Indonesia - Demographic and Health Survey - 1995

Publication date: 1995

Indonesia Demographic and Health Survey 1994 Central Bureau of Statistics State Ministry of Population/ National Family Planning Coordinating Board Ministry of Health ®DHS Demographic and Health Surveys Macro International Inc. Indonesia Demographic and Health Survey 1994 Central Bureau of Statistics Jakarta, Indonesia State Ministry of Population/ National Family Planning Coordinating Board Jakarta, Indonesia Ministry of Health Jakarta, Indonesia Macro International Inc. Calverton, Maryland USA October 1995 This report highlights the findings of the 1994 Indonesia Demographic and Health Survey (IDHS) undertaken by the Central Bureau of Statistics in collaboration with the State Ministry of Population/National Family Planning Coordinating Board (NFPCB) and the Ministry of Health (MOH). The DHS Project of Macro International inc. pro- vided technical assistance and some funding. Most of the local costs for the survey were provided by the World Bank through a loan to the NFPCB. USAID/Jakarta and the Government of Indonesia provided additional funding. The 1994 IDHS is part of the worldwide Demographic and Health Surveys (DHS) program, which is designed to collect, analyze, and disseminate demographic data on fertility, family planning, maternal and child health. Additional information on the 1994 IDHS may be obtained from the Central Bureau of Statistics, Jl. Dr. Sutomo 8, Jakarta 10710, Indonesia (Telephone 345-6285; Fax 384-1545), or the State Ministry of Population/National Family Planning Coordi- nating Board, J1. Permata 1, Halim Perdanakusumah, Jakarta 13650, Indonesia (Telephone 800-9029; Fax 800-9125), or the Institute for Health Research and Development, Ministry of Health, Jl. Percetakan Negara 29, Jakarta 1056(I, Indonesia (Telephone 424-4146; Fax 424-3933). Additional information about the DHS program may be obtained by writing to: Macro International Inc., 11785 Beltsville Drive, Calverton, Maryland 20705-3119, USA (Telephone 301- 572-0200; Fax 301-572-0999). Recommended citation: Central Bureau of Statistics (CBS) [Indonesia] and State Ministry of Population/National Family Planning Coordinating Board (NFPCB) and Ministry of Health (MOH) and Macro International Inc. (MI). 1995. Indonesia Demographic and Health Survey 1994. Calverton, Maryland: CBS and MI. CONTENTS Page Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii Figures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvii Preface: Central Bureau of Statistics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xix Preface: National Family Planning Coordinating Board . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxi Preface: Ministry of Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxiii Summary of Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxv Map of Indonesia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxviii CHAPTER 1 INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1.1 1.2 1.3 1.4 1.5 1.6 Geography, History and Economy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Population and Family Planning Policies and Programs . . . . . . . . . . . . . . . . . . . . . . . . . 4 Health Priorities and Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Objectives of the Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Organization of the Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 CHAPTER2 BACKGROUND CHARACTERISTICS OF HOUSEHOLDS AND RESPONDENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 2.1 Population by Age and Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 2.2 Population by Age from Selected Sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 2.3 Household Composition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 2.4 Fosterhood and Orphanhood . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 2.5 Educational Level of Household Population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 2.6 School Enrollment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 2.7 Housing Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 2.8 Presence of Durable Goods in the Household . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 2.9 Background Characteristics of Respondents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 2.10 Educational Level of Respondents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 2.11 Educational Attainment and Reasons for Leaving School . . . . . . . . . . . . . . . . . . . . . . 26 2.12 Husband's Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 2.13 Exposure to Mass Media . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 2.14 Employment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 2.15 Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 2.16 Child Care While Working . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 CHAPTER3 3.1 3.2 3.3 3.4 3.5 3.6 FERT IL ITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Fertility Levels and Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Fertility Differentials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Children Ever Born and Living . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 Birth Intervals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Age at First Birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Teenage Fertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 iii CHAPTER 4 4.1 4.2 4.3 4.4 4.5 Page KNOWLEDGE AND EVER USE OF FAMILY PLANNING . . . . . . . . . . . . . . . . 55 Knowledge of Family Planning Methods and Sources . . . . . . . . . . . . . . . . . . . . . . . . . 55 Knowledge of Blue Circle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 Knowledge of Golden Circle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 Dissemination of Family Planning Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 Ever Use of Family Planning Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 CHAPTER 5 CURRENT USE OF FAMILY PLANNING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 5.1 Current Use of Family Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 5.2 Trends in Contraceptive Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76 5.3 Contraceptive Use among Women over Thirty and among Those with Three or More Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 5.4 Reasons for Choice of Contraceptive Method . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 5.5 Quality of Use of the Pill, Injection and Condoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 5.6 Problems with Current Method . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85 5.7 Cost of Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86 5.8 Source of Method . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89 5.9 Reason for Using Source of Supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90 5.10 Timing of Sterilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 5.11 Knowledge of the Fertile Period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 CHAPTER 6 6.1 6.2 6.3 6.4 FERT IL ITY PREFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97 Desire for Additional Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97 Ideal Number of Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101 Uumet Need . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104 Unplanned and Unwanted Fertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 CHAPTER 7 7.1 7.2 7.3 7.4 7.5 NONUSE AND INTENTION TO USE FAMILY PLANNING . . . . . . . . . . . . . . 111 Discontinuation Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 Reasons for Discontinuation of Contraceptive Use . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 Intention to Use Contraception in the Future . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114 Reasons for Nonuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115 Preferred Method . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116 CHAPTER 8.1 8.2 8.3 8.4 8.5 OTHER PROXIMATE DETERMINANTS OF FERT IL ITY . . . . . . . . . . . . . . . 117 Current Marital Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 Marital Exposure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118 Age at First Marriage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120 Age at First Sexual Intercourse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124 Recent Sexual Activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126 iv 8.6 8.7 Page Postpartum Amenorrhea, Abstinence and Insusceptibility . . . . . . . . . . . . . . . . . . . . . 129 Termination of Exposure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132 CHAPTER 9 9.1 9.2 9.3 9.4 9.5 INFANT AND CHILD MORTAL ITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135 Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135 Assessment of Data Quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135 Levels and Trends in Infant and Child Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 Mortality Differentials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140 High-risk Fertility Behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143 CHAPTER 10 MATERNAL AND CHILD HEALTH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145 10.1 Antenatal Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145 10.2 Number of Antenatal Care Visits and Stage of Pregnancy . . . . . . . . . . . . . . . . . . . . . 147 10.3 Tetanus Toxoid Vaccination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151 10.4 Iron Pills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155 10.5 Place of Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155 10.6 Assistance during Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158 10.7 Delivery Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161 10.8 Complications of Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163 CHAPTER 11 IMMUNIZAT ION OF CHILDREN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165 11.1 Health Cards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165 11.2 Immunization Coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167 11.3 Immunizations by Background Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169 11.4 Immunizations by First Year of Life . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172 CHAPTER 12 12.1 12.2 12.3 CHILDHOOD DISEASES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175 Acute Respiratory Infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175 Prevalence and Treatment of Fever . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180 Diarrheal Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182 CHAPTER 13 13.1 13.2 INFANT FEEDING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197 Prevalence of Breastfeeding and Supplementation . . . . . . . . . . . . . . . . . . . . . . . . . . . 197 Duration of Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202 V CHAPTER 14 Page MATERNAL MORTAL ITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207 14.1 Data Quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207 14.2 Direct Estimates of Maternal Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209 14.3 Indirect Estimates of Maternal Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 210 14.4 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211 CHAPTER 15 KNOWLEDGE OF AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213 15.1 Source of Information about AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213 15.2 Knowledge of Ways to Prevent AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 216 15.3 Women's Perceptions of the Risk of Getting AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . 219 15.4 AIDS Prevention Behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221 15.5 Knowledge and Use of Condoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 223 CHAPTER 16 16.1 16.2 16.3 16.4 AVAILABIL ITY OF FAMILY PLANNING AND HEALTH SERVICES . . . . . 225 Availability of Selected Family Planning Providers in the Area . . . . . . . . . . . . . . . . . 226 Distance and Time to Selected FP/MCH Outlets Providing Family Planning Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 228 Availability of FP/MCH Outlets Offering Maternal and Child Health Services . . . . . 232 Distance and Time to Nearest FP/MCH Outlet Offering Maternal and Child Health Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233 REFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239 APPENDIX A A.1 A.2 A.3 A.4 A.5 SURVEY DES IGN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241 Sample Design and Implementation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243 Pretest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 244 Field-Staff Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247 Fieldwork . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247 Data Processing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247 APPENDIX B EST IMATES OF SAMPL ING ERRORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249 APPENDIX C DATA QUAL ITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287 APPENDIX D PERSONS INVOLVED IN THE 1994 INDONESIA DEMOGRAPHIC AND HEALTH SURVEY . . . . . . . . . . . . . . . . . . . . . . . . . . . 297 APPENDIX E QUEST IONNAIRES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 309 vi TaMe 1.1 Table 1.2 Table 2.1 Table 2.2 Table 23 Table 2.4.1 TaMe 2.4.2 Table 2.5.1 TaMe 2.5.2 Table 253 TaMe 2.5.4 Table 2.6 Table Z7 TaMe 2.8 Table 2.9.1 Table 2.9.2 Table 2.10.1 Table 2.10.2 Table 2.11 Table 2.12.1 Table 2.12.2 Table 2.13 TABLES Page Basic demographic indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Results of the household and individual interviews . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Household population by age, residence and sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Population by age from selected sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Household composition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Fosterhood and orphanhood: background characteristics . . . . . . . . . . . . . . . . . . . . . 13 Fosterhood and orphanhood: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Educational level of the household population by background characteristics: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Educational level of the household population by background characteristics: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Educational level of the household population by region and province: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Educational level of the household population by region and province: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 School enrollment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Housing characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Household durable goods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Distribution of respondents: background characteristics . . . . . . . . . . . . . . . . . . . . . . 23 Distribution of respondents: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Level of education: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Level of education: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 School attendance and reasons for leaving school . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Husband's level of education: background characteristics . . . . . . . . . . . . . . . . . . . . 28 Husband's level of education: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Husband's level of education according to respondent's level of education . . . . . . . 30 vii Table 2.14.1 Table 2.14.2 Table 2.15.1 Table 2.15.2 T~ ble 2.16.1 Table 2.16.2 Table 2.17.1 Table 2.17.2 Table 3.1 Table 3.2 Table 3.3 Table 3.4 Table 3.5.1 Table 3.5.2 Table 3.6 Table 3.7.1 Table 3.7.2 Table 3.8 Table 3.9.1 Table 3.9.2 Table 3.10.1 Table 3.10.2 Table 3.11 Table 4.1 Table 4.2.1 Page Access to mass media: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . 30 Access to mass media: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Employment: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 Employment: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 Occupation: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Occupation: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Child care while working: background characteristics . . . . . . . . . . . . . . . . . . . . . . . 36 Child care while working: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Fertility rates from various sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 Age-specif ic fertility rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Fertility by marital duration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 Total fertility rates for provinces in Java-Bali . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 Fertility: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 Fertility: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Children ever born and living . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 Birth intervals: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 Birth intervals: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Age at first birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 Median age at first birth: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . 50 Median age at first birth: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 Teenage pregnancy and motherhood: background characteristics . . . . . . . . . . . . . . . 52 Teenage pregnancy and motherhood: region and province . . . . . . . . . . . . . . . . . . . . 53 Children born to teenagers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 Knowledge of contraceptive methods and source for methods . . . . . . . . . . . . . . . . . . 55 Knowledge of contraceptive methods and source for methods: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 viii Table 4.2.2 Table 4.3 Table 4.4.1 Table 4.4.2 Table 4.5.1 Table 4.5.2 Table 4.6.1 Table 4.6.2 Table 4.7.1 Table 4.7.2 Table 4.8 Table 4.9 Table 5.1 Table 5.2.1 Table 5.2.2 Table 5.3 Table 5.4 Table 5.5 Table 5.6 Table 5.7 Table 5.8.1 Table 5.8.2 Table 5.9 Page Knowledge of contraceptive methods and source for methods: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58 Source of supply for contraceptive methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 Knowledge of Blue Circle: background characteristics . . . . . . . . . . . . . . . . . . . . . . . 60 Knowledge of Blue Circle: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 Knowledge of Golden Circle: background characteristics . . . . . . . . . . . . . . . . . . . . . 63 Knowledge of Golden Circle: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . 64 Visits by family planning fieldworkers: background characteristics . . . . . . . . . . . . . 66 Visits by family planning fieldworkers: region and province . . . . . . . . . . . . . . . . . . 67 Appropriate sources for family planning information: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 Appropriate sources for family planning information: region and province . . . . . . . 69 Ever use of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71 Number of children at first use of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 Current use of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 Current use of contraception: background characteristics . . . . . . . . . . . . . . . . . . . . . 74 Current use of contraception: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . 76 Trends in contraceptive use by province: Java-Bali 1976-1994 . . . . . . . . . . . . . . . . 77 Trends in use of specific contraceptive methods: Java-Bali, 1976-1994 . . . . . . . . . . 78 Trends in use of specific contraceptive methods: Indonesia, 1991 and 1994 . . . . . . 79 Contraceptive use status and type of method used . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 Reasons for using current method of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . 8 I Pill use compliance: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82 Pill use compliance: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 Use of pill and condom brands . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84 ix Table 5.10 Table 5.11 Table 5.12 Table 5.13 Table 5.14 Table 5.15.1 Table 5.15.2 Table 5.16 Table 5.17 Table 6.1 Table 6.2 Table 6.3. I Table 6.3.2 Table 6.4 Table 6.5.1 Table 6.5.2 Table 6.6.1 Table 6.6.2 Table 6.7 Table 6.8.1 Table 6.8.2 Table 7.1 Table 7.2 Page Use of injection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85 Problems with current method of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86 Payment for contraceptive methods and services . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87 Source of contraceptive methods and mean cost of methods . . . . . . . . . . . . . . . . . . . 88 Source of supply for modem contraceptive methods . . . . . . . . . . . . . . . . . . . . . . . . . 89 Reason for selecting current sources of supply for contraceptive methods: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91 Reason for selecting current sources of supply for contraceptive methods: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93 Timing of sterilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 Knowledge of fertile period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 Fertility preferences by number of living children . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 Fertility preferences by age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99 Desire to limit childbearing: background characteristics . . . . . . . . . . . . . . . . . . . . . 100 Desire to limit childbearing: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . 101 Ideal and actual number of children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102 Mean ideal number of children: background characteristics . . . . . . . . . . . . . . . . . . 103 Mean ideal number of children: region and province . . . . . . . . . . . . . . . . . . . . . . . 104 Need for family planning services: background characteristics . . . . . . . . . . . . . . . . 105 Need for family planning services: region and province . . . . . . . . . . . . . . . . . . . . . 107 Fertility planning status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108 Wanted fertility rates: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . 109 Wanted fertility rates: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109 Contraceptive discontinuation rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 Reasons for discontinuation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 × Table 7.3 TaMe 7A TaMe 7.5 TaMe 8.1 Table 8.2.1 Table 8.2.2 Table 8.3 TaMe 8.4.1 TaMe 8.4.2 TaMe 8.5 Table 8.6.1 TaMe 8.6.2 TaMe 8.7.1 TaMe 8.7.2 Table 8.8 TaMe 8.9.1 Table 8.9.2 Table 8.10 Table 9.1 TaMe 9.2 TaMe 9.3 Table 9.4 TaMe 9.5 Page Future use of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114 Reasons for not using contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115 Preferred method of contraception for future use . . . . . . . . . . . . . . . . . . . . . . . . . . . 116 Current marital status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 Marital exposure: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118 Marital exposure: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119 Age at first marriage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120 Median age at filst marriage: background characteristics . . . . . . . . . . . . . . . . . . . . 121 Median age at first marriage: region and province . . . . . . . . . . . . . . . . . . . . . . . . . 122 Age at first sexual intercourse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124 Median age at first intercourse: background characteristics . . . . . . . . . . . . . . . . . . 125 Median age at first intercourse: region and province . . . . . . . . . . . . . . . . . . . . . . . . 126 Recent sexual activity: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . 127 Recent sexual activity: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128 Postpartum amenorrhea, abstinence and insusceptibility . . . . . . . . . . . . . . . . . . . . . 129 Median duration of postpartum amenorrhea, abstinence, and insusceptibility: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131 Mecian duration of postpartum amenorrhea, ~bstine~ce, and insusceptibility: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132 Termination of exposure to the risk of pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . 133 Infant and child mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 Trends in infant and child mortality by region . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138 Infant mortality for five-year periods by region . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139 Infant and child mortality by background characteristics . . . . . . . . . . . . . . . . . . . . . 140 Infant and child mortality by biodemographic characteristics . . . . . . . . . . . . . . . . . 141 xi Table 9.6 Table 9.7 Table 10.1.1 Table 10.1.2 Table 10.2.1 Table 10.2.2 Table 10.3 Table 10.4.1 Table 10.4.2 Table 10.5 Table 10.6.1 Table 10.6.2 Table 10.7.1 Table 10.7.2 Table 10.8.1 Table 10.8.2 Table 10.9 Table 11.1.1 Table 11.1.2 Table 11.2 Table 11.3.1 Table 11.3.2 Table 11.4 Table 12.1.1 Page Infant and child mortality by region and province . . . . . . . . . . . . . . . . . . . . . . . . . . 143 High-risk fertility behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144 Antenatal care: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146 Antenatal care: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147 Place of antenatal care: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . 148 Place of antenatal care: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149 Number of antenatal care visits and stage of pregnancy . . . . . . . . . . . . . . . . . . . . . . 151 Tetanus toxoid vaccinations: background characteristics . . . . . . . . . . . . . . . . . . . . 152 Tetanus toxoid vaccinations: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . 153 Iron tablets taken during pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154 Place of delivery: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156 Place of delivery: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157 Assistance during delivery: background characteristics . . . . . . . . . . . . . . . . . . . . . 158 Assistance during delivery: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . 160 Delivery characteristics: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . 161 Delivery characteristics: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163 Complications of delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164 Health cards: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166 Health cards: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167 Vaccinations by source of information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168 Vaccinations: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169 Vaccinations: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171 Vaccinations in first year of life . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173 Prevalence and incidence cf acute respiratory infection: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176 xii Table 12.1.2 Table 12.2.1 Table 12.2.2 Table 12.3.1 Table 12.3.2 Table 12.4.1 Table 12.4.2 Table 12.5.1 Table 12.5.2 Table 12.6.1 Table 12.6.2 Table 12.7.1 Table 12.7.2 Table 12.8.1 Table 12.8.2 Table 12.9 Table 13.1.1 Table 13.1.2 Table 13.2 Table 13.3 Table 13.4.1 Table 13.4.2 Table 14.1 Page Prevalence and incidence of acute respiratory infection: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177 Prevalence and treatment of acute respiratory infection: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178 Prevalence and treatment of acute respiratory infection: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179 Prevalence and treatment of fever: background characteristics: . . . . . . . . . . . . . . . 181 Prevalence and treatment of fever: region and province . . . . . . . . . . . . . . . . . . . . . 182 Prevalence of diarrhea: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . 184 Prevalence of diarrhea: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185 Duration and incidence of diarrhea: background characteristics . . . . . . . . . . . . . . . 186 Duration and incidence of diarrhea: region and province . . . . . . . . . . . . . . . . . . . . 187 Knowledge of diarrhea care: background characteristics . . . . . . . . . . . . . . . . . . . . 188 Knowledge of diarrhea care: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . 189 Source of diarrhea treatment: background characteristics . . . . . . . . . . . . . . . . . . . . 191 Source of diarrhea treatment: region and province . . . . . . . . . . . . . . . . . . . . . . . . . 192 Treatment of diarrhea: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . 193 Treatment of diarrhea: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 194 Feeding practices during diarrhea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195 Initial breastfeeding: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . 198 Initial breastfeeding: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199 Breastfeeding status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200 Types of food received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202 Median duration and frequency of breastfeeding: background characteristics . . . . 203 Median duration and frequency of breastfeeding: region and province . . . . . . . . 205 Data on siblings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 208 xiii Table 14.2 Table 14.3 Table 14.4 Table 14.5 Table 15.1.1 Table 15.1.2 Table 15.2.1 Table 15.2.2 Table 15.3.1 Table 15.3.2 Table 15.4.1 Table 15.4.2 Table 15.5.1 Table 15.5.2 Table 16.1.1 Table 16.1.2 Table 16.2.1 Table 16.2.2 Table 16.3 Table 16.4 Table 16.5 Page Adult female mortality rates by age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 208 Adult female mortality rates: direct estimates and model life table rates . . . . . . . . 209 Direct estimates of maternal mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 210 Indirect estimates of maternal mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211 Knowledge of AIDS and sources of AIDS information: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 214 Knowledge of AIDS and sources of AIDS information: region and province . . . . 215 Knowledge of ways to avoid AIDS: background characteristics . . . . . . . . . . . . . . . 217 Knowledge of ways to avoid AIDS: region and province . . . . . . . . . . . . . . . . . . . . . 218 Perception of the risk of getting AIDS: hackground characteristics . . . . . . . . . . . . 219 Perception of the risk of getting AIDS: region and province . . . . . . . . . . . . . . . . . . 220 AIDS prevention behavior: background characteristics . . . . . . . . . . . . . . . . . . . . . . 221 AIDS prevention behavior: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . 222 Knowledge of condoms: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . 223 Knowledge of condoms: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 224 Availability of family planning providers in the area: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 226 Availability of family planning providers in the area: region and province . . . . . . 227 Distance to nearest principal FP/MCH outlet offering modem contraceptive methods: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . 228 Distance to nearest principal FP/MCH outlet offering modem contraceptive methods: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229 Distance to nearest principal FP/MCH outlet offering contraceptive methods by type of outlet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 230 Time to nearest principal FP/MCH outlet offering contraceptive methods by type of outlet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231 Availability of specific MCH services at nearest principal FP/MCH outlets offering MCH services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233 xiv Table 16.6.1 Table 16.6.2 Table 16.7 Table 16.8 Table A. 1 Table A.2 Table B. 1 Table B.2.1 Table B.2.2 Table B.2.3 Table B.2.4 Table B.2.5 Table B.2.6 Table B.2.7 Table B.2.8 Table B.2.9 Table B.2.10 Table B.2.11 Table B.2.12 Table B.2.13 Table B.2.14 Table B.2.15 Page Distance to nearest principal FP/MCH outlet offering MCH services: background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 234 Distance to nearest principal FP/MCH outlet offering MCH services: region and province . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235 Distance to nearest principal FP/MCH outlet offering MCH services by type of outlet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 236 Time to nearest principal FP/MCH outlet offering MCH services by type of outlet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237 Sample implementation: results of the household interview . . . . . . . . . . . . . . . . . . 245 Sample implementation: results of the individual interview . . . . . . . . . . . . . . . . . . 246 List of selected variables for sampling errors, Indonesia 1994 . . . . . . . . . . . . . . . . . 253 Sampling Sampling Sampling Sampling Sampling Sampling Sampling Sampling Sampling Sampling Sampling Sampling Sampling Sampling Sampling errors - National sample, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . . . 254 errors - Urban sample, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . . . . . 255 errors - Rural sample, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . . . . . 256 errors - Java-Bali, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257 errors - Outer Java-Bali I, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . . 258 errors - Outer Java-Bali II, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . 259 errors - DKI Jakarta, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 260 errors - West Java, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 261 errors - Central Java, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 262 errors - DI Yogyakarta, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . . . . 263 errors - East Java, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 264 errors - Bali, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265 errors - Dista Aceh, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 266 errors - North Sumatra, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . . . . 267 errors - West Sumatra, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . . . . . 268 XV Table B.2.16 Table B.2.17 Table B.2.18 Table B.2.19 Table B.2_20 Table B.2.21 Table B_2.22 Table B2 .23 Table B.2.24 Table B.2.25 Table B.2.26 Table B.2.27 Table B.2.28 Table B.2.29 Table B .230 Table B.2.31 Table B.2.32 Table B.2.33 Table C. 1 Table C.2 Table C.3 Table C.4 Table C.5 Table C.6 Page Sampling errols - South Sumatra, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . . . . 269 Sampling errors - Lampung, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 270 Sampling errors - West Nusa Tenggara, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . 271 Sampling errors - West Kalimantan, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . . 272 Sampling errors - South Kalimantan, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . 273 Sampling errors - North Sulawesi, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . . . . 274 Sampling errors - South Sulawesi, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . . . . 275 Sampling errors- Riau, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 276 Sampling errors - Jambi, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277 Sampling errors - Bengkulu, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 278 Sampling errors - East Nusa Tenggara, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . 279 Sampling errors - East Timor, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 280 Sampling errors - Central Kalimantan, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . 281 Sampling errors - East Kalimantan, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . . . 282 Sampling errors - Central Sulawesi, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . . 283 Sampling errors - Southeast Sulawesi, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . 284 Sampling errors - Maluku, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285 Sampling errors - lrian Jaya, Indonesia 1994 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 286 Household age distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289 Age distribution of eligible and interviewed women . . . . . . . . . . . . . . . . . . . . . . . . 290 Completeness of reporting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291 Births by calendar years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 292 Reporting of age at death in days . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 294 Reporting of age at death in months . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 295 xvi Figure 2.1 Figure 2.2 Figure 2.3 Figure 2.4 Figure 3.1 Figure 3.2 Figure 4.1 Figure 4.2 Figure 4.3 Figure 5.1 Figure 5.2 Figure 5.3 Figure 5.4 Figure 5.5 Figure 5.6 Figure 6.1 Figure 7.1 Figure 8.1 Figure 8.2 FIGURES Page Number of Persons Reported at Each Age by Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Distribution of the Household Population by Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Percentage of the Population Age 5-15 Enrolled in School by Age Group and Sex . . . 19 Housing Characteristics by Residence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Age-Specific Fertility Rates, Indonesia 1967-1994 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 Total Fertility Rates by Province, Java-Bali 1967-1994 . . . . . . . . . . . . . . . . . . . . . . . . 43 Percentage of Currently Married Women Who Know Specific Modem Contraceptive Methods, Indonesia, 1987, 1991, and 1994 . . . . . . . . . . . . . . . . . . . . . . 56 Percentage of Ever-Married Women Who Have Heard of the Blue Circle (BC) Program and Who Know It Is a Private Family Planning (FP) Program, by Region . 62 Percentage of Ever-Married Women Who Know of Golden Circle (GC) and Who Know It is a Private Family Planning (FP) Program, by Region . . . . . . . . . . . . . . . . . . 65 Percentage of Currently Married Women Age 15-49 Who Are Using a Contraceptive Method . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 Percentage of Currently Married Women Age 15-49 Using Contraception by Province, Java-Bali 1976-1994 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 Percentage of Currently Married Women Age 15-49 Using Specific Modem Contraceptive Methods, Java-Bali, 1976-1994 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 Percentage of Currently Married Women Age 15-49 Using Specific Contraceptive Methods, Indonesia 1991 and 1994 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 Distribution of Current Users of Modem Contraceptive Methods by Source of Supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90 Distribution of Current Users of Modem Contraceptive Methods by Reason for Using Most Recent Source of Supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92 Fertility Preferences of Currently Married Women 15-49 . . . . . . . . . . . . . . . . . . . . . . 98 Reasons for Discontinuation of Contraceptive Methods . . . . . . . . . . . . . . . . . . . . . . . 113 Median Age at Marriage by Province, Java-Bali 1987, 1991 and 1994 . . . . . . . . . . . 123 Median Age at Marriage by Region, Indonesia 1987, 1991 and 1994 . . . . . . . . . . . . 123 xvii Figure 8.3 Figure 9.1 Figure 9.2 Figure 9.3 Figure 10.1 Figure 10.2 Figure 11.1 Figure 11.2 Figure 12.1 Figure 13.1 Figure 13.2 Figure 15.1 Figure C. 1 Page Percentage of Births in the last Three Years for Which Mothers Are Amenorrheic or Abstaining . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130 Number of Reported Deaths among Children Under Two Years by Age at Death in Months . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136 Infant Mortality Rates, Selected Sources, Indonesia 1971-1994 . . . . . . . . . . . . . . . . . 138 Infant Mortality Rates by Province, Java-Bali 1979-1994 . . . . . . . . . . . . . . . . . . . . . 139 Number of Antenatal Care Visits and Stage of Pregnancy at First Visit for Births in the Five Years Preceding the Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150 Delivery Characteristics of Births in the Five Years Preceding the Survey . . . . . . . . 162 Health Card Coverage for Births in the Five Years Preceding the Survey, by Mother's Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170 Vaccination Coverage Among Children Age 12-23 Months . . . . . . . . . . . . . . . . . . . . 170 Feeding Practices Among Children Under Five with Diarrhea . . . . . . . . . . . . . . . . . . 196 Distribution of Children by Breastfeeding (BF) Status, According to Age . . . . . . . . . 201 Median Duration of Any Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204 Knowledge of AIDS Among Ever-Married Women . . . . . . . . . . . . . . . . . . . . . . . . . . 216 Calendar Birth Ratios for Living, Dead, and All Children . . . . . . . . . . . . . . . . . . . . . 293 xviii PREFACE The 1994 Indonesia Demographic and Health Survey (IDHS) is the third survey on demography and health in Indonesia and was conducted as part of the worldwide Demographic and Health Surveys (DHS) project. The first survey was the 1987 National Indonesia Contraceptive Prevalence Survey (NICPS) and the second was the 1991 IDHS. The 1994 IDHS was designed as a collaborative effort of four institutions, i.e., the Central Bureau of Statistics (CBS), the State Ministry of Population/National Family Planning Coordinating Board, the Ministry of Health, and Macro International Inc. In addition to funds provided by the Government of Indonesia, the survey received financial support from the World Bank and the United States Agency for International Development (USAID)/Jakarta. Technical assistance as well as funding for the survey were provided by Macro International through its DHS program, a USAID-funded project carried out in many developing countries. The Central Bureau of Statistics was responsible for conducting the survey, including survey design, fieldwork, and data processing. The 1994 IDHS fieldwork was carried out from July to November 1994 in selected enumeration areas in all of the 27 provinces in Indonesia. The sample is a subsample of the National Socio-Economic Survey and was designed to produce reliable estimates of major variables for each province and for urban and rural areas of the three family planning program development areas (Java-Bali, Outer Java- Bali I, and Outer Java-Bali II). The main objective of the 1994 IDHS is to provide policymakers and program managers in population and health with detailed information on fertility and family planning; infant, child and maternal mortality; and maternal and child health. The content of the 1994 IDHS has been significantly expanded from prior surveys to include two new modules in the individual questionnaire: maternal mortality and knowledge of AIDS. The survey also investigated the availability of family planning and health services, which provides possible linkage with women' s fertility, family planning and child health care behavior. The 1994 IDHS also included a household expenditure modules, thereby identifying the household's economic status as an important determinant in family planning and health. This report supplements the preliminary report released earlier. The success of this very important undertaking would not have been realized without the relentless effort and dedication of all parties concerned. To those who actively contributed to this project, I would like to extend my gratitude and appreciation, especially to the World Bank, USAID, and the DHS program of Macro International Inc. Central Bureau of Statistics Jakarta, Indonesia September 1995 Sugito, M.A. Director General xix PREFACE The 1994 Indonesia Demographic and Health Survey (IDHS) is a nationally representative survey of 28,000 ever-married women ages 15 to 49. This survey provides detailed information on levels and trends in fertility, mortality, and family planning; maternal and child health services; availability of family planning and health service facilities; maternal mortality; and knowledge of AIDS. This information should be highly useful to Indonesia's Ministry of Health, Ministry of Population/NFPCB, and other related government institutions in assessing the coverage and quality of current interventions and in developing population policy and new program initiatives designed to further enhance family welfare. Results from the 1994 IDHS confirm that Indonesia has continued to make considerable progress in providing more couples with effective, high quality family planning services. As of 1994, 55 percent of all currently married women were using a method of contraception. The contraceptive prevalence rate has contributed to the decline in fertility in Indonesia. The fertility level in Indonesia has undergone a notable decline in the past 25 years, from 5.6 births per woman in the 1960s to 2.9 births in the early 1990s. A particularly encouraging development reported by the 1994 IDHS is the rapid expansion of self- reliant family planning (KB Mandiri) over the past seven years. The percentage of clients acquiring family planning services through private sector outlets has increased from 11 percent in 1987 to 51 percent in 1994. As expected, the role of private midwives has grown rapidly. For example, 38 percent of injection users obtain their method from private midwives. Facilitating the practice of family planning at younger ages and promoting greater use of effective contraception to older women, which have been done before, will continue to be program priorities in the coming years. In addition, improving reproductive health status, further promoting family planning, and ensuring safer contraceptive practices through improvement of quality of care in family planning will be essential ingredients in the future expansion of Indonesia's family planning movement. However, beyond the need to recruit more family planning acceptors and promote greater use effectiveness, there is need to develop program strategies that enhance the welfare of mothers and children in the family and to promote greater economic opportunities for families. In conclusion, I would like to thank the Central Bureau of Statistics, Macro International Inc. in Maryland (USA), the IDHS Steering Committee and IDHS Technical Committee, and Office of Program Development at the NFPCB for their efforts in conducting the 1994 IDHS. In addition, USAID and the World Bank made substantial financial and technical contributions that helped ensure the ultimate success of this important undertaking. The high quality of the IDHS final country report is indicative of the professional manner in which this project was designed and implemented. State Ministry of Population/ National Family Planning Coordinating Board Prof. Dr. Haryono Suyono State Minister/Chairman xxi PREFACE The Broad Guidelines of the State Policy 1993 stated that in the Second Long-term Development Plan covering the 15-year period between 1994 and 2019, health development is focused in enhancing the quality of human resources, and improving community awareness on the importance of healthy living. The goal is to provide improved quality and distribution health services to build strong, healthy, intelligent and productive human beings. To monitor and evaluate the achievement of health development, reliable data are needed. These data can be obtained from service administration (service-based data) and collected directly from the community (community-based data). The two types of data complement each other in supporting the health information. Efforts to obtain data from the community which reflect the health situation in a certain period of time have been carried out through various surveys including the Household Health Surveys, the National Socio- Economic Surveys, and the Demographic and Health Survey. The result of the 1994 Indonesia Demographic and Health Survey (IDHS) showed that the family planning programs have been successful in reducing fertility. The survey also found that maternal and child health (MCH) programs have been improved; antenatal care coverage including tetanus toxoid immunization among pregnant mothers has increased. Infant and child mortality continues to decline, although maternal mortality remains high. The survey also showed that 38 percent of the respondents have ever heard about AIDS, but most of them did not know the means of prevention, transmission and whether this disease is curable. The findings of the 1994 IDHS together with other national surveys are very important in measuring the achievement of family planning and health programs. Information obtained from the 1994 IDHS can be used to review the progress of the Fifth Five-Year Development Plan (1989/90-1993/94), and to improve future health policies and programs, Based on the above-mentioned considerations, the results of the 1994 IDHS should be disseminated to decision makers at different levels of health management; in the central offices as well as local governments, and to the community at large. We would like to take this opportunity to thank the Demographic and Health Surveys (DHS) Program of Macro International, USAID, the World Bank, the Central Bureau of Statistics, the National Family Planning Coordinating Board, and all other parties who assisted in the implementation the 1994 DHS. We hope that the survey results are useful in developing health programs. Minister of Health Republic of Indonesia Prof. Dr. Sujudi xxiii SUMMARY OF FINDINGS The 1994 Indonesia Demographic and Health Survey (IDHS) is a nationally representative survey conducted between July and November 1994. This survey is the third survey in Indonesia carried out under the Demographic and Health Surveys project; the first two were conducted in 1987 and 1991. As in previous surveys, the main purpose of the survey was to provide policymakers and program managers in population and health with detailed information on fertility, infant and child mortality, family planning, and maternal and child health. For the first time, the IDHS also collected information on maternal mortality, knowledge of AIDS, and the availability of family planning and health services. The 1994 IDHS was carried out as a collaboration between the Central Bureau of Statistics, the State Ministry for Population/National Family Planning Coordinating Board, and the Ministry of Health. The DHS project of Macro International provided technical and financial assistance under a contract with the U.S. Agency for International Development (USAID). Most of the local costs for the survey were received from the World Bank, the Government of Indonesia, and USAID/Jakarta. A total of 33,738 households and 28,168 ever-married women age 15-49 were interviewed. Findings from the survey are presented at the national, regional, and provincial level, and by urban and rural residence. The results indicate that the majority of Indonesian women have had some formal education (84 percent), and 52 percent completed primary or higher education. More than half of respondents worked in the 12 months prior the survey. Fertility has been declining in Indonesia for more than two decades--from 5.6 births per woman in the period 1967-70 to 2.9 births per woman in 1991-94. The decline in fertility accelerated in the late 1970s and early 1980s, and then slowed. The total fertility rate (TFR) in Java-Bali is 2.6 births per woman, while in the Outer Java-Bali regions it is 3.3. In some provinces, fertility has reached, or is approaching, replace- ment level; these include: DKI Jakarta, DI Yogyakarta, East Java, Bali, South Kalimantan, and Central Kalimantan. Overall, women are beginning childbearing at older ages. More Indonesian women are staying single, and among those who marry, age at first marriage is increasing. The median age at first marriage for women 45-49 is 17.2, compared with 19.2 for women 25-29. Women in Java-Bali marry two years earlier than women in the Outer Java-Bali regions, while women with some secondary education marry more than five years later than women who have no education. Knowledge of family planning methods and sources for methods is virtually universal (96 percent), and almost all women know at least one modem method. There have been substantial increases in knowledge of Norplant, male sterilization, and female sterilization. Fifty-five percent of currently married women use a method of family planning and 95 percent of them use modem methods. The pill, injection, and the IUD are the most commonly used methods. Contraceptive use increases with level of education; 40 percent of married women with no education use a method, compared with 63 percent of women with secondary or higher education. Government facilities are the most important source for family planning methods, supplying 49 percent of modern contraceptive users. Other family planning sources include medical private sources (28 percent), and other private sources (23 percent). Among the medical private sources, midwives are the most popular, and among other private sources, health posts (posyandu) are the primary source for family planning services. Two-thirds of contraceptive users who obtained a family planning method from a government source paid for the method. The proportion of users who pay for their method is highest among users of injection, pill, and condoms. XXV Twenty-seven percent of family planning users discontinue using a method within 12 months of starting. The highest discontinuation rates are among users of condoms (51 percent), withdrawal (36 percent), the pill (34 percent) and periodic abstinence (32 percent). More than half of married women in Indonesia say that they want no more children or have been sterilized. Younger women are more likely to want to have another child soon or to space their children, while older women tend to want to stop childbearing. The ideal number of children expressed by Indonesian women declined from 3.1 children in 1991 to 2.9 children in 1994, indicating a desire for smaller families. If all unwanted births could be avoided, the total fertility rate in Indonesia would be around 2.4 births per woman instead of 2.9. In the fifteen years preceding the survey, infant mortality declined from 75 to 57 deaths per 1,000 live births. For children under five years, the mortality rate was 81 deaths per 1,000 live births. Infant mortality is lowest for children of mothers who received both antenatal care and assistance at delivery from medical professionals, and highest for children whose mothers had neither antenatal care nor medical assistance at delivery (39 and 107 deaths per 1,000 live births, respectively). Four of five births in the five years preceding the survey were to mothers who received antenatal care from a doctor or midwife. The proportion of children whose mothers received no antenatal care is high among high-order births, rural births, and births to mothers who have no education. Neonatal tetanus is a major cause of death among infants in Indonesia. The Ministry of Health recommends that women receive two tetanus toxoid injections before marriage, and a booster during each succeeding pregnancy. Overall, 49 percent of children born in the five years preceding the survey were to mothers who received two or more tetanus toxoid injections during pregnancy. The proportion of live births not protected against tetanus is lower in urban than rural areas, and in the Java-Bali region than outside Java- Bali. Tetanus coverage is higher among low-order births, and births to mothers with secondary education. Although lower than in 1991, the proportion of infants delivered at home remains high (77 percent). Mothers with no education are twice as likely to deliver at home as those who have some secondary educa- tion, and rural births are twice as likely to be delivered at home as births in urban areas. In Indonesia, breastfeeding is not only universal, but of relatively long duration. The median duration of breastfeeding is 23.8 months; however, supplementary feeding begins early. Four in ten infants under two months receive supplements in addition to breast milk. Based on information from health cards and mothers' reports, half of children 12-23 months have received immunizations against the six major childhood diseases: diphtheria, pertussis, tetanus, polio, measles, and tuberculosis. Vaccination coverage is higher' among low birth-order children, urban children, and children whose mothers have more education. During the two weeks preceding the survey, 10 percent of children under five had symptoms of acute lower respiratory infection, shown by cough accompanied with rapid breathing. Sixty-three percent of these children were taken to a health facility for treatment. Over the same period, 12 percent of children under five suffered from diarrhea, 53 percent of whom were taken to a health facility. Among children who had diarrhea, 45 percent were given oral rehydration therapy by means of solution prepared from ORS packets. Knowledge of ORS packets is almost universal among mothers with children under five. xxvi During the two weeks preceding the survey, 28 percent of children under five had fever, and 7 percent had fever (only) unaccompanied by cough, rapid breathing, or diarrhea. Among children who had fever only, 45 percent were taken to a health facility. Thirty-eight percent of ever-married women report that they have heard of AIDS. Among these, 21 percent say that there is no way to avoid getting the disease, 62 percent believe there is no cure for AIDS, and 71 percent say that they are not at risk of getting AIDS. A large majority of women who know of AIDS also know about condoms. In the 1994 IDHS, information necessary for estimating the level of maternal mortality was collected. Based on information about respondents' siblings, the maternal mortality ratio is estimated to be 390 deaths per 100,000 live births for the period 1989-94. The 1994 IDHS also collected information about health and family planning services available to women and children in the sampled clusters. The information was collected in two stages. In the first stage, an interview was held with knowledgeable residents. In the second stage, IDHS interviewers visited selected types of facilities, namely general hospitals, health centers, private doctors, private midwives, and pharma- cies. Combined, these types of facilities are the main suppliers of modern contraceptives and the major out- lets for maternal and child health services. Hereafter, these facilities are referred to as principal family plan- ning/maternal and child health (FP/MCH) outlets. Interviewers visited the nearest of each type of principal FP/MCH outlet if it was located within 10 kilometers of the cluster in urban areas and 30 kilometers in rural areas. Three in four currently married women live within 5 kilometers of a principal FP/MCH outlet offering contraceptive methods, and about 5 percent of married women have to travel 15 kilometers or more to a prin- cipal FP/MCH outlet. Overall, women are about 15 minutes from the nearest principal FP/MCH outlet pro- viding contraceptive methods. Almost no women live in an area where none of the MCH components included in the survey--antenatal care, tetanus toxoid ('IT) injection for pregnant women, delivery assistance, postnatal care, child growth monitoring, and child immunization--are available. xxvii X %, WEST MALAYSIA 7 PROVINCES 1. Dista Aceh 2. North Sumatra 3. West Sumatra 4. Riau 5. Jambi 6. South Sumatra 7. Bengkulu 8. Lampung 9. DKI Jakarta INDONESIA SINGAPORE ,j° 9 MALAYSIA I ~ \ • ~ ° I,~. ° . ,9 /'~ 10. West Java 11. Central Java 12. DI Yogyakarta 13. East Java 14. Bali 15. West Nusa Tenggara 16. East Nusa Tenggara 17. West Kalimantan 18. Central Kalimantan 19. South Kalimantan 20. East Kalimantan 21. North Sulawesi 22. Central Sulawesi 23. South Sulawesi 24. Southeast Sulawesi 25. Maluku 26. Irian Jaya 27. East Timor 16 ~,~27 CHAPTER1 INTRODUCTION 1.1 Geography, History and Economy The Republic of Indonesia, which consists of approximately 17,000 islands, is located between 6 degrees north and 11 degrees south latitude, and from 95 to 141 degrees east longitude. The Indonesian archipelago lies between Asia and Australia. It is bounded by the South China Sea in the north, the Pacific Ocean in the north and east, and the Indian Ocean in the south and west. There are five major islands: Sumatra in the west; Java in the south; Kalimantan straddling the equator; Sulawesi, which resembles the letter "K"; and Irian Jaya bordering Papua New Guinea on the west. Two remaining groups of islands are Maluku and Nusa Tenggara, running from Sulawesi to Irian Jaya in the north, and from Bali to Timor in the south. Other islands are small and mostly uninhabited. More than 80 percent of Indonesia's territory is covered with water; the land area is about 1.9 million square kilometers. The large number of islands and their dispersion over a wide area result in a diverse culture and hundreds of ethnic groups, each with its own language. This is the basis of the national motto "Unity in Diversity." Indonesia's climate is tropical with two seasons. The dry season extends from May to October, and the rainy season from November to April. Indonesia is divided administratively into 27 provinces. Each province consists of regencies and municipalities. Altogether, there are 243 regencies and 60 municipalities. The next lower administrative unit is the subdistrict, then the village. Classification of urban and mral areas is made at the village level. In 1993, there were 3,879 subdistricts, 7,585 urban villages, and 58,097 rural villages. Since proclaiming its independence in 1945, Indonesia has experienced several political shifts. In 1948, a rebellion by the Communist Party took place in Madiun. Up until the end of 1949, when the Dutch gave up control over Indonesia, there were disputes against the ruling democratic republic. Some factions, supported by the Dutch, formed the Federation of Indonesian Republics, which lasted less than one year. From 1950 to 1959, Indonesia faced several political problems, including the adoption of a multi-party system, which resulted in political and economic instability, and rebellions caused by ideological, ethnic and racial differences. The history of the Republic of Indonesia had a turning point after an aborted coup by the Communist Party in September 1965. In 1966, President Suharto began a new era with the establishment of the New Order Government, which is oriented toward overall development. After almost 30 years under the New Order Government, Indonesia has made substantial progress, particularly in stabilizing political and economic conditions. A period of great economic growth was experi- enced from 1968 to 1986, when per capita income increased sharply from about US $50 to US $385. This was primarily the result of the international oil boom in the early 1980s, from which more than 60 percent of the country's foreign exchange came. The drop in the price of crude oil and natural gas in 1985 forced the government to look for alternative sources of income, such as manufacturing, international trade, and service industries. This effort has been successful. In recent years, per capita income has increased to around US $842 in 1993. During the same period, the contribution of commodity exports other than crude oil to the total foreign exchange increased from 61 percent in 1988 to 89 percent in 1993. An important achievement of the Indonesian government is the improvement of the general welfare of the population by ensuring the availability of adequate food, clothing and housing, as well as providing adequate education and health services. Data from the 1971 and 1990 Population Censuses and the 1993 National Socio-Economic Survey (Susenas) show that in the last 23 years Indonesia has undergone a major improvement in the area of education. The percentage of persons age 10 years and over who are literate increased from 61 percent in 1971 to 84 percent in 1990 and to 86 percent in 1993. The improvement in education is most visible among females. Whereas school attendance among children 7 to 12 years in 1971 was 62 percent for males and 58 percent for females, the corresponding rate for both in 1993 was 93 percent. During the same period, the percentage of persons who never attended school decreased as the percentage of graduates at all levels increased. The percentage of primary school graduates increased from 20 percent in 1971 to 30 percent in 1990 to 31 percent in 1993, while persons who attended junior high school or higher education increased from 7 percent in 1971 to 22 percent in 1990 and to 24 percent in 1993. At all levels, the increase in education among females has been greater than the increase among males. One possible effect of more girls staying in school longer is the rise in the average age at first marriage. The singulate mean age at first marriage increased from 19.6 years in 1971 to 21.4 years in 1991); the increase was greater in urban areas than in rural areas. The increasing level of education has also provided women with greater opportunity for participation in the labor force. Labor force participation among women age 10 and over increased from 33 percent in 1971 to 45 percent in 1993. Most women work in agriculture, trade, or the service industries. It is expected tht the trend toward greater work force participation by women will continue. 1.2 Population According to the 1990 Population Census, the population of Indonesia was 179.4 million in 1990, and was projected to increase to 189.1 million in 1993. This would make Indonesia the fourth most populous country in the world after the People's Republic of China, India, and the United States. An estimated 55.4 million persons (31 percent of the population) were living in urban areas in 1990, compared with 64.4 million (34 percent of the population) in 1993. In addition to an already large population, Indonesia has a high rate of population growth. However, this rate has declined in the last two decades. Between 1971 and 1980, the average annual rate of population growth was 2.3 percent, compared with 2.0 percent between 1980 and 1990. The population growth rate was projected to decline further, to 1.8 percent, between 1990 and 1993. The decline in the growth rate occurred in all the islands except Kalimantan, where it increased from 3.0 in the period 1971-80 to 3.1 percent in the period 1980-90. The rate of growth among the islands and provinces varies significantly. For exarnple, in the period 1980-90, the growth rate in Java was 1.7 percent, while in Sumatra and Sulawesi the corresponding rates were 2.7 percent and 1.9 percent, respectively. In the same period, among the provinces of Java, DKI Jakarta and West Java showed the fastest growth (greater than 2 percent) and DI Yogyakarta the slowest (0.4 percent per annum). In the recent past, DKI Jakarta showed the greatest decline in growth rate, partly because a large number of people moved from DKI Jakarta to West Java to occupy new housing built in the areas of West Java surrounding Jakarta. Another characteristic of Indonesia is the uneven distribution of the population among the islands and provinces. The 1990 Population Census indicates that the population density varies across regions, not only among islands, but also among provinces of the same island. Java, which covers only 7 percent of the total area of Indonesia, is inhabited by 60 percent of the country' s population, making the population density of Java (814 persons per square kilometer) higher than that of other islands. By comparison, Kalimantan has a density of 17 persons per square kilometer. Comparison of provinces in Java shows that population density ranges from 12,500 persons per square kilometer in DKI Jakarta to 678 persons per square kilometer in East Java. Population density at the national level was 93 persons per square kilometer in 1990; in 1993 it was projected to be 99 persons per square kilometer. 