FILE C. Indonesia Appraisal of a Second Population Project. Annexes 1, 2, 3, 4 and 13 FOR OFFICIAL USE ONLY. Document of the World Bank

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1 Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Report No. 1534b-IND FILE C Indonesia Appraisal of a Second Population Project Annexes 1, 2, 3, 4 and 13 May 31, 1977 Population Projects Department FOR OFFICIAL USE ONLY U Document of the World Bank This document has a restricte distribution and may be used by recipients only in the performance of their official duties. Its contents may not otherwise be disclosed without World Bank authorization.

2 CURRENCY EQUIVALENT US$1 = Rupiahs (Rp) 415 Rp 1 = US$0.002 Rp 1,000,000 = US$2,410 Government of Indonesia Fiscal Year: April 1 to March 31 ABBREVIATIONS ABRI = Armed Forces of the Republic of Indonesia ANM = Auxiliary Nurse Midwife BAPPENAS = National Development and Planning Agency GOI = Government of Indonesia IPPA = Indonesia Planned Parenthood Association IPPF = International Planned Parenthood Federation TUD = Intra Uterine Device KAP = Knowledge, Attitude and Practice LEKNAS = Indonesian Institute of Sciences MCH/FP = Maternal and Child Health/Family Planning MOH = Ministry of Health NFPCB = National Family Planning Coordinating Board PKK = Community Health Nurse PTC = Provincial Training Centre STC = Sub-provincial Training Centre TFR = Total Fertility Rate UNESCO = United Nations Education, Scientific and Cultural Organization UNFPA = United Nations Fund for Population Activities UNICEF = United Nations Children's Fund USAID = United States Agency for International Development VCDC = Village Contraceptive Distribution Centre WHO = World Health Organization GLOSSARY BUPATI - Chief Executive of the Kabupaten or Regency CAMAT - Executive Head of the Kecamatan or Sub-district DUKUN = Indigeneous Midwife INPRES - Presidential Instruction KABUPATEN - Administrative Sub-division of a Province KECAMATAN - Administrative Sub-district LURAH - Village Headman PENMAS - Community Education Program PUSKESMAS - Kecamatan Health Centre

3 FOR OFFICIAL USE ONLY INDONESIA II: BASIC DATA Total Area ,904,345 km Total Population - latest Census (1971) million - latest Estimate (December 1976) million Density per km (1971) - Indonesia Java and Madura Rate of Natural Increase (1976) % Birth Rate (1976) Death Rate (1976) Life Expectancy at Birth (1973) years Urban Population as Percent of Total Population (1971) dul.t.,iteracy Rate in Percent (1971) - Males Females Total Adult Population.. 61 Primary School Enrollment in Percent (1971) - Males Females Total Population (aged 7-12) Age Structure in Percent (1976) years years and over Women aged (1976) million Population per Physician (1972).. 21,000 Population per Nurse (1972).. 6,000 Population per Auxiliary Nursing Personnel (midwife) (1972) 25,000 Population per Hospital Bed (1972).1,500 New Acceptors Recruited by the National Family Planning Program million Cumulative through March 1977 Current Family Planning Users (March 1977) - Java and Bali million - 10 Provinces in Other Islands.3 million Current Family Planning Users as Percentage of Married Women aged (March 1977) - Java and Bali % - 10 Provinces in Other Islands 6.2% GNP at Market Prices (1973)..... US$15.9 billion This document has a restricted distribution and may be used by recipients only it the performance of their official duties. Its contents may not otherwise be disclosed without Wwrd Dank autho>rization.

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5 INDONESIA APPRAISAL, OF A SECOND POPULATION PROJECT Table of Contents Page No. SUMMARY AND CONCLUSIONS i - iii I. INTRODUCTION... II. RECENT DEMOGRAPHIC TRENDS... III. FAMILY PLANNING PROGRAM AliD SERVICES... 3 IV. JOINT IDA/UNFPA-ASSISTED PROJECT V. NFPCB's MEDIUM-TERM PLANS VI. THE PROJECT A. Objectives and Components.. 12 B. Mobile Family Planning Services C. Family Planning Training D. Family Planning and Population Centres E. Population Education F. Research VII. PROJECT COST, FINANCING, DISBURSEMENT AND IMPLEMENTATION A. Cost B. Proposed Financing C. Disbursement and Accounts D. Procurement E. Implementation VIII. PROJECT JUSTIFICATION IX. RECOMMENDATIONS This report is based on the findings of a mission in October 1976 to Indonesia, composed of Messrs. H. M. Jones, D. B. Mills, A. Shaw, C. Chandrasekaran, and Dr. K. V. Ranganathan of the Bank, and Dr. F. Bayan, consultant to the Bank. The report was prepared bv MIr. Jones from the contributions of mission members.

6 Table of Contents (Continued) Annexes *1. Demographic Background *2. The National Family Planning Program *3. The Joint IDA/UNFPA-Assisted Project *4. NFPCB Medium-Term Plans 5. MIobile Family Planning Services 6. Family Planning Training 7. Family Planning and Population Centres 8. Population Education 9. Community Incentive Scheme 10. Oral Contraceptive Raw Materials Feasibility Study 11. Project Cost Estimates 12. Estimated Disbursement Schedule *13. Schedule of Civil Works Map IBRD 12696: Indonesia: Administration and Population * Available on request from the Population Projects Department.

7 ANNEX I Page 1 INDONESIA II: DEMOGRAPHIC BACKGROUND A. Population Characteristics Population Size and Distribution 1. Indonesia is the fifth most populous country in the world. The population count recorded by the most recent Census taken on Septimber 24, 1971 was million. With a total land area 2f 1.9 million km the density of population on that date was 63 persons per km, rather more moderate and lower than that of Asia (78) or India (172). However, 64% of the Indonesians lived in Java, including Madura, which accounts for less than 7% of the land area and had a density of 565 persons per km in 1971, almost twice that of the densely-populated countries in Northwest Europe, such as the Netherlands (326) or Belgium (318), and higher than in Bangladesh (510). 1/ The 22 provinces of Indonesia, excluding Java and Madura, have a much lower density with large differences among them. Bali had a density close to Java'5 in 1971, while Kalimantan and West Irian had only 9 and 2 persons per km respectively (Table 1). Sex and Age Composition 2. Females were slightly in excess of males, the 1971 Census having recorded 972 males per 1,000 females in the whole of Indonesia. There was a greater preponderance of females in Java and Madura (957 males to 1,000 females), while in the rest of Indonesia the sexes were more evenly balanced (998 males per 1,000 females). Indonesia's population is marked by a high proportion in the younger age groups (Table 2). In 1971, 44.0% were in the age group 0-14 years, 53.5% in the age group years and 2.5% in the age group 65 years and over. Such an age distribution is indicative of a high level of childbearing and a relatively low to moderate expectation of life at birth over the previous decades. Urban-Rural Distribution 3. Seventeen per cent of the population in the country was recorded in the 1971 Census as living in the urban areas (Table 3). In Java, including Madura, 18.0% of the population was classified as urban. In the other islands, Kalimantan was slightly more urban than Java and Madura (20.4%). The urban populations in Sumatra and Sulawesi were 17.1% and 16.1%, respectively. The provinces of Bali, West and East Nusatenggara, Maluku and West 1/ Figures for the Netherlands and Belgium refer to See United Nations Demographic Year Book 1972, New York 1973.

8 ANNEX 1 Page 2 Irian were the least urbanized. A high density of population in Java and Madura, coupled with a relatively low degree of urbanization, results in heavy population pressure on cultivable land. Selected Characteristics 4. Some selected population characteristics are shown in Table 4. Increasing urbanization and improvement in literacy rates are discernable. School enrollment ratios given in Table 5 show that universal education can be expected in the near future. B. Population Dynamics 5. Population growth in Indonesia is determined primarily by births and deaths occurring within the country, as international migration plays an insignificant part. Indonesia's population growth rate during was 2.1% per year, an increase of 0.6% over that recorded during International Migration 6. During , there was a net emigration from Indonesia of the order of 86,000 persons (immigrants: 693,000, emigrants: 779,000) which formed less than 0.01% of the enumerated population in / Despite the encouragement of private or foreign investment in recent years, immigration is generally restricted. The 1971 Census enumerated only 140,000 persons born abroad (sex ratio 1,488) and 162,400 (sex ratio 1,657) who reported their last place of residence to be abroad. Likewise, there is little prospect of a sizeable emigration of Indonesians in the years ahead, and it cannot provide a safety valve for the growing population pressure in Java. Vital Rates 7. Indonesia does not have a national system for the recording of births and deaths occurring in the country and it is, therefore, not possible to obtain, as in the case of most developed countries, information on levels or trends in birth and death rates from routine official records. 2/ 1/ Lembaga Demografi, Demographic Fact Book of Indonesia, Jakarta 1973, p / A "Sample Vital Registration Project" was undertaken as part of the joint IDA/UNFPA-assisted project to study the feasibility of introducing a routine vital statistics registration system in selected sample areas. On the basis of the experience gained in this project, a decision has been taken to extend the system to the entire East Java Province.

9 ANNEX 1 Page 3 Mortality 8. Fair indications of mortality levels are obtained by using the survival ratio of children given by the 1971 Census, and the data provided by the Fertility Mortality Survey, / Based on this information, infant mortality in the latter part of the 1960s was about 144 per 1,000 in rural Indonesia and 115 per 1,000 in urban Indonesia with an overall level of around 140 per 1,000 for the country as a whole. In addition to the urban rural differences, regional differences in mortality could be detected. Mortality rates appeared rather similar in the urban areas of Central Java, East Java and Sumatra (infant mortality rate of 110 per 1,000). In urban West Java and Sulawesi mortality rates appeared to be higher with an infant mortality rate of 126 per 1,000. In rural areas the ranking of the regions by infant mortality rates, from the highest to the lowest was West Java, Sulawesi, Sumatra, Central Java, and Bali with East Java showing the lowest mortality. The infant mortality rates varied from 167 per 1,000 in West Java to 120 per 1,000 in East Java. 2/ 9. Substantial and continuous declines in childhood mortality can be observed in all regions of Indonesia since The rates for are only about 50% of those applying 20 years earlier in This 50% decline in 20 years is consistent with the 25% decline in the 10 years between 1961 and 1971 estimated by McNicoll and Mamas. 3/ The decline in rural areas has been only slightly less than in urban areas. The trend in childhood mortality is presented in Table 6. These substantial declines in mortality, without a substantial change in fertility up to 1970 as will be shown later, have been contributing to the problems of rapid population growth. With the need and possibility for a considerable lowering in mortality rates, there is further scope for an increase in the rate of population growth unless fertility declines. Given the broad relationship between mortality rates for different age groups, the expectations of life at birth 1/ The Fertility Mortality Survey was a large one-round sample survey, covering the topics of marriage, marriage dissolution, fertility, mortality and knowledge, attitude and contraceptive practice (KAP) in Java, Sumatra, Sulawesi and Bali, which together contain 86% of Indonesia's total population. Jakarta, which constitutes a special region equivalent in status to a province, was not included in the sample (or in the above estimate of 86%). 2/ Peter F. McDonald, Mohammad Yasin and Gavin Jones. Levels and Trends in Fertility and Childhood Mortality in Indonesia, Indonesian Fertility Mortality Survey, 1973; Monograph #1, Lembaga Demografi, Fakultas Ekonori, University Indonesia (preliminary draft, unpublished). 3/ Geoffrey McNicoll and Si Cide Made Mamas, "The Demographic Situation in Indonesia", Papers of the East-West Population Institute, December 1973, p. 14.

10 ANNEX 1 Page 4 around 1971 can be placci at around 47 years for the whole of Indonesia. Differences between males and females, and between Java and the other islands are shown in Table 4; females had an expectation of life three years less than in Java. Fertility 10. Both the 1973 Fertility and Mortality Survey, and the 1971 Census provided data on cumulative fertility, namely the number of children born to ever-married women who had completed their reproductive span. The figures obtained from both sources fob the different regions are shown in Table 7 for ever-married wome' aged an(d years. In spite of deficiencies both the Census and survey data indicate that for women nearing the end of their childbearing period the number of children born is high in Sumatra, followed by Sulawesi, West Java, Bali, Central Java and lowest of all, East Java. This general pattern holds in both urban and rural areas. 1/ 11. The regional differentials in the number of children born are quite pronounced. For example, for women aged living in urban areas, parity is fully 2.4 childrel, higher in Sumatra than it is in East Java, and for rural areas, the Sumatra East Java differential is 1.9 children. Even within Java, the differentials are large for women aged 40-44, almost 1.5 children higher irl West than in East Java. 12. According to the data cited in Table 7, there is little difference between urban and rural areas in completed fertility. The differences in parity between regic s, along with a lack of differential between urban and rur,il areas, is suggestive of ethnic characteristics producing fertility differences as opposed to the effect of "modernization" on fertility. 13. The lev s of fertility as given in Table 7 when combined with mortality levels as given in Table 6 show that East Java and Central Java are the two provinces where "comparatively" low levels of fertility and mortality ar( prevalent. In general, Indonesia's demographic pattern, at least before the 1970s l ls one of high fertility and somewhat declining mortality leading to an increase in the population growth rate. 14. Hlas there b n a decline in fertility during the decade ? Cable 8 presents data on total fertility (equivalent to the average number of children during the course of reproductive life to all women) during , , and as given by age-specific birth rates for these periods obtained frout the Fertility Mortality Survey. These figures l/ Both sets of data suffer from inaccuracies. It is usual to find errors due to "recall lapse" especially among older women and this is shown by a smaller figure, in some instances, for women aged years as compared to that for women aged years. Census figures are known to have 5X to 10X women with parity not stated, resulting in a lowering of the estimate for the number of children born. The survey figures on the other hand were slightly over-estimated due to a tendency to neglect to obtain information from divorced and widowed women whose parity level would tend to be below average.

