to limit the birth, but was not using any contraceptive (see table-18). Table-18:
Percentage Distribution of Male Migrants by Number of Children Wanted
More, and Wife's Contraceptive Use
Conclusion This research found that level of fertility among women migrants relatively higher than non migrants. This was mostly related to the sample considetation since all mon migrants were coming from urban areas and most of non migrants were coming from rural areas. Theorically, fertility level among migrants is lower than among non migrants. In term of fertility situation, this survey found that most of respondents both males and females only hace one or two children. This is encourage the statement of succesfull of family planning programs in East Java in general or in Surabaya in particular eventhough it found there were few respondents who still have or want have children more than two. The family planning acceptance in this survey slightly higher than the level of contraceptive used that reported by the local government. However this result also seem related to the number of sample. Among them who not practicing family planning, wanted of more children was becoming a primary reason. References Republic of Indonesia, 1994, The Sixth Five-Years Developement Plan (Repelita VI) 1994/95-1998/99, Jakarta Indonesia City Government of Surabaya, 1994, The Sixth Five Years Regional Development Plan (Repelita VI Daerah 1994/95-1998/99), City of Surabaya, Surabaya, Indonesia Central Bureau of Statistic, 1995, Indonesia Demographic and Health Survey 1994, Jakarta, Indonesia Central Bureau of Statistic, 1982, Indonesia Census of Population 1980; Province of East Java, Jakarta, Indonesia Central Bureau of Statistic, 1992, Indonesia Census of Population 1990; Province of East Java, Jakarta, Indonesia Central Bureau of Statistic, 1988, East Java in Figure 1987, Surabaya, Indonesia Central Bureau of Statistic, 1988, Surabaya in Figure 1987, Surabaya, Indonesia Central Bureau of Statistic, 1994, East Java in Figure 1993, Surabaya, Indonesia Central Bureau of Statistic, 1994, Surabaya in Figure 1993, Surabaya, Indonesia The State Ministry for Population/NFPCB, 1994, Indonesia Country Report: Population and Development, Jakarta, Indonesia The State Ministry for Population/NFPCB, 1994, Indirect Method in Measuring Fertility, Mortality, and Life Expectancy in Indonesia, Jakarta, Indonesia Tjiptoherijanto, Prijono, 1995, Social, Economic, and Demographic Development in City of Surabaya During 1980-1990, paper submitted to Asian Urban Information Center of Kobe, Japan, Jakarta, Indonesia Surabaya, April 1996
Prijono Tjiptoherijanto Eddy N Hasmi Dwi Listia Wardani |
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