2 Table 1.1 presents the basic demographic indicators derived from several sources, i.e., the 1971, 1980, and 1990 Population Censuses, the 1985 Intercensal Population Survey, and the population projection for 1993. The first three indicators that pertain to population distribution have been discussed. The census and survey data show that Indonesia's fertility has declined significantly since the 1970s. The crude birth rate (CBR), which was estimated at 41 births per 1,000 population in the late 1960s, declined to 36 per 1,000 in the period 1976-79, resulting in an annual percentage decline of 1.3 percent. In the period 1986-89, the CBR declined further to 28 births per 1,000 population, with an average annual rate of decline of 2.1 percent between the periods 1976-79 and 1986-89. These figures suggest a more rapid decline in fertility in recent years. The 1993 CBR was projected to be 25 births per 1,000 population. Table 1.1 also shows that the total fertility rate (TFR) declined from 5.6 children per woman in the period 1967-70, to 4.7 children in 1976-79, and to 3.3 children in 1986-89. The average annual decline between the periods 1967-70 and 1976-79 was 1.8 percent; between the periods 1976-79 and 1986-89 it was 2.9 percent. The TFR was projected to be 2.9 children per woman in 1993. Table 1.1 Basic demographic indicators Demographic indicators from selected sources, Indonesia 1971 - 1993 1985 1971 1980 lntercensal 1990 1993 Index Census Census survey Census pr~ection ~ Population (millions) 119.2 147.5 164.6 179.4 189.1 Growth rate (GR) z (percent) 2.10 2.32 2.22 1.98 1.76 Density (pop/kin 2) 62.4 77.0 85.0 93.0 98.5 Percent urban 17.3 22.3 26.2 30.9 34.0 Reference period 1967-70 1976-79 1981-84 1986-89 1993 Crude birth rate (CBR) 3 40.6 35.5 32.0 27.9 24.5 Crude death rate (CDR) 4 19.1 13.1 11.4 8.9 7.9 Total fertility rate (TFR) 5 5.6 4.7 4.1 3.3 2.9 Infant mortality rate 6 (per 1,000 births) 142 112 71 70 58 Life expectancy 6 Male 45.0 50.9 57.9 57.9 60.8 Female 48.0 54.0 61.5 61.5 64.5 I Projected based on 1990 Population Census 2 Calculated using compound interest formula 3 Births per 1,000 population; estimated using the 4 Deaths per 1,000 population; CDR = CBR - GR 5 Estimated based on own children method 6 Estimated using indirect estimation techniques formula CBR = 9.48968 + 5.55 TFR Source: Central Bureau of Statistics, 1987a; 1987b; 1992; 1993a; Central Bureau of Statistics et al., 1989 The same data sources also demonstrate that there has been a significant decline in the level of mortality. An important achievement of the first long-term development plan (LTDP) (1969-70to 1993-94) was the reduction of infant and child mortality through integrated health and family planning services. The infant mortality rate (IMR) declined from 142 deaths per 1,000 live births in 1971, to 112 per 1,000 in 1980, to 70 per 1,000 in 1990, showing an average annual rate of decline of 2.7 percent. The 1MR was projected to reach 58 deaths per 1,000 live births in 1993. During the same period, the crude death rate (CDR) decreased from 19 deaths per 1,000 population in 1971 to 9 per 1,000 in 1990, resulting in an average annual rate of decline of 2.8 percent. The CDR was projected to be 8 deaths per 1,000 population in 1993. 1.3 Population and Family Planning Policies and Programs The Government of Indonesia has devoted many of its development programs to population-related issues since President Suharto joined other Heads of State in signing the Declaration of the World Leaders in 1967. In this declaration, rapid population growth was considered an obstacle to economic development. In order to carry out its population policy, the government has launched several programs, of which family planning is an important part. Family planning activities were initiated in Indonesia in 1957 by a private organization working under the auspices of the International Planned Parenthood Federation. It provided family planning advice and services, as well as maternal and child care. In 1968, the government established a National Family Planning Institute, which was reorganized as the National Family Planning Coordinating Board (NFPCB) two years later. NFPCB is a non-departmental body and the Chairman reports directly to the President. The government of Indonesia has a strong commitment to filmily planning and is working with religious and community leaders to develop programs to promote family planning. Family planning programs were not initiated simultaneously throughout the country. In the first five- year development plan (Repelita), which covered the period 1969-70 to 1973-74, programs began in the six provinces of Java and Bali. In the next five-year plan, the program was expanded to the provinces of Dista Aceh, North Sumatra, West Sumatra, South Sumatra, Lampung, West Nusa Tenggara, West Kalimantan, South Kalimantan, North Sulawesi, and South Sulawesi. In the development of family planning programs, these provinces are classified as the Outer Java-B ali I Region. In the third Repelita, the programs were further expanded to include the remaining 11 provinces, which are grouped as the Outer Java-Bali II Region. Twenty years later, the population policy not only is contributing significantly to the reduction of the fertility rate but is also helping to improve family welfare. Furthermore, as stated in the Broad Guidelines for State Policy in 1988, the objectives of the National Family Planning Program include improving the quality of human resources by promoting a small, happy and prosperous family as the norm. As a result, the implementation strategy of the family planning program has four dimensions: the extension of program coverage, the maintenance of the family planning program, the institutionalization and cultivation of the family planning program, and the integration of the family planning program with various other national development programs. Program extension is aimed at increasing the need and desirability of family planning. The main efforts include intensive information, education and communication (IEC) activities and supplying and resupplying contraceptives throughout the country. The latter activity is focused on people who live in remote areas, slum areas, new housing developments, and transmigration areas. Program extension is carried out by persuading eligible young couples who have a small number of children to adopt family planning. 4 Program maintenance involves stabilizing the acceptance of family planning, and improving the quality of contraceptives and services. It also encourages family planning acceptors to use more effective contraceptives, for better protection against pregnancy. Program maintenance is implemented by expanding the involvement of people and institutions, sustaining their commitment and ensuring good coordination. Program institutionalization is achieved by the acceptance of the small family norm and by greater participation of other government agencies, non-government organizations, and the private sector in managing the program. To support this effort, participation by all groups of society, including professional organizations, social leaders and business organizations, is required. Through the institutionalization process, self-reliance in the use of family planning is achieved, not only from an economic point of view, but individu- ally and psychologically as well. Program integration is aimed at strengthening and extending the institutionalization and maintenance of the program. Policies and strategies have been integrated with other intersectoral development programs and implemented and integrated into existing social mechanisms. The integrated program services cover the improvement of maternal and child welfare, increasing the acceptor's family income, providing long-term security to family planning acceptors, and encouraging individual participation in community development. Program emphasis has been shifted toward the establishment of a family planning movement. Based on past progress and in anticipation of future challenges, Act Number 10 was passed by the Government of Indonesia in 1992. This Act, which is concerned with population development, broadens family planning goals from spacing births to the creation of prosperous and happy families. The Broad Guidelines Act Number 10/1992 and State Policy 1993 expand the goals of the family planning program to include increasing emphasis on delaying marriage, using birth control methods, fostering family resilience, and improving family welfare. 1.4 Health Priorities and Programs The Indonesian government has always considered health development to be an integral part of human resource development, with the goal of achieving an advanced and self-reliant nation. The aim of health development is to build healthy, bright, productive human beings. Programs should be carried out throughout the entire life cycle, starting with pregnancy or earlier, e.g., by tending to the welfare of women who will become mothers, and proceeding with youth, adolescence, people of productive age, and ultimately the elderly. A Long-term Health Development Plan was set up which covered the 25-year period between 1969 and 1994 and consisted of five 5-year plans. Specific objectives of the Fifth Five-Year Development Plan (1989-90 to 1993-94) were directed towards achieving the following: • Improved quality and distribution of health services, especially for remote areas • Improved efficiency in resource utilization (funds, manpower and facilities) Enhanced health services, with special emphasis on lowering the mortality rates for infants, children under five and mothers through reducing morbidity rates and improving nutritional status Improved environmental health to promote a healthy outlook and behavior for individuals and families • Improved nutritional status based on family and community efforts Improved distribution of affordable drugs and health equipment Reduced fertility rate by institutionalizing the norm of a small, happy and harmonious family. (This objective will be carried out through the family planning and maternal and child health services of the Integrated Health Service Posts and the Health Centres) Improved access to and management of quality medical and public health services • Improved physical well-being of the population, especially those of productive age. The Broad Guidelines of the State Policy 1993 stated that in the Second Long-term Development Plan health development should be aimed at the following: Enhancing the status of community health Improving the quality, accessibility, and affordability of health services at all levels of the community Improving nutritional status • Practicing a clean, healthy life, supported by development of decent housing and communi- ties. In the Sixth Five-Year Development Plan, the first phase of the health development is aimed at: • Further improving the quality, accessibility and affordability of health services, including improved nutrition Decreasing maternal and infant mortality • Encouraging active community participation, including the private sector, in health development • Promoting community awareness for a healthy and clean life • Fostering concern about the environment, supported by adequate and capable manpower, including the development of pharmaceutical and health equipment industries. 1,5 Object ives of the Survey The 1994 Indonesia Demographic and Health Survey (IDHS) is a follow-on project to the 1987 National Indonesia Contraceptive Prevalence Survey (NICPS) and to the 1991 IDHS. The 1994 IDHS was significantly expanded from prior surveys to include two new modules in the women's questionnaire, namely maternal mortality and awareness of AIDS. The survey also investigated the availability of family planning and health services, which provides an opportunity for linking women's fertility, family planning ~md child health care with the availability of services. The 1994 IDHS also included a household expenditure module, which provides a means of identifying the household's economic status. All except the latter topic are discussed in this report. The 1994 IDHS was specifically designed to meet the following objectives: Provide data concerning fertility, family planning, maternal and child health, maternal mortality and awareness of AIDS that can be used by program managers, policymakers, and researchers to evaluate and improve existing programs; Provide data about availability of family planning and health services, thereby offering an opportunity for linking women's fertility, family planning and child-care behavior with the availability of services; Provide data on household expenditures, which can be used to identify the household's economic status; Provide data that can be used to analyze trends over time by examining many of the same fertility, mortality and health issues that were addressed in the earlier surveys (1987 NICPS and 1991 IDHS); Measure changes in fertility and contraceptive prevalence rates and at the same time study factors that affect the changes, such as marriage patterns, urban/rural residence, education, breastfeeding habits, and the availability of contraception; Measure the development and achievements of programs related to health policy, particularly those concerning the maternal and child health development program implemented through public health clinics in Indonesia. 1.6 Organization of the Survey The 1994 IDHS was implemented by the State Ministry of Population/National Family Planning Coordinating Board (NFPCB), the Ministry of Health (MOH) and the Central Bureau of Statistics (CBS). These organizations collaborated in the overall survey design, development of the questionnaire, and analysis and dissemination of the results. The NFPCB provided a large portion of the funds through a loan from the World Bank and grants from USAID/Jakarta, and also from the Government of Indonesia development budget. Macro International Inc. (Macro) furnished technical assistance as well as funds for the project through the Demographic and Health Surveys Program (DHS), a USAID-funded project providing support and technical assistance in the implementation of population and health surveys in developing countries. The CBS executed the survey, processed the data and was responsible for preparing the preliminary, final and summary reports. A survey Steering Committee was constituted, with senior representatives from the State Ministry of Population/NFPCB, CBS, MOH, the National Development Planning Board, and the Demographic Institute at the University of Indonesia. The Technical Team, consisting of members of the same organizations, met more frequently than the Steering Committee to discuss and decide on technical issues relating to the implementation of the survey. The directors of the regional statistical offices in the provinces were responsible for both the technical and the administrative aspects of the survey in their area. They were assisted by field coordinators, most of whom were chiefs of the population statistics sections in the regional office. The 1994 IDHS used four questionnaires--three at the household level and one at the community level. The three questionnaires administered at the household level are the household questionnaire, an indi- vidual questionnaire for women, and the household expenditure questionnaire. The household and individual questionnaires were based on the DHS Model "A" Questionnaire, which is designed for use in countries with high contraceptive prevalence. A deviation from the standard DHS practice is the exclusion of the anthro- pometric measurement of young children and their mothers. Topics covered in the 1994 IDHS that were not included in the 1991 IDHS are knowledge of AIDS and maternal mortality. Additions and modifications to the model questionnaire were made in order to provide detailed information specific to Indonesia. Except for the household expenditure module, the questionnaires were developed mainly in English and were trans- lated into Babasa Indonesia. The household expenditure schedule was adapted from the core Susenas ques- tionnaire model. Susenas is a national household survey carried out annually by BPS to collect data on vari- ous demographic and socioeconomic indicators of the potmlation. As in previous surveys, the household and individual data were collected by teams of interviewers. Altogether, 260 female interviewers, 86 male field supervisors, and 86 female field editors were recruited to form 86 interview teams. They were trained for 16 days in nine training centers in June 1994. The field supervisors and editors received additional training in supervisory tasks and editing techniques. One inter- viewer was appointed to collect data on family planning and health services in each subdistrict. In most cases, this person was the statistics officer at the subdistrict level (Mantri Statistik) and the interviewers for the household expenditure survey were temporary personnel (Mitra Statistik). The training for the inter- viewers for the service availability survey and the household expenditure survey was conducted separately by IDHS team supervisors. Training was usually conducted for a group of interviewers before the main sur- vey team arrived in a region. Data collection took place from July to November 1994. For more information about the fieldwork, see Appendix A. A list of the persons involved in the implementation of the survey is found in Appendix D. The survey questionnaires are reproduced in Appendix E. As in 1991, the 1994 IDHS was conducted in all 27 provinces in Indonesia. The sample was designed to produce estimates at the provincial level. Table 1.2 is a summary of the results of the fieldwork for the IDHS, from both the household and individual interviews by urban-rural resi- dence. In general, the response rates for both the household and individual interviews in the 1994 IDHS are relatively high. A total of 35,510 house- holds were selected for the survey, of which 34,060 were found. Of the encountered house- holds, 33,738 (99.1 percent) were successfully in- terviewed. In these households, 28,800 eligible women were identified and complete interviews were obtained from 28,168 women, or 97.8 per- cent of all eligible women. The generally high re- sponse rates for both household and individual in- terviews were due mainly to the strict enforcement of the role to revisit the originally selected house- hold if no one was at home initially. No substitu- tion for the originally selected households was al- lowed. Interviewers were instructed to make at least three visits in an effort to contact the house- hold or eligible woman. Table 1.2 Results of the household and individual interviews Number of households, number of interviews and response rates, according to urban-rural residence, Indonesia 1994 Residence Result Urban Rural Total Household interviews Households sampled 10,401 25,109 35,510 Households found 9,895 24,165 34,060 Households interviewed 9,730 24,008 33,738 Household response rate 98.3 99.4 99.1 Individual interviews Eligible women 8,111 20,689 28,800 Interviewed women 7,947 20,221 28,168 Eligible woman response rate 98,0 97.7 97.8 8 CHAPTER2 BACKGROUND CHARACTERISTICS OF HOUSEHOLDS AND RESPONDENTS The main objective of this chapter is to describe the general characteristics of the sample population, which include age and sex composition, residence, education, housing facilities, and presence of durable goods. This information is not only useful by itself, but can also be used to evaluate the quality of the 1994 IDHS data and to investigate changes in social and economic conditions over time. Data in this chapter will be presented for households, persons within households, and women eligible for the individual interview. The other objective of this chapter is to describe the environment in which the respondents (ever-married women 15-49) and their children live. Factors believed to influence nuptiality, fertility, and contraceptive behavior, as well as maternal care and child morbidity and mortality, are discussed. 2.1 Population by Age and Sex The household questionnaire in the 1994 IDHS was used to list all household members, i.e., persons who usually live in the household. Information was obtained from an adult who was familiar with the charac- teristics of the other household members. In addition to providing a background against which various demo- graphic processes are occurring, the age structure of the population incorporates the past history of the popu- lation. The reliability of the population's age data depends on the reporting of birth dates. For persons whose year of birth was not known, age was obtained directly from the stated age. As shown in Figure 2.1, there is a preference for certain ages, particularly those ending in 0 or 5. Errors are more obvious among the Figure 2.1 Number of Persons Reported at Each Age by Sex Number of Persons 20o0 1500 1000 5O0 0 i i , i i 0 5 10 15 20 25 30 i i ~ i i i i 35 40 45 50 55 60 65 70 Age 1994 IDHS population age 20 and over, partly because younger people tend to have more education than older people and are more likely to know their date of birth. To obtain the most accurate age reporting for respondents, the 1994 IDHS interviewers were instructed to (1) ask for legal documents or identity cards, (2) relate the respondent's age to the age of another household member whose age was known or to a household event whose date had been ascertained, or (3) relate the respondent's age to local or national events well known in the area. A chart used to convert reported dates from the Javanese, Sundanese and Muslim calendars to the Gregorian calendar was appended to the interviewers' manual. The Javanese and Sundanese calendars are actually the same as the Muslim calendar except for the names of the months. Table 2.1 and Figure 2.2 present the age distribution of the population by five-year age groups according to sex. Age composition is affected by past levels of fertility, mortality and migration. The popu- lation pyramid has a narrow top and a wide base, reflecting a pattern typical of countries with relatively high fertility in the past. The narrowing at the base was brought about by a decline in fertility in the last decade. Table 2.1 Household population by age T residence and sex Percent distribution of the de jure household population by five-year age groups, according to urban-rural residence and sex, Indonesia 1994 Urban Rural Total Age group Male Female Total Male Female Total Male Female Total 0-4 9.9 9.5 9.7 11.5 109 I 1,2 11.1 10.4 10.7 5-9 10.3 10.1 10.2 12.9 117 12.3 12.1 11.2 11.6 10-14 12.7 10.9 11.8 13.7 12~5 13.1 13.4 12,0 12.7 15-19 I 1.6 12.4 12.0 9.5 9 2 9.4 10.2 10.2 10.2 20-24 10.2 10.2 10.2 6.8 81 7.4 7.8 8.7 8.3 25-29 8.5 9.7 9.1 7.0 78 7.4 7.5 8.4 7.9 30-34 8.0 8.1 8.0 7.3 7.8 7.6 7.5 7.9 7.7 35-39 6.9 6.7 6.8 6.6 67 6.6 6.7 6.7 6.7 40-~ 5.6 5.0 5.3 5.8 51 5.4 5.7 5.0 5.4 45-49 3.9 4.0 3.9 4.0 4.2 4.1 3.9 4.1 4.0 50-54 3.9 4.0 4.0 4.1 44 4.3 4.0 4.3 4.2 55-59 2.7 2.7 2.7 3.0 34 3.2 2.9 3.2 3.0 60-64 2.3 2.7 2.5 3.0 32 3.1 2.8 3.0 2.9 65-69 1.4 2.0 1.7 1.9 20 1.9 1.7 2.0 1.9 70-74 1.4 I.I 1.2 1.7 16 1.6 1.6 1.4 1.5 75-79 0.4 0.5 0.5 0.5 07 0.6 0.5 0.7 0.6 80+ 0.3 0.5 0.4 0,8 07 0.7 0.6 0.7 0.6 Total 100.0 100.0 100.0 100.0 100~0 100.0 100.0 100.0 100.0 Number 23,230 23,441 46,671 51,963 52,216 104,179 75,193 75,657 150,850 10 Age 80+ 75 70 65 6O 55 50 45 40 35 3O 25 20 15 10 5 0 Figure 2.2 Distribution of the Household Population by Age 7 6 5 4 3 2 1 0 1 2 3 4 5 6 7 Percent 1994 IDHS 2.2 Population by Age from Selected Sources The percent distribution of the 1994 IDHS sample population by age group is presented in Table 2.2, along with comparable data from the 1980 Census, the 1985 Intercensal Population Survey (SUPAS), the 1987 National Indonesia Contraceptive Prevalence Survey (NICPS), and the 1991 IDHS. The percentage of the population under 15 years has decreased over time from 41 percent in 1980 to 35 percent in 1994. During the same period, the percentage of the population age 15-64 increased from 56 percent in 1980 to 60 percent in 1994. The dependency ratio, calculated as the ratio of nonproductive persons (under 15 and 65 and over) to persons 15-64 based on these figures, has been decreasing gradually from 79 percent in 1980 Table 2.2 Population by age from selected sources Percent distribution of the population by age group, according to selected sources, Indonesia 1994 1985 1980 Intercensal 1987 1991 1994 Age group Census survey N1CPS IDHS 1DHS <15 40.9 39.4 36.9 36.2 35.0 15-64 55.9 57.2 59.3 59.9 60.4 65+ 3.2 3.4 3.8 3.9 4.6 Total 100.0 100.0 1(30.0 100.0 100,0 Median age - - 21.5 22.8 Dependency ratio 78.9 73.1 68.6 67.2 65.8 11 to 66 percent in 1994. The smaller dependency ratio indicates a lessening of the economic burden on persons in the productive age groups, who support those in the nonproductive age groups. 2.3 Household Composition Table 2.3 presents information on the percent distribution of households by various characteristics, such as sex of the head of the household, size of the household, and presence of foster children. The size and composition of the household may affect the allocation of financial resources among household members, which in turn would affect the overall well-being of the members. Household size may be associated with crowding in the dwelling, which can lead to unfavorable health conditions. Single-parent families, especially if they are headed by females, usually have limited financial resources. As in the 1991 IDHS, 13 percent of households in the 1994 IDHS are headed by women. The propor- tion is slightly higher in urban than in rural areas (14 percent, compared with 13 percent). In general, seven in ten households have between 2 to 5 members. The average household size is 4.5 persons; 4.7 persons in urban areas, and 4.4 persons in rural areas. Seven percent of households include one or more children under age 15 who are living with neither their natural father nor their natural mother. Table 2.3 Household composition Percent distribution of households by sex of head of household, household size, and whether household includes foster children, according to urban-rural residence, Indonesia 1994 Characteristic Residence Urban Rural Total Household headship Male 86.5 87.5 87.2 Female 13.5 12.5 12.8 Total I00.0 100.0 100.0 Number of usual members I 7.3 4.8 5.5 2 8.3 11.2 10.3 3 15.5 19.2 18.1 4 19.4 22.1 21.3 5 18.3 17.9 18.0 6 12.9 11.2 11.7 7 8.0 6.6 7.0 8 4.8 3.6 4.0 9+ 5.4 3.4 4.0 Total 100.0 100.0 100.0 Mean size 4.7 4.4 4.5 Percent with foster children 5.8 7.0 6,6 Note: Table is based on de jure members, i.e., usual residents. 12 2.4 Fosterhood and Orphanhood Table 2.4. l presents the distribution of children under age 15 by survival status of parents and child's living arrangements, according to background characteristics. Nine of ten children are living with both parents, 6 percent live with the mother, 2 percent live with the father, and 5 percent live with neither parent. Except for age, there are no significant differentials in the living arrangements of children under age 15 by background characteristics. The proportion of children living with their parents declines as age of the child increases. There are no significant provincial differentials in fostering and orphanhood of children under 15; the overall pattern in Table 2.4.2 is almost identical to that shown in Table 2.4.1. Table2.4.1 Fosterhoodandorphanhood: background characteristics Percent distribution of de jure children under age 15 by survival status of parents and child's living arrangements, according to selected background characteristics, Indonesia 1994 Living Living with mother with father Not living with Missing/ but not father but not mother either parent Don't Living know if with Father Mother father/ Number Background both Father Father Mother Mother Both only only Both mother of characteristic parents alive dead alive dead alive alive alive dead alive Total children Age 0-2 929 4.5 0.7 0.3 0.2 0.9 0.1 0.1 0.0 0.3 100.0 9,662 3-5 90.1 3.4 1.9 0.6 0.5 2.5 0.4 0.3 0.2 0.3 100.0 9,490 6-8 87.2 3.4 2.6 0.9 0.9 3.7 0.4 0.3 0.3 0.3 100.0 10,885 9 11 83.6 2.8 4.1 0.8 1.2 5.2 1.0 0.5 0.4 0.6 100.0 11,397 12+ 81.1 2.9 5.0 0.8 1.6 5.6 0.7 0.7 0.7 1.0 100.0 11,482 Sex Male 86.7 3.4 3.2 0.7 0.8 3.5 0.6 0.4 0.3 0.5 100.0 27,440 Female 86.6 3.3 2.8 0.6 0.9 4.0 0.4 0.3 0.4 0.5 100.0 25,475 Residence Urban 88.0 3.3 2.5 0.9 0.5 3.5 0.2 0.3 0.3 0.6 100.0 14,793 Rural 86.1 3.4 3.2 0.6 1.0 3.8 0.6 0.4 0.4 0.5 100.0 38,122 Region/Residence Java Bali 85.9 3.7 3.0 0.9 0.7 4.0 0.6 0.4 0.3 0.5 100.0 30,614 Urban 87.9 3.6 2.6 1.0 0.4 3.4 0.3 0.2 0.2 0.6 100.0 10,281 Rural 84.9 3.8 3.2 0.9 0.9 4.3 0.7 0.5 0.3 0.5 100.0 20,333 Outer.lava Bali I 881 3.1 2.9 0.4 0.9 3.2 0.4 0.3 0.3 0.5 100.0 15,455 Urban 88.4 3.0 2.3 0.6 0.6 3.4 0.1 0.4 0.4 0.6 100.0 3,096 Rural 88.0 3.1 3.0 0.3 1.0 3.1 0.5 0.3 0.3 0.4 100.0 12,359 Outer ,lava-Bali 11 86.9 2.2 3.1 0.3 1.4 3.6 0.6 0.5 0.7 0.7 100.O 6,846 Urban 88.3 1.8 2.2 0A 0.7 4.4 0.4 0.5 0.7 0.7 100.0 1,415 Rural 86.5 2.3 3.3 0.3 1.6 3.4 0.6 0.5 0.7 0.7 100.0 5,431 Total 86.7 3.4 3.0 0.7 0.9 3.7 0.5 0.4 0.3 05 100.0 52,915 13 Table 2.4.2 Fosterhood and orphanhood: region and province Percent distribution of de jure children under age 15 by survival status of parents and chi ld's l iving arrangements, according to region and province, Indonesia 1994 Region and province Living Living with mother with father Not living with Missing/ but not father but not mother either parent Don't Living know if with Father Mother father/ Number both Father Father Mother Mother Both only only Both mother of parents alive dead alive dead alive alive alive dead alive Total children Java.Bali 85.9 3.7 3.1) 0.9 0.7 4.0 0.6 0.4 0.3 0.5 100.0 30,614 DKI Jakarta 90.8 2.8 2.1 0.6 0.5 1.8 0.2 0.1 0.2 0.9 1(30.0 1,937 West Java 86.3 3.8 3.2 0.8 0.8 3.3 0.6 0.3 0.4 0.5 100.0 10,946 Central Java 88.0 2.6 2.9 1.4 0.8 3.1 0.2 0.4 0.1 0.5 100.0 8,298 DI Yogyakarta 85.2 6.5 2.1 0.5 0.3 3.7 0.5 0.3 0.1 0.6 100.0 684 East Java 81.6 5.1 3.4 0.6 0.6 6.6 I.I 0.5 0.2 0.3 100.0 8,082 Bali 907 1.0 1.1 1.2 1.6 3.2 0.1 0.5 0.1 0.5 100.0 667 Outer Java-Bali I 88,1 3.1 2.9 0.4 0.9 3.2 0.4 0.3 0.3 0.5 100.0 15,455 Dista Aceh 87.8 2.7 3.2 0.2 1.5 2.6 0.8 0.8 02 0.2 100.0 1,134 North Sumatra 91.5 1.9 2.7 02 0.4 2.3 0.3 0.2 0.2 0.3 100.0 13,683 West Sumatra 84.1 6.0 3.1 04 0.7 4.0 0.7 0.1 0,2 0.6 100.0 1,147 South Sumatra 91.5 1.8 2.4 0,5 0.8 2.0 0.4 0.3 0.3 0.1 100.0 1,808 Lampung 914 2.0 2.5 02 0.5 2.6 0.2 0.0 0,2 0.4 100.0 1,820 West Nusa Tenggara 76.9 9.1 2.7 1.5 2.3 5.8 05 0.3 0.3 0.5 100.0 1,160 West Kalimantan 88.1 2.5 3.1 0.3 1.0 3.2 0.5 03 0,3 0.7 100.0 1,110 South Kalimantan 85.8 3.8 4.0 0.6 2.2 2.0 t1.4 0,4 0.7 0.1 100.0 715 North Sulawesi 85.9 2.2 2.7 0.6 1.3 3.9 0.5 0.5 0.8 1.5 100.0 614 South Sulawesi 864 2.9 3.2 0.2 0.7 4.7 0.4 0.4 0.5 0.7 100.0 2,264 Outer Java-Bal i I1 86.9 2.2 3.1 0.3 1.4 3.6 0,6 0.5 0.7 0.7 100.0 6,846 Riau 88.9 1.9 2.3 0.2 1.8 3.1 0,4 0.6 0.6 0.3 100.0 1,211 Jambi 91.8 0.8 3.5 0.0 0.4 0.9 0.2 0.1 0,6 1.7 100.0 675 Bcngkulu 90.1 2.3 2.7 02 0.9 3.0 0,5 0.1 0.2 0.1 100.0 406 East Nusa Tenggara 796 3.9 4.1 0.3 2.1 6.7 0.6 1.2 0.9 0.5 100.0 1,073 East Timor 869 0.8 3.1 0,4 0.7 5.1 09 0.4 1.2 0.6 100.0 335 Central Kalimantan 90.8 0.6 3.4 0.0 2.1 0.S 0.1 1) 0 1.0 1.4 100.0 466 East Kalimantan 91.2 2.3 1.4 0.3 0.5 2.7 0.7 0.2 0.1 0.5 100.0 590 Central Sulawesi 86,4 2.3 3.7 0.3 1.5 3.4 0.7 0.5 0.8 0.4 100.0 508 Southeast Sulawesi 86.4 3.7 2.3 0.2 1.9 2.6 0,4 0.4 0.7 1.4 100.0 449 Maluku 82.6 2.9 3.4 0.8 1.4 6.0 I, I 0.8 0.5 0.5 100.0 574 Irian Jaya 85.4 1.3 4.0 0.8 1.5 3.1 1,0 0.7 1.2 1.0 100.0 558 Total 86.7 3.4 30 0.7 0,9 3,7 0.5 0,4 0.3 0.5 100.0 5:2,915 2.5 Educational Level of Household Population Educational attainment is closely associated with other socioeconomic factors and demographic behavior such as income, lifestyle, reproductive behavior, use of contraception, health status of children, and housing conditions. Education is also a factor that influences the individual's worldview, and hence opens the mind to new ideas and technology. 14 Tables 2.5.1 and 2.5.2 indicate that among both men and women there are significant differences in level of education by background characteristics. Overall, men are slightly better educated than women: nine in ten men have had some schooling compared with eight in ten women. In addition, while 31 percent of men have had some secondary education, the corresponding figure for women is 24 percent. The proportion of men and women who have some primary schooling is almost the same, 38 and 36 percent, respectively, and the proportion of men and women who completed primary education is 20 percent and 18 percent, respec- tively. The gap in educational attainment is no longer visible among the youngest age cohort. Among boys and girls age 5-14, the median duration of schooling is very similar--l.2 and 1.3 years, respectively, for age 5-9, and 5.3 and 5.5 years, respectively, for age 10-14. These figures imply that, in recent years, girls have had as much opportunity as boys to pursue education. Table 2.5.1 Educational level of the household population by background characteristics: men Percent distribution of the de jure male household population age five and over by highest level of education attended, and median number of years of schooling, according to selected background characteristics, Indonesia 1994 Don't Median Background No Some Completed Some know/ years of characteristic education primary primary secondary+ missing Total Number schooling Age 5-9 26.5 72.8 0.0 0.2 0.4 1000 9,077 1.2 10-14 1.6 64.0 9.0 25.3 0.0 1130.0 10.053 5.3 15-19 1.3 15.3 26.3 57.1 0.0 100.0 7.638 9.0 20-24 1.5 12.6 28.4 57.5 0.0 1OO.0 5,874 10.2 25 29 4.1 17.6 27.8 50.5 0.0 100.0 5,637 8.1 30-34 7.3 27.5 26.3 38.8 0.1 I[X).0 5,676 7.6 35-39 8.5 30.7 28.1 32.7 0,1 100.0 5,019 7.4 40-44 10.2 31.9 28.9 29.0 0.0 100.0 4,304 7.3 45-49 13.5 31.1 27,6 27.6 0.1 100.0 2,964 7.2 50-54 17.2 33.5 252 23,8 0.3 100.0 3,036 6.0 55-59 24.2 38.1 17.4 20.3 0.1 100.0 2,187 3.8 60-64 33.7 39.7 16.4 10.0 02 100.0 2.085 3.1 65+ 42.8 35.4 14.3 7.2 0.4 100.0 3,323 2.1 Residence Urban 5.6 27.3 14.7 52.2 01 100.0 20,919 8.1 Rural 14.5 42.4 21.8 21.2 0.1 100.0 45,964 5.1 RegionllResidence Java-Bali 12.0 37.3 21.1 29.5 0.1 100.0 41,351 7.0 Urban 6.0 27.8 15.7 50.4 0.1 100.0 14,991 7.9 Rural 15.4 42.8 24.2 17.6 0.1 100.0 26,360 4.8 Outer Java-Bali 1 11.0 38.1 17.2 33.5 0.2 100,0 17,773 7.0 Urban 4.5 25.8 12.2 57.2 0.2 100.0 4,143 9.7 Rural 13.0 41.8 18.7 26,3 0.2 100.0 13,630 5.5 Outer Java-Bali 11 12.0 38.6 16.7 32.6 0.1 100.0 7,759 6.6 Urban 5.0 27.2 I 1.6 56.1 0.1 10£1.0 1,785 9.2 Rural 14.1 42.0 18,2 25.6 0.1 100.0 5.973 5.4 Total I 11.7 37.7 19.6 30.9 0.1 1000 66,883 70 i Includes cases with missing values on age. 15 Table 2.5.2 Educational level of the household population by background characteristics: women Percent distribution of the de jure female household population age five and over by highest level of education attended, and median number of years of schooling, according to selected background characteristics. Indonesia 1994 Don't Median Background No Some Completed Some know/ years of characteristic education primary primary secondary+ missing Total Number schooling Age 5-9 25,2 74,2 0.0 0,2 05 100.0 8,485 1.3 10-14 1.5 61,1 10,7 26.6 00 100.0 9,089 5.5 15-19 2.2 14.0 31.8 52.0 0.0 1000 7,716 8.3 20-24 4.3 15,5 33.6 46.5 0.1 100.0 6,603 7,9 25-29 9.9 26.4 26.7 36.9 0.0 100.0 6,343 7.5 30-34 15.0 35,2 26.1 23.7 0,0 100,0 5,960 6.8 35-39 20.4 37.1 22.0 20.4 0.1 100.0 5,052 5.0 40-44 22.1 37.5 22.4 18.1 0.0 100.0 3,813 4.7 45-49 32.8 32,4 17.6 172 00 100.0 3,136 3,5 50-54 489 28,1 12,1 10,6 03 1000 3.254 1.0 55-59 59.1 26.3 8.2 5.9 0.5 100.0 2,394 0.0 60-64 67.7 22.0 6.2 3.6 0.6 100.0 2,305 0.0 65+ 76,4 14.9 5,9 1,9 0,8 1000 3~586 0.0 Residence Urban 12.7 28.4 15.9 43.0 0.1 1000 21,216 75 Rural 25.3 40.0 19.3 15.1 02 100.0 46.540 38 Region/Residence Java-Bali 23.2 35.4 19.4 21.8 0.1 100.0 42,004 4.8 Urban 13,9 28,6 16.9 405 0.1 100.0 15,277 7.4 Rural 28,5 39,3 20.9 11.1 0.2 100.0 26,726 3.4 Outer Java-Bali 1 17.9 380 16.1 27,7 (13 1000 18.137 5.3 Urban 94 27,0 13,9 49,6 01 100,0 4,[76 7.9 Rural 205 41.3 16.8 21,2 03 100,0 13,961 4.5 Outer Java-Bali 11 19,5 377 16.9 258 02 It)00 7,615 5.1 Urban 10.0 29.6 11,8 485 01 100.0 1.762 7.8 Rural 22,4 401 184 189 02 100.0 5,853 4.4 Total I 21.4 36.3 18.3 23.8 112 1000 67,756 48 J Includes cases with missing values on age. Tables 2.5.1 and 2.5.2 also show that educational attainment is negatively associated with age; older persons are more likely to have no education or to stay in school for shorter periods. For example, the median duration of schooling among men age 50-54 years is 6 years, whereas for men age 20-24 the median is 10.2 years. The difference for females is even more striking: 0 years for females 50 years and over and 7.9 years for those 20 to 24. Urban residents are much more likely to attend school and stay in school than residents of rural areas. Only 6 percent of men in urban areas have never gone to school, while the proportion in rural areas is more than double (15 percent). For women, the corresponding figures are 13 percent in the urban areas and 25 percent in the rural areas. The urban-rural difference is more pronounced at the level of sec- ondary or higher education. The median years of schooling for urban men is 8.1 years compared with 5.1 years for rural men. Urban women spend 3.7 years longer in school than their rural counterparts (7.5 years and 3.8 years, respectively). 16 Tables 2.5.3 and 2.5.4 present the differentials in educational attainment by region and province for male and female populations, respectively. The median duration of schooling for males is longer than for females in all provinces. In general, males in Outer Java-Bali II attend school for a slightly shorter period than in other regions (see Table 2.5.3). Table 2.5.4 shows that for females, the median duration of schooling in Java-Bali is the shortest (4.5 years), while in Outer Java-Bali I it is the longest (5.3 years). Level of education varies between provinces in Java-Bali. For males and females, DKI Jakarta has the longest duration of schooling (10.3 years and 7.8 years, respectively), while East Java has the shortest (5.5 years for males and 3.6 years for females). Table 2.5.3 Educational level of the household population by region and province: men Percent distribution of the de jure male household population age five and over by highest level of education attended, and median number of years of schooling, according to region and province, Indonesia 1994 Don't Median Region and No Some Completed Some know/ years of province education primary primary secondary+ missing Total Number schooling Java-Bali 12.0 37.3 21.1 29.5 0.1 100.0 41,351 7.0 DKI Jakarta 3.8 21.1 14.0 61.1 0.0 100.0 2,970 10.3 West Java 11.0 40.9 21.5 26.5 0.1 100.0 12,982 6.0 Central Java 12.4 38.0 24.2 25.3 0.0 100.0 10,670 6.5 DI Yogyakarta 11.4 29.2 14.7 44.6 0.1 100.0 1,108 7.6 East Java 14.4 383 20.6 26.6 0.2 100.0 12,534 5.5 Bali 15.1 29.4 18.7 36.7 0.1 100.0 1,087 7.3 Outer Java-Bali 1 11.0 38.1 17.2 33.5 02 100.0 17,773 70 Dista Aceh 10.1 36.9 19.5 33.4 0.2 100.0 1,262 7.1 North Sumatra 5.5 35.9 15.1 43.1 0,3 100.0 3,815 7.5 West Sumatra 6.5 38.5 16,1 38.8 0.1 100.0 1,403 7.3 South Sumatra 9,4 38.3 22.2 30.0 0.1 100.0 2,173 7.1 Lampung 11.8 41.5 22.7 24.1 0.0 100.0 2,094 58 West Nusa Tenggara 20.9 39.6 13.9 25.4 0.2 1130.0 1,210 4.7 West Kalimantan 16.1 433 13.5 26.9 0.2 100.0 1,304 4.8 South Kalimantan 6.6 38.3 18.7 36.3 0.2 100.0 950 7.3 North Sulawesi 5.7 40.0 15.2 385 0.6 100.0 870 7.3 South Sulawesi 18.7 34.7 14.5 31.6 0.5 100.0 2,693 56 Outer Java-Bali I I 12.0 38.6 16,7 32,6 0.1 100.0 7.759 66 Riau 10.1 42.4 18,3 29.2 0.0 I000 1,382 5.6 Jambi 9.1 37.9 194 33.3 0.3 100.0 744 7.1 Bengkulu 8,3 42.3 148 34.6 0.0 100.0 466 6.7 East Nusa Tenggara 14,6 43.4 18.2 23.7 0.1 100.0 1,168 5.0 East Timor 386 34.8 3.8 22.5 0.3 100.0 309 2.5 Central Kalimantan 9.7 35.3 21.9 33.0 0.1 100.0 562 7.2 East Kalimantan 6.5 32.5 16.0 44.9 0 1 100.0 777 7.6 Central Sulawesi 8 1 37.7 18 8 35.3 0.1 100.0 609 7.2 Southeast Sulawesi 11.2 36.2 18.9 33.7 0.0 100.0 478 7. I Maluku 8.2 38.1 15.6 38.1 0.0 100.0 631 7.2 Irian Jaya 21.5 34.9 8.4 34.8 0.4 10~.0 634 5.2 Total I 1.7 37,7 19.6 30.9 0.1 100.0 66,883 70 17 In Outer Java-Bali I, for both males and females, West Nusa Tenggara shows the lowest median duration of schooling (4.7 years for males and 2.9 years for females). The highest median duration of schooling for males is in North Sumatra (7.5 years); for females it is in North Sulawesi (7.2 years). The range in median duration of schooling among provinces in Outer Java-Bali I for males is not as large as that for females (2.8 years versus 4.3 years). The median duration of schooling is relatively low in East Timor: 2.5 years for males and 0.9 years for females. Among provinces in Outer Java-Bali II, the highest median duration of schooling for males is 7.6 years in East Kalimantan, and 7.1 years for females in Central Sulawesi. The variation in median duration of schooling between provinces is around 5 years for men and 6 years for women. Table 2.5.4 Educational level of the household population by region and province: women Percent distribution of the de jure female household population age five and over by highest level of education attended, and median number of years of schooling, according to region and province, Indonesia 1994 Don't Median Region and No Some Completed Some know/ years of province education primat2¢ primary secondary+ missing Total Number schooling Java-Bali 23.2 35.4 19.4 21.8 01 100.0 42.004 4.5 DKI Jakarta 9.0 24.2 18.8 48.1 0.0 1000 3.105 7.8 West Java 18.8 40.1 20.3 20.6 02 100.0 13,276 4.6 Central Java 24.1 37.2 21.0 17.6 02 1000 10,728 4.3 DI Yogyakarta 26,5 26.4 12,9 34.1 0.1 100.0 1.208 5.2 East Java 29.6 33.3 18,1 18.9 0.2 100.0 12.642 3.6 Bali 30.4 27.2 17,3 25,0 0.0 100.0 1,045 39 Outer Java-Ball 1 17.9 38.0 16.1 27.7 0.3 100.0 18,137 53 Dista Aceh 19,8 34.2 17.2 28.7 0. I 100.0 1,308 5.2 North Sumatra 10.6 381 16.4 34,6 0.2 100.0 3,965 7.1 West Sumatra 9.5 39.4 14.6 36.4 01 1000 1,479 71 South Sumatra 16.0 38.6 20.1 25.2 01 100./I 2,155 5.4 Lampung 19.5 42,4 18.8 193 0.0 100.0 1.969 46 West Nusa Tenggara 34.4 34,8 12.0 18,4 0.3 1000 1,301 2.9 West Kalimantan 30.3 37.9 10.8 208 0.2 1000 1,249 3.5 South Kalimmat an 153 40,2 15.5 28.8 02 100.0 979 5.5 North Sulawesi 5 5 39.8 17.5 36.7 05 100,0 847 7.2 South Sulawesi 23.4 35.4 15.1 25.2 118 100(I 2.885 4.6 Outer Java-Bali I I 19.5 37.7 16,9 258 0.2 100.0 7.615 5.1 Riau 18.9 38.8 16.8 255 0.1 100.0 1.302 47 Jambi 18.7 37.6 16,4 272 0. I 100.0 766 5,4 Bengkulu 16.6 41.2 12.7 293 01 100.0 453 5.2 East Nusa Tenggara 23.2 39.7 211.3 16.8 0 1 1000 1,232 43 East Timor 49 9 31.2 2.9 15.7 0.4 100.0 296 0.9 Central Kalimantan 13.8 40.9 19.4 25.8 0.0 11300 546 5,7 East Kalimantan 12.9 36.9 16.4 33.5 0.3 1130.0 723 7.0 Central Sulawesi I 1.2 36.1 23.6 28.9 0.2 1000 586 7 1 Southeast Sulawesi 21.2 33,1 19.3 263 0.0 100.0 508 55 Maluku 12.6 37.6 17.2 32.3 0.3 100.0 635 6.9 Irian Jaya 29.4 34.7 9.9 256 04 1000 568 3.9 Total 21.4 36.3 18.3 238 0.2 It)0.0 67,756 4.8 18 2.6 School Enrollment Table 2.6 shows the percentage of the household population age 5 to 24 years enrolled in school, by age, sex and residence. The data confirm the findings presented in Tables 2.5.1 and 2.5.2; differences between boys and girls at the younger age groups are minimal (see Figure 2.3). While only two in five children age 5-6 are in school, nine in ten children age 7-12 are enrolled in school. This reflects the result of the 6 years of compulsory education that was initiated in the first Long-Term Development Plan (LTDP, 1969-70 to 1993-94). The proportion decreases for the older age groups. Table 2.6 indicates that at all ages, the urban population has consistently higher school enrollment rates than the mral population. Table 2.6 School enrollment Percentage of the de jure household population age 5-24 years enrolled in school, by age group, sex, and urban-rural residence, Indonesia 1994 Male Female Total Age group Urban Rural Total Urban Rural Total Urban Rural Total 5-6 50.2 32.2 36.7 54.6 37.0 41.7 52.5 34.6 39.2 7-12 96.1 89.3 91.2 97.3 89.5 91.7 96,6 89.4 91.4 13-15 83.9 60.8 67.9 77.2 56,1 62.6 80.7 58.5 65.4 7-15 92.0 80.6 83,9 90.3 79,0 82.2 91.2 79.8 83.1 16-18 58.9 29.1 39.6 50.2 22.2 32.9 54.3 25.7 36.2 19-24 24.4 5.8 13.3 18.1 3,2 8.6 21.2 4.4 10.8 , Figure 2.3 Percentage of the Population Age 5-15 Enrolled in School by Age Group and Sex Percent of Population 1 O0 80 60 40 20 0 5-6 7-12 13-15 Age Group 1994 IDHS 19 2.7 Housing Characteristics Table 2.7 presents the distribution of households by selected housing characteristics, such as the source of drinking water, type of sanitation facilities, type of flooring, and distance between the well and the cesspool. These are important determinants of the health status of household members, particularly children. They can also be used as indicators of household socioeconomic status. Proper hygiene and sanitation practices can help to prevent major childhood diseases, such as diarrhea. Overall, 63 percent of the households covered in the 1994 IDHS have electricity. There are significant urban-rural and regional differentials (see Figure 2.4). In urban areas, virtually all households have electricity, compared with 49 percent in rural areas. While 70 percent of households in Java-Bali have electricity, in Outer Java-Bali I the proportion is about 52 percent, and in Outer Java-Bali II it is only 41 percent. Wells are the main source of drinking water for half of the households in the 1994 IDHS sample. Water that is either piped into the residence or into the yard or obtained from the public tap is used by 15 percent of households, 37 percent in urban areas and 6 percent in rural areas. Other sources of drinking water include spring (either protected or unprotected) (16 percent) and pump (11 percent). Rural households are more likely to use spring water than urban households (22 percent compared with 2 percent, respectively). On the other hand, the pump is more common in urban areas (20 percent) than in rural areas (7 percent). The data in Table 2.7 indicate that for half of households, the source of drinking water is on the premises, for 28 percent the source is less than 10 minutes away, and for 22 percent of the households the source is 10 minutes or longer away. Urban households generally are closer to the source of water than rural households. While 78 percent of households in urban areas have water on the premises and 16 percent are within 10 minutes of the source, in rural areas the corresponding figures are 39 percent and 33 percent, respectively. Four in ten households have a private toilet, 11 percent use a shared facility, and the remaining 47 percent do not have a toilet. The majority of people who do not have a toilet facility go to a river or creek. The difference between urban and rural areas is significant. Overall, 64 percent of households in urban areas have a private toilet, compared with 32 percent in rural areas. Table 2.7 presents the distribution of households by the distance from the well to the nearest cesspool. Overall, for fifteen percent of the households, the nearest cesspool is less than 10 meters from their well, for 13 percent the nearest cesspool is between 10 and 14 meters, and for 22 percent the nearest cesspool is 15 meters or further from the well. In general, wells are closer to cesspools in urban areas: the median distance from well to cesspool for urban households is 10 meters, while in rural areas the median is 15 meters. More than half of households in the sample have a concrete, brick or tile floor, 16 percent have a wood floor, and one-fourth have a dirt floor. There are substantial urban-rural differentials by floor materials. Whereas 79 percent of urban households have a tile or concrete or brick floor, the proportion in rural areas is 42 percent. Conversely, 34 percent of rural households have a dirt floor, compared with 8 percent in urban areas. There are also substantial regional variations. In Java-Bali, most of the households (59 percent) have concrete or tile floors. In the Outer Java-Bali regions, wood is commonly used as floor material (37 percent). Seven in ten households have floors that are 10 square meters or more in area. The difference between urban and rural households is not significant (66 percent and 69 percent, respectively). However, households in Java-Bali in general have more space than households in other regions. Almost half of households in Outer Java-Bali I1 live in houses with less than 10 square meter floor area. 20 Table 2.7 Housing characteristics Percent distribution of households by housing characteristics, according to urban- rural residence and region, Indonesia 1994 Characteristic Residence Region Outer Outer Java Java- Java- Urban Rural Bali Bali 1 Bali 1I Total Electricity Yes 94.6 49.4 70.4 52.3 40.9 62.8 No 5.4 50.5 29.5 47.6 59.1 37.2 Total 100.0 100.0 100.0 100.0 100.0 100.0 Source of drinking water Piped into residence 23.2 2.1 6.7 11.5 10.8 8.4 Piped into yard/plot 3.7 0.7 1.2 2.0 3.1 1.6 Public tap 10.2 3.1 5.2 5.6 4.8 5.2 Pump 20.2 6.8 14.4 4.8 3.2 10.8 Protected well 32.8 35.9 40.5 27.6 18.7 35.0 Unprotected well 5.8 19.5 I 1.1 23.8 22.1 15.4 Protected spring 1.4 11.7 10.9 4. I 5.3 8.6 Unprotected spring 0.7 10.4 7.6 7.0 8.8 7.6 River/stream 0.4 6.7 1.5 9.2 14.4 4.8 Rainwater 1.1 2.5 0.3 4.0 8.1 2.1 Other 0.6 0.5 0.5 0.4 0.6 0.5 Total 100.0 100.0 100.0 100.0 100.0 100.0 Time to water source On premises 77.6 38.9 53.0 47.5 40.8 50.4 1-4 minutes 7.1 12.7 11.6 10.2 9.2 I 1.0 5-9 minutes 8.7 20.0 16.1 18.0 17.1 16.6 10+ minutes 6.2 28.1 19.1 23.8 31.9 21.6 Don't know/missing 0.4 0.4 0.3 0.5 0.9 0.4 Total 100.0 100.0 100.0 100.0 100.0 109.0 Median time to source 0.6 4.0 0.9 2.3 4.4 1.0 Sanitation facility Private with septic 39.4 9.1 17.7 19.2 17.0 18.0 Private, no septic 24.3 23.2 21.9 26.5 26.0 23.5 Shared, public toilet 15.8 9.2 13.6 7.2 5.9 11.2 River, stream, creek 15.3 32.5 29.4 24.8 21.3 27.4 Pit 0.4 5.1 3.4 4.7 2.9 3.7 Bush/forest/yard 0.9 11.0 6.2 11.1 11.9 8.0 Other 3.7 9.5 7.4 6.0 14.4 7.8 Missing 0.3 0.4 0.3 0.4 0.6 0.4 Total 100.0 100.0 100.0 100.0 100.0 100.0 Distance from well to cesspool No well 41.4 37.8 34.1 44.1 56.0 38.9 Less than 10 meters 19.7 13.1 17.6 11.8 7.3 15.1 10-14 meters 15.8 12.0 14.2 12.2 8.5 13.1 15 meters and over 13.5 25.9 23.5 21.5 16.3 22.2 Don't know/missing 9.6 11.1 10.6 10.4 12.0 10.7 Total 100.0 100.0 100.0 100.0 100.0 100.0 Median distance to cesspool 10.4 15.1 10.9 12.5 15.1 I I.l Floor material Earth 7.9 33.5 30.5 16.5 20.3 25.9 Bamboo 0.4 4.6 3.5 2.4 4.4 3.3 Wood 7.4 19.5 4.2 37.0 37.4 15.9 Concrete/brick 45.1 31.0 34.1 38.5 34.1 35.2 Tile 33.7 10.7 24.8 4.9 2.5 17.5 Ceramic/marble 5.5 0.4 2.7 0.6 0.4 1.9 Other 0.0 0.3 0.2 0.0 0.7 0.2 Missing 0.1 0.1 0.1 0.2 0.2 0.1 Total 100.0 100.0 100.0 100.0 100.0 100.0 Floor area <10m 2 33.2 30.6 24.0 43.4 47.9 31.4 10m2+ 66.3 69.0 75.8 56.3 49.6 68.2 Missing/Don't know 0.5 0.4 0.1 0.3 2.5 0.4 Total 100.0 100.0 100.0 100.0 100.0 100.0 Median area of floor 12,9 13.8 15.8 10.8 10.1 13.5 Number of households 9,998 23,740 21,734 8,488 3,516 33,738 21 Figure 2.4 Housing Characteristics by Residence Percent of Households 100 80 60 40 20 0 95 Electricity Piped Water Private Toilet [~Urban mRural 1Total / Note: Piped water includes public tap 79 Concrete/Tile Floor 1994 IDHS 2.8 Presence of Durable Goods in the Household The presence of durable goods in the household, e.g., radio, television, motorcycle, and private car, is an indicator of the household's socioeconomic status. Table 2.8 shows that 60 percent of households have a radio, 45 percent have a bicycle or boat, 37 percent have a televi- sion, and 15 percent have a motorcycle or motor boat. Only 4 percent of households have a private car. About 23 percent of households have none of the durable goods listed in Table 2.8. Urban-rural differentials can be seen in the own- ership of specific durable goods. In general, these goods are more available in urban households than in rural households. For example, two in three urban households have a television set, while in rural areas the proportion is one in four. A refrigerator is available in 21 percent of urban households, but it is almost nonexistent in rural areas. Urban households are seven times more likely to own a private car than rural households. Table 2.8 Household durable goods Percentage of households possessing various durable consumer goods, by urban-rural residence, Indonesia 1994 Residence Durable goods Urban Rural Total Radio 74.0 54.3 60.2 Television 67.1 24.5 37.1 Refrigerator 21.1 1.4 7.2 Bicycle/Boat 48.2 44.2 45.4 Motorcycle/Motorboat 25.6 10.9 15.3 Private car 9.4 1.3 3.7 None of the above 10.7 28.0 22.9 Number of households 9,998 23,740 33,738 22 2.9 Background Characteristics of Respondents Table 2.9.1 presents the distribution of ever-married women age 15-49 interviewed with the individual questionnaire by selected back- ground characteristics along with the actual and weighted number of eligible women interviewed. The weighting is necessary to compensate for dif- ferences in the selection probabilities and response rates, and to make the regional and urban-rural distribution of the sample correspond to that ex- pected from official sources. All results presented in this report are weighted. The distribution of ever-married women by age group is similar to that for the 1987 NICPS, the 1990 Population Census, and the 1991 IDHS. The majority of respondents are age 25-39 (57 percent), less than 5 percent are 15-19, and about I 1 percent are 45-49. Ninety-three percent of the women in the sample are currently married; the remaining 7 percent are either divorced or wid- owed. Seventy-one percent of respondents live in rural areas and 29 percent in urban areas. Sixteen percent of the survey respondents have never attended school, 32 percent have some primary education but did not finish primary school, 28 percent completed primary school, and 24 percent have some secondary or higher educa- tion. Almost none of the respondents was enrolled in school at the time of the survey. A majority of the women surveyed are Musl im (89 percent), 8 percent are Protestant or Catholic, 2 percent are Hindu, and less than one percent are Buddhist. Table 2.9.2 presents the weighted and un- weighted distribution of the respondents by region and province. The table shows that the majority of respondents (64 percent) live in Java-Bali, 25 per- cent live in Outer Java-Bali I, and 11 percent live in Outer Java-Bali II. The provinces of East Java and West Java account for 20 percent of respond- ents each; 16 percent reside in Central Java. Table2.9.1 Distribution of respondents: background characteristics Percent distribution of ever-married women by selected background characteristics, Indonesia 1994 Number of ever- married women Background Weighted Un- characteristic percent Weighted weighted Age 15-19 4.8 1,365 1,083 20-24 14.6 4,105 3,894 25-29 19.4 5,453 5,535 30-34 20.1 5,660 5,618 35-39 17.3 4,869 5,051 40-44 13.0 3,662 3,736 45-49 10.8 3,055 3,251 Marital status Married 93.0 26,186 26,220 Divorced 3.5 984 926 Widowed 3.5 999 1,022 Residence Urban 29.1 8,196 7,947 Rural 70.9 19,972 20,221 Region/Residence Java-Bali 63.7 17,953 8,672 Urban 21.3 5,991 3,880 Rural 42.5 I 1,962 4,792 Outer Java-Bali 1 25.2 7,108 10,229 Urban 5.4 1,520 2,256 Rural 19.8 5,588 7,973 Outer Java-Bali 11 11.0 3,106 9,267 Urban 2.4 685 1,811 Rural 8.6 2,422 7,456 Education No education 15.9 4,489 4,802 Some primary 31.9 8,997 8,270 Completed primary 28.1 7,904 6,962 Some secondary+ 24.1 6,778 8,134 Respondent in school Yes 0.2 48 60 No 99.7 28,097 28,084 Religion Muslim 89.3 25,148 22,049 Protestant/Christian 5. I 1,443 2,444 Catholic 2.9 830 2,049 Hindu 1.8 508 1,278 Buddhist 0.6 181 257 Other 0.2 44 71 Total ~ 100.0 28,168 28,168 t Includes 24 women with missing information on school enrollment, and 20 women for whom information on religion is missing. 23 Table 2.9.2 Distribution of respondents: region and province Percent distribution of ever-married women by region and province, Indonesia 1994 Number of ever- married women Region and Weighted Un- province percent Weighted weighted Java-Bali 63.7 17,953 8,672 DKI Jakarta 4.4 1,249 1,805 West Java 19.7 5,551 1,532 Central Java 16.3 4,578 1,472 DI Yogyakarta 1.6 457 1,118 East Java 20.2 5,685 1,503 Bali 1.5 432 1,242 Outer Java-Bali 1 25.2 7,108 10,229 Dista Aceh 1.9 522 1,079 North Sumatra 5.1 1,446 1,174 West Sumatra 1.9 531 870 South Sumatra 3.2 900 1,050 Lampung 3.0 834 975 West Nusa Tenggara 1.9 527 967 West Kalimantan 1.8 519 1,055 South Kalimantan 1.6 447 1,047 North Sulawesi 1.2 333 830 South Sulawesi 3.7 1,049 1,182 Outer Java-Bali II 1 1.0 3,106 9,267 Riau 2.0 552 1,046 Jambi 1.2 335 893 Bengkulu 0.7 190 819 East Nusa Tenggara 1.5 436 811 East Timor 0.4 124 968 Central Kalimantan 0.9 244 870 East Kalimantan I. I 321 823 Central Sulawesi 0.8 238 766 Southeast Sulawesi 0.7 191 687 Maluku 0.8 225 770 lrian Jaya 0.9 250 814 Total 100.(I 28,168 28,168 2.10 Educational Level of Respondents The distribution of respondents by education and selected background characteristics is presented in Table 2.10.1. One in six ever-married respondents never went to school, 32 percent did not finish primary school, 28 percent completed primary school, and one in four have some secondary or higher education. Comparison across cohorts shows that urban and younger women are more likely to have higher education than their rural and older counterparts. For example, while one in three women age 45-49 never went to school, the proportion among women 15 - 19 is less than 5 percent. On the other hand, half of women age 15- 19 have completed primary school, while among women in the oldest age group the proportion is only 17 percent. Only 8 percent of respondents in urban areas have not attended school; in rural areas the percentage is 19 percent. By contrast, almost half of urban women have attended secondary school, compared with 15 percent in rural areas. Data for currently married women (not shown) are similar to those for ever-married women. 24 Table2.10.1 Level of education: background characteristics Percent distribution of ever-married women by the highest level of education attended, according to selected background characteristics, Indonesia 1994 Highest level of education Number Background No Some Completed Some of characteristic education primary primary secondary+ Total women Age 15-19 3.9 23.1 50.2 22.8 100.0 1,365 20-24 5.5 20.0 42.3 32.3 100.0 4,105 25-29 10.7 28.8 29.0 31.5 100.0 5,453 30-34 14.7 36.3 26.5 22.4 100.0 5,660 35-39 20.4 37.6 22.1 19.9 100.0 4,869 40-44 21.5 38.4 21.8 18.2 100.0 3,662 45-49 33.1 32.5 17.3 17.1 100.0 3,055 Residence Urban 7.6 21.2 24.8 46.4 100.0 8,196 Rural 19.4 36.3 29.4 14.9 100.0 19,972 Region/Residence Java-Bali 16.3 32.5 30.3 20.8 100.0 17,953 Urban 8.2 22.6 26.9 42.4 100.0 5,991 Rural 20.4 37.5 32.0 10.1 100.0 11,962 Outer Java-Bali 1 14.1 32.0 23.5 30.4 100.0 7,108 Urban 5.8 17.4 19.7 57.2 100.0 1,520 Rural 16.4 35,9 24.5 23.2 100.0 5,588 Outer Java-Bali 1I 17.8 28.7 25.4 28.1 100.0 3,106 Urban 6. I 17.9 18.4 57.6 100.0 685 Rural 21.1 31.8 27.4 19.7 100.0 2,422 Total 15.9 31.9 28.1 24.1 100.0 28,168 There is no significant variation in women's educational attainment across regions; the proportion of women who did not go to school varies from 14 percent in Outer Java-Bali I to 18 percent in Outer Java- Bali II, and the proportion completing primary school or higher ranges from 51 percent in Java-Bali to 54 percent in Outer Java-Bali I and II. Comparison of women's educational attainment by province reveals more pronounced variations (see Table 2.10.2). The proportion of women who have never gone to school varies from less than 5 percent in North Sumatra, West Sumatra, and North Sulawesi, to more than 30 percent in Irian Jaya, West Kalimantan, and West Nusa Tenggara. In the province of East Timor, 63 percent of women in the sample have had no formal education. Differentials in educational attainment among currently married women are similar to those of ever- married women. Therefore, only tables based on ever-married women are presented in this section. 25 Table 2.10.2 Level of education: region and province Percent distribution of ever-married women by the highest level of education attended, according to region and province, Indonesia 1994 Highest level of education Number Region and No Some Completed Some of province education primary primary secondary+ Total women Java-Bali 16.3 32.5 30.3 20.8 100.0 17,953 DKI Jakarta 7.5 17.3 27.8 47.4 100.0 1,249 West Java 12.2 34.6 31.7 21.6 100.0 5,551 Central Java 17.1 35.2 32.6 15.1 100.0 4,578 DI Yogyakarta 16.2 21.6 24.6 37.6 100.0 457 East Java 21.2 32.9 28.6 17.3 100.0 5,685 Bali 23.6 27.4 24.7 24.3 100.0 432 Outer Java-Bali I 14.1 32.0 23.5 30.4 100.0 7,108 Dista Aceh 16.7 24.2 25.8 33.3 100.0 522 North Sumatra 3.7 30.1 26.0 40.2 100.0 1,446 West Sumatra 3.9 32.2 22.1 41.9 100.0 531 South Sumatra 12.0 32.3 28.5 27.2 100.0 900 Lampung 12.8 39.1 29.6 18.5 100.0 834 West Nusa Tenggara 37.7 28.3 14.3 19.6 100.0 527 West Kalimantan 32.2 31.9 13.2 22.7 10(I.0 519 South Kalimantan 10.7 39.1 22.3 27.9 100.0 447 North Sulawesi 2.4 31.5 20.0 46. I 100.0 333 South Sulawesi 19.5 31.3 21.8 27.4 100.0 1,049 Outer Java-Bali lI 17.8 28.7 25.4 28.1 100.0 3,106 Riau 17.2 31.9 23.5 27.4 100.0 552 Jambi 17.2 30.5 24.9 27.4 100.0 335 Bengkulu I I. 1 36.5 19.8 32.5 100.0 190 East Nusa Tenggara 22.1 28.9 32.0 17.0 100.0 436 East Timor 63.4 15.8 5.1 15.7 100.0 124 Central Kalimantan 10.6 33.5 29.3 26.6 100.0 244 East Kalimantan 8.9 30.9 23.9 36.3 100.0 32 I Central Sulawesi 7.6 25.5 34.5 32.4 100.0 238 Southeast Sul awesi 12.4 24.3 31.6 31.6 1 (30.0 191 Maluku 6.8 26. I 28.4 38.7 100.0 225 lrian Jaya 36.7 21.1 15.6 26.7 100.0 250 Total 15.9 31.9 28.1 24.1 100.0 28,168 2.11 Educational Attainment and Reasons for Leaving School Table 2.11 presents the distribution of ever-married women 15-24 who ever attended school by whether currently attending and, if not, the reason for leaving school. The table shows that, overall, most respondents left school for economic reasons (46 percent) or marriage (26 percent). Lack of funds to support higher education is reported by one in three primary school dropouts, and by six in ten women who completed primary school. One in three women who attended secondary school said that they dropped out of school because they got married. These two reasons are reported in both urban and rural areas, and at all levels of education. In urban areas, one in six respondents stopped going to primary school because they did not like school, and one in five said they stopped going to primary school because of other reasons. 26 Table 2.11 School attendance and reasons for leaving school Percent distribution of ever-married women 15-24 who ever attended school by whether currently attending school and, if not, the reason for leaving school, according to highest level of education attended and residence, Indonesia 1994 Educational attainment Reason for Incomplete Complete Incomplete Complete leaving school primary primary secondary secondary Total t URBAN Currently attending 2. I 1.2 0.5 0.7 2.2 Got pregnant 0.0 0.0 1.4 1.3 0.8 Got married 16.0 15.2 43.8 40.3 28.9 Take care of younger children 0.5 1.5 0.0 0.2 0.7 Family need help 7.7 0.4 0.3 0.0 1.2 Could not pay school 28.1 62.2 31.3 23.6 39.1 Need to earn money 5.3 1.6 5.3 7.9 4.5 Graduated/enough school 1.4 2.6 4.2 18.0 6.7 Did not pass exams 0.3 2.2 2.0 2.4 1.9 Did not like school 16.6 3.6 4.0 0.9 4.6 School not accessible 1.9 4.0 1.2 2.1 2.4 Other 19.6 4.4 5.6 1.5 6.2 Don't know/missing 0.3 1.0 0.5 1.2 0.9 Total 100.0 100.0 100.0 100.0 100.0 Number 148 417 347 252 1200 RURAL Currently attending 1.0 0.3 0.3 0.4 0.5 Got pregnant 0.1 0.0 0.4 1.7 0.2 Got married 24.0 21.2 32.4 40.1 25.1 Take care of younger children 3.1 1.0 0.4 0.2 1.4 Family need help 5.4 2.2 1.7 0.8 2.8 Could not pay school 36.5 58.7 43.0 32.4 48.4 Need to earn money 4.0 2.8 2.3 3.1 3.0 Graduated/enough school 1.8 5.3 5.0 10.8 4.9 Did not pass exams 1.2 0.7 1.7 1.6 1.1 Did not like school 9.0 2.2 4.6 4.6 4.5 School not accessible 3.0 1.9 2.9 0.9 2.3 Other 7.8 2.5 4.7 2.1 4.3 Don't know/missing 3.2 1.1 0.5 1.3 1.5 Total 100.0 ll)0.0 100.0 100.0 100.0 Number 987 2,004 734 252 3,991 TOTAL Currently attending I. I 0.5 0.4 0.6 0.9 Got pregnant 0.1 0.0 0.7 1.5 0.3 Got married 23.0 20.2 36.0 40.2 26.0 Take care of younger children 2.7 1.1 0.3 0.2 1.2 Family need help 5.7 1.9 1.3 0.4 2.4 Could not pay school 35.4 59.3 39.3 28.0 46.3 Need to earn money 4.1 2.6 3.2 5.5 3.3 Graduated/enough school 1.7 4.8 4.7 14.4 5.3 Did not pass exams 1.1 1.0 1.8 2.0 1.3 Did not like school 10.0 2.4 4.4 2.7 4.5 School not accessible 2.9 2.3 2.3 1.5 2.3 Other 9.3 2.9 5.0 1.8 4.8 Don't know/missing 2.8 1.1 0.5 1.2 1.4 Total 100.0 100.0 100.0 100.0 100.0 Number 1,134 2,421 1,080 504 5,191 I Includes 37 urban women, 15 rural women, and 52 total women who have more than secondary education. 27 2.12 Husband's Education Table 2.12.1 presents the distribution of respondents by their husband's educational attainment and background characteristics. In general, husbands of women interviewed in the survey are slightly better educated than their wives. Ten percent of husbands have never gone to school, and 32 percent have some secondary education, compared with 16 percent and 24 percent of the respondents, respectively. Differentials in educational attainment of the husbands by age and residence are similar to those of the wives. Regional variation in husbands' education is similar to that of wives. While less than 5 percent of husbands in DKI Jakarta, North Sumatra, West Sumatra, South Kalimantan, North Sulawesi, East Kalimantan and Maluku have no education, the corresponding proportion in East Timor is more than 50 percent (Table 2.12.2). Variation within regions is also substantial. While 63 percent of husbands in DKI Jakarta have attended secondary school, in Central Java and East Java the proportion is less than 25 percent. Table2.12.1 Husband'slevelofeducation: background characteristics Percent distribution of ever-married women by husband's highest level of education attended, according to selected background characteristics, Indonesia 1994 Husband's highest level of education Number Background No Some Completed Some Don't of characteristic education primary primary secondary+ know Total women Age 15-19 4.6 16.5 46.1 32.1 0.8 100.0 1,365 20-24 5.1 21.2 35.9 37.5 0.2 100.0 4,105 25-29 6.9 28.2 27.1 37.7 0.2 1130.0 5,453 30-34 9.8 31.4 28.3 30.1 0.4 100.0 5,660 35-39 12.6 31.0 26.5 29.6 0.3 100.0 4,869 40-44 13.5 32.5 27.0 26.6 0.3 100.0 3,662 45-49 19.5 32.5 24.1 23.4 0.4 100.0 3,055 Residence Urban 4.2 15.7 23.2 56,6 0.2 100.0 8,196 Rural 12.8 34.1 31.5 21.1 0.4 100.0 19,972 Region/Residence Java-Bali 10.4 30.1 31.2 27.9 0.4 100.0 17,953 Urban 4.5 16.8 25.2 53.3 0.2 100.0 5,991 Rural 13.4 36.8 34.2 15.1 0.4 100.0 11,962 Outer Java-Bali I 9.6 26.6 25.7 37.8 0.3 100.0 7,108 Urban 3.3 12.3 18.2 66.1 0.2 100.0 1,520 Rural I 1.3 30.6 27.7 30.1 0.3 100.0 5,588 Outer Java-Bali 11 I 1.2 25,8 25.0 37.7 0.3 100.0 3,106 Urban 4.0 13.8 16.7 65.2 0.3 100.0 685 Rural 13.2 29.2 27.3 30.0 0.3 100.0 2,422 Total 10.3 28.8 29.1 31.5 0,3 1130.0 28,168 28 Table 2.12.2 Husband's level of education: region and province Percent distribution of ever-married women by husband' s highest level of education attended, according to region and province, Indonesia 1994 Husband's highest level of education Number Region and No Some Completed Some Don't of province education primary primary secondary+ know Total women Java-Bali 10.4 30.1 31.2 27.9 0.4 1130.0 17,953 DKI Jakarta 2.2 10.7 23.5 63.3 0.2 100.0 1,249 West Java 7.0 32.4 32.1 28.0 0.5 100.0 5,551 Central Java 11.3 30.9 37.3 20.5 0.0 100.0 4,578 DI Yogyakarta 7.7 21.3 22.7 48.2 0.1 100.0 457 East Java 15.2 32.9 27.7 23.6 0.6 100.0 5,685 Bali 9.8 22.6 31.6 36.0 0,0 100.0 432 Outer Java-Bali I 9.6 26.6 25.7 37.8 0.3 1130.0 7,108 Dista Aceh 10.0 22.2 31.2 36.6 0.0 100.0 522 North Sumatra 1.8 22.5 24.9 50.6 0.2 100.0 1,446 West Sumatra 3.1 24.2 26.7 45.5 0.5 109.0 53 I South Sumatra 7.3 26.9 30.0 35.8 0,0 100.0 900 Lampung 8.0 32.8 34.7 24.2 0.3 100.0 834 West Nusa Tenggara 24.6 28.2 18.7 28.4 0.1 100.0 527 West Kalimantan 14.5 35.7 19.2 30.4 0.3 100.0 519 South Kalimantan 4.9 30.7 28.6 35.0 0.8 100.0 447 North Sulawesi 3.3 31.0 18.5 46.8 0.4 100.0 333 South Sulawesi 20.8 22.3 20.2 36.2 0.5 100.0 1,049 Outer Java-Bali II 11.2 25.8 25.0 37.7 0.3 100.0 3,106 Riau 7.6 33.9 26.3 31.7 0.4 100.0 552 Jambi 8.3 26.7 27.9 37.0 0.1 100.0 335 Bengkulu 5.4 30.2 21.0 43.3 0.1 100.0 190 East Nusa Tenggara 13.4 29.4 28.5 28.4 0.3 100.0 436 East Timor 51.8 18.5 6.9 22.7 0.0 100.0 124 Central Kalimantan 6.2 24.0 32.1 37.5 0.1 100.0 244 East Kalimantan 4.9 23.4 22.2 49.1 0.3 100.0 321 Central Sulawesi 5. I 24.5 27.4 42.2 0.8 100.0 238 Southeast Sulawesi 8. I 20.5 29.9 41.3 0.2 100.0 19 I Maluku 4.8 18.6 25.7 50.3 0.5 100.0 225 lrian Jaya 30. I 16.9 13.8 38.8 0.4 100.0 250 Total 10.3 28.8 29.1 31.5 0.3 100.0 28,168 In Table 2.13 the respondent's education is compared with that of her husband. Overall, a majority of couples marry within their educational level (see figures on the diagonal), and some women marry men who have higher education (see figures to the right of the diagonal). For example, among women who completed primary school, 53 percent are married to men who also have completed primary school, 26 percent are married to men who have attended secondary school, and 21 percent are married to men whose education is lower than theirs. 