11 ANNEX 1 Page 5 suggest a diminution in fertility during However, careful analysis of the data has led to the following summary statement: "The measured fertility decline in remains somewhat of a mystery. The explanation would appear to be a compound of age mis-statement, under-registration of young children and in the case of Bali and East Java at least, some actual decline in fertility. The last factor can account for only a small part of the measured decline; the main explanation would appear to be in age mis-statement and under registration." 1/ Levels and Trends of Age-Specific Fertility Rates 2/ 15. Age-specific fertility rates which provide the number of births per 1,000 women in a specified age-group during a 12-month period assist in appreciating the contribution to total fertility made at various ages in the reproductive span. These contributions are determined by cultural factors such as age at marriage and also give an insight to the deliberate control of fertility. The pattern of fertility in Indonesia as a whole can be described as an "early marriage, high fertility" pattern. Fertility rates are high even at extreme ages of childbearing such as and years. It is common for women's childbearing to be spread over a 20-year span or longer, whereas in the western Europe a 10-year span or shorter is much more typical. 16. Within regions there are considerable variations. In particular, fertility at the older ages (35 and above) accounts for a higher proportion of fertility in those regions where fertility is highest. This general pattern holds very clearly in urban areas. In rural areas there is greater uniformity between regions in pattern of fertility, although childbearing at older ages is least pronounced in the two lower fertility regions, Central and East Java. Sulawesi and Bali emerge as the two regions where childbearing continues into older age groups, closely followed by Sumatra. But even Central and East Java exhibit a much older pattern of childbearing than countries with low levels of fertility, such as Taiwan or Japan or France. Fertility at ages below 20 varies considerably and in each region is much higher in rural than in urban areas. The Javanese pattern of early marriage causes fertility rates for the ages to be higher in East Java than they are in Sumatra, despite much lower levels of fertility. The net result of high fertility at the extreme ages of the childbearing span is that these ages account for around 30% to 35% of the sum of the age-specific fertility rates in Indonesia, compared with only 10% to 20% in most Western countries and as low as 6% in Japan. 1/ Peter F. McDonald, et. al., op. cit. 2/ The discussion is based on the findings given in Peter F. MIcDonald's "Indonesian Fertility and Mortality Survey", op. cit.

12 ANNEX I Page Over the decade of the 1960s, or more specifically between and , some rather consistent trends in fertility rates emerge. In almost all regions fertility rates at ages showed a fall. This is clearly related to the rising age at marriage which occurred universally during the 1960s, though more pronounced in urban than in rural areas. Fertility rates at the main childbearing ages (20-34) mostly rose during the decade, whereas at the older ages (35-44) they fell fairly consistently in urban areas. The trend at these ages in rural areas was mixed. These trends--a decline in fertility at the youngest and oldest childbearing ages, more pronounced in urban than in rural areas--are fairly typical of countries entering the early stages of a transition to lower fertility rates. They can be optimistically interpreted as presaging a further decline in fertility as time goes on. The age-specific fertility rates during as estimated for Java and Madura and other islands from the data obtained in the Fertility Mortality Survey, and augmented by information from other sources, and corrected for certain inaccuracies in basic data are given in Table Interest centers on the trend in fertility after 1970, when the NFPCB took shape and the national family planning program in Java and Bali went into operation. Unfortunately precise figures are not yet available. Based on the number of persons who had accepted family planning methods through the program and on the continuity of use of these methods, it has been estimated that the birth rate declined by about six points between 1970 and The decline was more marked in East Java and Bali (Table 10). Under the aegis of the Central Bureau of Statistics an inter-censal survey in three stages has been completed and the data are being processed. Very preliminary findings from the survey tend to confirm the evidence of a decline in fertility but the final results will not be available until the end of C. Population Projections 19. Population projections have been made by the Indonesian Institute of Sciences (LEKNAS) under different alternate assumptions about fertility, transmigration and rural to urban migration for the 10 planning regions into which Indonesia has been divided by the National Development and Planning Agency (BAPPENAS). 1/ The assumptions are based on policy goals adopted by the Government but do not imply that the Government would or should adhere to these goals. In fact, the projections are intended to help policy-makers to evaluate these goals or alternatives and to estimate the magnitude of programs needed to achieve them. 1/ Alden Speare Jr. (July 1976) Summary Report Projections of Population and Labor Force for Regions of Indonesia , Vol. I; National Institute of Sciences (LEKNAS). See also accompanying Vols. II and III. Vol. II: Population Projections for Indonesia (according to BAPPENAS Regions). Vol. III: Population Projections for Java (according to BAPPENAS Regions).

13 ANNEX 1 Page The alternative assumptions made are: a. Fertility Assumptions Low fertility - High fertility - Total fertility in each region is assumed to decline linerally to a level consistent with a 50% decline in crude birth rate from the level. This decline is assumed to be achieved by the period in Java and Bali and by the period outside Java and Bali. Total fertility is assumed to decline linerally at one half the rate of decline of the low fertility assumption in regions comprising Java and Bali. No decline in regions making up the other islands is assumed. b. Migration Assumptions Low migration - High migration - Inter-regional migration is assumed to continue at the same rates estimated for from the 1971 Census with a small upward adjustment for the reported increase in transmigration from to The rates assumed for the low migration assumption have been increased so that the total transmigration for is 250,000 persons per year, which was the target of the second national five-year plan. The rates of migration calculated for are applied to the following periods which implies that transmigration will continue to increase in proportion to the total population of Indonesia. c. Urbanization Assumptions Low assumption - The difference in urban and rural growth rates in each region will remain the same as that observed between the 1961 and 1971 Censuses.

14 ANNEX 1 Page 8 High assumption - The difference in urban and rural growth rates will increase to 2.75% per year (UN medium assumption) in regions where the rate of urbanization between 1961 and 1971 was low and to 3.75% (UN high assumption) in regions of medium to high urbanization in On the average this results in an increase in urban growth by about 1.5% per year over the low urbanization assumption. All projections were made from the populations reported in the 1971 Census (Series B). The initial age distributions were obtained from the 1971 Population Census (Series E) adjusted for age misreporting. In respect of mortality, female life expectancy is expected to increase by 2.5 years for every 5 years projected, from 47.5 years in to 62.5 years in The male life expectancy is expected to increase from 45 years in to 59 years by West Model Life Tables of Coale and Demeny were used in projecting mortality rates. All projections were made using the component cohort approach and are given as of December 31 of the year under reference. 21. The insights gained from an analysis of the projections are as follows: a. Fertility Decline: fertility assumptions have the greatest effect on total population. If the goal of the national family planning program of reducing the crude birth rate by 50% by 2000 is achieved, the total population will be around 209 million. If the goal is only partly achieved on Java and Bali and there is no change in fertility outside Java and Bali (high fertility assumption), the total population will be around 258 million. The difference between the low and high fertility assumptions is about 49 million people (Table 11). The projections under the high fertility assumption show the imperative need to extend the national family planning program outside Java and Bali if the size of the Indonesian population is to be controlled. Of the 49 million difference in population size likely to be attained under the "low" and "high" assumptions of fertility, 23 million will occur inside Java and Bali and 26 million outside Java and Bali. The population outside Java and Bali will increase by 115% under the 'low fertility' assumption and by 180% under the 'high fertility' assumption.

15 ANNEX 1 Page 9 The age distribution of the population around the year 2000 will be affected by the speed with which fertility declines. Under the 'low fertility' assumption, 32.6% will be under 14 years of age, while on the 'high fertility' assumption 42.8% will be under this age (Tables 12 and 13). The expected birth and death rates for Indonesia under the two fertility assumptions are shown in Table 14. Whilst under the 'low fertility' assumption Indonesia's population will grow at the rate of 1.4% per annum around the year 2000, the rate of growth at that time would be 2.6% per annum under the 'high fertility' assumption. Since the latter assumes a decline in fertility in Java and Bali at one-half the rate of the 'low fertility' assumption, it is evident that with levels of fertility remaining constant at prevailing levels, the already fast rate of population growth will be further accelerated. b. Transmigration: the effect of transmigration is best seen on the rural population of Java and Bali. Under assumptions of "high" transmigration the rural population of Java and Bali will be about 8 million less around the year 2000 as compared with the number that will be expected under assumption of the "low" transmigration. c. Urbanization: a higher pace of urbanization will increase the urban population of Java and Bali by 10 million and will reduce the rural population of Java and Bali by the same amount, around the year Outside Java and Bali the difference will be of the order of 8 million. The expected 'urban' and 'rural' populations in Java and Bali and outside Java and Bali under the various assumptions around the year 2000 are given in Table 15.

16 ANNEX 1 Page 10 Table 1 INDONESIA II: POPULATION--1930, 1961, 1971, AVERAGE ANNUAL GROWTH RATE AND POPULATION DENSITY BY REGION AND PROVINCE (OOOs) Region Census Census Census/I Growth Rate Density (persons/km) M(%) 1971 Jakarta 811 2,907 4, ,944 West Java 10,586 17,615 21, Central Java 13,706 18,407 21, East Java 15,056 21,823 25, Yogyakarta 1,559 2,241 2, Sub-Total 41,718 62,993 76, Soith Sumatra 1,378 2,773 3, Lampung 361 1,668 2, Bengkulu Jambi ,006 Riau 493 1,235 1, West Sumatra 1,910 2,319 2, North Sumatra 2,541 4,965 6, Aceh 1,003 1,629 2, Sub-Total ,739 20, West Kalimantan 802 1,581 2, Central Kalimantan South Kalimantan 835 1,473 1, East Kalimantan Sub-Total 2,169 4,102 5, North Sulawesi 748 1,351 1, Central Sulawesi South Sulawesi 2,657 4,517 5, Soath-East Sulawesi Sub-Total 4,232 7,079 8, Bali 1,101 1,783 2, West Nusatenggara 1,016 1,808 2, East Nusatenggara 1,343 1,967 2, Sub-Total 3,461 5,558 6, Maluku , West Irian TOTAL 60,593 97, ,233 /1 Includes 67,725 homeless persons, 772,654 rural West Irian and 24,270 erroneous entries. Source: 1971 Population Census, Central Bureau of Statistics.

17 ANNEX 1 Page 11 Table 2 INDONESIA II: POPULATION BY AGE GROUP AND SEX, 1961 AND 1971 (OOOs) Age Group Male Female Total Male Female Total 0-4 9,152 9,276 18,428 9,606 9,493 19, ,571 7,524 15,095 9,525 9,237 18, ,763 4,417 9,180 7,353 6,826 14, ,567 3,635 7,202 5,588 5,738 11, ,529 4,354 7,883 3,602 4,429 8, ,630 4,543 8,173 3,978 4,947 8, ,555 3,779 7,334 3,690 4,214 7, ,140 2,914 6,054 3,948 4,031 7, ,457 2,310 4,767 3,064 3,038 6, ,923 1,869 3,792 2,427 2,223 4, ,487 1,477 2,964 1,903 1,961 3, ,052 1,040 2,092 1,126 1,100 2, ,632 1,082 1,256 2, and over 1,029 1,079 2,108 1,440 1,529 2,969 TOTAL 47,675 49, o /1 Based on 1% sample of complete return. /2 Excludes rural West Irian (772,654), homeless persons (67,725) and incorrectly counted (24,270). / Census total from complete tabulations including estimate for West Irian, homeless persons and incorrectly counted, and age not stated (15,059), are in thousands: Male: 59,103; Female: 60,129; Total: 119,232. Source: Central Bureau of Statistics.

18 ANNEX 1 Page 12 Table 3 INDONESIA II: POPULATION BY PROVINCE AND RURAL AND URBAN AREAS, 1971 (OOOs) Region Urban Rural Total- Jakarta 4,546-4,546 West Java 2,683 18,938 21,621 Central Java 2,345 19,520 21,865 East Java 3,694 21,814 25,508 Yogyakarta 406 2,082 2,488 Sub-Total 13,674 62,354 76,028 South Sumatra 928 2,510 3,438 Lampung 273 2,503 2,776 Bengkulu Jambi ,006 Riau 218 1,423 1,641 West Sumatra 479 2,313 2,792 North Sumatra 1,136 5,485 6,621 Aceh 169 1,839 2,008 Sub-Total 3,557 17,244 20,801 West Kalimantan 223 1,797 2,020 Central Kalimantan South Kalimantan 453 1,246 1,699 East Kalimantan Sub-Total 1,049 4,103 5,152 North Sulawesi 335 1,383 1,718 Central Sulawesi South Sulawasi 941 4,239 5,180 South-East Sulawasi Sub-Total 1,373 7,153 8,526 Bali 203 1,912 2,120 West NAsatenggara 179 2,025 2,204 East Nusatengga-a 129 2,166 2,295 Sub-Total 516 6,103 6,69 Maluk! ,090 West Irian TOTAL , ,140 /l Excludes 67,725 ho-neless persons and 24,270 persons incorrectly included. > irce: Indonesia 1971 Ce;:sus, Population tables for all Indonesia.

