To assess the effect of family planning use and fertility on family welfare and on the economic and social activities of women, researchers surveyed 931 married women from two urban and two rural sites, and in-depth interviews were conducted with 16 women, who were also survey respondents.

Indonesia

In Indonesia, the total fertility rate declined from 5.6 children per family in 1967-70 to 2.85 children in 1994. Dramatic increases in contraceptive use, spurred by economic growth and the government of Indonesia's family planning program, are credited for this decline. Indonesia's family planning program promotes smaller families as a means to improve family welfare. The government supports the concept of The Happy and Prosperous Family ( defined as a family based on "legal marriage, capable of adequately fulfilling spiritual and material needs, devoted to God, possessing harmonious, proportionate, and balanced relations among its members and between the family, society, and the environment.") Understanding how – and whether contraceptive use has indeed improved family welfare and women's activities will allow Indonesia to assess its family planning programs.

Research Findings

To assess the effect of family planning use and fertility on family welfare and on the economic and social activities of women, researchers surveyed 931 married women from two urban and two rural sites in the provinces of Central Java and East Java. After the survey, in-depth interviews were conducted with 16 women, who were also survey respondents.

• In the in-depth interviews, most women said family planning use allowed them to have fewer children and that having a smaller family offered numerous benefits ( the most common being economic. A woman from Central Java explained, "With fewer children, expenditures are low, so the family's economic well-being is guaranteed."

• Some women said family planning had a negative effect on their lives because of contraceptive side effects. Even women who were supportive of family planning and its benefits complained of side effects, which ultimately led some to discontinue or switch methods. One woman described her experiences: "There was an infection when I used the IUD, so I had it taken out. The doctor suggested I try the injection. I had spotting for a while, so I stopped using it after the third injection."

• In analysis of the survey data, neither family planning nor number of children had a significant effect on whether a woman worked for income, or on her level of participation in community activities. Findings from the in-depth interviews suggested that economic and social factors mainly influenced a woman's work status. Almost all working women reported that they worked out of economic necessity. In addition, they were more likely to work if family members were available to help with child care.

• When relationships between family planning and fertility and the three indicators of family welfare (family savings, household density, and per capita income-expenditure ratio) were examined, research showed family planning and lower fertility had only a modest effect on family welfare. Lower fertility was significantly associated with savings (but not in the direction hypothesized. Families with a small number of children were more likely to have no savings while families with a large number of children were more likely to have some savings. However, larger family size was associated with a lower per capita income-expenditure ratio and higher household density ( other measures of lower family welfare).

• In the in-depth interviews, women gave family planning credit for improving the quality of their lives; however, the quantitative analysis showed family planning and fertility had a very modest effect on women's social and economic activities and on family welfare. The apparent conflict between these two findings may be partly explained by the context of family planning in Indonesia. Because family planning was widespread before most of the women in this study entered their reproductive years, they did not witness a dramatic change in their lives. Family planning had already been accepted as a social and cultural norm before they and their husbands were faced with making reproductive decisions.

Recommendations

Since Indonesia's family planning program has already succeeded in lowering fertility substantially and modifying views of ideal family size, it should concentrate on improving the quality of its family planning services (counseling, choice of methods, female providers, lower cost) to reduce rates of contraceptive discontinuation and method switching. While women were supportive of family planning, they indicated the need for better counseling about potential side effects and assistance in managing side effects. Better quality of care in family planning services would enable couples to continue to successfully space births and limit family size.

Study Details

Researchers responsible for this study were: Dr. Agus Dwiyanto, Dr. Faturochman, Dr. Ken Suratiyah, Dr. Sukamdi, Dr. Henry Sembiring, Dr. I.A. Ratna Pawitrani, Dr. Winie Tamtiari and Dr. Ambar Widaningrum of the Population Studies Center, Gadjah Mada University; Dr. Karen Hardee of The Futures Group International; and Dr. Elizabeth Eggleston of Family Health International. Research was supported by the Women's Studies Project at Family Health International, through a Cooperative Agreement funded by the U.S. Agency for International Development with field support from the USAID Mission in Jakarta.