29 Table 2.13 Husband's level of education according to respondent's level of education Percent distribution of women by husband's highest level of education attended, according to respondent's level of education, Indonesia 1994 Husband's highest level of education Number Respondent's No Some Completed Some Don't of education education primary primary secondary+ know Total women No education 40.3 39.4 15.8 4.0 0.6 100.0 4,489 Some primary 9.4 50.3 26.7 13.2 0.4 100.0 8,997 Completed primary 2.8 18.3 52.8 25.7 0.3 100.0 7,904 Some secondary+ 0.4 5.3 13.5 80.7 0.1 100.0 6,778 Total 10.3 28.8 29.1 31.5 0.3 100.0 28,168 2.13 Exposure to Mass Media The availability of mass media (newspaper, television and radio) is presented in Table 2.14.1. Twenty-six percent of respondents read the newspaper weekly, two in three watch television weekly, and 57 percent listen to a radio every day; 17 percent have exposure to all three mass media. Eighteen percent of all respondents are exposed to none of these mass media. Table 2.14.1 Access to mass media: background characteristics Percentage of women who usually read a newspaper once a week, watch television once a week, or listen to radio daily, by selected background characteristics, Indonesia 1994 Mass media No Read Watch Listen to All Number Background mass newspaper television radio three of characteristic media weekly weekly daily media women Age 15-19 12.7 29.6 72.2 71.8 22.4 1,365 20-24 13.3 30.2 73.2 63.8 21.8 4,105 25-29 14.9 29.7 73.3 59.2 20.8 5,453 30-34 17.2 24.6 68.7 56.0 16.2 5,660 35-39 20.2 23.8 66.5 52.2 15.4 4,869 40-44 19.8 22.0 64.7 53.5 14.3 3,662 45-49 27.7 19.2 59.5 47.0 12. I 3,055 Residence Urban 5.2 46.8 90.7 59.7 31.5 8,196 Rural 23.2 16.9 59.4 55.3 11.6 19,972 Region/Residence Java-Bali 14.1 27.2 73.0 59.9 19.0 17,953 Urban 4.9 46.9 90.9 60.5 31.9 5,991 Rural 18.7 17.3 64.1 59.6 12.5 11,962 Outer Java-Bali l 21.9 22.2 62.4 53.9 14.3 7,108 Urban 5.4 44.6 90.6 59.0 28.9 1,520 Rural 26.4 16.1 54.7 52.5 10.4 5,588 Outer Java-Bali 11 31. I 24.0 56.3 43.3 14.9 3,106 Urban 7.2 51.0 89.1 53.8 33.3 685 Rural 37.8 16.4 47.0 40.3 9.7 2,422 Education No education 40.5 0.8 43.0 38.5 0.4 4,489 Some primary 20.8 10.7 62.7 53.4 7.1 8,997 Primary completed 13.2 26.3 72.0 64.4 18.5 7,904 Some secondary+ 4.8 61.0 89.0 63.5 41.0 6,778 Total 17.9 25.6 68.5 56.5 17.4 28,168 30 Younger women, women in urban areas, women living in Java-Bali, and better educated women are more likely to be exposed to mass media than other women. For example, 91 percent of urban women watch television, while the proportion in rural areas is 59 percent; 32 percent of urban women are exposed to all three media, while in rural areas only 12 percent are. There is a positive association between level of educa- tion and exposure to mass media: as education increases, exposure to mass media increases. The same pat- tern was also found in the 1991 IDHS (CBS, 1992). Table 2.142 shows the percentage of women exposed to mass media by region and province. Women in Java-Bali are more exposed to mass media than women in Outer Java-Bali. DKI Jakarta shows the largest percentage exposed to television (97 percent), followed by East Kalimantan (88 percent), and DI Yogyakarta (84 percent). At the other extreme, women in East Nusa Tenggara, East Timor and Central Kalimantan have the least exposure to mass media. Table 2.14.2 Access to mass media: region and province Percentage of women who usually read a newspaper once a week, watch television once a week, or listen to radio daily, by region and province, Indonesia 1994 Mass media No Read Watch Listen to All Number Region and mass newspaper television radio three of province media weekly weekly daily media women Java-Bali 14.1 27.2 73.0 59.9 19.0 17,953 DKI Jakarta 1.7 52.7 96.7 62.2 37.6 1,249 West Java 9.5 33.2 77.3 61.6 20.5 5,551 Central Java 17.7 20.7 65.8 64.1 17.0 4,578 DI Yogyakarta 9.4 35.1 83.6 59.2 25.7 457 East Java 18.8 21.0 68.4 54.0 14.8 5,685 Bali 14.2 18.3 77.2 64.5 15.3 432 Outer Java-Bali I 21.9 22.2 62.4 53.9 14.3 7,108 Dista Aceh 37.6 22.7 51.2 41.8 15.4 522 North Sumatra 24.4 23.8 68.8 43.3 12.6 1,446 West Sumatra 21.3 28.0 67.0 43.4 15.2 531 South Sumatra 29.0 17.4 59.0 40.1 I 0.4 900 Lampung 18.5 13.4 46.4 69.7 9.4 834 West Nusa Tenggara 20.7 19.9 57.7 63.6 13.9 527 West Kalimantan 19.1 16.2 74.7 46.6 10.9 519 South Kalimantan 10.2 23.1 79.7 69.4 18.9 447 North Sulawesi 18.0 36.6 73.2 47.6 23.9 333 South Sulawesi 15.8 27.4 57.9 73.2 19.9 1,049 Outer Java-Bali II 31.1 24.0 56.3 43.3 14.9 3,106 Riau 15.4 27.9 76.0 49.0 17.8 552 Jambi 12.3 30.7 76.2 61.3 21.9 335 Bengkulu 13.3 24.0 77.4 56.4 18.6 190 East Nusa Tenggara 70.1 11.4 13.8 20.1 3.4 436 East Timor 72.0 12.7 15.9 21.2 7.2 124 Central Kalimantan 33.7 12.1 36.4 53.3 7.8 244 East Kalimantan 5.6 37.3 88.1 49.9 21.2 321 Central Sulawesi 21.7 29.3 64.4 53.0 21.3 238 Southeast Sulawesi 33.7 20.1 43.7 47.3 11.5 191 Maluku 25.9 31.1 66.5 40.5 20.6 225 Irian Jaya 58.0 20.2 35.6 20.4 10.5 250 Total 17.9 25.6 68.5 56.5 17.4 28,168 31 2.14 Employment In the 1994 IDHS, respondents were asked if they worked aside from doing their housework, regardless of whether they were paid or not. Table 2.15.1 shows that 56 percent of women were engaged in an economic activity in the last 12 months. Older women, women in rural areas, and women who have no education are more likely to have been employed. For example, the proportion of women 35 years or older who worked is 65 percent, while for women under 25 the proportion is 40 percent or lower. The smaller proportion of young women who work may be related to the problem of securing child care, while urban and better educated women may have difficulty getting a job that fits their education. Table 2.15.2 shows that a large proportion of women (more than 70 percent) in DI Yogyakarta, Bali, Bengkulu, and East Nusa Tenggara worked in the 12 months preceding the survey. In contrast, low proportions (less than 40 percent) are found in North Sulawesi, South Sulawesi, East Timor, East Kalimantan, and Maluku. Table 2.15.1 Employment: background characteristics Percent distribution of women by employment status in the last 12 months, according to background characteristics, Indonesia 1994 Did not work Worked in last in Number Background 12 lasl 12 of characteristic months months Total women Age 15-19 66.8 33.2 100.0 1,365 20-24 59.7 40.3 100.0 4,105 25-29 49.8 50.2 100.0 5,453 30-34 40.9 59.1 100.0 5,660 35-39 34.8 65.2 100.0 4,869 40-44 34.4 65.6 100.0 3,662 45-49 35.5 64.5 100.0 3,055 Residence Urban 55.2 44.8 100.0 8,196 Rural 39.6 60.4 100.0 19,972 Region/Residence Java-Bali 44.5 55.5 100.0 17,953 Urban 53.6 46.4 100.0 5,991 Rural 40.0 60.0 100.0 11,962 Outer Java-Bali I 42.5 57.5 100.0 7,108 Urban 58.1 41.9 100.0 1,520 Rural 38.3 61.7 100.0 5,588 Outer Java-Bali 1I 45.6 54.4 100.0 3,106 Urban 62.4 37.6 100.0 685 Rural 40.9 59.1 100.0 2,422 Education No education 29.2 7(I.8 100.0 4,489 Some primary 38.7 61.3 100.0 8,997 Completed primary 50.3 49.7 100.0 7,904 Some secondary+ 54.0 46.0 100.0 6,778 Total 44,1 55.9 100.0 28,168 32 Table 2.15.2 Employment: region and province Percent distribution of women by employment status in the last 12 months, according to region and province, Indonesia 1994 Did not work Worked in last in Number Region and 12 last 12 of province months months Total women Java-Bali 44.5 55.5 100.0 17,953 DKI Jakarta 59.5 40.5 100.0 1,249 West Java 57.6 42.4 100.0 5,551 Central Java 42.3 57.7 100.0 4,578 DI Yogyakarta 21.9 78.1 100.0 457 East Java 33.8 66.2 100.0 5,685 Bali 22.0 78.0 100.0 432 Outer Java-Bali I 42.5 57.5 100.0 7,108 Dista Aceh 40.0 60.0 100.0 522 North Sumatra 34.9 65.1 100.0 1,446 West Sumatra 39.0 61.0 100.0 531 South Sumatra 36.4 63.6 100.0 900 Lampung 48.4 51.6 100.0 834 West Nusa Tenggara 30.7 69.3 100.0 527 West Kalimantan 31.6 68.4 100.0 519 South Kalimantan 38.5 61.5 100.0 447 North Sulawesi 63.6 36.4 1130.0 333 South Sulawesi 63.0 37.0 100.0 1,049 Outer Java-Bali lI 45.6 54.4 100.0 3,106 Riau 49.9 50. I 100.0 552 Jambi 42.6 57.4 100.0 335 Bengkulu 25.5 74.5 100.0 190 East Nusa Tenggara 29.1 70.9 100.0 436 East Timor 67.1 32.9 100.0 124 Central Kalimantan 41.4 58.6 100.0 244 East Kalimantan 60.1 39.9 100.0 321 Central Sulawesi 44.9 55.1 100.0 238 Southeast Sulawesi 44.6 55.4 100.0 191 Maluku 65.3 34.7 100.0 225 lrian Jaya 43.1 56.9 100.0 250 Total 44.1 55.9 100.0 28,168 2.15 Occupation Table 2.16.1 presents the percent distribution of women who worked in the 12 months prior to the survey by occupation, according to selected background characteristics. Half of the women (53 percent) worked in agriculture, and six in ten of those worked on their own land. The table also shows that for women outside the agricultural sector, sales is a popular choice of employment (22 percent), followed by manufacturing industries (12 percent), professional and technical occupations (5 percent), and services (5 percent). 33 Table2.16.1 Occupation: background characteristics Percent distribution of women employed in the last 12 months by occupation and type of agricultural land worked or type of non- agricultural employment, according to selected background characteristics, Indonesia 1994 Agricultural Non-agricultural Some- one Don't Number Background Own Rented else's Prof./ Mgmt./ Cleri- Serv- Indus- know/ of characteristic land land land tech. admin, cal Sales ices trial Other missing Tolal women Age 15-19 39.5 1.2 19.6 0.3 0.0 0.0 12.4 5.3 20.7 1.0 0.0 100.0 453 20-24 32.2 2.8 20.7 2.3 0.3 2.2 18.0 6.7 14,4 0.4 0.1 1011.0 1,652 25-29 28.6 3.3 17.5 5.9 0.2 4.1 19.2 5.3 15.4 0.3 0.1 10(I.0 2,735 30-34 28.4 3.4 16.6 7.0 0.4 3.0 23.3 4.1 13.6 0.2 0.0 1011.0 3,346 35-39 30.2 2.9 18.1 5.8 0.2 2.1) 26.0 4.5 10.2 0.1 0.0 101).11 3,176 40-44 34.4 2.7 18.2 4.8 0.3 2.0 23.3 4.9 9.1 0.1 0.3 1011.11 2,401 45-49 42.4 2.7 17.0 4.1 0.4 1.5 22.5 2.9 6.2 0.1 0.0 10(I.0 1,9711 Residence Urban 2.8 0.2 5.4 12.1 0.8 7,6 40.5 12.3 17.8 0.4 0.1 10(I .0 3,675 Rural 41.1 3.8 21.7 3.1 0.1 0.9 16.5 2.3 10.1 0.1 0.0 lffl.0 12,059 Region/Residence Java-Bali 24.2 2.1 20,7 4A 0.3 2.3 24.9 5.7 15.4 0.2 0.0 10().0 9,959 Urban 2.5 0.2 5.9 9.4 0.6 6.6 40.5 13.1 20.7 0.4 0.1 100.0 2,780 Rural 32.6 2.9 26.4 2.0 0.1 0.7 18.9 2.9 13.3 0.1 0.0 10(l.0 7,178 Outer Java-Bali I 41.3 5.8 14.8 7.5 0.3 2.6 18.9 2.9 5.7 0.2 0.1 100.0 4,086 Urban 2.8 0,3 4.0 20.3 0,9 9.8 43.4 9.5 8.4 0.6 0.0 1011.0 637 Rural 48.4 6,9 16.7 5.1 0,2 1.3 14.4 1.6 5.2 0.1 0.1 10(I.0 3,449 Outer Java-Bali 11 57.0 1.0 8.9 6.2 0.6 2.9 13.6 2.7 6.7 0.2 0.1 10(l.0 1,689 Urban 6.2 0.3 2.7 20.4 3.2 12.9 34.2 10.1 9.4 0.5 0.0 10(h0 258 Rural 66.1 1.1 10.1 3.7 0.1 1.1 9.9 1.4 6.3 0,2 0.1 10() .0 1,431 Education No education 39.4 3.3 30~7 0. l 0.0 0. I 15.9 3.0 7.2 0.2 0.0 100.0 3,179 Sorne primary 36.9 3.6 21.3 0.1 0.0 0.0 20.8 4.5 12.5 0.2 0.1 10().0 5,513 Primary completed 35.8 2.8 13.8 0.2 0.0 0.13 26.0 5.4 15.5 0.2 0.0 10(l.0 3,926 Some secondary+ I 1.8 1.6 4.1 25.8 1.4 11.9 26.1 5.7 11.1 0.3 0.1 100.0 3,115 Total 32.2 3.0 17.9 5.2 0.3 2.5 22.1 4.7 I 1.9 0.2 0.0 100.0 15,734 Women's occupations vary by age. Among women who worked in agriculture, the proportion who worked on their own land was highest for those in the youngest and oldest age groups. The proportion declines from 40 percent for women age 15-19 to 28 percent for women ages 30-34, and increases to 42 percent for women 45-49. On the other hand, among women working as professional and technical workers, the pattern is the opposite: low at younger ages, peaking at age 30-34, and then declining for older women. Manufacturing industries attract younger women, while sales is more popular among older women. Table 2.16.1 shows that women's occupations vary significantly by urban-rural residence and education. While 67 percent of working women in rural areas are engaged in the agricultural sector, the corresponding proportion in urban areas is 8 percent. In contrast, in urban areas women worked in sales (41 percent), manufacturing industries 118 percent), services (12 percent), and professional jobs 112 percent). The urban-rural differentials between Java-Bali and the Outer Java-Bali regions are similar to those at the national level. In addition, women living in the urban areas of Outer Java-Bali I and II are more likely 34 to work in professional and technical occupations than women in urban Java-Bali (20 percent compared with 9 percent, respectively). Women's education is inversely related to their propensity to work in agriculture; women with no education are much more likely to be working in agriculture than better educated women. For example, three in four women with no education worked in agriculture compared with only 18 percent of women who have attended secondary school. In contrast, women who are better educated are more likely to be employed in professional, technical, sales, clerical or industrial occupations. Table 2.16.2 shows differences among provinces in respondents' patterns of work. In DKI Jakarta, virtually all women work in the nonagricultural sector. In this province, one in three women work in sales, 24 percent in services, 18 percent in industry and 13 percent in clerical jobs. Large proportions of women work in industrial occupations in all provinces in Java-Bali, West Sumatra, North Sulawesi and East Nusa Tenggara, while professional and technical professions are popular in West Sumatra, North Sulawesi, South Sulawesi, and Maluku. More than three-quarters of working women in West Kalimantan, Bengkulu, and Irian Jaya work in agriculture. Table 2.16.2 Occupation: region and province Percent distribution of women employed in the last 12 months by occupation and type of agricultural land worked or type of non- agricultural employment, according to region and province, Indonesia 1994 Agricultural Non-agricultural Sorlle- one Don'l Number Region and Own Rented else's Prof./ Mgmt./ Cleri- Serv- Indus- know/ of province land land land tech. admin, ca/ Sales ices trial Other missing Total women Java-Bali 24.2 2.1 20.7 4.1 0.3 2.3 24.9 5.7 15.4 0.2 0.0 100.0 9,959 DKI Jakarta 0.0 0.0 0.5 7.3 1.4 13.1 35.7 24.3 17.7 0.0 0.1 100.0 505 West Java 17.8 1.1 26.2 4.9 0.5 2.9 28.5 4.0 13.7 0.4 0.1 100.0 2,352 Central Java 26.2 3.6 15.4 4.2 0.0 1.0 25.1 6.1 18.4 0.1 0.0 100.0 2,642 DI Yogyakarta 33.7 1.7 I 1.1 5.7 0.7 3.8 21.6 5.5 15.9 0.2 0.0 100.0 357 East Java 29.5 2.3 24.9 2.8 0.1 1.3 21.1 4.4 13.3 0.2 0.1 100.0 3,765 Bali 20.3 0.1 17.7 4.9 0.3 3.0 28.3 2.9 22.4 0.1 0.0 100.0 337 Outer Java-Bali I 41.3 5.8 14,8 7.5 0.3 2.6 18.9 2.9 5.7 0.2 0.1 100.0 4,086 Dista Aceh 44.1 7.8 24.0 7.5 0.1 2.6 8.6 1.4 4.0 0.0 0.0 100.0 313 North Sumatra 36.3 16.0 10.7 8.6 0.5 2.6 17.9 3.0 3.9 0.2 0.1 100.0 942 West Sumatra 34.4 3.6 18.4 11.0 0.4 2.9 15.3 2.1 11.6 0.2 0.0 1130.0 324 South Sumatra 48.2 3.1 14.1 7,4 0.1 2.6 15.8 4.1 4.1 0.5 0.0 100.0 572 Lampung 48.2 0.4 18.2 4.8 0.0 0.5 20.2 2.0 5.5 0.1 0.0 100.0 431 West Nusa Tenggara 28.6 0.5 25.1 2.6 0.0 2.5 30.6 2.5 7.6 0.2 0.0 100.0 365 West Kalimantan 61.2 5.4 11.4 4.5 0.0 2.1 10.1 2.8 2.4 0.1 t).0 100.0 355 South Kalimantan 49.4 2.8 8.3 5.0 0.3 2.3 21.0 3.4 7.3 0.1 0.1 100.0 275 North Sulawesi 21.3 0.8 10.5 17.9 0.9 7.4 24.3 6.0 10.7 0.3 0.0 1130.0 121 South Sulawesi 33.3 0.6 10.4 11,0 0.4 3.9 29.9 2.5 7.4 0.2 0.3 100.0 388 Outer Java-Bali II 57.0 1.0 8.9 6.2 0.6 2.9 13.6 2.7 6.7 0.2 0.1 100.0 1,689 Riau 51.4 1.9 13.5 7.3 0.3 2.8 12.2 4.2 6.2 0.2 0.0 100.0 277 Jambi 61.0 1.5 11.4 6.8 0.4 2.6 10.7 2.1 3.2 0.3 0.0 100.0 192 Bengkulu 61.2 2.4 14.3 4.1 0.3 2.7 12.1 1.2 1.1 0.4 0.3 100.0 142 East Nusa Tenggara 60.2 0.8 10.2 3.6 0,2 1.0 6.2 1.3 16.2 0.0 0.2 100.0 309 East Timor 67.7 0.0 2.2 4.0 0.7 4.8 8.6 2.3 8.7 0.5 0.3 100.0 41 Central Kalimantan 63.1 0.8 5.2 5.2 0,0 1.6 15.2 1.5 7.3 0.0 0.1 100.0 143 East Kalimantan 29.4 0.0 4.7 7.7 2.6 4.0 31.1 10.8 9.4 0.3 0.0 100.0 128 Central Sulawesi 56.7 0.5 8.6 6.1 0.4 4.7 17.7 1.7 3.5 0.0 0.0 100.0 131 Southeast Sulawesi 62.4 0.4 9.1 6.8 0.5 2.2 15.3 0.3 2.4 0.4 0.2 100.0 106 Maluku 37.7 0.0 1.5 16.8 2.0 5.3 28.2 3.1 5.0 0.4 0.0 100.0 78 lrian Jaya 73.6 0.0 2.6 5.4 0.6 5.5 8.8 1.7 1.2 0.6 0.0 100.0 142 Total 32.2 3.0 17.9 5.2 0.3 2.5 22.1 4.7 11.9 0.2 0.0 100.0 15,734 35 2.16 Child Care Whi le Work ing The welfare of children under five years whose mothers are employed is the focus of Table 2.17.1. Overall, four in ten women who worked in the 12 months prior to the survey have one or more children under five. This proportion varies by residence, education, and occupation. Rural women, better educated women, and women who work occasionally are more likely to have children under five. As a reflection of regional fertility differentials, women in Java-Bali are less likely to have children under five than women on the other islands. Table 2.17.1 Child care while working: background characteristics Percent distribution of employed women by whether they have a child under five years of age and percent distribution of employed mothers who have a child under five by person who cares for child while mother is at work, according to background characteristics, Indonesia 1994 Background characteristic Employed womel l One or Child's caretaker, among employed mothers who have children <5 years more Hus- Not No chi[- Re- band/ Other Child Institu- Other Other worked Number child dren spond part- rela- Neigh- Hired is in tional female male since of <5 <5 ent ner tire bor Friend help school care child child birth Other Missing Total women Residence Urban 64.2 358 40.9 48 33.1 2.6 03 97 08 0.2 47 12 1) 5 0.8 04 10(I.0 3.675 Rural 616 384 35.4 31 37,5 2.4 0.4 1.2 1.3 0.1 L33 39 06 (14 0.4 1()0 t} 12,059 Region/Residence Java Bali 65.9 34.1 342 3.7 41.1 2.8 0.5 3.7 0,5 0.0 8.9 3.4 (1.6 0.4 03 1(10.0 9,959 Urban 655 34.5 42.4 49 32.3 2,5 0.4 10.4 04 0.0 38 12 05 08 (1.4 1(10.0 2.780 Rural 66.1 33.9 31.0 32 44.5 29 0.6 1.0 05 0.0 10.9 4.2 0.6 0.3 03 100.0 7,178 Outer Java-Bali 1 549 45.1 40.9 32 29.5 1.9 0.2 2.5 23 0.2 14.7 3.0 0.6 0.6 04 100.0 4,086 Urban 593 40.7 38.7 5.1 34,3 2.9 0.0 7.5 2.3 0.5 6.6 0.7 02 (18 03 1(10.0 637 Rural 54.1 45.9 41.3 2.9 28.7 1.7 0.2 1.7 23 0.2 16.0 3.4 0.6 06 0.4 1000 3,449 OulerJava-BalilI 57.8 42.2 369 3.1 33.2 2.2 0.3 2.0 1.9 01 148 35 06 08 05 1000 1,689 Urban 62.2 37.8 32.2 2.8 37.2 2.0 0,7 8.9 1.9 08 82 27 16 04 B5 100.0 258 Rural 57.0 430 377 3.2 32.6 2.2 02 09 1.9 00 159 36 04 0.9 0.5 11100 1,431 Education No education 73 I 26.9 28.5 3.3 365 24 05 0.0 0.9 0.0 200 53 0.6 16 05 100.0 3.179 Some primary 63.8 36.2 38.1 26 32 0 2.4 05 02 1.8 0 1 160 5 0 0 8 112 (14 11}(1.() 5,513 Completed primary 58.5 41.5 411 42 39.1 2.2 0.4 0.2 09 01 84 2.3 0.5 (I.3 04 1110.0 3,926 Some secondary+ 52.9 47.1 344 4.(1 399 2.8 0.3 121 (19 0 2 34 (18 11.5 (k6 (12 1110.0 3,115 Respondent's occupation Professional/technical 53.3 46,7 8.9 8.0 44.5 4.7 1,2 25.8 0.7 07 4.1 04 05 0.5 01 ll100 818 Managerial/admin. 70.8 29,2 0.0 2.3 48.1 0,0 0.0 43.3 0.0 00 1.7 0.0 0.0 46 0.0 100.0 46 Clerical 53.4 46.6 3.1 2,9 60.5 6.4 0.0 23.3 0.3 0.3 0.3 01 1.7 0.8 0.4 100.0 389 Sales 63.5 36.5 59.8 5.7 202 2.5 0.1 2.6 1.1 0.0 5.8 1.5 0.1 0.4 0.2 100.0 3,485 Service 67.8 32.2 49,0 3.8 31.4 2.0 0,(1 0.7 0.6 0.0 6.8 1.4 2.2 0.2 19 100.0 734 Agricultural 63.1 36.9 25,2 2.1 43.4 2.2 0.6 0.0 1.7 0.0 177 53 08 0.7 (1.4 100.0 8,344 Induslrial 59.3 407 623 3.0 28.1 1.3 0.0 0.5 01 0,1 3.1 (1.9 01 01 0.4 1000 1,875 Other 526 47.4 618 3,9 28.8 0.0 00 0.0 00 00 5.5 00 00 0.0 00 1000 33 Employment year round/seasonal Allyear 61.4 38.6 40.3 3,7 349 2.5 0.4 43 1,1 0.1 8.6 2.8 0.7 0.5 0.2 1000 11,118 Seasonal 65,1 34.9 25.2 3.1 41.8 2.5 0.4 0.0 14 0,0 20.4 3.5 0.5 0.4 0.8 100.0 3,890 Occasional 587 41.3 365 2.4 363 1.5 00 0.0 19 00 10.7 8.8 0,0 1,5 0,5 1(100 718 Total 622 37,8 36.6 3.5 36.5 2.4 0,4 3.1 1.2 0.1 11.4 3.3 (1.6 05 (1.4 100.0 15,734 Note: Totals include 8 women with time frame missing and 11 women with occupation missing 36 Among working women, 37 percent take care of their children while they work. Relatives and older female siblings are the most common caretakers for children of working women (37 percent and 11 percent, respectively). The role of female siblings in child care in the absence of their mother is significant in rural areas and in families where the mother has limited education, works in agriculture, or works as a seasonal worker. Children whose mothers have attended secondary school, live in urban areas, are professionals or managers, or work in clerical occupations are more likely to be cared for by servants or hired help. Across all subgroups, husbands and male siblings have a very limited role in child minding while the mother is at work (4 percent each). The proportion of working mothers with children under five varies between regions, and is lower in Java-Bali than in the other islands. The proportion varies between a low of less than 30 percent in DKI Jakarta, DI Yogyakarta, East Java and Central Kalimantan, to 56 percent in North Sumatra (see Table 2.17.2). With some exceptions, mothers, relatives and female siblings are the most important caregivers while the mother is working. Servants or hired help are popular in DKI Jakarta, where they care for one in six children under five. Children in West Kalimantan, Riau and Southeast Sulawesi are likely to be cared for by female siblings while the mother is at work (24 to 30 percent). Table 2.17.2 Child care while working: region and province Percent distribution of employed women by whether they have a child under five years of age and percent distribution of employed mothers who have a child under five by person who cares for child while mother is at work, according to region and province, I Indonesia 1994 Region and 9rovince Employed women Child's caretaker, among employed mothers who have children <5 years One or more Hus- Not No chil- Re- band/ Other Child lnstdu- Other Other worked Number child dren spond- part- rela- Neigh Hired isin tionat female male since of <5 <5 ent net rive bor Friend help school care child child birth Other Missing Total women Java-Bali 65.9 34.1 34.2 3.7 41.1 2.8 DKI Jakarta 70.3 29.7 37.2 1.5 35,4 0.0 West Java 60.2 39.8 32,2 3.6 34.4 2.0 Central Java 59.4 40.6 35.1 4.9 42.5 2.9 DIYogyakarta 71.7 28.3 34.2 1.7 45.5 4.0 East Java 73,0 27.0 33.0 2.9 46.9 3.9 Bali 65.5 34.5 49.8 4.7 33.6 0.5 Outer Java-Bali I 549 45.1 40,9 3,2 295 1.9 DI Aceh 55,0 45.0 36,0 1.0 43.4 0.9 North Sumatra 43.6 56.4 42.4 2.8 24.6 0.8 West Sumatra 60.2 39.8 34.1 5.0 32.8 2.7 South Sumatra 60.5 39.5 50.0 5.6 245 2.6 Lampung 546 454 42.1 2.5 315 3.2 West NusaTenggara 53,0 47,0 38,3 2.3 36,6 West Kalimantan 54.4 45,6 33.5 3.3 29,1 South Kalimantan 66.3 33.7 38.1 3,2 26.1 North Sulawesi 61.4 38.6 44.2 18 36.5 SouthSulawesi 61.9 38.1 42.3 4.3 27.8 Outer Java-Bali 11 57.8 42.2 36.9 3.1 33.2 Riau 60.7 39.3 28.5 3.5 26.0 Jambi 582 41,8 43.3 2.8 28.5 Bengkulu 49,5 50.5 48.3 2.3 26.3 EastNusaTenggara 52.8 47.2 36.6 3,2 41.0 East Timor 494 50.6 32.9 4,0 43,9 Central Kalimantan 72,2 27,8 495 0,6 23,4 East Kalimantan 64.1 35.9 44.2 3.0 24.0 Central Sulawesi 58.4 41.6 28.2 4.3 375 Southeast Sulawesi 52.6 47.4 29.0 1,3 31.2 Maluku 49.5 50.5 33.6 5,0 50.1 Irian Jaya 60.6 39.4 35.1 4.5 389 Total 62.2 37.8 36.6 3.5 36.5 0.5 3.7 0,5 0.0 8,9 3.4 0.6 0.4 0.3 100.0 9,959 0.0 15.6 0.0 00 5.7 1.2 1.1 1.9 0.5 100.0 505 0.0 5.2 1.1 0.0 17.8 3.0 0.7 00 0.0 10().0 2,352 09 2.8 03 t).O 6.2 3.2 0,0 0,9 0,3 100,0 2,642 11.4 4.3 1.6 00 4.3 2.3 0.4 1,3 0,0 100.0 357 0.8 1.1 0,0 0.0 5.1 4.5 1.2 0,0 117 100.0 3,765 0.0 4.9 (1.3 00 3.3 1.9 0.0 0.3 0.7 100.0 337 02 2.5 2.3 02 14.7 3.0 0.6 0.6 0.4 100.0 4,086 00 2.0 0.4 0.4 13.9 1.3 0.0 0.0 0.7 100.0 313 0.0 35 4,1 0,4 15.8 4,0 0.9 05 0.2 100.0 942 0,0 3,tl 1,9 0,0 150 2 5 07 1.8 0.4 100.0 324 03 3,1 3,4 00 6.9 2.2 0,8 0.4 0.4 100.0 572 I1 1.0 3.2 0.0 12.0 2.9 0.0 05 0.0 100.0 431 2,3 0,0 1.8 0,6 t),0 14,9 2.2 0.3 0.6 0.0 100.0 365 1.4 00 1,9 0.6 00 23.9 4.2 t),8 1,1 0.3 I 0t).0 355 45 0.4 23 15 18 15.0 3.0 t),8 0.8 2.4 100.0 275 2.4 0.0 38 0.0 0.0 7.6 1.2 1.1 0.6 0.9 100.0 121 1.3 0.0 12 0.0 0.0 18.9 3.5 0.0 (18 0.0 100.0 388 2.2 0.3 2.0 1.9 0.1 14.8 35 06 0.8 0.5 100.0 1,689 2.3 1.1 5.0 5,4 00 236 38 00 0.0 0.8 1000 277 2.8 0.0 2.2 0.9 0.0 14.4 2.7 0.0 0.9 16 100.0 192 0.6 0.0 1.1 4.6 0.0 I 1.0 3.6 1.0 1.3 0.0 100.0 142 1.4 0.0 0,0 0.3 00 I 1.7 3.8 0.7 1.2 0.0 100.0 309 2.5 0.0 3.2 22 0.0 7.4 3.5 0.3 0.0 0.0 100.0 41 14 0.0 0.8 20 00 12.5 6.4 1.1 2.0 0.4 100.0 143 2.7 0.0 5,5 2,1 I1 10.7 3.1 2.9 07 0.0 ItFO.O 128 2.7 0.6 1.5 06 0,0 18,5 46 1,0 0.0 t),6 100,0 131 3.5 I1.(I 0.4 0.0 0.0 29.6 3.1 0.0 0.0 2.0 100.0 106 2,4 07 12 2.3 00 2.9 1.2 0.0 O0 0.8 100.0 78 3.7 0.0 2.5 0.0 0,5 10,5 2,1 0.0 22 0,0 100.0 142 2.4 0.4 3.1 1,2 0.1 11.4 3.3 17.6 05 0.4 100.0 15.734 37 CHAPTER '3 FERTIL ITY A major objective of the 1994 IDHS is to estimate fertility levels, trends and differentials. Like the 1991 IDHS, detailed information from all ever-married women on current, cumulative and past levels of fer- tility was collected for the 1994 IDHS. The fertility information was collected using two procedures. First, each woman was asked a series of questions about the number of live births and the number of children sur- viving. Experience has indicated that certain types of events are underreported. To minimize error, children were identified by sex, whether they lived with their mother or elsewhere, and whether they were living or dead. Identification by sex improves reporting and allows estimation of sex-specific mortality rates. Second, a full birth history was obtained from each woman, and for each live birth the following information was col- lected: name, sex, month and year of birth, whether the birth was single or multiple, and the survival status of the child. For living children, the woman was asked whether the child was living in the household or away. For dead children, the age at death was recorded. To reduce underreporting of births, if the interval between births was four years or longer, interviewers were required to check whether the respondent had had a child during the interval. Information on whether currently married women were pregnant was also solic- ited. From population censuses and surveys in Indonesia, fertility and mortality rates have been estimated using indirect methods, based on information on the number of children ever born and children surviving. The fertility measures presented here are calculated directly from the birth history. In applying a direct fertility estimation procedure, it is important to note that although the birth history offers a richer set of data for analysis, it has limitations and is susceptible to data collection errors. Because interviews were conducted only with living women, there is no information on the fertility of women who died. The fertility rates would be biased if the mortality of women of childbearing age were high and if there were significant differences in fertility between living and dead women. In Indonesia, neither of these appears to be the case. Also, the 1994 IDHS collected birth histories only from ever-married women. Since most births in Indonesia occur within marriage, the number of births to single women is negligible. The accuracy of fertility data is affected primarily by underreporting of births (especially children who died in early infancy) and misreporting of date of birth. Errors in underreporting of births affect the esti- mates of fertility levels, while misreporting of dates of births can distort estimates of fertility trends. If these errors vary by socioeconomic characteristics of the women, the differentials in fertility will also be affected. 3.1 Fertility Levels and Trends Table 3.1 and Figure 3.1 present the total fertility rates (TFR) and the age-specific fertility rates (ASFR) ~ derived from the 1994 IDHS along with results from various other sources. The TFR is calculated by summing the age-specific fertility rate and can be interpreted as the average number of births a hypo- thetical woman would have at the end of her reproductive life if she were subject to the currently prevailing age-specific rates from age 15 to 49. It is important to note that the rates are not strictly comparable because Numerators of the age-specific fertility rates are calculated by summing the number of live births that occurred in the period 1-36 months preceding the survey (determined by the date of interview and the date of birth of the child), and classifying them by the age (in five-year groups) of the mother at the time of birth (determined by the mother's date of birth). The denominators of the rates are the number of woman-years lived in each of the specified five-year groups during the 1-36 months preceding the survey. 39 Table 3.1 Fertility rates from various sources Age-specific and cumulative fertility rates from selected sources, Indonesia 1971-1994 1971 1976 1980 Age Census SUPAS Census group (1967-70) (1971-75) (1976-79) 1985 1987 1990 1991 SUPAS NICPS I Census IDHS (1980-85) (1984-87) ~ (1986-89) (1988-91) 2 1994 IDHS (1991-1994) 2 Urban Rural Total 15-19 155 127 116 95 78 71 67 34 78 61 20-24 286 265 248 220 188 178 162 108 170 147 25-29 273 256 232 206 172 172 157 141 155 150 30-34 211 199 177 154 126 128 117 105 110 109 35-39 124 118 104 89 75 73 73 57 73 68 40-44 55 57 46 37 29 31 23 16 38 31 45-49 17 18 13 10 10 9 7 1 5 4 TFR 15-49 5.61 5.20 4.68 4.06 3.39 3.31 3.02 2.31 3.15 2.85 TFR 15-44 5.52 5.11 4.62 4.01 3.34 3.27 2.99 2.30 3.12 2,83 GFR 108 81 111 101 CBR 25.1 21.0 24.2 23.3 Note: Estimates for 1971 through 1985 and for 1990 were computed using the own children method, while the 1987 NICPS, 1991 IDHS and 1994 IDHS rates were calculated directly from birth history data. TFR: Total fertility rate expressed per woman GFR: General fertility rate (births divided by number of women 15-44), expressed per I,/)00 women CBR: Crude birth rate expressed per 1,000 population I Excludes 7 provinces in Outer Java-Bali 11 2 1-36 months prior to survey Figure 3.1 Age-Specific Fertility Rates Indonesia 1967-1994 300 Births per 1,000 Women 250 200 / 150~/ 'il ! i i 15-19 20-24 25-29 Age i i i 30-34 35-39 40-44 45-49 40 of differences in data collection procedures, geographic coverage, and estimation techniques. Nevertheless, they serve the purpose of reflecting recent fertility trends in Indonesia. Table 3.1 shows that the TFR has declined steadily in Indonesia since the late 1960s. The overall fertility rate for the period 1991-94 (2.9 children per woman) is half of that reported for the period 1967-70 (5.6 children per woman). Results from the 1994 IDHS indicate that the pattern of fertility by age group is the same as in the past, except that the peak in fertility has shifted from age 20-24 to age 25-29. Fertility has declined in all age groups in Indonesia. For example, in the youngest age group (women 15-19), fertility declined 60 percent between the periods 1967-70 and 1991-94, from 155 births per 1,000 women to 61 births per 1,000 women. There was also a substantial decline among women 20-24 years, from 286 to 147 births per 1,000 women. The shape of the age-specific fertility curve has flattened considerably, due to the sharp decline in fertility among women age 20-34 years. Table 3.1 presents the general fertility rate (GFR) and the crude birth rate (CBR) for the three years preceding the 1994 IDHS. The GFR is the number of live births per 1,000 women age 15-44 years. The CB R is the number of births per 1,000 population; it is calculated by summing the product of the age-specific fertility rates and the proportion of women in the specific age group out of the total number of persons who usually live in the selected households. The GFR is 101 and the CBR is 23.3. The IDHS data indicate that there is a substantial gap in fertility between urban and rural residents. Urban women have, on average, almost one child less than rural women (2.3 versus 3.2). The largest urban- rural difference is for women age 15-24. Fertility trends can also be investigated using retrospective data from a single survey. Tables 3.2 and 3.3 are generated from the birth history data collected in the 1994 IDHS. The numerators of these rates are classified by four-year segments of time preceding the survey and by mother's age at the time of birth in five- year intervals. Because women 50 years and over were not interviewed in the 1994 IDHS, the data in Table 3.2 are truncated. For example, rates cannot be calculated for women age 45-49 for part of the 4-7 years and all of the 8-11 years prior to the survey, because those women would have been 50 years or older at the time of the survey. The bottom diagonal of estimates is also partially truncated. Table 3.2 Age-specific fertility rates Age-specific fertility rates for four-year periods preceding the survey, by mother's age at the time of birth, Indonesia 1994 Maternal age at birth Number of years preceding the survey 0-3 4-7 8-11 12-15 16-19 15-19 63 86 109 129 135 20-24 151 169 220 250 250 25-29 149 163 200 239 246 30-34 110 124 156 185 [221] 35-39 72 79 98 [150] 40-44 30 35 [55] 45-49 [4] [4] Note: Age-specific fertility rates are per 1,000 women. Estimates in brackets are truncated. 41 Table 3.3 Fertility by marital duration Fertility rates by duration (years) since first marriage/'or four-year periods preceding the survey, Indonesia 1994 Marital duration at birth Number of years preceding the survey 0-3 4-7 8-11 12-15 16-19 0-4 281 286 308 328 317 5-9 162 185 223 273 273 10-14 128 132 177 218 238 15-19 81 104 134 168 [192] 20-24 52 61 [971 [122] a 25-29 23 [34] a a a Note: Duration-specific fertility rates are per 1,000 women. Estimates in brackets are truncated. a Less than 125 woman-years of exposure As in the 1991 IDHS, there are indications of an acceleration in the rate of fertility decline among women 15-24 accompanied by a slower decline among older women. Tables 3.2 and 3.3 show similar patterns, i.e., for the same age group or marriage duration, recent fertility is lower than that in the distant past, and fertility has declined more rapidly in recent years. Table 3.4 and Figure 3.2 present TFRs for the six provinces in Java-Bali from selected sources. In demographic studies of Indonesia, it is important to set this region apart from the rest of the country because of its distinct socioeconomic and political context. In addition to the availability of comparable data from the population censuses and past demographic surveys, family planning programs in this region were initiated earlier than in other regions in the country. Table 3.4 Total fertility rates for provinces in Java-Bali Total fertility rates for provinces in Java-Bali from selected sources, Indonesia 1971-1994 Province 1971 1976 1980 1985 1987 1990 1991 1994 Census SUPAS Census SUPAS NICPS I Census IDHS IDHS (1967-70t (1971-75) (1976-79) (1980-85/ (1984-87) 2 (1986-89) (1988 91)2(1991-1994) 2 DKI Jakarta 5.18 4.78 3.99 3.25 2.8 2.33 2.14 1.90 West Java 6.34 5.64 5.07 4.31 3.6 3.47 3.37 3.17 Central Java 5.33 4.92 4.37 3.82 3.2 3.05 2.85 2.77 DI Yogyakarta 4.76 4.47 3.42 2.93 2.3 2.08 2.04 1.79 East Java 4.72 4.32 3.56 3.20 2.7 2.47 2.13 2.22 Bali 5.96 5.24 3.97 3.09 2.6 2.27 2.22 2.14 Note: Estimates for 1971 through 1985 and for 1990 were computed using the own children method, while the 1987 NICPS, 1991 IDHS and 1994 IDHS rates were calculated directly from birth history data. I Excludes 7 provinces in Outer Java-Bali 11 2 1-36 months preceding the survey 42 Figure 3.2 Total Fertility Rates by Province Java-Bali 1967-1994 Number of Ch i ldren E)KI Jakarta West Central DI Yogyakarta East Bali Java Java Java According to Table 3.4, fertility in Java-Bali has declined significantly since the late 1960s. Among the provinces, West Java consistently shows the highest fertility rates, and DI Yogyakarta the lowest. Until the mid-1970s, the fertility rate in Bali was second highest after West Java. However, a rapid decline in the early 1980s brought the rate in Bali to a level lower than that of all other provinces in the region except DI Yogyakarta. The 1994 IDHS presents slightly different results. The fertility rate for Bali is slightly higher than the rate for DKI Jakarta, shifting its position to third lowest. Table 3.4 and Figure 3.2 show that fertility in Java-Bali has continued to decline, except in East Java, where fertility increased slightly from 2.1 children per woman ( 1991 IDHS) to 2.2 children per woman ( 1994 IDHS). However, these figures should not be interpreted as indicating that fertility in East Java has actually increased in the recent past, since the change (0.09 children per woman) is so small. 3.2 Fertility Differentials Tables 3.5.1 and 3.5.2 present differentials in fertility by residence, region and level of education using the TFR as the measure of current fertility. The first column of each table shows TFRs for the three years prior to the survey (mid- 1991 to mid- 1994), the second column presents the percentage of women who are currently pregnant, and the third column presents the mean number of children ever born (CEB) to the oldest women (age 40-49). The mean number of CEB is an indicator of cumulative fertility; it reflects the fertility performance of older women who are nearing the end of their reproductive period, and thus represents completed fertility. If fertility had remained stable over time, the two fertility measures, TFR and CEB, would be equal or similar. 43 Table 3.5.1 Fertility: background characteristics Total fertility rate for the three years preceding the survey, percentage currently pregnant, and mean number of children ever born (CEB) to women age 40-49, by selected background characteristics, Indonesia 1994 Mean number Total Percentage of CEB Background I~rtility currently to women characteristic rate I pregnant ~ age 40-49 Residence Urban 2.31 4.11 4.50 Rural 3.15 4.86 4.88 Region/Residence Java-B ali 2.60 4.18 4.47 Urban 2.18 3.89 4.43 Rural 2.90 4.39 4.50 Outer Java-Bali 1 3.26 5.35 5.26 Urban 2.54 4.63 4.73 Rural 3.51 5.58 5.42 Outer Java-Bali |1 3.33 5.18 5.12 Urban 2.88 4.83 4.61 Rural 3.48 5.28 5.25 Education No education 2.88 4.05 4.61 Some primary 3.28 4.46 5.20 Completed primary 2.96 5.44 4.86 Some secondary+ 2.57 4.27 4.01 Total 2.85 4.61 4.76 tWomen age 15-49 years Compared with other regions, Java-Bali consistently shows the lowest fertility in the country. However, in recent years, fertility in Outer Java-Bali, particularly in Outer Java-Bali II, declined rapidly, narrowing the difference in fertility between this region and the rest of the country (data not shown). Fertility in Java-Bali is 20 percent lower than in Outer Java-Bali 1 and 22 percent lower than in Outer Jawt-Bali II. These figures are less than those reported in the 1991 IDHS: fertility in Java-Bali was 23 percent lower than in Outer Java-Bali I, and 28 percent lower than in Outer Java-Bali II. As in the 1991 IDHS, the 1994 IDHS findings show an inverted U-shape relationship between educa- tion and fertility, where the peak is for women who have some primary education. Comparing TFRs from the 1991 and 1994 IDHSs indicates that fertility is declining faster among women who have no education ( 12 percent) than among those who have gone to school (7 percent or less). Table 3.5.1 shows that 5 percent of women are currently pregnant. This percentage varies between regions and by urban-rural residence, and education. The last column of Table 3.5 shows that the mean number of CEB among women age 40-49 is much higher than the TFR for the three years preceding the survey, suggesting a substantial reduction in fertility. The 1987 NICPS and 1991 IDHS show a similar pattern. Table 3.5.2 presents fertility differentials among the provinces. Based on the 1991 and 19!)4 IDHS results, the TFR in Indonesia has declined slightly from 3.0 children to 2.9 children per woman. The decline occurred in all regions, but most substantially in Outer Java-Bali II. In the Java-Bali region, the TFR decreased from 2.7 to 2.6 children per woman. 44 Table 3.5.2 Fertility: region and province Total l~:rtility rate for the three years preceding the survey, percentage currently pregnant, and mean number of children ever born (CEB) to women age 40-49, by region and province, Indonesia 1994 Mean number of CEB Total Percentage ever born Region and fertility currently, to women province rate I pregnant I age 40-49 Java-Bali 2.60 4.18 4.47 DKI Jakarta 1.90 3.97 4.14 West Java (3.17) 5.38 5.39 Central Java 2.77 3.53 4.55 DI Yogyakarta 1.79 3.15 3.64 East Java 2.22 3.72 3.82 Bali 2.14 3.54 3.90 Outer Java-Ball 1 3.26 5.34 5.27 DI Aceh 3.30 4.78 5.42 North Sumatra (3.88) 6.70 5.55 West Sumatra (3.19) 5.69 5.26 South Sumatra 2.87 4.12 5.20 Lampung (3.45) 4.78 5.40 West Nusa Tenggara (3.64) 5.93 6.03 West Kalimantan (3.34) 7.06 5.62 South Kalimantan 2.33 4.64 4.66 North Sulawesi (2.62) 3.05 4.24 South Sulawesi 2.92 4.87 4.95 Outer Java-Bali II 3.33 5.19 5.12 Riau 3.10 5.50 5.37 Jambi (2.97) 4.58 4.94 Bengkulu (3.45) 4.92 6.06 East Nusa Tenggara 3.87 4.69 5.17 East Timor (4.69) 8.88 4.28 Central Kalimantan (2.31) 5.06 4.75 East Kalimantan (3.21) 4.33 5.07 Central Sulawesi (3.08) 5.51 5.40 Southeast Sulawesi (3.50) 4.85 4.85 Maluku (3.70) 4.98 4.82 lrian Jaya (3.15) 6.20 4.88 Total 2.85 4.61 4.76 Note: Rates in parentheses indicate that one or more of the com- ponent age-specific rates is based on fewer than 250 woman-years of exposure. IWomen age 15-49 years Among the six prov inces in Java-Bal i , two have reached a fert i l i ty level o f less than 2 ch i ldren per woman- -D l Yogyakar ta (1.8) and DK I Jakarta (1.9). Two other p rov inces - -Ba l i (2.1) and East Java (2 .2 ) - -a re approach ing the level o f 2 chi ldren per woman. West Java cont inues to have the h ighest fert i l i ty in the region (3.2 chi ldren per woman) , which is a d i f ference o f more than one chi ld f rom the prov inces wi th the lowest fert i l i ty. 45 Data from the 1994 IDHS show that the TFR. is at least 3 for almost all the provinces in the Outer Java-Bali II region, except Central Kalimantan, which has a TFR of 2.3 children per woman. The rate for this province may be underestimated. 2 3.3 Ch i ld ren Ever Born and L iv ing In the survey questionnaire, the total number of children ever born was ascertained by a sequence of questions designed to maximize recall. Since lifetime fertility reflects the accumulation of births over the past 30 years, it has limited direct relevance to the current situation. Nevertheless, the data are important in providing background information for understanding current fertility. Table 3.6 presents the distribution of all women and of currently married women by the number of children ever born and the average number of children still living. Since the respondents in the 1994 IDHS are ever-married women, information on the reproductive history of never-married women is not available. However, since virtually all births in Indonesia occur within marriage, it is safe to assume that never-married women have had no births; differences in results between all women and currently married women are greatest at the younger ages because of the large proportion of women who are still single and presumed to have had no births. Table 3,6 Children ever born and living Percent distribution of all women and of currently married women age 15-49 by number of children ever born (CEB) and mean number ever born and living, according to five-year age groups, Indonesia 1994 Number of children ever born (CEB) Number Mean no. Mean no. Age of of of living group 0 I 2 3 4 5 6 7 8 9 10+ Total women CEB children ALL WOMEN 15-19 911 8.0 0.9 0.0 0.0 0.0 0.0 0.0 0,0 0.0 0.0 100.0 7.580 010 0,09 20-24 473 34.3 14.1 3.6 0,6 0.1 00 0.0 00 0,0 00 100.0 6,563 0.76 070 25-29 19.1 24.5 29.6 16.5 7.11 2.4 0.7 0,2 0.1 00 0.0 100.0 6,342 179 1.63 30-34 8.6 9.6 262 25.0 14.7 8.4 4,6 1.7 0.7 03 01 100,0 5,964 288 2.56 35-39 5.2 7.0 15.6 22.6 18.2 11.7 8,6 5.0 2.8 1.8 14 100.0 5,/119 3.78 3.34 40-44 5.7 5.1 11.8 15.9 13.7 13.7 12.9 8.4 5.1 3.5 4.2 100.0 3.754 453 389 4549 47 6.5 9.1 113 13.5 12.2 12.6 10.7 82 4.2 6.9 100.0 3,111 5.04 4,23 Total 32.2 149 155 12.7 8.4 5.6 4,2 2.6 17 1.0 1.2 CURRENTLY MARRIED WOMEN 100.0 38,334 2,24 1.97 15-19 492 45.3 52 0,1 0.2 0.1 0.0 0.0 00 0.0 0.0 1000 1,291 0,57 0.53 20-24 15,5 54.6 22.7 5.8 I,I 0.2 0.0 0.0 00 00 00 1000 3.936 1.23 1,13 25-29 53 278 34.7 19.7 84 2,9 1).8 0.2 01 0.0 0,t) 100.0 5.234 2.11 1.92 30-34 32 9,3 27.4 27.2 15.7 9.1 5.0 1.9 0.8 0,3 0.1 100.0 5.387 3.08 2 74 35-39 211 6.3 15.9 23.6 19,1 12.3 9.2 5.3 2,9 2.0 1.5 100.0 4,483 3,96 3.51 40-44 3.1 4.3 I1,1 165 14.6 144 13.3 9.2 5.3 38 4.4 100.0 3,262 4.75 4.10 45-49 2.8 5.7 84 11.1 13,5 12.6 12.9 11.6 8.9 4.6 7.8 100.0 2,594 531 447 Total 75 201 212 17.6 11.5 76 5.7 36 2.2 13 16 100.0 26.186 3.1)6 2.70 2 Based on the results of the 1990 Population Census, the TFR for Central Kalimantan for the 1986-1989 period was 4.0 births per woman. Assuming continued fertility decline, the TFR was projected to be 3.3 births per woman in 1994, one child higher than the IDHS rate. 46 It is estimated that, by the time a woman reaches the end of her childbearing period, she will have given birth to an average of 5 children (see Table 3.6). The average number of children ever born increases with age; women 15-24 have had an average of less than one live birth, while women 35-39 have had an average of 3.8 births. One in three Indonesian women does not have any children. About 15 percent each have one child, 15 percent have two children, and 13 percent have three children. The remaining 25 percent have four or more children. Five percent of women age 45-49 are childless. For all women and for currently married women, the difference between the number of children ever born and still living is notable only after age 30. 3.4 Birth Intervals A child's health status is closely related to the length of the preceding birth interval. Children born after a short birth interval are at greater risk of illness and death than those born after a long interval. Further, the occurrence of closely spaced births gives the mother insufficient time to restore her health, which may limit her ability to take care of her children. The duration of breastfeeding for the older child may be shortened, since the mother must breastfeed the younger child. Tables 3.7.1 and 3.7.2 show the percent distribution of births in the five years preceding the survey by length of the previous birth interval. Overall, women in Indonesia favor a relatively long birth interval--a median of 42 months. Forty-two percent of births occur four or more years after a previous birth, 41 percent. occur at an interval of two or three years, and 17 percent occur less than two years after a previous birth. As with the 1991 IDHS, the 1994 IDHS indicates that birth intervals vary little according to the child's birth order (up to 6), sex, urban-rural residence, mother's education and mother's work status. However, there are significant differences in birth intervals by mother's age and survival of the preceding birth. Younger women have shorter birth intervals than older women; the median for women age 15-19 is 25.9 months, while for women age 40-44 it is 51.4 months. For children whose preceding sibling is alive, the median interval between births is 15 months longer than for children whose preceding sibling died (44 months, compared with 29 months). Table 3.7.2 indicates that birth intervals vary widely by region and province. On average, women in Java-Bali have an interval one year longer than women in other parts of Indonesia (48 months, compared with 36 months in the Outer Java-Bali region). Among all the provinces, women in East Java have the longest median birth interval (56 months), and women in North Sumatra and East Timor have the shortest (31 months). 47 Table3.7.1 Birth intervals: background characteristics Percent distribution of non-first births in the five years preceding the survey by number of months since previous birth, according to demographic and socioeconomic characteristics, Indonesia 1994 Median Number of months since previous birth number of Number Background months since of characteristic 7-17 18-23 24-35 36-47 48+ Total previous birth births Age of mother 15-19 19.2 19.2 42.4 14.9 4.3 100.0 25.9 74 20-24 11.4 17.6 31.8 19.2 20.0 100.0 31.0 1,341 25-29 7.6 11.4 25.0 18.5 37.4 100.0 39.2 3,594 30-34 5.8 8.1 22.4 15.9 47.9 100.0 46.3 3,563 35-39 3.9 8.9 21.5 14.7 51.0 100.0 48.6 2,287 4044 2.8 8.1 20.9 15.4 52.8 100.0 51.4 978 45-49 1.5 5.1 28.5 20.0 44.9 100.0 43.5 189 Birth order 2-3 7.1 10.3 21.5 16.3 44.7 100.0 43.8 6,699 4-6 5.0 8.7 24.9 17.6 43.8 100.0 42.8 3,861 7 + 6.7 14.6 34.0 17.2 27.5 100.0 33.8 1,466 Sex of prior birth Male 6.8 10.4 22.9 15.4 44.4 100.0 42.9 6,212 Female 6.0 10.2 25.4 18.3 40.1 100.0 40.8 5,814 Survival of prior birth Living 4.8 9.3 24.3 17.1 44.5 100.0 43.6 10,780 Dead 19.9 18.9 23.0 14.4 23.8 100.0 28.5 1,246 Residence Urban 6.2 8.7 22.8 15.9 46.4 100.0 44.6 3,102 Rural 6.4 10.9 24.6 17.2 40.9 100.0 40.9 8,924 Region/Residence Java Bali 4,3 8.0 21.0 16.7 50.1 100.0 48.0 6,569 Urban 4.2 6.9 21.5 15.1 52.3 100.0 49.7 2,088 Rural 4.3 8.5 20.7 17.4 49.0 100.0 47.3 4,481 Outer Java-Bali 1 9.4 13.0 27.7 16.5 33.4 100.0 35.9 3,789 Urban 11.1 11.1 25.9 18.2 33.7 100.0 36.7 693 Rural 9.1 13.4 28.1 16.1 33.3 100.0 35.7 3,096 Outer Java Bali II 7.7 13.3 28.4 18.3 32.2 100.0 36.3 1,669 Urban 8.4 14.7 24.7 16.5 35.7 100.0 37.3 322 Rural 7.6 12.9 29.3 18.7 31.4 10O.0 36.1 1,347 Education No education 5.6 11.1 24.7 17.2 41.5 100.0 42.1 1,769 Some primary 5.0 9.5 23.7 17.1 44.7 100.0 44.0 4,365 Completed primary 6.8 9.9 23.1 16.4 43.8 1000 42.2 3,219 Some secondary+ 8.7 11.7 25.8 16.7 37.2 100.0 38.2 2,674 Work status Worked in past year 5.8 9.7 24.4 15.9 44.2 100.0 43.2 5,941 Did not work 6.9 10.9 23.9 17.7 40.5 100.0 40.7 6,085 Total 6,4 10.3 24.1 16.8 42.3 100.0 41.8 12,026 Note: The interval for multiple births is the number of months since the preceding pregnancy that ended in a live birth. 48 Table 3.7.2 Birth intervals: region and province Percent distribution of non-first births in the five years preceding the survey by number of months since previous birth, according to region and province, Indonesia 1994 Median Number of months since previous birth number of Number Region and months since of province 7-17 18-23 24-35 36-47 48+ Total previous birth births Java-Bali 4.3 8.0 21.0 16.7 50.1 100.0 48.0 6,569 DKI Jakarta 4.3 8.7 24.1 18.0 44.8 100.0 45.6 387 West Java 5.4 7.4 20.2 18.7 48.3 100.0 46.6 2,725 Central Java 3.0 9.9 21.2 16.7 49.3 100.0 47.5 1,805 DI Yogyakarta 4.7 7.3 17.6 14.6 55.8 100.0 51.4 I I 1 East Java 3.3 6.8 21.1 12.6 56.3 100.0 56.4 1,404 Bali 8.1 7.2 26.6 16.8 41.3 100.0 39.5 137 Outer Java-Bali I 9.4 13.0 27.7 16.5 33.4 100.0 35.9 3,789 DI Aceh 10.0 12.9 29.1 17.6 30.5 100.0 35.1 289 North Sumatra 13.5 16.5 32.9 14.3 22.8 100.0 30.5 1,015 West Sumatra 7.1 13.7 23.5 17.3 38.4 100.0 38.8 274 South Sumatra 7.3 l 1.5 25.4 19.6 36.2 100.0 38.4 397 Lampung 3.2 8.6 26.1 17.7 44.3 100.0 43.9 415 West Nusa Tenggara 5.8 13.9 26.6 18.3 35.4 100.0 38.1 303 West Kalimantan I 1.3 11.8 26.9 15.9 34.1 100.0 36.0 281 South Kalimantan 8.9 8.9 21.3 15.2 45.8 100.0 43.6 155 North 8ulawesi 7.4 7.8 21.2 15.6 48.1 100.0 46.2 140 South Sulawesi 10.9 13.1 26.8 16.4 32.9 100.0 35.6 520 Outer Java.Bali II 7.7 13.3 28.4 18.3 32.2 100.0 36.3 1,669 Riau 9.4 14.7 28.2 16.4 31.4 100.0 34.8 293 Jambi 5.6 12.3 22.3 19.5 40.3 100.0 41.8 156 Bengkulu 6.9 10.1 28.6 16.1 38.3 100.0 38.6 101 East Nusa Tenggara 6.5 13.4 34.7 18.3 27.1 100.0 33.2 276 East Timor 9.2 17.8 34.0 18.0 21.0 100.0 30.8 100 Central Kalimantan 4.3 12.1 26.6 22.9 34.1 100.0 39.3 80 East Kalimantan 6.6 9.7 22.4 16.8 44.6 100.0 44.1 150 Central Sulawesi 9.5 13.1 22.0 20.6 34.8 100.0 37.8 123 Southeast Sulawesi 10.2 13.0 27.6 19.3 30.0 100.0 35.8 113 Maluku 9.9 16.3 31.9 18.2 23.8 100.0 32.7 147 lrian Jaya 6.1 12A 30.0 18.8 33.1 100.0 37.0 130 Total 6.4 10.3 24.1 16.8 42.3 100.0 41.8 12,026 Note: The interval for multiple births is the number of months since the preceding pregnancy that ended in a live birth. 3.5 Age at First Birth Table 3.8 presents the distribution of women by age at first birth. The distribution is similar to that in the 1991 IDHS, and shows that the prevalence of early childbearing has declined over time. While 9 percent of women 45-49 had their first child before age 15, only 1 percent of women 15-19 did so. The median age at first birth among Indonesian women (see last column) has changed little over time. 49 Table 3.8 Age at first birth Percent distribution of women 15-49 by age at first birth, according to current age, Indonesia 1994 Women Median with Age at first birth Number age at no of first Current age births <15 15-17 18-19 20-21 22 24 25+ Total women birth 15-19 91.1 1.0 5.2 2.7 NA NA NA 100.0 7,580 a 20-24 47.3 2.4 13.1 17.9 14.1 5.1 NA 100.0 6,563 a 25-29 19.1 4.6 17.4 19.8 16.1 15.3 7.8 100.0 6,342 21.(I 30-34 8.6 5.5 20.7 22.7 18.1 14.6 9.9 100.0 5,964 20.1 35-39 5.2 6.7 23.0 19.5 18.6 15.2 11.8 100.0 5,019 20.1 40-44 5.7 7.6 23.0 20.7 16.3 13.4 13.3 100.0 3,754 19.9 45-49 4.7 8.8 24.7 16.7 15.2 15.9 14.0 100.0 3,111 20.0 NA = Not applicable aomitted because less than 50 percent of the women in the age group x to x+4 have had a birth by age x Table 3.9.1 presents data on differentials in median age at first birth among women age 25-49 years by selected background characteristics. Results of the 1994 IDHS indicate there are wide differences in the age at which women have their first child. Overall, the median age at first birth is 20.3 years; urban women start childbearing two years later than their rural counterparts, and women in Java-Bali have their first birth one year earlier than women in other regions. Women with some secondary or higher education start childbearing four years later than women with less education. Table 3.9.1 Median age at first birth: background characteristics Median age at first birth among women age 25-49 years, by current age and selected background characteristics, Indonesia 1994 Current age Women Background age characteristic 25-29 30-34 35-39 40-44 45-49 25-49 Residence Urban 23.6 21.0 21.2 20.6 20.6 21.6 Rural 20.0 19.7 19.6 19.5 19.7 19.7 Region/Residence Java-Bali 20.5 19.7 19.6 19.4 19.5 19.8 Urban 23.2 20.7 20.8 20.3 20.0 21.1 Rural 19.4 19.1 18.8 19.0 19.1 19.1 Outer Java-Bali I 21.8 20.9 20.8 20.5 20.6 21.0 Urban 24.6 22.5 22.2 21.8 21.8 22.8 Rural 21.0 20.5 20.5 20.3 20.2 20.5 Outer Java-Bali I1 21.8 21.0 21.0 20.8 20.7 21.1 Urban 24.1 22.3 22.6 21.4 21.1 22.6 Rural 20.9 20.5 20.5 20.6 20.7 20.7 Education No education 19.2 19.3 19.3 19.5 19.4 19.3 Some primary 19.1 19.3 19.3 19.3 19.0 19.2 Completed primary 19.9 19.6 19.8 19.8 19.8 19.8 Some secondary+ 24.4 22.8 22.8 22. I 22.7 23.3 Total 21.0 20. I 20.1 19.9 20.0 20.3 Note: The medians for cohort 15-24 could not be determined because half the women have not yet had a birth. 50 The median age at first birth varies substantially by province, ranging from 19.2 years in West Java to 22 years and older in DI Yogyakarta, South Sulawesi, East Nusa Tenggara, East Timor and Maluku (see Table 3.9.2). Childbearing begins before age 20 in West Java, East Java, Bengkulu, Lampung, and South Kalimantan. Table 3.9.2 Median age at first birth: region and province Median age at first birth among women age 25-49 years, by current age, region and province, Indonesia 1994 Current age Women Region and age province 25-29 30-34 35-39 40-44 45-49 25-49 Java-Bali 20.5 19.7 19.6 19.4 19.5 19.8 DKI Jakarta 24.2 20.8 20.9 20.8 20.9 21.8 West Java 19.7 19.2 18.8 18.6 19.0 19.2 Central Java 20.5 19.5 19.9 19.9 20.0 20.0 DI Yogyakarta 23.6 21.9 22.1 20.9 20.2 22.0 East Java 20.4 19.7 19.1 19.0 18.8 19.5 Bali 22.2 21.4 20.8 20.2 20.6 21.0 Outer Java-Bali I 21.8 20.9 20.8 20.5 20.6 21.0 DI Aceh 21.0 20.5 20.3 19.5 19.3 20.2 North Sumatra 22.5 21.9 21,5 21.3 21.1 21.8 West Sumatra 23.6 21.3 20.5 20.9 21.0 21.5 South Sumatra 22.2 20.4 20.8 20.3 19.8 20.7 Lampung 19.5 19.2 20.2 19.0 20.3 19.4 West Nusa Tenggara 20.3 20.4 20.2 20.8 21.4 20.4 West Kalimantan 21.1 21.1 20.3 19.8 20.0 20.5 South Kalimantan 20.5 19.8 19.4 19.4 18.8 19.6 North Sulawesi 22.3 21.5 21.7 21.6 22.9 21.9 South Sulawesi 23.9 21.9 21.5 21.7 21.5 22.0 Outer Java-Bali 1I 21.8 21.0 21.0 20.8 20.7 21.1 Riau 22.2 20.7 20.4 20.0 18.5 20.5 Jambi 20.8 20.0 20.4 20.5 18.5 20.2 Bengkulu 21.1 19.6 19.5 19.3 19.3 19.7 East Nusa Tenggara 23.9 23.0 22.4 22.0 22.5 22.9 East Timor 21.4 22.4 23.3 22.3 23.9 22.3 Central Kalimantan 20.5 20.0 21.2 21.1 21.9 20.8 East Kalimantan 22.1 21.7 20.4 20.6 20.6 21. I Central Sulawesi 21.8 21.3 21.3 21.2 22.5 21.5 Southeast Sulawesi 20.8 19.4 20.0 20.7 21.7 20.4 Maluku 21.9 21.9 22,1 22.8 23.6 22.3 lrian Jaya 20.7 20.6 21.8 19.9 20.2 20.6 Total 21.0 20. I 20.1 19.9 20.0 20.3 Note: The medians for cohort 15-24 could not be determined because half the women have not yet had a birth. 3.6 Teenage Fertility The topic of teenage fertility is important because teenage mothers and their children are at increased risk of social and health problems. Births to teenage mothers usually follow an early marriage. Because women who marry at an early age often come from poor families with limited education and low health status, their children are more prone to illness and to higher mortality during childhood than other children. 5l Table 3.10.1 presents information on fertility among women age 15-19. Teenagers who have never married are assumed to have had no pregnancies and no births. Overall, 9 percent of women 15-I 9 years have become mothers, and 2 percent are currently pregnant with their first child. There are large differentials between subgroups of women. As expected, there is a positive relationship between age and teenage fertility; the proportion of women who have started childbearing increases with age. While less than 1 percent of 15- year-olds have become mothers or are pregnant with their first child, by age 19 the proportion has reached 29 percent. Women's education is inversely related to the initiation of childbearing; while one in five teenagers who have less than primary education have given birth or are currently pregnant with their first child, the proportion among those with some secondary schooling is only 5 percent. Table 3.10.1 Teenage pregnancy and motherhood: background characteristics Percentage of women 15-19 who are mothers or pregnant with their first child, by selected background characteristics, Indonesia 1994 Percentage who are: Percentage who have Pregnant begun Number Background with first child- of characteristic Mothers child bearing women Age 15 0.6 0.3 0.9 1.626 16 2.1 1.1 3.2 1,544 17 7.3 1.5 8.8 1,527 18 13.2 4.0 17.2 1,535 19 23.8 5.1 29.0 1,348 Residence Urban 4.7 1.4 6. I 2,862 Rural 11.5 2.8 14.4 4,716 Region/Residence Java-Bali 10.4 2.6 13.0 4,549 Urban 5.3 1.6 6.9 2,072 Rural 14.6 3.4 18.0 2,477 Outer Java-Bali 1 6.7 1.8 8.5 2,128 Urban 2.5 1.2 3.7 563 Rural 8.2 2.1 10.2 1,565 Outer Java-Bali 11 7.0 2.1 9.0 899 Urban 4. I 0.4 4.6 233 Rural 7.9 2.6 10.6 665 Education No education 18.8 1.3 20.0 171 Some primary 17.3 2.3 19.6 1,092 Completed primary 13.3 3.8 17.1 2,4112 Some secondary+ 3,5 1.4 4.9 3,91 I Total 8.9 2.3 I 1.2 7,580 Table 3.10.1 also shows that there is a substantial difference m teenage fertility between urban and rural women; rural teenagers are two times more likely than urban teenagers to have given birth or to have become pregnant with their first child. Among the regions, Java-Bali has the highest level of teenage fertility (13 percent, compared with 9 percent in the Outer Java-Bali regions). 52 Table 3.10.2 Teenage pregnancy and motherhood: region and province Percentage of women 15-19 who are mothers or pregnant with their first child, by region and province, Indonesia 1994 Percentage who are: Percentage who have Pregnant begun Number Region and with first child- of province Mothers child bearing women Java-Bali 10.3 2.6 12.9 4,578 DKI Jakarta 3.0 1.0 4.0 483 West Java 13.4 2.7 16.2 1,501 Central Java 7.2 2.8 10.0 1,121 DI Yogyakarta 4.4 1.0 5.5 123 East Java 13.2 3.0 16.3 1,233 Bali 6. I 1.8 7.8 118 Outer Java-Bali I 6.7 1.8 8.5 2,119 DI Aceh 5.9 0.0 5.9 138 North Sumatra 4. I 0.9 4.9 460 West Sumatra 3.8 1.7 5.6 202 South Sumatra 8.8 1.5 10.3 266 Lampung 12.0 2.7 14.7 220 West Nusa Tenggara 8.4 3.0 I 1.4 152 West Kalimantan 9.8 2.7 12.5 152 South Kalimantan 7.5 1.4 8.9 120 North Sulawesi 3.5 1.5 5.0 91 South Sulawesi 5.6 3.1 8.7 319 Outer Java-Bali II 7.1 2.1 9.2 88 I Riau 6.9 1.8 8.6 152 Jambi 10.3 3.6 13.9 88 Bengkulu 11.4 2.0 13.4 53 East Nusa Tenggara 2.6 2.0 4.7 146 East Timor 5.7 1.9 7.6 25 Central Kalimantan 8.1 3.3 11.4 70 East Kalimantan 8.6 1.3 10.0 89 Central Sulawesi 6.6 3.5 I 0. I 47 Southeast Sulawesi 7.4 1.2 8.5 57 Maluku 6.8 1.1 7.9 85 Irian Jaya 7.7 2.1 9.8 67 Total 8.9 2.3 I 1.2 7,580 Variation in teenage fertility is also found among provinces within regions. Table 3.10.2 shows that among the provinces in Java-B ali, West Java and East Java have the highest percentage of teenagers who have begun childbearing (16 percent). In Outer Java-Bali I, the highest percentage is in Lampung (15 percent), while the lowest is in North Sumatra and North Sulawesi (5 percent). In the Outer Java-Bali II region, the corresponding provinces are Jambi (14 percent) and East Nusa Tenggara (5 percent). 53 The cumulative fertility of teenage women (mean number of children ever born) is presented in Table 3.11. Very few teenagers (9 percent) have children. Of those who have become mothers, 89 percent have one child, and 11 percent have two or more children. Overall, the contribution of women age 15-19 to total fertility in Indonesia is not only small, but also decreasing. Table 3.11 Children born to teenagers Percent distribution of women 15-19 by number of children ever born (CEB), according to single year of age, Indonesia 1994 Age 0 I 2+ Number of Mean children ever born number Number of of Total CEB women 15 99.4 0.6 0.0 100.0 0.01 1,626 16 97.9 2.1 0.1 100.0 0.02 1,544 17 92.7 6.6 0.7 100.0 0.08 1,527 18 86.8 I 1.7 1.5 100.0 0.15 1,535 19 76.2 21.1 2.8 100.0 0.27 1,348 Total 91.1 8.0 1.0 100.0 0.10 7,580 54 CHAPTER4 KNOWLEDGE AND EVER USE OF FAMILY PLANNING 4.1 Knowledge of Family Planning Methods and Sources Knowledge of family planning methods and of places to obtain family planning services is crucial in the decision whether to use a contraceptive method and which method to use. Usually, the higher the level of knowledge of family planning methods the greater the use of contraceptives. In the 1994 IDHS, data on knowledge of family planning meth- ods were obtained by first asking the respondent to name the ways that a couple can delay or avoid a pregnancy or birth. If the respondent did not spontaneously mention a particular method, the method was described by the interviewer and the respondent was asked if she recognized the method. The questionnaire included descrip- tions for eleven methods: pill, IUD, injection, intravagl/diaphragm/foam, condom, Norplant, female steriliza- tion, male sterilization, abortion, peri- odic abstinence, and withdrawal. In addition, other methods mentioned spontaneously by the respondent, such as herbs (jamu), abdominal massage (pijat), and prolonged abstinence, were recorded. For each method rec- ognized, the respondent was asked if she had ever used the method. Finally, for all modem methods recognized, the respondent was asked where a per- son could obtain the method if she wanted to use it. If the respondent rec- ognized periodic abstinence, she was asked where a person could go to ob- tain advice about the method if she wanted to use it. Table 4.1 Knowledge of contraceptive methods and source for methods Percentage of ever-married women and currently married women who know specific contraceptive methods and who know a source (for information or services), by specific methods, Indonesia 1994 Know method Know a source I Ever- Currently Ever- Currently Contraceptive married married married married method women women women women Any method 95.7 96.3 94.2 95.0 Any modern method 95.5 96.1 94.2 95.0 Pill 92.0 92.7 89.7 90.6 IUD 83.9 84.8 79.9 80.9 Injection 89.7 90.6 87.7 88.8 Intravag/Diaphragm/Foam 10.8 11.1 9.5 9.8 Condom 65.4 66.5 56.5 57.4 Norplant 76.3 77.3 70.9 72.0 Female sterilization 58.7 59.9 55.3 56.4 Male sterilization 36.3 37.2 34.3 35.2 Abortion 33~ 1 33.6 27.0 27.4 Any traditional method 33.9 34.6 23.1 23.6 Periodic abstinence 26.4 27.0 23.1 23.6 Withdrawal 15.8 16.1 NA NA Herbs 6.9 7.1 NA NA Massage 2.9 3.0 NA NA Other traditional methods 0.8 0.9 NA NA Number of women 28,168 26,186 28,168 26,186 Mean number of methods 6.0 6.1 5.3 5.4 NA = Not applicable For modern methods, source refers to a place where the method or procedure can be obtained. Table 4.1 indicates that knowledge of family planning methods and sources for methods is almost universal among both ever-married women and currently married women. The percentage of women who know any method is the same among ever-married women and currently married women (96 percent), and virtually all of these women recognize at least one modem method. A tissue containing spermicide placed in the vagina before intercourse. 55 The most widely known methods among currently married women are the pill, injection, IUD, and Norplant, known by 93, 91, 85, and 77 percent of women, respectively. Knowledge of female sterilization is also high (60 percent). In contrast, the least known methods are intravag/diaphragm/foam. Likewise, familiarity with traditional methods is acknowledged by only one in three married women (35 percent). Abortion is also known by one in three married women. Figure 4.1 shows that knowledge of most modem contraceptive methods among currently married women has increased since 1987. As expected, there has been a large increase in knowledge of Norplant, male sterilization and female sterilization. In 1987, only 30 percent of married women had heard of Norplant, compared with 77 percent in 1994. Figure 4.1 Percentage of Currently Married Women Who Know Specific Modern Contraceptive Methods, Indonesia, 1987,1991, and 1994 Pil IU[~ Injection Condom Norplanl Female Sterilization Male Sterilizatio~ I)1 93 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~) / jS2385 185 B7 77 20 40 60 80 1 O0 Percent 1994 IDHS Table 4.1 also shows that almost all women know at least one source for family planning. Over 90 percent of currently married women know a source for the pill, 89 percent know a source for injection, and 81 percent know a source for the IUD. The gap between knowledge of methods and knowledge of sources is relatively small for most methods, ranging from 2 percent for the pill and injection to 9 percent for condoms. 