19 ANNEX 1 Page 13 Table 4 INDONESIA II: SELECTED POPULATION DATA Selected Population Data Java Other Islands Indonesia Census Count (millions) / Adjusted for undercount- and mid-year Intercensal Growth Rate (%) ; Estimated Vital Rates, Birth Rate (per 1000) Death Rate (per 1000) Total Fertility Rate (children per woman)/ Life Expectancy at Birth (years), Males Females Persons Mean Age at Marriage (Years) Males Females Marital Status Females 10 years and over (%) Single Married Widowed Divorced Age Distribution (%) Males Females Percentage Urban Literacy Rate/- Population 10 Years and Over (%) Males Females Persons /1 The net undercount is estimated to be 2.5% in rural areas and in urban areas,or 2.76% in the total population. /2 The total fertility rate is defined as the average number of children born to women who finish their fertile period. /3 Ability to read and write in either Latin or non-latin characters was considered adequate - to classify a person as literate.

20 ANNEX 1 Page 14 Table 5 INDONESIA II: SCHOOL ENROLLMENT RATIOS FOR POPULATION AGED FIVE YEARS AND ABOVEL/ Age Urban Rural Total Males Females Males Females Males Females Indonesia All Ages Java All Ages Other Islands All Ages / Census.

21 ANNEX I Page 15 Table 6 INDONESIA IT: PROPORTION OF CHILDREN DYING BEFORE AGE FIVE FROM 1000 LIVE BIRTHS BIRTH YEAR COHORT, FERTILITY MORTALITY SURVEY Region Child Birth Year Urban West Java Central Java East Java Sumatra Sulawesi Rural West Java Central Java East Java Sumatra Sulawesi Bali Source: Peter F. McDonald, et. al., op. cit.

22 ANNEX 1 Page 16 Table 7 INDONESIA II: NUMBER OF CHILDREN BORN TO EVER-MARRIED WOMEN AGED AND YEARS IN DIFFERENT REGIONS Age of Mother Region Years Years Fertility 1971 Census Fertility 1971 Census Mortality Mortality Survey, 1973 Survey,1973 Urban West Java Central Java East Java Sumatra Sulawesi Rural West Java Central Java East Java Sumatra Sulawesi Bali/L /1 Data for Bali are for the island as a whole, including both urban and rural areas. The population of Denpasar, the largest town in Bali, is only about 70,000 and the proportion of Balinese population living in urban areas only 9.8%. Source: Fertility Mortality Survey, 1973.

23 ANNEX 1 Page 17 Table 8 INDONESIA II: RECORDED TOTAL FERTILITY RATES BY REGIONj, Region Urban West Java Central Java East Java Sumatra Sulawesi Rural West Java Central Java East Java Sumatra Sulawesi Bali / Survey. Source: Peter F. McDonald, et. al., op. cit.

24 ANNEX 1 Page 18 Table 9 INDONESIA II: AGE SPECIFIC FERTILITY RATES, FERTILITY MORTALITY SURVEY, Age Groups Java-Madura Other Islands Indonesia Fertility Mortality Fertility Mortality Fertility Mortality Survey Survey Survey /1 All Areas /2 All Areas /3 All Areas Total Fertility Rate /1 Excludes Jakarta. /2 Excludes Kalimantan, East and West Nusatenggara, Maluku and West Irian. /3 Excludes Jakarta, Kalimantan, East and West Nusatenggara, Maluku and West Irian. Source: Peter F. McDonald, et. al., o.cit.

25 ANNEX 1 Page 19 Table 10 INDONESIA II: ESTIMATED CRUDE BIRTH AND TOTAL FERTILITY RATE FOR (PREPROGRAM) AND 1975, BY PROVINCE Province Crude Birth Rate Total Fertility Rate Jakarta West Java Central Java and Yogyakarta East Java Bali Java and Bali Source: NFPCB, Jakarta, unpublished work.

26 ANNEX 1 Page 20 Table 11 INDONESIA II: POPULATION PROJECTIONS UNDER LOW AND HIGH FERTILITY ASSUMPTIONS / (in millions) Year Java and Bali Other Islands Indonesia Low High Low High Low High Fertility Fertility Fertility Fertility Fertility Fertility /1 The figures relate to December 31 of the year indicated and were derived on the basis of "low migration", "low urbanization" assumptions. Java and Bali comprise all of BAPPENAS Regions IV and V except for Lampung which is a part of Region IV but has been omitted here because its inclusion would have obscured the effects of transmigration. Source: Alden Speare Jr., Sumnary Report Projections of Population and Labor Force for Regions of Indonesia , Vols. I, II and III, July 1976.

27 ANNEX I Page 21 Table 12 INDONESIA II: POPUIATION PROJ CTIONS BY AGE GROUPS ) Age Group Males 0-4 9,708 10,924 11,525 12,049 12,271 12,060 11, ,424 9,057 10,292 10,946 11,531 11,826 11, ,204 8,249 8,890 10,122 10,787 11,386 11, ,978 7,048 8,091 8,736 9,968 10,643 11, ,182 5,794 6,855 7,891 8,543 9,772 10, ,925 4,026 5,600 6,647 7,678 8,337 9, ,091 3,758 3,875 5,414 6,449 7,476 8, ,494 3,889 3,592 3,723 5,224 6,247 7, ,886 3,290 3,683 3,420 3,560 5,023 6, ,368 2,679 3,073 3,459 3,232 3,385 4, ,905 2,154 2,454 2,833 3,211 3,016 3, ,424 1,680 1,913 2,199 2,557 2,914 2, ,086 1,200 1,425 1,642 1,901 2,228 2, ,142 1,328 1,555 1, , Total 58,152 65,485 73,275 81,461 89,730 97, ,663 Females 0-4 9,606 10,695 11,246 11,730 11,920 11,698 10, ,277 3,976 10,081 10,694 11,243 11,513 11, ,090 8,088 8,797 9,906 10,538 11,102 11, ,062 6,849 7,924 8,642 9,754 10,395 10, ,452 5,881 6,667 7,738 8,461 9,576 10, ,939 4,299 5,695 6,477 7,543 8,275 9, ,126 3,780 4,142 5,513 6,292 7,355 8, ,374 3,943 3,626 3,992 5,333 6,114 7, ,920 3,284 3,764 3,479 3,844 5,159 5, ,453 2,758 3,116 3,588 3,329 3,694 4, ,046 2,286 2,580 2,932 3,393 3,163 3, ,620 1,859 2,092 2,376 2,717 3,162 2, ,287 1,417 1,639 1,860 2,128 2,452 2, ,055 1,177 1,376 1,576 1,822 2, ,011 1,240 1, ,148 1,370 Total 59,182 66,386 74,009 82,009 90,095 97, ,788 TOTAL (Male 117, , , , , , ,451 and Female) /1 Low Fertility Assumption. Source: Alden Speare Jr., op. cit.

28 ANNEX 1 Page 22 Table 13 INDONESIA II: POPULATION PROJECTIONS BY AGE GROUP ,q (OOOs) Age Group Males O - 4 9,703 11,197 12,781 14,680 16,766 19,121 21, ,424 9,021 10,551 12,140 14,051 16,151 18, ,204 8,250 8,854 10,376 11,963 13,873 15, ,978 7,055 8,087 8,697 10,216 11,799 13, ,182 5,802 6,859 7,886 8,501 10,008 11, ,725 4,027 5,607 6,648 7,671 8,294 9, ,091 3,755 3,877 5,420 6,453 7,472 8, ,494 3,887 3,592 3,727 5,233 6,254 7, ,886 3,289 3,682 3,422 3,566 5,035 6, ,368 2,678 3,073 3,460 3,232 3,390 4, ,905 2,153 2,473 2,832 3,211 3,016 3, ,424 1,679 1,911 2,198 2,557 2,916 2, ,086 1,197 1,424 1,640 1,900 2,223 2, ,142 1,327 1,555 1, , Total 58,152 65,727 74,755 85,505 98, , ,208 Females 0-4 9,606 10,955 12,475 14,291 16,290 18,551 21, ,277 8,933 10,336 11,866 13,700 15,730 18, ,090 8,089 8,759 10,149 11,690 13,528 15, ,062 6,857 7,921 8,597 9,998 11,531 13, ,452 5,889 6,670 7,732 8,416 9,812 11, ,939 4,300 5,702 6,485 7,538 8,232 9, ,126 3,778 4,145 5,517 6,296 7,348 8, ,374 3,941 3,627 3,996 5,342 6,120 7, ,920 3,283 3,763 3,478 3,846 5,167 5, ,453 2,758 3,115 3,587 3,328 3,698 4, ,046 2,286 2,581 2,931 3,391 3,162 3, ,620 1,859 2,091 2,377 2,716 3,160 2, ,287 1,416 1,639 1,868 2,129 2,451 2, ,055 1,176 1,376 1,576 1,823 2, ,069 1,239 1, ,144 1,371 Total 59,182 66,618 75,457 85,958 98, , ,614 TOT AJI. (Male and Female) 117, , , , , , ,822 /1 High Fertility Assumption. Source: Alden Speare Jr., op.cit.

29 ANNEX 1 Page 23 Table 14 INDONESIA II: BIRTH RATE, DEATH RATE AND GROWTH RATE TO (OOOs) Year Birth Rate Death Rate Growth Rate Low Fertility High FertilityL' /1 Assumptions--Low migration and low urbanization. Source: Alden Speare Jr., on.cit.

30 ANNEX 1 Page 24 Table 15 INDONESIA II: ALTERNATIVE PROJECTIONS OF URBAN AND RURAL POPULATIONS FOR YEAR 2000 /1 Region Population end Population in the year 2000 by Projection- Year 1970 (1) (2) (3) (4) (5) (6) Assumption Fertility - Low High Low High Low High Transmigration - Low Low High High Low High Urbanization - Low Low Low Low High High Java and Bali Urban Rural Total Outside Java and Bali Urban Rural Total Total Population Urban Rural Total /1 Projection in millions. Soarce: Alden Speare Jr., op. cit.

31 ANNEX 2 Page 1 INDONESIA II: THE NATIONAL FAMILY PLANNING PROGRAM A. Background 1. Family planning in Indonesia was pioneered by a private organization, the Indonesian Planned Parenthood Association (IPPA) which began operating in President Suharto signed the Declaration of World Leaders on Population in Recognizing the need to stem population growth in the country, the Government of Indonesia (GOI) set up a semi-governmental institute in 1968 to coordinate family planning activities which were being carried out by various private and official agencies. At the same time, the GOI invited a joint UN/WHO/IBRD mission to help it to develop a comprehensive program. As the next step, the GOI replaced the institute in 1970, by the fully governmental National Family Planning Coordinating Board (NFPCB) to plan, coordinate, supervise and evaluate a national family planning program, at first restricted to Java (including Madura) and Bali. B. Organization 2. The President is personally responsible for the progress of the program; this devolves upon the Provincial Governors insofar as the province is concerned and upon the Bupatis with regard to their kabupatens which are the next administrative division. Advising the President on policy matters is a ministerial council composed of all the concerned ministers, with the State Minister of People's Welfare as the Chairman and the Chairman of the NFPCB as its secretary. The NFPCB is a non-departmental body with a Chairman, three deputy chairmen, a Secretariat for administrative and financial support, and nine bureaus representing the various staff functions required to fulfill its responsibilities (Chart 1). The Chairman reports directly to the President and the State Minister of People's Welfare, acting on behalf of the President, exercises certain powers on day-to-day matters. Actual implementation of program activities is vested in the concerned operational Ministeries of the Government such as Health, Information, Education, Interior, and the Armed Forces and voluntary organizations such as the IPPA, Muhammadiyah and the Indonesian Council of Churches. A program consultative committee composed of the heads of the implementing units advises the Chairman on policy formulation and operational strategy. 3. The NFPCB has an office in each of the provinces in which the program functions--six in Java and Bali and 10 in the other islands. Each office is headed by a Chairman and has a secretary, three division chiefs (planning, supervision and research and evaluation) and several project leaders taking responsibility for one or more operational aspects of the program. Inasmuch as provincial governors are responsible to the President for the progress of the developmental programs within the province, provincial chairmen are required to obtain his directives on operational matters.

32 ANNEX 2 Page 2 Provincial chairmen are also responsible to the Chairman of the Central NFPCB for all administrative, financial and technical matters. 4. At the kabupaten level, which is really the operational base of the program, the NFPCB has a chairman, a field work supervisor and an administrative staff. The kabupaten chairman is responsible to the Chairman of NFPCB but is directed by Bupatis in operational matters. Working with the medical officer of the kabupaten (DOKABU) and kabupaten officials of other implementing units, he coordinates program activities within his jurisdiction and exercises supervisory powers. 5. At the kecamatan level, the Camat from the Ministry of the Interior, the PUSKESMAS (public health centre) physician from the Ministry of Health (MOH) and the group leader of the non-medical fieldworkers of the NFPCB, assisted by other officials, organize educational, informational and service activities. At the village-level, the Lurah from the Ministry of Interior, the non-medical fieldworker from the NFPCB and the midwife from the MOH, assisted by the voluntary village-level family planning worker (PPKBD) are responsible for recruiting acceptors and sustaining their practice of contraception. C. Program Development 6. Program development is an elaborate process and involves several levels of administration. The National Working Meeting meets once a year, is presided over by the Chairman of the NFPCB and is attended by all senior and middle level officials of the central and provincial NFPCB and of the family planning cells of the implementing units; representatives of BAPPENAS, the Ministry of Finance and other concerned ministries also participate. Reviewing past experiences and anticipating future needs, this body recommends programs and policies to the Chairman of the NFPCB. After further discussions of the National Working Meeting's recommendations with the appropriate authorities, the Chairman enunciates national policy and indicates the kind of programs required to implement the policy. This information is then relayed to the provincial NFPCB Chairman for evolving specific program activities; the provincial chairman in turn sends it to the several kabupaten NFPCB to review needs and work out operational details. The recommendations of these operational level units are consolidated and coordinated by the provincial NFPCB and after obtaining the Governor's approval are presented to the central NFPCB as the provincial program. The Central NFPCB after reviewing the provincial programs, formulates the national program which it discusses with representatives of the central level implementing units, BAPPENAS and the Ministry of Finance. When this group endorses the program it becomes the basis both for the budget and for program operations.

