Family Planning in Asia and the Pacific - International Council on ...

Family Planning in Asia and the Pacific - International Council on ... Family Planning in Asia and the Pacific - International Council on ...

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TableTable1TableTable2For spacong>inong>gFor limitong>inong>gTotal25.437.963.328.138.366.330.037.467.430.037.467.429.541.170.6Percentage of demong>andong> satisfied 79.9 84.0 876.4 87.6 87.2Source: Indonesian Demographic ong>andong> Health Surveys.pressure on FP programme managers to provide additionalservices for ong>theong> growong>inong>g proportion of ong>theong> population thatis currently unmarried. However, an FP programme thatcontong>inong>ues to restrict itself to providong>inong>g services almostexclusively to married couples will necessarily miss a vital,ong>andong> ong>inong>creasong>inong>gly large, part of ong>theong> action.Sources of supplyAnoong>theong>r major trend is that FP clients have been shiftong>inong>gto ong>theong> private sector at a rapid rate ong>inong> recent years (seeTable 5). The 2007 DHS reported that 69.1 per cent ofclients were usong>inong>g a “private medical” source of supply, afigure that rose to more than 75.0 per cent when “oong>theong>rprivate” sources were ong>inong>cluded. Government-provided“public” sources account for only 22.2 per cent of ong>theong> total.The trend towards ong>theong> private sector was, if anythong>inong>g,accelerated by ong>theong> 1997/98 ong>Asiaong>n fong>inong>ancial crisis (Strausset al., 2004). The precise details are complicated becauseong>theong> public-private distong>inong>ction is not clear-cut, with manyprivate practitioners also workong>inong>g ong>inong> ong>theong> public sector,ong>andong> because what gets listed under each category headong>inong>gof “source” ong>inong> ong>theong> DHS has changed over ong>theong> years (e.g.,posyong>andong>u was listed as a “Government source” ong>inong> 1991, as“Oong>theong>r private” ong>inong> 1994 ong>andong> 1997, ong>andong> as “Oong>theong>r source”ong>inong> 2002/03: see Table 5). Noneong>theong>less, ong>theong> overall trendong>inong> privatization is clear ong>andong> corroborated by oong>theong>r datasources, such as ong>theong> annual National Socio-EconomicSurvey ong>andong> ong>theong> Indonesia ong>Familyong> Life Survey.This trend ong>inong> privatization is broadly consistent with ong>theong>government’s objectives; ong>theong> policy of KB Mong>andong>iri (“selfreliantfamily plannong>inong>g”) was first ong>inong>troduced ong>inong> 1989.Policymakers still need to question some of ong>theong> nuancesof this trend, however. One obvious question is wheong>theong>r,as ong>theong> programme becomes ong>inong>creasong>inong>gly privatized, thiswould lead to a rise ong>inong> clients’ out-of-pocket costs so as tocause many among ong>theong> poor to lose access to services. Oong>theong>rquestions are wheong>theong>r ong>theong> private sector is adequatelyregulated to guarantee a satisfactory mong>inong>imum stong>andong>ardof services, ong>andong> wheong>theong>r adequate systems of redress areong>inong> place when needed. There are also questions regardong>inong>gwheong>theong>r providers ong>inong> ong>theong> private sector are equipped ong>andong>motivated to provide clients with an adequate choice ofmethods, or wheong>theong>r ong>theong> method mix to some extent may230

TableTable3Source: BPS (Central Bureau of Statistics) (1992). ‘Population of Indonesia: Result of 1990 Population Census’, Jakarta: BPSTableTable4TableTable5231

TableTable3Source: BPS (Central Bureau of Statistics) (1992). ‘Populati<strong>on</strong> of Ind<strong>on</strong>esia: Result of 1990 Populati<strong>on</strong> Census’, Jakarta: BPSTableTable4TableTable5231

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