56 Table 4.2.1 indicates that among married women, knowledge of at least one contraceptive method is slightly lower among women age 45- 49 than among younger women. This is also true for knowledge of modern contraceptive methods and of a place to obtain a modern method. There are no significant differ- ences by residence in knowledge of contraceptive methods and sources for methods. The percentage of married women who know at least one family planning method is 95 percent in rural areas and 99 percent in urban areas. The same relationship holds for knowledge of a modem method and of a place to obtain it. There are differences in con- traceptive knowledge by education; the proportion of women who know methods increases with level of educa- tion. For example, 87 percent of wom- en with no education have heard of a modem method. The proportion rises to 96 percent among women with some primary school, and to almost 100 percent of women with some sec- ondary or higher education. With re- spect to knowledge of family planning sources, the pattern is similar. Differences in contraceptive knowledge by region are small. Table 4.2.2 shows that the percentage of married women who have heard of at least one contraceptive method in Java-Bali is 98 percent, followed by Table 4.2.1 Knowledge of contraceptive methods and source for methods: background characteristics Percentage of currently married women who know at least one contraceptive method and at least one modern contraceptive method and who know a source (for information or services), by selected background characteristics, Indonesia 1994 Know a Know Know source for Number Background any a modern modern of characteristic method method I method women Age 15-19 97.3 96.6 95.2 1,291 20-24 97.1 96.9 95.9 3,936 25-29 97.0 96.8 96.3 5,234 30-34 97.4 97.3 96.2 5,387 35-39 96.5 96.4 95.8 4,483 40-44 95.6 95.4 93.9 3,262 45-49 91.4 91.1 88.1 2,594 Residence Urban 99.3 99.3 98.6 7,591 Rural 95.1 94.8 93.5 18,595 Region/Residence Java-Bali 97.7 97.6 96.3 16,663 Urban 99.6 99.5 98.8 5,523 Rural 96.8 96.7 95.1 11.140 Outer Java-Bali I 94.8 94.6 93.8 6,619 Urban 99.2 99.2 98.8 1,423 Rural 93.6 93.3 92.4 5,197 Outer Java-Bali 11 91.7 90.9 89.8 2,903 Urban 97.4 97.3 96.3 645 Rural 90. I 89. I 88.0 2,259 Education No education 87.4 86.6 83.1 3,904 Some primary 96.3 96.2 95.2 8,299 Completed primary 98.3 98.2 97.3 7,526 Some secondary+ 99.4 99.3 99.0 6,457 Total 96.3 96.1 94.9 26,186 llncludes pill, IUD. injection, intravag/diaphragm/foam, condom, female sterilization, male sterilization and Norplant. Outer Java-Bali I (95 percent) and Outer Java-Bali II (92 percent). Knowledge of a modern method and of a source of supply have a similar pattern, which is consistent with the pattern of development of the national family planning program--areas where the program has been functioning longest are those with the highest levels of knowledge. 57 Table 4.2.2 Knowledge of contraceptive methods and source for methods: region and province Percentage of currently married women who know at least one contra- ceptive method and one modem contraceptive method and who know a source (for information or services), by region and province, Indonesia 1994 Know a Know Know source for Number Region and any a modem modern of province method method I method women Java-Bali 97.7 97.6 96.3 16,663 DKI Jakarta 99.9 99.9 99.8 1,140 West Java 97.7 97.6 96.2 5,170 Central Java 99.4 99,4 98.7 4,302 D1 Yogyakarta 99.8 99.8 99.7 423 East Java 95.6 95.3 93.3 5,209 Bali 98.5 98.5 97.8 418 Outer Java-Bali I 94.8 94.6 93.8 6,619 Dista Aceh 82.7 82.2 82.0 477 North Sumatra 93.0 92.9 92.0 1,374 West Sumatra 97.2 97.2 95.6 489 South Sumatra 96.6 96.6 96.3 843 Lampung 99.3 99.3 99.0 801 West Nusa Tenggara 99.3 99.0 98.5 469 West Kalimantan 95.0 94.6 94.2 489 South Kalimantan 98.6 98.5 97.5 398 North Sulawesi 98.8 98.8 98.3 318 South Sulawesi 91.5 91.0 89. I 962 Outer Java-Bali It 91.7 90.9 89.8 2,903 Riau 94.7 94.4 92.7 520 Jambi 90.9 90.9 90.7 316 Bengkulu 99.4 99.4 99.1 179 East Nusa Tenggara 94.8 94.3 93.1 393 East Timor 49.9 48.3 47.7 115 Central Kalimantan 95.8 95.7 95.3 227 East Kalimantan 97.9 97.6 96.8 304 Central Sulawesi 91.6 90.4 87.9 225 Southeast Sulawesi 94.5 93.6 93.4 178 Maluku 95.3 95.3 94.3 209 lrian Jaya 78.2 72.9 71.5 238 Total 96.3 96.1 94.9 26,186 I Includes pill, IUD, injection, intravag/diaphragm/foam, condom, female sterilization, male sterilization and Norplant. Women who said that they know a particular method were also asked where they thought a person could go if they wanted to use the method. The responses to this question are summarized in Table 4.3. For all modem methods except female and male sterilization, the most commonly named source is the public health center (puskesmas). In the case of female and male sterilization, the government hospital is mentioned as a source by 63 percent or more of women. 58 Table 4.3 Source of supply for contraceptive methods Percent distribution of ever-married women who know a contraceptive method, by source of supply they would use if they wanted the method, according to specific methods, Indonesia 1994 Contraceptive method lntravag/ Female Male Periodic Injec- Diaphragm/ sterili- sterili- absti- Source of supply Pill IUD tion Foam Condom Norplant zation zation hence Public 46.2 69.1 62.1 44.3 44.9 69.4 78.3 76.5 20.2 Government hospital 3.4 10.5 5.1 6.7 3.9 14.8 64.5 63.0 3.6 Health center (puskesn~is) 39.3 57.2 55.9 36.2 38.9 53.0 13.6 13.3 13.6 Family planning fieldworker 2.7 0.3 0.4 1.1 1.5 0.2 0.0 0.1 2.5 Family planning mobile clinic 0.2 0.4 0.3 0.1 0.2 0.7 0.0 0.0 0.1 Other government 0.6 0.6 0.4 0.2 0.3 0.7 0.1 0.1 0.3 Medteal private 16.2 20.7 28.1 38.1 28.9 17.6 15.6 17.5 28.0 Hospital 1.2 2.1 1.6 2.9 1.0 2.1 7.0 7.9 1.5 Family planning clinic 1.2 1.3 1.4 1.0 1.0 1.0 0.6 0.6 0.7 Doctor 2.7 5.9 6.5 7.4 2.3 5.7 5.9 7.2 9.4 Midwife 8.6 11.4 18.3 7.8 6.1 8.7 2.1 1.8 15.8 Pharmacy 2.1 0.0 0.0 18.9 18.4 0.0 0.0 0.0 0.2 Other private 0.4 0.0 0.3 0.0 0.1 0.0 0.0 0.0 0.3 Other private 35.0 5.5 7.6 5.4 12.6 5.9 0.2 0.5 39.3 Village delivery post (polindes) 0.3 0.2 0.3 0.1 0.2 0.3 0.0 0.0 0.1 Health post (posyandu) 18.4 4.5 6.4 3.2 8.9 4.4 0.1 0.1 3.1 Family planning post 10.0 0.2 0.4 1.3 2.3 0.4 0.0 0.0 0.9 Traditional healer (dukun) 0.3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 O. 1 Friend/relative 0.6 0.0 0.0 0.3 0.2 0.0 0.0 0.0 30.7 Other source 5.5 0.6 0.4 0.4 0.9 0.8 0.0 0.3 4.4 Don't know 2.3 4.5 2.1 11.9 13.2 6.6 5.7 5.2 11.4 Missing 0.2 0.2 0.2 0.4 0.5 0.5 0.2 0.3 1.2 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number of women 25,908 23,637 25,272 3,035 18,435 21,491 16,548 10,229 7,432 Familiarity with private sources, such as private doctors and midwives, private hospitals, and pharmacies, is acknowledged by a sizeable proportion of women. Eighteen percent of women named pharmacies (or drugstores) as places to obtain condoms, and 18 percent mentioned private midwives as sources for injections. This may be partly due to the intense social marketing activities that have gone on in the area of family planning (see Section 4.2). 4.2 Knowledge of Blue Circle The self-reliant family planning movement known as KB Mandiri was introduced in 1987. The approach is based on the belief that people seek family planning services because of some fundamental motivation to create a better life for their family. The Self-reliant Family Planning concept and campaign encourage family planning participants to take individual responsibility for their family planning needs, including payment for services and supplies. In order to encourage the growth of self-reliance, the government implemented a new service scheme that works through private doctors, midwives, clinics and dispensaries in encouraging the community to fulfill their needs for family planning. In further support of the self-reliance effort, a special information, education, and communication (IEC) campaign utilizing social marketing was developed, called the "Blue Circle" campaign. The program was initiated in large cities, such as Jakarta, Surabaya, and Bandung, and has gradually been expanded to almost all of the municipalities throughout Indonesia. The private sector program logo, 59 Blue Circle, is present on the packages of contraceptives (e.g., condoms, pills) sold to users. For IEC purposes, the Blue Circle logo is also put on signs outside the offices of private doctors and midwives and is widely displayed in other strategic locations such as billboards. In order to evaluate the progress of the Blue Circle campaign, respondents in the 1994 IDI-IS were asked whether they had ever heard of Blue Circle, and if so, if they knew what it was. Table 4.4.1 shows that 52 percent of ever-married women had heard of Blue Circle; however, only 35 percent knew that it was a private family planning service, and 12 percent thought Blue Circle represented other family planning services. Fifty-three percent of those who had heard of Blue Circle said that they did not know what it was. Table4.4.1 KnowledgeofBlueCircle: background characteristics Percentage of ever-married women who have heard of Blue Circle and of those who have heard of Blue Circle, the percentage who think Blue Circle is a private family planning service, by background characteristics, Indonesia 1994 Among those who heard of Blue Circle, percentage who think it is: Don't Heard Private Other know if of Family family heard of Number Background Blue planning planning Don't Blue of characteristic Circle service service know Total Circle women Age 15-19 61.4 24.2 12.5 63.3 100.0 6.9 1,365 20-24 64.4 33.9 14.0 52.0 100.0 6.3 4,105 25-29 59.4 36.0 12.1 51.9 100.0 7.1 5,453 30-34 51.8 37.0 12.1 50.9 100.0 8.8 5,660 35-39 48.1 36.5 I 0.0 53.5 100.0 9.8 4,869 40-44 41.1 36.9 I 1.4 51.7 100.0 10.7 3.662 45-49 34.0 37.5 12.8 49.7 100.0 13.3 3,055 Residence Urban 76.7 38.8 15.5 45.7 100.0 3.6 8,196 Rural 41.3 32.9 9.5 57.6 100.0 I1.1 19,972 Region/Residence Java-Bali 56.1 35.0 13.4 51.6 100.0 6.6 17,953 Urban 78.0 37.3 16.9 45.8 100.0 3.0 5,991 Rural 45.1 33.0 10.3 56.7 100.0 8.4 11,962 Outer Java-Bali 1 45.5 35.9 10.3 53.8 100.0 11.9 7,108 Urban 74.9 42.9 12.9 44.2 100.0 4.4 1,520 Rural 37.6 32.1 8.9 59.0 100.0 14.0 5,588 Outer Java-Bali II 39.7 37.7 6.6 55.6 100.0 15.5 3,106 Urban 69.3 43.6 8.5 47.9 100.0 6.4 685 Rural 31.4 34.1 5.4 60.5 100.0 18.0 2,422 Education No education 15.9 18.5 4.6 76.8 100.0 18.4 4,489 Some primary 38.0 24.3 10.7 65.0 100.0 11.0 8,997 Completed primary 59.5 33.9 11.0 55,0 100.0 6.8 7.904 Some secondary+ 84.2 45.5 14.8 39.7 100.0 2.4 6,778 Total 51.6 35.4 12.1 52.5 100.0 8.9 28,168 Although the level of knowledge of Blue Circle is low, there has been improvement over time. In 1991, only 34 percent of women had heard of Blue Circle. Of these, 34 percent knew that Blue Circle was a private family planning service. Therefore, in three years the level of knowledge of Blue Circle increased by 53 percent. 60 Young women are more familiar with Blue Circle than older women. About 60 percent of women under 30 years of age had heard of Blue Circle, and about one-third knew that Blue Circle was a private family planning service. Knowledge of Blue Circle differs by urban-rural residence. The proportion of urban women who have heard of Blue Circle is almost twice that of rural women (77 percent compared with 41 percent). Blue Circle is known throughout the country, but with some variation by region. The percentage of women who have heard of Blue Circle is highest in Java-Bali (56 percent), followed by Outer Java-Bali I (46 percent) and Outer Java-Bali II (40 percent). There are differences in knowledge of Blue Circle by level of education. Sixteen percent of women with no education have heard of Blue Circle. This proportion rises to 38 percent among women with some primary education, 60 percent among those who completed primary school, and 84 percent among women with some secondary or higher education. Among the provinces, DKI Jakarta has the highest level of knowledge of Blue Circle (88 percent), followed by DI Yogyakarta (70 percent), East Kalimantan (66 percent), Bali (65 percent) and West Java (60 percent) (see Table 4.4.2 and Figure 4.2). This finding is consistent with the development of Blue Circle Table 4.4.2 Knowledge of Blue Circle: region and province Percentage of ever-married women who have heard of Blue Circle and of those who have heard of Blue Circle, the percentage who think Blue Circle is a private family planning service, by region and province, Indonesia 1994 Among those who heard of Blue Circle, percentage who think it is: Don't Heard Private Other know if of family family heard of Number Region and Blue planning planning Don't Blue of province Circle service service know Total Circle women Java-Ball 56.1 35.0 13.4 51.6 100.0 6.6 17,953 DKI Jakarta 87.7 37.5 18.1 44.4 100.0 1.4 1,249 West Java 60.2 20.2 19.1 60.7 100.0 5.8 5,55 I Central Java 49.4 59.9 3.7 36.3 100.0 12.6 4,578 DI Yogyakarta 69.8 45.9 13.1 41.1 100.0 3.5 457 East Java 48.8 30.0 12.5 57.6 100.0 4.2 5,685 Bali 64.7 37.2 14.3 48.5 100.0 3.7 432 Outer Java-Ball I 45.5 35.9 10.3 53.8 100.0 11.9 7,108 Dista Aceh 30.3 33.4 4.7 61.9 100.0 9.2 522 North Sumatra 54.4 22.8 25.2 52.0 100.0 4.7 1,446 West Sumatra 42.8 17.0 20.6 62.4 100.0 5.0 531 South Sumatra 49.8 40.4 2.4 57.2 100.0 15.6 900 Lampung 44.6 45.0 6.2 48.8 100.0 16.9 834 West Nusa Tenggara 45.8 46.4 7.6 46.0 100.0 17.5 527 West Kalimantan 38.0 27.8 2.9 69.3 100.0 10.5 519 South Kalimantan 54.6 38.4 8.4 53.2 100.0 17.5 447 North Sulawesi 51.6 48.3 0.2 51.5 100.0 5.6 333 South Sulawesi 37.2 51.1 0.8 48.0 100.0 17.1 1,049 Outer Java-Bali II 39.7 37.7 6.6 55.6 100.0 15.5 3,106 Riau 37.8 27.6 22.5 49.9 100.0 1 1.6 552 Jambi 45.9 59.7 2.4 38.0 100.0 16.4 335 Bengkulu 54.6 50.3 5.6 44.1 100.0 7.0 190 East Nusa Tenggara 28.5 24.7 5.1 70.2 100.0 14.2 436 East Timor 16.8 55.2 6.9 37.9 100.0 36.0 124 Central Kalimantan 49.4 44.7 0.5 54.8 100.0 10.2 244 East Kalimantan 65.6 39.6 0.6 59.7 100.0 8.9 321 Central Sulawesi 38.1 26.7 2.0 71.3 100.0 14.2 238 Southeast Sulawesi 32.1 28.2 6,5 65.2 100,0 18.4 191 Maluku 32.0 24.8 6.3 68.9 100.0 13.6 225 lrian Jaya 27.3 37.4 7.6 55.0 100.0 35.4 250 Total 51.6 35.4 12.1 52.5 100.0 8.9 28,168 61 Figure 4.2 Percentage of Ever-Married Women Who Have Heard of the Blue Circle (BC) Program and Who Know It Is a Private Family Planning (FP) Program, by Region JAVA-BALI ~ DKI Jakarta~ West dava~ Central J a v a ~ DI Yogyakarta ~ East J ava~ B a l i ~ OUTER JAVA-BALI I~ OUTER JAVA-BALI I 1 ~ 0 20 56 16o 49 49 65 70 146 140 188 40 60 80 100 Percent 1994 IDHS campaigns, which started in large cities. The lowest level of knowledge of Blue Circle is found in East Timor in Outer Java-Bali II (17 percent). However, more than half of these women know that it is a private family planning service. 4.3 Knowledge of Golden Circle Although the Blue Circle program has been successful in increasing the percentage of clients who acquire family planning services through the private sector, clients need more varied and complete method choices. The Golden Circle program is intended to provide a wider range of contraceptive choices. In order to evaluate the progress of the Golden Circle campaign, IDHS respondents were asked whether they had ever heard of the Golden Circle, and if so, whether they knew what it was. Table 4.5.1 shows that 8 percent of ever-married women had heard of the Golden Circle. Of these, 27 percent knew that it was a private family planning service. However, the majority of women did not know the meaning of Golden Circle (67 percent). Women in their late 20s and early 30s are more likely to know about Golden Circle than younger or older women. Golden Circle is more known in urban areas than in rural areas (13 percent compared with 6 percent, respectively). Women's education is positively associated with knowledge of Golden Circle. Better educated women are more familiar with the Golden Circle program than those with less education. Very few women with no education have heard of Golden Circle. 62 Table 4.5.1 Knowledge of Golden Circle: background characteristics Percentage of ever-married women who have heard of Golden Circle and of those who have heard of Golden Circle, the percentage who think Golden Circle is a private family planning service, by background characteristics, Indonesia 1994 Among those who heard of Golden Circle, percentage who think it is: Don't Heard Private Other know if of family family heard of Number Background Golden planning planning Don't Golden of characteristic Circle service service know Total Circle women Age 15-19 5.0 10,3 0.8 88.9 100.0 14.3 1,365 20-24 8.6 17,4 7.9 74.7 100.0 13.4 4,105 25-29 9.4 29,1 2.7 68,2 100.0 14.6 5,453 30-34 8.5 25,6 7.6 66.8 100.0 15.2 5,660 35-39 7.8 31,2 6.0 62.8 100.0 15.5 4,869 40-44 6.4 29,7 6.6 63.7 100.0 15,9 3,662 45-49 6.1 41,7 5.1 53.2 100.0 19.3 3,055 Residence Urban 13.2 30.4 6.2 63.4 100.0 10.7 8,196 Rural 5.7 24.5 5.3 70.2 I00.0 17.3 19,972 Region/Residence Java-Bali 7.5 25.4 6.8 67.9 100.0 12.1 17,953 Urban 11.8 25.8 7.3 67.0 100.0 9.7 5,991 Rural 5.3 24.9 6.2 68.9 100.0 13.3 11,962 Outer Java-Bali I 8.5 29.9 4.2 65.9 100.0 20.3 7,108 Urban 16.8 41.5 4.6 53.9 100.0 12.5 1,520 Rural 6.2 21.4 3.8 74.8 100,0 22.5 5,588 Outer Java-Bali II 8.6 31.9 3.8 64.3 100.0 23.1 3,106 Urban 17.5 34.0 3.0 63.0 100.0 15.7 685 Rural 6.1 30.1 4.5 65.3 100.0 25.2 2,422 Education No education 1.3 9.2 1.6 89.2 100.0 21.5 4,489 Some primary 3.5 14.5 3.9 81.6 100.0 16.6 8,997 Completed primary 6.3 21.6 6.6 71.9 100.0 14.9 7,904 Some secondary+ 20.0 33.2 6.0 60.8 100.0 10.4 6,778 Total 7.9 27.4 5.7 66.9 100.0 15.4 28,168 Knowledge of Golden Circle varies slightly by region, but widely by province (see Table 4.5.2 and Figure 4.3). The highest proportion is shown by Bengkulu (25 percent), followed by North Sulawesi and East Kalimantan (16 percent), and DKI Jakarta (14 percent). The lowest level of knowledge of Golden Circle is in East Nusa Tenggara and Southeast Sulawesi (4 percent). Although knowledge about Golden Circle is low in several provinces, a moderate proportion of women who have heard of Golden Circle know that it is a private sector family planning service. 63 Table 4.5.2 Knowledge of Golden Circle: region and province Percentage of ever-married women who have heard of Golden Circle and of those who have heard of Golden Circle, the percentage who think Golden Circle is a private family planning service, by region and province, Indonesia 1994 Among those who heard of Golden Circle, percentage who think it is: Don't Heard Private Other know if of family family heard of Number Region and Golden planning planning Don't Golden of province Circle service service know Total Circle women Java-Bali 7.5 25.4 6.8 67.9 100.0 12.1 17,953 DKI Jakarta 13.6 26.3 6.4 67.3 100.0 9.2 1,249 West Java 8.3 13.8 10.3 75.9 100.0 10.6 5,551 Central Java 7.0 46.4 5.1 48.5 100.0 20.4 4,578 DI Yogyakarta 10.8 27.7 8.0 64.4 100.0 10.7 457 East Java 5.6 20.0 3.6 76.4 100.0 7.7 5,685 Bali 6.6 28.3 4.2 67.5 100.0 10.2 432 Outer Java-Bali I 8.5 29.9 4.2 65.9 1130.0 20.3 7,108 Dista Aceh 7.1 26.4 0.0 73.6 100.0 17.8 522 North Sumatra 7.2 37.8 5.5 56.7 100.0 8.7 1,446 West Sumatra 10.6 16.2 11.6 72.3 100.0 9.5 531 South Sumatra 11.8 21.9 2.6 75.5 100.0 25.4 900 Lampung 5.3 22.5 2.4 75.1 100.0 31.0 834 West Nusa Tenggara 6.0 19.3 7.5 73.2 100.0 33.0 527 West Kalimantan 6.3 17.4 4.7 77.9 100.0 16.6 519 South Kalimantan 12.1 28.8 4.9 66.3 100.0 27.5 447 North Sulawesi 15.6 43.3 0.0 56.7 100.0 11.1 333 South Sulawesi 8.1 46.2 3.0 50.9 100.0 25.6 1,049 Outer Java-Bali 11 8.6 31.9 3.8 64.3 100.0 23.1 3,106 Riau 7.3 15.7 5.6 78.8 100.0 17.6 552 Jambi 9.6 37.5 1.1 61.4 100.0 28.6 335 Bengkulu 25.0 29.9 10.3 59.8 100.0 13.9 190 East Nusa Tenggara 3,9 39.1 3.3 57.5 100.0 19.2 436 East Timor 9,6 50.6 7.9 41.5 100.0 39.8 124 Central Kalimantan 7.6 37.9 0.0 62.1 100.0 16.6 244 East Kalimantan 15,5 34.0 0.5 65.4 100.0 19.7 321 Central Sulawesi 5,2 28.6 0.0 71.4 100.0 25.5 238 Southeast Sulawesi 4.1 43.4 1.8 54.8 100.0 26.8 191 Maluku 6.4 27.9 3.8 68.2 100.0 17.7 225 lrian Jaya 6.0 32.4 2.0 65.6 100.0 44.0 250 Total 7.9 27.4 5.7 66.9 100.0 15.4 28,168 64 Figure 4.3 Percentage of Ever-Married Women Who Know of Golden Circle (GC) and Who Know It Is a Private Family Planning (FP) Program, by Region JAVA-BALI DKI Jakarta West Java Central Java DI Yogyakarta East Java Bali OUTER JAVA-BALI Outer JAVA-BALI 7 . . 114 ~ i i i t 9 . . . . . Ig 2 4 6 8 10 Percent 12 14 16 1994 IDHS 4.4 Dissemination of Family Planning Information The objectives of the IEC component of Indonesia's family planning movement are to disseminate knowledge about family planning and to institutionalize the "small, happy, and prosperous family" norm. IEC activities are conducted through the mass media and through family planning groups and workers. Use of the mass media, including newspaper, radio and television, is integral to the IEC program at both the central and provincial levels. Family planning television programs are shown on both central and regional stations run by the government and the private sector. Family planning information is carried on the radio by government and private stations throughout the country. IEC activities are also carried out through community groups that are formed at the village or neighborhood level. IEC activities at periodic community group meetings generally are handled by a family planning fieldworker or by the group leader. Family planning information is also disseminated through word- of-mouth among neighbors and friends (gethok tular). Provision of Information by Family Planning Workers Family planning workers operate at the grassroots level and include family planning fieldworker supervisors, family planning fieldworkers, cadres, the head and members of village family planning posts, and the head and members of sub-village family planning posts. These people play a very important role in the IEC component of the family planning movement. They are not only agents of dissemination of family planning innovations, but are also the "motor" of the family planning movement. Various activities, such as recording and reporting current contraceptive users, IEC activities, referrals to the appropriate family planning services, self-reliant family planning movement (KB Mandiri) activities, and other activities integrated with family planning, e.g., income generation and family welfare education, are carried out by these staff. 65 Table 4.6.1 shows the percentage of currently married women who were visited by family planning workers in the six months prior to the survey. Overall, just over one in four married women was visited by a family planning worker. Contraceptive users are more likely to be visited than nonusers. This finding suggests that there is a need for family planning workers to visit and give family planning information to nonusers. The proportion of women visited is slightly higher among married women in their 20s and early 30s than among younger or older married women. The proportion of women visited by family planning workers varies little by urban- rural residence or level of education. Table 4.6.1 Visits by family planning fieldworkers: background characteristics Percentage of currently married women who have been visited by a family planning fieldworker in the six months prior to the survey, by selected background characteristics, Indonesia 1994 Using contraception Number Background of characteristic Yes No Total women Age 15-19 45.4 12,5 24.5 1,291 20-24 45.9 16.0 32.6 3,936 25-29 45.6 15.1 33.3 5,234 30-34 41.5 16.8 31.9 5,387 35-39 35.0 13.8 26.5 4,483 40-44 34.5 10.1 23,1 3,262 45-49 24.8 7.3 13.1 2,594 Residence Urban 36.6 13.4 27.3 7,591 Rural 41.8 13.4 28.3 18,595 Region/Residence Java-Bali 40.5 13.7 29.3 16,663 Urban 37.2 14.0 28.4 5,523 Rural 42.2 13.5 29.8 11,140 Outer Java-Bali 1 38.0 12.4 25.0 6,619 Urban 32.2 11.5 23.0 1,423 Rural 39.8 12.6 25.6 5,197 Outer Java-Bali 1I 43,0 14.3 27.4 2,903 Urban 40.4 13.2 27.9 645 Rural 44.0 14.5 27.3 2,259 Education No education 37.3 9.6 20.6 3,904 Some primary 41. I 12.1 27.3 8,299 Completed primary 42.6 16.0 31.5 7,526 Some secondary+ 37.5 15.8 29.4 6,457 Total 40.1 13,4 28.0 26,186 66 The proportion of married women who were visited by family planning workers varies slightly by region (see Table 4.6.2). In Java-Bali, East Java (16 percent) has the lowest percentage and Central Java (39 percent) has the highest percentage of married women who were visited by family planning workers. In Outer Java-Bali I, the lowest percentage is in North Sumatra (17 percent) and the highest in West Kalimantan (39 percent). In Outer Java Bali II, the lowest percentage occurs in Maluku (20 percent) and the highest is in Bengkulu (47 percent). Table 4.6.2 Visits by family planning fieldworkers: region and province Percentage of currently married women who have been visited by a family planning fieldworker in the six months prior to the survey, by region and province, Indonesia 1994 Using contraception Number Region and of province Yes No Total women Java-Bali 40.5 13.7 29.3 16,663 DKI Jakarta 43.1 11.7 30.5 1,140 West Java 51.3 16.1 36.0 5,170 Central Java 50.8 20.7 39. I 4,302 DI Yogyakarta 27.7 12.5 23.0 423 East Java 22.9 6.8 15.8 5,209 Bali 19.8 10.9 17.0 418 Outer Java-Bali I 38.0 12.4 25.0 6,619 Dista Aceh 51.2 5.9 20.5 477 North Sumatra 27.5 6.8 16.5 1,374 West Sumatra 34. I 14.2 23.0 489 South Sumatra 31.8 8.4 20.8 843 Lampung 47.5 19.4 36.1 801 West Nusa Tenggara 40.8 28.3 34.5 469 West Kalimantan 64.4 13.8 39.4 489 South Kalimantan 27.5 6.2 17.9 398 North Sulawesi 40.1 24.9 35.9 318 South Sulawesi 33.9 13.8 22.4 962 Outer Java-Bali l I 43.0 14.3 27.4 2,903 Riau 42.4 9.3 22.9 520 Jambi 35.9 8.7 23.7 316 Bengkulu 59.7 27.7 47.4 179 East Nusa Tenggara 49.6 18.3 30.0 393 East Timor 66.6 12. I 24.4 115 Central Kalimantan 43.2 7.3 23.3 227 East Kalimantan 32.4 13.0 24.8 304 Central Sulawesi 49.4 17.6 34.3 225 Southeast Sulawesi 52.2 19.6 34.7 178 Maluku 34.0 12.1 19.8 209 lrian Jaya 33.5 21.6 26.5 238 Total 40.1 13.4 28.0 26,186 Appropriate Sources of Family Planning Information Mass media programs used to disseminate information about family planning in Indonesia through radio and television include spot shows, dramas, reports, discussions, and regular series. Another important means of disseminating family planning information is the family planning worker system, which operates in all parts of the country. Family planning workers focus their efforts on increasing family planning use, providing family planning information and recording service statistics. An important aspect of a family 67 planning worker's job is institutionalization, i.e., working through community organizations, such as mothers' clubs, religious groups, women's organizations (PKK), and the organization for wives of civil servants (Dharma Wanita). Income-generating activities and rewards to long-term users are among the strategies used to introduce family planning and maintain motivation. In an effort to investigate which actual or potential sources of family planning information are considered appropriate by ever-married women in Indonesia, the 1994 IDHS included a set of questions on this subject (see Table 4.7.1). Table 4.7.1 Appropriate sources lor family planning information: background characteristics Percentage of ever-married women who believe specific sources are appropriate for obtaining family planning information, by background characteristics, Indonesia 1994 News- Family Reli- Vii- paper/ plan- Coin- gious lage Worn- Number Background Tele- Maga- Pamph- ning Teat:h- munity- lead Mid lead en's Phar of characteristic Radio vision zine Poster let officer er leader er Doctor wife er group macy women Age 15-19 718 76,0 519 45.3 39.9 798 27,5 46.7 35.5 72.7 85.6 51.1 52.9 352 1,365 20-24 682 75.2 52.7 440 40.7 817 29.q) 45.9 38.8 74.0 85.8 52.9 56.9 346 4,105 25-29 69.0 75.5 535 427 38.8 806 29.2 45.0 38.7 74.1 85.4 53.9 575 3~7 5,453 30-34 670 73.0 497 40.9 376 79.5 31 3 46.2 400 72 7 83 4 54 3 57 6 344 5,660 35-39 66,4 71.5 48.3 406 366 786 323 46.2 40.2 718 81.3 55.2 569 340 4,869 40-44 682 71.1 503 409 386 77.6 368 477 431 720 831 57 I 574 369 3,662 45-49 62.2 658 412 35,0 31.8 74.2 296 412 37 I 677 781 51.3 505 296 3,055 Residence Urban 723 84.9 65.1 54.9 503 85.8 34.2 53.0 46.6 83.4 89.2 552 66.4 4~ 4 8,196 Rural 65.3 676 43.7 35.6 32.6 763 29.8 426 36.6 67.9 80,9 53,6 52,2 31.0 19,972 Reglon/Residence Java-Bali 739 77.0 57.4 494 450 82.5 36.8 53.7 454 74 4 85 3 648 658 40.8 17,953 Urban 77.8 86.9 704 61.8 56.4 902 38.6 59.2 513 86(1 925 62.4 73.7 463 5,991 Rural 719 72.1 50.8 432 39.3 78.6 35.8 51.0 424 68 6 81.7 659 61.9 38.0 11,962 Outer Java-Bali I 56.9 66.2 380 28.6 26.7 716 22.8 33.1 307 675 784 377 41.1 24.2 7,108 Urban 57.1 78.0 497 367 34.8 71.4 240 36.8 343 732 774 374 46.8 288 1,521) Rural 56.8 63.0 34.8 264 24.5 71.6 22.5 32 I 297 660 787 37.8 39.6 2~0 5.588 Outer Java Bali 11 53.4 62.2 341 231 213 76.2 172 272 255 717 826 295 36.1 175 3,106 Urban 576 82.5 530 351 323 78.5 179 345 324 832 862 324 455 2"72 685 Rural 522 564 28.8 198 18.2 756 17.0 25.1 23.5 68.5 81.5 287 33.4 1,18 2,422 Education No education 545 542 30.8 27.3 241 662 28.2 368 32.9 58.4 72.2 506 4(10 26.1 4,489 Some primary 678 708 45.7 38.7 35,2 77,7 33.2 458 396 696 819 563 553 344 8,997 Completed primary 71.1 76,1 51.7 41.0 37.7 81,4 294 454 38.1 73.4 854 558 586 3L0 7,904 Some secondary+ 70.6 83.4 66.1 541 50.3 867 32.2 513 45.3 841 899 513 658 40.0 6,778 Total 67.3 72,7 49.9 41.2 37.7 79,1 311 45.6 395 724 83.3 540 563 340 28,168 The majority of women believe that doctors (72 percent), midwives (83 percent), and family planning officers (79 percent) are appropriate sources of family phmning information. Women's groups and village leaders were considered as good sources of family planning information by more than half of women. Television and radio are also popular mass media (73 percent and 67 percent, respectively); other sources are thought to be appropriate by half of women or less. There is little difference by urban-rural residence in the sources considered appropriate for family planning information except for television and those sources requiring reading skills, which are more widely accepted in urban areas. Primarily due to their availability, doctors, midwives, and family planning workers are more popular in urban than in rural areas. The government currently has a policy to post midwives in villages throughout the country. 68 Overall, women with higher education are more likely than women with less education to accept the various media as a source for family planning information. At least eight in ten women with some secondary or higher education thought of doctors, midwives, family planning officers and television as appropriate sources for family planning information. Provincial differentials in the proportion of women who believe that a specific source of family planning information is appropriate are shown in Table 4.7.2. In most provinces, midwives are the most popular source of family planning information, followed by family planning workers and doctors. Meanwhile, the importance of television and radio is emphasized in all provinces. In Java-Bali, a relatively large proportion of women believe that teachers and community and religious leaders are appropriate sources of family planning information. Table 4.7.2 Appropriate sources for family planning information: region and province Percentage of ever-married women who believe specific sources are appropriate for obtaining family planning information, by region and province, Indonesia 1994 News- Family Refi- Vii- paper/ plan- Com- gious lage Worn- Number Region and Tele- Maga- Pamph- ning Teach- munity- lead- Mid- lead- en's Phar- of province Radio vision zine Poster let officer er leader er Doctor wife er group macy women Java-Bali 73.9 77.0 57.4 49.4 45.0 82.5 36.8 53.7 45.4 74.4 85.3 64.8 65.8 40.8 17,953 DKI Jakarta 86.9 95.7 85.9 72.3 65.8 96.8 36.4 57.5 49.6 95.9 97.6 611 72.8 52.9 1,249 West Java 71.4 75.5 58.1 49.5 40.3 81.0 36.3 52.1 45.0 74.6 83.9 56.7 62.1 32.3 5,551 Central Java 70.7 68.7 36.3 23.1 21.0 76.0 18.0 33.5 26.8 55.7 78.5 59.5 55.9 19.3 4,578 DI Yogyakarta 88.5 89.9 811.6 74. I 73.3 98.7 69.3 86.4 82.2 96.5 98.6 88.8 92.6 722 457 East Java 74.3 79.5 65.6 63.5 62.1 84.1/ 49.9 68.7 57.4 81.7 877 76.4 74.0 61.2 5,685 Bali 79.9 85.2 55.2 48.5 44.8 92.7 35.5 46.5 37.4 89.9 96.3 559 63.4 411.2 432 Outer Java-Bafi 1 56.9 66.2 38.0 28.6 26.7 71.6 22.8 33.1 30.7 67.5 78.4 37.7 41.1 242 7,108 Dista Aceh 49.1 66.4 35.1 26.8 20.6 83.9 11.8 25.0 16.6 75.5 797 22.2 41.3 18.11 522 North Sumatra 60.2 76.7 47.8 37.8 34.8 74.7 33.0 42.2 39.1 71.4 74.5 462 51.0 37.9 1,446 West Sumatra 68.1 74.5 49.3 39.9 38.3 82.5 30.3 41.4 42.3 78.8 83.8 52.1 59.5 33.1 531 South Sumatra 37.4 46.0 18.7 4.3 4.3 56.2 5.5 6.6 5.8 37.7 71.3 15.7 16.4 9.8 900 Lampung 68.7 70.1 39.4 26.8 24.7 83.6 14.7 30.7 26.9 78.1 89.7 459 47.9 21.0 834 West Nusa Tenggara 79.3 80.8 45.2 43.8 43.9 87.4 45.3 60.0 59.0 74.1 85.0 62.0 51.5 35.0 527 West Kalimantan 66.4 77.7 48.0 37.7 35.4 84.4 36.5 45.3 42.0 849 90.1 40.6 45.0 28.1 519 South Kalimantan 79.4 86.3 62.9 53.4 53.1 88.1 43.3 65.9 64.5 82.1 86.2 58.6 69.7 423 447 North Sulawesi 47.4 62.4 32.1 16.1 18.3 705 12.7 299 28.1 59.4 72.0 30.5 39.3 12.6 333 South Sulawesi 35.2 41.5 18.2 145 11.9 38.4 79 12.5 11.3 54.0 67.3 18.6 152 7.6 1,049 Outer Java-Bali I1 53.4 62.2 34.1 23.1 21.3 76.2 17.2 27.2 25.5 717 826 29.5 36.1 17.5 3,106 Riau 68.4 84.6 46.0 31.6 29.5 81.3 22.9 33.6 33.5 78.9 890 36.7 503 292 552 Jambi 30.6 46.3 21.1 11.3 10.3 541 9.0 13.9 13.4 49.8 72.8 23.6 29.4 10.7 335 Bengkulu 84.4 92.1 59.3 42.6 43.7 95.2 36.7 61.8 48.7 94.6 973 68.8 67.1 33.6 190 East Nusa Tenggara 42.1 29.6 22.2 16.6 13.9 84.1 20.4 27.5 29.0 726 89.0 3/11 28.1 12.5 436 East Timor 245 21.2 8.9 6.5 7.0 47.6 6.6 10.6 8.6 63.8 62.0 3.6 8.5 6.5 124 Central Kalimantan 65.5 81.2 32.5 25.5 24.5 80.8 10.3 20.1 19.9 84.4 88.7 17.6 28.4 13.4 244 East Kalimantan 60.9 88.6 47.4 34.7 29.1 85.4 21.7 43.6 38.4 85.1 83.7 378 40.3 23.5 321 Central Sulawesi 66.9 71.9 41.4 287 23.11 87.5 11.3 18.8 17.0 78.7 83.2 254 47.4 10.0 238 Southeast Sulawesi 53.9 55.4 28.3 17.4 18.4 62.7 15.4 17.7 16.4 49.0 69.9 15.5 19.4 14.1 191 Maluku 55.3 63.0 39.1 18.8 20.5 77.4 17.6 26.0 21.5 69.3 81.2 25.4 40.0 17.3 225 Irian Jaya 25.1 310 16.8 11.2 8.6 62.9 7.7 14.4 15.8 53.3 72.2 22.8 18.1 9.5 250 Total 673 72.7 499 41.2 37.7 79.1 31.1 456 39.5 72.4 833 540 56.3 340 28,168 69 4.5 Ever Use of Family Planning Methods For each method recognized, the respondent was asked if she had ever used that method. Seventy-three percent of ever-married women, and 76 percent of currently married women reported that they had used a method of family planning at some time (see Table 4.8). The percentage of women who have ever used a method has increased since 1991 when it was 66 percent for ever-married women, and 69 percent for currently married women. This is also tree for ever users of modem methods. Among ever-married women, the most common method used is the pill (43 percent), followed by injection (35 percent). IUD is the third most widely used method, with 21 percent of women having used it. Much smaller proportions of women report having used Norplant (6 percent), condoms (5 percent), and female sterilization (3 percent). Nine percent of women have used a traditional method at some time: periodic abstinence (4 percent), withdrawal (3 percent), herbs (2 percent), and massage (1 percent). Table 4.9 presents the percent distribution of ever-married women by the number of living children at the time of first use of family planning, according to current age. The table is useful in identifying the acceptance of the small family norm and the adoption of family planning for spacing purposes. The data show that 32 percent of women started using a family planning method when they had only one child and 15 percent when they had two children. There is a shift in the timing of first contraceptive use. While only 1 percent of women 45-49 used contraception when they had no children, the proportion for women 20-24 is 15 percent, and for women 15-19 it is one in four. The proportion of women who started using contraception when they had one child increases rapidly from 24 percent among women 15-19 to 46 percent or higher among women in their twenties. Higher proportions among older women after having two children suggest that they use family planning for limiting purposes. The same conclusion can be reached regarding the median number of children at first use of contraception--younger women tend to start using family planning at a lower parity. 70 Table 4.8 Ever use of contraception Percentage of ever-married women and currently married women who have ever used any contraceptive method, by specific method and age, Indonesia 1994 Modem method Traditional method Female Male Any lntravag/ sten- steri- Any Periodic Number Any modem lnjec- Diaphragm/ liza- liza- trad. absh- With- of Age method method Pill IUD tion Foam Condom Norplant tion tion Abortion method nence drawal Herbs Massage Other women EVER-MARRIED WOMEN 15-19 50.0 49.0 29.8 2.8 23.2 0.0 0.9 3.7 0.0 0.0 0.0 2.1 0.6 07 1.2 0.1 0.0 1,365 20-24 70.6 69.3 38.2 10.5 40.7 0.2 2.3 7.6 0.0 0.0 0.1 5.2 1.6 2.1 0.9 0.5 0.2 4.105 25-29 78.8 76.8 44.2 18.9 44.7 0,2 4.1 7.6 0.8 0.2 0.3 7.6 3.3 3.1 2.1 0.3 0.4 5,453 30-34 81.2 78.7 47.7 25.0 41.8 0.3 6.3 8.3 2.3 0.7 0.5 10.7 4.7 4.4 2.2 0.8 0.6 5,660 35-39 78.6 76.2 47.0 26.4 33.2 0.4 7.0 6.8 5.6 1.4 0.6 9.9 5.2 3.2 2.4 0.4 0.6 4,869 40-44 71.1 68.6 44.3 25.3 24.6 0.1 56 3.2 5.9 1.2 0.6 96 4.0 3.3 2.9 0.6 0.8 3,662 45-49 58.2 55.4 33.9 22.5 13.0 0.3 5.6 2.3 5.4 0.9 1.2 103 59 2.6 3.1 0.7 0,6 3,055 Total 73.4 71.2 42.7 20.6 34.5 0.2 5.0 6.3 2.9 0.7 0.5 8.6 3.9 3.1 2.2 0.5 0.5 28.168 CURRENTLY MARRIED WOMEN 15-19 50.6 49.5 29.5 2 9 242 0.0 1.0 3.9 0.0 00 0.0 2.2 0.6 0.8 13 0.1 0.0 1.291 20-24 71.7 70.4 38.9 10.5 41.5 0.2 2.4 8.0 0.0 0.0 0.1 5.3 1.7 2.2 0.9 0.5 0.2 3,936 25-29 80.3 78.2 452 19.3 45.6 0.2 4.1 7.7 0.9 0.2 0.2 7.7 3.4 3.2 2.1 0.3 0.4 5,234 30-34 82.7 80.4 48.6 259 42.7 0.3 6.4 8.6 2.3 0.8 0.5 10.8 4,8 4.5 2.2 0.7 0.6 5,387 35-39 80.9 78.6 49.0 27.2 34.4 0.4 6.9 7,1 5.9 1.4 0.5 10.3 5.3 3.2 2.4 0.4 0.7 4,483 40-44 74.9 72.4 46.9 27.1 26.5 0.1 5.6 3.4 6.3 1.4 0.7 10.0 4.1 3.5 3.1 0.5 0.9 3,262 45-49 62.7 59.8 37.2 24.1 14.7 0.3 5.9 2.7 6.1 0.9 1.1 10.9 6.2 2.9 3.2 0.8 0.6 2.594 Total 75.7 73.6 44.2 21.3 36.0 0.3 5.0 6.6 3.1 0.7 0.5 8.8 4.0 3,2 2.2 0.5 0.5 26,186 Table 4.9 Number of children at first use of contraception Percent distribution of ever-married women by number of living children at the time of first use of contraception and median number of children at first use, according to current age, Indonesia 1994 Never Number of living children at time used of first use of contraception Number Current contra- of age ception 0 I 2 3 4+ Missing Total women Median number of children at first use ol contra- ception 15-19 50.0 24.7 24.0 1.3 0.0 0.0 0.0 100.0 1,365 1.0 20-24 29.4 14.6 46.1 8.3 1.2 0.3 0.0 100.0 4,105 1.4 25-29 21.2 5.8 47.8 17.5 5.6 2.0 0.0 100.0 5,453 1.7 30-34 18.8 3.0 37.3 20.9 11.6 8.3 0.0 100.0 5,660 2.0 35-39 21.4 2.3 23.0 19.5 15.2 185 0.1 1000 4,869 2.7 40-44 28.9 1.6 14.1 14.7 12.8 27.9 0.1 100.0 3,662 3.4 45-49 41.8 1.4 9.9 8.0 9.7 28.9 0.3 1130.0 3,055 4.0 Total 26.6 5.8 31.5 15.0 9.0 121 0.1 100.0 28,168 2.0 72 CHAPTER 5 CURRENT USE OF FAMILY PLANNING Information on the current level of contraceptive use, i.e., contraceptive prevalence, is important for measuring the success of the national family planning movement. Contraceptive prevalence is defined as the proportion of currently married women age 15-49 who were using some method of family planning at the time of the survey. This chapter presents data concerning levels, trends, and differentials in current use, sources of family planning methods, age at time of first use of contraception, reasons for using a particular method, and some indicators of the quality of use of the pill, injection and condom. 5.1 Cur rent Use of Fami ly P lanning Table 5.1 shows that 55 percent of currently married women are using contraception, 52 percent modem methods and 3 percent traditional methods. As with ever use, the pill (17 percent), injection (15 percent), and IUD (10 percent) are the most commonly used methods, together accounting for 78 percent of current contraceptive use. Other modem methods with significant proportions of users are Norplant and female sterilization, used by 5 and 3 percent of married women, respectively. Table 5.1 Current use of contraception Percent distribution of ever-married women and of currently married women who are currently using a contraceptive method by specific method, according to age, Indonesia 1994 Age Modem method Any modern Any metb- lnjec- Con- Nor- method od Pill IUD tion dom plant Traditional method Female Male Peri- Not steri- steri- Any odic With- Other cur- Number liza- liza- trad. absti- draw- meth- rently of tion tion method nence al ods using Total women EVER-MARRIED WOMEN 15-19 34.4 33.7 13.8 2.1 14.8 0.0 30 0.0 0,0 07 0.1 0.l 0.6 65.6 100.0 1,365 20-24 53.2 51.8 17.3 5,9 22.2 0.2 6.2 0.0 00 1.4 0.4 0.7 0,4 46.8 100.0 4,105 25-29 57.3 55.5 18.9 8.9 20.3 0.6 5.7 0.8 0.2 1.7 0.7 0.5 0.5 42.7 100.0 5,453 30 34 581 54,8 17,9 10.7 15.9 1,2 6.1 2.3 0,7 3.3 1.2 1.3 08 41.9 1000 5,660 35-39 552 51,9 17.6 11,3 10.5 1.3 4,5 5.6 1.2 3.2 1.6 08 0.8 44.8 100.0 4,869 40-44 47.8 44,4 13.4 13.1 7.6 1.0 2.2 5,9 1.2 3.4 1.4 0.7 1.3 52.2 100.0 3,662 45-49 28.2 25,8 6.4 9.6 2,5 0.4 0.9 5.4 0.6 2.4 1.2 0.4 0.8 71.8 100.0 3.055 Total 51,0 48.5 15.9 9.5 14.1 0,8 4.5 2.9 0.6 2.5 1,0 0.7 0.8 49.0 100.0 28,168 CURRENTLY MARRIED WOMEN 15-19 36.4 35.6 14.6 2.2 15.7 0.0 3.2 00 0.0 0.8 0.1 0.1 0.6 63.6 100.0 1,291 20 24 555 54.0 180 6.1 232 0.2 6.5 0,0 0.0 1.5 0.4 0.7 0.4 44.5 100.0 3,936 25-29 59.6 57,8 19.7 9.3 21.2 0.7 5.9 0.9 0.2 1,8 0.7 0.6 0.5 40.4 100,t) 5,234 30-34 61,0 57.5 18,8 11.2 16.7 1.3 64 2.3 0,7 3.4 1.2 1.3 0.9 39,0 100.0 5,387 35-39 59.7 56.2 19.1 12.3 11,4 1.4 48 59 1.3 3,5 1.8 0.8 0.9 40.3 100.0 4,483 40-44 53A 49.5 15,1 14.7 8.5 1.1 2.5 6.3 1.4 3.9 1.6 0.8 1.5 46,6 100.0 3.262 45-49 329 30,1 7.5 11.3 2,9 0.4 l.I 6,1 0.7 2.8 1.4 0.5 0.9 6%1 100.0 2,594 Total 54.7 52.1 17.1 10.3 15.2 0.9 4.9 3.1 0.7 2,7 l.l 0.8 0.8 45.3 100,0 26,186 Note: Total includes 2 users of Intravag/Diaphragm/Foam. 73 Modern methods are popular among women of all ages. However, younger and older women are less likely to be using contraception than women in the mid-childbearing ages (25 to 39 years). Injection and Norplant are more common among women under 30, while the IUD, male sterilization, and female sterilization are more common among women over 30. Use of family planning is higher among urban women than rural women (see Table 5.2.1 and Figure 5.1). Sixty percent of currently married urban women are using a method, compared with 53 percent of rural women. The mix of methods also differs, with urban women relying more heavily on the IUD and female sterilization. The pill, Norplant, and male sterilization are used more commonly by rural women. Contraceptive use increases with the respondent's level of education. Forty percent of currently married women with no education are using a method, compared with 63 percent of those with secondary or higher education. The type of contraceptive method used also varies by level of education. Although IUD use is higher among women who have some secondary education than among those with no education (l 5 percent, compared with 8 percent), the proportion of women using Norplant is higher among women with no education than among those with secondary or higher education (5 percent, compared with 3 percent). Women with a higher level of education are more likely to use long-term methods, such as the IUD, injection, and female sterilization, than women with less education. Table5.2.1 Current useofcontraception: background characteristics Percent distribution of currently married women by contraceptive method currently used, according to selected background characteristics, Indonesia 1994 Any modern Background Any meth- characteristic method od Modernrnethod Traditional method Female Male Any Peri- Not steri- steri- trad. odic With Other cur- Number Injec Con Nor- liza- liza- meth- absti draw- meth- rently of Pill IUD lion dom plant lion tion od nence al ods using Total women Residence Urban 60.2 55.8 15.8 122 16.8 2.2 28 5.6 0.4 4.4 22 Rural 52.5 50.5 177 95 14.6 0.3 5.7 2.0 0.8 20 06 Region/Residence Java-Bali 58.4 56.4 16.7 12.1 16.8 0.9 5.5 3.5 (1.9 2.0 0.7 Urban 62.0 58.6 15.3 13 .0 18.0 2.2 3.5 6.1 0.5 3.5 1.6 Rural 56.6 55.4 17 .4 117 16.2 0.2 6.5 2.2 1.1 1.2 0.3 Outer Java-Bali 1 49.5 45.5 18.8 7.4 119 0.8 3.7 2.5 0.3 40 18 Urban 55,8 48.1 16.3 106 13.4 2.0 1.1 4.6 0.2 7.7 4,5 1.5 Rural 47.8 44.8 19.5 6.5 11.5 0.5 4.5 1.9 0.3 3.0 1.1 1.2 Outer Java-Bali It 457 41.8 15.4 6.0 136 0.6 40 1.8 0,3 3 9 14 (1.7 Urban 54.0 48.7 18.7 92 14.1 1.9 0.6 4.1 0.1 5.3 2.7 I I Rural 43.3 39.8 145 50 13.5 0.3 5.0 1.1 0.3 3.5 I.I (1.6 Education No education 39.6 38.1 t50 75 8.2 0.0 5.2 1~4 0.9 I 5 0 I 03 Some primary 52.6 50.6 18.5 8.5 13.7 0,3 5.8 30 09 19 0.5 0.6 Completed primary 58.2 561 18.8 9,9 17,9 0.4 58 27 11.6 2,1 (1,7 08 Some secondary+ 62.6 57.5 14.7 14.6 18.3 2.5 2.5 4.5 03 5.1 2.9 13 Number of living children 0 9.0 8.9 6.4 O0 2.0 0.0 0.3 0 0 0,0 0.2 0.1 0.0 l 54.1 52.1 18.8 8,1 19.3 0,4 5.2 0.2 0A 2.0 0.7 0.7 2 65.2 61.8 205 14,9 18.0 0,9 5.8 I I 0,6 3.4 1.4 1.0 3 65.4 62.3 18,3 14,4 16.6 IA 6.0 4.6 1.2 3,1 1.4 0.9 4+ 53.3 50.2 154 85 12.7 1.2 4.5 6.9 1.0 31 1.2 0.8 1.0 12 39,8 1000 7,591 0.7 0.7 47.5 1 (~).0 18,595 0.6 0.6 41.6 10O.0 16,663 0.8 1.0 38.0 10O,0 5,523 0.5 0.4 43.4 1013.0 11,I40 1.2 0.9 50.5 100,0 6,619 1.6 44.2 100.0 1,423 0.7 52.2 100.0 5,197 1.8 543 100.0 2.903 1.5 46.0 10().0 645 1.9 567 I(X)(I 2,259 I 1 604 100.0 3.904 0.8 47.4 100.0 8.299 0.6 41.8 100.0 7.526 0.9 3%4 I(Kt,0 6,457 0.0 91.0 10(I.0 2,203 0.6 45.9 100.0 5.779 1.0 34.8 100.0 6.234 0.8 34.6 100.0 4,672 I.I 46.7 100,0 7,298 Total 54.7 52.1 17.1 103 15.2 0.9 4.9 3.1 0.7 2.7 1.1 0.8 0.8 45.3 1000 26,186 Note: Total includes 2 users of Intravag/Diaphragm/Foam 74 Figure 5.1 Percentage of Currently Married Women Age 15-49 Who Are Using a Contraceptive Method RESIDENCE Urban~ Rural REGION Java-Bali Outer Java-Bali I Outer Java-Bali EDUCATIOI No Education Some Primary . . . . Completed primary ,; ,; ,; Some Secondary+ NO. OF CHILDREN 1 ~.-.\\\\\\\\x'~ 3 It~'-\N\\\N\\N\N~ 4 + ~\ \ \ \ " \ \ \ \ \~ 60 53 58 50 46 1 4 0 F 153 ;~; ~;~ ~ ~ ~ ~;~i ~ ,; ; ;;~;;~,;,~,, ~ ~ ,; ;~; ,; ; ,158 ¸¸163 ~ N X \ \ \ N X \ ~ l SS 10 20 30 40 50 60 70 Percent Using Method 1994 IDHS Contraceptive use increases with the number of living children a woman has, reaching 65 percent among women with two or three children, then declines among women with four or more children. Nine percent of childless women are current users of family planning (mostly the pill), presumably to delay their first birth. After having one child, women tend to use the pill, injection, and IUD. Use of female and male sterilization increases with the number of living children. Table 5.2.2 shows the proportion of married women who are using contraception by region and province. Contraceptive use is highest in Java-Bali (58 percent), followed by Outer Java-Bali I (50 percent) and Outer Java-Bali II (46 percent). Women in Java-Bali tend to rely more heavily on modem methods than women in the Outer Islands. There are major differentials in the use of contraception within regions. In Java-Bali, contraceptive use is highest in DI Yogyakarta (70 percent), followed by Bali (68 percent); East Java and West Java have the lowest levels of contraceptive use (56 and 57 percent, respectively). In Outer Java-Bali I, contraceptive use is highest in North Sulawesi (73 percent) and lowest in Dista Aceh (32 percent). The highest level of contraceptive use in Outer Java-Bali II occurs in Bengkulu (62 percent) and the lowest in East Timor (23 percent). The mix of methods varies considerably by province. Provinces with the highest overall prevalence rate have the smallest proportion of pill users. For example, in Bali and DI Yogyakarta, pill use accounts for only 7 and 13 percent of contraceptive use, respectively, while in East Java and West Java, 34 percent of users depend on the pill. In Bali, 41 percent of currently married women--or 60 percent of users--are using the IUD. Injection and female sterilization are the second most widely used contraceptive methods in Bali (12 and 6 percent, respectively). DI Yogyakarta shows a pattern similar to that in Bali, with the IUD and injection predominating. It is interesting to note that although contraceptive prevalence in DI Yogyakarta is 75 Table 5.2.2 Current use of contraception: region and province Percent distribution of currently married women by contraceptive method currently used, according to region and province, Indonesia 1994 Any modern Region Any meth- and province method od Pill Modem method Traditional method Female Male Any Pert- Not steri- steri- trad. odic With- Other cur- Number lnjec- Con- Nor- liza- liza- meth- absti- draw- meth- rently of IUD lion dom plant lion lion od hence al ods using Total women Java-Bali 58,4 56.4 16.7 12.1 16.8 0.9 5.5 3,5 0.9 20 07 0.6 06 41,6 10~).0 16,663 DKI Jakarta 59.7 548 145 12.4 19.0 1,9 1.2 5.7 0,0 5.0 2.8 0.7 1.5 403 10~)0 1,140 West Java 56.7 56.0 19.1 7.2 21.0 (}.9 48 1.4 1.6 0.7 0.4 0,1 0.2 43.3 11~).0 5,170 Central Java 61.1 59.6 13.9 10.8 19.0 1.1 10.0 3.6 1.2 1.5 06 0,6 0.4 38.9 10410 4,302 DI Yogyakarta 695 597 88 27.3 12.3 37 2.8 40 119 97 3.1 3.8 2.8 311.5 10~)0 423 Easl Java 55.9 53.5 18 .8 14.5 I1.1 0.4 4.0 4.6 0.1 2.3 0.6 0,9 09 44.1 11~).0 5,209 Bali 68,4 66,5 4.8 41.1 12.0 0.9 0.6 6.3 0,8 1.9 1.3 0.2 0.4 31.6 1t~13) 418 Outer Java-Balil 49.5 455 18.8 74 11.9 0,8 3.7 2,5 0.3 40 1.8 1.2 09 50.5 1181.0 6,619 Dista Aceh 323 30.1 12.5 2.2 12.9 0.9 1.1 0.4 0.1 2.2 15 00 0,7 67.7 100.0 477 North Sumatra 470 4112 13.9 8.0 9.7 1.3 21 5.1 0.2 68 3.6 2.4 08 53.0 10~).0 1,374 West Sumatra 442 41.1 6.4 14 .0 14,4 07 31 2.6 0.0 3.1 1.4 13 0.4 55.8 100.0 489 South Sumatra 529 50.1 196 49 10.9 1,3 100 3.0 04 28 24 0.2 03 47.1 100.0 843 Lampung 59.3 57.9 28.9 95 13.6 11.5 2 7 1,8 1.1 1 3 0.2 06 05 40.7 1000 801 West Nusa Tenggara 49.8 47.9 178 108 9.7 01 84 I I 0,0 1.9 06 0.1 1.2 511.2 1(~1.0 469 West Kalimantan 50.6 49.5 25.2 50 15.0 1.3 16 1.0 0.4 1.1 05 0.0 06 494 100.0 489 South Kalimantan 54,7 51.2 339 30 7.6 0.7 2.8 3.1 0.1 3.6 12 1),1 22 45.3 1000 398 NorthSulawesi 725 69.1 21,5 214 187 00 47 26 00 3.5 2.1 01 1.3 27.5 1000 318 South Sulawesi 426 35.2 165 3.1 11.7 0.4 2 1 1.3 0.0 74 20 37 1,7 57.4 1000 962 Outer Java-Bali I I 45.7 41.8 154 60 13.6 0,6 40 1.8 0.3 3.9 14 0.7 1.8 54.3 1000 2,903 Riau 41 0 38.6 18.0 4.5 I 1.0 12 18 17 0.3 2.4 1.5 0.6 0.2 59.0 100.0 520 Jambi 55.1 54.1 24.5 6.0 13.7 0.7 8.5 0.6 01 1.0 0.6 0.0 04 44,9 1t81.0 316 Bengkulu 61.6 60.2 196 14.6 12.0 1.0 10.2 2.7 0.1 1.4 0.2 0.5 0.6 38,4 100,0 179 Easl NusaTenggara 373 32.6 32 8 0 138 00 4 0 25 1 1 47 24 1 6 0.7 627 1000 393 East Timor 226 20.7 2,0 1,0 14.4 1) 2 30 0.1 00 19 09 0.0 1.0 77.4 1000 115 Central Kalimantan 445 41.1 26.4 1.5 10.4 0.0 2.4 0.4 00 3.4 00 00 34 55.5 100.0 227 East Kalimantan 60,5 547 237 9.0 14.6 1.5 2.0 3.6 (1.2 5.8 19 1.8 21 39.5 lb~/0 304 Central Sulawesi 52.5 48.3 157 6.4 20,9 0A 4(1 1.2 0.0 4.2 13 1.0 18 47.5 1000 225 Southeast Sulawesi 463 41.8 12,9 60 166 (11 42 19 01 4.5 3,1 1,0 04 53.7 1000 178 Maluku 34.9 33.4 89 49 14.2 1) 3 3.3 1.3 113 1.5 11 01 0.4 65.1 11~10 2119 lrian Jaya 413 29.1 %5 2.6 12.0 0.9 3,5 2.6 0.0 12.1 1.6 0.3 102 58.7 10~/0 238 Total 54.7 52.1 17.1 10.3 15.2 0.9 49 3.1 0.7 2.7 11 0.8 08 45.3 1t81.0 26,186 Note: Total includes 2 users of Intravag/Diaphragm/Foam the highest in Java-Bali, the proportion of current users of traditional methods is also high (10 percent of current users). 5.2 Trends in Contraceptive Use The dramatic changes that have taken place in the level and pattern of contraceptive use in Indonesia over the past 18 years are shown in Tables 5.3 through 5.5. Table 5.3 and Figure 5.2 focus on the provinces that constitute the Java-Bali region, for which it is possible to construct comparable estimates of contraceptive prevalence over an 18-year period between 1976 and 1994. Overall, prevalence doubled in Java-Bali between 1976 and 1987. However, between 1987 and 1991, the percentage of married women using family planning increased only slightly (from 51 to 53 percent), as it did between 1991 and 1994 (from 53 to 58 percent). The largest increase in Java-Bali between 1991 and 1994 occurred in Central Java (11 percentage points), while in Bali there was actually a decrease of 4 percentage points. 76 Table 5.3 Trends in contraceptive use by province: Java-Bali 1976-1994 Percentage of currently married women who are currently using a method of contraception, by province, Java-Bali, I976-1994 Ratio Ratio IFS NICPS IDHS IDHS 1991/ 1994/ Province 1976 1987 1991 1994 1987 1991 DKI Jakarta 28 54 56 60 1.04 1.07 West Java 16 46 51 57 1.11 I.I 2 Central Java 28 54 50 61 0.93 1.22 DI Yogyakarta 40 68 71 70 1.04 0.99 East Java 32 50 55 56 !.10 1.02 Bali 38 69 72 68 1.04 0.94 Total 26 51 53 58 1.04 1.09 Figure 5.2 Percentage of Currently Married Women Age 15-49 Using Contraception, by Province, Java-Bali 1976-1994 Java-Bali DKI Jakarta West Jaw Central Java DI Yogyakarta East Java Bali . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . In] 56 ,JJJ, J JiiiJii ii . i . i ¸¸¸¸In1 ,o I 4~ 57 o, ' i . . . . . . . . . I 6Q ~8 20 40 60 Percent 80 Table 5.4 and Figure 5.3 show trends in the use of specific contraceptive methods among currently married women in Java-Bali. Between 1991 and 1994, use of injection and Norplant showed the greatest gain from 13 to 17 percent for injection and from 3 to 6 percent for Norplant. Use of the pill and female sterilization increased also, while IUD use actually decreased from 16 to 12 percent. Condom use continued to be less than 1 percent. 77 Table 5.4 Trends in use of specific contraceptive methods: Java- Bali r 1976-1994 Percentage of currently married women who are currently using a specific contraceptive method, by method, Java-Bali, 1976-1994 IFS NICPS 1DHS IDHS Method 1976 1987 1991 1994 Any method 26.3 50.9 53.4 58.4 Pill 14.9 16.0 14.5 16.7 IUD 5.6 15.5 16.1 12.1 Injection 0.2 10.7 13.0 16.8 Condom 1.8 1.8 0.8 0.9 Female sterilization 0.3 3.5 2.9 3.5 Male sterilization 0.0 0.2 0.7 0.9 Norplant - 0.4 3.1 5.5 Periodic abstinence 0.8 1.1 1.0 0.7 Withdrawal 0.3 0.7 0.5 0.6 Other 2.3 2.3 0.6 0.6 Number of women 7,974 7,265 13,419 16,663 Figure 5.3 Percentage of Currently Married Women Age 15-49 Using Specific Modern Contraceptive Methods Java-Bali, 1976-1994 Pil lUn injection Female St~rilizatio n 6 0 5 t0 15 20 Percent Note: Other methods are 1 percent or less. 78 Table 5.5 and Figure 5.4 show trends in the use of specific contraceptive methods among currently married women in Indonesia in the 1991 and 1994 surveys. The overall prevalence increased from 50 percent in 1991 to 55 percent in 1994. The largest increase was in the use of injection (from 12 to 15 percent) and the pill (from 15 to 17 percent). On the other hand, IUD use decreased from 13 percent in 1991 to 10 percent in 1994. 5.3 Contraceptive Use among Women over Thirty and among Those with Three or More Children One of the five principles of the family planning movement is that women over 30 and those with three or more children should be using the most effective means of fertility control available. Table 5.6 presents information on contraceptive use status and type of method used by current users. This information can be used to evaluate the success of the family planning program in meeting these goals. Table 5.5 Trends in use of specific contraceptive methods: Indonesia~ 1991 and 1994 Percentage of currently married women who are currently using a specific con- traceptive method, by method, Indonesia 1991 and 1994 IDHS IDHS Method 1991 1994 Any method 49.7 54.7 Pill 14.8 17.1 IUD 13.3 10.3 Injection 11.7 15.2 Condom 0.8 0.9 Norplant 3.1 4.9 Female sterilization 2.7 3.1 Male sterilization 0.6 0.7 Periodic abstinence 1.1 1.1 Withdrawal 0.7 0.8 Other 0.9 0.8 Number of women 21,109 26,186 Figure 5.4 Percentage of Currently Married Women Age 15-49 Using Specific Contraceptive Methods, Indonesia, 1991 and 1994 17 lnjec Cond Norpl Female Steriliza Male Sterilization ~ Periodic Abstinence 11 Withdrawal 0 10 20 Percent Note: Other methods are less than 1 percent, The data in Table 5.6 show that among currently married women, 26 percent have never used a mod- em contraceptive method, 22 percent have used a modem method in the past, and 52 percent are currently using a modem method. The proportion of married women in their 20s who are using long-term methods (about 15 percent) is higher than among women in their 30s (over 20 percent). These proportions are 79 Table 5.6 Contraceptive use status and type of method used Percent distribution of currently married women by contraceptive use status, and among current users of modern methods, the type of method used (temporary or long-term) by number of living children, according to current age, Indonesia 1994 Percentage who are currently using a modem method by number of living children Percentage Percentage who used 0 1-2 3+ who never modern used method Any Long- Long- modem in the modem Temporary term Temporary term Current age method past method method method I method method I Total Number 15-19 50.5 13,9 9.4 21.2 5.1 0.0 0.0 100.0 1,291 20-24 29.6 16.3 1.3 38.4 12.1 1.8 0.5 100.0 3,936 25-29 21.8 20.4 0.2 30.9 11.8 10.5 4.4 100.0 5,234 30-34 19.6 22.9 0.1 15.5 10.1 21.3 10.6 100.0 5,387 35-39 21.4 22.4 0.0 7.2 6.3 24.6 18.0 100.0 4,483 40-44 27.6 22.9 0.1 3.1 4.5 21.5 20.3 100.0 3,262 45-49 40.2 29.7 0.0 1.0 1.6 9.9 17.6 100.0 2,594 Total 26.4 21.5 0.7 17.9 8.3 14.6 10.5 100.0 26,186 I Long-term methods include female and male sterilization, the IUD, and Norplant. roughly similar to those in 1991, indicating little if any increase in the proportion of older women or higher- parity women who are using long-term methods. There has been a slight shift to greater use of long-term methods among women who are both over age 35 and who have three or more children. 5.4 Reasons for Choice of Contraceptive Method The reasons women give for choosing their current contraceptive method are important for the family planning movement, particularly in view of the current emphasis on program self-sustainability. As shown in Table 5.7, side effects of other methods (30 percent), the desire for a more effective method (18 percent), and convenience (I 5 percent) were the most common reasons given for choosing a specific method. Reasons for using a specific method vary according to method. The majority (58 percent) of condom users reported that they chose condoms because the side effects were less than with other methods. This reason was also reported most frequently by pill and injection users (39 and 33 percent, respectively). Among IUD and injection users, 22 percent and 24 percent, respectively, said they chose their method because of its effectiveness, while more than 20 percent of Norplant and injection users said that convenience was the reason they chose their method. A substantial proportion of pill users (13 percent) said that they chose this method because of its accessibility or availability, and about 11 percent stated that they chose the pill because of its affordability. These reasons were not commonly reported by other modem method users. Most sterilized women said that they chose this method because they wanted a permanent or more effective method. 80 Table 5.7 Reasons for using current method of contraception Percent distribution of contraceptive users by reason for deciding to use current contraceptive method, according to specific method, Indonesia 1994 Method Female Male Reason for using sterili- sterili- current method Pill IUD Injection Condom Norplant zation zation Total Recommended by FP worker 7.4 16.7 4. I 5.3 18.7 8.4 17.5 9.5 Recommended by friend/relative 3.7 4.1 4.0 0.5 4.2 2.6 3.9 3.8 Side effects of other methods 38.5 21.6 32.8 57.5 17.4 13.1 11.6 30.0 Convenience 6.9 15.6 22.5 4.2 20.6 9.3 5.2 14.5 Access, availability 12.8 1.1 2.3 5.2 0.7 0.0 0.0 5.3 Lower cost I 1.0 3.3 1.4 0.7 4.6 0.4 2.2 5.1 Want permanent method 0.8 9.3 2.0 1.5 9.6 27.6 18.0 5.5 Husband preferred 2.0 0,7 2.3 15.3 1.4 1.5 17.4 2.1 Want more effective method 12. I 21.5 23.7 7.9 ! 6.8 19.6 12.5 18.2 Other 3.4 5.6 4.3 1.7 4.4 16.6 8.1 5.0 Don't know 1.3 0.7 0.6 0.1 1.5 0.8 3.6 1.0 Total 1130.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number 4,484 2,686 3,985 224 1,278 829 172 13,661 Note: Total includes some users of other methods not shown separately. 5.5 Quality of Use of the Pill, Injection and Condoms The pill is the most popular method of contraception used in Indonesia. In order to study the "quality" of pill use, the 1994 IDHS included a series of questions for women who said they were using the pill. Each respondent was first asked if she had a packet of pills in the house. If not, the respondent was asked why she did not have a pill packet and was requested to identify the brand of pills she was using from a brand chart carried by the interviewer. If the respondent said she did have a packet of pills in the house, the interviewer asked to see it, then recorded the brand and noted on the questionnaire whether pills were missing in order. If no pills were missing or pills were missing out of order, the interviewer asked why. Finally, all pill users were asked when they last took a pill. Table 5.8.1 indicates that 94 percent of pills users were able to show their pill packet to the interviewer, and most of those who could not said that they had run out of supplies (84 percent) (data not shown). Among those who had a pill packet, 86 percent had taken the pills in order. Among women who had not taken pills in order, 33 percent said that they did not know what to do, 23 percent had started a new packet, and 15 percent were menstruating (data not shown). Of concern is the fact that only 85 percent of pill users said they had taken a pill in the two days before the interview. Most of the women who had not taken a pill during that period said that they were menstruating (49 percent), 15 percent ran out of pills, and 10 percent had an absent husband (data not shown). Although many women who missed taking a pill for two consecutive days are still protected from the risk of pregnancy, the data indicate that the effective level of pill use is somewhat lower than the reported level. Table 5.8.1 shows no meaningful differences in the quality of pill use by the respondent' s background characteristics, except by age. The respondent's age has a negative association with the quality of pill use; older women are less likely than younger women to have taken a pill in the last two days. 81 Table 5.8.1 Pill use compliance: background characteristics Percentage of currently married women using the pill, and the percentage of pill users who could show pill packet, who took pills in order, and who took a pill less than two days ago, by background characteristics, Indonesia 1994 Percentage of pill users who: Could Took Percent show Took pill Number Background using pill pills <2 days of pill characteristic pill packet in order ago users Age 15-19 14.6 95.8 85.2 94.0 188 20-24 18.0 94.5 86.8 83.3 709 25-29 19.7 94.4 89.0 87,0 1,032 30-34 18.8 92.8 87,4 85.1 1,013 35-39 19.1 93.3 83.0 85.7 856 40-44 15. I 93.8 83.5 78.6 492 45-49 7.5 91.2 85.6 76.9 195 Residence Urban 15.8 94.3 88.0 86.9 1,198 Rural 17.7 93.5 85.6 83.8 3.286 Region/Residence Java-Bali 16.7 93.9 84.4 84.2 2,79(I Urban 15.3 95.2 88.5 88.6 846 Rural 17.4 93.4 82.6 82.3 1,944 Outer Java-Bali 1 18.8 93.6 " 89.1 85.6 1,246 Urban 16.3 91.9 86.0 82.9 231 Rural 19.5 94,0 89.8 86.2 1,015 Outer Java-Bali I1 15.4 92.7 89.8 85.0 448 Urban 18.7 92. I 88.8 82,5 120 Rural 14.5 92.9 90.2 85.9 327 Education No education 15.0 94.2 86,6 85.2 587 Some primary 18.5 92.7 84.3 84.6 1,534 Completed primary 18.8 94.1 87.0 86,0 1,412 Some secondary+ 14.7 94.4 88.0 82.5 951 Total 17.1 93.7 86.2 84.7 4,484 The variability of pill compliance among regions and provinces is shown in Table 5.8.2. In only three provinces (DI Yogyakarta, Jambi, and Maluku) was the percentage of pill users who could show a packet less than 90 percent. Between 82 percent (East Java) and 95 percent (Central Kalimantan) of women took their pills in order. Pill use compliance--i.e., took a pill less than two days before the interview--was highest in Central Kalimantan (93 percent) and lowest in Maluku (71 percent). 82 Table 5.8.2 Pill use compliance: region and province Percentage of currently married women using the pill, and the percentage of pill users who could show pill packet who took pills in order, and who took a pill less than two days ago, by region and province, Indonesia 1994 Percentage of pill users who: Could Took Percent show Took pill Number Region using pill pills <2 days of pill and province pill packet in order ago users Java-Bali 16.7 93.9 84.4 84.2 2,790 DKI Jakarta 14.5 95.4 92.8 90.3 166 West Java 19.1 93.4 82.3 87.3 990 Central Java 13.9 94.3 89. I 79.8 597 DI Yogyakarta 8.8 89.9 87.8 83.0 37 East Java 18.8 94.1 81.8 82.7 980 Bali 4.8 95.8 94.0 83.7 20 Outer Java-Bali I 18.8 93.6 89.1 85.6 1,246 Dista Aceh 12.5 95.9 90.1 80.4 59 North Sumatra 13.9 93. I 86.5 85.9 190 West Sumatra 6.4 90.8 88.7 86.5 31 South Sumatra 19.6 95.3 89. I 84.7 165 Lampung 28.9 92.5 88.9 82.7 232 West Nusa Tenggara 17.8 92.4 87.4 85.6 83 West Kalimantan 25.2 95.9 91. I 91.0 123 South Kalimantan 33.9 95.1 88.7 89.4 135 North Sulawesi 21.5 95.3 93.8 88.1 68 South Sulawesi 16.5 90.8 89.7 83.7 159 Outer Java-Bali II 15.4 92.7 89.8 85.0 448 Riau 18.0 93.0 88.3 88.3 94 Jambi 24.5 89.5 88.7 85.8 77 Bengkulu 19.6 91.7 88.1 83.5 35 East Nusa Tenggara * * '~ * 13 East Timor * '~ ~ * 2 Central Kalimantan 26.4 97.3 95.4 92.6 60 East Kalimantan 23.7 95.6 92.5 86.9 72 Central Sulawesi 15.7 91.8 87.6 81.9 35 Southeast Sulawesi 12.9 90.2 87.6 79.3 23 Maluku 8.9 87.0 82. I 71.3 19 lrian Jaya 7.5 92.8 92.8 72.3 18 Total 17. I 93.7 86.2 84.7 4,484 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. Al l p i l l users were asked about the brand of pi l ls they used. Tab le 5.9 shows that the most popular brand is M ic rogynon 30 (Scher ing) (22 percent), fo l lowed by Nordette 28 (20 percent) , M ic rogynon (K imia Farma) (17 percent) , and Marve lon 28 (16 percent). A s izable number o f users named Mic rogynon 30 ED (8 percent) , Ex luton (7 percent), and B lue Circ le M ic rogynon 30 ED (3 percent). Other brands are used by very few women. 