33 ANNEX 2 Page 3 D. Program Funding 7. The Indonesian family planning program has progressed from the stage where contraceptive information and services were provided primarily through foreign donor assistance (96.5% of the total family planning budget in ) to one where the GOI has assumed primary responsibility for providing these services and has committed itself to underwriting a large percentage of program costs (49% of the family planning budget in , not including MOH personnel salaries) (Table 1). The family planning budget per capita has steadily increased from US$.028 in to US$.297 in On the other hand, the cost of recruiting a new acceptor has declined to a level of US$10 to US$15 per acceptor. E. Service Delivery 8. Until recently, the bulk of the family planning services was being provided by a network of clinics operated by the MOH, the Armed Forces (ABRI) Health Services, and other Government and private agencies. As of March 1977, there were in Java and Bali 2,719 registered family planning clinics located in PUSKESMAS, sub-clinics and satellite clinics, of which 2,261 belonged to the MOH, 199 to the ABRI, 51 to other governmental agencies and 208 to private organizations. In addition, there were 1,443 mobile teams which carried services to those who did not have an easy access to clinics. Most of the PUSKESMAS in Java and Bali now have a physician in charge and/or other supporting staff and the sub-clinics are manned by midwives and/or a PKK (primary health nurse). The mobile team consists of a midwife/pkk, a non-medical family planning fieldworker and a local volunteer. The latter two prepare the community for the midwife's visit; the midwife provides the services. 9. In the 10 other provinces to which the program was extended in 1974, as of March 1977, there were 901 family planning clinics of which 637 belonged to the MOH, 108 to the ABRI, 47 to other Government departments and 109 to voluntary organizations. There were 194 mobile teams in operation. In the mobile team, there is an auxiliary health worker known as a motivator, instead of the fieldworker as in Java and Bali. 10. Involved in the field operations in the country are 2,145 doctors, 3,416 midwives, 2,967 assistant midwives, 2,097 recording personnel, 1,557 information workers, 6,574 fieldworkers, 1,295 group leaders, 202 supervisors, 6 field work coordinators and 21 assistant coordinators, 274 motivators and others. 11. Some institutional contraceptive methods (vasectomy and tubal ligation) are available in specially designated hospitals. Availability is contingent upon the existence of a demand for such methods and the socio-cultural

34 ANNEX 2 Page 4 conditions which permit them. Field trials on the commercial distribution of condoms through the vendors of herbal medicine (Jamu Jago) and other small drug retail outlets have been carried out. Distribution by mail upon request has also been tried. Results of both studies are encouraging. Commercial distribution may soon become a national scheme. Community-Based Distribution Scheme 12. The national family planning program has launched an all out effort to make the resupply of such contraceptives as the oral contraceptive and the condom as easy and as convenient for the user as possible. This is the Community-Based Distribution Scheme. For this purpose, a variety of village contraceptive distribution centres (VCDCs) have been established through most of Java and Bali. These are staffed by various categories of individuals, including paid acceptors, members of the Village Social Institute who come under the authority of the Ministry of Interior, and members of the village headman's staff. In Bali, contraceptive resupply, among other family planning activities, has been integrated into the traditional Balinese banjar or hamlet administrative system. All told, there are approximately, 28,000 VCDCs in Java, and over 3,000 in Bali. Compared with the number of clinic supply points, the VCDCs outnumber clinics 9 to 1. The proportions of all oral contraceptive resupplies distributed through the VCDCs are 36% in West Java, 45% in Central Java, 81% in East Java and 31% in Bali. Contraceptive Supplies 13. The Bureau of Logistics of the Central NFPCB is responsible for procuring contraceptives and maintaining a steady supply line. The Bureau dispatches the contraceptives to the provincial offices where a reserve of 25% of the supplies is always maintained; the rest is distributed to the kabupaten. Maintaining a small reserve, the kabupaten NFPCB supplies the PUSKESMAS which, in turn, supplies the PPKBD with a month's stock. Staff members are available at each administrative level to handle the distribution and supply. Except for the 27.5 mm Lippes loop, all other sizes of this type of IUD are manufactured in Indonesia. Oral contraceptives have been and will continue to be supplied by USAID until December Thereafter, the demand will be r.met by local production--tableting in the initial stages followed by complete production eventually. F. Information, Education and Communications Community Education 14. Education of the community in Java and Bali is carried out primarily by non-medical family planning fieldworkers. At the national level, the Special Bureau of Fieldworkers plans the overall program and directs

35 ANNEX 2 Page 5 and supervises it. A coordinator at the provincial level, backed up by assistant coordinators does the detailed planning of the provincial program and provides guidance for its implementation and supervises performance. A supervisor at the kabupaten is in overall charge of operations and works through a group leader and fieldworkers who are attached to the PUSKESMAS. On an average there are four fieldworkers for every PUSKESMAS which works out to a ratio of one fieldworker to about 14,000 population and one group leader for every four or five fieldworkers. With the coming in of the Community- Based Distribution Scheme the fieldworkers assist and supervise the educational activities of the VCDC. In addition to this direct input of the NFPCB, family planning is included in the health education programs of the MOH in the clinic and the community. Information officers of the Ministries of Religious Affairs and of Information, who are largely face-to-face communication practitioners working at the kecamatan level, also participate in the community education program. 15. Face-to-face communications in 10 provinces of the other islands include campaigns directed at special groups in the community, involvement of community leaders, orientation of community leaders and youth groups and special teams to carry out informational/educational activities at the kecamatan and village levels. Paramedical staff of the PUSKESMAS educate the community regarding family planning as part of their health education activities. The NFPCB plan to intensify this educational program by attaching four volunteer motivators to each PUSKESMAS. The PUSKESMAS staff will then have a role similar to that of the group leader in Java and Bali and will operate through the four volunteers at the intermediate stage and the VCDC and traditional midwives (dukuns) at the village level. The plan will also provide support to the paramedical staff through the appointment of a coordinator at the provincial level and a supervisor at the kabupaten level. Volunteer motivators at PUSKESMAS level are already being recruited and trained. Public Information 16. When the NFPCB was established in 1970, there was hardly any activity in family planning in the Ministry of Information or its associated agencies, such as the Radio Republik Indonesia or the Television Republik Indonesia. The first step taken by the Bureau of Information and Motivation of the Central NFPCB was to conduct a series of orientation courses, seminars and workshops for officials of the Ministry of Information and its associated agencies, as well as for officials of the Ministries of Social Welfare and of Religious Affairs, journalists, practitioners of indigeneous media, ullemas (religious leaders), community leaders, and the leaders of women's and youth groups. The NFPCB provided the funds, technical advice and in some cases teachers and the organization concerned conducted the sessions. This approach has resulted in the formation of organized groups such as the Family Planning Writers Association, Zero Population Group of the students, and others with population and family planning as the binding force; it has also helped to introduce family planning into the activities of existing organized groups such as KOWANI (women's organization) and HMI (Muslim Students Association).

36 ANNEX 2 Page 6 These national -ganizations have branches all over the country. They conduct orientation coumr,-cs with financial, material and technical assistance from the NFPCB and thus help in stimulating and sustaining community interest in population matters. 17. The Ministry of Information has also developed a family planning unit; this was reorganized recently and now consists of a Chairman and six others including the news directors of the State radio and television networks and those in charge of public relations and regional publicity. The NFPCB provides this unit with its assessment of the information needs of the program, technical information, guidance and funds. At the provincial level, the Ministry of Information maintains a provincial information office called the KANWIL consisting of a chairman, and four divisions--public speaking, mobile units, press and general--each with one or more professional staff; with other supporting and administrative personnel the total staff strength is between 50 and 60. There is a project leader for information and motivation in each provincial NFPCB office in Java and Bali. This officer coordinates public information activities in the provinces through an information and motivation team comprising representatives of the implementing units. The Governor's role is pivotal; since he is responsible for the progress of the program in his province, he personally directs the agencies to participate in the public information program and thus sets the pace for the Bupatis and others to do likewise within their areas. 18. At present, the information, education and communication program in the 10 other provinces is the direct charge of the Chairman of the provincial NFPCB. A coordinating team with the provincial information officer as the Chairman and representatives of the implementing units as members has been appointed by the Governor to assist the Chairman of the provincial NFPCB and actually carry out an information service. 19. At the kabupaten level in Java and Bali--the operational base--the Ministry of Information has an information office with about three to five information officers and a total staff strength of between 25 and 30. It operates a PUSPENMAS (public information centre). Areas of concentration are the same as at the provincial level and a multi-media approach is used including posters, leaflets, exhibitions, traditional media, bulletins and films. A mobile information unit (provided under the joint IDA/UNFPAassisted project) is located in each kabupaten with a driver, an operator and a speaker. As there is no special functionary for information at the kabupaten NFPCB office, the Chairman himself coordinates public information activities in the area. 20. The kecamatan information worker is largely a face-to-face communications functionary. As of July 1976, there were 1,577 kecamatan information workers in the six provinces of Java and Bali, of whom 52.8% sent in reports. Collectively, they organized 26,848 meetings: mixed group (43%), men's group (16%), women's groups (34%) and youth groups (7%); of these 73% were mass meetings, 13% group discussions, and 0.73% were sessions using indigeneous

37 ANNEX 2 Page 7 media. Media or audiovisual aids were used on 944 occasions; films accounteu for 38% of these occasions, slides 7%, flipcharts 48%, filmstrips 0.6%, and cassettes 6.25%. Total attendance reported was 3,214,070. Subjects covered included the population problem, religion and family planning, family planning and family welfare, as well as information on contraceptive methods. Radio and Television 21. There are 46 Radio Republik Indonesia stations in the country, of which 18 are in Java and Bali. In addition, there are 700 governmental and non-governmental commercial radio stations owned by regional governments, universities, the Armed Forces and the nrivate sector. There are six television stations, three in Java, two in Sumatra and one in South Sulawesi; the recently launched domestic satellite will enable the establishment of a station in each province during the third five-year plan. There is a great deal of coverage of family planning in the radio programs of both Radio Republik Indonesia and commercial stations. Initially, the NFPCB provided funds to both types of stations for family planning broadcasts. Now both Radio and Television Republik Indonesia include funds for this purpose in their own budgets, in addition to NFPCB funding. Printed Material 22. Initially, because of the lack of an infrastructure to stimulate and coordinate production of printing material, the Bureau of Information and Motivation of the Central NFPCB formerly prepared prototypes, pretested them, commissioned their production and arranged for their distribution. Now, except for magazines, bulletins and press reviews, all printed materials are produced in the provinces. From 1970 to date, the Central NFPCB has produced 8 booklets on the population problem, 16 on the social, economic and cultural aspects of family planning, 5 on medical and health aspects, 7 on religion and family planning, 1 on law and family planning, and 15 on political and organizational aspects. During this period 5.7 million copies of 27 leaflets and over a million copies of 20 posters were produced. Two sets of flipcharts were produced in 1972 and 1973, 2,000 copies of each set. The Central NFPCB publishes a monthly magazine. The annual print order has increased from 90,000 in to 300,000 in Special calendars were issued from to with a print order of 10,000 each year. Films 23. In all, 24 films have been produced--18 by the Central NFPCB, four by the IPPA and two by the NFPCB of West Java. Together they account for 624 minutes of running time. There are 1,191 copies of the 24 titles. Both local and international funds have been used to produce these films. Eight sets of slides have been prepared. A thousand copies of four cassettes with family planning songs have also been produced. Training and Communications 24. Some of the communications personnel involved in the program have been trained in established training programs at the University of Chicago

