1 - RH Commodity Needs and Indigenous Suppliers. Practice ... · RH Commodity Needs and Indigenous Suppliers’ Practice in Indonesia Dr. Siswanto Agus Wilopo, M.Sc., Sc.D. ... Microsoft

Copyright © 2006 Deputi KB dan KR, BKKBN, [email protected]

RH Commodity Needs and Indigenous Suppliers’ Practice in

IndonesiaDr. Siswanto Agus Wilopo, M.Sc., Sc.D.

Deputy for Family Planning and Reproductive HealthNational Family Planning Coordinating Board (BKKBN)

Indonesia


Introduction


Demographic Indicators (2006)

Population : 220 MillionRank 4 in the worldPop. Density: 112/km2

CBR :22CDR: 10Pop. Growth 1.48%Life Expectancy: 66 TFR: 2.4MMR 307 per 100.000 birthIMR 35Level of Urbanization: 46%


Introduction

• a significant momentum of growth• entering a window opportunity • FP integral part of national policy• decentralization and reform• the economic crisis in the 1997


RH Commodity Need in Indonesia


Trends in Contraceptive Prevalence Rates

Modern methods

All methods

Percent of Couples Using Any Contraception: Indonesia 1997-2006

40

45

50

55

60

65

70

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Year

Perc

ent U

sing

C

ontra

cept

ion

IDHS

Susenas



Trend of Prevalence of Current Used Contraceptive in Indonesia:

1994-2002

1.63.1

4.9

10.3

17.115.2

3

68.1

15.4

21.1

1.3

3.7 4.3

13.2

27.8

1.1

6.2

Codom & MaleStreril

WomenSterilization

Implant IUD Pill Injectable

IDHS 1994IDHS 1997IDHS 2002

Source: IDHS 1994, 1997, and 2002

Women Marriage at Reproductive Ages

Percent


Male Contraceptive Used in Indonesia (%)

1.5

1.6

0.4

0.9

1.3

4.4

0.8

1.1

0.4

0.7

1.1

3

Coitus Interuptus

Calender

Vasectomi

Condom

Male User

Male Participation

IDHS 1997

IDHS 2002-

Percent

Sumber : SDKI 1997 dan 2002 Perempuan Berstatus Kawin


“Unmet Need” for Contraceptive Services in Indonesia: 1997-2002

4.2 5

9.2

4 4.6

8.6

Spacing Limiting Total "Unmeet Need"

IDHS-1997

IDHS-2002Percent


women who would prefer to avoid pregnancy do not use contraception

• Constraints in access to and quality• Shortages supply of contraception• Method failure• Health concerns about contraceptives and

side effects;• Lack of information;• Opposition from husband, family, and

community; and• Little perceived risk of pregnancy.


FP Policy on RH Commodity Supply


Challenges

• First, diversification in contraceptive methods used and method preference

• Second, capacity to provide appropriate and high quality services for family planning

• Third, decentralization and programming at different levels


National Suppliers’ Practice


• Previously, all family planning services were fully subsidized by the government for all Indonesians.

• In the late 1990s there was a gradual shift towards the private sector.


• Use of government sources decreased from 43% in 1997 to 28% in 2002/3;

• Use of private medical sources increased from 42% in 1997 to 63% in 2002/3;

• Use of other sources(such as village birth delivery posts (polindes), integrated health

posts (posyandu), village contraceptive distribution centres(VCDCs), traditional birth attendants, or friends)

dropped from 15% in 1997 to 8% in 20002/3.


Percent of Couples Using Any Contraception, National Surveys, 1980-2002

26.8

38.5

47.849.7

54.7

57.4

60.3

48.950.1

51.1 50.551.4 51.5 51.4

54.452.5

54.2

0

5

10

15

20

25

30

35

40

45

50

55

60

65

70

75

1982

1981

1983

1984

1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

Perc

ent U

sing

Con

trac

eptio

n

DHS SERIES

SUSENAS SERIES

Source: Ross, 2005


Use by Method: Percent of Couples Using Each Method: 15 Year Trend in National Surveys

0

5

10

15

20

25

30

Pill IUD Injections Condom Femalesterilization

Male sterilization Implants

Perc

ent o

f Cou

ples

1987

1991

1994

1997

2002-03

Source: Ross, 2005


Injectable: Shifts in Source of Supply, 1997-2002

0

10

20

30

40

50

60

70

1994 1997 1998 1999 2000 2001 2002

Shar

e of

Inje

ctab

le U

se

BidanPrivate DoctorPolindes/BDD/PosyanduPuskesmas/PustuOther

Source: Ross, 2005


Pill: Shifts in Sources of Supply, 1997-2002

0

5

10

15

20

25

30

35

1994 1997 1998 1999 2000 2001 2002

Shar

e of

Pill

Use

BidanPuskesmas/PustuPharmacyPolindes/BDD/Posyandu


IUD: Shifts in Sources of Supply, 1997-2002

0

10

20

30

40

50

60

1994 1997 1998 1999 2000 2001 2002

Shar

e of

IUD

Use

BidanPrivate DoctorPuskesmas/PustuGovt. HospitalPolindes/BDD/PosyanduOther

Source: Ross, 2005


Commom Logistic Problems

at District Level


Problems

• Excess stock

• Poor reporting

• Poor storage

• Low morale


Stock balances are not monitored.


Warehouses are not well-maintained



Unwanted pregnancies


Keys to Success


Keys to Success:

• Logistics training

• Supervision

• Program plans include logistics


1 - RH Commodity Needs and Indigenous Suppliers. Practice ... · RH Commodity Needs and Indigenous Suppliers’ Practice in Indonesia Dr. Siswanto Agus Wilopo, M.Sc., Sc.D. ... Microsoft

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