83 Table 5.9 Use of pill and condom brands Percent distribution of currently married pill users and condom users by pill/condom brand used, Indonesia 1994 Pill/condom Number brand Percent of users Pill Microgynon 30 ED 8.2 370 Microgynon 50 ED 0.9 40 Microgynon 30 (Scbering) 22,0 985 Blue Circle Microgynon 30 ED 3.3 150 Marvelon 28 15.7 705 Restovar 28 micro 0.7 32 Ovostat 28 0.8 34 Nordette 28 20.3 912 Exluton 6.6 294 Microgynon (Kimia Farina) 17.2 773 Other 2.9 132 Don't know 1.3 58 Total 100.0 4,484 Condom BKKBN 31.5 71 Dua Lima 22.2 50 Other/Don't know 46.2 1 (30 Total 100.0 224 This pattern of pill use is very different from that found in the 1987 NICPS, where the majority of pill users used Pil Keluarga Berencana (89 percent). In 1991, Marvelon 28 and BKKBN Microgynon were the most popular pill brands (each used by 21 percent of users). Other popular pill brands in 1991 were Stophamil (17 percent) and Microgynon 30 ED (14 percent). Only two condom brands have substantial numbers of users: BKKBN (32 percent) and Dua Lima (22 percent). Other brands include Young Young 002, Young Young Super Skin, and Kingtex Longtime (data not shown due to the small number of users). This pattern is similar to that in 1991, when the most popular condom brands were KB and KB Dua Lima (30 percent and 15 percent, respectively). Although the number of condom users is small, these findings suggest that the use of subsidized brands ~ BKKBN and Dua Lima) has increased in the past three years. In addition to the quality of pill use, the quality of injection use was also investi ated in the 1994 IDHS. Interviewers asked all injection users when they received their last injection. Table 5.10 indicates that 97 percent of injection users received an injection less than three months before the survey, suggesting that 3 percent of injection users may be at risk of pregnancy. Among those who had not received an injection, 15 percent said they had forgotten to get it (data not shown). The variability in the quality of injection use by background characteristics and region is very small, which is why data by province are not presented. 84 Table 5.10 Use of iniection Percentage of currently married women using injection, and the percentage of injection users who received an injection in the last three months, by background characteristics, Indonesia 1994 Injection users Percent who received Number Percent injection of Background using <3 months injection characteristic injection ago users Age 15-19 15.7 94.1 202 20-24 23.2 98.7 911 25-29 21.2 97.7 1,109 30-34 16.7 97.7 901 35-39 11.4 96.9 509 40-44 8.5 96.9 277 45-49 2.9 89.6 76 Residence Urban 16.8 98.3 1,274 Rural 14.6 97.0 2,712 Region/Residence Java-Bali 16.8 98.2 2,802 Urban 18.0 98.8 992 Rural 16.2 97.9 1,810 Outer Java-Bali 1 11.9 95.5 787 Urban 13.4 96. I 190 Rural 11.5 95.3 597 Outer Java-Bali 1I 13.6 95.7 396 Urban 14.1 97.8 91 Rural 13.5 95.1 305 Education No education 8.2 96.2 318 Some primary 13.7 97.5 1,138 Completed primary 17.9 97.4 1,348 Some secondary+ 18.3 97.8 1,181 Total 15.2 97.4 3,985 5.6 Problems with Current Method All contraceptive users in the 1994 IDHS were asked whether they had experienced problems with the method they were using. Respondents were asked separately about health problems and problems not related to health. Table 5.11 shows that, in general, most contraceptive users did not have problems with their method. The proportion of users who experienced health problems is higher among users of hormonal contraceptives than users of other methods. This is seen from the lower percentages of users who reported having no health problems among injection users (78 percent), Norplant users (81 percent), and pill users (89 percent). The most common health problem reported by users of the pill, IUD, and Norplant is headache, while women who use injection experience irregular menstrual periods most frequently. 85 Table 5.11 Problems with current method of contraception Percent distribution of current users of modern contraceptive methods by the main health problem with the method and by other non-health problem with the method, according to specific methods, Indonesia 1994 Method Female Male Main problem with sterili- sterili current method Pill IUD Injection Condom Norplant zation zation Health problem No health problem 89.4 92.2 77.7 100.0 80.5 92.2 98.0 Weight gain 0.9 0.5 0.9 0.0 0.8 0.3 0.0 Weight loss 0.2 0.4 0.3 0.0 0.9 0. I 0.0 Bleeding 0.I 1.1 1.2 0.0 0.7 I.I 0.0 Hypertension 0. I 0.1 0.1 0.0 0.0 0.1 0.0 Headache 5.9 1.7 4.7 0.0 5.3 0.7 0.0 Nausea 0.8 0.4 0.2 0.0 0. I 0.2 0.0 Amenorrhea 0.6 0.2 9.4 0.0 4.6 0.1 0.0 Weak/tired 0.2 0.1 0.7 0.0 0.7 1.0 1.8 Other 1.6 3.3 4.7 0.0 5.9 3.6 0.2 Don't know 0.1 0.0 0.0 0.0 0.3 0.7 0.0 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number 4,484 2,686 3,985 224 1,278 829 172 Other problem Any other problem 1.0 0.5 2.6 1.4 3.0 1.1 3.8 No other problem 99.0 99.5 97.4 98.6 97.0 98.9 96.2 Total 100.0 100.0 1(30.0 100.0 100.0 100.0 100.0 Number 4,484 2,686 3,985 224 1,278 829 172 5.7 Cost of Methods The Indonesian national family planning movement is implemented by the government, with active participation by the community and private sectors. One indicator of community participation in the program is self-sustainability, which is measured by the proportion of users who pay for the methods and services. All women who were using modern contraceptives were asked where they obtained the method the last time and how much the method cost (i.e., the cost for the method and any associated services). Table 5.12 shows that about 48 percent of users obtained services from a government outlet, and most (64 percent) paid for both the method and the services. Around 28 percent of users obtained services from the private sector; only 10 percent obtained their methods and services free of charge. Most users who obtained services from other sources--such as village delivery posts (polindes), health posts (posyandu), family planning posts, traditional birth attendants, and friends--also paid for family planning methods and services. The highest level of self-sustainability is among users of injection, 94 percent of whom pay for their method. Almost 80 percent of condom users pay for their method, as do 70 percent of women using female sterilization and 56 percent of Norplant users. 86 Table 5.12 Payment for contraceptive methods and services Percent distribution of current users of modem contraceptive methods by source of method and whether method is free or respondent pays for it, according to method and region, Indonesia 1994 Source of contraceptive method and method of payment Government Private Other Method/Region Free Pay Free Pay Free Pay Total Number Method Pill 7.9 24.3 1.7 12.8 9.2 44.0 100.0 4,484 IUD 44.6 21.2 5.1 20.2 7.5 1.4 100.0 2,686 Injection 3.7 38.2 1.0 49.4 1.1 6.6 100.0 3,985 Condom 8.1 12.3 3.8 62.5 9.0 4.3 100.0 224 Norplant 33.6 44.1 1.5 6.4 8.8 5.6 100.0 1,278 Female sterilization 25.1 45.8 5.1 21.7 0.3 2.0 100.0 829 Region Java-Bali 15.9 29.9 2.0 28.3 5.0 18.9 100.0 9,274 DKI Jakarta 9.6 28.7 3.7 52.5 2. I 3.4 100.0 625 West Java 8.8 24.0 2.0 33.4 3.4 28.4 100.0 2,817 Central Java 19.9 33.1 1.3 26.0 6.5 13.2 100.0 2,517 DI Yogyakarta 23.2 30.3 2.4 27.4 7.7 9.1 100.0 250 East Java 20.3 32.0 2.0 19.1 5.9 20.7 100.0 2,789 Bali 15.7 41.5 3.4 36.8 0.9 1.8 I00.0 275 Outer Java-Bali 1 18.9 32.9 3.4 22.8 7.2 14.8 100.0 3,007 Outer Java-Bali 11 25.7 32.6 3.3 14.6 9.6 14.2 100.0 1,207 Total 17.5 30.8 2.4 25.9 5.9 17.6 100.0 13,489 Note: Total includes 2 users of Intravag/Diaphragm/Foam. Among the regions, the highest level of self-sustainability is in Java-Bali (77 percent), followed by Outer Java-Bali I (71 percent) and Outer Java-Bali II (61 percent). Among provinces in Java-Bali, the highest levels of self-sustainability are in West Java and DKI Jakarta (85 percent or more). Table 5.13 shows the distribution of current users according to source of methods and mean cost of methods (including services). Contraceptive users who obtain their method from a government source pay, on average, about half the cost of methods obtained from a private source (Rp. 12,058, compared with Rp. 23,104). t The difference in the mean cost varies by method. For example, IUD users who obtain their method from a private source pay more than four times as much as those who obtain the method from a government source. The cost of methods and services from the public sector is most expensive in the Java- Bali region. By contrast, the private sector cost is highest in the Outer Java-Bali I region. The mean cost of contraceptive methods and services from a government source varies by province (see Table 5.13). ~ Women in West Sumatra pay the most for contraceptive methods and services (Rp. 43,477), while women in Central Sulawesi pay the least (Rp. 1,974). The exchange rate is about Rp. 2,200 to US $1.00. 2 This analysis is limited due to the small number of cases in some provinces. 87 Table 5.13 Source of contraceptive methods and mean cost of methods Percentage of current users of modern contraceptive methods who get their method free and the mean cost (in rupiahs) of the method (including services) for those who pay, by type of source, method, region, and province, Indonesia 1994 Method/Region Source of contraceptive method and mean cost of method Government Private Other Mean Mean Mean cost Number cost Number cost Number Free (Rp.) 1 of users Free (Rp.) I of users Free (Rp.) I of users Method Pill 24.4 621 1,441 12.0 1,532 654 17.3 455 2,389 IUD 67.8 8,489 1,767 20.1 34,051 681 84.6 1,057 238 Injection 8.8 2,765 1,670 2.0 4,367 2,008 14.3 2,474 308 Condom * * 45 5.7 2,250 148 (67.5) (439) 30 Norplant 43.2 5,878 993 19.2 7,780 101 60.9 3,552 185 Female sterilization 35.4 103,736 588 19.2 337,496 222 * * 19 Region/Province Java-Bali 34.8 12,910 4,246 6.5 22,181 2,810 20.8 832 2,218 DKI Jakarta 25.1 15,683 239 6.7 71,725 351 (38.7) (491) 35 West Java 26.9 21,790 925 5.6 16,418 997 10.7 898 895 Central Java 37.5 10,745 1.334 4.8 7,385 688 33.1 1,037 496 DI Yogyakarta 43.4 5,692 134 8.0 15,025 74 45.8 283 42 East Java 38.8 7,594 1,458 9.5 21,073 588 22.3 652 743 Bali 27.4 16,353 157 8.4 23,107 111 * * 7 Outer Java-Bali I 36.5 9,919 1,555 13.0 26,514 789 32.9 1,015 662 DI Aceh 38.3 12.354 80 23.3 27,346 38 62.6 490 26 North Sumatra 45.4 24,647 279 10.3 31,179 225 (16.71 (1,5251 53 West Sumatra 64.3 43,477 109 21.8 49,384 64 58.8 799 29 South Sumatra 35.8 4,601 211 18.0 19,882 117 33.2 2,064 92 Lampung 19.0 3,150 193 7.1 5,922 133 13.0 730 130 West Nusa Tenggara 58.2 7,353 140 (8.5) (35,384) 21 77.9 1,922 65 West Kalimantan 15.1 6,184 13(1 3.3 62,448 40 25.6 597 71 South Kalimantan 36.1 2,363 94 8.5 9,007 39 29.8 263 71 North Sulawesi 26.1 3,485 109 14.0 13,431 60 23.1 1,478 51 South Sulawesi 30.4 8,773 210 20.8 50,445 53 35.8 604 75 Outer Java-Bali I1 44.1 11,408 705 18.3 23,548 215 40.3 832 288 Riau 37.0 11,703 108 9.7 29,710 49 29.2 554 43 Jambi 39.7 5,223 103 12.9 4,219 38 36.2 1.072 30 Bengkulu 54.4 20,746 53 8.6 5,946 22 44.1 1,202 33 East Nusa Tenggara (75.6) (16,293) 74 * * 5 86.8 2,486 44 East Timor (82.3) (2,913) 18 * * I (100.01 5 Central Kalimantan 30.0 2,490 68 (8.2) (4,008) 12 24.1 393 14 East Kalimantan 22.7 24,524 72 26.2 48,980 52 10.6 760 42 Central Sulawesi 24.7 1,974 59 (18.11 (25,027) 14 27.5 585 37 Southeast Sulawesi 43.6 15,209 47 * * 3 31.1 980 24 Maluku 57.7 7,125 52 (43.1) (7,2311 12 * * 6 lrian Jaya 56.1 21,885 52 (16.6) (18,3091 7 (51.5) (563) 1(I Total 36.2 12,058 6,506 8.5 23,104 3,815 25.1 868 3,168 Note: Total includes 2 users of lntravag/Diaphragm/Foam. Figures in parentheses are based on 25-49 unweighled cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. i The exchange rate is about Rp. 2,200 to US$1.00. 88 5.8 Source of Method Information concerning sources of contraceptives is important for family planning program administrators since the family planning movement is currently directed toward self-sustainability. Table 5.14 and Figure 5.5 show that the government is the most common source of methods (49 percent), followed by medical private sources (28 percent) and other private sources (23 percent). Most women who obtain a family planning method through the public sector obtain it from a health center (37 percent). Among private medical sources, midwives are the most popular (16 percent), and among other private sources, health posts (posyandu) are the primary choice for family planning services (13 percent). Table 5.14 Source of supply for modern contraceptive methods Percent distribution of current users of modern contraceptive methods by most recent source of supply or infi,~rrnation, according to specific methods, Indonesia 1994 Contraceptive method Female Male lnjec- sterili sterili- Source of supply Pill IUD tion Condom Norplant zation zation Total Public 32.1 65.8 41.9 20.4 77.7 70.9 77.3 48.6 Government hospital 0.8 8.3 1.5 3.5 4.9 69.3 54.2 7.7 Health center (puskesmas) 24.9 53.0 39.4 13.4 62,1 1.7 23.2 36.5 Family planning fieldworker 4.9 0.2 0,5 2.2 0.4 0.0 0.0 1.9 Family planning mobile clinic 0.1 1.2 0.2 0.4 4.8 0.0 0.0 0.8 Other government 1.4 3.1 0.3 0.8 5.5 0,0 0.0 1.7 Medical private 14.6 25.4 50.4 66.3 7.9 26.8 14.0 28.1 Hospital 0.7 4.2 1.2 2.0 0.3 24.1 10.7 3.1 Family planning clinic 1,3 2.5 2.4 1.4 0.7 1.0 0,9 1.8 Doctor 0.5 8.5 9.2 2.6 2.9 1.7 2.4 5.0 Midwife 8.5 10.2 37.5 3.9 3.5 0.0 0.0 16.1 Pharmacy 3.3 0.0 0.0 56.3 0,0 0.0 0,0 2.0 Other private 0, I 0.0 0,0 0.0 0.4 0.0 0.0 0.1 Other private 53.1 8.8 7.7 13.4 14.4 0.8 8.0 23.1 Village delivery post (polindes) 0.3 0.4 0.2 0.0 1.9 0.0 0.0 0.4 Health post (posyandu) 26.0 6. I 6,4 9,3 7.7 0.0 0.0 12.5 Family planning post 15.7 0,5 0.7 3.9 2.3 0.0 0.0 5,7 Traditional birth attendant (dukun) 0.7 0.0 0.0 0.0 0.0 0.0 0.0 0.2 Friend/relative 2.5 0.0 0.0 0.0 0.0 0.0 0.0 0.8 Other source 8.0 1.9 0.4 0.2 2.6 0.8 8.0 3.5 Don't know 0.0 0.0 0.0 0.0 0.0 0.3 0.7 0.0 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number of users 4,484 2,686 3,985 224 1,278 829 172 13,661 Note: Total includes 2 users of lntravag/Diaphragm/Foam. The source for family planning methods varies by type of method. The majority of sterilized women go to a government hospital for their operation, while public health centers supply more than half of Norplant and IUD users. Pill users, on the other hand, commonly obtain their supplies from health posts (26 percent) and public health centers (25 percent). 89 Figure 5.5 Distribution of Current Users of Modern Contraceptive Methods by Source of Supply Private Private Pharmacy 2% Midwife 16% Other Private Government Hospital 8% Goverment Health Center 37% Private Doctor 5% Private Hospital ** 5% Other Government* 4% * Includes family planning fleldworker and family planning mobile units ** Includes private family planning clinic 1994 IDHS Private sources play an important role in providing some methods, especially injection and condoms. One in three injection users obtains her method from a private midwife. At the same time, more than half of condom users obtain their supplies from a pharmacy. 5.9 Reason for Using Source of Supply People select the place where they get family planning services for various reasons, including convenience, service, and cost. In the 1994 IDHS, data on satisfaction with source of supply were obtained by asking current users the main reason they were using their current source of supply (rather than another source). Table 5.15.1 and Figure 5.6 show that more than half (52 percent) of current users selected a source of supply because of its proximity to their home. Other reasons commonly cited are lower cost (8 percent), use of other services at the facility (8 percent), availability of transportation (7 percent), and friendly staff (6 percent). There is little difference in the selection of source of supply between users in urban and rural areas, although urban women are more likely to choose their family planning source for reasons related to quality of service, such as more competent/friendly staff and more privacy (see Table 5.15.1 ). 90 Table 5.15.1 Reason for selecting current sources of supply for contraceptive methods: background characteristics Percent distribution of current users of modem contraceptive methods by main reason for using current source of supply (rather than another source), according to background characteristics, Indonesia 1994 Main reason for using current source of supply Recom- Recom- More More mended mended Closer Avail- compe- hours Avail- by local by Closer to ability tent/ Offers Shorter of Use ability autbo~ farmly Wanted Don't Background to market/ of friendly Cleaner more waiting opera other of Lower ity/em- planning ano- know/ Number characteiistic home work transport staff facility privacy time tion services services cost ployer provider nymity Other Missing Total of users Residence Urban 46.0 1.4 6.2 8.7 0.8 5.2 1.9 0.9 8.6 1.1 9.9 1.1 1.8 0.2 5.6 0.4 100.0 4,248 Rural 55.1 1.0 7.5 43 0.4 2.4 0.9 1.0 7.1 1.8 7.7 2.1 1.7 0.5 6.0 0.5 1{30.0 9,412 Region/Residence Java-Bali 50.0 0.8 6.5 6.0 0.5 3.0 1.3 1.0 8.4 1.7 8.3 2.3 2.1 0.5 71 0.3 10~.0 9,420 Urban 45.6 0.9 5.5 8.9 0.8 5.0 2.1 0.9 8.8 1.1 10.4 1.1 21 02 6.3 0.3 100.0 3,242 Rural 52.3 0.8 7.1 44 0.3 2.0 1.0 1.0 8.2 2.0 7.2 2.9 2.2 0.7 7.6 0.4 100.0 6378 Outer Java-Bali I 56.9 1.5 8,1 5.5 0.6 4.4 0.8 1.1 5.4 1.3 9.3 0.7 0.9 0.2 2.8 0.6 100.0 3,025 Urban 47.8 2.2 8.4 8.8 0.9 6.6 0.8 0.9 8.5 1.1 8.8 10 06 0.1 3.0 0.5 100.0 691 Rural 59.5 1.3 8.0 4.5 0.6 3.8 0.8 1.2 4.5 1 4 9.4 0.6 1.0 0.2 2.7 0.7 100.0 2,335 Outer Java-Bali 1I 58.4 2.4 8.9 3.5 0.5 2.5 1.4 0.6 6.2 1.9 7.2 0.4 0.9 0.3 40 0.8 100.0 1,215 Urban 46.4 47 8.7 6.7 1.0 4.3 3.0 0.6 6.7 1.5 7.7 0.9 1.9 0.6 4.4 0.9 100.0 316 Rural 62.6 1.6 9.0 2.3 0.4 1.9 0.9 0.6 60 2.0 7.1 0.3 0.5 0.2 3.9 0.7 1000 900 Education No education 53.5 08 4.3 2.4 0.2 1.7 0.6 1.0 7.1 1.9 10.3 3.5 2.0 0.6 9.0 0.9 1120.0 1,494 Some primary 55.6 0.6 5.9 3.9 03 2.6 0.9 1.0 81 17 8.8 2.1 2.2 0.5 5.4 0.5 100.0 4,213 Completed primary 54.6 0.7 9.2 46 0.5 3.0 1.0 1.0 70 13 7.9 1.4 1.4 0.4 5.7 0.2 100.0 4,231 Some seconda~+ 45.3 2.3 7.1 10A 1.0 5.0 2.1 1.0 7.8 1.8 7.8 1.1 1.5 0.3 5.3 0.4 100,0 3,723 Reason for using method To space birdas 58.3 1 1 6.3 6.0 0.3 3.3 1.5 0.9 5.9 1.3 6.6 1.3 1.3 0.3 5.2 0.3 100.0 5,646 To limit births 48.0 1.1 7.6 5.4 0.7 3.3 1.1 1.0 8.7 1.8 9.7 2.1 2.1 0.5 6.3 0.6 100.0 8,014 Total 52.3 1.1 7.1 5.6 0.5 3.3 1.2 1.0 7.5 1.6 8.4 1.8 1.8 0.4 5.9 04 100.0 13,661 Figure 5.6 Distribution of Current Users of Modern Contraceptive Methods by Reason for Using Most Recent Source of Supply Use of Other Services 8% Close to Home 52% Ither 19% Friendly Staff 6% er Cost 8% Transportation 7% IDHS 1994 There is little variation in the main reason for selecting a family planning source by province (see Table 5.12.2). In all provinces, proximity to home is the most common reason cited. Women in Central Kalimantan are more likely than women in other provinces to base their decision on the availability of transportation (24 percent); while 12 percent of women in Bali indicated that competent and friendly staff are an important reason for choosing a source. As part of the strategy of the family planning movement, programs are being developed to enhance the accessibility and availability of family planning services in remote areas, and to provide users with better quality services. 92 tad Table 5.15.2 Reason for selecting current sources of supply for contraceptive methods: region and province Percent distribution of current users of modem contraceptive methods by main reason for using current source of supply (rather than another source), according to region and province, Indonesia 1994 Main reason for using current source of supply Recom- Recom- More More mended mended Closer Avail- compe- hours Avail- by local by Closer to ability tent/ Offers Shorter of Use ability author- family Wanted Don't Region and to market/ of friendly Cleaner more waiting opera- other of Lower ity/em- planning ano- know/ Number province home work transport staff facility privacy time tion services services cost ployer provider nymity Other Missing Total of users Java-Bali 500 08 6.5 60 0.5 3.0 1.3 1.0 8.4 1.7 8.3 2.3 2.1 0.5 7.1 0.3 100.0 9,420 DKI Jakarta 54.6 1.1 5.0 6.6 0.2 6.3 0.8 0.7 5.5 0.8 14.1 0.2 1.0 0.1 2.9 0.0 100.0 625 West Java 54.5 0.3 5.1 4.7 0.5 5.7 1.6 0.8 6.6 1.8 8 2 23 1.6 0.1 5.8 0.5 100.0 2,901 Central Java 478 0.6 16.1 4.7 0.3 1.6 1.1 16 9.7 0.5 8.5 0.9 0.5 0.5 5.3 0.2 100.0 2,569 DI Yogyakarta 52.2 1.9 1.3 9.7 02 1.7 1.6 1.1 3.4 2.3 5.9 2.6 5.3 0.5 10.2 0.4 1(30.0 254 East Java 46.0 1.5 0.6 7.4 0.8 1.1 1.4 0.8 9.6 2.7 7.4 4.1 4.2 1.1 11.0 0.4 100.0 2,793 Bali 51.2 1.0 0.4 12.0 0.4 1.1 1.0 1.3 13.5 2.6 5.8 1.6 2.7 0.1 5.3 0.1 100.0 278 Outer Java-BaU I 569 1.5 8.1 5.5 0.6 4.4 0.8 1.1 5.4 1.3 9.3 0.7 0.9 0.2 2.8 0.6 100.0 3,025 Dista Aceb 50.7 2.7 6.4 9.0 0.0 8.0 0.7 2.3 5.4 0.6 I0.4 0.3 0.3 1.0 1.6 0.7 I00.0 145 North Sumatra 47.8 1.9 4.3 9.0 0.7 6.0 0.7 0.4 11.5 1.1 7.6 1.1 2.0 0.0 5.3 0.7 100.0 561 West Sumatra 43.7 1.2 3.5 4.7 0.0 8.6 1.7 12 5.3 5.7 12.0 1.8 2.5 0.0 7.9 0.2 100.0 202 South Sumatra 56.2 2.2 10.8 6.1 1.1 1.2 0.6 1.2 4.1 0.6 13.0 0.5 0.4 0.4 1.3 0.4 I00.0 424 Lampung 60.2 0.7 5.9 3 I 1.2 4.9 1.1 2.8 2.1 1.0 13.6 0.2 0.3 0.1 1.9 1.0 100.0 464 West Nusa Tengga.ra 52.7 20 12.0 5.9 0.5 1.7 0.9 0.7 4.8 1.5 11.5 2.0 0.7 0.0 2.8 0.3 100.0 225 West Kalimantan 74.2 0.9 4.0 4.4 0.2 1.4 0.2 0.5 3.6 1.7 4.6 0.0 1 7 0.0 2.0 0.6 100.0 243 South Kalimantan 58.1 2.0 13.2 3.1 0.4 4.0 1.8 0.7 8.4 1.4 2.7 0.6 0.4 0.4 22 0.6 100.0 204 North Sulawesi 52.5 0.3 15.0 6.0 0.9 3.6 0.4 0.0 4.0 03 13 6 0.3 0.4 0.0 1.3 1.3 100.0 220 South Sulawesi 70.9 1.0 10.3 2.9 0.4 5.8 0.4 0.9 2.7 0.7 2.3 0.0 0.2 0.0 0.9 0.6 100.0 338 Outer JavaoBali I1 58.4 2.4 8.9 3.5 0.5 2.5 1.4 0.6 6.2 1.9 7.2 0.4 0.9 0.3 4.0 0.8 100.0 1,215 Riau 53.9 3.0 5.7 5.7 0.3 5.0 0.9 0.2 5.4 3.7 5.8 0.8 0.7 0.4 7.9 0.6 100.0 202 Jambi 60.8 3.2 10.2 2.3 0.4 1.5 1.3 0.7 9.2 0.0 7.3 0.0 0.2 0.4 2.4 0.0 100.0 171 Bengkulu 583 1.0 5.7 4.3 0.0 1.4 0.6 1.5 6.9 1.0 15.0 2.0 0.0 0.5 1.8 0.0 100.0 108 East Nusa Teaggara 66.4 2.4 3.0 3.8 0.4 0.4 0.3 0.0 4.0 2.4 7.9 0.0 1.0 0.3 6.7 0.8 100.0 128 East Timor 75.9 0.0 32 7.1 1.0 4.0 0.4 0.0 3.1 1.9 1.1 0.0 0.0 0.0 2.2 0.0 100.0 24 Central Kalimantan 46.4 1.1 24.4 0.6 0.0 18 0.6 0.2 11.2 3.6 7.6 0.0 02 0.0 0.8 1.5 100.0 93 East Kalimantan 58.6 3.1 5.3 2.9 0.9 4.4 3.2 00 5.1 1.1 7.2 0.6 2.8 03 3.9 0.7 100.0 167 Central Sulawesi 64.1 2.1 13.6 1.2 0.7 20 3.0 1.9 2.4 1.4 4.1 0.0 0.2 0.0 1.1 2.2 100.0 109 Southeast Sulawesi 59.5 1.5 15.2 2.9 1.0 0.8 1.1 2.7 6.1 0.7 4.8 0.2 0.0 0.2 2.7 0.7 1(30.0 74 Maluku 56.4 1.2 7.7 4.2 0.8 4.0 1.7 0.0 7.4 0.4 7.0 00 1.3 0.5 5.9 1.6 100.0 70 Ir i~ Jaya 52.5 4.0 7.9 5.3 1.2 0.2 1.8 0.0 5.9 4.6 7.4 04 2.8 0.0 4.4 1.4 100.0 69 Tom 52.3 1.1 7.1 5.6 0.5 3.3 1.2 1.0 7.5 16 8.4 1.8 1.8 0.4 5.9 0.4 1~.0 13,~1 5.10 Timing of Sterilization Female sterilization is an important way for women in high-risk groups to avoid becoming pregnant. The family planning movement provides information about this method as well as about facilities that provide services. As with other methods, voluntary sterilization is provided to a woman in accordance with her age and health status. Trends in the use of this method, especially regarding women' s age at the time of the opera- tion, provide important information for program planners. In using these data, however, the problem of censoring must be taken into account. Since the survey included only ever-married women 15-49, women age 50 and over who had been sterilized were not covered. Table 5.16 presents the percent distribution of sterilized women by age at the time of sterilization, according to the number of years since the operation. A total of 65 percent of women were sterilized at age 30 or over. The median age at the time of sterilization is 31.6 years, which suggests there has been no change since 1991 (31.4 years). Table 5.16 Timing of sterilization Percent distribution of sterilized women by age at the time of sterilization, according to the number of years since the operation, Indonesia 1994 Age at time of sterilization Number Years since of Median operation <25 25-29 30-34 35-39 40-44 45-49 Total women age t <2 2~0 25.8 24.4 34.5 12.5 0.8 100.0 120 34.2 2-3 3.5 20.4 40.2 27.6 2.8 5.4 100.0 125 32.7 4-5 5.0 25.4 42.4 20.1 7.1 0.0 100.0 98 30.8 6-7 8.9 20.9 34.4 33.5 2.4 0.0 100.0 133 32.0 8-9 6.0 33.9 34.2 25.9 0.0 0.0 100.0 117 31.3 10+ 8.5 39.1 39.2 13.2 0.0 0.0 100.0 236 a Total 6.1 29.1 36.1 24.3 3.5 0.9 100.0 829 31.6 IMedian age was calculated only for women less than 40 years of age to avoid problems of censoring. aNot calculated due to censoring 5.11 Knowledge of the Fertile Period A basic knowledge of female reproductive physiology and the fertile period is useful for the successful practice of periodic abstinence. The success of periodic abstinence depends on women's under- standing of the monthly cycle and the days when a woman is most likely to conceive. Table 5.17 presents information on knowledge of the fertile period among current users of periodic abstinence, current users of calendar rhythm, and current users of any method. The data indicate that knowledge of the reproductive cycle is generally limited. One in three current users of contraception does not know when a woman is most likely to conceive, 30 percent believe a woman can conceive at any time in her cycle, and 17 percent say that a woman is most likely to conceive just after her period has ended. Only 17 percent gave the "correct" response: that a woman has the greatest probability of conceiving in the middle of her ovulatory cycle. 94 Women who are using periodic abstinence are considerably more knowledgeable about the ovulatory cycle than women in general. Two out of three of these women know when they are most fertile; only 2 percent say they do not know. It should be noted that the precoded response categories for this question are only one way of dividing the cycle into periods. It is possible that women who gave "other" responses, such as "one week after her period," were coded in the category "right after period has ended," instead of in the category "in the middle of the cycle." Thus, women may actually have a more accurate understanding of their cycle than is presented in Table 5.17. Table 5.17 Knowledge of fertile period Among currently married women who are currently using a method of contraception, the percent distribution of all users of periodic abstinence, of users of calendar rhythm, and of users of any method by knowledge of the fertile period during the ovulatory cycle, Indonesia 1994 Current users of: Perceived Periodic Calendar Any fertile period abstinence rhythm method During menstrual period 0.9 0.4 0.2 Right after period has ended 19.9 22.0 17.2 In the middle of the cycle 63.4 67.3 17.2 Just before period begins 6.2 8.0 2.4 No particular time 5.3 0.0 29.9 Other 1.7 2.0 0.4 Don't know 2.4 0.3 32.6 Missing 0.2 0.0 0.1 Total 100.0 100.0 100.0 Number 286 219 14,334 95 CHAPTER 6 FERTIL ITY PREFERENCES This chapter addresses questions that allow an assessment of the extent of unwanted fertility in Indonesia, the degree of acceptance of the two-child family norm, and the level of need for contraceptive services. Respondents in the 1994 IDHS were asked questions concerning whether they wanted more children; if so, how long they would prefer to wait before the next child; and if they could start afresh, how many children in all they would want. Since an underlying objective of the Indonesian family planning program is to persuade couples to have only two children and to space them at least five years apart, it is important to understand to what extent these fertility preferences have been accepted. Two other issues are examined here as well: the extent to which unwanted or mistimed births occur and the effect that the prevention of such births would have on fertility rates. Interpretation of data on fertility preferences has always been the subject of controversy. Survey questions have been criticized on the grounds that (I) answers are misleading because they may reflect unformed, ephemeral views, which are held with weak intensity and little conviction, and (2) they do not take into account the effect of social pressures or the attitude of other family members, particularly the husband, who may exert a major influence on reproductive decisions. The first objection has greater force in noncontracepting societies where the idea of conscious reproductive choice may still be alien; preference data from these settings should be interpreted with caution. This objection probably has little relevance in Indonesia where widespread public exposure to the family planning program has probably caused most people to establish opinions regarding fertility regulation prior to the interview. The second objection is correct in principle. In practice, however, its importance is doubtful; for instance, the evidence from surveys in which both husbands and wives are interviewed separately suggests that there is little difference in their views. The inclusion of women who are currently pregnant complicates the measurement of views on future childbearing. For these women the question on desire for more children was rephrased to refer to desire for another child after the one that they were expecting. To take into account the way in which the preference variable is defined for pregnant women, the results have been classified by number of living children, including current pregnancies. In addition, the question on preferred waiting time before the next birth was rephrased for pregnant women to make clear that the information wanted is the preferred waiting time after the birth of the child the respondent was expecting. Data of women who have been sterilized for contraceptive purposes also require special analytic treatment. The general strategy in some tables in this chapter is to classify these women as wanting no more children. 6.1 Desire for Additional Children Table 6.1 presents the distribution of currently married women by desire for more children according to the number of living children. Figures in the last column show that 48 percent of these women indicated that they wanted no more children, while 4 percent have been sterilized. Forty-three percent of married women said that they wanted to have additional children; 14 percent wanted the child within two years, 25 percent wanted the child after two years, and 4 percent were unsure about the time. Four percent of women were not sure whether they wanted another child (see Figure 6.1). 97 Table 6.1 Fertility preferences by number of living children Percent distribution of currently married women by desire for more children, according to number of living children, Indonesia 1994 Desire for Number of living children I children 0 1 2 3 4 5 6+ Total Have another soon 2 77.6 23.2 10.9 5.8 3.1 1.9 0.9 14.4 Have another later 3 11.5 59.8 26.8 14.6 8.3 4.2 2.2 24.8 Have another, undecided when 4.2 6.0 4.6 2.7 2.2 1.3 1.2 3.7 Undecided 1.5 2.6 5.8 5.2 3.8 4.2 5.4 4.3 Want no more 2.9 7.4 49.7 65.3 73.0 78.1 79.7 47.8 Sterilized 0.1 0.3 1.7 5.7 8.4 7.7 6.8 3.7 Declared infecund 2.2 0.9 0.5 0.8 1.1 2.3 3.7 1.3 Missing 0.0 0.0 0.1 0.0 0.2 0.2 0.1 0.1 Total 100.0 100.0 1(30.0 100.0 100.0 100.0 100.0 100.0 Number of women 1,666 5,852 6,357 4,802 3,039 1,945 2,524 26,186 ilncludes current pregnancy 2Want next birth within 2 years 3Want to delay next birth for 2 or more years Figure 6.1 Fertility Preferences of Currently Married Women 15-49 Undecided 8% Infecu nd/Missing 1% Want No More 52% "' dudes sterilized 33en) Want Child Soon (<2 years) 14% Went Child Later (2+ years) 25% 1994 IDHS More than half of married women with two children want no more children or have been sterilized. Almost three-quarters of women with three children either have been sterilized or want no more children, and 15 percent want to delay the next birth for at least two years. Findings from the 1991 IDHS show similar patterns, with slightly more desire for terminating childbearing. 98 Table 6.2 shows the distribution of currently married women by desire for children, according to current age. The table indicates the expected pattern, i.e., younger women (15-29) are more likely to want to have another child soon or to space their children, whereas older women (30 years and over) tend to want to stop childbearing. For example, nine in ten women age 15-19 want to have another child, while among women 30-34 the corresponding proportion is less than 40 percent, and among women 40-44 it is only 12 percent. At the same time, six in ten women 15-24 want to delay their next child for at least two years, while at most 18 percent of women 30 years and older want to do so. Table 6.2 Fertility preferences by age Percent distribution of currently married women by desire for more children, according to age, Indonesia 1994 Age of woman Desire for children 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Total Have another soon L 29.6 18.4 15.9 16.8 12.3 8.1 4.6 14.4 Have another later 2 57.3 58.1 40,4 17.8 6.4 2.3 0.7 24.8 Have another, undecided when 5.5 5.0 4.5 3.9 3.6 1.6 1.3 3.7 Undecided 2.9 3.7 5.3 5.1 5.1 3.4 2.1 4.3 Want no more 4.8 14.7 32.8 53.0 65.0 74.9 75.3 47.8 Sterilized 0.0 0.0 1.0 3.0 7.2 7.7 6.8 3.7 Declared infecund 0.0 0.0 0.0 0.3 0.4 2.0 9.0 1.3 Missing 0.0 0.0 0.0 0.2 0.0 0.1 0.2 0.1 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number of women 1,291 3,936 5,234 5,387 4,483 3,262 2,594 26,186 IWant next birth within 2 years 2Want to delay next birth for 2 or more years Table 6.3.1 shows the percentage of married women who want no more children by number of living children and background characteristics. Figures in the bottom row show that the desire to stop childbearing increases significantly among women with two or more children. More than half of women who have two children want no more children, and at least eight in ten women who have four or more children want to stop childbearing. Looking at differentials by background characteristics, the table shows that in general, urban women, and women in Java-Bali are more likely to want to terminate childbearing than other women. These differentials were also evident in the 1991 IDHS (see CBS et al., 1992). There is an interesting pattern in the data on proportion wanting no more children by education. At parities zero and one, women with less educa- tion are more likely to want no more children than women with more education. At parity two, differences by education are negligible. At parities four and higher, the proportion who want no more children increases with increasing education. 99 Table6.3.1 Desire to lirnit childbearing: background characteristics Percentage of currently married women who want no more children, by number of living children and selected background characteristics, Indonesia 1994 Number of living children l Background characteristic 0 1 2 3 4 5 6+ Total Residence Urban 2.5 6.5 54.7 79.6 88.3 91.7 94.4 56.1 Rural 3.2 8.1 50.0 67.2 78.1 83.6 83.8 49.7 Region/Residence Java-Bali 3.5 8.5 58.7 78.6 86.6 89.7 89.4 53.3 Urban 2.7 6.6 58.3 81.4 89.4 93.2 97.3 56.7 Rural 3.8 9.3 58.9 77.1 84.9 87.9 85.5 51.6 Outer Java-Bali 1 2.0 5.5 34.8 58.4 74.9 82.1 83.5 49.0 Urban 2.1 6.2 43.0 74~4 88.1 87.5 89.0 55.4 Rural 2.0 5.3 32.3 54.5 71.0 80.7 82.3 .:17.2 Outer Java-Bali 11 1.6 6.0 36.0 57.2 71.9 80.5 83.7 ,:17.3 Urban 1.2 6.8 46.3 73.9 79.0 92.1 88.3 52.5 Rural 1.7 5.7 32.8 51.9 69.9 77.8 82.9 :15.8 Education No education 10.0 18.5 51.6 70.0 79.2 83.4 82.2 59.6 Some primary 5.3 I 1.6 48.5 65.6 77.4 85.5 88.0 56.9 Completed primary 0.8 5.9 52.2 72.3 83. I 85.8 85.3 46.3 Some secondary+ 0.1 3.8 53.3 77.7 88.1 90.2 92.6 45.8 Total 3.0 7.6 51.4 70.9 81.3 85.8 86.5 51.5 Note: Women who have been sterilized are considered to want no more children. llncludes current pregnancy Table 6.3.2 shows the percentage of currently married women who want no more children by province. Women in Java-Bali (except West Java) are generally more likely to want to stop childbearing than women in other regions regardless of the number of surviving children they already have (53 percent, compared with 49 percent or less). The desire to stop childbearing is particularly high in DI Yogyakarta, Bali and North Sulawesi (59 percent or more), and low in West Nusa Tenggara and East Timor (40 percent and 23 percent, respectively). As observed in the 1991 IDHS, Balinese women stand out as having adopted a two-child norm. Four in five Balinese women and more than 65 percent of women in DI Yogyakarta, East Java, and North Sulawesi are ready to stop childbearing after having two children. 100 Table 6.3.2 Desire to limit childbearing: region and province Percentage of currently married women who want no more children, by number of living children, region, and province, Indonesia 1994 Number ofl iving children I Region and province 0 1 2 3 4 5 6+ Total Java-Bali 3.5 8.5 58.7 78.6 86.6 89.7 89.4 53.3 DKI Jakarta 2.4 9.5 50.4 80.3 92.5 94.9 94.6 55.6 West Java 0.9 3.6 44.1 65.4 76.2 83.8 84.8 47.1 Central Java 5.3 7.6 59.8 80.4 91.3 93. I 90.2 57.9 DI Yogyakarta 1.7 11.9 78.2 93.9 97.6 (97.9) (97.8) 65.1 East Java 5.0 11.9 67.9 87.5 90.6 93~ I 98.2 53.0 Bali 0.0 14.7 80.3 93.2 92.6 (89.4) 93.4 66.7 Outer Java-Bali I 2.0 5.5 34.8 58.4 74.9 82.1 83.5 49.0 Dista Aceh 0.0 3.7 15.8 40.9 51.7 69.7 82.6 40.1 North Sumatra (0.0) 4.2 31.6 57.4 76.9 83.6 82.6 52.7 West Sumatra (2.1) 2.1 31.3 55.3 77.2 73.0 89.0 47.9 South Sumatra 2.7 5.7 32.5 67.8 86.7 88.7 86.2 52.1 Lampung (3.0) 4.7 40.2 71.7 81.1 94.2 92.0 54.4 West Nusa Tenggara (0.0) 4.3 29.2 40.8 64.2 76.4 82.5 39.7 West Kalimantan 7.0 4.1 37.4 58.3 7 ] .2 82.6 77.9 46.9 South Kalimantan 4.3 8.7 44.2 63.6 80.7 82.6 88.5 47.1 North Sulawesi (0.0) 17.1 65.6 77.6 88.5 (97.2) (77.5) 59.1 South Sulawesi 1.6 4.5 26.9 48.7 70.6 76.9 77.3 44.4 Outer Java-Bali II 1.6 6.0 36.0 57.2 71.9 80.5 83.7 47.3 Riau 1.5 4.3 34.0 51.0 74.9 85.8 85.8 48.4 Jambi 0.0 9.3 38.8 63.5 81.3 87.3 91.6 51.3 Bengkulu (0.0) 1.2 46.5 74.6 86.7 91.5 96.3 57.9 East Nusa Tenggara (6.3) 7. I 27.9 45.4 61.4 80.4 90.6 46.7 East Timor 2.9 3.7 13.7 22.6 30.9 42.3 44.1 23.2 Central Kalimantan 0.0 5.3 49.1 68.0 84.1 81.8 76.3 47.6 East Kalimantan 2.2 5.7 52.7 73.5 77.0 79.8 75.9 49.9 Central Sulawesi 2.0 4.7 29.4 55.5 75.8 86.8 77.8 44.2 Southeast Sulawesi (0.0) 5.9 28.9 63.5 60.8 67.5 76.3 44.6 Maluku (0.0) 6.8 25.8 52.3 67.1 74.4 84.0 44.6 lrian Jaya 0.0 10.2 33.3 54.3 74.8 89.2 94.0 47.4 Total 3.0 7.6 51.4 70.9 81.3 - 85.8 86.5 51.5 Note: Women who have been sterilized are considered to want no more children. Figures in parentheses are based on 25-49 unweighted women. llncludes current pregnancy 6.2 Ideal Number of Children Previously, this chapter focused on the respondent's wishes for the future, implicitly taking into account the number of children she already had. In ascertaining the ideal number of children (i.e., ideal family size), the respondent is required to perform the more difficult task of considering, abstractly and independently of her actual family size, the number of children she would choose if she could start again. About 22 percent of the women in the IDHS gave a non-numeric reply when asked this question (see Table 6.4). 101 Table 6.4 Ideal and actual number of children Percent distribution of ever-married women by ideal number of children, and mean ideal number of children for ever.- married women and for currently married women, according to number of living children, Indonesia 1994 Number of living children I Ideal number of children 0 I 2 3 4 5 6+ Total 0 0.3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 I 4.6 3.0 I.I 1.1 0.4 0.2 0.4 1.5 2 54.4 56.9 48.1 24.8 17.9 13.3 7.8 36.4 3 12.4 19.4 19.9 31.1 13.1 15.2 I 1.0 19.3 4 8.7 7.1 13.2 16.4 29.0 12.4 14.2 13.9 5 1.6 1.6 2.5 3.8 6.2 13.0 5,5 3.9 6+ 0.5 0.9 1.3 2.5 4.6 6.2 I 1.5 3.1 Non-numeric response 17.6 11.2 13.9 20.3 28,8 39.8 49.7 21.7 Total 100.0 100.0 100.0 100.0 100.0 100.0 1130.0 100.0 Number of women 1,944 6,366 6,744 5,096 3,271 2,070 2,677 28,168 Ever .marr ied women Mean ideal number 2.4 2.4 2.7 3.1 3.5 3.8 4.2 2.9 Number of women 1,603 5,652 5,805 4,061 2,330 1,246 1,347 22,044 Current ly marr ied women Mean ideal number 2.4 2.5 2.7 3.1 3.5 3.8 4.2 2.9 Number of women 1,421 5,275 5,523 3,877 2,177 1388 1,281 20,742 Note: The means exclude women who gave non-numeric responses. i Includes current pregnancy The distribution of ever-married women 15-49 by ideal number of children is presented in Table 6.4. Since most ever-married women are currently married, the ideal number of children for both groups is almost the same. Overall, ideal family size in Indonesia declined from 3.1 children in 1991 to 2.9 children in 1994. Observance of the two-child family norm was stronger in 1994 than in 1991; 36 percent of women reported two children as their ideal family size, compared with 34 percent in 1991. At the same time, the percentage of women whose ideal number of children was three or more declined by 2 percentage points. The correlation between actual and ideal family size can be seen in the fact that women who have a small number of children are more likely to want a small number of children. As parity increases, the ideal number of children also increases. Two reasons have been suggested. First, to the extent that women want to achieve their fertility desires, women who want large families tend to have larger families. Second, women may rationalize their ideal family size. As the actual number of children increases, their preference increases also. Further, women with larger families--being on average older than women with small families--may have larger idea[ family sizes because of attitudes they acquired 20 to 30 years ago. Despite the likelihood of some rationalization, respondents frequently state ideal family sizes that are lower than their actual number of living children. This can be taken as an indicator of surplus or unwanted fertility. At three and higher numbers of surviving children, the proportion of women stating ideal family sizes smaller than their own becomes sizeable. In fact, among women with six or more children, 39 percent say that if they were to start again they would have fewer children. The corresponding proportion in 1991 was 45 percent. 102 Table 6.5.1 presents the mean ideal number of children for ever-married women by age and selected background characteristics. Ideal number of children varies across age groups: older women tend to want larger families than younger women. Urban women and women with some secondary education are slightly more likely to want small families than rural women and women with less education. The mean ideal number of children is negatively associated with the woman's education: the higher the level of education, the lower the ideal number of children. Table 6.5.1 Mean ideal number of children: background characteristics Mean ideal number of children for ever-married women, by age and selected background characteristics, Indonesia 1994 Age of woman Background characteristic 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Total Residence Urban 2.5 2.4 2.6 2.7 3.0 3.0 3.3 2.8 Rural 2.4 2.6 2.8 3.1 3.2 3.4 3.5 3.0 Region/Residence Java-Bali 2.3 2.3 2.6 2.7 2.9 3.0 3. I 2.7 Urban 2.5 2.3 2.6 2.6 2.9 2.9 3.2 2.7 Rural 2.3 2.4 2.6 2.8 2.9 3.0 3.1 2.7 Outer Java-Bali I 2.6 3.0 3.1 3.4 3.6 3.8 4.0 3.4 Urban (2.4) 2.7 2.9 3.1 3.3 3.5 3.7 3.1 Rural 2.7 3.0 3.2 3.5 3.8 3.9 4.2 3.5 Outer Java-Bali II 2.7 2.9 3.1 3.5 3.7 4.0 4.3 3.4 Urban (2.5) 2.6 2.8 2.9 3.1 3.5 3.5 3.0 Rural 2.8 3.0 3.2 3.7 3.9 4.1 4.5 3.6 Education No education (2.3) 3.0 3.0 3.2 3.3 3.2 3.5 3.2 Some primary 2.6 2,7 2.9 3.1 3.2 3.3 3.5 3.1 Completed primary 2.3 2.5 2.6 2.9 3. I 3.2 3,5 2~8 Some secondary+ 2.4 2.5 2.7 2.8 3.0 3.2 3.2 2.8 Total 2.4 2.5 2.8 3.0 3.2 3.2 3.4 Note: Figures in parentheses are based on 25 to 49 unweighted women. 2.9 There are notable differences in the mean ideal number of children between regions (see Table 6.5.2). Women in Java-Bali want an average of 0.7 children less than women in other regions. Variation between provinces is even more substantial, ranging from a low of 2.4 children in Bali and North Sulawesi to 4 children or more in Dista Aceh, East Nusa Tenggara and East Timor. In Java-Bali, mean ideal number of children is highest in West Java and Central Java (2.9 children). Since 1991, the mean ideal number of children has declined or remained the same in all provinces. In 1994, the mean ideal number of children was less than three in all the provinces of Java and Bali, North Sulawesi, and East Kalimantan. 103 Table 6.5.2 Mean ideal number of children: region and province Mean ideal number of children for ever-married women, by age, region, and province, Indonesia 1994 Age of woman Region and province 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Total Java-Bali 2.3 2.3 2.6 2.7 2.9 3.0 3. I 2.7 DKI Jakarta (23) 2.4 2.5 2.8 2.8 2.9 3.1 2.7 West Java 2.5 2.5 2.8 3.0 3.2 3.4 3.2 2.9 Central Java 2.3 2.4 2.6 2.9 3.1 3.1 3.5 2.9 DI Yogyakarta * 2.1 2.3 2.3 2.5 2.8 3.2 2.5 East Java 2.2 2.2 2.3 2.4 2.7 2.7 2.9 2.5 Bali (2.4) 2.2 2.3 2.3 2.4 2.6 2.5 2.4 Outer Java-Bali I 2.6 3.0 3.1 3.4 3.6 3,8 4.0 3.4 Dista Aceh * 3.7 3.8 3.8 4.5 4.4 4.6 4.0 North Sumatra * 3.5 3.5 3.7 3.8 4.4 4.2 3.8 West Sumatra * 2.9 3.2 3.7 3.7 3.8 4.3 3.5 South Sumatra (2.7) 2.9 3.0 3.4 3.4 3.4 3.5 3.2 Lampung (2.4) 2.6 2.8 3.2 3.2 3.5 (3.6) 3.0 West Nusa Tenggara (2.6) 2.9 3.0 3.2 3.9 4.1 (4.1) 3.4 West Kalimantan (2.8) 2.8 2.9 3.3 3.4 3.8 4.4 3.2 South Kalimantan (2.6) 2.3 2.7 2.9 3.5 (3.2) 3.8 3.0 North Sulawesi * 2.1 2.2 2.5 2.6 2.7 (2.7) 2.4 South Sulawesi (2.4) 3.0 3.1 3.6 3.7 3.5 4.0 3.4 Outer Java-Bali II 2.7 2.9 3.1 3.5 3.7 4.0 4.3 3.4 Riau (2.8) 3.1 3.2 3.4 3.8 3.7 4.3 3.5 Jambi (2.7) 2.9 3.0 3. I 3.5 4.0 3.6 3.2 Bengkulu (2.5) 2.6 2.9 3.4 3.6 4.0 3.8 3.2 East Nusa Tenggara " 3.0 3.7 4.1 4.2 4.7 5.4 4. I East Timor * 4.3 4.2 4.5 4.9 * * 4.4 Central Kalimantan (3.6) 2.8 3.0 3.7 3.9 (4.1) (4.9) 3.4 East Kalimantan (2.1) 2.6 2.6 3.0 3.4 3.3 (3.1) 2.9 Central Sulawesi * 2.8 2.8 3.2 3.3 (3.9) (3.8) 3.1 Southeast Sulawesi * 2.8 2.9 3.7 3.7 (3.8) (4.2) 3.3 Maluku * 3.0 3.3 3.4 3.8 3.9 (4.1) 3.4 lrian Jaya * 2.9 3.0 3,4 3.4 (3.4) * 3.2 Total 2.4 2.5 2.8 3.0 3.2 3.2 3.4 2.9 Note: Figures in parentheses are based on 25 to 49 unweighted women; an asterisk indicates that a figure is based on fewer than 25 women and has been suppressed, 6.3 Unmet Need Unmet need is defined as the percentage of currently married women who either do not want any more children or want to wait before having their next birth, but are not using any method of family planning. Women with an unmet need for spacing include pregnant women whose pregnancy was mistimed, amenor- rheic women whose last birth was mistimed, and women who are neither pregnant nor amenorrheic and who are not using any method of family planning and want to wait two or more years for their next birth. Also included in unmet need for spacing are women who are unsure whether they want another child or who want another child but are unsure when to have the birth. Unmet need for limiting refers to pregnant women whose pregnancy was unwanted, amenorrheic women whose last child was unwanted and women who are neither pregnant nor amenorrheic and who are not using any method of family planning and who want no more chil- dren. Measures of unmet need for family planning are used to evaluate the extent to which programs are meeting the demand for services. According to these criteria, in 1994 the total unmet need in Indonesia was 11 percent- -of which about half was for limiting and half for spacing (see Table 6.6.1). A similar pattern was found in 1991, when total unmet need was 13 percent, evenly split between the need for spacing and for limiting. 104 Table 6.6.1 Need for family planning services: background characteristics Percentage of currently married women with unmet need for family planning, and met need for family planning, and the total demand for family planning services, by selected background characteristics, Indonesia 1994 Met need for Unmet need for family planning Total demand for Percentage family planning I (currently using) 2 family planning 3 of demand Number Background For For For For For For satis- of characteristic spacing limiting Total spacing limiting Total spacing limiting Total fled women Age 15-19 12.7 1.0 13.7 34.7 1,7 36.4 48.6 2.7 51.3 73.4 1,291 20-24 9.1 1.8 10.9 47.4 8.1 55.5 57.8 10.0 67.8 83.9 3,936 25-29 7.2 3.2 10.4 37.1 22.5 59.6 45.8 26.0 71.8 85.6 5,234 30-34 4.0 6.8 10.8 20.6 40,4 61.0 25.1 47.7 72.8 85.2 5,387 35-39 2.1 9.4 11.5 9.3 50.4 59.7 11.8 60.1 71.9 84.0 4,483 40-44 0.8 9.6 10,5 3.2 50.2 53.4 4.1 60.0 64.1 83.7 3,262 45-49 0.5 6.8 7,3 0.7 32.1 32.9 1.3 38.9 40.2 81,8 2,594 Residence Urban 4.2 5.8 10.1 21.6 38.6 60.2 26.6 44,6 71.2 85.9 7,591 Rural 5,0 5.8 10.8 23.0 29,6 52.5 28.6 35.7 64.3 83.2 18.595 Region/Residence Java-Bali 4.3 5.5 9.8 23.8 34.6 58.4 28.9 40.3 69,1 85.9 16,663 Urban 4.0 5.6 9.6 22.5 39.5 62.0 27.2 45.4 72.6 86.7 5,523 Rural 4.4 5.4 9.9 24.5 32.1 56.6 29.7 37.7 67.4 85.4 l 1,140 Outer Java-Bali I 5,5 6.3 11.8 20.9 28.6 49.5 27.1 35.3 62.4 81.1 6,619 Urban 4.8 6.5 11.3 19,5 36.3 55.8 25.2 43.1 68.3 83.5 1,423 Rural 5.7 6.3 11.9 21.3 26.4 47.8 27.7 33,1 60.8 80.4 5.197 Outer Java-Bali 11 5.8 6.8 12.6 19.0 26.7 45,7 25.4 33.6 58.9 78.7 2,903 Urban 4.8 6.3 I1.1 18.9 35.1 54.0 24,1 41.6 65.7 83.1 645 Rural 6.1 6.9 13.0 19,0 24.3 43.3 25.7 31.3 57,0 77,2 2,259 Education No education 4.1 7.6 11.7 12,0 27.7 39.6 16.2 35.3 51.5 77.3 3,904 Some primary 4,4 7.3 11.6 18.3 34.3 52.6 23.3 41,8 65. I 82.1 8,299 Completed primary 5.1 5.4 10.5 27.7 30.5 58,2 33.8 36.2 70.0 85.0 7,526 Some secondary+ 5.3 3.4 8,7 28.5 34.1 62.6 34.7 37,8 72.4 88.0 6.457 Total 4,8 5.8 10.6 22.6 32.2 54.7 28,1 38.3 66,3 84.0 26,186 ~Unmet need for spacing includes pregnant women whose pregnancy was mistimed, amenorrheic women whose last birth was mistimed, and women who are neither pregnant nor amenorrheic and who are not using any method of family planning and say they want to wait two or more years for their next birth. Also included in unmet need for spacing are women who are unsure whether they want another child or who want another child but are unsure when to have the birth. Unmet need for limiting refers to pregnant women whose pregnancy was unwanted, amenorrheic women whose last child was unwanted and women who are neither pregnant nor amenorrheic and who are not using any method of family planning and who want no more children. Excluded from the unmet need category are pregnant and amenorrheic women who became pregnant while using a method (these women are in need of better contraception). Also excluded are menopausal or infecund women. 2Using for spacing is defined as women who are using some method of family planning and say they want to have another child or are undecided whether to have another. Using for limiting is defined as women who are using and who want no more children. Note that the specific methods used are not taken into account here. 3Total demand includes pregnant or amenorrheic women who became pregnant while using a method (method failure). They account for 1.0 percent of all currently married women. 105 Demand for family planning is defined as the sum of contraceptive prevalence (including currently pregnant or amenorrheic women whose pregnancy or last birth was the result of a contraceptive failure) and unmet need (Westoff and Ochoa, 1991). Overall, the total demand for family planning is 66 percent; 84 percent of this demand is satisfied. Comparison of the 1991 and 1994 IDHS survey findings indicates that demand for family planning services and the percentage of the demand that is satisfied has increased by 3 and 4 percentage points, respectively. Unmet need varies with age. Younger women are more likely to express a need for spacing births, while older women more often want to limit births. This can be seen from the inverse relationship between a woman's age and unmet need to space births, contraceptive use, and, in consequence, demand for family planning to space births. There is no notable difference in the need for family planning between urban and rural women. Total unmet need declines linearly with increasing education; the more educated the women, the lower the percentage with unmet need. Women with no education and women with some primary school are in need of family planning for limiting births, whereas more educated women report greater need for spacing. Additional motivational and service delivery efforts should be directed toward the limiting needs of older and less educated women and the spacing needs of younger and more educated women. The total unmet need figures for the Outer Java-Bali regions are slightly higher than for Java-Bali (see Table 6.6.2). The lower unmet need in Java-Bali might reflect the earlier initiation of family planning efforts in that region. Of the 27 provinces, Dista Aceh, East Nusa Tenggara and Maluku have the highest levels of unmet need (16 percent or higher), while unmet need in Bali and DI Yogyakarta is less than 6 percent. For Java-Bali, total unmet need is slightly higher in West Java than in the other provinces; additionally, West Java is the only province in Java-Bali in which unmet need for family planning (12 percent) exceeds the national average. In the Outer Java-Bali regions, unmet need for limiting and spacing varies by province. In Dista Aceh and East Timor, for example, most of the unmet need is for spacing births (56 percent and 62 percent, respectively); in Maluku, on the other hand, 61 percent of the unmet need is for limiting births. Table 6.6.2 indicates that 84 percent of the demand for family planning services has been met. If all of this need were satisfied, a contraceptive prevalence rate of about 66 percent could, theoretically, be expected. DI Yogyakarta, Bali and North Sulawesi lead the other provinces in fulfilling the demand for family planning (90 percent or more), while Dista Aceh, East Nusa Tenggara, East Timor, and Maluku lag behind (70 percent or less). 106 Table 6.6.2 Need for family planning services: region and province Percentage of currently married women with unmet need for family planning, and met need for family planning, and the total demand for family planning services, by region and province, Indonesia 1994 Met need for Unmet need for family planning Total demand for Percentage family planning I (currently using) 2 family planning 3 of demand Number Region and For For For For For For satis- of province spacing limiting Total spacing limiting Total spacing limiting Total fled women Java-Bali 4.3 5.5 9.8 23.8 34.6 58.4 28.9 40.3 69.1 85.9 16,663 DKI Jakarta 3.8 5.3 9.1 22.1 37.6 59.7 26.4 43.0 69.5 87.0 1,140 West Java 5.3 6.1 11.5 28.4 28.3 56.7 34.6 34.7 69.3 83.5 5,170 Central Java 3.7 5.9 9.6 21.6 39.4 61.1 26.0 45.4 71.4 86.5 4,302 DI Yogyakarta 2.0 3.7 5.7 19.4 50.1 69.5 22.2 54.4 76.6 92.6 423 East Java 4.3 4.8 9.0 22.7 33.2 55.9 27.6 38.4 66.0 86.3 5,209 Bali 1.8 4.1 5.9 14.8 53.7 68.4 17.4 57.8 75.1 92.2 418 Outer Java.Ball I 5.5 6.3 11.8 20.9 28.6 49.5 27.1 35.3 62.4 81.1 6,619 Dista Aceh 9.7 7.6 17.3 18.0 14.3 32.3 27.9 22.2 50.0 65.5 477 North Sumatra 5.3 7.5 12.9 16.0 31.0 47.0 22.2 39.0 61.2 79.0 1,374 West Sumatra 5.5 7.5 13.0 17.7 26.5 44.2 24.5 34.6 59.1 78.0 489 South Sumatra 4.4 5.2 9.7 20.8 32.1 52.9 25.6 37.6 63.2 84.7 843 Lampung 3.5 7.2 10.7 24.7 34.6 59.3 29.0 42.7 71.8 85.1 801 West Nusa Tenggara 7.4 5.4 12.8 27.4 22.5 49.8 35.4 28.0 63.3 79.8 469 West Kalimantan 3.3 4.5 7.8 23.8 26.8 50.6 28.1 31.6 59.7 87.0 489 South Kalimantan 4.4 4.6 9.0 27.1 27.6 54.7 32.5 32.3 64.8 86.1 398 North Sulawesi 2.5 4.0 6.5 24.9 47.6 72.5 28.0 52.4 80.4 91.9 318 South Sulawesi 7.7 6.3 14.0 19.6 23.0 42.6 28.0 29.4 57.4 75.6 962 Outer Java-Ban n 5.8 6.8 12.6 19.0 26.7 45.7 25.4 33.6 58.9 78.7 2,903 Riau 7.1 7.6 14.7 17.3 23.7 41.0 24.8 31.5 56.3 74.0 520 Jambi 3.3 6.1 9.4 22.7 32.5 55.1 26.7 38.6 65.2 85.6 316 Bengkulu 4.7 4.6 9.2 21.4 40.2 61.6 27.5 45.3 72.8 87.3 179 East Nusa Tenggara 7.6 8.9 16.5 17.0 20.2 37.3 25.4 29. I 54.5 69.7 393 East Timor 8.2 5.1 13.3 13.8 8.8 22.6 22.3 14.2 36.5 63.6 115 Central Kalimantan 3.1 5.5 8.6 17.7 26.8 44.5 21.3 32.4 53.7 84.0 227 East Kalimantan 4.0 4.8 8.8 24.3 36.2 60.5 28.8 41.1 69.9 87.4 304 Central Sulawesi 5.9 5.0 10.9 22.4 30.1 52.5 28.7 35.1 63.8 83.0 225 Southeast Sulawesi 9.4 4.8 14.1 19.7 26.5 46.3 30.0 31.4 61.4 77.0 178 Maluku 7.4 11.9 19.4 16.5 18.4 34.9 24.2 30.3 54.5 64.5 209 lrian Jaya 3.6 7.3 10.9 14.4 26.9 41.3 18.5 34.2 52.7 79.3 238 Total 4.8 5.8 10.6 22.6 32.2 54.7 28.1 38.3 66.3 84.0 26,186 tUnmet need for spacing includes pregnant women whose pregnancy was mistimed, amenorrheic women whose last birth was mistimed, and women who are neither pregnant nor amenorrheic and who are not using any method of family planning and say they want to wait two or more years for their next birth. Also included in unmet need for spacing are women who are unsure whether they want another child or who want another child but are unsure when to have the birth. Unmet need for limiting refers to pregnant women whose pregnancy was unwanted, amenorrheic women whose last child was unwanted and women who are neither pregnant nor arnenorrheic and who are not using any method of family planning and who want no more children. Excluded from the unmet need category are pregnant and amenorrheic women who became pregnant while using a method (these women are in need of better contraception). Also excluded are menopausal or infecund women. 2Using for spacing is defined as women who are using some method of family planning and say they want to have another child or are undecided whether to have another. Using for limiting is defined as women who are using and who want no more children. Note that the specific methods used are not taken into account here. 3Total demand includes pregnant or amenorrheic women who became pregnant while using a method (method failure). They account for 1.0 percent of all currently married women. 6.4 Unplanned and Unwanted Fertility In the 1994 IDHS, women were asked a series of questions about each child born in the preceding five years and any current pregnancy, to determine whether the pregnancy was wanted then, wanted but at a later time, or unwanted. These questions form a particularly powerful indicator of the degree to which couples successfully control childbearing. In addition, the data can be used to gauge the effect of the prevention of unwanted births on fertility. 107 The IDHS questions are extremely demanding. The respondent is required to recall accurately her wishes at one or more points in time the last five years, and to report them honestly. The danger of rationali- zation is present; an unwanted conception may well have become a cherished child. Despite these potential problems of comprehension, recall and truthfulness, results from previous surveys have proved surprisingly plausible. Respondents clearly are willing to report unwanted conceptions, although some postpartum ration- alization probably occurs. The result is probably an underestimate of unwanted fertility. Table 6.7 shows the percent distribution of births in the five years preceding the survey and current pregnancies by fertility planning status, according to birth order and mother's age at birth. Eight of ten births were wanted at the time of conception an additional 10 percent were wanted but at a later time. Only 8 per- cent were not wanted at all. These findings indicate that women are becoming increasingly successful at planning their families--the proportion of births wanted at the time of conception has increased from 77 per- cent in 1991 to 82 percent in 1994 and the proportion of mistimed births has declined from 16 to 10 percent. Table 6.7 Fertility planning status Percent distribution of births in the five years preceding the survey and current pregnancies, by fertility planning status, according to birth order and mother's age, Indonesia 1994 Planning status of birth Birth order Number and mother's Wanted Wanted Not of age then later wanted Missing Total births Birth order 1 93.1 6.4 0.2 0.3 100.0 5,429 2 84.5 14.2 1.2 0.1 100.0 4,297 3 79.8 11.3 8.6 0.3 100.0 3,177 4+ 71.3 7.9 20.4 0.4 100.0 5,846 Age at birth <20 91.1 8.4 0.5 0.1 100.0 2,546 20-24 86.0 11.9 1.8 0.3 100.0 5,351 25-29 83.5 10.1 6.2 0.2 100.0 5,149 30-34 77.7 8.0 13.9 0.4 100.0 3,426 35-39 68.7 6.1 24.5 0.7 100.0 1,726 40-44 57.6 5.4 36.7 0.3 100.0 517 45-49 63.6 4.7 30.6 1.2 100.0 34 Total 82.1 9.5 8.2 0.3 100.0 18,749 Note: Birth order includes current pregnancy. Birth order strongly affects the planning status of births. In the 1994 IDHS, the proportion uf births that were wanted at the time of conception decreases with increasing birth order, while the percentage wanted later or not wanted at all increases. While almost all first births were wanted, one in five of fourth or higher order births were unwanted (see Table 6.7). The planning status of births is also affected by the age of the mother. In general, the older the moth- er, the smaller the percentage of children that were wanted at conception. The proportion wanted later in- creases up to age 25-29 years, and then decreases. The percentage of births that were not wanted increases substantially with age. While almost none of the births to women under 20 years were unwanted, more than 30 percent of births to women age 40-49 were not wanted. This level of unwanted births among older women is higher than that reported in the 1991 IDHS (25 percent for women 40-49). 108 Tables 6.8.1 and 6.8.2 present wanted fertility rates. These are calculated in the same manner as con- ventional age-specific fertility rates, except that only births classified as wanted are included in the numerator. A birth is considered wanted if the number of living children at the time of conception was less than or equal to the current ideal number of children reported by the respondent. Wanted fertility rates express the level of fertility that would theoretically result if all unwanted births were prevented. Comparison of actual fertility rates and wanted fertility rates suggests the potential demographic impact of the elimination of unwanted births. Overall, the total wanted fertility rate is 17 per- cent lower than the total fertility rate. Thus, if unwanted births could be eliminated, total fertility in Indonesia would be around 2.4 births per woman, instead of 2.9. The differences in wanted fertility rates by various background characteristics are similar to those for actu- al fertility rates, except they are all slightly lower. Wanted fertility rates range from lows of 1.5 to 1.8 children per woman in DKI Jakarta, DI Yogyakarta, East Java and Bali to a high of 4.5 children in East Timor. The wanted fertility rate is 3 children or more in Dista Aceh, North Sumatra, West Nusa Tenggara, East Nusa Tenggara, East Timor, Southeast Sulawesi and Maluku. Table6.8.1 Wanted fertility rates: background characteristics Total wanted fertility rates and total fertility rates for the three years preceding the survey, by selected background characteristics, Indonesia 1994 Total wanted Total Background fertility fertility characteristic rate rate Residence Urban 1.8 2.3 Rural 2.7 3.2 Region/Residence Java-Bali 2.1 2.6 Urban 1.7 2.2 Rural 2.4 2.9 Outer Java-Bali 1 2.8 3.3 Urban 2.1 2.5 Rural 3.0 3,5 Outer Java-Bali II 2.9 3.3 Urban 2.3 2.9 Rural 3.1 3.5 Education No education 2.6 2.9 Some primary 2.7 3.3 Completed primary 2.4 3.0 Some secondary+ 2.1 2.6 Total 2.4 2.9 Note: Rates are based on births to women 15-49 in the period 1-36 months preceding the survey. The total fer- tility rates are the same as those presented in Table 3.5.1. Table 6.8.2 Wanted fertility rates: region and province Total wanted fertility rates and total fertility rates for the three years preceding the survey, by region and province, Indonesia 1994 Total wanted Total Region and fertility fertility province rate rate Java-Bali 2.1 2.6 DKI Jakarta 1.6 1.9 West Java 2.6 3.2 Central Java 2.3 2.8 DI Yogyakarta 1.5 1.8 East Java 1.8 2.2 Bali 1.7 2.1 Outer Java-Bali I 2.8 3.3 Dista Aceh 3.0 3.3 North Sumatra 3.2 3.9 West Sumatra 2.6 3.2 South Sumatra 2.5 2.9 Lampung 2.9 3.4 West Nusa Tenggara 3.0 3.6 West Kalimantan 2.9 3,3 South Kalimantan 2.1 2.3 North Sulawesi 2.2 2.6 South Sulawesi 2.6 2.9 Outer Java-Bali II 2.9 3.3 Riau 2.6 3.1 Jambi 2.4 3.0 Bengkulu 2.8 3.5 East Nusa Tenggara 3.4 3.9 East Timor 4.5 4.7 Central Kalimantan 2.1 2.3 East Kalimantan 2.7 3.2 Central Sulawesi 2.7 3.1 Southeast Sulawesi 3.2 3.5 Maluku 3.4 3.7 lrian Jaya 2.7 3.1 Total 2.4 2.9 Note: Rates are based on births to women 15-49 in the period 1-36 months preceding the survey. The total fer- tility rates are the same as those presented in Table 3.5.1. 109 CHAPTER7 NONUSE AND INTENTION TO USE FAMILY PLANNING This chapter focuses on women who are not using family planning and the reasons women stop using contraceptive methods. Five topics are discussed: contraceptive discontinuation rates, reasons for discontinu- ing contraception, reasons for nonuse, intention to use contraception in the future, and methods potential users intend to use. 7.1 Discontinuation Rates Improvement in the quality of contraceptive use is one of the goals of Indonesia's family planning program. One measure of the quality of use is the rate at which users discontinue using a method of contra- ception. Reasons for discontinuation may include contraceptive failure, dissatisfaction with the method, side effects, lack of availability, or other reasons. High rates of discontinuation, method failure, and method switching may indicate that improvements are needed in counseling in the selection of methods, follow-up care, and accessibility of services. Life-table contraceptive discontinuation rates derived from the survey are presented in Table 7.1. These are cumulative first-year discontinuation rates and represent the proportion of users discontinuing a method within 12 months after the start of use. The rates are calculated by dividing the number of discontinu- ations for each reason at each duration of use in single months by the number of months of exposure at that duration. The single-month rates are then summed to produce a one-year rate. The reasons for discontinua- tion are treated as competing risks (net rates). Three specific reasons for discontinuation--method failure (became pregnant while using contraception), desire to become pregnant, and side effects or health con- cerns--were identified. The rates were calculated from information collected in the calendar portion of the 1994 IDHS indi- vidual questionnaire. All episodes of contraceptive use between January 1989 and the date of interview were recorded in the calendar along with the reason for any discontinuation of use during this period. The dis- Table 7.1 Contraceptive discontinuation rates First-year contraceptive discontinuation rates due to method failure, desire to become pregnant, health reasons, or other reasons, according to specific method, Indonesia 1994 Reason for discontinuation To Health/ All Contraceptive Method become Side other All method failure pregnant effects reasons reasons Pill 4.1 10.7 10,9 8.1 33.8 IUD 1.8 0.9 8.4 4.1 15.2 Injection 1.6 4.5 15.0 8.0 29.1 Condom 5.5 9.3 2.2 33.9 50.9 Periodic abstinence 12.1 6.2 0.7 13.3 32.3 Withdrawal 11.6 6.2 0.0 18.3 36.1 Total 2.8 5.8 10.5 7.7 26.8 111 continuation rates presented here refer to all episodes of contraceptive use that began during the period of time covered by the calendar, not all episodes that occurred during this period. Specifically, the first-year contraceptive discontinuation rates presented in Table 7.1 refer to the period 3-63 months prior to the interview; the month of interview and the preceding two months are ignored in order to avoid bias that may be introduced by unrecognized pregnancies. Overall, 27 percent of contraceptive users discontinued using a method within 12 months of starting use; 3 percent stopped using because they became pregnant while using the contraceptive method (method failure), 6 percent stopped in order to become pregnant, 11 percent stopped because they experienced side effects or were concerned about health problems, and 8 percent stopped for other reasons (including cost, infrequent sex, and availability of method). The highest overall one-year discontinuation rate is for condom users (51 percent), followed by the pill (34 percent), injection (29 percent), and the IUD, 5 percent). The rates of discontinuation for traditional methods are 36 percent for withdrawal and 32 percent for periodic abstinence. The rates of discontinuation according to specific reasons vary by method. For example, the proportion of users who stopped using because they became pregnant (method failure) is very low for injec- tion and the IUD (2 percent each), higher for the pill (4 percent) and condom (6 percent) and considerably higher for traditional methods such as periodic abstinence and withdrawal (12 percent each). There was virtually no change in discontinuation rates between 1991 and 1994. While rates for the pill and condom increased slightly (4 and 3 percentage points, respectively), rates for injection, periodic abstinence and withdrawal decreased. 