38 ANNEX 2 Page 8 and the East-West Communication Institute, and in India, Japan and the Philippines. Others have gone on study tours of Asian countries and yet others on conducted tours to program sites within the country. Recently, study tours financed under the joint IDA/UNFPA-assisted project were undertaken by seven batches of three staff each. These persons were drawn from the central and provincial NFPCB offices; the Ministries of Information, Health, Interior, Education, Manpower and Religious Affairs, and the Armed Forces, as well as the IPPA, Muhammadiyah and the Indonesian Council of Churches. The main objective of the tours was to study the communications program for family planning of the countries visited with special reference to organization, programming and research. Countries visited included the Arab Republic of Egypt, Hong Kong, India, Iran, the Republic of Korea, Hfalavsia, the Philippines, Singapore, and Thailand. G. Training 25. The IPPA established the National Training Centre in Jakarta in 1968 and in the following year provincial training centres (PTCs) in the six provinces of Java and Bali. In 1971 a new building was constructed for the National Training and Research Centre (NTRC). The PTCs, however, were housed in rented premises. Training staff was part time, drawn from the MOH and from universities and other teaching institutions. These institutions not only trained volunteers, staff and field personnel of the IPPA but also doctors, nurses, social workers and others from the MOH and other Government agencies. '26. With the establishment of the national family planning program in 1970, training needs soared enormously. A Bureau of Education and Training was set up in the Central NFPCB and project leaders for training appointed to the provincial NFPCB offices. Actual training was carried out by the TPPA training centres and the provincial training centres of the MOH, the U7FPCB meeting the training costs. With financial assistance from the joint IDA/UNFPA-assisted project, seven sub-provincial training centres (STCs) in West, Central and East Java were established primarily to train the large number of fieldworkers and group leaders required in the national program. Four of these were managed by the MOH and the other three by the IPPA. The joint project provided support for the construction of 10 STCs in these three provinces and one PTC in each of the six provinces in Java and Bali. 27. During the period to , a total of 40,452 persons were trained. These included: 1,480 physicians; 4,905 paramedical and auxiliary personnel; 3,880 clinic-based and 259 kabupaten-based reporting and recording personnel; 8,590 fieldworkers for initial training and 1,214 in refresher courses; 1,533 group leaders for initial training and 147 in refresher courses; 76 fieldworkers' supervisors; 23 fieldworkers' coordinators and assistant coordinators; 282 administrators--61 from the central level, 62 provincial, 119 kabupaten, and 40 logistics personnel; 33 information

39 ANNEX 2 Page 9 officers; 5,583 information workers; 129 mobile information unit technicians; 161 social workers; 20 research and evaluation personnel; 37 trainers; 10,695 dukuns; and 1,405 others. In addition, several workshops and seminars were conducted for curriculum development and for special subject areas. 28. Training was included as a component in the joint IDA/UNFPA-assisted project. The training component included: construction and equipment of buildings for six PTCs and 10 STCs; defraying a portion of the operational costs; and instituting a staff development program. Except for the PTC in East Java, the construction and equipment of all the buildings has been completed. 29. At the same time, the NFPCB was concerned that the two parallel sets of training institutions under the management of two different implementing units, each set with its own orientations and emphases, was resulting in variations in concepts, methods and standards. Careful examination of the problem led to the conclusion that qualitative improvement would require a greater degree of uniformity in standards--work-programs, personnel and facilities--and more and sustained technical guidance from a well-staffed, multi-disciplinary central institution to peripheral ones which could be ensured only by developing a cohesive and well-knit training system under a single management. Since the training of family planning personnel is interdisciplinary in nature, and hence cuts across the specialties of the several implementing units, the NFPCB decided to create a national training system and keep it under its own administrative control. 30. Ultimately the national training system will include: the NFPCB's Bureau of Education and Training which is to be expanded during ; six PTCs and 10 STCs in Java and Bali--the successors to the erstwhile IPPA institutions; and 10 new PTCs to replace the existing ad hoc training facilities of the IPPA in the 10 provinces of the other islands. The NFPCB placed the new PTCs--housed in the new buildings constructed with joint project assistance--under the administrative control of the respective provincial chairmen from October 1, The NFPCB will endeavor to retain as many of the IPPA trainers as possible. Remaining positions will be filled by secondment on a fixed-term basis from universities, teacher training colleges, other technical institutions, and concerned Government departments or by open recruitment. All faculty members--whether NFPCB staff or seconded from other agencies--will be assigned full-time to the training centres. It is expected that the full complement of staff will be in position by July 1, The NFPCB has evolved a staff development program in two phases-- a short-term one to improve current training programs and a long-term one to prepare for eventualities. The need for such a program is emphasized by the anticipation of a staff turnover as a result of the change in management; this would necessitate the training of a number of new trainers and it was considered more pragmatic as well as more economical to use a new curriculum

40 ANNEX 2 Page 10 for this pur-ose, rather than expose the trainers to the old curriculum and call them back for retraining. 32. The short-term staff development program envisaged sending about a dozen trainers to the University of Connecticut for the 13-week course on training of trainers, and about 20 trainers to the National Institute of Family Planning in India for exposure to an adapted version of their training course for Indian trainers to be followed by placement in a regional family planning training centre and state and local program headquarters for practical training experience, the whole program lasting for about six months. On their return home the two groups of trainers would meet in a workshop situation, review the existing curriculum for trainers and revise it in the light of their experience in two very different situations. The expectation was that such a process, without foisting any one ideology on Indonesia, would encourage the national training program to develop in the light of its own needs and interests enriched by experience elsewhere. 33. Five trainers financed by USAID have participated in the University of Connecticut training course. Sixteen trainers spent 5-1/2 months in India and stopped in Thailand and Singapore on the way back home; funds from the joint project were used for this purpose. In addition to these two major groups, other trainers have visited several other countries and studied their programs. 34. The long-term aspect of the staff development program consists of sending suitable trainers for full academic courses at a master's degree or diploma level in universities abroad in disciplines or professions relevant to family planning. Financed by the joint project four trainers are scheduled to go to the Philippines and the United States of America during for specialization in management, communications, education and sociology. These funds will permit sending another five or six persons in the following year. The rest of the scheme will depend upon availability of funds--national or international. 35. The NFPCB has used funds from various sources to strengthen the competence of other staff members as well as those of the implementing units in all aspects of the program. Staff members have gone to other countries for regular academic courses in universities and institutions of higher learning, established specific- purpose courses, study tours, international and regional seminars and workshops and observation tours. H. Service Statistics System 36. In July 1970, a comprehensive and standardized data system was designed by the NFPCB for the national family planning program. The service statistics portion of the system incorporated the field-proven

41 ANNEX 2 Page 11 aspects of various African and Asian family planning service statistics systems. Following field testing, which resulted in minor changes, the system was adopted in The NFPCB provides a feedback report to the field within 30 days of data receipt. As an average of 92% of the family planning clinics submit their reports on time, i.e., within days after the end of the reporting month, the speed with which the monthly statistics are compiled and reported back to the field in Indonesia is unique for a national family planning program of comparable size. In 1971, NFPCB also implemented a monthly contraceptive stock inventory and utilization program. Both systems continue to be in operation with minor changes necessitated from time to time to cope with changes in the program. In addition to the routine statistics, data for specific studies such as continuation rates, side-effects, etc., are obtained through ad hoc surveys. I. Program Results New Acceptors 1/ 37. Since its inception in through the end of / the national family planning program recruited 8,442,054 new acceptors in Java and Bali. The number of new acceptors recruited annually is shown in Table 2, together with the annual targets, and acceptors as a proportion of married women age In terms of the methods selected by new acceptors in Java and Bali, (Table 3) oral contraceptive has increased considerably in importance from around 28% of all methods selected in to 68.5% in since when there has been a slight decline. The IUD, on the other hand, declined in relative importance, from a high of 55% in to a low of 11% in but subsequently rose to over 18% in New acceptors of the condom have fluctuated from about 18% in the first year of the national program to 5% in back up to 19% in and and down again to about 13% in Other methods, including injectables and sterilization, make up a relatively small proportion of total acceptances, generally in the neighborhood of 1% or more each year. 39. In the 10 provinces of the other islands, where the program has been in operation since 1974, the number of new acceptors increased from 117,966 in (24 per 1,000 MWRA 3/) to 233,345 in (62 per 1/ An acceptor is defined as a woman who accepts contraception for the first time or who reaccepts after the termination of a pregnancy. 2/ The program year coincides with the Indonesian fiscal year, i.e., April 1-March 31. 3/ MWRA: Married woman in the reproductive age group (i.e., years).

42 ANNEX 2 Page 12 1,000 MWRA). The pattern of acceptance does not differ markedly from that of Java and Bali. Acceptor Characteristics 40. In terms of new acceptor characteristics, the family planning program on Java and Bali has been recruiting progressively younger and less well-educated women whose husbands are likely to be farmers or fishermen and who have fewer living children. Table 4 summarizes the changes that have occurred in new acceptors over the life of the program. On Java and Bali the "typical" acceptor is a 27-year old woman with less than a primary school education, with 2.54 living children and whose husband is a farmer, fisherman, a laborer or was unemployed. The "typical" acceptor in the 10 provinces of the other islands is a 29-year old woman with a primary school or better education, with 3.88 living children, whose husband is a Government official or a tradesman. Continuation Rates 41. Data for the calculation of up-to-date continuation rates are presently being collected and analysed. Listed in Table 5 are a selection of 12-month first method continuation rates as derived from a number of different surveys. First method continuation rates for IUD acceptors, especially in the case of Bali and East Java, run consistently higher than comparative figures for other national family planning programs in the region. Oral contraceptive continuation rates, on the other hand, are more in line with those found in other programs. Current Users 42. There has been a continual increase in the estimated number of current program users. As shown in Table 6, current users of all contraceptive methods in Java and Bali in were approximately 738,000 or nearly 8% of all MWRA. By March 1977, there were an estimated 3,486,323 current users, or 24.1% of MWRA. In the 10 provinces of the other islands, there were an estimated 322,567 current users as of March 1977, which represented 6.2% of MWRA. Program Impact on Fertility 43. Although data on the direct measurement of fertility change in Indonesia are not yet available, several estimates of fertility change for Java and Bali have been made. In a 1975 study, it was estimated that the total fertility rate (TFR) on Bali had decreased from 5.9% to 4.3% between 1970 and 1975 (a 27% reduction). East Java followed with a 19% decline, from a TFR of 5.1% to approximately 4.1%. The decline estimated for Central Java was in the neighborhood of 11%, with the TFR dropping from 5.6% to 5.0%. West Java registered the smallest reduction, with a TFR of 6.3% in 1975 compared to a TFR 6.8% in 1970 (a 7% reduction).

43 ANNEX 2 Page Initial indications from a sample vital registration project in selected sub-districts of the country suggest that fertility has perhaps declined further. What is of particular interest is the apparently strong relationship between the number of current users in the sub-district and crude birth rate for those areas, as seen in Table 7. J. Evaluation and Research 45. Research activities undertaken through the auspices of the NFPCB have been grouped under four broad categories: information and motivation, management, training and medical. Some 130 research projects have been undertaken since the inception of the program. Under the first category are included a wide variety of knowledge, attitude and practice (KAP) studies of particular areas of the country and various minority groups; studies concerning acceptor characteristics; the use of various media, including the mass media, traditional media and the folk arts, and informal channels for the communication of family planning information; the use of paramedical personnel for motivation and service delivery. Other studies have examined the source and effect of rumors on contraceptive acceptance and use, the status of women in customary law, and the value of children. Under management studies, several manpower evaluations have been conducted on fieldworkers, the feasibility and advantage of paid incentives for fieldworkers, verification of service statistics data, and evaluations of the organization and management of the family planning program at various levels. Under training, studies include routine evaluation of specific training programs for particular categories of individuals in addition to studies of the training provided fieldworkers. Medically-oriented studies consist of evaluations of mobile clinics and mobile service units, contraceptive continuation rates (including a major on-going quarterly acceptor survey for Java and Bali), evaluations of sterilization pilot projects, condom mailing schemes, and the integration of family planning and maternal and child health activities.

44 ANNEX 2 Page 14 Table 1 INDONESIA II: POPULATION AND FAMILY PLANNING PROGRAM FINANCIAL RESOURCES, GOVERNMENT OF INDONESIA AND FOREIGN DONOR, TO (US$ OOOs) Government of ,323 2,300 5,134 5,885 8,400 12,500 Indonesia 3.5% 18.9% 28.5% 44.1% 52.7% 40.8% 39.9% 49.0% Foreign 2,051 1,288 3,319 2,913 4,600 8,552 12,636 13,000 Donor 96.5% 81.1% 71.5% 55.9% 47.3% 59.2% 60.1% 51.0% Total Per Capita Java and Bali Total Per Acceptor Java and Bali Source: USAID estimates.

45 ANNEX 2 Page -5 Table 2 INDONESIA II: ANNUAL NEW ACCEPTOR TARGETS AND PROGRAM ACCOMPLISHMENTS JAVA AND BALI, TO (OOOs) Target ,000 1,250 1,400 1,645 1,756 Accomplishment ,079 1,369 1,475 1,786 1,979 % of Target New Acceptors per 1000 Married Women Age Source: National Family Planning Coordinating Board.

46 ANNEX 2 Page 16 Table 3 INDONESIA II: TRENDS IN METHODS SELECTED BY NEW ACCEPTORS JAVA AND BALI, TO Year Contraceptive Methods (%) Oral IUD Condom Others / Percentages may not add to 100 due to rounding. Source: National Family Planning Coordinating Board.

47 ANNEX 2 Page 17 Table 4 INDONESIA II: TRENDS IN PROGRAM ACCEPTOR CHARACTERISTICS JAVA AND BALI, TO Characteristics Age at Acceptance Parity 3 or Less More than Education Less than Primary Primary or Higher Husband's occupation Farmer/Fisherman Other Source: National Family Planning Coordinating Board.

48 ANNEX 2 Page 18 Table 5 INDONESIA II: SELECTED TWELVE-MONTH FIRST METHOD CONTINUATInN RATES. JAVA AND BALI 7% Continuation of Area Survey Date Contraceptive Methods Oral IUD Mojokerto, East Java 1974 Acceptors before January Special Drive Acceptors East Java 1974 Regular Acceptors Special Drive Acceptors Bali 1975 Regular Acceptors Special Drive Acceptors Central Java West Java Jakarta Source: National Family Planning Coordinating Board.

49 ANNEX 2 Page 19 Table 6 INDONESIA II: TRENDS IN CURRENT USERS BY METHODS, JAVA AND BALI TO (OOOs) Methods Oral Contraceptives ,102 1,859 2,070 IUD ,223 Other TOTAL 737,408 2,_105 2_ Current Users as a Percentage of MINRAL /1 MWRA: Married Women in the Reproductive Age Group (i.e., years) Source: National Family Planning Coordinating Board.

50 ANNEX 2 Page 20 Table 7 INDONESIA II: FAMILY PLANNING USE AND ESTIMATED FERTILITY LEVELS AND CHANGES-BY SELECTED AREAS Area MWRA Using Increase in Family Planning.-l Rate/ 2 Rate! 3 Population Jakarta Cirebon, W. Java Sukabumi, W. Java Pekalongan, C. Java Malang, E. Java Klungkung, Bali W. Lombok, Lombok C. Tapanuli, N. Sumatra Banjar, S. Kalimantan Bone, S. Sulawesi /1 MWRA: Married Women in the Reproductive Age Group (i.e., years). /2 Kabupaten Data, National Family Planning Coordinating Board, August /3_ Vital Registration Project Data by Sub-district Level (kecamatan). Source: National Family Planning Coordinating Board.

51 Chart 1 ORGANIZATION CHART IN ACCORDANCE WITH THE PRESIDENTIAL DECREE NO 33/1972 PRESIDENT STATE MINISTER FOR PEOPLE'S WELFARE L.N COMMITTEE COUNCIL. CONSULTING IMPLEMENTING CHAIRMAN.. UNITSjNFC rn CB.P r - SERTRA r r----- GOVERNOR DEPUTY I DEPUTY 11 DEPUTY 11 I~~~~ I II.BUREAU OF * BUREAU OP BUREAU OP * BUREAU OP. BUREAU OF * BUREAU OF REPORT., PLANNING _ I. LOGISTICS MEDICAL SERVICE EDUCATION &. ESEAR E VAL- * NO & DDCUMENTA- TRAINING *~~ UATION TION BUREAU i F BURAU OF UREAU DF SPECIAL PROJECTS _ SUREAUISIDN B OFHINFORMATION& B NMOTIVATION PROVINCIAL IMPLEMENTING UNITS CHAIRMAN PROVINCIAL N FP C B -T~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ j F.TS R F VA E L E I REGENT REGIONAL CHAIRMAN X v : IMPLEMENTING REMARKS REGIONAL UNITS LINE OF OPERATIONAL STRATEGIES N, LINE OF COORDINATION E F R T, _.... LINE OF STAFF CLERICAL STAFF _- - LINE OF TECHNIQUE.. LINE OF TECHNICAL ADMINISTRATION & FINANCE LINE OF RESPONSIBILITY W-rld B-1, 16882

52 ANNEX 3 Page 1 INDONESIA II: THE JOINT IDA/UNFPA-ASSISTED PROJECT Introduction 1. In 1969, a UN-WHO-IBRD mission visited Indonesia at the Government's request to make recommendations on the establishment of a national family planning program. On the basis of its report a five-year operational plan covering Java and Bali was prepared. Subsequently the GOI asked the Bank for assistance and in May 1972 legal agreements covering a first population project were signed. This project was prepared on the basis of GOI requests and with the assistance of the UN and specialized agencies including WHO, UNICEF, UNESCO, UNFPA and the Bank Group. Project costs were estimated at US$33 million to be disbursed over a five-year period. The joint project was funded by an IDA Credit of US$13.2 million, a UNFPA Grant of US$13.2 million and a GOI contribution of US$6.6 million. The project became effective in November At the UNFPA's request, IDA acts as the executing agency. 2. The objective of this joint IDA/UNFPA-assisted project is to support the development of the GOI's national family planning program. Its components covered a wide range of family planning activities including: a. the construction and equipment of 10 paramedical training schools; b. the construction and equipment of about 320 MCH/FP centres in East Java, Bali and Jakarta; C. the construction and equipment of six provincial and 10 sub-provincial family planning training centres; d. salary support for some 7,000 non-medical fieldworkers; e. support for research and evaluation acitivities covering technical assistance, fellowships, research studies, seminars and a demonstration field postpartum program; f. the construction and equipment of one central and six provincial NFPCB administrative centres; g. the provision of transport for staff involved in MCH/FP services and motivation activities; h. support for an extension of the hospital postpartum program;

53 ANNEX 3 Page 2 i. the provision of 115 mobile information units, technical assistance, fellowships and studies for information and communication activities; j. support for a population education program; and k. technical assistance and fellowship support for program management and project implementation. Implementation 3. In order to implement the project, the NFPCB established a project implementation unit (PIU) which included staff for construction, accounting, procurement and project management. This was considered necessary because of the NFPCB's inadequate management experience, particularly in civil works. In the course of time, as the NFPCB's management capability has improved, the functions of the PIU have been absorbed by the appropriate NFPCB bureaus, with the exception of the construction unit. The latter is now being absorbed by the NFPCB secretariat in preparation for the proposed second project. Foreign management consultants were contracted to assist the PIU in project implementation, and technical assistance was also provided for family planning program management, training, information, research, vehicle maintenance and operations, and population education. 4. The joint project was the first attempt at donor coordination in a Bank-assisted population project. Not only was the UNFPA involved as a funding partner, but other agencies coordinated the provision of technical assistance and services. WHO supported the project on the basis of its overall assistance agreement with the GOI. UNESCO, UNICEF and the Population Council, a privately-funded agency based in New York, negotiated and signed specific technical asistance agreements with the GOI. On the one hand, coordination undoubtedly affected the pace of implementation because of the time taken to sign agreements after the resolution of difficulties caused primarily by the need to recognize differing agency operating procedures and GOI assistance requirements. On the other hand, the joint project helped the GOI to coordinate assistance from several sources for a variety of activities, avoid overlap and assist the GOI in channelling this assistance to key program development areas. Construction 5. The construction program got off to a slow start in part due to the inexperience of the NFPCB with a program of this size. Failure to brief the local architects adquately on user requirements was also in part responsible. Retention of foreign management consultants was of little help in overcoming these problems. Increasing familiarity of NFPCB staff with Indonesian construction requirements and the establishment of effective tendering

54 ANNEX 3 Page 3 procedures and documentation with the support of Bank supervision missions has eventually produced a unit of the NFPCB capable of managing a construction program of this size and nature. To date, 45 MCH/FP centres have been built in the Mojokerto Regency of East Java for the demonstration field postpartum program, five provincial training centres (PTCs) and 10 subprovincial training centres (STCs). The central NFPCB headquarters and 50 MCH/FP centres in East Java are under construction. Tenders will be let in June for the remaining PTC in Surabaya, six provincial offices, and nine paramedical training schools. The GOI has proposed that the civil works program be limited to the construction of paramedical training schools, leaving one nurse-midwifery school and 223 MCH/FP centres in East Java, Bali and Jakarta to be dropped from the project. The reasons are that the GOI, through the INPRES program, has built or rehabilitated a total of 3,675 centres in the period (45% in Java and Bali) which has eliminated the need for additional centres to be constructed from project funds. The nursemidwife school is no longer needed following a change in the paramedical staffing pattern subsequent to the start of the project. And on policy grounds, the national program is moving towards a service system based to a lesser extent on static service outlets than at the conception of the project. The Bank and the UNFPA have formally agreed with these proposals. Transport 6. With the assistance of UNICEF, the joint project procured 158 fourwheel drive vehicles, 213 minibuses, 3,180 motorcycles and 4,570 bicycles. They are all in use in the field and provide program staff with much needed mobility. In addition, 115 mobile information units were procured and are in use in each kabupaten in Java and Bali. With the assistance of a foreign expert, the NFPCB has established systems and procedures covering the maintenance and operation of its vehicles, including those provided by other donors and those procured from local resources. Further details of the transport provided by the joint project are given in Annex 5. Training 7. Two of the joint projects' components are directly concerned with training, providing facilities and equipment for training paramedical staff and family planning workers. One of the project's objectives was to assist the process of restructure the 28 classes of paramedical staff which the MOH employed into two or three categories, all of which would be important in providing family planning services. As a result of discussions and seminars, the concept of an auxiliary nurse-midwife as considered in the project appraisal report was developed into that of a community health nurse (PKK). The MOH plans to train 31,500 PKKs by 1980, 50% of whom would be nurses retained from existing categories in a one-year course. An essential part of the development of the PKK course was the retraining of 34 nurses as PKKs at Sidoardjo in East Java in They received field training in Mojokerto Regency and have been posted to the demostration field postpartum

55 ANNEX 3 Page 4 program. An evaluation of their performance is contributing to the development of the PKK training curriculum. The nurse-midwife category has been replaced by that of a graduate supervisory midwife and the proposed training school for this category is no longer required. Tendering of the construction of the nine PKK training schools is scheduled for early June 1977, and completion of construction is scheduled for April The joint project's assistance for the development of family planning training is discussed in paragraphs 6.09 and 6.10 of this report and in Annex 6. One of the more important training activities conducted by the IPPA with NFPCB financial assistance was the training of fieldworkers, the salaries of whom were provided from joint project funds. Over 8,000 fieldworkers and the necessary supervisory staff have been trained. The current number of fieldworkers is about 5,500 which gives a level of about 1:14,000 people in Java and Bali. The project aimed at a level of 1:10,000 but this was lowered because of steep salary increases since 1971, problems of retaining temporary staff such as fieldworkers, and the development of the village-based contraceptive distribution system which provides new and wider peripheral motivation and service activities. Problems of implementing this assistance were caused by the dual budget system. The GOI share of salaries was channelled through the development budget whilst project assistance was channelled through a supplementary budget. Problems in monitoring the two sources were eventually overcome and project assistance in this respect has been phased out to the point where the GOI is now entirely responsible for fieldworkers' salaries. Information 9. In addition to the mobile information units, the joint project has provided two foreign advisors. One, who assisted the NFPCB's Bureau of Information, has completed his assignment. A second advisor, recruited to assist the Ministry of Information's family planning unit, was recruited in November 1976, for one year. His appointment coincides with the reorganization of this unit and more effective radio, television and mass media support for family planning activities should result. Problems of providing adequate audiovisual materials for the mobile information units have been partly overcome by the provision of an adequate number of copies of existing family planning films. With the assistance of UNESCO, the production of a new film and other audiovisual materials is nearing completion and should resolve these problems. The project has also supported study teams, drawn from the staff of the NFPCB and its implementing units to observe the information programs of major national family planning programs. Population Education 10. The joint project's support for population education is described in Annex 8.

56 ANNEX 3 Page 5 Hospital Postpartum Program 11. The joint project provided support for an extension of the hospital postpartum program to 86 hospitals. WHO provided the services of a technical advisor, and the project provided salary support, essential hospital and office equipment, informational and educational materials, in-service training programs, vehicles and funds for the evaluation of activities. The strength of the hospital postpartum program does not lie in its ability to add substantial numbers of new acceptors to the progam but in the provision of contraceptive services immediately after delivery or abortion, particularly surgical methods such as sterilization. The program recruits about 25% of all delivery and abortion cases as "direct" acceptors, i.e., those who accept before or within three months of their discharge. This figure compares well with international experience. Of the methods chosen, about 10% selected tubectomy, 39% oral contraceptives and 28% the IUD, the remainder selecting conventional contraceptives. Research 12. The research component of the joint IDA/UNFPA-assisted project was designed to strengthen the research/evaluation capability of the NFPCB, provide support for local contract research, and develop a demonstration field postpartum program. The Population Council was made the executing agency; it has coordinated technical assistance support for the NFPCB, the Population Studies Centre of the Institute for Social and Economic Research (LEKNAS), and the demonstration field postpartum program in Mojokerto. The project also provided for fellowships, data processing equipment, vehicles and salary supplements. 13. It is in the field of family planning evaluation and research that aid from other agencies, notably USAID and the Ford Foundation, has complemented the first project activities most directly. Progress made in this component particularly must be judged against the perspective of overall development which has occurred in this field. About 10 studies have been supported from joint project funds covering both service and motivational aspects of family planning activities. Of these, the more important include a survey to evaluate the effectiveness of the special drive for new acceptors in East Java, a sample vital registration project which is contracted to the Central Bureau of Statistics, and a quarterly acceptor survey, which provides feedback on contraceptive use-effectiveness in the provinces in which the program operates. 14. The project is supporting the development of the LEKNAS Population Studies Centre by funding overseas training fellowships, technical assistance for both research and teaching duties, and specific studies including the preparation of population projections for development planning purposes, including the preparation of the NFPCB's medium-term strategy. Two research papers have been produced on the status of women and work is proceeding on a study of population distribution policies.