7.2 Reasons for Discontinuation of Contraceptive Use Another perspective on contraceptive discontinuation is provided by Table 7.2 which shows the percent distribution of discontinuations in the five years preceding the survey by reason for discontinuation, according to method. The most common reason for discontinuing a method is the desire to become pregnant (31 percent). This is true for all methods, except the condom, for which the most common reason given for discontinuing is because it is inconvenient to use, and withdrawal, for which the most common reason given is method failure. Other reasons for discontinuing a method are health concerns (15 percent), side effects (14 percent), and method failure (12 percent) (see Figure 7.1). Health concerns and side effects are mentioned frequently for Norplant and injection (by 20 percent or more), while method failure is a commonly cited reason for discontinuing traditional methods. The reasons for discontinuing contraceptive methods have changed little since 1991. 112 Table 7.2 Reasons for discontinuation Percent distribution of discontinuations of contraceptive methods in the last five years by main reason for discontinuation, according to specific methods, Indonesia 1994 Method Periodic Reason for absti- With- Other All discontinuation Pill IUD Injection Condom Norplant nence drawal methods methods Became pregnant 13.6 12.9 6.8 18.8 1.6 32.3 38.2 22.8 12.0 To become pregnant 38,9 31.0 24.6 19.6 25.4 36.0 27.4 32.6 31.2 Husband disapproved 0.8 1.2 0.5 5.3 0.0 1.3 6.1 2.0 1.0 Side effects 10.5 16.1 19.6 1.1 25.1 0,7 0.0 3.7 14.2 Health concerns 12.7 13.3 20.3 3.2 20.9 1.6 0.0 2.3 14.8 Access/availability 0.8 0,5 2.1 1.3 0.1 0.0 0.0 5.0 1.3 More effective method 5.2 1.5 3.6 7,1 2.7 I 0.0 7.1 7.2 4.3 Inconvenient to use 1.0 2.8 1.0 23.9 0.2 2.3 9.4 0.3 2.0 Infrequent sex 2.3 0.5 1.3 1.3 0.2 4.2 0,7 5.7 1.7 Cost 0.4 0.1 7,0 0.0 1.8 0.0 0.0 0.2 2.8 Fatalistic 1.0 0.4 0.7 0.5 0.0 0.0 0.7 0.7 0.7 Menopause 1.9 1.9 1.0 0.6 0.7 1.3 0.6 1.1 1.4 Marital dissolution 2.3 3.2 1.4 1.5 1.8 0.5 2.1 1.9 2.0 IUD expelled 0.6 8. I 0.5 2.2 1.0 0.8 1.4 1.0 1.6 Other 7.4 5.9 8.9 13.7 18.4 8.7 6.0 11.7 8.4 Don't know 0.6 0.6 0,4 0. I 0.0 0.2 0.4 1.9 0.5 Total 100.0 100.0 100.0 100.0 100.0 100.0 I00.0 100.0 100.0 Number of discontinuations 4,349 1,480 4,237 283 353 319 234 208 I 1,494 Note: Total includes 19 discontinuations of lntravag/Diaphragm/Foam and I 1 discontinuations of male sterilization. Figure 7.1 Reasons for Discontinuation of Contraceptive Methods Cost/Access/ More Effective Inconven- Method 4% ience 6% Health Other terns 15% Reasons 17°~ Became Pregnant 12~ Side Effects 14% To Beoome Pregnant 31% Note: Based on discontinuations in the last 5 years. 1994 IOHS 113 7.3 Intention to Use Contraception in the Future Intention to use contraception in the future provides a forecast of potential demand for family planning services and represents a summary indicator of attitudes toward contraception among current nonusers. The distinction between intention to use in the next 12 months and intention to use later is useful in assessing the extent of demand in the near future. In Indonesia, where the contraceptive prevalence rate is high, nonusers are the group most targeted by family planning programs and providers. Respondents who were not using any method of contraception at the time of the interview were asked if they intended to use a method at any time in the future. Table 7.3 presents the distribution of currently mar- ried women who are not using a contraceptive method by intention to use in the future, according to number of living children. According to the data, 43 percent of nonusers intend to use family planning some time in the future and 43 percent do not intend to use. The remaining women are unsure about their intentions. Among women who intend to use, 68 percent intend to use contraception in the next 12 months, and 27 per- cent intend to use later. Intention to use a family planning method is highest among women with one child; however, women with 2 or 3 children are more likely to want to use contraception within the next 12 months. It is interesting to note that 47 percent of women with no children intend to use family planning some time in the future. Table 7.3 Future use of contraception Percent distribution of currently married women who are not using a contraceptive method by past experience with contraception and intention to use in the future, according to number of living children, Indonesia 1994 Past experience with contraception and future intentions Number of living children I 0 1 2 3 4+ Total Never used contraception Intend to use in next 12 months 10.6 21.5 9.4 6.3 5.2 10.6 Intend to use later 23.4 8.6 2.5 2.5 1.1 6.1 Unsure as to timing 4.7 1.4 0.5 1.0 0.2 1.2 Unsure about use 17.1 8.0 8.1 6.4 6.5 8.4 Do not intend to use 30.8 26.1 22.7 24.0 31.1 27.2 Missing 0.0 0.1 0.0 0.1 0.1 0.1 Previously used contraception Intend to use in next 12 months 1.7 12.6 26.6 30.7 19.3 18.7 Intend to use later 5.4 9.6 7.1 4.5 2.0 5.5 Unsure as to timing 1.1 1.6 2.0 0.9 0.8 1.3 Unsure about use 1.7 3.1 5.5 4.6 5.5 4.4 Do not intend to use 3.2 6.9 14.9 18.5 27.9 16.1 Missing 0.2 0.6 0.5 0.6 0.3 0.5 Total 100.0 100.0 100.0 100.0 100.0 100.0 All currently married nonusers Intend to use in next 12 months 12.3 34.1 36.1 37.0 24.5 29.3 Intend to use later 28.8 18.2 9.7 6.9 3.1 11.6 Unsure as to timing 5.8 3.0 2.6 1.8 1.0 2.5 Unsure about use 18.8 I 1.1 13.6 11.0 12.0 12.8 Do not intend to use 34.0 32.9 37.5 42.5 59.0 43.3 Missing 0.3 0.7 0.5 0.7 0.4 0.5 Total 100.0 100.0 100.0 100.0 100.0 100.0 Number of women 1,467 2,726 2,292 1,749 3,619 11,852 ~lncludes current pregnancy 114 Most nonusers who say they intend to use contraception in the future have used a method in the past. Of the 43 percent who say they plan to use, 26 percent have used a method previously; only 18 percent have never used a method. 7.4 Reasons for Nonuse One of the best ways of assessing obstacles to family planning programs is to ask women why they are not using a contraceptive method; this was done in the 1994 IDHS. Table 7.4 gives the distribution of currently married nonusers who do not intend to use family planning by reason for not using, according to age. The major reason for not intending to use a contraceptive method is the desire to become pregnant. Overall, 18 percent of nonusers cite this reason. Additionally, 14 percent say that they are either menopausal or have had a hysterectomy. As expected, the proportion who do not intend to use because they want to have more children is greater among younger than older women (36 percent, compared with 14 percent). Seventeen percent of nonusers age 30 and over say that they do not intend to use contraception because they are menopausal or have had a hysterectomy. Side effects and health concerns are the next most commonly cited reasons for nonuse. Based on this finding, family planning counseling is recommended to eliminate any misunderstandings women may have about methods and to explain more about the possible side effects. This would enable nonusers to make informed choices about the use of contraceptive methods. Table 7.4 Reasons for not using contraception Percent distribution of currently married women who are not using a contraceptive method and who do not intend to use in the future, by main reason for not using, according to age, Indonesia 1994 Age Reason for not using contraception 15-29 30-49 Total Infrequent sex 2.7 2.5 2.6 Menopausal/hysterectomy 0.0 16.9 14.0 Subfecund/infecund 0.1 8.8 7.4 Postpartum/breast feeding 1.2 0.3 0.5 Want children 36.1 14.1 17.8 Respondent opposed 6.5 6.4 6.4 Husband opposed 11.5 6.5 7.3 Others opposed 0.4 0.3 0.3 Religious prohibition 1.2 0.5 0.6 Knows no method 4.8 2.1 2.6 Knows no source 0.8 0.3 0.4 Health concerns 8.9 8.6 8.7 Side effects 14.6 8.5 9.5 Hard to get 0.3 0.2 0.2 Cost 0.4 0.5 0.5 Inconvenient 0.0 0.2 0.2 Interferes with body 0.1 0.7 0.6 Other 9.5 21.4 19.4 Don't know 0.9 0.8 0.8 Missing 0.1 0.2 0.2 Total 100.0 100.0 1130.0 Number of women 862 4,272 5,134 115 7.5 Preferred Method Table 7.5 presents data on women who are not currently using family planning but intend to use in the future. An overwhelmingly large proportion of women want to use injection (43 percent), while 27 percent say that they want to use the pill. There is little variation in the potential method choice between women who intend to use in the next 12 months and those who intend to use later. Comparing the results of this survey with those from the 1987 NICPS and the 1991 IDHS, larger proportions of women intend to use injection (34 percent in 1987, 39 percent in 1991, and 43 percent in 1994), and smaller proportions intend to use the pill (40 percent in 1987, 32 percent in 1991, and 27 percent in 1994). Table 7.5 Preferred method of contraception for future use Percent distribution of currently married women who are not using a contraceptive method but who intend to use in the future by preferred method, according to whether they intend to use in the next 12 months or later, Indonesia 1994 Intend to use In next After Unsure Preferred method 12 12 as to of contraception months months timing Total Pill 26.9 25.5 26.2 26.5 IUD 9.4 10.8 8.3 9.7 Injection 42.4 42.9 42.4 42.6 lnt ravag/Diaphragm/Foam 0.2 0.0 0.0 0. I Condom 0.5 0.5 0.0 0.5 Norplant 6.4 6.4 1.6 6. I Female sterilization 3.3 2.2 2.1 3.0 Male sterilization 0.1 0.0 0.0 0.1 Periodic abstinence 1.1 1. I 0.4 1.0 Withdrawal 0.4 II.5 0.1 0.4 Other method 1.2 0.5 0.5 I .ll Missing 8.1 9.6 18.4 9. I Total 100.0 100.0 100.0 100.0 Number of women 3,468 1,373 296 5,137 116 CHAPTER 8 OTHER PROXIMATE DETERMINANTS OF FERTILITY The principal factors, other than contraception, that affect a woman's risk of becoming pregnant-- marriage, sexual intercourse, postpartum amenorrhea, postpartum abstinence from sexual relations, and secondary infertility--are discussed in this chapter. Marriage is a primary indicator of exposure to the risk of pregnancy and is, therefore, important for an understanding of fertility. Low age at first marriage usually is associated with early childbearing and high fertility. Trends in the age at which women marry can help explain trends in fertility levels. This chapter also presents information on more direct measures of the beginning of exposure to pregnancy and levels of exposure, such as age at first sexual intercourse and the frequency of intercourse. Other factors that influence the risk of pregnancy, including the durations of postpartum amenorrhea, postpartum abstinence, and secondary infertility are discussed. In the 1994 IDHS, women age 15-49 who had ever been married were identified during the household interview and, during the individual interview, were asked about their current marital status, i.e., currently married, divorced, or widowed. Some of the tables in this report are based on data from both ever- married and never-married women. Figures that include never-married women are calculated by multiplying the number of interviewed ever-married women by an inflation factor that is the ratio of all women to ever- married women as reported in the household questionnaire. This procedure expands the denominators of the tables to be representative of all women. The inflation factors are calculated by single years of age and, if results are presented by background characteristics, the single-year inflation factors are calculated separately for each category of the background characteristic. 8.1 Current Marital Status Table 8.1 shows the marital status of women at the time of the survey, by age. Overall, 27 percent of women have never been married, 68 percent are currently married, 3 percent are divorced, and 3 percent are widowed. The proportion of single women has not changed from that reported for the 1987 National Indonesia Contraceptive Prevalence Survey (NICPS) and the 1991 IDHS. In the 1994 IDHS, the percentage Table 8.1 Current marital status Percent distribution of the household population of women age 15-49 by current marital status, according to age, Indonesia 1994 Marital status Number Never of Age married Married Divorced Widowed Total women 15-19 82.0 17.0 0.9 0.1 100.0 7,580 20-24 37.5 60.0 2.0 0.6 100,0 6,563 25-29 14.0 82.5 2.7 0~8 100.0 6,342 30-34 5.1 90.3 2.8 1.8 100.0 5,964 35-39 3.0 89.3 3.2 4.4 100.0 5,019 40-44 2.4 86.9 4.3 6.4 100.0 3,754 45-49 1.8 83.4 4.1 10.8 100.0 3,111 Total 26.5 68.3 2.6 2.6 100.0 38,334 Note: Figures may not add to 100.0 due to rounding. 117 of women never married decreases rapidly from 82 percent among teenagers to 38 percent at age 20-24. The proportion of divorced women increases gradually with age from 2 percent for women 20-24 to 4 percent for women age 40-49. The proportion of women who are widowed increases steadily with age, from less than 1 percent of women under age 30 to 6 percent among women age 40-44, and then to 11 percent among women age 45-49. 8.2 Marital Exposure Tables 8.2.1 and 8.2.2 show variations in marital exposure for the five years preceding the survey by age and selected background characteristics of women. The tables are calculated using information collected in the calendar located in the back of the questionnaire (see Appendix E). The data show the percentage of months spent married in the five years prior to the survey, L and incorporate the effects of age at first marriage, marital dissolution, and remarriage. Table 8.2.1 Marital exposure: background characteristics For all women 15-49, the percentage of months in the five years preceding the survey spent in marital union, by age and selected background characteristics, Indonesia 1994 Current age Background characteristic 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Total Residence Urban 3.1 24.7 63.6 85.7 89.4 87.8 83.7 53.1 Rural 9.9 56.4 84.1 91.6 90.9 89.1 86.6 68.5 Region/Residence Java-Bali 9.1 48.4 78.5 90.2 90.8 89.3 87.1 65.2 Urban 3.5 24.8 64.8 86.0 90.2 88.9 84.8 53.9 Rural 13.7 64.9 88.4 92.6 91.2 89.6 88.4 72.7 Outer Java-Bali 1 4.5 39.1 74.0 88.2 89.8 87.4 83.2 60.0 Urban 1.8 23.6 58.7 82.8 86.3 85.8 81.0 50.5 Rural 5.4 45.2 79.4 89.9 90.9 87.9 84.0 63.2 Outer Java-Bali It 5.0 38.6 74.7 90.4 90.4 87.6 83.6 60.5 Urban 2.4 26.5 64.5 90.2 89.4 85.8 82.8 52.9 Rural 5.9 43.6 78.4 911.4 90.7 88.2 83.7 63.0 Education No education 18.4 68.0 79.7 85.3 86.1 81.5 83.4 80.4 Some primary 14.7 62.9 88.3 92.9 91.5 90.1 86.4 79.5 Completed primary 10.9 60.0 85.4 91.7 93.2 91.3 88.5 65.2 Some secondary+ 2.5 25.6 61.1 86.0 90.0 90.6 85.1 42.5 Total 7.3 44.8 76.8 89.7 90.5 88.6 85.6 63.3 The percentage of months spent married increases with age from less than 10 percent among women 15-19 to about 90 percent among women age 30-44, and then declines. This pattern reflects the pace of entry into marriage among young women and the increasing incidence of widowhood among women age 40 and above. The same pattern was found in previous DHS surveys. 1 Note that the table is based on all women, so 60 months are added to the denominator for each never-married woman. 118 Table 8.2.2 Marital exposure: region and province For all women 15-49, the percentage of months in the five years preceding the survey spent in marital union, by region and province, Indonesia 1994 Current age Region and province 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Total Java-Bali 9.0 48.4 78.4 90.2 90.7 89.3 86.9 65.1 DKI Jakarta 1.9 24.2 59.0 82.1 86.8 87.4 83.9 49.4 West Java 12.0 53.0 82.4 90.1 94.5 93.2 88.5 66.8 Central Java 5.8 49.5 81.3 94.0 92.5 87.5 91.2 67.4 DI Yogyakarta 3.6 27.2 62.9 84.7 90.0 85.9 89.3 58.9 East Java 12.2 54.2 79.3 89.6 86.5 87.6 81.9 ' 67.1 Bali 3.2 31.7 72.8 88.9 92.8 91.2 88.6 61.0 Outer Java-Bali I 4.5 39.0 74.0 88.2 89.9 87.6 83.3 60.0 Dista Aceh 3.9 34.9 73.4 87.7 92.7 89.5 80.5 59.7 North Sumatra 2.2 32.6 72.8 88.8 88.7 89.5 84.2 58.1 West Sumatra 2.7 26.4 65.7 88.6 94.6 90.2 89.2 55.1 South Sumatra 5.8 43.4 76.1 89.5 90.6 85.7 85.7 61.9 Lampung 8.4 54.7 88.0 94.4 95.2 95.5 93.0 69.2 West Nusa Tenggara 5.3 47.4 78.1 86.4 90.3 87.3 80.5 61.3 West Kalimantan 7.2 49.3 79.7 90.7 91.0 86.2 89.5 63.2 South Kalimantan 6.2 43.3 82.5 87.9 91.9 81.7 75.1 61.7 North Sulawesi 1.8 35.2 72.9 88.5 90.7 88.2 89.5 60.9 South Sulawesi 3.9 33.4 58.7 82.2 83.2 80.6 78.4 54.9 Outer Java-Bali II 5.1 38.6 74.7 90.3 90.4 87.5 83.6 60.7 Riau 5.0 35.9 75.5 93.0 92.4 88.8 82.2 62.0 Jambi 7.7 42.9 78.1 93.9 93.0 88.4 85.0 64.9 Bengkulu 5.7 50.7 79.6 94.3 91.2 93.6 87.0 64.6 East Nusa Tenggara 2.1 23.8 63.3 82.3 85.4 81.3 80.9 52.9 East Timor 4.1 40.3 76.5 92.1 89.5 91.9 83.4 65.3 Central Kalimantan 7.0 49.3 77.1 93.7 92.4 86.7 84.4 62.7 East Kalimantan 6.8 40.8 75.2 92.8 89.4 86.4 88.7 61.1 Central Sulawesi 5.0 39.9 75.8 87.9 88.5 90.5 90.7 64.1 Southeast Sulawesi 4.5 38.0 81.3 87.8 86.5 83.8 78.6 59.1 Maluku 3.1 34.4 72.3 87.3 91.1 86.1 78.5 53.9 lrian Jaya 7.5 48.2 79.8 92.8 93.4 92.6 84.4 65.8 Total 7.3 44.8 76.8 89.7 90.5 88.6 85.6 63.3 There are significant differentials in marital exposure between urban and rural women. Overall, the percentage of months spent married is lower among urban women than among rural women in all age groups. The difference is most striking among women age 20 to 30 years. At these ages, urban women have 20 to 30 percentage points less marital exposure than their counterparts in the rural areas. This is true in all regions, but is most pronounced in Java-Bali. Overall, women in Java-Bali spend more time in marital union than women in the outer islands, a pattern that holds in urban and rural areas. Marital exposure varies widely by women's education. Women with less than completed primary education spend almost twice as much time married as women with some secondary education (80 percent and 43 percent, respectively). This pattern most likely reflects the higher age at first marriage among more educated women. Among women under 30, those with no education spend more time married than women with some secondary education. The pattern changes at older ages, where all women spend between 80 to 90 percent of their time in marital union. 119 There are large differentials in marital exposure by province. For example, women in DKI Jakarta were in marital union for less than half of the time in the past five years, while women in West Java, Central Java, East Java, Lampung, East Timor and Irian Jaya were married for 65 percent or more of the period. The variations are more pronounced among younger women. Women age 20-24 in DKI Jakarta were married for less than 25 percent of the five-year period, while the same age group in West Java, East Java, Lampung, and Bengkulu were married for more than 50 percent of the time. 8.3 Age at First Marriage Table 8.3 shows the percentage of women ever married by selected exact ages and median age at first marriage, according to current age. There is a substantial increase in age at marriage across cohorts. One in four women age 40 and over was married by age 15, compared with only 17 percent of women age 30-34 and less than 10 percent of women age 20-24. Similarly, while 7 in 10 women age 40 and older were married by age 20, less than half of women 20-24 were. The median age at first marriage is defined as the age by which 50 percent of women in the age group x to x + 4 have been married. For example, 50 percent of women age 25-29 were married by age 19.2. The median age at marriage has increased from 17.2 years among women in the oldest age cohort to 19.2 years among those age 25-29. Between 1991 and 1994, the median age at first marriage increased from 17.7 to 18.1 years among women age 25-49 (CBS et al., 1992). Table 8.3 Age at first marriage Percentage of women who were first married by exact age 15, 18, 20, 22, and 25. and median age at first marriage, according to current age, Indonesia 1994 Percentage of women who were first married by exact age: Current age 15 18 20 22 Percentage Median not/ Number age at never of first 25 married women marriage 15-19 4.0 NA NA NA NA 82.0 7,580 a 20-24 9.4 30.8 48.5 NA NA 37.5 6,563 a 25-29 13.5 39.6 56.0 68.7 80.8 14.0 6,342 19.2 30-34 16.9 48.1 67.1 79.1 88.3 5.1 5,964 18.2 35-39 21.0 50.8 68.2 80.8 89.8 3.0 5,019 17.9 40-44 25.0 57.4 71.6 81.3 90.6 2.4 3,754 17.3 45-49 26.7 57.4 72.3 82.1 91.4 1.8 3,111 17.2 20-49 17.2 45.2 62.1 73.4 82.1 12.8 30,754 18.5 25-49 19.4 49.1 65.8 77.5 87.4 6.2 24,191 18.1 NA = Not applicable aomitted because less than 50 percent of the women in the age group x to x + 4 were first married by age x. Large differences in age at marriage according to women's residence and level of education can be seen in Table 8.4.1. For all age cohorts, urban women marry at least two years later than their rural counter- parts; this pattern is true throughout the country. The difference between women with some secondary educa- tion and all other women is especially pronounced. Overall, women who have attended secondary school marry at least five years later than women with less than completed primary education. Among women with some secondary education, the median age at marriage is 21.9 years; for women with less than secondary 120 Table8.4.1 Median age at first marriage: background characteristics Median age at first marriage among women age 25-49 years, by current age and selected background characteristics, Indonesia 1994 Current age Women Background age characteristic 25-29 30-34 35-39 40-44 45-49 25-49 Residence Urban 22.0 19.6 19.7 18.8 18.5 20.0 Rural 18.1 17.6 17.1 16.7 16.5 17.4 Region/Residence Java-Bali 18.6 17.6 17.2 16.6 16.5 17.5 Urban 21.6 18.9 19.2 18.1 17.9 19.5 Rural 17.3 16.8 16.2 15.8 15.8 16.5 Outer Java-Bali 1 20.3 19.2 18.9 18.3 18.1 19.1 Urban 23.3 21.0 20.6 20.1 19.9 21.2 Rural 19.4 18.7 18.5 17.9 17.5 18.6 Outer Java-Bali I1 20.2 19.5 19.1 18.9 18.6 19.4 Urban 22.4 20.7 21.1 20,1 20.1 21.0 Rural 19.3 18.9 18.5 18.6 18.4 18.8 Education No education 16.9 16.8 16.6 16.4 15.9 16.5 Some primary 17.2 17.2 16.8 16.5 16.5 16.9 Completed primary 18.1 17.9 17.8 17.2 17.6 17.8 Some secondary+ 23.0 21.7 21.3 20.7 21.0 21.9 Total 19.2 18.2 17.9 17.3 17.2 18.1 Note: The medians for women 15-19 and 20-24 could not be determined because less than 50 percent of the women were first married by age 15 and 20, respectively. education, age at marriage ranges from 16.5 to 17.8 years. In addition, the gap between women with secondary schooling and other women has increased among younger women. For example, the difference in age at marriage between women with a secondary education and those who completed primary education increased from 3.4 years for women 45-49 to 4.9 years for women 25-29. Women in Java-Bali marry about two years earlier than women in the outer islands. The median age at marriage is 17.5 in Java-Bali, compared with J9.1 in Outer Java-Bali I and 19.4 in Outer Java-Bali II. There is a great deal of variation in the median age at first marriage by province (see Table 8.4.2). In Java-Bali, the median for women 25-49 ranges from 17 years in West Java to 20 years or older in DKI Jakarta and DI Yogyakarta (see Figure 8.1 ). Since 1987, age at marriage has generally increased in all of the provinces in Java-Bali, as well as in the Outer Islands (see Figure 8.2). A few provinces have shown slight declines. 121 Table 8.4.2 Median age at first marriage: region and province Median age at first marriage among women age 25-49 years, by current age and region and province, Indonesia 1994 Current age Women Region and age province 25-29 30-34 35-39 40-44 45-49 25-49 Java-Bali 18.6 17.6 17.2 16.6 16.5 17.5 DKI Jakarta 22.4 19.2 18.8 19.1 19.4 20. I West Java 17.7 17.2 16.2 15.9 16.4 17.0 Central Java 18.9 17.9 18.1 17.1 16.7 17.9 DI Yogyakarta 22.2 20.6 20.4 19.0 18.0 20.3 East Java 18.0 17.2 16.3 15.5 15.5 16.7 Bali 20.9 20.0 19.6 18.7 19.1 19.8 Outer Java-Bali 1 20.3 19.2 18.9 18.3 18. I 19.1 Dista Aceh 19.6 18.9 18.2 17.6 17. I 18.4 North Sumatra 21.2 20.3 19.9 19.8 19.6 20.3 West Sumatra 22.2 19.7 18.6 18.8 18.5 19.6 South Sumatra 20.6 18.7 19.0 18.2 16.8 18.9 Lampung 18.0 16.9 17.0 16.2 16.2 16.9 West Nusa Tenggara 18.4 18.4 18.2 17.9 18.3 18.3 West Kalimantan 19.2 19.4 18.8 17.9 18.1 18.8 South Kalimantan 18.4 18.3 17.3 16.3 15.9 17.4 North Sulawesi 2 I. 1 20.3 20.6 20.4 21.2 20.7 South Sulawesi 22.0 19.6 19.4 18.9 18.3 19.8 Outer Java-Bali II 20.2 19.5 19.1 18.9 18.6 19.4 Riau 20.4 19.3 18.6 17.7 16.3 18.6 Jambi 18.9 18.0 18.2 16.6 16.5 17.9 Bengkulu 19.8 18.3 18.0 17.6 16.7 18. I East Nusa Tenggara 22.4 21.3 20.9 20.9 20.3 21.2 East Timor 20.3 20.7 22.0 20.6 22.1 20.8 Central Kalimantan 19.0 18.8 19.6 18.9 20.3 19.2 East Kalimantan 20.5 19,7 18.4 18.7 18.4 19.4 Central Sulawesi 19.9 19.4 19.1 19.8 19.8 19.6 Southeast Sulawesi 19.1 18.0 17.9 18.8 20.4 18.6 Maluku 20.6 20.5 20.1 20.5 21.1 20.5 Irian Jaya 19.0 18.7 19.5 18.5 18.7 18.8 Total 19.2 18.2 17.9 17.3 17.2 18.1 Note: The medians for women 15-19 and 20-24 could not be determined because less than 50 percent of the women were first married by age 15 and 20, respectively. 122 Figure 8.1 Median Age at Marriage by Province Java-Bali 1987, 1991, and 1994 Central Java DI Yogyakarta East Java Ball ~ 1 o ( 1 DKI Jakarta I . ] 201~ i West Java 17.0 ~e~Q . J . jJJ~ . ~JJllr~| ,7. 1Q.O 1200 20,3 ~ 1 ~ , 7 I l e .g 16.7 m ~ m m ~ m ' n ~ !" 2 ,202 ~9,8 15 16 17 18 19 20 Age at Marriage 21 1994 IDHS Figure 8.2 Median Age at Marriage by Region Indonesia 1987, 1991 and 1994 20 19 18 17 16 15 INDONESIA Java-Bali Outer Java-Bali I Outer Java-Bali II Age at Marriage 1994 IDHS 123 8.4 Age at First Sexual Intercourse Currently married IDHS respondents were asked at what age they first had sexual intercourse. This information is presented in Table 8.5. In the table, divorced and widowed women are assigned an age at first intercourse equal to that of the last currently married women in the data file who got married at the same age, while never-married women are assumed to have not had sex. For Indonesia as a whole, 6 percent of women 25-49 reported never having had sexual intercourse. At age 15, fewer than one in five women have had intercourse; by age 18, this figure rises to almost one in two. The patterns shown in this table are almost identical to those for age at first marriage, indicating that, for most women, first sexual intercourse; occurs at the time of first marriage. Table 8.5 Age at first sexual intercourse Percentage of women who had first sexual intercourse by exact age 15, 18, 20, 22, and 25, and median age at first intercourse, according to current age, Indonesia 1994 Current age 15 Percentage of women who had Percentage Median first intercourse by exact age: who Number age at never had of first 18 20 22 25 intercourse women intercourse 15-19 4.1 NA NA NA NA 82.1 7,580 a 20-24 9.3 31.0 48.9 NA NA 37.5 6,563 a 25-29 13.7 40.0 56.3 69.0 80.7 14.0 6,342 19.2 30-34 16.7 48.2 67.3 79.2 88.2 5.1 5,964 18.2 35-39 19.9 50.7 68.3 80.9 89.8 3.0 5,019 17.9 40-44 23.3 56.9 71.4 81.6 9(I.4 2.5 3,754 17.3 45-49 24.9 56.9 71.9 81.7 91.1 1.8 3,111 17.3 20-49 16.6 45.2 62.2 73.5 82.0 12.9 30,754 18.5 25-49 18.6 49.0 65.9 77.6 87.3 6~2 24,191 18.1 Note: Divorced and widowed women are assigned an age at first intercourse that is the same as that of the last currently married women in the data file who got married at the same age. Never-married women are assumed to have not had intercourse. NA = Not applicable a Median was not calculated because less than 50 percent of the women in the group x to x + 4 had had intercourse by age x. 124 The differentials in age at first intercourse (see Tables 8.6.1 and 8.6.2) are similar to the differentials in age at first marriage, with rural women, women in Java-Bali, and women with less than secondary educa- tion first having sexual intercourse at an earlier age than urban women, women in the outer islands, and those with secondary or higher education. Table 8.6.1 Median age at first intercourse: background characteristics Median age at first sexual intercourse among women age 25-49 years, by current age and selected background characteristics, Indonesia 1994 Current age Women Background age characteristic 25-29 30-34 35-39 40-44 45-49 25-49 Residence Urban 21.9 19.5 19.6 18.9 18.5 20.0 Rural 18.1 17.6 17.1 16.8 16.7 17.4 Region/Residence Java-Bali 18.6 17,6 17.3 16.7 16.7 17.6 Urban 21.6 18.9 19.1 18.4 17.9 19.5 Rural 17.4 16.8 16.3 16.0 15.9 16.6 Outer Java-Bali 1 20.2 19.1 18.9 18.3 18.1 19.1 Urban 23.2 20.9 20.6 20.0 19.9 21.1 Rural 19.3 18.7 18.4 17,9 17.5 18.5 Outer Java-Bali I1 20.1 19.4 19.0 18.8 18.6 19.3 Urban 22.2 20.6 21.0 19,8 19.9 20.9 Rural 19.2 18.9 18.5 18.5 18.4 18.7 Education No education 17.0 16.8 16.7 16.6 16.0 16.6 Some primary 17.2 17.2 16.9 16.7 16.5 17.0 Completed primary 18.1 17.8 17.7 17.3 17.6 17.8 Some secondary+ 22.9 21.6 21.3 20.7 20.9 21.8 Total 19.2 18.2 17.9 17.3 17.3 18.1 125 Table 8.6.2 Median age at first intercourse: region and province Median age at first sexual intercourse among women age 25-49 years, by current age and region and province, Indonesia 1994 Current age Women Regionand age province 25-29 30-34 35-39 40°44 45-49 25-49 Java-Bali 18.6 17.6 17.3 16.7 16.7 17.6 DKI Jakarta 22.4 19.0 18.8 19.1 19.3 20.1 West Java 17.7 17.1 16.4 15.9 16.5 17.0 Central Java 19.0 17.9 18.1 17.3 17.0 17.9 DI Yogyakarta 22.0 20.6 20.5 19. I 18.3 20.3 East Java 18.0 17.2 16.4 15.9 15.8 16.8 Bali 20.8 20.0 19.5 18.7 19.1 19.7 Outer Java-Bali I 20.2 19.1 18.9 18.3 18.1 19.1 Dista Aceh 19.6 18.9 18.1 17.7 17.3 18.4 North Sumatra 21.2 20.3 19.9 19.7 19.6 20.3 West Sumatra 22.3 19.7 18.5 18.8 18.5 19.6 South Sumatra 20.5 18.7 19.0 18.2 16.8 18.9 Lampung 17.9 16.8 16.9 16.3 16.6 16.9 West Nusa Tenggara 18.4 18.3 18.1 17.9 18.3 18.2 West Kalimantan 19. I 19.4 18.7 17.8 18.1 18.8 South Kalimantan 18.4 18.2 17.3 16.3 15.9 17.4 North Sulawesi 20.8 20.1 20.2 20.0 20.8 20.3 South Sulawesi 22.0 19.5 19.5 19.0 18.3 19.8 Outer Java-Bali II 20. I 19.4 19.0 18.8 18.6 19.3 Riau 20.3 19.2 18.5 17.7 16.2 18.5 Jambi 18.9 18.0 18. I 16.6 16.5 17.9 Bengkulu 19.8 18.3 17.9 17.6 16.9 18.1 East Nusa Tenggara 22.3 21.2 20.9 2(I.7 20.3 21.1 East Timor 19.9 20.3 21.5 20.1 20.6 20.3 Central Kalimantan 18.9 19.0 19.6 18.9 20.2 19.3 East Kalimantan 20.5 19.7 18.5 18.8 18.5 19.4 Central Sulawesi 19.8 19.2. 19.3 19.6 19.6 19.5 Southeast Sulawesi 19.2 17.9 18.0 18.6 20.4 18.5 Maluku 20.0 20.1 19.9 211.4 20.6 20.2 lrian Jaya 18.6 18.6 18.8 18.2 18.7 18.5 Total 19.2 18.2 17.9 17.3 17.3 18.1 8.5 Recent Sexual Activity In the absence of contraception, the probability of pregnancy is related to the frequency of sexual intercourse. Thus, information on intercourse is important for refining the measurement of exposure to pregnancy. Several questions in the 1994 IDHS covered the topic of recent sexual intercourse. For example, currently married women were asked how long ago they had last had sexual intercourse and how many times they had had sex in the last four weeks. Tables 8.7.1 and 8.7.2 present the results of the question on time since last intercourse. The data allow an assessment of the level of sexual activity according to age, marital duration, and other background 126 Table 8.7.1 Recent sexual activity: background characteristics Percent distribution of currently married women by sexual activity in the four weeks preceding the survey, and among those who were not sexually active, the length of time they had been postpartum abstaining or were abstaining for other reasons, according to selected background characteristics and contraceptive method currently used, Indonesia 1994 Not sexually active in last 4 weeks Background Sexually Postpartum Abstaining for characteristic/ active abstaining other reason Number Contraceptive in last of method 4 weeks 0-1 years 2+ years 0-1 years 2+ years Missing Total women Age 15-19 85.6 6.3 0.1 7.3 0.0 0.3 100.0 1,291 20-24 84.2 6.3 0.2 8.9 0.1 0.3 100.0 3,936 25-29 85.7 5.1 0.3 8.6 0.1 0.2 100.0 5,234 30-34 85.0 3.6 0.3 10.3 0.4 0.3 100.0 5,387 35-39 82.8 3.1 0.2 12.5 1.2 0.2 100.0 4,483 40-44 77.2 1.6 0,3 18.2 2,4 0.3 100.0 3,262 45-49 64.5 0.3 0.2 28.0 5.9 1.0 100.0 2,594 Duration of marriage (years) 0-4 84.0 7.3 0.1 8.2 0.1 0.2 100.0 4,645 5-9 85.9 4.6 0.2 8.9 0A 0.3 100.0 4,592 10-14 86.5 4.3 0.2 8.2 0.4 0.4 100.0 5,054 15-19 83.5 2.8 0.5 12.4 0.7 0.1 100.0 4,320 20-24 80.7 1.7 0.2 15.3 1.8 0.3 100.0 3,481 25-29 73.4 1.4 0.2 21.3 3.3 0.4 100.0 2,554 30+ 57.3 0.3 0.1 33.5 7.9 0.9 100.0 1,540 Residence Urban 86.1 2.8 0.1 9.9 0.8 0.3 100.0 7,591 Rural 79.9 4.2 0.3 13.9 1.4 0.3 100.0 18,595 Region/Residence Java-Bali 80.8 3.6 0.2 13.7 1.4 0.2 100.0 16,663 Urban 85.8 2.8 0.1 10.2 0.9 0.3 100.0 5,523 Rural 78.2 4.1 0.3 15.5 1,7 0.2 100.0 11,140 Outer Java-Bali l 84.8 3.6 0.2 10.2 0.8 0.4 100.0 6,619 Urban 88.0 2.6 0.0 8.3 0.7 0.3 100.0 1,423 Rural 84.0 3.9 0.2 10.7 0.8 0.4 100.0 5,197 Outer Java-Bali 11 79.8 5.0 0.5 12.8 1.3 0.5 100.0 2,903 Urban 84.4 3.4 0.1 11.0 0.9 0.2 10B.0 645 Rural 78.4 5.5 0.7 13.3 1.4 0.5 10O.0 2,259 Education No education 70.9 3.5 0.6 21.3 3.3 0.3 100.0 3,904 Some primary 80.2 3.7 0.4 14.0 1.4 0.4 100.0 8,299 Completed primary 83.4 4. I 0.1 11.2 0.8 0.4 100.0 7,526 Some secondary+ 88.1 3.7 0.0 7.6 0.3 0.1 100.0 6,457 Contraceptive method No method 73.2 6.9 0.3 16.9 2.2 0.5 100.0 11,852 Pill 92.3 0.4 0.2 6.8 0.2 0.0 100.0 4,484 IUD 87.0 1.9 0.2 9.7 1.1 0.2 100.0 2,686 Sterilization 83. I 1.6 0,0 13.6 0.9 0.9 100.0 971 Periodic abstinence 91.1 0.2 0.0 8.7 0.0 0.0 100.0 286 Other 87.5 1.5 0.4 10.3 0.3 0.1 100.0 5,907 Total 81,7 3.8 0.3 12.7 1.2 0.3 100.0 26,186 127 Table 8.7.2 Recent sexual activity: region and province Percent distribution of currently married women by sexual activity in the four weeks preceding the survey, and among those who were not sexually active, the length of time they had been postpartum abstaining or were abstaining for other reasons, according to region and province, Indonesia 1994 Not sexually active in last 4 weeks Sexually Postpartum Abstaining for active abstaining other reasons Number Region and in last of province 4 weeks 0-1 years 2+ years 0-1 years 2+ years Missing Total women Java-Bali 80,8 3,6 0.2 13.7 1.4 0.2 100.0 16,663 DKI Jakarta 87.1 2,1 0.2 9.3 1.3 0.0 100.0 1,140 West Java 86.3 2,3 0.1 10,6 0.5 0.2 100.0 5,170 Central Java 77.8 4,4 0.4 15.8 1.4 0,2 100,0 ,1,302 DI Yogyakarta 76.5 4,7 1.3 13.6 3.7 0. I 100.0 423 East Java 75.7 4,7 0.2 16.8 2.2 0.3 100.0 5,209 Bali 92.6 2,0 0.1 4.9 0.2 0.2 100.0 418 Outer Java-Bali I 84.8 3.6 0.2 10.2 0.8 0.4 100.0 6,619 Dista Aceh 88.0 3.3 0,2 7.2 0.8 (1.3 100.0 477 Noah Sumatra 85.7 3.8 0.2 9.7 0.2 0.3 100.0 1,374 West Sumatra 87.3 3.9 0,2 7.8 0.6 0,2 100.0 489 South Sumatra 85,8 2. I 0.0 1 I. I 0.8 0.3 100.0 843 Lampung 81,4 5.0 0.6 12.4 0.2 0.4 100.0 801 West Nusa Tenggara 82.3 5.9 0.3 9.8 1.7 0.0 100.0 469 West Kalimantan 81.1 3.7 0.0 13.8 0.7 0.6 100.0 489 South Kalimantan 92.3 1.5 0.1 5.1 0.8 0.2 100.0 398 North Sulawesi 89.6 1.3 0. I 8.2 0,6 0. I 100.0 318 South Sulawesi 81.2 3.8 0.0 12.3 1.6 1.0 100,0 962 Outer Java-Bali II 79.8 5.0 0.5 12.8 1.3 0.5 100.0 2,903 Riau 82. I 2.8 (1.0 13.4 1.3 0.3 100.0 520 Jambi 78.3 3.9 0.0 16.3 0.9 (1.5 100.0 316 Bengkulu 85.8 3.1 0.0 9.6 1.0 0.4 100.0 179 East Nusa Tenggara 71.1 12.2 1.4 12.6 2.6 0.1 100.0 393 East Timor 83.2 5.1 0. I I 0.3 0.3 0.8 100.0 115 Central Kalimantan 89.6 1.5 0.2 8.5 0.0 0.2 100.0 227 East Kalimantan 83.8 3.4 0. I 11.6 1.0 0.0 100.0 304 Central Sulawesi 84. I 3.7 0.1 9.4 1.4 1.2 100.0 225 Southeast Sulawesi 79.4 4.2 0.3 14.6 0.9 0.6 100.0 178 Maluku 74. I 7.2 0.7 16.6 1,0 0.4 100.0 209 lrian Jaya 71.5 6.6 3.0 15.1 2.3 1.2 100.0 238 Total 81.7 3.8 0.3 12.7 1.2 0.3 100.0 26,186 characteristics. Overall, 82 percent of married women were sexually active in the month preceding the survey, 4 percent were postpartum abstaining, and 14 percent were not sexually active for reasons other than a recent birth (e.g., spousal separation, illness). The proportion sexually active and the proportion postpartum abstaining declines as age and duration of marriage increase. At the same time, the proportion not sexually active for other reasons increases with increasing age and duration of marriage. Urban women are more likely to be sexually active than rural women, primarily because rural women tend to spend more time abstaining for reasons other than a recent birth. The percentage of women who were sexually active in the month preceding the survey is closely associated with education. Seventy-one percent of women with no education were sexually active, compared with 80 percent of those with some primary education, 83 percent of those who had completed primary school and 88 percent of those with some', second- ary or higher education. These differences by education are due mainly to the greater proportions of less educated women who are abstaining for reasons other than a recent birth. 128 Among contraceptive users, the proportion of women who are sexually active varies little according to method (from 83 to 92 percent). However, women who are not using any method of family planning are less likely to be sexually active than those who are using a method. Among women who were not using family planning, only 73 percent had had sex in the month prior to the survey; 7 percent were postpartum abstaining and 19 percent were abstaining for other reasons. Although there are small differences between regions in the proportion of women who were sexually active in the four weeks preceding the survey, there are substantial variations by province. Proportions range from 72 percent or less in East Nusa Tenggara and Irian Jaya to 93 percent in Bali. Within the Java-Bali region, proportions range from 76 percent in East Java to 93 percent in Bali. 8,6 Postpartum Amenorrhea, Abstinence and Insusceptibility Among women who are not using contraception, exposure to the risk of preg- nancy in the period following a birth is influ- enced by two factors: breastfeeding and sexu- al abstinence. Postpartum protection from conception can be prolonged by breast- feeding--which can lengthen the duration of amenorrhea--and by delaying the resump- tion of sexual relations. Table 8.8 shows the percentage of births for which mothers are postpartum amenorrheic, abstaining, and postpartum in- susceptible by the number of months since the birth. Women who are insusceptible are de- fined as those who are either amenorrheic or abstaining following a birth and, thus, are not exposed to the risk of pregnancy. The esti- mates shown in Tables 8.8, 8.9.1 and 8.9.2 are based on current status data. That is, they re- fer to whether or not the woman was amenor- rheic or abstaining at the time of the survey. All births occurring during the three years pri- or to the survey are included. Table 8.8 uses cross-sectional data, representing all women at a single point in time, rather than showing the experience of an actual cohort over time. For this reason, the proportions at increasing durations do not always decline smoothly. Such fluctuations have been reduced by grouping the births in two-month intervals. Table 8.8 Postpartum amenorrhea, abstinence and insusceptibility Percentage of births in the three years preceding the survey for which mothers are postpartum amenorrheic, abstaining and insusceptible, by number of months since birth, and median and mean durations, Indonesia 1994 Percentage of births for which mothers are: Number Months Amenor- lnsus- of since birth rheic Abstaining ceptible births < 2 96.3 90.7 98.7 490 2-3 70.7 38.9 75.2 564 4-5 58.3 17.6 61.5 538 6-7 51.2 12.9 55.5 583 8-9 49.2 10,9 51.4 548 10-11 30.2 7.7 33.3 570 12-13 29.0 6.6 31.8 644 14-15 26.0 5.0 27.8 545 16-17 25.6 5.4 28.2 544 18-19 14.9 6,7 19.3 495 20-21 9.4 4.2 12.5 465 22-23 10.3 1.7 11.9 514 24-25 8.2 2.4 10.5 719 26-27 5.9 1.6 7.5 61 I 28-29 7.6 2.1 9.7 543 30-31 5.6 3.8 8.0 603 32-33 4.2 2.7 6.8 500 34-35 2.9 0.7 3.6 576 Total 27.6 I 1,7 30.2 10,052 Median 7.1 2.4 7.8 NA Mean 10.4 4.7 11.3 NA Prevalence/ Incidence mean I 9.8 4.2 10,7 NA NA -- Not applicable 1The prevalence-incidence mean is borrowed from epidemiology and is defined as the number of children whose mothers are amenorrheic (prevalence) divided by the average number of births per month (incidence). The percentage of women who are still amenorrheic is 71 percent at 2 to 3 months after birth, 51 percent at 6 to 7 months, and 29 percent at 12 to 13 months. Figure 8.3 shows the rapid drop in postpartum abstinence, compared with amenorrhea. Only 39 percent of women are still abstaining from sexual relations 2-3 months after a birth and only about 7 percent are still abstaining after a year. Overall, half of the women are susceptible to the risk of pregnancy 8 months after the birth of a child (excluding contraceptive use). 129 Figure 8.3 Percentage of Births in the last Three Years for Which Mothers Are Amenorrheic or Abstaining Percent of Births 100 80 6O 4O 20 0 i 2 4 6 8 t0 12 14 16 18 20 22 24 26 28 30 32 Months S ince Birth 34 1994 IDHS The median duration of postpartum amenorrhea, abstinence and insusceptibility by various background characteristics of the women is shown in Table 8.9.1. Women less than 30 years of age and urban women are amenorrbeic for a shorter period of time than women over age 30 and rural women, although the period of abstinence is similar. The duration of amenorrhea in the three major regions varies little, ranging from 6.3 months in the Outer Java-Bali II region to 7.4 months in Java-Bali. Education has an inverse relationship with the duration of amenorrhea. Women with no education are amenorrheic twice as long (8.5 months) as women with some secondary education (4.5 months). The difference is largely due to longer breastfeeding among rural and older women (see Table 13.4.1 ). The combined effect of amenorrbea and abstinence is reflected in the median duration of insusceptibility, which is shown in Tables 8.9.1 and 8.9.2. Women under 30 years are insusceptible to the risk of pregnancy 3 months less than women 30 years and over (6.7 months versus 9.7 months); the corresponding periods for urban and rural women are 4.4 and 8.3 months, respectively. Women with less education are insusceptible for a longer period than more educated women. The period of insusceptibility is 9.1 months for women with no education and 5.3 months for women with some secondary education. 130 Table 8.9.1 Median duration of postpartum amenorrhea T abstinence~ and insusceptibility: background characteristics For births in the three years preceding the survey, the median number of months mothers are postpartum amenorrheic, postpartum abstaining, and postpartum insusceptible, by selected background characteristics, Indonesia 1994 Median number of months mothers are: Postpartum Number Background Postpartum Postpartum insus- of characteristic amenorrheic abstaining ceptible births Age <30 5.8 2.4 6.7 6,114 30+ 8.6 2.5 9.7 3,938 Residence Urban 3.8 2.2 4.4 2,798 Rural 7.9 2.5 8.3 7,254 Region/Residence Java-Bali 7.4 2.4 8.2 5,780 Urban 3.6 2.2 4.3 1,928 Rural 8.2 2.6 8.6 3,851 Outer Java-Bali 1 6.7 2.3 7.1 2,966 Urban 4.6 2.1 4.9 582 Rural 7.4 2.4 7.8 2,383 Outer Java-Bali I1 6.3 2.6 7.3 1,307 Urban 3.5 2.2 4.3 288 Rural 7.3 2.9 8.4 1,019 Education No education 8.5 2.9 9.1 1,077 Some primary 8.2 2.4 9.4 2,979 Completed primary 6.9 ~ 2.4 7.8 2,999 Some secondary+ 4.5 2.3 5.3 2,997 Total 7. I 2.4 7.8 10,052 Note: Medians are based on current status. Table 8.9.2 presents the differentials in postpartum amenorrhea by region and province. Postpartum amenorrhea ranges from less than 3 months in DKI Jakarta to 9 months or longer in Central Java, West Nusa Tenggara and East Nusa Tenggara. In Java-Bali, the median duration of amenorrhea is 3 months in DKI Jakarta, 5 months in DI Yogyakarta, about 7 months in West Java, East Java, and Bali, and 10 months in Central Java. Subgroup differences in the duration of abstinence tend to be less pronounced than differences in amenorrhea. In almost all subgroups, women abstain for 2 to 3 months following a birth. In DI Yogyakarta and Irian Jaya, the duration of abstinence is somewhat longer, about 4 months. It is of interest to note that the duration of postpartum abstinence in East Nusa Tenggara, almost 6 months, is extremely long, resulting in a period of insusceptibility of more than one year ( 13.4 months). Regional differences in the duration of insusceptibility generally replicate the differences in the duration of amenorrhea. 131 Table 8.9.2 Median duration of postpartum amenorrhea, abstinence~ and insusceptibility: region and province For births in the three years preceding the survey, the median number of months mothers are postpartum amenorrheic, postpartum abstaining, and postpartum insusceptible, by region and province, Indonesia 1994 Median number of months mothers are: Postpartum Number Region and Postpartum Postpartum insus- of province amenorrheic abstaining ceptible births Java-Bali 7.4 2.4 8.2 5,780 DKI Jakarta 2.8 1.8 3.2 371 West Java 7.3 2.1 7.4 2,147 Central Java 10.2 3.2 10.7 1,513 DI Yogyakarta 5.3 4.2 8.8 108 East Java 6.9 3.5 8.3 1,517 Bali 6.9 1.9 7.6 124 Outer Java-Bali I 6.7 2.3 7.1 2,966 Dista Aceh 6.4 2.4 6.6 213 Noah Sumatra 5.6 2.3 5.6 754 West Sumatra 6.5 2.4 6.5 223 South Sumatra 5.6 2.0 5.8 318 Lampung 8.8 2.6 9.1 348 West Nusa Tenggara 9.2 2.8 10.3 233 West Kalimantan 6.0 2.2 6.5 220 South Kalimantan 5.0 2.0 5.1 124 North Sulawesi 3.8 1.6 4.4 119 South Sulawesi 7.9 2.4 8.8 414 Outer Java-Bali II 6.3 2.6 7.3 1,307 Riau 5.9 2.2 5.9 213 Jambi 5,3 2.5 6.9 121 Bengkulu 3.8 2.2 4.4 81 East Nusa Tenggara 9.0 5.6 13.4 221 East Timor 7.3 2.1 7.5 76 Central Kalimantan 3.2 1.7 4.1 69 East Kalimantan 7.9 2.2 8.4 128 Central Sulawesi 4.5 2.4 5.0 96 Southeast Sulawesi 5.8 2.4 6.2 90 Maluku 6.5 3.1 9.3 I 13 lrian Jaya 7.4 4.2 8.8 99 Total 7.1 2.4 7.8 10,052 Note: Medians are based on current status. 8.7 Termination of Exposure Two measures of exposure, menopause and long-term abstinence, are shown in Table 8.10. Menopause is an indicator of secondary infertility--the proportion of non-pregnant, non-amenorrheic currently married women whose last menstrual period occurred six or more months prior to the survey or who report that they are menopausal. This proportion rises rapidly with age, particularly after age 42. The propor- tion menopausal is 6 to 9 percent before age 41, and reaches 51 percent in the oldest age group (48-49). 132 Table 8.10 Termination of exposure to the risk of pregnancy Indicators of menopause, terminal infertility and long-term abstinence among currently married women age 30-49, by age, Indonesia 1994 Long-term Menopausal~ abstinence 2 Age Percent Number Percent Number 30-34 6.6 4,373 0.5 5,387 35-39 5.7 3,936 1.0 4,483 40-41 8.5 1,465 1.5 1,574 42-43 13.2 1,147 2.5 1,203 44-45 23.5 1,167 2.8 1,183 46-47 35.1 886 5.1 898 48-49 51.0 996 5.5 998 Total 13.5 13,969 1.6 15,725 tPercentage of non-pregnant, non-amenorrheic currently married women whose last menstrual period occurred six or more months ~receding the survey or who report that they are menopausal. Percentage of currently married women who did not have intercourse in the three years preceding the survey. Long-term abstinence is an indicator of terminal abstinence the percentage of currently married women who did not have sexual intercourse in the three years prior to the survey. Although long-term abstinence is an important factor in the termination of exposure in some countries, especially in sub-Saharan Africa, it is not significant in Indonesia, where only 6 percent of women in the oldest age group are terminally abstaining. 133 CHAPTER 9 INFANT AND CHILD MORTALITY 9.1 Background For some time, Indonesia's health programs have focused on reducing the high levels of infant and childhood mortality. Various efforts have been carried out to achieve the goal of "a healthy population by the year 2000." To reach this goal, the government developed the National Health System, which is part of the national development plan. The infant mortality rate has been identified as one of the key indicators used to assess improvements in health development. Infant and child mortality rates are relevant not only in evaluating the progress of health programs, but can also be used to monitor the current demographic situation and to provide input for population projections. In addition, they can be used to identify subgroups of the population that have high mortality risks. This chapter reports on levels, trends, and differentials in infant and child mortality based on the 1994 IDHS and selected earlier surveys. The following rates are used to measure early childhood mortality: Neonatal mortality: the probability of dying within the first month of life; Postneonatal mortality: the probability of dying after the first month of life but before exact age one year; Infant mortality: the probability of dying between birth and exact age one year; Child mortality: the probability of dying between exact age one and exact age five; Under-five mortality: the probability of dying between birth and exact age five. Data on infant and child mortality in the 1994 IDHS are derived from the birth history section of the individual questionnaire. The section begins with questions about the respondent' s childbearing experience, i.e., the number of sons and daughters who live in the household, who live elsewhere, and who have died. Next, for each live birth, information on name, date of birth, sex, whether the birth was single or multiple, and survivorship status was recorded. For living children, information about his/her age at last birthday and whether the child resides with his/her mother was obtained. For children who had died, the respondent was asked to provide the age at death. 9.2 Assessment of Data Quality A retrospective birth history, such as that included in the 1994 IDHS, is susceptible to several possible data collection errors. First, only surviving women age 15-49 were interviewed; therefore, no data were available for children of women who died. The resulting mortality estimates will be biased if the fertility of surviving and nonsurviving women differs substantially. In Indonesia, this bias is likely to be negligible. Another possible error is underreporting of events; respondents are likely to forget events that occurred in the past. Also, the misreporting of date of birth and/or age at death can bias rates. In general, these problems are less serious for time periods in the recent past than for those in the more distant past. The existence and extent of some of these potential biases can be examined with the 1994 IDHS data. As shown in Table C.4 in Appendix C, there is a deficit of births in calendar year 1989 and an excess in calendar year 1988. This pattern, which has been found in previous DHS surveys, is thought to result from interviewers' transference of births out of the period for which the health and calendar data were collected (i.e., January 1989 through the date of the survey) in order to reduce their workload. 135 The most common source of error in the reporting of children's age at death is the tendency of mothers to report them as occurring at multiples of six months. To reduce this type of error, detailed instruc- tions were given to the interviewers to record age at death under one month in days, and age at death under two years in months. Interviewers were also instructed to probe for exact age at death in months when it was reported as "one year" or "12 months." Nevertheless, as shown in Figure 9.1, there is considerable heaping of deaths at age 12 months. The same pattern was found in the 1991 IDHS. Heaping in age at death is more severe for deaths that occurred farther in the past than for those that occurred more recently. It should be noted that although misreporting of age at death may result in biased estimates of infant and child mortality, a simulation study using DHS data indicates that the magnitude of misreporting evident in the 1994 IDHS would bias estimates by no more than 5 percent (Sullivan et ah, 1990). Thus, the results presented in this report are unadjusted for misreporting. In particular, all deaths reported as occurring at 12 months are not included in the calculation of the infant mortality rate. 180 160 120- - 100 80 60 4O 2O 0 Figure 9.1 Number of Reported Deaths among Children Under Two Years by Age at Death in Months Number of Deaths 2 3 4 5 6 7 8 g 10 11 12 13 14 15 16 17 18 lg a0 21 22 23 Age at Death (Months) 1994 IDHS It should also be noted that most infant and child mortality estimates using survey data are based on relatively small numbers of cases, particularly when fertility levels are low. This situation can lead to unstable estimates. To reduce this problem, mortality measures based on the 1994 IDHS are calculated for five- or ten-year periods. Another problem concerns the fact that the mortality estimates are based only on those births reported by women of reproductive age at a given point in time and these are truncated because women past age 49 are not interviewed. As the time-period covered extends further into the past, the resulting censoring of information becomes progressively more severe, and the higher rates of infant and child mortality are usually associated with more advanced maternal ages. To mininaize the effect of censoring, analysis of infant and child mortality trends from the 1994 IDHS is limited to a period no more than 15 years prior to the survey. 136 9.3 Levels and Trends in Infant and Child Mortality Table 9.1 presents estimates of childhood mortality for three five-year periods preceding the survey. The data indicate that infant mortality has declined 24 percent during the fifteen-year period, from 75 deaths per 1,000 live births in the period mid- 1979 to mid- 1984 to 57 per 1,000 in the period mid- 1989 to mid- 1994. During the same period, postneonatal mortality, child mortality, and under-five mortality declined at a faster rate (30 percent, 31 percent, and 26 percent, respectively), while the neonatal mortality rate declined by only 18 percent. The direct estimate of infant mortality for the most recent five-year period, 57 deaths per 1,000 births, is similar to an estimate, calculated using an indirect estimation technique referring to the year 1993 (58 deaths per 1,000 births) t (CBS, 1993a). Table 9.1 also gives infant mortality rates for the ten-year period preceding the survey. For infant mortality, the rate is 66 deaths per 1,000 live births; the neonatal mortality rate is 33 per 1,000, and the ratio of postneonatal to neonatal mortality is 1.05. For the same time period, the probability of dying between birth and the fifth birthday was 93 per 1,000 live births. The data indicate that the under-five mortality rates declined from 110 deaths per 1,000 live births in the period 10-14 years prior to the survey to 81 per 1,000 in the period 0-4 years preceding the survey. The ratio of postneonatal to neonatal mortality decreased from 1.02 to 0.87 during the fifteen-year period before the survey, due to the more rapid decline in postneonatal deaths in the most recent five-year period. Table 9.1 lnl~nt and child mortality Neonatal, postneonatal, infant, child, and under-five mortality rates for three five-year periods preceding the survey and the ratio of postneonatal to neonatal mortality, Indonesia 1994 Post- Post- Under- neonatal/ Years Approximate Neonatal neonatal Infant Child five neonatal preceding calendar mortality mortality mortality mortality mortality mortality survey periods (NN) (PNN) (tq0) (4ql) (sqo) ratio 0-4 mid-1989 to mid-1994 30.4 26~5 57.0 25.8 81.3 0.87 5-9 mid-1984 to mid-1989 34.3 40.6 74.9 30.4 103.1 1.18 10-14 mid-1979 to mid-1984 37.3 38.0 75.3 37.5 109.9 1.02 0 9 mid-1984 to mid-1994 32.5 34.0 66.4 28.3 92.8 1.05 Trends in mortality can also be studied using estimates based on the 1971,1980, and 1990 population censuses, the 1987 NICPS, and the 1991 and 1994 IDHS. Infant mortality based on the census data is estimated indirectly using information on the number of children ever born and the number of children who died; estimates from the 1987 NICPS and the 1991 IDHS are obtained from the birth history data. Figure 9.2 shows that in 24 years, the infant mortality rate has declined by 60 percent, from 142 deaths per 1,000 births in 1968 to 57 per 1,000 births in 1992. Table 9.2 shows the trends in mortality by region based on the results of the 1987 NICPS, the 1991 IDHS, and the 1994 IDHS. Infant and child mortality have declined in all regions and regional variations have narrowed; however, the 1991 IDHS results are not in line with those from the 1987 NICPS and the 1994 IDHS. The 1987 NICPS and 1994 IDHS rates for Java-Bali are either lower or about the same as those in L The 1993 infant mortality rate projection was calculated based on the 1990 population census. 137 Figure 9.2 Infant Mortality Rates Selected Sources, Indonesia 1971-1994 Deaths per 1,000 Births 160 140 120 1 O0 80 6O 40 20 0 1967 142 (1971 Census) IK 7o (199o Census I " "~, , , , , , ,~ 57 (1994 IDHS) R8 (1991 IDHS) ] E I i i i i i 1970 1973 1976 1979 1982 1985 1988 1991 1994 Calendar Year Table 9.2 Trends in infant and child mortality by region Infant and child mortality for the ten-year period preceding the surveys by region, 1987 NICPS, 1991 IDHS, and 1994 IDHS Infant Child Under-five mortality rate mortality rate mortality rate Region and 1987 1991 1994 I987 1991 1994 1987 1991 1994 province NICPS IDHS IDHS NICPS IDHS IDHS NICPS IDHS IDHS Java-Bali 70.3 78.8 66.5 36.9 34.3 25.3 104.5 110.3 90.1 DKI Jakarta 52.9 44.9 29,8 26.9 15.7 21.1 78.4 59,9 50.3 West Java 94.7 116.9 88.8 51.3 53.3 33.8 141.1 164.0 119.6 Central Java 47.8 48.8 51.1 35.4 32.6 25.0 81.6 79.8 74.8 DI Yogyakarta 37.6 37.5 30.4 19.1 11.8 4.9 56.0 48,9 35.1 East Java 71.4 69.3 62.1 27.6 20.6 17.8 97.0 88.5 78.8 Bali 65,6 49.1 58.0 16.3 12.2 5.2 80.8 60.7 62.9 Outer Java-Bali 1 83.7 69.2 66.8 42.0 37.3 32.4 122.2 104.0 97.0 Outer Java-Bali II 75.5 65.9 65.3 47,1 36.0 31.8 119.1 99.6 95.0 Total 75.2 74.2 66.4 39.1 35.4 28.3 114.1 107.0 92.8 Note: Approximate calendar periods covered: 1987 NICPS (1977-1987), 1991 IDHS (1981-1991), 1994 IDHS ( 1984-1994) Outer Java-Bali I and II, while the 1991 IDHS rates are higher for infant and under-five mortality. The 1994 IDHS data indicate that infant and child mortality rates in Outer Java-Bali II are converging with the rates in other regions; the difference in infant mortality rates between Java-Bali and Outer Java-Bali t in the 1987 NICPS was 13 deaths per 1,000 live births, while the 1994 IDHS found the rates to be about the same for all three regions. 138 Despite the fact that mortality rates in West Java have declined in recent years, this province continues to have the highest mortality in Java (see Table 9.2). At the same time, DI Yogyakarta generally has the lowest mortality in the Java-Bali region. (Results from the 1980 and 1990 Population Censuses indicate the same pat- tern.) The infant mortality rate in DKI Jakarta has declined from 48 to 26 deaths per 1,000 live births, which is the same level found in DI Yogyakarta. Table 9.3 and Figure 9.3 show that the infant mortality rates in Outer Java-Bali I and Outer Java-Bali II and in all the provinces in Java-Bali have declined in the past fifteen years, although at varying rates. In West Java, the rate was stable, then declined rapidly in recent years. The pattern is consistent with findings from the Table 9.3 Infant mortality for five-year periods by region Infant mortality rates for three five-years period preceding the survey by region, Indonesia 1994 Years preceding survey Region and province 0-4 5 -9 I 0-14 Java-Bal l 53.7 78.0 73.8 DK1 Jakarta 26.3 32.9 47.6 West Java 78.7 98.0 97.0 Central Java 33.0 67.6 55.7 DI Yogyakarta 25.5 34.5 46. ! East Java 47.7 75.0 69.7 Bali 49.1 66.1 71.6 Outer Java-Ball I 60.6 72.5 80.5 Outer Java-Bali I1 63.0 67.3 70.5 Note: Approximate calendar periods covered: 0-4 years (mid- 1989 to mid-1994), 5-9 years (mid-1984 to mid-1989), and 10- 14 years (mid-1979 to mid-1984). population censuses; the infant mortality rate in West Java may have increased in the mid-1980s, and then declined. On the other hand, the patterns of infant mortality rates in Central Java and East Java in the past 15 years are not stable; they seem to fluctuate, with higher rates for the period 5-9 years prior the survey. Figure 9.3 Infant Mortality Rates by Province Java-Bali 1979-1994 Deaths par 1,000 Births 120 t00 80 60 40 20 0 97 98 75 72 DKI Jakarta West Central DI Yogyakarta East Bali Java Java Java 1994 IDHS 139 9.4 Morta l i ty Dif ferentials A number of socioeconomic, environmental and biological factors influence infant and child mortality. Mosley and Chen's (1984) framework for the study of child mortality in developing countries outlines various proximate and socioeconomic determinants of infant mortality. In the following section, infant and child mortality differentials are discussed according to biodemographic and socioeconomic variables that were included in the 1994 IDHS. Several variables, namely age of the mother, parity, and birth interval, were used as the biodemographic determinants. The socioeconomic determinants, which operate through the biodemographic determinants to influence infant mortality, include place of residence and mother's educational attainment. Additionally, several variables related to health, such as the type of birth attendant and birth weight, as well as variation among provinces are discussed. Table 9.4 presents mortality rates by socioeconomic characteristics of the mother for the ten-year period preceding the survey, i.e., from 1984 to 1994. Children born to women living in urban areas have lower mortality rates than those born to women in rural areas. The same pattern was found in the 1987 NICPS and 1991 IDHS, for all ages at death, and in all regions. The lower mortality rates in the urban areas may be related to the greater availability of health facilities. Table 9.4 Infant and child mortality by background characteristics Infant and child mortality rates for the ten-year period preceding the survey, by selected socioeconomic characteristics, Indonesia 1994 Neonatal Postneonatal Infant Child Under-five Background mortality mortality mortality mortality mortality characteristic (NN) (PNN) (1%) (4ql) (sq0) Resldenee Urban 22.9 20.1 43.1 16.2 58.5 Rural 36.0 39. l 75.2 33.0 105.7 Region/Residence Java-Bali 32.5 33.9 66.5 25.3 90.1 Urban 20.4 22.0 42.4 16.5 58.2 Rural 38.6 39.9 78.5 29.9 106.0 Outer Java-Bali I 32.6 34.2 66.8 32.4 97.0 Urban 29.7 15.7 45.4 17.3 61.9 Rural 33.3 38.5 71.8 36.1 105.3 Outer Java-Bali 11 31.8 33.5 65.3 31.8 95.0 Urban 26.5 16.0 42.5 10.8 52.8 Rural 33.1 37.8 70.9 37.0 105.3 Education No education 38.4 52.2 90.5 44.8 131.2 Some primary 37.6 41.5 79.2 34.3 110.8 Completed primary 29.0 30.2 59.2 22.3 80.2 Some secondary+ 25.2 14.4 39.5 I 1.6 50.7 Medical/maternity care t No antenatal or delivery care 52.4 54.6 107.0 53.5 154.8 Either antenatal or delivery care 25.8 26.0 51.8 22.7 73.3 Both antenatal and delivery care 26.0 12.9 39.0 10.4 49.0 Total 32.5 34.0 66.4 28.3 92.8 Note: The approximate calendar period covered is mid-1984 to mid-1994. i Rates are for the five-year period preceding the survey. 140 Mother's level of education is closely associated with socioeconomic factors such as income, life style, health practices, nutrition, and housing and living conditions. Women who have limited education usually have low income and live in less sanitary housing conditions; thus, their children usually have a higher risk of morbidity and mortality. The 1994 IDHS data show that mother's educational attainment is inversely associated with childhood mortality levels; children of less educated mothers generally have higher mortality than those born to better educated mothers. Table 9.4 also shows the relationship of infant and child mortality to antenatal care and delivery assistance. Mortality among children whose mothers had neither antenatal care nor medical assistance at the time of delivery is noticeably highest, followed by that for children with either antenatal care or delivery assistance by a medical professional. As expected, childhood mortality is lowest for children of mothers who received antenatal care and were assisted by a medical professional at delivery. The same pattern was found in the 1991 IDHS. The relationship between infant and child mortality rates for the ten-year period prior to the survey (1984 to 1994) and various biodemographic variables can be seen in Table 9.5. Mortality rates for males in Indonesia are higher than for females. Infant and under-five mortality rates for males are about 20 percent higher than those for females, postneonatal and childhood mortality rates are about 10 percent higher, and neonatal mortality is 45 percent higher. Sex differentials in childhood mortality were also observed in the 1987 NICPS and the 1991 IDHS. Table 9.5 Infant and child mortality by biodemographic characteristics Infant and child mortality rates for the ten-year period preceding the survey, by selected biodemographic characteristics, Indonesia 1994 Neonatal Posmeonatal Infant Child Under-five Biodemographic mortality mortality mortality mortality mortality characteristic (NN) (PNN) (1%) (4ql) (5%) Sex of child Male 38.2 35.4 73.5 29.9 101.2 Female 26.3 32.4 58.8 26.5 83.8 Age of mother at birth t < 20 44.4 42.3 86.8 29.8 114.0 20-29 28.4 31.8 60.2 27.3 85.8 30-39 33.4 33.9 67.2 29.9 95. I 40-49 42.1 30.3 72.4 25.9 96.4 Birth order 1 29.9 29.8 59.7 21.8 80.2 2-3 29.9 29.8 59.7 23.7 81.9 4-6 34.1 38.6 72.7 33.4 103.7 7+ 46.9 52.1 98.9 54.1 147.6 Previous birth interval < 2 yrs 57.2 60.4 117.7 46.2 158.4 2-3 yrs 27.8 35.3 63.1 31.9 93.0 4 yrs + 24.2 18.4 42.6 15.6 57.5 Size at birth 1 Very small (238.9) 18.7 257.6 (67.8) 308.0 Small 50.7 42.8 93.5 31.0 121.6 Average or larger 22.4 22.4 44.8 21.3 65.1 Don't know 84.3 75.4 159.6 57.2 207.7 Note: The approximate calendar period covered is mid-1984 to mid-1994. Figures in ~arentheses are based on 250-499 births. Rates are for the five-year period preceding the survey. 