57 ANNEX 3 Page The demonstration field postpartum program in Mojokerto had the objectives of assuring improved maternal child care and more effective family planning. The joint project provided for the construction of 45 MCH/FP centres, additional staff, technical assistance, vehicles, equipment and support for studies. Thirty-four communty health nurses have been trained and added to the Regency MCH/FP staff, the centres have been constructed and the necessary vehicles and equipment procured. Baseline surveys, including a contraceptive continuation rate survey, KAP studies, and a village ecological survey (probing into factors such as distance, which affect the provision of family planning services) have been regulated. In mid-1976, the NFPCB and the Ministry of Health modified the program's objectives to emphasize the integration of family planning into MCH care and to improve health services within the framework of the national family planning program. As a result, operational plans are being revised, responsibility for evaluation has been delegated to the Institute for Public Health in Surabaya, and technical assistance in health/family planning systems analysis is being provided. Thus far, the demonstration has provided useful basic program data and the opportunity to examine the effectiveness of PKK training. 16. The development of an effective family planining research program is difficult to manage because of its diversification. With donor support, the NFPCB has managed a contract research program which has focussed on providing important operational data and information on fertility and contraceptive use trends; the available results have been successfully used for program feedback and the development of the NFPCB's medium-term strategy. An adequate institutional research capability will be evident after the completion of the fellowship program and collaboration with foreign advisors. Disbursements 17. At April 30, 1977, US$13.2 million (50%) of the combined Credit and Grant had been disbursed.

58 ANNEX 4 Page 1 INDONESIA II: NFPCB MEDIUM-TERM PLANS Program Strategy and Rationale 1. The Indonesian family planning program has evolved through several critical and overlapping stages. Prior to , limited family planning information and services were administered essentially through a privatelyfunded and single purpose program. Once the Government became publicly involved in administering the program, services were first provided through health channels and in particular through maternal and child health (MCH) services. In spite of the extremely encouraging response to the expanded public program which was built up with National Family Planning Coordinating Board (NFPCB) as the coordinating agency and with several Ministries (Health, Information, Education and Interior), the Armed Forces(ABRI) Health Services and voluntary agencies (such as Muhammadiyah and the Indonesian Council of Churches) cooperating, it was felt that for ultimate success family planning had to be viewed in a wider context. The second five-year plan, promulgated in 1974, articulated family planning as a general development issue and linked national population strategy to national development priorities and activities. 2. The NFPCB has recognized that ultimate success depended on: a. a shift in responsibility for the program to the field level, i.e., the degree to which fertility control and the small family norm are accepted by the community itself and the degree to which the community bears the ultimate responsibility for motivating, recruiting and maintaining family planning acceptors and supporting and reinforcing the small family norm; and b. the undertaking of the responsibility for the family planning program by the entire Government, i.e., the degree to which the Government has initiated the process whereby family planning and the goals of the national population policy are integrated into the national development programs of other ministries. 3. The redirection of the program towards the field is not new. One of the early efforts to achieve this consisted of special drives in East Java and Bali where the local population and community structures of entire villages were mobilized for short but intensive campaigns to recruit new acceptors. Although the special drives were initiated by the Government at provincial level, their immediate success demonstrated the type of contribution which communities themselves could make to a more widespread acceptance of family planning. Similarly, the community contraceptive distribution schemes and the village acceptor groups emerged as much because of.the *spontaneous involvement and participation of the communities in the family planning program as because of direct Government intervention.

59 ANNEX 4 Page 2 4. Ilarnessing local forces consists of a step-by-step procedure of identifying and training key individuals--formal and informal leaders-- such as the village chief, his staff, local religious leaders and the school teacher, who have the capacity to organize and positively influence others. The Government does not consider the transfer of responsibility to the field possible without a simultaneous improvement of the life of the individual and the community. It has begun to initiate and implement programs designed to overcome obstacles to family planning acceptance imposed by such features as high rates of infant and childhood mortality, widespread illiteracy and unemployment. For this reason family planning is working in close conjunction with the national development program for the rural areas to create a responsibility for disseminating, maintaining, and cultivating the small family norm in the community. Program Objectives 5. The long-term aim of the family planning program is to reduce fertility by 50% by the year On a linear decline, using a base total fertility rate (TFR) around 5.8 in 1970, the TFR should reach a level of about 4.5 by which is the end of the third five-year plan. This would roughly correspond to a 10-point decline in the birth rate by from the level round 44 per 1,000 in In setting this target, the following factors have been taken into account: a. Geographical Coverage: As of this year, the national family planning program provides direct information and services in 16 provinces of the country. The program in West, Central and East Java, in Bali and in Jakarta and Yogyakarta has been in operation since the inception of the family planning effort. In the national program activities were expanded to 10 provinces in the other islands. During the third five-year plan activities will be initiated in the remaining provinces of the country. b. Current Users of Contraception (Prevalence): The shortterm goal of fertility decline has been set in terms of prevalence rates to be attained by These are 35% for Java and Bali, 25% for the 10 other provinces to which the program was extended in and 15% for the remaining provinces which will be brought into the program in the third five-year plan. The response of the public to the family planning program has varied between provinces. Within Java and Bali the acceptor rate has differed markedly with the result that by March 1977, prevalence rates have also correspondingly differed, with Bali and East Java recording prevalence rates of 35.4% and 33.7% respectively of currently married women aged 15-44, while the other four provinces had

60 ANNEX 4 Page 3 prevalence rates varying from 15% to 20%. In working out the targets of acceptors, these differentials in response between provinces have been taken into account. Within Java and Bali, the goal of 42% prevalence rate has been set for Bali and East Java while the goals for the other provinces are less than 35, the average for the entire area. In the 10 provinces of the other islands included in the program, provinces, such as North Sulawesi, which have done comparatively well are expected to reach higher prevalence rates than others. It is premature to adjudge differences in response likely to arise in the remaining provinces and all these provinces have been considered as a group to reach the target of 15% prevalence by c. Contraceptive Mix: An important aspect in relating goals of prevalence rates to the number of acceptors to be recruited into the program is the acceptor choice of the different types of contraceptives. A method such as the IUD has a greater continuation rate than the oral contraceptive and it is to be expected that with a lesser number accepting the IUD the same prevalence rate as that reached with a larger number of oral contraceptive acceptors can be obtained. The contraceptive mix as displayed by acceptors is not only important in terms of prevalence rates but also in terms of effective protection given by different contraceptives as reckoned by avoidance of accidental pregnancies. Oral contraceptives, for instance, give rise to less accidental pregnancies as compared with the TUD. The net effect of acceptance of a contraceptive on fertility is affected by continuance rate as well as its effectiveness; contraceptive mix is, therefore, also important in determining fertility decline. Two sets of contraceptive mix have been assumed for Java and Bali in working out acceptor targets, and are given in Table 1. Both assume a reversal of the trend towards a lower acceptance of the IUD. Mix A sets an increase in the acceptance rate of IUDs to 20% by while Mix B aims at a more ambitious goal of 30% by that time. The NFPCB has used Mix B as its target. Oral contraceptives are expected to make up 50% of the acceptors in both mixes, the rest being made up of "other" contraceptives. In the provinces of the other islands, the program strategy will aim at obtaining Mix B. d. Number of New Acceptors Required: Having estimated the prevalence rates and contraceptive mixes required

61 ANNEX 4 Page 4 Program Needs to achieve the desired reduction in the birth rate, the NFPCB has set targets of the number of new acceptors which must be recruited. As indicated in Tables 2, 3, 4 and 5, these differ from province to province in accordance with population size, length of program, and results achieved thus far. In Java and Bali, in the next seven years covered by the program, ( to ) if contraceptive Mix A which indicates greater use of oral contraceptives is followed, 16.1 million acceptors will need to be recruited. If Mix B (the NFPCB target mix) is achieved, million new acceptors are needed to meet the target. Using Mix B, 4.45 million new acceptors are needed in the 10 provinces of the other islands, and 0.7 million in the remaining provinces. 6. To meet the program's objectives in Java and Bali, program expansion will concentrate on the provision of information and services to areas not completely or adequately covered yet. These will be provided through a number of channels, including mobile service units and paramedical units as well as the existing social structures and institutions of the community. The latter will include village-based contraceptive supply depots, acceptor groups, community leaders and social organizations which will become the final and crucial supply link to rural inhabitants. Because of the nature of the geography and population dispersion of the other islands, and because of the experience gained by the programs of Java and Bali in involving local institutions, greater reliance will be placed on mobile services as compared with static clinics. The NFPCB does not plan to utilize family planning fieldworkers in the other islands in the way they have been used on Java and Bali. Instead village volunteers, village leaders and community organizations will be trained to assume the roles and functions which fieldworkers have filled elsewhere. At present, the NFPCB facilities in the other islands are inadequate because they have to share already overcrowded offices with other Government agencies. To accommodate the expanding activities of the NFPCB in these areas, there is a need to increase the number of program staff and new office facilities will be required. 7. Expansion of program activities will be sought through greater interaction with the ministries of the national Government whose programs, particularly in the realm of development, reach down to the community level. Although the mechanism of involvement of other ministries in the family planning program has already been set into motion, the NFPCB will provide considerable assistance, primarily through population training programs and seminars for the staff of these ministries. Similarly, plans have already been made for training various key persons in the community such as community leaders, religious leaders, teachers, local Government officials, voluntary organizations, labor leaders and intellectuals who heretofore have not been formally included in the information and educational component of the program.

62 ANNEX 4 Page 5 Acceptor Maintenance 8. The program will also need to lengthen effective contraceptive use. One means of achieving this is to encourage new acceptors to adopt more effective methods. During the seven-year period to there has been a steady erosion of IUD acceptances in Java and Bali, from a high 54.7% of new acceptors in to a low 11.3% in In the percentage increased to 18.4% and the NFPCB hopes to maintain this reversal of the trend away from the IUD and has set the objectives of a method mix for oral contraceptives, IUD and condoms of 50:30:20 (Mix B) by One obvious approach to achieve this is simply the intensification of campaigns to encourage acceptance of more effective methods. In the November 1975 special drive in East Java, particular emphasis was placed on increasing the proportion of IUD acceptances. The result was that IUD acceptances made up 25% of the total of new acceptances during the intensive campaign compared to an average of 10% in the regular program. Aside from encouraging adoption of the IUD, the national program is investigating the feasibility of expanding institutional methods such as sterilization. Although such services are now available in only a few hospitals on Java and Bali, interest is growing, particularly on Bali. The role of injectables is likely to increase substantially in the next few years. A small pilot project in Yogyakarta demonstrated the potential popularity of this method. 9. Contraceptive use can also be maintained by the removal of identified obstacles such as rumours on side effects, real or imagined, which discourage continued contraceptive use. There already exists a substantial international literature on medically validated side effects which may be encountered by users of various contraceptives. The NFPCB has conducted research with the support of joint project funds and will embark on a major informational and educational campaign to dispel those rumours which have no scientific basis. The campaign will be designed to inform acceptors and community leaders about common and mostly minor side effects which often accompany initial and continued contraceptive use. Trained community leaders can provide local counseling. Also, through the Government's expansion of community health centres and the provision of mobile service units, increased professional back-up support is expected to be made readily accessible to those few individuals who do experience major difficulties with contraceptive use. Greater emphasis will be made at the community level to create a community awareness of the obstacles to contraceptive use and to encourage the community as a whole to support sustained contraceptive use. 10. Another of the major obstacles to the continued use of contraceptives, especially those which must be renewed periodically, is a break, even a temporary one, in the chain of contraceptive supplies. Here again, the Village Community Distribution Centre (VCDC) and the village acceptor groups will play a major part in ensuring that contraceptive supplies are available when and where they are needed. The mobile service units, too, will contribute significantly to this effort.

63 ANNEX 4 Page At the national level, a decision has been taken by the Government to make Indonesia as nearly self-sufficient in its contraceptive needs as possible. With the likely phasing out of supplies through foreign assistance and grants, the Government is moving towards local production. The Government launched a domestic IUD production program in 1974, which today supplies 100% of the national need. A local oral contraceptive manufacturing capability is also planned; production is expected to begin in December 1977 and should provide all requirements by the end of the third five-year plan. Program Support Activities 12. In order to meet its medium-term objectives and respond to program needs, the NFPCB has identified principal program support activities which require strengthening. These are: a. Population Education: The Ministry of Education and Culture instituted the National Population Education Project to run in close collaboration with NFPCB. The project, supported by joint project funds, has been operating for three years. The earlier phase of the project had the limited objective of probing into the integration of population education into the school curricula and out-ofschool program. The feasibility of such integration has been established. With this in mind and with the decision to gradually introduce from 1976 over a three-year period the new curricula at all the stages of school education, acccompanied by a massive program of upgrading all teachers, the GOI decided to integrate population education in the national education system. The program of the first phase of the National Population Education Project which was to end in 1978 was changed accordingly. By the end of the second phase, , population education will be assimilated in the educational system of the country covering all the primary, lower secondary and higher secondary schools of all types (general, vocational, technical, etc.). It will become an integral part of the pre-service and in-service training of teachers at all levels. Its management would become the responsibility of the existing educational administrative machinery of the Ministry of Education and Culture at different levels. Thus, by 1980, population education would become an integral part of the activities of the Ministry of Education and Culture. Though as a start, attention has been focused on integrating population education in formal and non-formal education, through the Ministry of Education and Culture, the plan is to incorporate it in the activities of other ministries in due course.