141 Mother' s age at birth can affect a child' s chances of survival. As in the 1987 NICPS and 1991 IDHS, the 1994 IDHS results indicate that childhood mortality rates follow a U-shaped pattern according to mother' s age. Rates are high among children whose mothers are younger than 20 years at the time of delivery., lower for mothers who are age 20-29 at the child's birth, and increase again among mothers age 30 years or older. These data support the family planning program's efforts to encourage women to have children when they are in their 20s. Table 9.5 also shows that birth order affects a child's chances of survival. It is often hypothesized that first births and higher order births have higher mortality risks. However, the data in Table 9.5 indicate that mortality rates for first births are no higher than those for second and third births. Data from the 1994 IDHS show that mortality risk for fourth or higher births increases considerably. For example, the under-five mortality rate is 80 per 1,000 live births for first births, more than 100 per 1,000 for birth orders 4 to 6, and close to 150 per 1,000 for seventh and higher births. As expected, there is an inverse relationship between mortality rates and the interval since the previous birth; childhood mortality rates decline as the birth interval increases. Mortality rates for children born less than two years after a previous birth are almost three times those for children born after an interval of four or more years. Except for postneonatal mortality, the probability of dying for infants who were judged by their mothers to be very small at birth is higher than for infants described as average or larger at birth (see Table 9.5). The period after birth is critical, especially for babies reported to be very small. The probability of dying during the month after birth for this group is 10 times higher than for infants reported to be of average size or larger than average at birth. However, it should be noted that the information on infant size at birth presented here is subjective (because it is based on the judgment of mothers), and is not comparable with actual birth weight. In a country as large and geographically dispersed as Indonesia, considerable variation in mortality among regions and provinces is not surprising. Table 9.6 shows patterns of provincial mortality in the 1994 IDHS that are similar to those found in the 1990 Population Census. The lowest infant mortality rates in the country are found in DKI Jakarta and DI Yogyakarta (30 deaths per 1,000 live births), 2 and the highest are in West Nusa Tenggara (110 per 1,000). Another province that has relatively tow infant mortality is Lampung (38 deaths per 1,000 live births), while West Java, West Kalimantan, South Kalimantan, and Central Sulawesi have relatively high levels of infant mortality, above 80 deaths per 1,000 live births. In Java-Bali, West Java is the only province that has infant and child mortality rates higher than those for Indonesia as a whole. The variation in infant and child mortality among the provinces in the Outer Java- Bali regions is greater than among the provinces in Java-Bali. Since infant and child mortality rates in the two regions outside Java-Bali cannot be presented by province from the 1991 IDHS data, the estimates from the 1994 IDHS are compared with those of the 1990 Population Census. The 1994 IDHS estimates of infant mortality are lower than the 1990 Population Census estimates for Lampung, and Central Kalimantan (not shown); estimates based on the 1994 IDHS are higher than those from the 1990 Population Census lor West Kalimantan, Riau, and Bengkulu. 2 Central Kalimantan has an exceptionally low rate of 16 per 1,000, which should be used with caution. 142 Table 9.6 Infant and child mortality by region and province Infant and child mortality rates for the ten-year period preceding the survey, by region and province, Indonesia 1994 Neonatal Posmeonatal Infant Child Under-five Region and mortality mortality mortality mortality mortality province (NN) (PNN) (lqo) (4ql) (sq0) Java-Bali 32.5 33.9 66.5 25.3 90.1 DKI Jakarta 16.0 13.8 29.8 21.1 50.3 West Java 43.6 45.3 88.8 33.8 119.6 Central Java 24.0 27.1 51.1 25.0 74.8 D1 Yogyakarta * 15.8 30.4 4.9 35. I East Java 31.4 30.7 62.1 17.8 78.8 Bali * 34.6 58.0 5.2 62.9 Outer Java-Bali I 32.6 34.2 66.8 32.4 97.0 Dista Aceh (32.8) 25.7 58.4 21.9 79.0 North Sumatra 37.9 23.5 61.4 37.8 96.9 West Sumatra (27.5) 40.0 67,6 32.5 97.9 South Sumatra 25.8 33.8 59.6 34.5 92.0 Lampung 13.3 24.8 38. I 20.2 57.6 West Nusa Tenggara (46.0) 63.8 109.8 55.9 159.5 West Kalimantan (42.9) 53.9 96.8 42.3 135.0 South Kalimantan * 41.4 82.9 30.6 1 I 1.0 North Sulawesi * 45.0 65.6 18.3 82.7 South Sulawesi 34. I 29.5 63.7 23.6 85.8 Outer Java-Bali I1 31.8 33.5 65.3 31.8 95.0 Riau (44.2) 27.6 71.7 24. I 94.1 Iambi * 25.2 60.2 29.0 87.5 Bengkulu * (36.2) 74.1 54.2 124.2 East Nusa Tenggara (30.0) 40.6 70.6 39.7 107.5 East Timor * (30.3) (45.8) (58.8) 101.9 Central Kalimantan * (9.4) 16,4 21.7 37.8 East Kalimantan * 31.9 6 I. 1 16.2 76.4 Central Sulawesi * (53.3) 87.4 42.9 126.5 Southeast Sulawesi * (38.5) 78.9 27.8 104.5 Maluku * 41.8 68.0 24.5 90.8 lrian Jaya * (33.0) 61.3 28.6 88. I Total 32.5 34.0 66.4 28.3 92.8 Note: The approximate calendar period covered is mid-1984 to mid-1994. Figures in parentheses are based on 250-499 births. An asterisk indicates that a figure is based on fewer than 250 births and has been suppressed. 9.5 High-risk Fertility Behavior Table 9.7 presents the distribution of women and children according to fertility behavior characteristics that place children at an elevated risk of dying. Children at elevated risk include those whose mothers are too young or too old when they give birth, those of high birth order, and those born after short birth intervals. Assumptions about these risks are that the physiological condition of young women ( 18 years or younger) is not sufficiently mature for healthy reproduction, which leads to greater risk of neonatal death. On the other hand, women age 35 years or older may be physically debilitated as a result of having many children, which may adversely affect the baby's health. Short birth intervals can affect the health of both mother and child, and reduce the baby's chances of survival. Table 9.7 also shows the relative risk of dying for children born in the five years preceding the survey by comparing the proportion dead in each high-risk category to the proportion dead among children who are not in any high-risk category. Table 9.7 shows that 45 percent of children born in the five years preceding the survey have an elevated risk of dying; 30 percent are in a single high-risk category, while 15 percent are in a multiple high- risk category. Among children in single high-risk categories, 17 percent are fourth births or higher, 6 percent 143 Table 9.7 High-risk fertility behavior Percent distribution of children born in the five years preceding the survey by category of elevated risk of mortality, and the percent distribution of currently married women at risk of conceiving a child with an elevated risk of mortality, by category of increased risk, Indonesia 1994 Births in 5 years preceding the survey Percentage of currently Risk Percentage Risk married category of births ratio women a Not in any high-risk category 55.1 1.00 33.6 b Single high-risk category Mother's age < 18 4.9 1.77 0.7 Mother's age > 34 1.8 1.39 8.9 Birth interval < 24 months 6.3 1.80 8.0 Birth order > 3 17.4 1.36 12.8 Subtotal 30.4 1,52 30.5 Multiple high-risk category Age <18 & birth interval <24 mo c 0.4 4.34 0.2 Age >34 & birth interval <24 mo 0.2 3.47 0.1 Age >34 & birth order >3 8.9 1.40 28.3 Age >34 & birth interval <24 & birth order >3 1.2 3.01 2.6 Birth interval <24 & birth order >3 3.8 2.73 4.7 Subtotal 14.5 1.99 35,9 In any high-risk category 44.9 1.67 66.4 Total 100.0 1 (30.0 Number of births 16,804 26,186 Note: Risk ratio is the ratio of the proportion dead of births in a specific high- risk category to the proportion dead of births not in an), high-risk category. a Women were assigned to risk categories according to the status they would have at the birth of a child, if the child were conceived at the time of the survey: age less than 17 years and 3 months, age older than 34 years and 2 months, latest birth less than 15 months ago, and latest birth of order 4 or ~igher. Includes sterilized women c Includes the combined categories Age < 18 and birth order >3. are children born less than two years after a prior birth, and 5 percent are children born to mothers younger than 18 years. Among children in multiple high-risk categories, 9 percent were born to mothers 35 or older and are of birth order 4 or higher. The second column in Table 9.7 presents risk ratios for children in various risk categories. Children in the single high-risk categories have a 1.5 greater risk of dying prematurely than children who are not in any high-risk category, and children in multiple high-risk categories have twice the risk of dying as those who are not in any high-risk category. The highest mortality risks are found in the combination of short birth interval and early childbearing (risk ratio of 4.3) as well as the combination of short birth interval and late childbearing (risk ratio of 3.5). The third column in Table 9.7 shows that two in three currently married women are at risk of conceiving a child with an elevated risk of dying. Three in ten women are at risk due to a single risk, while 36 percent are at risk due to multiple risk factors. The most likely risks are due to high birth order (13 percent), giving birth at age 35 years or older (9 percent), and short birth intervals (8 percent). The table also indicates that high birth order combined with late childbearing accounts for 28 percent of currently married women being in the multiple high-risk category. 144 CHAPTER10 MATERNAL AND CHILD HEALTH This chapter presents findings on three issues relevant to maternal and child health--antenatal care and delivery assistance, immunization, and childhood morbidity. The information is important because it provides baseline data for maternal and child health programs, the main objective of which is to reduce the infant mortality rate. In line with the program, the Indonesian Government has improved health care services by providing health centers in every subdistrict (kecamatan), with emphasis on maternal and child health services. To make the health care facilities more accessible, ambulatory health services, auxiliary health centers (puskesmas pembantu), and health posts (posyandu) have been established. By the end of the fifth Five-Year Development Plan (1989-90 to 1993-94), village delivery posts will have been established to provide antenatal care and delivery assistance by trained traditional birth attendants under the supervision of a midwife. I0.I Antenatal Care Table 10.1.1 shows the percent distribution of live births in the five years preceding the survey by selected background characteristics. The Government of Indonesia defines antenatal care as pregnancy- related health care provided by a medical professional (doctor, nurse, or midwife). Excluded are traditional birth attendants, friends, etc. Although women reported all sources from whom they obtained antenatal care, in this report, the evaluation of medical care for early detection of high-risk pregnancies is based on the most qualified provider. The location for antenatal care recorded in the survey is the most frequently visited service in the last 3-month period. Among the 28,168 ever-married women age 15-49 interviewed in the survey, 13,393 were mothers who gave birth to a total of 16,983 live births in the five years preceding the survey. Eighty-two percent of these births were to mothers who received antenatal care from a medical professional--about 72 percent were cared for by a nurse/midwife or an auxiliary nurse/midwife. Antenatal care coverage is slightly lower among births to mothers age 35 and older. Low birth-order births and births to mothers living in urban areas and in Java-Bali are more likely to have received antenatal care from medical personnel than other births. Overall, women in Java-Bali are also more likely to have had care from a medical professional than women in other regions. There is a strong relationship between mother's education and antenatal care. More than 40 percent of births to mothers with no education did not receive antenatal care from medical personnel, compared with only 4 percent of children whose mothers had some secondary education. The corresponding proportions for children whose mothers had some primary education and who have completed primary school are 25 percent and 13 percent, respectively. Doctors are the most common antenatal care providers among women 25-34, mothers with first to third births, respondents who live in urban areas, and those with some secondary education. On the other hand, higher-order births and rural births are more likely not to receive antenatal care. Although there is little variation in antenatal care coverage by health professionals between regions, there are sharp differentials between urban and rural areas within regions. 145 Table 10.1.1 Antenatal care: background characteristics Percent distribution of live births in the five years preceding the survey by source of antenatal care (ANC) during pregnancy, according to selected background characteristics, Indonesia 1994 Source of antenatal care I Tradi- Auxiliary tional Number Background Nurse/ nurse/ birth of characteristic Doctor Midwife Midwife attendant Other No one Total births Mother's age at birth < 20 6.8 66.8 7.8 5.7 0.7 12.2 100.0 2,374 20-24 9.7 68.9 6.8 3.3 0.5 10.8 100,0 4,855 25-29 13.5 64.2 5.5 36 0.8 12.4 100.0 4,645 30-34 11.2 63.2 6.5 4.4 1.1 13.6 100.0 3,057 35+ 9.7 60.7 5.6 6.0 1.1 17.0 100.0 2,052 Birth order 1 13.3 68.9 6.2 29 0.6 8.2 100.0 4,930 2-3 11.4 67.3 6.4 33 0.7 11.0 100.0 6,726 4-6 7.9 61.4 6,6 56 1.2 17.2 100.0 3,861 7+ 4.7 54.3 6.7 95 1.0 23.8 100.0 1,466 Residence Urban 22.5 68.3 4.6 09 0.3 3.4 100.0 4.646 Rural 6.1 64.2 7.1 5~5 1.0 16.2 100.0 12,337 Region/Residence Java-Bali 11.0 70.3 5.0 3.1 0.6 10.0 100.0 9,678 Urban 21.9 69.5 4.6 0.9 0.2 3,0 100.0 3,184 Rural 5.6 70.8 5.3 4 1 0.8 13.4 100.0 6,494 Outer Java-Bali l 10.1 60.9 8.4 5.5 1.0 14.] 100.0 5,073 Urban 23.6 66.2 5. I 0.9 0.4 3.8 100.0 995 Rural 6.8 59.6 9.2 6 6 1.2 16.6 100.0 4,077 Outer Java-Bali 11 10.1 53.6 7.7 6A 1.0 21.1 100.0 2,233 Urban I 24.4 64.9 3,5 1 4 0.6 5.2 100.0 467 Rural 6.3 50.6 8.8 7 7 1 1 25.4 100.0 1,766 Mother's education No education 2.4 48.5 5.8 8 1 1.6 33.6 100.0 2,012 Some primary 5.2 63.4 6.9 6,4 1.0 17.1 100.0 5,246 Completed primary 6.5 73.1 7.3 36 0.7 8.9 10t3.0 5,010 Some secondary+ 24A 66.3 5.1 0,9 0.4 2.9 100.0 4,715 Total 10,6 65.3 6.4 4,2 0,8 12.7 100.0 16,983 Note: Total includes births with missing information on ANC provider. i If the respondent mentioned more than one provider, only the most qualified was considered. Table 10.1.2 shows the provincial differentials in antenatal care coverage. Virtually all women in DKI Jakarta and DI Yogyakarta were examined during pregnancy. The level of antenatal coverage is also high (90 percent or higher) in Central Java, Bali, West Sumatra, and North Sulawesi. On the other hand, antenatal care is limited in East Timor (50 percent). The care giver also varies between provinces; doctors are popular in DKI Jakarta, North Sulawesi, and East Kalimantan, while traditional birth attendants are more common in South Kalimantan, Jambi, and Southeast Sulawesi. 146 Table 10.1.2 Antenatal care: region and province Percent distribution of live births in the five years preceding the survey by source of antenatal care (ANC) during pregnancy, according to region and province, Indonesia 1994 Source of antenatal care L Tradi- Auxiliary tional Number Region and Nurse/ nurse/ birth of province Doctor Midwife Midwife attendant Other No one Total births Java-Bali I 1.0 70.3 5.0 3.1 0.6 10.0 1130.0 9,678 DKI Jakarta 25.5 67.6 4.2 0.7 0.5 1.6 100.0 618 West Java 8.3 66.3 7.3 5.7 1.2 I 1.2 100.0 3,675 Central Java 8.9 75.2 6.1 0.9 0.5 8.4 100.0 2,599 DI Yogyakarta 18.3 70.3 9.4 0.0 0.0 1.9 100.0 182 East Java 13.2 71.1 0.3 2.6 0.0 12.8 100.0 2,393 Bali 9.6 78.6 3.4 0.5 0.4 7.4 100.0 210 Outer Java-Bali I 10.1 60.9 8.4 5.5 1.0 14.1 100.0 5,073 Dista Aceh 10.7 54.0 5.8 0.4 0.8 28.2 100.0 374 North Sumatra I 1.4 63.9 5.3 7.3 0.7 11.4 100.0 1,298 West Sumatra 15.8 70.6 4. I 5.7 0.3 3.4 100.0 366 South Sumatra 10.0 59.2 10.5 8.5 2.2 9.3 100.0 563 Lampung 2.9 60.4 18.3 7.5 1.7 9.2 100.0 563 West Nusa Tenggara 6.4 56.5 8.4 3.6 0.0 25.1 100.0 399 West Kalimantan 7.4 54.8 13.3 1.6 2.8 20.0 100.0 380 South Kalimantan 5.2 60.5 8.9 11.2 0.2 14.0 100,0 225 North Sulawesi 23.9 51.9 16.5 1.0 0.4 6.5 100.0 203 South Sulawesi I 1.2 64.1 2.8 3.5 0.7 17.7 100.0 701 Outer Java-Bali II 10.1 53.6 7.7 6.4 1.0 21.1 100.0 2,233 Riau 9.6 56.9 9.3 9.7 1.4 13.1 100.0 389 Jambi 8.9 49.8 I 1.3 15.4 0.9 13.6 100.0 207 Bengkulu 6.8 61.5 5.7 7.3 0.6 18.2 100.0 138 East Nusa Tenggara 4.5 59.7 4.9 1.7 1.1 28.2 100.0 361 East Timor 7.5 41.0 1.8 0.3 0.0 49.4 100.0 123 Central Kalimantan 6.5 42.0 20.5 4.3 0.4 26.2 100.0 126 East Kalimantan 24.3 52.3 6.0 4.1 2.2 I 1.1 100.0 215 Central SuLawesi 12.3 46.9 6.5 7.0 0.7 26.2 100.0 166 Southeast Sulawesi 13.7 60.6 4.4 14.2 I.l 5.9 10(3.0 149 Maluku 11.1 49.8 4.2 3.3 0.7 30.6 100.0 190 lrian Jaya 7.2 55.7 12.6 1.7 0.3 22.5 100.0 167 Total 10.6 65.3 6.4 4.2 0.8 12.7 100.0 16,983 Note: Includes births with missing information on ANC provider. J I1 the respondent mentioned more than one provider, only the most qualified was considered. 10.2 Number of Antenatal Care Visits and Stage of Pregnancy Table 10.2.1 indicates that public health centers are the facility most often used by women for ante- natal care (42 percent of births). Rural women are more likely to go to a health center for antenatal care than urban women (46 percent, compared with 32 percent). Twenty-eight percent of women use private medical services; of these, 18 percent go to a midwife. Since not every village has a health post or a delivery post, the antenatal care 147 Table 10.2.1 Place of antenatal care: background characteristics Percent distribution of live births in the five years preceding the survey by place of antenatal care (ANC) during pregnancy, according to selected background characteristics, Indonesia 1994 Place of antenatal care Government PriwUe Deliv- Family Number Background Hos- Health ery Health Hos- planning Mid- TBA No of characteristic pital center post post pital clinic Doctor wife visit Other one Missing Total births Mother's age at birth < 20 3.4 46.3 0.5 10.7 0.9 2.8 2.1 15.0 4.6 1.5 12.2 0.1 100.0 2,374 20-24 4.0 44.0 0.3 7.7 2.0 4.3 3.3 19.7 2.6 0.9 10.8 0.4 100.0 4,855 25-29 5.2 39.5 0.5 6.0 3.8 5.0 5.4 17.9 3.3 0.8 12.4 0.2 100.0 4,645 30-34 4.7 41.8 0.3 6.9 3.3 4.1 3.5 16.7 3.9 0.9 13.6 0.4 100.0 3,057 35+ 4.1 38.6 0.1 6.4 1.9 2.5 3.2 18.9 5.6 1.2 17.0 0.4 100.0 2,052 Birth order 1 4.8 45.2 0.4 7.4 3.4 4.7 4.5 18.0 2.4 0.7 8.2 0.2 100.0 4,930 2-3 4.3 42.7 0.4 7.6 2.9 4.5 4.7 18.3 2.7 0.8 I 1.0 0.3 100.0 6,726 4-6 4.3 40.3 0.2 7.6 1.7 3.2 2.1 16.6 5.0 1.4 17.2 0.3 100.0 3,861 7+ 3.7 33.3 0.1 5.1 0,7 1.7 1.2 19.6 8.8 1.8 23.8 0.2 100.0 1,466 Residence Urban 7.9 32.4 0.2 2.3 7.9 8.1 8.7 27.8 0.9 0.2 3.4 0.2 Ill0.0 4,646 Rural 3.1 45.7 0.4 9.3 0.6 2.5 1.9 14.2 4.7 1.3 16.2 0.3 100.0 12,337 Region/Residence Java-Bali 3.2 44.2 0.5 6.6 2.7 3.7 4.4 21.1 2.5 0.9 IO.I) 0.3 100,(l 9,678 Urban 6.0 32.4 0.3 2.0 7.8 7.1 8.7 31,7 0.9 O.l 3.0 0.1 I00.O 3,184 Rural 1.8 50.0 0.6 8.8 0.2 2.0 2.3 15.9 3.3 1.4 13.4 0.3 IO0.O 6,494 Outer Java-Bali 1 6.0 38.9 0.2 7.0 2.2 5.6 3.0 16.7 5,0 0.9 14.1 0.3 100.0 5.073 Urban 11,5 30.3 0.0 2.0 7.3 13.1 9.4 21.2 0,7 0.4 3.8 0.3 100.0 995 Rural 4.7 41.0 0.2 8.2 1.0 3.8 1.4 15.6 6.1 1.0 16.6 0.4 100.0 4,077 Outer Java-Bali II 5.8 39.6 0.1 11.5 3.0 2.0 2.5 7.1 5.4 1.6 21.1 0.3 100.0 2,233 Urban 13.3 36.6 0.1 5.1 10.0 4,5 7.9 15.6 I.I 0.4 5.2 0.3 100.0 467 Rural 3.8 40,4 0.2 13.2 1.1 1.4 1.1 4.8 6.5 1.9 25.4 0.3 100.0 1,766 Mother's education No education 1.8 36.0 0.0 8.5 0.2 0.7 0.5 9.3 7.4 1.5 33.6 0.6 100.0 2,012 Some primary 3.3 42.3 0.6 9.5 0.6 2.5 1.1 15.5 5.6 1.6 17.1 0.3 100.0 5,246 Cornpleted primary 3.1 48.3 0.5 8.5 1.2 3.3 2.3 20.1 2.7 0.9 8.9 0.2 lqX).0 5,010 Some secondary+ 8.0 37.7 0.1 3.3 7.2 8.0 9.6 21.9 0.8 0.3 2.9 0.2 ll)O.0 4,715 Total 4.4 42.0 0,3 7.4 2.6 4.0 3.7 17.9 3.6 1.0 12.7 0.3 100.0 16,983 TBA = Traditional birth attendant received in these facilities is limited (7 percent and less than 1 percent, respectively). In urban areas, more than half of mothers seek private services for antenatal care, compared with 19 percent in the rural areas. Obtaining antenatal care through private facilities is more common among better educated wornen~7 percent of mothers with some secondary education, compared with 11 percent of women with no education. Table 10.2.2 shows provincial variations in place of antenatal care. In most provinces, public health centers are the most common source of antenatal care; however, in DKI Jakarta and Noah Sumatra, private midwives are the main source. Government hospitals are particularly popular in North Sulawesi (17 percent) and in Central Sulawesi, South Sulawesi, and East Timor (10 percent or higher). 148 Table 10.2.2 Place of antenatal care: region and province Percent distribution of live births in the five years preceding the survey by place of antenatal care (ANC) during pregnancy, according to region and province, Indonesia 1994 Place of antenatal care Government Private Deliv- Family Number Region and Hos- Health ery Health Hos- planning Mid- TBA No of province pitaI center post post pital clinic Doctor wife visit Other one Missing Total births Java-Bali 3.2 44.2 0.5 6.6 2.7 3.7 4.4 21.1 2.5 0.9 10.0 0.3 100.0 9,678 DKI Jakarta 7.1 24.0 0.0 0,1 12.0 6.5 8.2 39.7 0.9 0.0 1.6 0.0 100.0 618 West Java 4.2 34.3 0.0 9.3 1.8 3.6 3.4 25.8 4.2 2.0 11.2 0.3 100.0 3,675 Central Java 1.3 56.7 1.2 5,3 1.3 2.4 5.1 16.8 0,9 0.1 8.4 0.5 100.0 2,599 DI Yogyakarta 7.5 59.0 0.0 2.7 3.3 3.4 7.3 14.9 0.0 0.0 1.9 0.0 100.0 182 East Java 2.4 50.3 0.6 6.2 3.2 4.7 3.9 12.7 2.5 0.6 12.8 0.0 100.0 2,393 Bali 2.5 41.6 0.0 1.5 1.1 1.0 5.7 37.9 0,3 0.6 7.4 0.1 100.0 210 Outer Java-Bali I 6.0 38.9 0.2 7.0 2.2 5.6 3.0 16.7 5.0 0.9 14.1 0.3 100.0 5,073 Dista Aceh 2.7 35.0 0.0 3,9 1.8 7.3 3.5 16.1 0.4 0.7 28.2 0.4 100.0 374 North Sumatra 6.2 24.4 0.2 4.1 1.2 12.2 3.6 27.9 6.8 1.5 11.4 0.4 100.0 1,298 West Sumatra 6.3 39.8 0.2 4.5 3.6 2.7 5.1 27.2 6.5 0.5 3.4 0.3 100.0 366 South Sumatra 6,3 39.3 0,0 8.0 1.1 4.9 3,7 17.8 8.3 0.9 9.3 0.4 100.0 563 Lampung 1.3 47.0 0.0 9.8 0.8 4.2 0.9 19.6 6.6 0.5 9.2 0.0 100.0 563 West Nusa Tenggara 1.4 44.8 0.5 19.2 0.8 0.9 1.1 1.3 3.5 1.2 25.1 0.2 10O.0 399 West Kalimantan 4.4 52.5 0.0 8.1 3.2 3.4 1.9 4.3 1.2 0.7 20.0 0.4 100.0 380 South Kalimantan 3.7 45.2 0,0 5,4 0.9 3.3 3,1 14.9 7.8 1.7 14.0 0.0 100.0 225 North Sulawesi 17.3 50.2 0.8 9.9 3.7 1.7 5.2 4.2 0.2 0.0 6.5 0.4 100.0 203 South Sulawesi 12.1 44.9 0.1 4.6 5.7 1.4 2.6 7.0 3.0 0.1 17.7 0.7 100.0 701 Outer Java-Bali II 5.8 39.6 0.1 11.5 3.0 2.0 2.5 7.1 5.4 1.6 21.1 0.3 11210.0 2,233 Riau 5.6 38.9 0.0 6.2 2.9 2.4 3.7 17.8 8.5 0.6 13.1 0.2 100.0 389 Jambi 6.3 39.4 0.0 4.2 1.8 4.0 2.3 12.2 14.8 1.0 13.6 0.2 100.0 207 Bengkulu 3.4 29.3 0.2 18.0 0.2 1.3 2.2 18.9 6.7 1.7 18.2 0.1 1130.0 138 East Nusa Tenggara 3.8 33.6 0.2 22.1 3.1 4,0 0.8 0.6 1.6 1.8 28.2 0.2 100.0 361 East Timor 11.1 29.4 0.6 4.7 0,5 1,6 0.3 0.5 0.3 1.1 49.4 0.4 100.0 123 Central Kalimantan 0.7 59.4 0.0 1.9 1.6 0.5 0.0 3.8 3.9 0.7 26.2 1.3 100.0 126 East Kalimantan 4.5 47.6 0.0 9.7 8,4 2.6 7.0 4.8 3.7 0.5 11.1 0.2 10t3.0 215 Central Sulawesi 10.2 42.0 0.0 8.0 0.8 0.4 1.3 2.8 3.7 3.4 26,2 1,1 100.0 166 Southeast Sulawesi 5.7 49.4 0.0 18.3 0.5 0.0 2.6 2.7 9.3 5.7 5.9 0.0 100.0 149 Maluku 7.1 33.1 0.0 8.4 7.8 0.0 2.8 5.1 3.1 1.7 30.6 0.2 100.0 190 lrian Jaya 7.5 41.3 1.0 20.6 1.0 1.4 2.3 0.4 0.9 0.9 22.5 0.2 100.0 167 Total 4.4 42.0 0.3 7.4 2.6 4.0 3.7 17.9 3.6 1.0 12.7 TBA = Traditional birth attendant 0.3 100.0 16,983 149 The Indonesian maternal health program recommends that pregnant women have at least four antenatal care visits during pregnancy, according to the following schedule: one visit in the first trimester, one visit in the second trimester, and two visits in the third trimester. Table 10.3 shows that the median number of antenatal care visits was 6.2, well above the recommended number. Sixty-three percent of births were to mothers who had four or more antenatal care visits (see Figure 10.1). Figure 10.1 Number of Antenatal Care Visits and Stage of Pregnancy at First Visit for Births in the Five Years Preceding the Survey 1 Visit 4% 2-3 Visit 4 No Visit 13% 4+ Visit 64% Number of Antenatal Care Visits 0-2 Months 32% No Antenatal ~ Care 13% 6+ Months 11% 3-5 Months 44% Stage of Pregnancy at First Visit 1994 IDHS In addition to the 13 percent of births to mothers had no antenatal care, 75 percent were to mothers who had their first antenatal care in the first or second trimester, and 12 percent were to mothers who had their first antenatal visit in the third trimester. The median number of months at the first antenatal visit is 3.5, which means that 50 percent of pregnant women had their first antenatal care earlier than 3.5 months of pregnancy. Column 2 in Table 10.3 gives the same information for women who obtained their antenatal care from a medical professional (doctor, nurse, or midwife). 150 Table 10.3 Number of antenatal care visits and stage of pregnancy Percent distribution of live births in the five years preced- ing the survey by number of antenatal care (ANC) visits, and by the stage of pregnancy at the time of the first visit, according to type of antenatal care, Indonesia 1994 Any ante- Any natal care Antenatal care antenatal from a medical indicator care professional 1 Number of ANC visits 0 12.7 17.7 1 4.3 3.7 2-3 19.2 17.0 4-6 26.6 25.2 7-9 21.0 20.6 10+ 15.5 15.4 Don't know/missing 0.8 0.4 Total 100.0 100.0 Median 6.2 6,1 Number of months pregnant at time of first ANC visit No antenatal care 12.7 17.7 0-2 months 31.8 30.9 3-5 months 43.5 40.8 6+ months 11.5 10.3 Don't know/missing 0.5 0.2 Total 100.0 100.0 Median 3.5 3.4 Number of births 16,983 16,983 i Medical professional includes doctor, nurse, and midwife. 10.3 Tetanus Toxoid Vaccination Immunization of pregnant women is a coordinated activity of the Expanded Program on Immuniza- tion (EPI) and the maternal and child health care (MCH) units of the Ministry of Health, which recommends that women receive two tetanus toxoid injections during the first pregnancy. Booster injections are given once during each subsequent pregnancy to maintain full protection. In recent years, tetanus toxoid immuniza- tion was also given to women before marriage, so that any pregnancy occurring within three years of the wed- ding would be protected against tetanus. Antenatal cards, on which tetanus toxoid immunizations are re- corded, are distributed to every pregnant woman. Of 16,983 live births in the five years preceding the survey, 43 percent were to mothers who received antenatal cards (KMS) (see Table 10.4.1). Antenatal card coverage is higher in urban areas than in rural areas (57 percent, compared with 38 percent). Women in Java-Bali are more likely to have an antenatal card than women in the Outer Islands (49 percent, compared with 35 percent or less). The percentage of mothers with antenatal cards is higher among those with higher education. 151 Table 10.4.1 Tetanus toxoid vaccinations: background characteristics Percent distribution of live births in the five years preceding the survey by number of tetanus toxoid injections received by mothers during pregnancy, according to background characteristics, Indonesia 1994 Number of tetanus toxoid injections Percent Two Number with Background One doses Don't know/ of antenatal characteristic None dose or more Missing Total births card Mother's age at birth < 20 32.1 17.3 50.3 0.3 100.0 2,374 45.9 20-24 29.3 16.2 52.9 1.6 100.0 4,855 46.7 25-29 33.0 16.5 49.2 1.2 100.0 4,645 42.8 30-34 34.6 16.6 47.4 1.3 100.0 3,057 42.6 35+ 43.9 16.0 38.5 1.6 100.0 2,052 33.4 Birth order 1 25.3 17.4 55.8 1.5 100.0 4,930 49.8 2-3 30.3 16.9 51.6 1.3 100.0 6,726 47.1 4-6 41.0 15.3 42.7 1.0 100.0 3,861 35.3 7+ 55.2 15.0 28.7 I.I 100.0 1,466 23.7 Residence Urban 20.9 19.1 58.4 1.7 100.0 4,646 56.9 Rural 38.2 15.5 45.2 I.I 100.0 12,337 38.0 Region/Residence Java-Bali 26.8 17.2 55.0 1.1 100.0 9,678 49.2 Urban 17.9 19.2 61.5 1.4 100.0 3,184 61.2 Rural 31.2 16.2 51.8 0.9 100.0 6,494 43.4 Outer Java-Bali l 42.4 16.2 39.9 1.6 I00.0 5,073 35.4 Urban 29.4 18.9 49.2 2.5 100.0 995 46.4 Rural 45.5 15.5 37.6 1.3 100.0 4,077 32.7 Outer Java-Bali II 41.9 14.3 42.4 1.3 100.0 2,233 34.4 Urban 23.0 18.5 56.5 2.0 I00.0 467 49.7 Rural 46.9 13.2 38.7 I.I 100.0 1,766 30.4 Mother's education No education 58.6 14.4 25.4 1.7 100.0 2,012 21.7 Some primary 41.3 15.9 41.9 0.8 100.0 5,246 36.1 Completed primary 27.9 15.7 55.6 0.9 100.0 5,010 46.3 Some secondary+ 19.8 18.9 59.3 1.9 100.0 4,715 56.8 All births 33.4 16.5 48.8 1.3 100.0 16,983 43.2 Because less than half of mothers have antenatal cards, tetanus toxoid immunization coverage cannot be estimated from cards alone. Respondents' recall is used to supplement information on immunization status. As a result, the proportion of births that are fully protected against tetanus may be underestimated. In addition, some women may have received tetanus toxoid immunization before marriage or during a previous pregnancy, so they might not need another injection or a booster immunization. On the other hand, women may incorrectly report other types of injections as tetanus, which will overestimate the level of immunization coverage. It is difficult to evaluate the extent to which each of these biases exist in the DHS data. Therefore, the information on tetanus immunization should be regarded as an approximate indicator of the level of coverage. 152 Overall, 49 percent of births in the five years before the survey were to mothers who received two or more tetanus toxoid injections during the pregnancy, 17 percent were to mothers who received one injection, and 33 percent were to mothers who received no injection. The percentage of mothers with no tetanus toxoid injection tends to increase as the mother's age and the birth order increase (see Table 10.4.1). The percentage of unprotected births in rural areas is substantially higher than in urban areas and is higher in the Outer Java-Bali regions (42 percent) than in the Java-Bali region (27 percent). Fifty-nine percent of births to mothers without education never received a tetanus toxoid immunization, compared with 20 percent of births to mothers with some secondary education. In the five years preceding the survey, the proportion of births for which an antenatal card was presented varies significantly by province (see Table 10.4.2), from 17 percent in East Timor to 61 percent in Bali. Tetanus toxoid injection coverage also varies among provinces. While only 10 percent of births in DI Yogyakarta were to women who did not receive this injection, the proportion in Dista Aceh, West Nusa Tenggara, Riau, and East Timor is 50 percent or higher. Table 10.4.2 Tetanus toxoid vaccinations: region and province Percent distribution of live births in the five years preceding the survey by number of tetanus toxoid injections received by mothers during pregnancy, according to region and province, Indonesia 1994 Number of tetanus toxoid injections Percent Two Number with Region and One doses Don't know/ of antenatal province None dose or more Missing Total births card Java-Bali 26.8 17.2 55.0 1.1 100.0 9,678 49.2 DKI Jakarta 25.6 17.5 55.8 1.1 100.0 618 59.8 West Java 27.4 17.2 53.9 1.5 100.0 3,675 54.0 Central Java 20.2 16.1 63.0 0.7 100.0 2,599 42.1 DI Yogyakarta 10.0 21.6 66.8 1.6 100.0 182 48.0 East Java 35.8 17.4 46.0 0.8 100.0 2,393 46.0 Bali 13.1 23.4 63.2 0.3 100.0 210 60.7 Outer Java-Bali I 42.4 16.2 39.9 1.6 100.0 5,073 35.4 Dista Aceh 52.1 15.6 31.4 0.8 100.0 374 33.3 North Sumatra 49.9 14.8 33.3 2.1 100.0 1,298 22.6 West Sumatra 41.0 15.3 40.9 2.8 100.0 366 32.1 South Sumatra 41.4 16.5 40.2 1.9 100.0 563 35.9 Lampung 34.9 12.2 51.7 1.3 100.0 563 44.8 West Nusa Tenggara 50.8 12.8 35.5 1.0 100.0 399 41.6 West Kalimantan 41.1 13.9 44.3 0.7 100.0 380 39.1 South Kalimantan 38.9 14.4 44.3 2.4 100.0 225 27.1 North Sulawesi 16.6 22.3 59.1 2.0 100.0 203 59.5 South Sulawesi 35.2 24.5 39.7 0.7 100.0 701 44.0 Outer Java-Bali 1I 41.9 14.3 42.4 1.3 100.0 2,233 34.4 Riau 50.2 12.6 36.1 1.2 100.0 389 29.9 Jambi 48.4 10.8 40.1 0.7 1(30.0 207 32.1 Bengkulu 41.4 9.3 48.9 0.4 100.0 138 37.1 East Nusa Tenggara 39.3 16.4 44.1 0.3 100.0 361 35.3 East Timor 53.9 7.9 37.4 0.7 100.0 123 16.6 Central Kalimantan 36.4 16.2 45.2 2.3 100.0 126 24.3 East Kalimantan 26.4 18.8 52.8 2.1 100.0 215 46.3 Central Sulawesi 43.4 13.2 41.5 1.8 100.0 166 30.4 Southeast Sulawesi 31.4 12.3 56.2 0.1 100.0 149 47.6 Maluku 49.3 13.3 36.1 1.3 100.0 190 35.3 lrian Jaya 35.5 24.3 35.4 4.8 100.0 167 40.4 Total 33.4 16.5 48.8 1.3 100.0 16,983 43.2 153 Table 10.5 Iron tablets taken during pregnancy Percent distribution of women whose last birth occurred in the five years preceding the survey, by the number of iron tablets taken during the pregnancy, according to selected background characteristics, Indonesia 1994 Number of iron tablets taken during pregnancy Number Background Don't of characteristic 0 1-14 15-29 30-59 60-89 90+ know Total women Mother's age at birth < 20 28.5 11.7 11.9 20.0 9.4 12.5 6.0 100.0 1.822 20-24 22.6 12,9 11.6 20.8 10.6 14.9 6.5 100.0 3,687 25-29 24.0 12.3 10.3 20.4 9.1 16.9 7.1 100.0 3~641 30-34 27.4 11.6 12.9 19.7 8.6 13.7 6.1 100.0 2.466 35+ 35.6 10.4 10.4 17.6 8.1 11.3 6.7 100.0 1.777 Birth order 1 20.3 10.0 12.5 21.3 11.2 18.0 6.8 100.0 3,716 2-3 22.8 12.8 10.9 20.7 9.8 16.1 6.9 100.0 5,458 4-6 33.3 13.8 11.2 17.5 7.8 10.3 6.0 100.0 3,100 7+ 45.3 10.0 10.2 18.8 4.9 5.3 5.5 100.0 I,I 19 Residence Urban 13,5 9.2 9.7 20.7 12.7 25.0 9.2 100.0 3,767 Rural 31.4 13.1 12.0 19.7 8.0 10.3 5.5 100.0 9,626 Region/Residence Java-Bali 21.6 12.2 12.1 21.8 10.8 18.1 3.5 100.0 8,019 Urban 12.2 8.5 9.3 21.5 13.5 29.5 5.5 100.0 2,664 Rural 26.2 14.0 13.6 21.9 9.4 12.4 2.5 100.0 5,355 Outer Java-Bali I 32.6 12.9 10.5 17.5 6.8 7.9 11.8 100.0 3,743 Urban 16.6 12.3 11.0 18.6 10.4 I 1.9 19.2 100.0 750 Rural 36.6 13.1 10.3 17.3 5.9 6.8 9.9 100.0 2,992 Outer Java-Bali I1 36.0 8.9 9.6 16.7 7.9 I 1.3 9.5 100.0 1,632 Urban 16.8 7.7 9.7 19.5 12.1 18.7 15.5 100.0 353 Rural 41.3 9.3 9.6 16.0 6.8 9.2 7.9 100.0 1,278 Mother's education No education 52.7 10.8 11.1 12.4 4.6 5.5 3.0 100.0 1,518 Some primary 33.2 14.4 12.2 18.7 7.6 9.0 4.9 100.0 4,090 Completed primary 21.9 12.9 12.4 22.1 10.5 13.6 6.6 100.0 4,072 Some secondary+ 13.1 8.8 9.5 22.1 11.8 24.9 9.7 100.0 3,713 Number of months preg- nant at first ANC visit No antenatal care 93.1 2.4 0.9 1.7 0.3 0.4 1.3 100.0 2,078 0-2 10.0 10.3 9.8 21.4 13.5 26.5 8.5 100.0 4,229 3-5 14.5 14.3 14.6 26.4 10.7 12.6 6.9 100.0 5,688 6+ 25.2 22.5 18.7 16.7 4.6 5.6 6.8 100.0 1,383 Place of antenatal care Government hospital 14.1 15.2 9.1 18.5 11.2 20.8 11.1 100.0 584 Health center 14.1 14.4 14.3 26.2 10.3 14.4 6.4 100.0 5,850 Delivery post (16.3) (19.3) (28.3) (28.4) (2.3) (2.9) (2.5) (100.0) 42 Health post 18.9 18.5 15.2 18.6 7.8 14.9 6.1 100.0 991 Private hospital 10.2 7.5 8.0 17.7 7.0 43.2 6.4 100.0 339 Private FP clinic 7.0 10.4 10.9 24.2 12.8 21.9 12.8 100.0 533 Private doctor 12.4 10.3 7.6 13.7 14.4 30.5 I 1.0 100.0 510 Private midwife 14.5 12.1 12.9 22.6 13.5 15.9 8.5 100.0 2,473 TBA visit (94.5) (1.8) (I.3) (1.2) (0.3) (0.4) (0.5) (100.0) 420 Other 54.5 14.8 12.2 5.3 0.7 4.2 8.2 100.0 132 No one 97.1 1.3 0.3 0.5 0.1 0.0 0.6 100.0 1,492 Total 26.4 12.0 11.4 20.0 9.3 14.4 6.5 100.0 13,393 Note: Totals include women with missing information as to number of months pregnant at first ANC visit and place of antenatal care (ANC). Figures in parentheses are based on 25-49 unweighted cases. TBA = Traditional birth attendant 154 10.4 Iron Pills Anemia during pregnancy is still prevalent in Indonesia. Iron pills are distributed to pregnant women during their antenatal care visits. The maternal health program of the Indonesia Ministry of Health recommends that pregnant women take at least 90 iron pills during their pregnancy. In order to evaluate this program, in the 1994 IDHS, all women who gave birth during the five years before the survey were asked if they had received iron tablets during their most recent pregnancy, and if so, how many they had taken. Among 13,393 women whose last-born child was born in the five years before the survey, only 14 percent took at least 90 iron pills during pregnancy, and 26 percent took none (see Table 10.5). Mothers less than 20 years or 35 years and over, high parity women, and women whose level of education is low are more likely to have not taken any iron pills during pregnancy. Iron pills are better distributed in urban areas than in rural areas. In the Java-Bali region, 18 percent of last-born children were to mothers who had taken least 90 iron pills during pregnancy, while 22 percent were to mothers who did not take any pills. In the Outer Java-Bali regions, only 11 percent or less of pregnant women had taken 90 or more iron pills during pregnancy, and over 30 percent took none. Table 10.5 shows that over 90 percent of mothers who received no antenatal care or who received antenatal care from a traditional birth attendant took no iron pills during pregnancy. Among mothers who had their first antenatal care visit in the first trimester, only 10 percent did not take iron pills, compared with 25 percent among those who had their first antenatal care visit in the third trimester. The number of pills taken varies by place of antenatal care. Women who received antenatal care at a private hospital and from a private doctor were much more likely than other women to have taken 90 or more iron pills. 10.5 Place of Delivery Table 10.6.1 shows that a large proportion of births in Indonesia are delivered at either the mother' s home or another home (77 percent) and 5 percent are delivered at the midwife's home. Women less than 20 years are slightly more likely to deliver at home than older women (86 percent, compared with 80 percent). Seventy percent of first births are delivered at home, compared with over 80 percent of fourth or higher births. This implies that a relatively large proportion of high-risk births are delivered at home. Births in rural areas are twice as likely to be delivered at home as those in urban areas (90 percent, compared with 43 percent). There is a slightly higher percentage of home deliveries in the Outer Java-Bali regions (79 percent or more) than in Java-Bali (74 percent). Births to mothers who have no education are twice as likely to be delivered at home as births to mothers who have some secondary education (94 percent and 49 percent, respectively). Of the 23 percent of births that occur in health facilities, approximately equal proportions are delivered in government hospitals, midwives' homes, and private hospitals or clinics (roughly 5 percent of births). The utilization of private hospitals or private clinics for delivery is considerably higher in urban than rural areas. It is also higher for first through third births, and among births to mothers with secondary education. Significant variations are found in the place of delivery by province (see Table 10.6.2). A majority of births are delivered at home in all provinces except DKI Jakarta and Bali, where the majority are delivered in a health facility. In DKI Jakarta, one in five births takes place at the respondent's home or someone else's home, one in three births occurs in a private midwife's home, and 30 percent are born in hospitals. It is interesting to note that the proportion of births delivered in a private midwife's home is 20 percent or more in Bali, West Sumatra, and DKI Jakarta, while the role of the hospital (whether public or private) is important in DKI Jakarta, DI Yogyakarta, Bali, North Sulawesi, South Sulawesi, and East Kalimantan. 155 Table 10.6.1 Placeofdelivery: background characteristics Percent distribution of live births in the five years preceding the survey by place of delivery, according to selected background characteristics, Indonesia 1994 Place of delivery Government Private Respond- Mid- Deliv- Number Background ent's Other wife's Hos- Health ery Hos- Other Miss- of characteristic home home home pital center post pital Clinic private ing Total births Mother's age at birth <20 72.7 13.6 4.1 2.8 1.8 0.0 2.0 2.8 0.1 0.0 100.0 2,374 20-24 68.7 7.3 6.0 5.5 2.6 0.1 4.0 5.1 0.2 0.3 100.0 4,855 25-29 66.4 5.3 6.2 7.4 2.2 0.1 6.5 5.6 0.3 0.1 100.0 4,645 30-34 73.6 2.6 5.0 5.4 1.7 0.0 6.4 4.5 0.1 0.5 100.0 3,057 35+ 78.1 2.1 4.4 6.0 1.2 0.2 4.1 3.4 0.1 0.4 100.0 2,052 Birth order 1 60.2 9.8 6.4 8.2 2.4 0.0 6.6 5.7 0.3 0.2 100.0 4,930 2-3 69.2 5.8 6.0 5.6 2.5 0.1 5.4 5.0 0.1 0.3 100.0 6,726 4-6 80.5 3.6 4.0 3.9 1.3 0.0 2.9 3.2 0.1 0.4 100.0 3,861 7+ 86.6 2.2 3.0 2.3 0.5 0.2 1.9 2.9 0.0 0.3 100.0 1,466 Residence Urban 37.6 5.5 13.9 12.5 4.1 0.2 13.4 12.2 0.3 0.2 100.0 4,646 Rural 83.1 6.4 2.2 3.1 1.3 0.0 1.6 1.7 0.1 0.3 100.0 12,337 Region/Residence Java-Bali 67.7 6.7 7.6 4.9 2.3 0.1 5.7 4.6 0.2 0.3 1(30.0 9,678 Urban 36.1 5.5 17.8 10.2 4.9 0.2 13.9 10.8 0.5 0.1 100.0 3,184 Rural 83.2 7.3 2.6 2.3 1.1 0.0 1.6 1.5 0.1 0.3 100.0 6,494 Outer Java-Bali 1 73.2 5.6 3.1 6.5 1.8 0.1 3.9 5.4 0.1 0.3 100.0 5,073 Urban 40.5 6.0 5.0 16.5 2.5 0.0 11.9 17.3 0.1 11.2 100.0 995 Rural 81.2 5.5 2.6 4.1 1.7 0.1 1.9 2.5 0.1 0.3 100.0 4,077 Outer Java-Bali 11 77.8 5.4 1.5 7.1 1.3 0.0 3.6 2.9 0.2 0.3 100.0 2,233 Urban 42.0 4.4 6.3 19.8 2.3 0.0 13.4 11.2 0.1 0.5 100.0 467 Rural 87.2 5.6 0.2 3.7 1.0 0.0 1.0 0.7 0.2 0.2 100.0 1,766 Mother's education No education 88.3 5.2 1.7 1.5 1.0 0.2 0.5 0.5 0.1 0.8 100.0 2,012 Some primary 83.5 6.0 2.8 2.1 1.3 0.1 1.6 2.2 0.1 0.2 100.0 5,246 Completed primary 76.2 6.9 5.8 3.4 2.3 0.0 1.9 3.2 0.1 0.2 100.0 5,010 Some secondary+ 43.0 6.1 9.6 13.9 3.0 0.0 13.4 10.5 0.3 0.1 100.0 4,715 Number of antenatal care visits 0 90.6 6.6 0.3 0.4 0.0 0.1 0.4 0.1 0.1 1.3 100.0 3,009 1-3 83.5 7.6 1.4 2.8 1.1 0.1 0.9 2.4 0.1 0.1 100.0 3,515 4+ 60.6 5.6 8.2 8.2 2.9 0.0 7.5 6.7 0.2 0.0 100.0 10,385 Total 70.6 6.2 5.4 5.7 2.1 0.1 4.9 4.6 0.2 0.3 100.0 16,983 Note: Total includes 75 births for which the number of antenatal care visits is missing. 156 Table 10.6.2 Place of delivery: region and province Percent distribution of live births in the five years preceding the survey by place of delivery, according to region and province, Indonesia 1994 Place of delivery Government Private Respond- Mid- Deliv- Number Background ent's Other wife's Hos- Health cry Hos- Other Miss- of characteristic home home home pital center post pital Clinic private ing Total births Java-Ball 67.7 6.7 7.6 4.9 2.3 0.1 5.7 4.6 0.2 0.3 100.0 9,678 DKI Jakarta 16.3 3.5 32.7 12.6 7.9 0.l 16.3 8.7 1.8 0.0 100.0 618 West Java 69.2 11.5 6.2 3.4 1.2 0.0 3.7 4.5 0.0 0.3 100.0 3,675 Central Java 77.7 3.3 3.1 4.2 1.6 0.3 4.7 4.5 0.0 0.6 100.0 2,599 DI Yogyakarta 54.4 4.3 8.0 8.4 4.7 0.0 10.8 9.4 0.0 0.0 100.0 182 East Java 71.5 3.7 6.6 4.8 2.9 0.0 6.6 3.6 0.3 0.0 100.0 2,393 Bali 35.0 9.0 25.4 15.9 6.8 0.0 5.1 2.3 0.3 0.1 100.0 210 Outer Java-Bali I 73.2 5.6 3.1 6.5 1.8 0.1 3.9 5.4 0.1 0.3 100.0 5,073 Dista Aceh 85.2 3.9 0.5 4.8 0.8 0.0 0.7 3.6 0.0 0.4 100.0 374 Noah Sumatra 70.1 7.8 2.6 6.3 0.7 0.2 3.7 8.3 0.0 0.3 100.0 1,298 West Sumatra 48.9 4.2 20.2 8.8 6.6 0.0 4.7 5.1 0.8 0.6 100.0 366 South Sumatra 68.8 4.8 4.2 7.3 0.4 0.0 4.4 9.7 0.0 0.4 100.0 563 Lampung 83.6 3.2 2.6 2.7 0.7 0.2 1.5 5.5 0.0 0.0 100.0 563 West Nusa Tenggara 87.1 4.0 0.2 4.1 2.0 0.0 1.1 1.2 0.2 0.0 100.0 399 West Kalimantan 76.7 5.8 0.0 6.5 0.6 0.0 6.0 3.8 0.2 0.4 100.0 380 South Kalimantan 86.3 3.9 0. I 5.8 0.3 0.0 1.6 1.9 0.0 0.0 100.0 225 North Sulawesi 63.0 10.9 1.0 12.7 4.0 0.6 3.8 3.5 0.2 0.2 100.0 203 South Sulawesi 69.2 5.7 0.5 9.0 4.4 0.0 8.3 2.5 0.1 0.3 100.0 701 Outer Java-Bali II 77.8 5.4 1.5 7.1 1.3 0.0 3.6 2.9 0.2 0.3 100.0 2,233 Riau 68.3 5.7 3.7 6.2 1.1 0.0 4.9 9.7 0.0 0.2 100.0 389 Jambi 77.5 3.1 0.8 7.1 3.7 0.0 2.7 4.7 0.1 0.2 100.0 207 Bengkulu 82.9 8.4 0.1 3.5 0.0 0.0 0.5 1.4 1.7 0.1 100.0 138 East Nusa Tenggara 83.4 6.0 0.0 5.1 0.6 0.0 3.5 1.0 0.0 0.2 100.0 361 East Timor 89.4 0.7 0.0 7.0 0.9 0.0 0.4 1.3 0.0 0.2 100.0 123 Central Kalimantan 89.3 4.7 0.0 3.2 0.0 0.0 0.8 0.7 0.0 1.3 100.0 126 East Kalimantan 56.3 8.7 7.2 11.9 1.0 0.0 11.2 3.2 0.4 0.2 100.0 215 Central Sulawesi 75.0 13.6 0.3 8.5 0.4 0.0 1.5 0.0 0.2 0.6 100.0 166 Southeast Sulawesi 91.3 3.1 0.0 4.5 0.2 0.0 0.8 0.1 0.0 0.0 100.0 149 Maluku 87.0 1.3 0.0 5.2 0.2 0.0 5.8 0.1 0.0 0.4 100.0 190 lrian Jaya 74.2 1.7 0.4 15.8 6.0 0.0 1.1 0.8 0.1 0.0 100.0 167 Total 70.6 6.2 5.4 5.7 2.1 0.1 4.9 4.6 0.2 0.3 100.0 16,983 157 10.6 Assistance during Delivery In the survey, respondents were asked about all of the persons assisting during the delivery. If more than one delivery attendant was present, only the least qualified attendant was recorded, since the person was usually the first choice to assist during delivery. Only complicated cases are referred to the more qualified attendants. Table 10.7.1 shows that most births (60 percent) are assisted by a traditional birth attendant; 34 percent are assisted by a midwife. Deliveries to mothers under age 20 and those 35 years and over are more Table 10.7.1 Assistance during delivery: background characteristics Percent distribution of live births in the five years preceding the survey by type of assistance during delivery, according to selected background characteristics, Indonesia 1994 Assistance during delivery I Traditional Number Background birth of characteristic Doctor Midwife attendant Relative Other No one Total births Mother's age at birth < 20 1.2 22.2 74.0 2.4 0.2 0.1 100.0 2,374 20-24 2.2 34.6 59.7 3.0 0.3 0.2 100.0 4,855 25-29 3.4 40.3 51.7 3 7 0.4 0.4 100.0 4,645 30-34 3.8 34.5 57.0 3 1 0.8 0.7 100.0 3,057 35+ 2.5 29.2 63.5 34 0.7 0.7 100.0 2,052 Birth order 1 3.7 39.1 54.8 2A 0.3 0.0 100.0 4,930 2-3 2.9 36.3 57.4 30 0.4 0.1 100.0 6,726 4-6 1.9 27.3 64.9 43 0.7 0.9 100.0 3,861 7+ 0.8 21.4 70.8 52 0.6 1.2 100.0 1,466 Residence Urban 7.3 66.3 25.2 0.9 0.2 0.1 100.0 4,646 Rural 1.0 21.5 72.4 4.0 0.6 0.5 100.0 12,337 Region/Residence Java-Bali 3.1 31.0 64.9 0.6 0.3 0.1 100.0 9,678 Urban 7.9 62.5 28.9 0.6 0.1 0.0 100.0 3,184 Rural 0.8 15.5 82.5 0.6 0.4 0.2 100.0 6,494 Outer Java-Bali l 2.3 41.5 51.1 3.8 0.7 0.5 100.0 5,073 Urban 5.9 77.1 16.0 0.8 0.1 0.1 100.0 995 Rural 1.4 32.9 59.6 4.6 0.9 0.6 100.0 4,077 Outer Java-Bali 11 1.8 28.2 55.3 12.9 0.6 1.2 100.0 2,233 Urban 6.3 69.0 19.7 3.9 0.8 0.3 100.0 467 Rural 0.6 17.4 64.8 15.3 0.6 1.4 100.0 1,766 Mother's education No education 0.7 8.8 80.0 8.7 0.8 1.0 100.0 2,012 Some primary 0.9 20.3 74.3 3.6 0.2 0.6 100.0 5,246 Completed primary 1.2 29.1 66.4 2.5 0.5 0.2 100.0 5,010 Some secondary+ 7.2 64.3 26.8 1.1 0.5 0.1 100.0 4,715 Number of antenatal care visits 0 0.2 5.9 82.7 8.6 1.3 1.3 100.0 3,009 1-3 0.8 21.2 72.9 4.4 0.4 0.3 100.0 3,515 4+ 4.1 46.0 48.3 1.2 0.2 0.1 100.0 10,385 Total 2.7 33.8 59.5 3.2 0.4 0.4 100.0 16,983 Note: Total includes 75 births for which the number of antenatal care visits is missing. I If the respondent mentioned more than one attendant, only the least qualified attendant was considered (see text for explanation). 158 likely than those to mothers age 20-34 to be assisted by a traditional birth attendant (74 percent and 64 percent, respectively), despite the fact that these births are known to have a higher risk of negative pregnancy outcome and should, therefore, have more highly trained delivery assistance. Similarly, seventh and higher births are more likely to be assisted by traditional birth attendants (71 percent) or relatives (5 percent) than lower-order births. Use of traditional birth attendants is much higher among mothers with no education than among those with some secondary education (80 percent, compared with 27 percent). More than 80 percent of births to women who had no antenatal care are assisted by a traditional birth attendant. In urban areas, most deliveries are assisted by a midwife (66 percent), while in rural areas more mothers were assisted by traditional birth attendants (72 percent). In the Java-Bali region, 65 percent of births are assisted by a traditional birth attendant and 34 percent by a medical professional (doctor or midwife). More than half of deliveries in the Outer Java-Bali I region were assisted by a traditional birth attendant and 44 percent by a medical professional, but in the Outer Java-Bali II region, 55 percent of births are assisted by a traditional birth attendant, 13 percent by relatives, and 30 percent by a medical professional. Deliveries assisted by relatives (especially elderly relatives or friends) may involve higher mortality and more risk than those assisted by a traditional birth attendant because relatives generally have no training and are less experi- enced in assisting delivery than traditional birth attendants. Over 70 percent of deliveries in West Java, Central Java, Lampung, Southeast Sulawesi, West Nusa Tenggara, and Maluku are assisted by a traditional birth attendant (see Table 10.7.2). Some provinces may need special attention due to the high proportion of deliveries assisted by relatives. These provinces are Bengkulu (11 percent), South Sulawesi (12 percent), Central Sulawesi (17 percent), East Nusa Tenggara (22 percent), Irian Jaya (34 percent), and East Timor (67 percent). 159 Table 10.7.2 Assistance during delivery: region and province Percent distribution of live births in the five years preceding the survey by type of assistance during delivery, according to region and province, Indonesia 1994 Assistance during delivery I Traditional Number Region and birth of province Doctor Midwife attendant Relative Other No one Total births Java-Bali 3.1 31.0 64.9 0.6 0.3 0.1 100.0 9,678 DK1 Jakarta 9.4 76.9 12,6 0.5 0.3 0.2 100.0 618 West Java 3.1 23.9 72.7 0.2 0.1 0.0 100.0 3,675 Central Java 2.2 25.0 71.5 0.3 0.7 0.1 100.0 2,599 DI Yogyakarta 0.5 47.1 52.4 0.0 0.0 0.0 100.0 182 East Java 2.8 32.0 64.0 0.8 0.0 0.4 100.0 2,393 Bali 3.2 67.7 19.6 8.7 0.8 0.1 100.0 210 Outer Java-Bali I 2.3 41,5 51.1 3.8 0.7 0.5 100.0 5,073 Dista Aceh 2.4 38.9 55.8 2.2 0.4 0.3 100.0 374 North Sumatra 3.6 56.7 32.7 4.7 1.4 0.9 100.0 1,298 West Sumatra 3.2 67.0 28.4 0.9 0.5 0.0 100.0 366 South Sumatra 2.7 46.1 46.6 2.8 1.0 0.5 100.0 563 Lampung 0.6 27.5 7 ] .0 0.7 0.2 0.0 100.0 563 West Nusa Tenggara 1.8 11.4 84.4 2.4 0.0 0.1 100.0 399 West Kalimantan 1.4 28.9 67.8 1.2 0.6 0.0 100.0 380 South Kalimantan 0.6 35.1 63.7 0.3 0.0 0.2 100.0 225 North Sulawesi 3.1 39.9 55.0 1.0 1.0 0.0 100.0 203 South Sulawesi 1.5 35.9 48.7 12.1 0.6 I. I 100.0 701 Outer Java-Bali I1 1.8 28.2 55.3 12.9 0.6 1.2 100.0 2,233 Riau 1.9 41.7 54.5 1.5 0.3 0.2 100.0 389 Jambi 5.9 28.9 63.1 1.7 0.4 0.0 100.0 207 Bengkulu 0.8 29.4 58.0 10.5 0.4 0.9 100.0 138 East Nusa Tenggara 0.4 16.4 58.2 21.6 0.6 2.9 100.0 361 East Timor 1.5 15.3 8.5 67.4 2.0 5.2 100.0 123 Central Kalimantan 0.5 29.2 65.4 3.7 1.2 0.0 100.0 126 East Kalimantan 3.5 48.9 44.5 2.6 0.5 0.0 100.0 215 Central Sulawesi 1.7 17.6 62.7 16.7 0.5 0.4 100.0 166 Southeast Sulawesi 0.9 14.7 82.0 1.4 0.5 0.6 1130.0 149 Maluku 1.0 21.2 73.1 3.0 0.5 1.0 100.0 190 Irian Jaya 1.2 32.8 28.9 34.1 0.7 2.3 100.0 167 Total 2.7 33.8 59.5 3.2 0.4 0.4 100.0 16,983 Note: Total includes 75 births for which the number of antenatal care vistis is missing. I If the respondent mentioned more than one attendant, only the least qualified attendant was considered (see text for explanation). 160 10.7 Delivery Characteristics In Indonesia, caesarean sections generally are performed only for certain medical indications and to terminate complicated deliveries. According to the 1994 IDHS, only 3 percent of births were reported as delivered by a caesarean operation (see Table 10.8.1 and Figure 10.2). This percentage is slightly higher among first births (3 percent) and among mothers with some secondary education (4 percent). Caesarean sections are more common in the urban areas (5 percent) than in the rural areas (2 percent). Table 10.8.1 Delivery characteristics: background characteristics Among births in the five years preceding the survey, the percentage of deliveries by caesarean section, the percentage of premature births, and the percent distribution by birth weight and by the mother's estimate of baby's size at birth, according to background characteristics, Indonesia 1994 Birth weight Size of child at birth Delivery Pre- Less 2.5 kg Don't Smaller Average Don't Number Background by mature than or know/ Very than or know/ of characteristic C-section birth 2.5 kg more Missing small average larger Missing Total births Mother's age at birth <20 1.9 4.9 10.4 89.6 58.3 2.1 16.2 80.1 1.5 100.0 2,374 20-24 2.1 2.2 8.2 91.8 49.2 1.4 12.1 84.9 1.6 100.0 4,855 25-29 3.1 3.0 5.6 94.4 46.8 1.5 11.3 85.4 1.7 100.0 4,645 30-34 2.2 1.3 5.6 94.4 52.3 1.0 10.8 86.3 2.0 100.0 3,057 35+ 3.1 2.7 6.9 93.1 58.6 1.7 13.2 82.8 2.3 100.0 2,052 Birth order 1 3.4 4.0 8.0 92.0 43.2 1.9 I3.3 83.3 1.5 100.0 4,930 2-3 2.5 2.3 6.4 93.6 48.6 1.2 I 1.3 85.8 1.7 100.0 6,726 4-6 1.8 1.9 5.6 94.4 60.2 .1.4 12.2 84.3 2.1 100.0 3,861 7+ 1.3 2.0 11.9 88.1 69.6 1.6 14.5 81.6 2.3 100.0 1,466 Residence Urban 4.8 4.0 6.8 93.2 17.6 1.6 10.8 86.3 13 100.0 4,646 Rural 1.6 2.2 7.3 92.7 64.3 1.4 12.9 83.7 2.0 100.0 12,337 Region/Residence Java-Bali 2.4 3.2 7.3 92.7 47.1 1.8 13.0 84.2 1.0 100.0 9,678 Urban 4.6 4.4 7.4 92.6 17.0 1.9 11.4 85.8 0.9 100.0 3,184 Rural 1.4 2.6 7.1 92.9 61.8 1.7 13.8 83.5 1.1 100.0 6,494 Outer Java-Bali I 2.8 2.2 6.1 93.9 54.6 1.0 11.6 85.0 2.4 100.0 5,073 Urban 5.6 3.2 4.9 95.1 16.9 0.7 9.8 88.0 1.6 100.0 995 Rural 2.1 2.0 6.8 93.2 63.8 1.1 12.1 84.3 2.6 100.0 4,077 Outer Java-Bali II 2.1 1.5 8.8 91.2 63.9 1.3 11.4 83.6 3.7 100.0 2,233 Urban 4.3 3.3 7.0 93.0 22.5 1.8 9.2 86.0 3.0 100.0 467 Rural 1.5 1.1 10.3 89.7 74.9 1.1 12.0 83.0 3.9 100.0 1,766 Mother's education No education 0.6 1.7 9.4 90.6 82.1 2.5 14.7 80.1 2.6 100.0 2,012 Some primary 1.6 1.8 8.1 91.9 65.4 1.5 12.8 83.8 1.9 100.0 5,246 Completed primary 1.7 2.6 7.3 92.7 51.6 1.1 12.8 84.3 1.8 100.0 5,010 Some secondary+ 5.2 4.2 6.2 93.8 23.0 1.4 10.3 86.9 1.3 100.0 4,715 Total 2.5 2.7 7,1 92.9 51.5 1.5 12.4 84.4 1.8 100.0 16,983 161 Percent Figure 10.2 Delivery Characteristics of Births in the Five Years Preceding the Survey 5O 40 30 2O 10 0 2.5 2.7 Caesarean Premature Delivery 48 14 Weighed <2.5 kg Small at Birth at Birth* at Birth** * Based on infants weighed at birth ** Identified by mother as 'very small" or "smaller than average' 1994 IDHS There are only negligible differences in the percentage of caesarean sections between the Java-Bali and Outer Java-Bali regions. However, in certain provinces, such as DKI Jakarta, Bali, West Sumatra, North Sulawesi, and East Kalimantan, more than 5 percent of births are delivered by caesarean section (see Table 10.8.2). Since most deliveries are attended by traditional birth attendants at home, birth weights were not reported for 52 percent of births in the 1994 IDHS. This proportion is higher in rural than in urban areas (64 percent and 18 percent, respectively). Among babies who were weighed at birth, 7 percent were under 2.5 kilograms (i.e., low birth weight). The prevalence of low birth weight is 10 percent among children born to mothers less than 20 years. The prevalence of low birth weight fluctuates with birth order: it is 8 percent among first births, declines to 6 percent among second through sixth births, and increases to 12 percent for seventh and higher births. The prevalence of low birth weight declines slightly as mother's level of education increases; 8 to 9 percent of children born to mothers with less than primary education were low birth weight, compared with 6 percent among those born to mothers with some secondary education. There is no significant difference in the prevalence of low birth weight between births in rural and urban areas. In the Outer Java-Bali II region, 9 percent of births weighed less than 2.5 kilograms, compared with 6 percent in Outer Java-Bali I, and 7 percent in Java-Bali. Survey respondents were asked their perception of the size of their newborns. Approximately 14 percent of births were perceived by their mothers as being either very small or smaller than average. Younger mothers and those with less education are more likely to report that their newborn is smaller than average (see Table 10.8.1). 162 Table 10.8.2 Delivery characteristics: region and province Among births in the five years preceding the survey, the percentage of deliveries by caesarean section, the percentage of premature births, and the percent distribution by birth weight and by the mother's estimate of baby's size at birth, according to region and province, Indonesia 1994 Birth weight Size of child at birth Delivery Pre- Less 2.5 kg Don't Smaller Average Don't Number Region and by mature than or know/ Very than or know/ of province C-section birth 2.5 kg more Missing • small average larger Missing Total births Java-Bali 2.4 3.2 7.3 92.7 47.1 1.8 13.0 84.2 1.0 I00.0 9,678 DKI Jakarta 5.7 3.5 7.3 92.7 8.5 1.5 13.1 83.6 1.9 100.0 618 West Java 2.2 2.6 8.6 91.4 51.8 1.3 18.1 80.2 0.4 100.0 3,675 Central Java 1.7 0.9 4.1 95.9 45.6 1.0 4.8 91.5 2.7 100.0 2,599 DI Yogyakana 1.9 3.0 5.5 94.5 30.1 1.0 11.4 87.3 0.2 100.0 182 East Java 2.5 6.5 9.3 90.7 54.1 3.5 14.6 81.9 0.0 100.0 2,393 Bali 6.1 4.3 7.4 92.6 29.8 2.1 8.3 89.5 0.l 100.0 210 Outer Java-Ban I 2.8 2.2 6.1 93.9 54.6 1.0 11.6 85.0 2.4 100.0 5,073 Dista Aceh 2.1 1.4 5.1 94.9 73.7 0.7 18.4 79.4 1.5 100.0 374 North Sumatra 3.8 2.0 2.3 97.7 53.8 0.5 10.1 88.3 IA 100.0 1,298 West Sumatra 6.5 5.3 5.3 94.7 23.8 0.7 10.8 85.4 3.2 100.0 366 South Sumatra 2.4 0.9 6.5 93.5 45.2 0.1 9.4 85.1 5.4 100.0 563 Lampung 0.9 1.6 6.5 93.5 60.7 0.6 9.3 87.1 3.0 100.0 563 West Nusa Tenggara 1.2 3.2 8.1 91.9 58.3 4.3 13.2 81.8 0.7 100.0 399 West Kalimantan 1.9 1.9 6.9 93.1 65.2 0.8 15.2 83.0 0.9 100.0 380 South Kalimantan 1.9 3.4 8.6 91.4 56.1 1.1 12.6 84.5 1.8 100.0 225 North Sulawesi 5.9 4.4 10.0 90.0 57.4 4.2 12.7 76.0 7.1 100.0 203 South Sulawesi 2.2 1.4 10.5 89.5 55.3 0.7 I 1.4 85.6 2.3 100.0 701 Outer Java-Bali II 2.1 1.5 8.8 91.2 63.9 1.3 I 1.4 83.6 3.7 100.0 2,233 Riau 3.1 1.5 7.9 92.1 55.1 0.6 8.6 87.0 3.8 100.0 389 Jambi 0.7 1.2 3.6 96.4 57.9 0.4 8.6 90.8 0.2 100.0 207 Bengkulu 0.6 2.1 4.0 96.0 64.1 1.0 9.0 89.4 0.5 100.0 138 East Nusa Tenggara IA 0.8 13.1 86.9 71.0 1.1 16.2 77.9 4.7 100.0 361 East Timor 0.9 0.5 2.8 97.2 85.5 1.5 10.3 87.8 0.4 100.0 123 Central Kalimantan 0.8 0.5 12.3 87.7 77.4 0.3 4.4 93.4 1.9 100.0 126 East Kalimantan 5.1 3.5 7.9 92.1 36.0 1.7 12.2 84.4 1.8 100.0 215 Central Sulawesi 1.8 1.3 16.7 83.3 60.6 1.5 17.9 68.7 11.9 100.0 166 Southeast Sulawesi 2.9 1.5 I 1.1 88.9 74.0 2.0 8.7 80.3 8.9 100.0 149 Maluku 1.6 0.8 6.6 93.4 72.7 1.6 12.6 84.6 1.2 100.O 190 Irian Jaya 2.7 3.2 10.l 89.9 70.5 3.3 12.3 79.6 4.8 100.0 167 Total 2.5 2.7 7.1 92.9 51.5 1.5 12,4 84,4 1.8 100.0 16,983 According to respondents' reports, about 3 percent of births were delivered prematurely. This figure is relatively low considering the actual percentage of low birth weight deliveries and the percentage of new- borns reported as small by their mothers. The prevalence of low birth weight is more than 10 percent in some provinces, such as all of the provinces in Sulawesi, East Nusa Tenggara, Central Kalimantan, and Irian Jaya (see Table 10.8.2). 10.8 Complications of Delivery Information on all live births in the five years prior to the survey were recorded in the IDHS. To identify complications associated with delivery, respondents were asked about certain signs and symptoms that they had experienced. Table 10.9 shows that of 16,983 live births, 24 percent involved complications. 163 Prolonged labor was reported for 19 percent of births, while 7 percent were reported to involve excessive bleeding, 4 percent had associated vaginal infection, and 2 percent involved convulsions. There is little difference in the prevalence of delivery complications by the respondent's residence. The prevalence of delivery complications was 31 percent among deliveries by caesarean section, mostly due to prolonged labor (23 percent) and excessive bleeding (13 percent). Thirty-two percent of births followed by early neonatal deaths involved complications: 25 percent with prolonged labor, 12 percent with excessive bleeding, 12 percent with vaginal infection, and 4 percent with convulsions (see Table 10.9). Table 10.9 Complications of delivery Percentage of live births in the five years preceding the survey for which respondents had compli- cations associated with delivery, by type of complication, residence, and selected medical maternity care indicators, Indonesia 1994 Type of complication Number Medical maternity Prolonged Excessive Vaginal of care indicator labor bleeding infection Convulsions None births URBAN Antenatal care/ delivery assistance Both ANC and DA 20.5 8.5 :3.5 1.5 74.1 3,501 ANC only 14.4 4.3 ;3.3 1.6 83.2 93] DA only 19.1 14.2 5.4 1.2 74.6 50 Neither ANC nor DA 17.3 6.6 7.0 1.0 77.9 164 Caesarean section 21.1 15.1 4.8 1.0 71.0 223 Early neonatal death 33.9 10.8 11.5 2.7 61.6 93 Total 19. l 7.7 3.6 1.5 76.0 4,646 RURAL Antenatal care/ delivery assistance Both ANC and DA 25.7 8.9 6.1 3.4 68.3 3,057 ANC only 14.9 5.8 3.7 1.8 80.4 6,485 DA only 32.0 18.3 12.7 4.5 61.4 152 Neither ANC nor DA 17.7 8.8 5.4 2.4 76.8 2,643 Caesarean section 25.7 10.8 7.2 6.7 67.2 203 Early neonatal death 22.1 13.0 12.2 4.5 70.8 253 Total 18.4 7.4 4.7 2.4 76.4 12,337 TOTAL Antenatal care/ delivery assistance Both ANC and DA 22.9 8.7 4.7 2.4 71.4 6,558 ANC only 14.9 5.6 3.6 1.8 80.8 7,416 DA only 28.8 17.3 10.9 3.7 64.7 201 Neither ANC nor DA 17.7 8.6 5.5 2.3 76.9 2,807 Caesarean section 23.3 13.1 6.0 3.7 69.2 426 Early neonatal death 25.3 12.4 12.1 4.0 68.3 346 Total 18.6 7.4 4.4 2.1 76.3 16,983 ANC = Antenatal care (from medical prol~ssional) DA = Delivery assistance (from medical professional) 164 CHAPTER 11 IMMUNIZATION OF CHILDREN The Expanded Program of Immunization, launched by the Indonesia Ministry of Health in 1977, recommended that all children should receive immunization against six diseases: tuberculosis (BCG), diphtheria, pertussis, tetanus (DPT), polio, and measles. In the fifth Five-Year Development Plan ( 1989-90 to 1993-94), efforts to reduce childhood morbidity and mortality by improving the immunization coverage among children have been continued. Infants who were brought to health centers or to health posts for postnatal care were provided with a health card on which feeding, growth, and immunization information could be recorded. The type and date of vaccinations received were also recorded in a registration book maintained by the field vaccinators. The cards were given to the mothers to monitor the child's health. However, not all of the mothers kept the cards. Further, not all infants received postnatal care; therefore, they never received cards. In this survey, immunization information was collected for children born in the five years before the survey. For children with a health card, the interviewer asked to see the card, then copied the vaccination dates onto the questionnaire. If the child had never received a health card or if the mother was unable to show the card to the interviewer, the mother was asked questions about the types of immunizations her children received--i.e., BCG, DPT, polio and measles vaccine--and the number of doses of DPT and polio vaccines received. 11.1 Health Cards Table 11.1.1 shows the percentage of children for whom mothers reported they had a health card and whether or not it was seen by the interviewer. Overall, among children age 12-59 months, 79 percent had been given a health card, but only 24 percent had health cards that were actually seen by the interviewer. Fifty-three percent were reported by their mothers to have cards but these were not seen by the interviewer. The large proportion of children reported to have cards but whose mothers could not show them to the interviewers probably reflects the fact that many cards are held at the health centers or kept by health cadres. The percentage of children whose mothers could show their health cards declines with increasing age of the child. The decline with age may reflect either an increase in the use of health cards over time or the fact that the health cards of older children are more likely to have been lost or discarded. There is virtually no difference in health card coverage by the sex of the child, although coverage is higher for children of low birth order, urban children, and children of educated women. While 53 percent of children born to mothers with no education have a health card, only 14 percent were able to show it to the survey interviewer (see Figure 11.1). Among children of women with some secondary education 93 percent have a health card and 30 percent were able to show it to the interviewer. Children in Outer Java-Bali I are less likely to have a health card than children in other regions (see Table 11.1.2). The percentage of children who have a health card varies by province, ranging from 54 percent in Dista Aceh to 95 percent in DI Yogyakarta, while the percentage with cards seen varies from 9 percent in West Nusa Tenggara to 45 percent in DI Yogyakarta. Provinces in which health card coverage is relatively high (90 percent or higher) include DKI Jakarta, DI Yogyakarta, and Bali. However, the percentage of children for whom a health card was issued but was no longer available in the respondent's house is particularly high in DKI Jakarta (8 percent). 165 Table I 1.1.1 Health cards: background characteristics Among children one to four years of age, the percentage who had a health card that was seen by the interviewer, the percentage who had a health card that was not seen, the percentage who no longer had a health card, and the percentage who never had a health card, by background characteristics, Indonesia 1994 Card No Never Number Background Card not longer had of characteristic seen seen has card card Missing Total children Child's age 12-23 months 38.7 39.5 1.5 20.2 0.1 100.0 3,065 24-35 months 25.5 52.4 2.2 19.7 0.2 100.0 3,352 36-47 months 19.6 55.2 3.1 21.8 0.3 100.0 3,165 48-59 months 12.8 62.5 3.4 21.2 0.2 100.0 3,148 Child's sex Male 24.5 51.8 2.8 20.8 0.1 100.0 6,449 Female 23.7 53.2 2.3 20.6 0.2 100.0 6,282 Birth order 1 29.2 53.2 2.6 14.9 0.1 100.0 3,689 2-3 26.6 54.3 2.1 16.9 0.2 100.0 5,062 4-6 17.9 52.0 3.4 26.6 0.2 100.0 2,917 7+ 11.6 42.7 2.3 42.9 0.5 100.0 1,063 Residence Urban 29.1 58.8 3.0 9.1 0.1 100.0 3,526 Rural 22.2 50.1 2.4 25.2 0.2 100.0 9,204 Region/Residence Java-Bali 27.1 52.1 3.5 17.3 0.1 100.0 7,307 Urban 31.1 58.1 3.9 7.0 0.0 100.0 2,418 Rural 25.1 49.2 3.3 22.4 0.1 100.0 4,889 Outer Java-Bali 1 19.0 52.5 1.4 26.7 0.4 100.0 3,766 Urban 24.7 59.7 0.8 14.5 0.3 100.0 755 Rural 17.6 50.7 1.5 29.7 0.4 100.0 3,011 Outer Java-Bali I1 22.4 54.0 1.0 22.4 0.2 100.0 1,658 Urban 24.7 61.5 1.7 I 1.7 0.4 100.0 353 Rural 21.8 52.0 0.9 25.3 0.1 100.0 1,305 Education No education 14.0 35.9 2.9 47.0 0.2 100.0 1,513 Some primary 19.9 48.7 3.5 27.6 0.3 100.0 4,014 Completed primary 27.4 55.1 2. I 15.2 0.2 100.0 3,734 Some secondary+ 29.8 61.2 1.7 7.2 0.1 100.0 3,469 Total 24.1 52.5 2.5 20.7 0.2 100.0 12,731 The presence o f a heal th card in the ch i ld ' s house is important , because the purpose o f hav ing a heal th card is to enab le the mother to mon i to r the ch i ld ' s g rowth process and to keep a record of the immunizat ion schedu le . In th is survey, a large propor t ion o f the heal th cards i ssued to ch i ld ren were not seen, poss ib ly because they were be ing kept at the local hea l th center or at the heal th post . 166 Table I 1.1.2 Health cards: region and province Among children one to four years of age, the percentage who had a health card that was seen by the interviewer, the percentage who had a health card that was not seen, the percentage who no longer had a health card, and the percentage who never had a health card, by region and province, Indonesia 1994 Card No Never Number Region and Card not ionger had of province seen seen has card card Missing Total children Java-Bali 27.1 52.1 3.5 17.3 0.1 100.0 7,307 DKI Jakarta 21.7 64.4 7.6 6.4 0.0 100.0 481 West Java 20.1 51.6 4.0 24.2 0.0 100.0 2,668 Central Java 28.6 55.9 3.1 12.0 0.3 100.0 2,050 DI Yogyakarta 44.6 49.7 1.0 4.7 0.0 100.0 146 East Java 34.7 45.3 2.4 17.6 0.0 100.0 1,806 Bali 36.1 54.4 1.8 7.7 0.0 100.0 155 Outer Java-Bali I 19.0 52.5 1.4 26.7 0.4 100.0 3,766 Dista Aceh 10.9 42.6 0.7 44.9 0.9 100.0 289 North Sumatra 18.9 48.4 0.5 31.9 0.4 100.0 955 West Sumatra 11.2 67.1 1.6 20.0 0.0 100.0 265 South Sumatra 27.8 49.6 1.6 20.5 0.4 100.0 417 Lampung 23.3 55.9 2.2 18.5 0.2 100.0 426 West Nusa Tenggara 8.8 63.4 3.5 23.9 0.3 100.0 283 West Kalimantan 22.3 37.7 2.3 37.3 0.4 100.0 273 South Kalimantan 23.0 55.6 0.4 21.0 0.0 100.0 178 North Sulawesi 19.2 69.3 0.3 10,3 1.0 100.0 153 South Sulawesi 19.8 53.7 1.3 24.8 0.4 100.0 527 Outer Java-Bali II 22.4 54.0 1.0 22.4 0.2 100.0 1,658 Riau 19.9 48.4 1.3 30.3 0.2 100.0 300 Jambi 11.3 59.4 1.4 27.9 0.0 100.0 154 Bengkulu 20.9 56.9 2.6 19.3 0.4 100.0 99 East Nusa Tenggara 33.2 52. I 0.7 13.8 0.2 100.0 261 East Timor 20.0 44.7 0. I 35. I 0.0 100.0 88 Central Kalimantan 12.9 58.3 2.6 26.3 0.0 100.0 102 East Kalimantan 29.2 58.3 0.4 11.8 0.3 100.0 162 Central Sulawesi 21.8 49.2 1.0 27.5 0.5 100.0 117 Southeast Sulawesi 18.6 67.2 I. 1 13. I 0.0 100.0 115 Maluku 21.7 51.9 0.1 26. I 0.2 100.0 134 lrian Jaya 26.7 54.4 0.5 18.4 0.0 100.0 125 Total 24.1 52.5 2.5 20.7 0.2 1(30.0 12,731 11.2 Immunization Coverage Table 11.2 presents vaccination coverage according to information recorded on health cards (top panel), information from mothers' reports (middle panel), and both sources (bottom panel). The table shows that among children age 12-59 months whose health cards were seen, the percentage fully immunized was 75 percent (see top panel). This is slightly higher than the level reported in the 1991 IDHS (73 percent). The highest coverage rate is for BCG (94 percent), followed by 85 percent for both DPT 3 vaccine and polio 3 vaccine, and 81 percent for measles vaccine. Immunization coverage rates based on mothers' reports are considerably lower than those based on health cards (see Table 11.2 middle panel). For example, BCG coverage among children age 12-59 months is 73 percent, DPT 3 is 51 percent, and polio 3 is 53 percent. Measles immunization coverage is 62 percent, and the percentage completely immunized is only 46 percent. 