64 ANNEX 4 Page 7 b. Tar!Ti4gR: The term, here is broadly defined to include both formal training of field-level personnel, community leaders and the like, as well as more informal training of other groups, such as personnel of national ministries and other agencies whose greater involvement in the program is desired. It will be primarily through such training that a common awareness and appreciation of the goals and objectives of the national family planning program are created and the basis for unified support to the program will be provided. Training has been provided so far by a National Training and Research Centre (NTRC), six provincial training centres (PTCs) and four sub-provincial training centres (STCs) of the Indonesian Planned Parenthood Association (IPPA). Family planning training has also been provided for medical and paramedical staff at four provincial and four sub-provincial public health training centres of the MOH. The IPPA also operates 10 regional training facilities in the other islands. Under the joint IDA/UNFPAassisted project, six PTCs and 10 provincial STCs are being constructed to provide satisfactory facilities. Training is now recognized as a development function which meets the needs of and strengthens the entire range of program operations. It is against this background that the NFPCB, in consultation with the concerned implementing units, is developing a single national training system, under its own administrative control which will be responsible for all family planning training activities. In pursuance of these objectives, the NFPCB's Bureau of Education and Training will be expanded and developed and will replace the NTRC run by the IPPA. At present, training facilities in the provinces of the other islands are ad hoc institutions, utilizing public buildings for training courses and staffed by part-time teachers brought in from various organizations. The NFPCB will establish a full-time PTC in each of the 10 provinces in the course of the next two years; new buildings will be required to house these training centres. In terms of staffing and facilities, the NFPCB intends to develop these training centres on the same lines as those in Java and Bali. Their function will be to train all categories of personnel required for the province. c. Management Improvement: Improvement of the internal management of the program will be achieved through an improvement and strengthening of the coordinating function both within the NFPCB itself, and between the

65 NFPCB and the implementing units. Improvement is contingent upon a careful and clear statement of the activities, which each must undertake so that the function of each at the central, provincial and district levels are fully understood and implemented. Since the major thrust of the program is to achieve the total involvement of the community and its institutions in the population program, the management operation style at the community level will reflect traditional modes of operation and will differ markedly from those existing at higher levels. At the national level, the dialogue between population specialists and members of the legal profession will be continued and expanded with a view toward clarifying the legal aspects of the family planning program, reconciling any discrepancies between reality and existing statutes, and investigating a variety of legislative approaches to encouraging the acceptance of family planning and the small family norm. A variety of innovative approaches to encourage the greater participation, involvement and enthusiasm of communities in promoting family planning and the small family norm will be designed and executed. These will include a number of incentive schemes which reward family planning achievements at the community level. ANNEX 4 Page 8

66 ANNEX 4 Page 9 Table 1 INDONESIA II: MIXES OF CONTRACEPTIVES USED IN SETTING TARGETS OF ACCEPTORS Contraceptive Methods Year MIX A (%) MIX B (%'. Oral IUD Condom Total Oral IUD Condom Total ' Source: National Family Planning Coordinating Board.

67 ANNEX 4 Page 10 Table 2 INDONESIA II: ACCEPTOR TARGETS FROM TO AND EXPECTED FERTILITY RATES FOR JAVA AND BALI MIX A/ 1 Year Number of Acceptors (OOs) MWRAL 2 Total Prevalence Birth Contraceptive Methods (0OOs) Fertility (a) RateL4 Oral IUD Condom Total Rate/ , , , ,000 14, , ,100 14, , ,200 15, , , , ,400 15, , ,500 16, , ,600 16, /1 Basis of estimation is woman-years of protection necessary for an essentially linear decline in total fertility rate (TFR). First-year continuation rates used are 92%, 62% and 21% respectively for Oral, IUD, and Condom. Effective protection after allowing for accidental pregnancies and overlap of use with postpartum amenorrhea assumed to be 83% of woman-years of protection. /2 MWRA: Married Women in the Reproductive Age Group (i.e., years). /3 Total Fertility Rate - Base 5.78 /4 Birth Rate - Base Source: National Family Planning Coordinating Board.

68 ANNEX 4 Page 11 Table 3 INDONESIA II: ACCEPTOR TARGETS FROM TO AND EXPECTED FERTILITY RATES FOR JAVA AND BALI MIX BL 1 Year Number of Acceptors (000s) MWRA L 2 Total Prevalence Birth Contraceptive Methods (000s) Eertili-ty (%) RateL4 Oral IUD Condom Total Rate R , ,800 14, , ,900 14, , ,000 14, , ,100 15, , ,175 15, , ,250 15, ,325 16, , ,400 16, /1 Basis of estimation is woman-years of protection necessary for an essentially, linear decline in total fertility rate (TFR). First-year continuation rates used are 92%, 62% and 21% respectively for Oral, IUD, and Condom. Effective protection after allowing for accidental pregnancies and overlap of use with postpartum amenorrhea assumed to be 83% of woman-years of protection. /2 MWRA: Married Women in the Reproductive Age Group (i.e., years). /3 Total Fertility Rate - Base 5.78 /4 Birth Rate - Base Source: National Family Planning Coordinating Board.

69 ANNEX 4 Page 12 Table 4 INDONESIA II: ACCEPTOR TARGETS FROM TO AND EXPECTED RATES FOR TEN OTHER PROVINCES MIX B 5 L Year Number of Acceptors (000s) MWRA/ 2 Total Prevalence Birth Contraceptive Methods (OOOs) Fertility (%) Rate/4 Oral IUD Condom Total Rate/ , , , , , , , ,003 6, /1 Basis of estimation is woman-years of protection. First year continuation rate used was 60%. Effective protection after allowing for accidental pregnancies and overlap of use with postpartum amenorrhea assumed to be 83% of woman-years of protection. /2 MWRA: Married Women in the Reproductive Age Group (i.e., years). /3 Total Fertility Rate - Base 6.0. /4 Birth Rate - Base Source: National Family Planning Coordinating Board.

70 ANNEX 4 Page 13 Table 5 INDONESIA II: ACCEPTOR TARGETS FROM TO AND EXPECTED RATES MIX BL/' Year Number of Acceptors (000s) MWRAL 2 Total Prevalence Birth Contraceptive Methods (000s) Fertility (%) Rate 4 Oral IUD Condom Total Rate / , , , , , /1 Basis of estimation is woman-years of protection. First year continuation rate used was 60%. Effective protection after allowing for accidental pregnancies and overlap of use with postpartum amenorrhea assumed to be 837/ of woman-years of protection. /2 MWRA: Married Women in the Reproductive Age Group (i.e., years). /3 Total Fertility Rate - Base 6.0. /4 Birth Rate - Base Source: National Family Planning Coordinating Board.

71 ANNEX 13 Page 1 Table 1 INDONESIA II: SCHEDULE OF CIVIL WORKS Province Town Facility size m2 Jakarta Jakarta NFPCB's Bureau of Education and Training 2,250 Aceh Banda Aceh Provincial Training Center Type I (PTCI) 1,500 NFPBC Provincial Offices Type 1 (PO1) 650 North Sumatra Medan PTC1 1,500 PO1 650 West Sumatra Padang PTC1 1,500 PO1 650 South Sumatra Palembang PTC1 1,500 PO1 650 Lampung Tanjung Karang Provincial Training Center Type 2 (PTC2) 1,200 NFPCB Provincial Offices Type 2 (P02) 600 West Kalimantan Pontianak PTC1 1,500 PO1 650 South Kalimantan Banjarmasin PTC1 1,500 PO1 650 North Sulawesi Menado PTC2 1,200 P02 60o South Sulawesi Ujung Pandang PTC1 1,500 PO1 650 West Nusatenggara Mataram PTC2 1,200 P Source: National Family Planning Coordinating Board.

72 ANNEX 13 Page 2 Table 2 (A) INDONESIA II: NFPCB's BUREAU OF EDUCATION AND TRAINING SCHEDULE OF ACCOMMODATION Space Personnel Visitors Capacity Area h2) I. OFFICE Bureau Chief Secretary to Bureau Chief Sub-Director 2 x1 2 x 2 2 x3 40 Secretary to Sub-Director ecretary Secretariat Training Division Trainer Field Services Documentation Services _ Documentalist & IBM Typist Camera Processor, Operator and Layout Artist, Plate Maker Offset Press Operator 2 _ 2 25 Prototype Development - Photographer and Dark Room 2 _ 2 25 Technician Artist Script Writers 3 _ 3 15 Exhibit Mechanics Video Technician Small Studio Recording Technician Projectionist Research Division Division of Curriculum Development Supervision Division TOTAL 615

73 Table 2 (A) (contd.) ANNEX 13 Page 3 Space Personnel Visitors Capacity Area (m2) II. TRAINING Auditorium Classrooms 2x30 2 x30 2 x Discussion Rooms 2 x 15-2 x Operation Room 32 _ Library Reception III. HOSTEL Bedroom Accommodation Dining Room Kitchen _ 50 Laundry Worship Room Storage Bathroom and Toilet Mechanical Hostel Warden Quarters Sitting Room TOTAL I + II + III Circulation, walling, etc. TOTAL GROSS AREA 1)770 m2 480 m2 2,250 m2 SUMMARY I. OFFICE 615 II. TRAINING 452 III. HOSTEL 703 CIRCULATION, Etc. 480 TOTAL 2,250 m2

74 ANNEX 13 Page 4 Table 2 (B) INDONESIA II: PROVINCIAL TRAINING CENTRE TYPE I SCHEDULE OF ACCOMMODATION Space Personnel Visitors Capacity Are I. SCHOOL BUILDING Director's Room Secretariat Room Trainer's/Teacher's Room Library AVA Room Mimeograph Room Storage Classrooms 2 x30 2 x10 2 x Discussion Room 2 x 15-2 x Operation Room 4o II. HOSTEL ACCOMMODATION Bedroom Accommodation Dining Room Kitchen Sitting Room Worship Room Laundry 2-15 Director Quarters -70 Hostel Warden Quarters 50 Bathroom and Toilets (10 units) - 80 Servants Room, Bathroom and Toilet Storage TOTAL I + II 740 1,9154 m2 Circulation, walling, etc. 346 m2 TOTAL GROSS AREA 1,500 m2 i4otes: PTC, Type I (1O00 m2) - The two classrooms should be separated from each other by a movable screen in order to facilitate using them for opening/closing ceremonies. Student bedroom: maximum 3-4 persons each bedroom.

75 ANNEX 13 Page 5 Table 2 (C) INDONESIA II: PROVINCIAL TRAINING CENTRE,TYPE II SCHEDULE OF ACCOMMODATION Area Space Personnel Visitors Capacity (m2) I. SCHOOL BUILDING Director's Room Secretariat Room Trainer's/Teacher's Room Library AVA Room Mimeograph Room Storage Class Rooms Discussion Room 2 x 15-2 x Operation Room 35 _ II. HOSTEL ACCOMMODATION Bedroom Accommodation Dining Room Kitchen Sitting Room - - _ 35 Worship Room Laundry Director Quarters - 70 Hostel Warden Quarters Servant's Room, Bathroom and Toilet Bathroom and Toilets Storage TOTAL I + II Circulation, walling, etc. TOTAL GROSS AREA 927 m2 273 m m2 NOTES: PTC,Type II (1,200 m2) - classroom and conference room should be separated from each other by a movable screen (sec. 2.1.). Students bedroom: maximum 3-4 persons each bedroom.

76 ANNEX 13 Page 6 Table 2 (D) INDONESIA II: PROVINCIAL OFFICE, EYPE I SCHEDULE OF ACCOMMODATION Space Personnel Visitors Capacity ArAa Director Secretary, Division Chief. Project Officer Sub-Division Chiefs, Treasurers I Staff, Typists Central Data, Library Mimeograph _ Storage Conference Room Toilet - 12 Sub-total m2 Circulation, walling, etc. 130 m 2 TOTAL GROSS AREA 650 m2 Table 2 (E) INDONESIA II: PROVINCIAL OFFICE,TYPE II SCIHEDULE OF ACCOMMODATION Space Person el Xii. tors Capacity (m2) Director Secretary, Division Chief, Project Officer K Sub-Division Chief, Treasurer 42 4< 126 Staff, Typists Central Data, Library, Mimeograph Storage Conference Room Toilet Sub-total m2 Circulation, walling, etc. 122 m2 TOTAL GROSS AREA 600 m2

77 Table 3 INDONFSIA II: CIVIL WORKS IMPLEMENTATION SCHEDULE Province- Facility Location ID U D R D0 U r II Jakarta Bureau(2,250m 2 ) Jakarta iii Aceh PTC I (1,5OOm 2 ) Banda Aceh PO I ( 650m 2 ) Lampung PTC II (1,200m 2 ) Tanjung Karang PO II ( 600Dm 2 ) S. Kalimantan PTC I (1,500m 2 ) Banjarmasin PO I ( 65Dm 2 ) N. Sulawesi PTC II (1,20Om 2 ) Menado PD II ( 60Dm 2 ) W. Nusatenggara PTC 11 (1,200m 2 ) Mataram C L1 I Po II ( 600m 2 ) S. Sumatra PTC I (1,500m 2 ) Palembang PO I ( 65Dm 2 ) W. Sumatra PTC I (1,500m 2 ) Padang PO I ( 65Dm 2 ) N. Sumatra PTC I (1,500m 2 ) Medan PO I ( 65Dm 2 ) W. Kalimantan PTC I (1,50Dm 2 ) Pontianak PO I ( 65Dm 2 ) 'Oa S. Sulawesi PTC I (1,500m 2 ) Ujung Pandang _ PO I ( 65Dm 2 ) Furniture i!i!i'}fll1ili -1 /1 In order of construction priority. LEGEND: g Preliminary Designs Bureau - NFPCB Bureau of Education and Training PTC I - Provincial Training Centre Type I flhjiffl7flifl Production Drawings and Documentation PTC II = Provincial Training Centre Type II PO I NFPCB Provincial Office Type I Bidding and Evaluation PO II = NFPCB Provincial Offiee Type TT Construction Post Contract Work Source: National Family Planning Coordinating Board.

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