167 Table 11.2 Vaccinations by source of information Among children one to four years of age, the percentage who had received specific vaccines at any time before the survey, by source of information (health cards, mothers' reports, or both) and current age of child, Indonesia 1994 Child's age 12-23 24-35 36-47 48-59 Vaccine months months months months Total HEALTH CARDS Health card seen 100.0 100.0 100.0 100.0 100.0 BCG 93.2 94.7 92.8 94.1 93.7 DPT I 96.2 970 95.7 96.3 96.4 DPT 2 90.1 926 89.5 92.7 91.0 DPT 3 82.4 872 85.6 85.6 84.8 Polio 0 6.5 46 5.5 3.4 5.4 Polio 1 97.4 970 95.4 95.2 96.6 Polio 2 91.9 92.5 89. I 92.5 91.6 Polio 3 82.9 86.9 85.3 85.4 84.8 Measles 76.5 83.6 83.3 86.5 81.2 All I 71.0 75.9 76.6 80.2 74.7 None 1.5 1.5 2.2 1.2 1.6 Number of children 1,187 855 622 402 3,066 MOTHERS'REPORTS BCG 68.0 DPT 1 65. I DPT 2 55.2 DPT 3 44.2 Polio 0 1.0 Polio 1 67.0 Polio 2 57.0 Polio 3 45.4 Measles 53.7 All I 37,4 None 28.4 Number of children 1,878 73.3 74.6 74.6 73.0 70.0 71.7 72.4 70.2 62.4 63.9 63.5 61.7 51.4 54,0 53.1 51.2 1.6 1.5 0.9 1.2 72,6 73.6 74.2 72.2 64.2 65.8 65.9 63.7 52.6 55.6 55.3 52.7 62.9 63.6 64,4 61.7 46.3 49.2 47.4 45.7 23.5 22.7 22.4 24.0 2,497 2,544 2,747 9,665 BOTHSOURCES Health card seen 38.7 25.5 19.6 12.8 24.1 BCG 77.8 78.8 78.2 77.1 78.0 DPT 1 77.2 76.9 76.4 75.4 76.5 DPT 2 68.7 70.1 68.9 67.3 68.8 DPT 3 59.0 60.6 60.2 57.3 59.3 Polio 0 3.2 2.4 2.3 1.2 2.2 Polio 1 78,8 78.8 77.9 76.9 78.1 Polio 2 70,5 71.4 70.4 69.3 70.4 Polio 3 59.9 61.4 61.4 59.1 60.5 Measles 62.5 68.1 67.5 67.2 66.4 All I 50.4 53.9 54.6 51,6 52.7 None 18.0 17.9 18.7 19.7 18.6 Number of children 3,065 3,352 3,165 3,148 12,731 I Children who are fully vaccinated (i.e., those who have received BCG, measles, and three doses each of DPT and polio vaccine). 168 11.3 Immunizat ions by Background Characteristics Table 11.3.1 shows vaccination coverage by background characteristics among children age 12-23 months at the time of the survey. The figures in this table are based on both health cards and mothers' reports. The table also shows health card coverage. Table 11.3.1 Vaccinations: background characteristics Percentage of children 12-23 months who had received specific vaccines by the time of the survey (according to health card or mother's report) and the percentage with a health card, by selected background characteristics, Indonesia 1994 Percentage of children who received: Percent DPT Polio I with Number Background health of :haracteristic BCG 1 2 3+ 0 1 2 3+ Measles All 2 None card children Sex Male 77.5 77.1 68.5 58.5 3.4 78.4 70.9 60.2 62.9 50.5 17.7 40.9 1,520 Female 78.0 77.2 69.0 59.5 2.9 79.1 70.2 59.6 62.1 50.3 18.2 36.6 1,545 Birth order I 84.3 86.1 80.1 69.0 3.0 87.7 81.0 70.4 72.2 59.9 10.5 44.7 870 2-3 80.1 79.4 72.2 63.2 3.6 80.0 73.2 63.6 65.3 55.1 16.1 40.1 1,258 4-6 74.4 71.6 57.2 47.8 2.9 74.0 61.7 48.5 54.1 39.6 22.2 35.6 701 7+ 51.0 48.6 42.5 33.7 2.3 53.5 44.0 35.2 37.0 22.3 43.1 19.1 236 Residence Urban 90.6 90.0 83.7 76.6 4.6 92.3 87.1 77.9 76.2 67.0 6.4 46.2 861 Rural 72.8 72.1 62.9 52.2 2.6 73.5 64.1 52.9 57.2 43.9 22.5 35.8 2,204 Region/Residence Java-Bali 80.3 80.0 71.4 61.3 1.6 82.2 74.0 62.2 65.8 52.8 14.4 42.0 1,781 Urban 92.2 91.4 85.0 77.9 2.3 94.4 89.0 78.6 77.9 68.3 4.7 47.1 605 Rural 74.2 74.2 64.5 52.8 1.2 76.0 66.3 53.8 59.6 44.8 19.4 39.4 1,176 Outer Java-Bali I 73.0 71.7 62.8 53.0 5.7 72.9 64.0 54.0 55.0 43.9 24.1 33.1 890 Urban 86.2 85.9 79.7 72.3 10.7 86.3 82.5 75.6 69.1 61.4 10.6 44.8 171 Rural 69.9 68.3 58.8 48.3 4.5 69.7 59.6 48.8 51.7 39.8 27.4 30.3 718 Outer Java-Bali 11 77.0 76.4 69.8 62.3 4.7 76.4 69.9 62.7 64.4 54.3 20.2 36.6 394 Urban 88.0 88.2 83.4 75.8 8.7 89.2 83.6 77.7 77.6 68.6 9.6 41.9 85 Rural 74.0 73.2 66.1 58.6 3.6 72.9 66.1 58.7 60.8 50.4 23.1 35.2 309 Mother's education No education 52.7 46.8 40.7 31.2 2.1 51.1 40.8 29.7 40.3 25.5 445 23.6 330 Some primary 65.8 65.4 54.7 43.8 2.7 67.1 55.4 43.0 48.0 34.0 27.4 32.6 905 Completed primary 83.8 84.5 74.8 62.4 2.0 86.0 77.7 65.4 69.8 55.2 11.0 41.7 929 Some secondary+ 92.7 92.5 86.8 81.0 5.1 93.2 89.2 82.3 77.7 71.0 6.0 47.4 902 All children 77.8 77.2 68.7 59.0 3.2 78.8 70.5 59.9 62.5 50.4 18.0 38.7 3,065 Note: The DPT coverage rate for children without a written record is assumed to be the same as that for polio vaccine since mothers were specifically asked whether the child had received polio vaccine. i Polio 0 is given at birth 2 Children who are fully vaccinated (i.e., those who have received BCG, measles, and three doses each of DPT and polio vaccine). There is practically no difference in vaccination coverage between male and female children, although male children are slightly more likely than female children to have a health card. The percentage of children receiving each vaccine decreases with increasing birth order and increases with increasing level of mother's education. Twenty-six percent of children whose mothers have no education have been fully immunized, compared with 71 percent of children whose mothers have some secondary education. Health card coverage does not vary as much by mother's education. Urban children are more likely to be vaccinated 169 Figure 11.1 Health Card Coverage for Births in the Five Years Preceding the Survey, by Mother's Education Percent 70 60 50 40 30 20 10 0 61 55 36 49 47 27 30 28 14 20 15 Card Seen Card Not Seen No Longer No Card Have Card 1994 IDHS Figure 11.2 Vaccination Coverage Among Children Age 12-23 Months Percent 100 91 78 77 i' 2O 0 78 76 59 60 63 67 BCG DPT 3 Polio 3 Measles ImUrban [-]Rural BBTotal i * Includes BOG, measles, and three doses each of DPT and polio. All* 50 1994 IDHS 170 than mral children: the percentage of children who have had all their immunizations is 67 percent in urban areas and 44 percent in rural areas (see Figure 11.2). Although immunization coverage among children in the urban areas is high, it should be noted that less than 50 percent of the mothers were able to show the health card. In 1994, children in Outer Java-Bali II were more likely to be fully immunized than children in other regions (see Table 11.3.2). This differs from 1991, when immunization coverage in Java-Bali was the highest in the country. Within Java-Bali, DI Yogyakarta and Bali show the highest levels of complete vaccination coverage at 76 and 77 percent, respectively. Two provinces, Dista Aceh and West Sumatra, have the lowest immunization coverage (under 30 percent). Health card coverage also varies widely by province, ranging from 19 percent in Dista Aceh to 62 in DI Yogyakarta. Table 11.3.2 Vaccinations: region and province Percentage of children 12-23 months who had received specific vaccines by the time of the survey (according to health card or mother's report) and the percentage with a health card, by region and province, Indonesia 1994 Percentage of children who received: Percent DPT Polio I with Number Region and health of 9rovince BCG 1 2 3+ 0 1 2 3+ Measles All 2 None card children Java-Bali 80.3 80.0 71.4 61.3 1.6 82.2 74.0 62.2 65.8 52.8 14.4 42.0 1,781 DKI Jakarta 92.2 89.8 87.0 79.2 0.0 91.7 88.6 79.9 67.9 62.1 6.8 30.8 107 West Java 73.2 73.9 64.4 53.5 1.6 77.8 68.2 54.6 62.6 43.6 18.0 37.4 681 Central Java 88.5 89.1 82.8 70.0 1.2 90.5 84.8 69.3 73.7 63.3 8.1 47.8 458 D1 Yogyakar ta 92.0 93.2 86.9 80.4 5.4 93.2 90.2 80.4 83.5 76.2 5.8 61.7 40 East Java 77.7 75.4 63.9 56.3 0.8 76.1 65.4 58.7 59.2 49.7 18.9 42.7 457 Bali 93.7 94.7 91.4 86.4 14.3 95.6 89.9 86.7 83.7 76.7 4.4 57.4 39 Outer Java-Bali 1 73.0 71.7 62.8 53.0 5.7 72.9 64.0 54.0 55.0 43.9 24.1 33. I 890 Dista Aceh 49.3 51.1 38.9 31.0 4.2 51.5 40.0 31.0 33.1 25.1 46.1 19.4 65 North Sumatra 68.9 68.5 59.6 50.5 2.9 70.7 62.7 53.3 49.4 40.8 27.5 31.9 232 West Sumatra 77.0 72.3 56.6 42.0 5.6 75.1 56.4 40.2 47.6 28.4 20.1 20.2 65 South Sumatra 78.7 75.8 68.7 59.7 12.2 78.5 72.1 64.9 67.6 56.2 19.5 49.6 98 Lampung 74.5 71.8 67.0 58.8 7.6 75.1 69.7 61.6 57.3 48.1 22.4 40.6 93 West Nusa Tenggara 81.1 79.3 70.5 53.7 8.4 77.6 64.4 46.2 64.0 38.0 17.6 29.3 66 West Kalimantan 68.2 69.1 58.4 48.8 4.8 66.4 54.0 46.6 50.7 41.5 26.1 30.1 63 South Kalimantan 80.9 75.4 63.5 51.8 3.4 77.8 70.3 56.9 64.6 48.2 16.8 39.3 36 North Sulawesi 86.3 86.7 77.0 70.2 12.8 86.7 80.3 73.5 78.1 64.6 12.6 37.6 40 South Sulawesi 76.5 75.9 69.5 61.0 2.5 75.3 69.6 60.3 56.2 50.9 22.2 31.1 132 Outer Java-Bali I I 77.0 76.4 69.8 62.3 4.7 76.4 69.9 62.7 64.4 54.3 20.2 36.6 394 Riau 72.6 70.7 67.8 59.0 3.1 70.0 66.2 59.2 61.2 52.1 25.4 33.8 69 Jambi 81.6 76.1 67.6 63.4 6.5 76.1 70.1 64.4 60.3 53.8 17.5 21.2 32 Bengkulu 79.8 78.5 73.8 68.2 7.5 78.7 75.0 66.4 70.0 58.7 19.1 31.7 21 East Nusa Tenggara 78.1 83.1 73.1 66.9 1.9 81.6 72.4 67.8 68.0 57.0 14.7 44.5 76 East Timor 65.0 65.6 60.4 53.4 3.7 66.3 61.7 53.9 53.3 45.3 32.2 29.2 24 Central Kalimantan 77.4 74.8 65.9 52.7 5.6 77.3 66.1 63.9 60.2 43.0 21.7 25.9 23 East Kalimantan 88.3 88.7 83.8 81.3 15.6 90.8 83.4 78.1 81.0 74.7 9.2 46.9 39 Central Sulawesi 69.2 67.4 58.1 47.3 3.3 66.2 59.1 45.8 53.1 41.9 29.6 34.8 27 Southeast Sulawesi 86.8 83.5 73.5 63.9 1.0 84.1 74.2 65.4 70.7 59.9 10.9 38.1 29 Maluku 66.9 65.9 63.5 57.5 4.0 66.0 62.5 52.7 56.2 45.8 30.5 44.2 24 Irian Jaya 77.8 75.4 70.2 58.4 2.5 75.4 71.3 60.4 64.6 51.5 21.2 38.3 30 Total 77.8 77.2 68.7 59.0 3.2 78.8 70.5 59.9 62.5 50.4 18.0 38.7 3,065 Note: The DPT coverage rate for children without a written record is assumed to be the same as that for polio vaccine since mothers were ~pecifically asked whether the child had received polio vaccine. Polio 0 is given at birth. 3 Children who are fully vaccinated (i.e., those who have received BCG, measles, and three doses each of DPT and polio vaccine). 171 The types of immunization received also vary by province. However, for any vaccination, Dista Aceh consistently shows the lowest level of immunization coverage and highest percentage of children who have never been immunized, while Bali has the highest level of immunization coverage and lowest percentage of children who have never been immunized. 11.4 Immunizations by First Year of Life The immunization series should be completed by the end of the first year of life. Therefore, immunization coverage for the first 12 months is evaluated in Table 11.4. The top panel presents the immunization coverage based on information recorded in the health cards, and the bottom panel combines two sources of information, health cards and mothers' reports. Information from health cards and mothers' reports shows that 42 percent of children 1 to 4 years have been fully immunized by age one. This is considerably higher than the 28 percent reported in 1991 (CBS et al., 1992). The patterns of immunization coverage by current age of the child may be interpreted as reflecting time trends in immunization program activities. Based on information from health cards and mothers' reports, the data show increasing coverage for all types of immunizations. With reference to children age 12- 23 months (born in the period 1992-93), the percentage fully immunized in the first year of life is 44 percent, compared with 41 percent among children age 48-59 months (born in the period 1989-90). The proportion of children who have received no vaccinations in the first year of life has been decreasing over time--25 percent in the period 1989-90, compared with 20 percent in the period 1992-93. Based on information from health cards and mothers' reports, BCG vaccinations were received by 73 percent of children by the age of 12 months, 54 percent received polio 3, 53 percent received DPT 3, and 53 percent received measles vaccine. Overall, 42 percent of children age 12-59 months were completely vaccinated during the first year of life. 172 Table 11.4 Vaccinations in first ),ear of life Among children one to four years of age, the percentage who had received specific vaccines during the first year of life, by source of information (health cards or health cards and mothers' reports), and age of child, Indonesia 1994 Child's age 12-23 24-35 36-47 48-59 Vaccine months months months months Total HEALTH CARDS Health card seen 100.0 1130.0 100.0 1130.0 100.0 BCG 87.1 83.6 78.2 77.3 83.0 DPT 1 92.1 85.9 81.4 82.2 86.9 DPT 2 85.8 80.6 75.2 74.0 80.7 DPT 3 75.0 72.6 66.9 64.5 71.3 Polio 0 5.4 2.9 2.4 1.6 3.6 Polio I 93.1 85.9 80.5 81.2 87.0 Polio 2 87.4 80.4 74.9 73.4 8 I. I Polio 3 75.9 71.7 66.2 64.4 71.3 Measles 63.1 61.2 54.2 62.2 60.7 AIlk 57.6 55.5 49.4 53.8 54.8 None 6.1 12.2 17.6 14.2 11.2 Number of children 1,187 855 622 402 3,066 HEALTH CARDS AND MOTHERS' REPORTS Health card seen 38.7 25.5 19.6 12.8 24.1 BCG 75.5 74.4 71.9 71.8 73.4 DPT 1 75.2 71.4 70.0 70.0 71.6 DPT 2 67.0 64.3 61.9 60.0 63.3 DPT 3 56.2 54.1 52.1 49.9 53.0 Polio 0 3.1 2.0 2.1 1.0 2.1 Polio 1 76.9 72.9 70.5 71.3 72.9 Polio 2 68.6 65.4 63.2 61.5 64.7 Polio 3 57.3 54.3 52.4 51.7 53.9 Measles 54.6 53.7 48.6 54.3 52.8 All I 44.4 43.1 40.2 41.4 42.3 None 20.2 23.1 27.1 25.2 23.9 Number of children 3,065 3,352 3,165 3,148 12,731 i Children who are fully vaccinated (i.e., those who have received BCG, measles, and three doses each of DPT and polio vaccine). 173 CHAPTER 12 CHILDHOOD DISEASES 12.1 Acute Respiratory Infection Acute lower respiratory tract infection, primarily pneumonia, is a common cause of morbidity and death among children under five years of age. Pneumonia is characterized by cough with difficult or rapid breathing and chest indrawing. Severe pneumonia needs hospitalization; otherwise, ambulatory treatment with antibiotics is recommended. Early diagnosis and treatment with antibiotics can prevent a large proportion of deaths caused by acute lower respiratory infection. It should be noted that in this survey identification of acute respiratory infection is based on the respondent's perceptions of the respiratory symptoms suffered by the child. Prevalence and Incidence of Acute Respiratory Infection (ARI) The prevalence of a cough in the two weeks preceding the survey among children under five is 29 percent, and the incidence is 26 percent. The prevalence of a cough with rapid breathing in the two weeks prior to the survey is 10 percent, and the incidence is 9 percent (see Table 12.1.1).1 Higher rates of prevalence and incidence are observed among children age 6 to 35 months. The prevalence and incidence of a cough is slightly higher among males than females. High birth order children (seventh or higher) are less likely than low birth order children to have cough. Children born to mothers with no education have slightly lower prevalence and incidence rates for cough than children of mothers who have attended school. There is little variation in the prevalence of cough with rapid breathing by the sex of the child, birth order, and residence, but prevalence is lower among children of better educated mothers than among children of mothers with little or no education. Children in Java-Bali have slightly higher prevalence and incidence rates for cough than children in the Outer Java-Bali regions, while the prevalence and incidence of cough with rapid breathing show negligible differences by region. Provinces in which the prevalence and incidence of cough are 30 percent or higher include West Java, West Sumatra, West Nusa Tenggara, and North Sulawesi (see Table 12.1.2). Provinces that have high prevalence and incidence of cough with rapid breathing (15 percent or higher) include West Sumatra, West Nusa Tenggara, and North Sulawesi. Prevalence refers to the percentage of children having ARI in the two weeks preceding the survey; incidence refers to the percentage of children who became sick with ARI in the two weeks preceding the survey. 175 Table 12.1.1 Prevalence and incidence of acute respiratory infection: background characteristics Among children under five years of age, the prevalence of cough and cough accompa- nied by rapid breathing, and the incidence of cough and cough accompanied by rapid breathing, according to background characteristics, Indonesia 1994 Prevalence Incidence Cough Cough Number Background and rapid and rapid of characteristic Cough breathing Cough breathing children Age of child <6 months 21.3 6.9 18.9 5.8 1,542 6-11 months 39.9 13.3 34.2 12.2 1,611 12-23 months 35.1 12.3 32.0 11.7 3,065 24-35 months 30.2 11.5 27.0 10.8 3,352 36-47 months 25.1 8.6 22.1 8.0 3,165 48-59 months 22.7 7.4 20.8 6.9 3,148 Sex of child Male 30.2 10.7 27.2 10.0 8,113 Female 27.2 9.3 24,1 8.6 7,771 Birth order 1 28.7 9.4 25.1 8.5 4,665 2-3 29.4 9.7 26.6 9.0 6,314 4-6 29.0 I 1,13 26.2 10.6 3,585 7+ 25.0 10.5 22.2 10.3 1,319 Residence Urban 32.8 9.13 29.2 8.7 4,472 Rural 27. I 10.13 24.4 9.5 11,411 Region/Residence Java-Bali 30.6 9.9 27.4 9.3 9,111 Urban 35.3 9.4 31.4 8.8 3,072 Rural 28.2 10.2 25.4 9.5 6,038 Outer Java-Bali I 27.2 10,1 24.4 9.4 4,701 Urban 28.6 9.4 25.2 8.7 954 Rural 26.9 10,3 24.2 9.6 3,747 Outer Java-Bali II 24.2 10.2 21.1 9.3 2,071 Urban 25.1 8.9 22.5 8.3 446 Rural 23.9 10. 5 20.7 9.6 1,625 Education No education 26.5 12.1 23.6 11.6 1,817 Some primary 28.2 11.5 25.6 10.8 4,869 Completed primary 28.0 8,8 25.0 8.1 4,686 Some secondary+ 30.9 8.8 27.5 8.1 4,510 Total 28.7 10.0 25.7 9.3 15,883 176 Table 12.1.2 Prevalence and incidence of acute respiratory infection: region and province Among children under five years of age, the prevalence of cough and cough accom- panied by rapid breathing, and the incidence of cough and cough accompanied by rapid breathing, according to region and province, Indonesia 1994 Prevalence Incidence Cough Cough Number Region and and rapid and rapid of province Cough breathing Cough breathing children Java-Bali 30.6 9.9 27.4 9.3 9,111 DKI Jakarta 27.6 5.2 24.3 4.5 601 West Java 36.2 14.5 31.8 13.2 3,352 Central Java 24.0 7.8 21.1 7.7 2,493 DI Yogyakarta 29.5 5.1 26.7 4.0 178 East Java 31.5 7.2 29.8 7.0 2,286 Bali 18.9 8.1 15.7 7.7 201 Outer Java-Bali I 27.2 10. I 24.4 9.4 4,701 Dista Aceh 27.9 10.2 24.6 9.8 355 North Sumatra 31.8 10.6 29.3 9.7 1,202 West Sumatra 36.6 15.5 36.1 15.5 336 South Sumatra 17.9 6.8 15.2 6.2 521 Lampung 17.0 4.1 13.8 3.9 537 West Nusa Tenggara 33.4 16.6 31.5 16.0 357 West Kalimantan 28.8 10.4 26.4 9.5 342 South Kalimantan 23.8 8.2 21.3 7.5 209 North Sulawesi 38.1 16.6 32.5 16.0 190 South Sulawesi 23.0 9.2 19.0 7.6 652 Outer Java-Bali II 24.2 I 0.2 21.1 9.3 2,071 Riau 21.4 11.2 19.9 11.0 361 Jambi 23.2 10.8 21.0 10.4 193 Bengkulu 26.4 10.1 24.4 9.3 125 East Nusa Tenggara 32.7 15.8 26.8 13.3 332 East Timor 18.8 5.7 15.7 5.3 115 Central Kalimantan 17.5 5.9 16.6 5.9 123 East Kalimantan 23.0 7.5 20.6 6.4 202 Central Sulawesi 23.8 11.8 20.0 10.2 150 Southeast Sulawesi 23.4 7.1 19.6 7.0 140 Maluku 27.8 10.7 25.7 10.0 177 Irian Jaya 19.4 6.1 14.3 5.2 153 Total 28.7 10.0 25.7 9.3 15,883 Treatment of Acute Respiratory Infection More than 60 percent of children with cough and rapid breathing in the two weeks preceding the survey were taken to a health facility or provider, e.g., hospital, health center, health post (posyandu), private clinic, doctor, nurse, or midwife (see Table 12.2.1 ). Twenty-four percent of children received self-treatment (medicine from a pharmacy or shop), and 10 percent received no treatment. A small percentage of ill children (2 percent) were taken to a traditional healer. Infants under 6 months of age are less likely to be taken to a health facility than older children. One in four infants under 6 months received no treatment, and 6 percent were taken to a traditional healer. There is little variation in the treatment of cough with rapid breathing according to the sex or birth order of the child, although fourth or higher birth-order children are less likely to be taken to a health facility or to receive treatment. 177 Table 12.2.1 Prevalence and treatment of acute respiratory infection: background characteristics Among children under five years of age, the percentage who were ill with a cough accompanied by rapid breathing during the two weeks preceding the survey, and the percent distribution of these children by type of treatment received, according to background characteristics, Indonesia 1994 Treatment received by children with cough and rapid breathing Taken to Percent a health No with cough facility Tradi- advice/ Number Background and rapid or pro- tional Self- treatment of characteristic breathing rider t healer treatment 2 sought Total children Age of child <6 months 6.9 51.7 6.0 18.2 24.1 I00.0 1,542 6-11 months 13.3 71.4 2.6 19.9 6.1 100.0 1,611 12-23 months 12.3 63.1 2.8 24.6 9.5 100.0 3,065 24-35 months 11.5 58.2 2.4 28.6 10.8 100.0 3,352 36-47 months 8.6 69.3 0.7 22.9 7.1 100.0 3,165 48-59 months 7.4 59.4 1.7 26.1 12.8 100.0 3,148 Sex of child Male 10.7 65.0 2.5 21.6 10.9 100.0 8,113 Female 9.3 60.1 2.2 27.8 9.9 100.0 7,771 Birth order 1 9.4 66.0 3.3 20.7 10.0 100.0 4,665 2-3 9.7 65.1 1.0 26.4 7.6 100.0 6,314 4-6 11.3 57.3 3.5 24.5 14.7 100.0 3,585 7+ 10.5 58.4 2.4 27.3 11.9 100.0 1,319 Residence Urban 9.3 77.9 0.5 19.2 2.3 1013.0 4,472 Rural 10.3 57.4 3.0 26.3 13.3 100.0 11,411 Region/Residence Java-Bali 9.9 65.0 1.1 24.5 9.4 100.0 9,111 Urban 9.4 79.2 0.0 19.3 1.6 100.0 3,072 Rural 10.2 58.4 1.6 27.0 13.1 100.0 6,038 Outer Java-Bali I 10.1 60.6 4.5 23.7 11.2 100.0 4,701 Urban 9.4 75.3 2.2 18.6 3.9 100.0 954 Rural 10.3 57.2 5.1 24.9 12.8 100.0 3,747 Outer Java-Bali 11 10.2 58.1 2.9 25.7 13.2 100.0 2,071 Urban 8.9 75.0 0.8 20.2 3.9 100.0 446 Rural 10.5 54.2 3.4 27.0 15.4 100.0 1,625 Education No education 12.1 47.0 3.4 26.0 23.7 100.0 1,817 Some primary l 1.5 58.6 3.5 26.2 11.7 100.0 4,869 Completed primary 8.8 62.9 1.9 27.1 8.1 100.0 4,686 Some secondary+ 8.8 77.2 0.7 18.3 3.7 100.0 4,510 Total 10.0 62.8 2.4 24.4 10.4 1(1t3.0 15,883 I Includes hospital, health center, health post, private clinic, doctor, nurse, midwife, village delivery post, and health cadre 2 Pharmacy or shop Urban ch i ldren are more l ikely than rural ch i ldren to be taken to a health faci l i ty when they have a cough with rapid breathing. Ch i ldren o f better educated mothers are more l ikely to be taken to a health faci l i ty for t reatment o f cough than chi ldren o f mothers with less educat ion. Only 47 percent o f ch i ldren o f mothers wi th no educat ion were taken to a health fac i l i ty - -o f which 24 percent rece ived no t reatment - - compared wi th 77 percent o f ch i ldren o f mothers with some secondary educat ion, of which 4 percent rece ived no treatment. 178 Chi ldren in the Java-Ba l i region who have cough with rapid breath ing are more l ike ly to be taken to a health faci l i ty than ch i ldren in the Outer Java-Ba l i regions (65 percent, compared with 61 percent or less). More than 15 percent o f ch i ldren with cough and rapid breath ing rece ived no treatment in 10 prov inces (DI Yogyakar ta , East Java, West Sumatra, West Nusa Tenggara , South Sulawesi , Bengku lu , East Nusa Tenggara , East T imor , Centra l Su lawes i , and Southeast Sulawesi ) (Tab le 12.2.2). Table 12.2.2 Prevalence and treatment of acute respiratory infection: region and province Among children under five years of age, the percentage who were ill with a cough accompained by rapid breathing during the two weeks preceding the survey, and the percent distribution of these children by type of treatment received, according to region and province, Indonesia 1994 Treatment received by children with cough and rapid breathing Taken to Percent a health No with cough facility Tradi- advice/ Number Region and and rapid or pro- tional Self- treatment of province breathing vider t healer treatment 2 sought Total children Java-Bali 9.9 65.0 1.1 24.5 9.4 100.0 9,111 DKI Jakarta 5.2 79.4 0.0 15.9 4.7 100.0 601 West Java 14.5 61.9 0.0 28.9 9.2 100.0 3,352 Central Java 7.8 75.7 5.1 14.7 4.6 100.0 2,493 DI Yogyakarta 5.1 56.1 0.0 25.9 18.0 100.0 178 East Java 7.2 58.5 0.0 25.4 16.1 100.0 2,286 Bali 8.1 74.7 0.0 16.3 9.0 100.0 201 Outer Java-Bali I 10.1 60.6 4.5 23.7 11.2 100.0 4,701 Dista Aceh 10.2 57.6 3.1 32.0 7.4 100.0 355 North Sumatra 10.6 67.2 0.9 23.4 8.5 100.0 1,202 West Sumatra 15.5 56.6 l 1.0 16.3 16.1 100.0 336 South Sumatra 6.8 67.9 3.9 24.2 3.9 100.0 521 Lampung 4. l 59.9 4.1 27.2 8.9 100.0 537 West Nusa Tenggara 16.6 59.4 12.7 12.0 15.9 100.0 357 West Kalimantan 10.4 52.7 0.0 37.8 9.5 100.0 342 South Kalimantan 8.2 53.4 0.0 39.8 6.8 100.0 209 North Sulawesi 16.6 68.7 2.8 24.6 3.9 100.0 190 South Sulawesi 9.2 51.6 4.7 22.5 21.3 100.0 652 Outer Java-Bali II 10.2 58.1 2.9 25.7 13.2 100.0 2,071 Riau 11.2 52.8 2.7 33.3 11.3 100.0 361 Jambi 10.8 59.1 7.1 25.4 8.4 100.0 193 Bengkulu 10.1 45.9 11.5 22.7 19.8 100.0 125 East Nusa Tenggara 15.8 62.1 0.0 22.3 15.6 100.0 332 East Timor 5.7 74.2 0.0 4.4 21.4 100.0 115 Central Kalimantan 5.9 75.4 0.0 24.6 0.0 100.0 123 East Kalimantan 7.5 58.4 0.0 32.1 9.5 100.0 202 Central Sulawesi 11.8 46.8 9.7 25.7 17.8 100.0 150 Southeast Sulawesi 7.1 49.5 4.1 31.4 15.0 100.0 140 Maluku 10.7 61.2 0.0 25.0 13.7 100.0 177 Irian Jaya 6.1 72.1 0.0 18.2 9.7 100.0 153 Total 10.0 62.8 2.4 24.4 10.4 100.0 15,883 i Includes hospital, health center, health post, private clinic, doctor, nurse, midwife, village delivery post, and health cadre 2 Pharmacy or shop 179 12.2 Prevalence and Treatment of Fever Information about the presence of fever in children under five years was recorded in the survey, although the causes of fever were not specified. Various infectious diseases are accompanied by fever. In Indonesia, the most common diseases with fever are malaria, respiratory and intestinal infections, measles, and typhoid. The overall prevalence of fever (including children who also had cough, rapid breathing, or diarrhea) is 28 percent; the prevalence of fever only is 7 percent (see Table 12.3.1). The prevalence of any fever is highest among infants age 6-11 months (42 percent), whereas, fever only is 8 percent for this age group. These proportions are higher than for children under 6 months and for those 2 years or older. There are negligible differences in the prevalence of any fever by sex of child, birth order, and mother's education. The prevalence of any fever is higher in the urban areas (30 percent) than in the rural areas (27 percent) and higher in the Java-Bali and Outer Java-Bali I regions than in the Outer Java-Bali II region. However, the prevalence of fever only shows significant differences by residence and region. Since fever may accompany cough and diarrhea, the treatment of any fever may overlap with the treatment of cough and diarrhea. Therefore, in this analysis, treatment of fever refers to children with fever only, without cough or diarrhea. Forty-five percent of children with fever only were taken to a health facility for treatment, 37 percent received self-treatment, and 16 percent received no treatment. Infants under 6 months of age with fever are more likely to receive no treatment than older children (36 percent, compared with I 1 - 18 percent). There were no major differences in the utilization of health facilities by sex of child. High birth order children with fever are more likely not to get treatment than low birth order children (20 percent for seventh or higher birth order, compared with 11 percent for first children). The percentage of children with fever who received no treatment is higher among children of mothers with no education than other children. Three in five children with fever whose mothers had some secondary education were taken to a health facility and 28 percent received self-treatment. Children whose mothers have no education are more likely to get self-treatment (42 percent) than to be taken to a health facility (36 percent). The prevalence of any fever as well as fever only among children born in the five years preceding the survey varies by province (see Table 12.3.2). High prevalence of any fever (36-43 percent) is found in West Java, West Sumatra and North Sulawesi. The prevalence of fever only is high in North Sulawesi and Southeast Sulawesi (10 and 14 percent, respectively). The percentage of children with fever who received no treatment is higher in the Outer Java-Bali regions than in Java-Bali. In Java-Bali, 14 percent of children received no treatment, compared with 18-19 percent of children in the Outer Java-Bali regions. 180 Table 12.3.1 Prevalence and treatment of fever: background characteristics Among children under five years of age, the percentage who were ill with a fever during the two weeks preceding the survey, and among those ill with fever only the percent distribution by type of treatment received, according to background characteristics, Indonesia 1994 Treatment received by children with fever only Percent Taken to No Percent with a health Tradi- advice/ Number Background with fever facility or tional Self- treatment of characteristic fever I only provider 2 healer treatment 3 sought Total children Age of child <6 months 19.9 5.3 34.0 5.1 24.9 36.0 100.0 1,542 6-11 months 41.7 8.0 59.3 0.3 25.7 14.6 100.0 1,611 12-23 months 35.9 8.4 50.0 4.5 33.1 12.4 100.0 3,065 24-35 months 28.6 6.8 43.6 3.3 35.5 17.7 100.0 3,352 36-47 months 23.3 7.2 36.9 1.8 46.8 14.5 100.0 3,165 48-59 months 20.7 6.1 42.3 0.2 46.3 11.3 100.0 3,148 Sex of child Male 28.3 6.7 44.9 2,7 35.0 17.4 1130.0 8,113 Female 27.4 7.4 44.3 2.3 39.3 14.1 100.0 7,771 Birth order 1 26.3 6.8 52.7 3.1 32.9 l l .3 100.0 4,665 2-3 28.0 6.6 40.5 2.8 39.2 17.5 100.0 6,314 4-6 29.6 8.0 46.2 1.2 36.3 16.3 100.0 3,585 7+ 28.1 7.3 30.9 3.1 45.7 20.2 100.0 1,319 Residence Urban 29.8 7.4 45.6 0.6 40.1 13.8 100.0 4,472 Rural 27.1 6.9 44.1 3.3 36.0 16.5 100.0 11,411 Region/Resldence Java-Bali 29.7 7.2 39.7 1.7 45.0 13.5 100.0 9,111 Urban 31.2 7.0 43.1 0.2 44.0 12.6 100.0 3,072 Rural 28.9 7.2 38.1 2.4 45.5 14.0 100.0 6,038 Outer Java-Bali I 26.7 6.8 49.0 4.2 27.9 18.9 100.0 4,701 Urban 27.7 8.0 45.3 1.8 38. l 14.9 100.0 954 Rural 26.4 6.5 50.1 5.0 24.7 20.2 100.0 3,747 Outer Java-Bali 11 22.6 7.0 56.6 2.3 22.8 18.4 100.0 2,071 Urban 24.9 8.9 59.8 0.0 22.2 18.0 100.0 446 Rural 22.0 6.5 55.4 3.1 23.0 18.5 100.0 1,625 Education No education 28.5 6.9 36.2 0.3 42.3 21.2 100.0 1,817 Some primary 28.8 7.2 40.7 3.0 38.5 17.8 100.0 4,869 Completed primary 26.7 6.3 36.1 4.0 45.0 14.9 100.0 4,686 Some secondary+ 27.8 7.7 58.7 1.4 27.5 12.4 100.0 4,510 Total 27.9 7.0 44.6 2.5 37.2 15.7 100.0 15,883 i Can include cough with short, rapid breathing, and diarrhea 2 Includes hospital, health center, health post, private clinic, doctor, nurse, midwife, village delivery post, and health cadre 3 Pharmacy or shop 181 Table 12.3.2 Prevalence and treatment of fever: region and province Among children under five years of age, the percentage who were ill with a fever during the two weeks preceding the survey, and among those ill with fever only the percent distribution by type of treatment received, according to region and province, Indonesia 1994 Treatment received by children with fever only Percent Taken to No Percent with a health Tradi- advice/ Number Background with fever facility or tional Self- treatment of characteristic fever I only provider 2 healer treatment 3 sought Total children Java-Bali 29.7 7.2 39.7 1.7 45.0 13.5 100.0 9,111 DKI Jakarta 26.1 4,8 63.3 1.8 27.0 7.8 100.0 601 West Java 38.3 7.9 26.8 0.0 53.2 20.1 100.0 3,352 Central Java 22.6 6.0 47.0 2.1 44.3 6.7 1130.0 2,493 DI Yogyakarta 28.4 8.0 65.6 0.0 25.3 9.0 100.0 178 East Java 26.9 7.9 46.5 4.0 39.2 10.2 100.0 :2,286 Bali 17.6 5.9 47.9 0.0 29.9 22.2 100.0 201 Outer Java-Bali I 26.7 6.8 49.0 4.2 27.9 18.9 100.0 4,701 Dista Aceh 29.1 8.6 46.2 5.8 24.8 23.2 100.0 355 North Sumatra 28.0 6.4 63.2 0,0 23.9 13.0 100.0 1,202 West Sumatra 35.5 8.8 42.2 16.8 16.0 25.0 1130.0 336 South Sumatra 19.8 7.4 46.5 0.0 36.8 16.7 100.0 521 Lampung 16.6 3.9 54.2 8.8 26.1 10.9 100.0 537 West Nusa Tenggara 32.8 5.9 46.0 5.5 17.8 30.7 100.0 357 West Kalimantan 24.6 5.3 44.1 2.8 44.0 9.1 100.0 342 South Kalimantan 29.4 9.9 40.5 6.3 45.9 7.3 100.0 209 North Sulawesi 42.5 10.1 53.7 0.0 42.7 3.6 100.0 190 South Sulawesi 24.2 6.9 35.9 4.5 21.2 38.3 100.0 652 Outer Java-Bali II 22.6 7.0 56.6 2.3 22.8 18.4 100.0 2,071 Riau 22.0 6.1 50.8 1.8 34.6 12.9 100.0 361 Jambi 22.4 7.9 68.5 0.0 20.0 11.5 100.0 193 Bengkulu 23.7 5.4 62.3 0.0 16.8 20.8 100.0 125 East Nusa Tenggara 29.3 8.6 52.3 0.0 24.4 23.3 100.0 332 East Timor 15.2 4.5 65.0 7.8 2.5 24.7 100.0 115 Central Kalimantan 14.8 3.6 57.5 0.0 31.6 10.9 100.0 123 East Kalimantan 21.8 6.8 45.1 0.0 36.2 18.7 100.0 202 Central Sulawesi 22.0 7.8 45. I 5.5 29.7 19.7 1130.0 150 Southeast Sulawesi 32.8 13.6 72.8 2.5 6.1 18.6 100.0 140 Maluku 19.1 5.4 62.9 14.8 9.8 12.5 100.0 177 lrian Jaya 17.6 5.8 45.2 0.0 24.3 30.5 100.0 153 Total 27.9 7.0 44.6 2.5 37.2 15.7 100.0 15,883 1 Can include cough with short, rapid breathing, and diarrhea 2 Includes hospital, health center, health post, private clinic, doctor, nurse, midwife, village delivery post, and health cadre 3 Pharmacy or shop 12.3 Diarrheal Disease Diarrheal diseases continue to be a public health problem in Indonesia. Diarrhea is more prevalent at the end of the dry season or the beginning of the rainy season. A Diarrhea Control Program has been instituted to reduce the prevalence of diarrhea by improving health services in the hospitals, health centers and health posts. Training for doctors and nurses has been provided in hospitals at the regency level to improve the quality of care. Oral rehydration centers have been 182 established in health centers and health posts. Education about use of oral rehydration therapy (ORT) for treatment of diarrhea has been introduced through the mass media, especially television. Prevalence of Diarrhea In the survey, mothers with children under five years of age were asked if their children had had diarrhea at any time in the two weeks preceding the survey, and whether they still had diarrhea in the last 24 hours. The survey was conducted in July and continued through November 1994, which was the end of the dry season. Twelve percent of children were reported to have had diarrhea in the two weeks preceding the survey, including 3 percent who had diarrhea in the last 24 hours (see Table 12.4.1). The prevalence of bloody diarrhea (i.e., blood in stools) is 1 percent. The prevalence of diarrhea in the two-week period and in the 24 hours preceding the survey is high among children age 6-11 months. The prevalence of bloody diarrhea is also slightly higher in this age group. There are small differences in the prevalence of diarrhea according to background characteristics. Birth order has a positive relationship with the likelihood of getting diarrhea, whereas mother's education has a negative association. For example, the prevalence of diarrhea among children whose mothers have no education is 14 percent, 12 percent among children of mothers with completed primary education, and 10 percent among children of mothers with some secondary education. Table 12.4.1 also presents the prevalence of persistent diarrhea. A child is said to have persistent diarrhea if s/he had diarrhea in the last 24 hours, and had diarrhea in the preceding two weeks that lasted for at least 14 days. Overall, very few children have persistent diarrhea, and there is little variation by background characteristics. However, infants under one year are more likely to have persistent diarrhea than older children. The prevalence of diarrhea varies considerably by region. The two-week prevalence in Java-Bali ( 13 percent) is higher than in the Outer Java-Bali regions (11 percent or less). The prevalence of diarrhea in the two-week period and in the 24 hours preceding the survey is highest in West Java (21 and 7 percent) and Bengkulu (22 and 7 percent) (see Table 12.4.2). 183 Table 12.4.1 Prevalence of diarrhea: background characteristics Among children under five years of age, the percentage with diarrhea and diarrhea with blood during the two weeks preceding the survey, and the percentage with diarrhea in the last 24 hours, by background characteristics, Indonesia 1994 Diarrhea in the preceding 2 weeks I Diarrhea in the Number Background All Diarrhea last 24 Persistent of characteristic diarrhea 2 with blood hours diarrhea 3 children Age of child <6 months 10.5 0.9 2.4 0.4 1,542 6-11 months 20.2 1.9 6.9 0.6 1,611 12-23 months 18.3 1.5 4.2 0.1 3,065 24-35 months 12.4 1.2 3.8 0.1 3,352 36-47 months 9.0 1.0 2.4 0.0 3,165 48-59 months 5.5 0.6 1.0 0.0 3,148 Sex of child Male 13.1 1.3 3.7 0.2 8,113 Female 11.0 1.1 2.8 0.1 7,771 Birth order I 10.1 1.0 2.1 0.2 4,665 2-3 12.0 0.8 3.6 0.1 6,314 4-6 13.5 1.5 3.3 0.1 3,585 7+ 15.5 2.2 5.1 0.3 1,319 Residence Urban 12.4 1.1 2.7 0.0 4,472 Rural 12.0 1.2 3.5 0.2 11,411 Region/Residence Java-Bali 13.0 1.3 3.7 0.2 9,111 Urban 13.7 1.3 3.0 0.0 3,072 Rural 12.7 1.3 4.1 0.3 6,038 Outer Java-Bali I I 1.3 1.0 2.5 0.0 4,701 Urban I 0. I 0.9 1.8 0.0 954 Rural I 1.6 1.1 2.6 0.1 3,747 Outer Java-Bali 11 9.8 0.9 2.8 0.0 2,071 Urban 8.1 0.2 2.6 0.0 446 Rural I 0.3 1.1 2.8 0.0 1,625 Education No education 14.2 1.6 4.7 0.1 1,817 Some primary 13.7 1.3 3.7 0.2 4,869 Completed primary 11.5 1.0 3.1 0.2 4,686 Some secondary+ 10.1 1.0 2.2 0. I 4,510 Total 12.1 1.2 3.2 0.1 15,883 i Includes diarrhea in the last 24 hours 2 Includes diarrhea with blood 3 Diarrhea in the last 24 hours and diarrhea in the preceding two weeks that lasted for at least 14 days 184 Table 12.4.2 Prevalence of diarrhea: region and province Among children under five years of age, the percentage with diarrhea and diarrhea with blood during the two weeks preceding the survey, and the percentage with diarrhea in the last 24 hours, by region and province, Indonesia 1994 Diarrhea in the preceding 2 weeks I Diarrhea in the Number Background All Diarrhea last 24 Persistent of characteristic diarrhea 2 with blood hours diarrhea s children Java-Bali 13.0 1.3 3.7 0.2 9,111 DKI Jakarta 6.9 0.8 1.0 0.0 601 West Java 20.5 2.3 6.5 0.5 3,352 Central Java 7.8 0.2 2.4 0.0 2,493 DI Yogyakarta 4.6 0.5 0.8 0.0 178 East Java 10.5 1.2 2.3 0.1 2,286 Bali 7.5 0.0 1.7 0.0 201 Outer Java-Bali I 11.3 1.0 2.5 0.0 4,701 Dista Aceh 7.9 0.8 1.8 0.0 355 North Sumatra 13.1 1.1 2.2 0.0 1,202 West Sumatra 12.3 1.7 3.5 0.2 336 South Sumatra 7.0 0.6 1.2 0.0 521 Lampung 8.1 0.8 2.3 0.2 537 West Nusa Tenggara 15.3 1.8 5.4 0.0 357 West Kalimantan 14.4 0.4 3.4 0.1 342 South Kalimantan 12.9 1.4 1.4 0.0 209 North Sulawesi 13.2 0.8 2. l 0.0 190 South Sulawesi 10.6 0.9 2.3 0.0 652 Outer Java-Ball 1I 9.8 0.9 2.8 0.0 2,071 Riau 11.1 0.9 2.6 0.0 361 Jambi 10.9 1.1 5.2 0.0 193 Bengkulu 21.6 1.8 6.9 0.0 125 East Nusa Tenggara 11.0 1.4 3.0 0.0 332 East Timor 6.9 0.5 2.2 0.1 115 Central Kalimantan 5.8 1.9 2.1 0.0 123 East Kalimantan 7.6 0.5 2.0 0.0 202 Central Sulawesi 9.3 0.5 1.3 0.0 150 Southeast Sulawesi 9.0 0.2 1.9 0.0 140 Maluku 3.7 0.6 0.9 0.0 177 lrian Jaya 9.4 0.2 2.6 0.2 153 Total 12.1 1.2 3.2 0.1 15,883 i Includes diarrhea in the last 24 hours 2 Includes diarrhea with blood 3 Diarrhea in the last 24 hours and diarrhea in the preceding two weeks that lasted for at least 14 days 185 Duration and Incidence of Diarrhea The average duration of a diarrheal epi- sode is calculated from the durations for all chil- dren who had diarrhea in the preceding two weeks, excluding those who had diarrhea in the last 24 hours (i.e., terminated episodes only). The results indicate that the average duration of a diarrheal episode is 3.1 days (see Table 12.5.1). There is little difference in the duration of diarrheal episodes by background characteris- tics. However, the mean duration of diarrhea is slightly longer among children in the rural areas and higher birth order children than among other children. The mean duration of diarrhea among children whose mothers have no education is 3.5 days, compared with 2.8 days among children whose mothers have some secondary education. The two-week diarrheal incidence is de- fined as the percentage of children having a diar- rheal episode that started in the preceding two weeks and is estimated from the relationship of prevalence to incidence as follows: 11-14 = /°2-14 × 14/(13 + D), incidence in the 14 days preceding the survey Pz.14 = prevalence in days 2-14 preced- ing the survey D = average duration of a diarrheal episode in the 2-14 days preced- ing the survey. The two-week incidence of diarrhea is 8 percent, which is slightly lower than that record- ed in the 1991 Demographic and Health Survey (1 1 percent) (CBS et al., 1992). Diarrheal inci- dence is higher among children age 6-23 months ( 11-12 percent) than among older children, high- er in urban areas (9 percent) than rural areas (7 percent), and higher in Java-Bali and Outer Java- Table 12.5.1 Duration and incidence of diarrhea: background characteristics Mean duration of diarrhea (days) among children who had diarrhea in the preceding two weeks but not in the last 24 hours and the two-week incidence of diarrhea, by background characteristics, Indonesia 1994 Mean Number Background duration of Incidence characteristic (days) children 1-14 Age of child <6 months 3.1 1,542 7.0 6-11 months 3.2 1,611 11.4 12-23 months 3.3 3,065 12.0 24-35 months 2.9 3,352 7.6 36-47 months 3.0 3,165 5.8 48-59 months 3.0 3.148 3.9 Sex of child Male 3.1 8,113 8.2 Female 3.1 7,771 7.2 Birth order 1 2.8 4,665 7. I 2-3 3.0 6,314 7.3 4-6 3.4 3,585 8.6 7+ 3.7 1,319 8.8 Residence Urban 2.8 4,472 8.6 Rural 3.3 11,411 7.3 Region/Residence Java-Bali 3.1 9,111 8.1 Urban 2.7 3,072 9.5 Rural 3.3 6,038 7.3 Outer Java-Bali l 3.1 4,701 7.7 Urban 2.8 954 7.4 Rural 3.1 3,747 7.8 Outer Java-Bali 11 3.4 2,071 6.0 Urban 3.1 446 4.7 Rural 3.4 1,625 6.4 Education No education 3.5 1,817 8.0 Some primary 3.3 4,869 8.6 Completed primary 3.0 4,686 7.4 Some secondary+ 2.8 4,510 6.9 Total 3.1 15,883 7.7 Bali I regions (8 percent) than Outer Java-B ali II (6 percenl). Diarrheal incidence is higher for children whose mothers have some primary education than for those whose mother have secondary education. The mean duration of diarrhea that had terminated in the 24 hours preceding the survey is 3.5 days or longer in DI Yogyakarta, West Kalimantan, Bengkulu, East Nusa Tenggara, Central Kalimantan, Maluku, and Irian Jaya (see Table 12.5.2). The incidence of diarrhea in the two weeks preceding the survey is highest in Bengkulu (13 days). 186 Table 12.5.2 Duration and incidence of diarrhea: region and province Mean duration of diarrhea (days) among children who had diarrhea in the preceding two weeks but not in the last 24 hours and the two-week incidence of diarrhea, by region and province, Indonesia 1994 Mean Number Region and duration of Incidence province (days) children 1-14 Java-Bali 3.1 9,111 8.1 DKI Jakarta 2.6 601 5.3 West Java 3.4 3,352 12.0 Central Java 2.7 2,493 4.8 DI Yogyakarta 3.5 178 3.3 East Java 2.8 2,286 7.3 Bali 2.6 201 5.2 Outer Java-Bali I 3.1 4,701 7.7 Dista Aceh 3.3 355 5.2 North Sumatra 3.1 1,202 9.5 West Sumatra 2.5 336 7.9 South Sumatra 3.0 521 5.0 Lampung 3.2 537 5.0 West Nusa Tenggara 3.1 357 8.5 West Kalimantan 3.7 342 9.3 South Kalimantan 2.6 209 10.4 North Sulawesi 2.2 190 10.2 South Sulawesi 3.3 652 7.1 Outer Java-Bali I1 3.4 2,071 6.0 Riau 3.1 361 7.4 Jambi 3.2 193 5.0 Bengkulu 3.5 125 12.5 East Nusa Tenggara 3.5 332 6.8 East Timor 3.2 115 4.0 Central Kalimantan 4.8 123 2.9 East Kalimantan 3.1 202 4.9 Central Sulawesi 2.9 150 7.0 Southeast Sulawesi 3.3 140 6.1 Maluku 4.4 177 2.3 lrian Jaya 3.9 153 5.7 Total 3.1 15,883 7.7 Knowledge of Diarrhea Care The recommended treatment for diarrhea is oral rehydration therapy (ORT), including solution prepared from ORS packets (prepackaged oral rehydration salts) and increased fluids. In Indonesia, ORT is promoted through health education and mass media campaigns. A mother is classified as knowing about ORT if she reported ever having heard about Oralit--the brand of ORS most commonly used--or had seen an ORS packet. The vast majority (93 percent) of mothers have heard about or seen ORS packets (see Table 12.6.1). Knowledge of ORT is greater in the urban areas and among more educated mothers. Virtually all women with some secondary education have heard of Oralit or seen ORS packets, while only 80 percent of mothers 187 Table 12.6.1 Knowledge of diarrhea care: background characteristics Percentage of mothers with births in the last five years who know about the use of oral rehydration therapy (ORT) for treatment of diarrhea and the percent distribution by knowledge of appropriate feeding practices during diarrhea, according to background characteristics, Indonesia 1994 Quantities that should be given during diarrhea Know Liquids Solid foods about ORT for Don't Don't Number Background treatment know/ know/ of characteristic of diarrhea I Less Same More Missing Less Same More Missing mothers Age of mother 15-19 88.1 201 27.9 47.6 4.4 32.0 35.2 27.7 5.1 672 20-24 94.2 13.7 24.8 58.6 3.0 31.6 34.8 30.2 3.2 3,127 25-29 93.8 13,1 20.4 63.9 2.6 32.3 33.4 30.9 3.4 3,793 30-34 93.7 I 1,9 20.5 64.5 3.1 30.8 32.9 32.8 3.4 2,982 35+ 89.1 12.3 25.3 58.9 3.6 31.9 36.8 27,6 3.6 2,820 Residence Urban 97.3 6.2 15.5 76,8 1.5 26.9 35,0 35.7 2.3 3,767 Rural 90.8 15.9 25.7 54.7 3.8 33.6 34.2 28.2 3.9 9,626 Region/Residence Java-Bali 94.0 14.3 21.6 61.9 2.2 33.6 32.0 31.8 2,5 8,019 Urban 97.7 6.5 15.0 77.4 1.1 27.6 33.8 36,5 2.1 2,664 Rural 92.2 18.2 24.9 54.2 2.7 36.6 31.1 29.5 2.6 5,355 Outer Java-Bali 1 91,9 10.5 24.5 61.2 3.9 30.3 39.3 25.6 4.7 3,743 Urban 97.6 5.1 15.0 77.7 2,2 27.3 39.0 30.6 3.0 750 Rural 90.4 11.8 26.8 57.0 4,3 3 I.I 39.4 24.4 5. I 2,992 Outer Java-Bali 11 87.5 13.5 25.2 55.4 5.9 25.6 35.1 33.5 5.8 1,632 Urban 93.7 5.9 20.6 70.6 2.8 21.0 35.8 40.2 2.9 353 Rural 85.8 15.6 26.5 51.2 6.7 26.8 34.9 31.6 6.6 1,278 Education No education 80.2 21.8 26.1 44.9 7.2 40.8 31.7 19.3 8.1 1,518 Some primary 88,7 15.3 26.9 54.2 3.6 37.4 33.3 25.7 3.5 4,090 Completed primary 95.4 12.9 24.3 60.0 2.8 29.9 35.7 31.3 3.0 4,072 Some secondary+ 98.9 7.5 15.3 75.9 1,3 23.7 35.3 38.8 2.1 3,713 Total 92.6 13.1 22.8 60.9 3.1 31.7 34.4 30.3 3,5 13,393 ORT = Oral rehydra0on therapy ] Respondent had heard of or seen Oralit packets (i.e., packets of of oral rehydration salts commonly used to treat diarrhea in Indonesia). with no education have. The percentage of mothers with knowledge of ORS packets in the Outer Java-Bali II region is slightly lower than in the other two regions (88 percent, compared with 92 percent or higher). In DKI Jakarta and DI Yogyakarta, virtually all mothers have heard of or seen ORS packets; however, in certain provinces of the Outer Java-Bali regions--Riau, East Timor, Central Sulawesi, Maluku and Irian Jaya--less than 85 percent of mothers have heard of or seen ORS packets (see Table 12.6.2). Information was collected on mothers' knowledge of appropriate feeding practices during diarrhea. Table 12.6.1 shows that 61 percent of mothers reported they would give increased fluids, 23 percent would give the same amount of fluids, and 13 percent would give less fluids. Mothers age 15-20 years, and those with no education are less likely to increase fluids to their children during a diarrheal episode. Almost one- third of mothers said they would give less food to children with diarrhea, one-third would give the same amount of food, and one-third would give more food to their children during a diarrheal episode. 188 Table 12.6.2 Knowledge of diarrhea care: region and province Percentage of mothers with births in the last five years who know about the use of oral rehydration therapy (ORT) for treatment of diarrhea and the percent distribution by knowledge of appropriate feeding practices during diarrhea, according to region and province, Indonesia 1994 Quantities that should be given during diarrhea Know Liquids Solid foods about ORT for Don't Don't Number Region and treatment know/ know/ of province of diarrhea I Less Same More Missing Less Same More Missing mothers Java-Bali 94.0 14.3 21.6 61.9 2.2 33.6 32.0 31.8 2.5 8,019 DKI Jakarta 99,5 2.5 11.1 85.3 1.1 33.4 37.3 26.2 3.1 516 West Java 96.6 9.3 18.8 68.6 3.3 28.8 30.7 36.7 3.9 2,966 Central Java 92.8 17.0 21.0 59.9 2.1 34.4 25.3 38.5 1.6 2,167 DI Yogyakarta 97.8 7.8 10.2 81.7 0.3 32.6 24.5 42.3 0.5 160 East Java 89.7 22.3 29.7 46.8 1.1 40.3 39.9 18.4 1.3 2,043 Bali 95.3 13.6 21.4 63.9 1.1 29.5 37.9 31.8 0.8 167 Outer Java-Bali I 91.9 10.5 24.5 61.2 3.9 30.3 39.3 25.6 4.7 3,743 Dista Aceh 89.9 5.5 23.9 67.7 3.0 27.9 46.9 22.2 2.9 271 North Sumatra 92.6 4,7 21.1 71.3 2.9 27.7 40.5 28.3 3.5 860 West Sumatra 91.1 9.9 24.4 61.1 4.6 26.9 40.5 27.0 5.6 277 South Sumatra 95.6 3.7 22.2 70.8 3.3 20.9 43.2 28.4 7.3 440 Lampung 94.1 7,6 44.1 43.4 4.8 24.8 53.5 16.8 4.9 450 West Nusa Tenggara 94.5 32.6 22.5 43.5 1.4 44.5 24.2 30.0 1.1 301 West Kalimantan 84.5 11.3 26.2 60.5 2.0 38.0 46.3 13.7 1.9 284 South Kalimantan 94.5 16.9 31.9 46.8 4.4 19.9 52.3 23.0 4.3 185 North Sulawesi 94.4 18.8 14.6 64.5 2.0 28.1 24.0 45.9 2.0 165 South Sulawesi 87.5 12.9 15.8 62.9 8.3 42.6 21.7 26.1 9.3 510 Outer Java-Bali 11 87.5 13.5 25.2 55.4 5.9 25.6 35.1 33.5 5.8 1,632 Riau 82.1 9.7 24.4 59.7 6.3 26.8 35.4 31.6 6.2 287 Jambi 86.5 12.5 18.4 65.7 3.4 41.7 30.2 23.7 4.4 162 Bengkulu 95.7 13.2 29.8 55.1 1.8 41.5 34.3 22.8 1.3 105 East Nusa Tenggara 91.4 18.7 25.4 51.5 4.4 27.1 28.6 39.6 4.8 246 East Timor 83.1 19.6 33.3 43.7 3.4 25.4 34.6 37.3 2,7 80 Central Kalimantan 91.3 14.9 30.5 50.3 4.3 19,2 36.5 40.9 3.0 101 East Kalimantan 95.9 6.5 22.7 69.6 1.2 10.2 50.9 37.6 1.3 168 Central Sulawesi 80.4 15.8 29.2 44.1 10.9 27.0 30.0 31.1 11.2 122 Southeast Sulawesi 92.3 15.3 32.2 43.7 8.7 16.2 46.0 29.8 8.0 109 Maluku 83.4 17.7 21.6 56.1 4.7 30.5 31.8 33.3 4.1 131 lrian Jaya 82.2 9,1 19.5 53.3 18.0 12.4 30.8 39.2 17.3 120 Total 92.6 13.1 22.8 60.9 3.1 31.7 34.4 30,3 3.5 13,393 ORT = Oral rehydration therapy t Respondent had heard of or seen Oralit packets (i.e., packets of oral rehydra0on salts commonly used to treat diarrhea in Indonesia). Urban mothers are more likely than rural mothers to give more food to their children during a diarrheal episode. There is little difference in mothers' knowledge of appropriate feeding practices during diarrhea by age. Children born to mothers with some secondary education are more likely to be given more food during diarrhea than children of mothers with less education. Two in three mothers in Java-Bali and in the Outer Java-Bali I regions would give more fluids, and 11-14 percent would reduce the fluid intake of their children during a diarrheal episode. In DKI Jakarta and DI Yogyakarta, 82 percent of mothers would give more fluids to their children during diarrhea, and only 3-8 percent would reduce it (see Table 12.6.2). 189 In West Java, where outbreaks of diarrheal disease occur frequently, 69 percent of mothers would increase the children's fluid intake and 9 percent would reduce it during a diarrheal episode. More than half of mothers in Bengkulu, where the prevalence and incidence of diarrhea are also high, would increase fluid intake, and 13 percent would reduce it during diarrhea. Less than half of mothers in certain provinces~East Java, Lampung, West Nusa Tenggara, South Kalimantan, East Timor, Central Sulawesi, and Southeast Sulawesi--would give more fluids to their children during diarrheal episodes. Diarrhea Treatment More than half of children who had diarrhea in the two weeks preceding the survey were taken to a health facility or provider (hospital, health center, health post, private clinic, doctor, nurse or health volunteer), 23 percent received self-treatment, and 23 percent were not treated (see Table 12.7.1 ). Treatment of diarrhea varies by the child's age. Infants under 6 months who have diarrhea are less likely to be taken to a health facility and less likely to receive self-treatment than older children. Forty-six percent of infants under 6 months were taken to a health facility and 12 percent received self-treatment; the corresponding percentages for older children were 49 percent or higher and 18-31 percent. First children are more likely to be taken to a health facility than other children. Among first children who had diarrhea, 61 percent were taken to a health facility for treatment, compared with 47 to 52 percent for higher birth order children. Urban mothers are more likely to take their children who have diarrhea to a health facility than rural mothers. Children of mothers with no education are less likely to be taken to a health facility, more likely to receive self-treatment, and more likely to receive no treatment than children whose mothers are better educated. For example, 44 percent of diarrheal cases among children whose mothers had no education were taken to a health facility for treatment, 28 percent were self-treated, and 27 percent were not treated. Among children of mothers who had some secondary education, 63 percent were taken to a health facility, 15 percent received self-treatment, and 21 percent received no treatment (see Table 12.7.1). There is little difference according to region in the percentage of children with diarrhea who were taken to a health facility. The Outer Java-Bali I region is slightly lower (50 percent) than the Java-Bali and Outer Java Bali II regions (55 and 53 percent, respectively). In certain provinces--Bali, Dista Aceh, North Sumatra, Lampung, West Kalimantm~, South Kalimantan, Rian, Jambi, East Kalimantan, Central Sulawesi, Southeast Sulawesi and Maluku--less than half of the children with diarrhea are taken to a health facility. They are also more likely to receive self-treatment or no treatment (Table 12.7.2). 190 Table 12.7.1 Source of diarrhea treatment: background characteristics Among children under five years who had diarrhea in the preceding two weeks, the percent distribution by source of treatment received, according to background characteristics, Indonesia 1994 Source of treatment received by children with diarrhea Taken to No a health Tradi- advice/ Children Background facility or tional Self- treatment with characteristic provider I healer treatment 2 sought Total diarrhea Age of child < 6 months 46.0 1.3 i 1.5 41.2 100.0 162 6-11 months 60.3 0.4 17.6 21.7 100.0 325 12-17 months 55,3 1.5 22.0 21.2 100.0 561 18-23 months 49.2 1.3 31.2 18.4 100.0 416 24-29 months 51.1 0.6 27.6 20.7 100.0 286 30-35 months 53.5 1.7 21.4 23.4 100.0 172 Sex of child Male 52.6 0,9 25.3 21.2 100.0 1,064 Female 54,1 1.5 20.4 24.0 100.0 857 Birth order 1 60,8 0,1 18.0 21.1 100.0 473 2-3 51.5 1.0 23.5 24.0 100.0 760 4-5 51,0 1.2 25.3 22.4 1000 484 6+ 47.2 3.9 28.6 20.2 1000 205 Residence Urban 59,7 0.7 23.7 16.0 100.0 553 Rural 50.6 1,3 22.9 25.1 100.0 1,368 Region/Residence Java-Bali 54.8 0.6 23.6 21.0 100.0 1,187 Urban 59.5 0.8 25,4 14.2 100,0 421 Rural 52.2 0.6 22.6 24.7 100.0 766 Outer Java-Bali 1 49.9 1.5 23,3 25.3 100.0 532 Urban 63.2 0.5 17,2 19,0 1000 97 Rural 47.0 1.7 24.6 26.7 100.0 435 Outer Java-Bali 11 53.0 3.1 20.1 23.8 100.0 203 Urban 51.6 0.0 20.5 27.9 100.0 36 Rural 53.3 3,8 20.0 229 100.0 167 Education No education 43,5 1,6 27.7 27.2 100.0 257 Some primary 47. l 1,6 28,0 23.3 100,0 669 Completed primary 56,9 1,2 21.8 20.1 I000 541 Some secondary+ 63.4 0.3 14.9 21,4 100 0 454 Total 53.2 1.1 23.2 22.5 100.0 1,921 J Includes hospital, health center, health post, private clinic, doctor, nurse, midwife, village delivery post, and health cadre 2 Pharmacy or shop 191 Table 12,7.2 Source of diarrhea treatment: region and province Among children under five years who had diarrhea in the preceding two weeks, the percent distribution by source of treatment received, according to region and province, Indonesia 1994 Source of treatment received by children with diarrhea Taken to No a health Tradi- advice/ Children Region and facility or tional Self- treatment with province provider I healer treatment 2 sought Total diarrhea Java-Bali 54.8 0.6 23,6 21.0 100.0 1,187 DKI Jakarta 62.0 0.0 19.7 18.3 100.0 42 West Java 53.0 0.6 29,9 16.5 100.0 688 Central Java 58.7 1.7 21.4 18.1 100,0 194 DI Yogyakarta 86.4 0.0 3.8 9.8 100.0 8 East Java 54.6 0.0 9.3 36.1 100.0 240 Bali 47.8 2.2 17.8 32.2 100.0 15 Outer Java-Bali I 49.9 1,5 23.3 25.3 100.0 532 Dista Aceh 42.8 5.5 24.1 27.6 100.0 28 North Sumatra 44.9 0.0 30.2 24.9 100.0 157 West Sumatra 54.5 4,5 17.0 24./) 100.0 41 South Sumatra 66.1 0,0 16.2 177 100.0 36 Lampung 41.8 1.3 28.6 28,3 100.0 44 West Nusa Tenggara 52.6 4.5 12.9 311.0 100.0 54 West Kalimantan 44.8 0,9 27.7 26,6 100.0 49 South Kalimantan 45.8 0.0 40.2 14.11 100,0 27 North Sulawesi 63.0 4.4 8.0 24.5 100.0 25 South Sulawesi 56,7 0.0 15.1 28.2 100.0 69 Outer Java-Bali I I 53.0 3. I 20.1 23.8 100.0 203 Riau 45.1 2.6 29.4 22.9 100,0 40 Jambi 42.0 5.5 18.0 34,5 100,0 21 Bengkulu 54.5 3.5 14.3 27.7 100.0 27 East Nusa Tenggara 66.6 3.7 17.7 12.0 100.0 37 East Timor 67.2 0.0 7,1 25.8 100.0 8 Central Kalimantan 72.1 0.0 23,2 4.7 100,0 7 East Kalimantan 47.5 0.0 37,2 15.3 100.0 15 Central Sulawesi 42,1 8.9 22.4 26.7 100.0 14 Southeast Sulawesi 41.5 2.4 16.2 39.9 100.0 13 Maluku 48.7 4.5 15.9 30,8 100.0 7 lrian Jaya 64.9 0.0 4.7 30,4 100.0 14 Total 53.2 1.1 23.2 22,5 100.0 1,921 i Includes hospital, health center, health post, private clinic, doctor, nurse, midwife, village delivery post, and health cadre 2 Pharmacy or shop Children who have diarrhea may receive ORS solution (prepared from ORS packets), other fluids, other treatments, increased fluids, or receive a combination of these treatments. Although more than 90 percent of mothers reported that they had heard of or seen ORS packets, in practice, only 45 percent of children with diarrhea were treated with ORS (see Table 12.8.1). Forty-four percent of children with diarrhea were given other fluids, 70 percent received either ORS or other fluids, and 78 percent were given some other treatment, including those obtained from a pharmacy. A majority of children with diarrhea (84 percent) were given ORS or increased fluids. 192 Table 12.8.1 Treatment of diarrhea: background characteristics Among children under five years who had diarrhea in the preceding two weeks, the percentage who received oral rehydration therapy (solution prepared from ORS packets or increased fluids), the percentage who received neither ORS nor increased fluids, and the percentage given other treatments, by background characteristics, Indonesia 1994 Oral rehydration therapy (aRT) Neither ORS or In- ORS nor Other No Children Background ORS Other other creased increased treat- treat- with characteristic packets fluids fluids fluids fluids ment ment Missing diarrhea Age of child < 6 months 23.1 21.9 43.9 23.8 46.7 58.8 34.8 0.0 162 6-11 months 44.6 40.3 70.1 48.7 16.2 78.3 8.5 0.1 325 12-17 months 50.2 451 72.8 49.5 16.0 78.8 7.7 0.0 561 18-23 months 44.1 48.5 70.7 67.7 10.1 81.6 4.5 0.1 416 24-29 months 45.4 48.4 76.8 67.6 11.6 79.3 7.6 0.0 286 30-35 months 51.8 50,3 74.2 68.1 12.2 76.6 6.9 2.3 172 Sex of child Male 43.7 45.2 69.9 55.8 17.6 78.8 105 0.4 1,064 Female 46.8 42.6 70.5 55.0 14.8 76.0 7.9 0.0 857 Birth order 1 54.0 46.7 76.4 55.3 13.2 78.9 6.0 0.0 473 2-3 42.2 38.9 66.7 55.3 18.3 76.0 11.0 0.1 760 4-5 45.1 47.2 71.6 55.5 15.7 77.6 9.6 0.9 484 6+ 35.3 49.4 65.1 56.3 18.0 79.8 10.6 0.0 205 Residence Urban 42.1 50.5 74.2 60.5 12.3 84.0 6.9 0.1 553 Rural 46.3 41.4 68.5 53.5 18.0 74.9 10.4 0.3 1,368 Region/Residence Java-Bali 44.7 43.8 69.7 58.5 15.8 79.0 9.2 0.3 1,187 Urban 39.7 51.2 73.0 61.8 12.7 85.8 7.1 0.0 421 Rural 47.4 39.8 67.8 56.7 17.5 75.3 10.3 0.5 766 Outer Java-Bali 1 43.1 44.1 69.0 52.0 18.0 74.7 10.2 0.0 532 Urban 47.7 49.2 78.7 58.0 9.4 81.0 5.1 0.0 97 Rural 42.1 42.9 66.8 50,6 19.9 73.3 11.3 0.0 435 Outer Java-Bali 11 52.7 45.1 76.3 470 15.4 76.2 8.5 0.3 203 Urban 54.8 45.3 76.9 51.9 15.0 72.1 9.2 0.8 36 Rural 52.3 45.1 76.2 45.9 15.5 77.1 8.3 0.2 167 Mother's education No education 44.3 353 69.3 490 18.5 72.8 14.2 0.0 257 Some primary 42.0 45.3 66.1 54.7 18.l 76.7 10.9 0.0 669 Completed primary 47.2 43.3 71.8 57.7 14.8 79.9 6.7 0.8 541 Some secondary+ 47.5 47.9 74.7 57.7 14.5 78.6 7.6 0.1 454 All children 45.1 44.0 70.2 55.5 16.4 77.5 9.4 0.2 1,921 ORS = Oral rehydration salts Infants under 6 months with diarrhea are less likely than older children to be given ORS or increased fluids; in fact, they are less likely to be treated at all, probably because most are still being breastfed. There is no difference in the treatment of diarrhea according to the sex of the child. Treatment does vary by the birth order: whereas over half of first children were given ORS, only 35 percent of seventh or higher birth order children were treated with ORS. Overall, urban children with diarrhea are somewhat more likely to be treated than children rural children, and are also more likely to receive increased fluids or other treatments. There is little difference in treatment by mother's level of education; however, children whose mothers have no education are less likely to be treated with oral rehydration therapy than children of mothers who have attended school. 193 One in eleven children with diarrhea received no treatment at all--that is, neither ORS nor increased fluids, and they were not taken to a health facility and received no self-treatment. Children under six months were more likely than older children to receive no treatment for diarrhea. Urban children with diarrhea were less likely to be treated than rural children. Fifty-three percent of children with diarrhea in the Outer Java-Bali II region were given ORS, compared with 45 percent in Java-Bali and 43 percent in Outer Java-Bali I. The use of ORS varies substantially across provinces, from 76 percent in DI Yogyakarta to less than 30 percent in North Sumatra and Central Kalimantan (see Table 12.8.2). Ninety-five percent of children with diarrhea in DI Yogyakarta were given ORS or increased fluids; in East Java, Bali and Central Sulawesi the proportion was less than 75 percent. Table 12.8.2 Treatment of diarrhea: region and province Among children under five years who had diarrhea in the preceding two weeks, the percentage who received oral rehydration therapy (solution prepared from ORS packets or increased fluids), the percentage who received neither ORS nor increased fluids, and the percentage given other treatments, by region and province, Indonesia 1994 Oral rehydration therapy (ORT) Neither ORS or In- ORS nor Other No Children region and ORS Other other creased increased treat- treat- with ~rovince packets fluids fluids fluids fluids ment ment Missing diarrhea Java-Bali 44.7 43.8 69.7 58.5 15.8 79.0 9.2 0.3 1,187 DKI Jakarta 38.7 37.3 63.6 70.3 12.0 81.7 7.5 0.0 42 West Java 42.7 46.0 70.4 63.3 12.4 83.5 8.2 0.0 688 Central Java 48.8 57.1 81.0 68.6 7.9 81.9 4.7 0.0 194 DI Yogyakarta 75.6 22.3 85.5 69.1 4.9 90.2 4.9 0.0 8 East Java 47.0 28.7 59.1 34.4 31.9 63.9 15.7 1.7 240 Bali 41.7 43.4 65.2 52.5 28.9 67.8 14.0 0.0 15 Outer Java-Bali I 43.1 44.1 69.0 52.0 18.0 74.7 10.2 0.0 532 Dista Aceh 45.5 53.9 79.5 54.2 14.3 72.4 10.8 0.0 28 North Sumatra 24.9 42.9 57.7 50.9 23.1 75.1 13.9 0.0 157 West Sumatra 56.0 46.7 77.6 55.1 14.8 76.0 5.6 0.0 41 South Sumatra 48.6 46.2 76.4 63.8 9.4 82.3 6.7 0.0 36 Lampung 57.3 51.4 86.5 33.5 13.5 71.7 9.3 0.0 44 West Nusa Tenggara 55.9 36.6 67.4 48.4 20.4 70.0 11.8 0.0 54 West Kalimantan 45.6 36.8 65.8 57.7 20.6 73.4 11.7 0.0 49 South Kalimantan 43.0 32.6 60.4 50.5 21.5 86.0 4.9 0.0 27 North Sulawesi 63.2 56.7 80.1 69.1 3.2 75.5 1.6 0.0 25 South Sulawesi 44.7 46.3 73.3 50.2 17.4 71.8 9.3 0.0 69 Outer Java-Bali II 52.7 45.1 76.3 47.0 15.4 76.2 8.5 0.3 203 Riau 54.0 49.4 82.7 48.5 10.1 77.1 6.6 0.0 40 Jambi 44.8 53.0 74.6 41.4 18.6 65.5 16.9 0.0 21 Bengkulu 59.3 45.6 76.5 39.2 17.2 72.3 13.2 0.0 27 East Nusa Tenggara 56.0 48.7 79.8 47.0 15.5 88.0 6.2 0.0 37 East Timor 60.4 27.5 78. I 50.6 6.3 74.2 4.9 0.0 8 Central Kalimantan 29.2 55.4 68.3 64.7 7.8 95.3 4.7 0.0 7 East Kalimantan 52.9 39.2 73.7 50.2 22.5 84.7 1.7 0.0 15 Central Sulawesi 45.5 30.5 61.4 39.3 26.6 73.3 10.4 2.7 14 Southeast Sulawesi 48.8 49.3 77.7 52.6 12.9 60.1 7.4 0.0 13 Maluku 53.0 63.6 81.7 55.8 9.5 69.2 9.5 0.0 7 Irian Jaya 57.8 24.4 68.9 49.9 17.1 69.6 8.3 1.9 14 Total 45.1 44.0 70.2 55.5 16.4 77.5 9.4 0.2 1,921 ORS = Oral rehydration salts 194 Although use of ORS is low (less than 40 percent) in the provinces of DKI Jakarta and Central Kalimantan, most children with diarrhea received some form of treatment. In North Sumatra, however, not only is the use of ORS low (less than 25 percent), but a relatively large proportion of children with diarrhea received no treatment at all (14 percent). The percentage of children with diarrhea who received no treatment ranges from a low of 2 percent in North Sulawesi and East Kalimantan to a high of 17 percent in Jambi. Feeding Practices during Diarrhea Diarrheal episodes are frequently accompanied by vomiting, which makes feeding difficult because the child frequently refuses food. In the 1994 IDHS, one in three children with diarrhea in the preceding two weeks received the same amount of food, one in five received more food, and 45 percent had less food (see Table 12.9 and Figure 12.1). More than half of the children with diarrhea were given an increased amount of fluids to drink, which suggests that a majority of mothers knew that children should be given more fluids during diarrhea in order to rehydrate them. Twenty-nine percent of mothers gave the same amount of fluids to their children, and 13 percent gave less liquid. Among last-born children with diarrhea who are still breast- fed, 53 percent were given the same amount of breast milk, 11 percent received an increased amount of breast milk, and 5 percent received less breast milk. Table 12.9 Feeding practices during diarrhea Percent distribution of children under five who had diarrhea in the preceding two weeks by amount of solid foods given and amount of fluids given, and the percent distribution of last-born children with diarrhea by pattern of breastfeeding, Indonesia 1994 Feeding practices Total Amount of solid foods Same 33.4 Increased 18.6 Decreased 44.5 Don't know/Missing 3.5 Amount of fluids Same 28.5 Increased 55.5 Decreased 12.8 Don't know/Missing 3.1 Total 100.0 Number of children 1,921 Diarrhea breastfeeding pattern Unchanged 53.4 Reduced 4.7 Increased I 0.8 Stopped 0.3 Don't know/Missing 30.8 Total 10tl.() Number 1,712 195 Percent Figure 12.1 Feeding Practices Among Children Under Five with Diarrhea 70 60 50 40 30 20 10 45 AMOUNTOFFOOD 56 AMOUNT OF FLUIDS * Last-born ch i ldren only 53 f °¢ AMOUNT OF BREAST MILK* 1994 IDHS 196 CHAPTER 13 INFANT FEEDING Breastfeeding is of utmost importance for the health and survival of infants. In Indonesia, exclusive breastfeeding is recommended for infants under 4 months of age; the introduction of supplementary foods is recommended at age 4 to 6 months. 13.1 Prevalence of Breastfeeding and Supplementation Table 13.1.1 shows that virtually all children born in the five-year period preceding the survey were breastfed for at least some time (97 percent). There are negligible differences in the proportion of children ever breastfed by background characteristics. In Indonesia, 8 percent of newborns are breastfed within the first hour, and more than half (52 percent) start within the first day. Differences between subgroups of children in the percentage receiving breast milk during the first day are small. Mothers in Java-Bali are more likely to start giving breast milk to their babies earlier than women in other regions. The percentage of children who breastfeed the first day declines as mother's level of education increases; 62 percent of children whose mothers had no education began breastfeeding the first day, compared with 49 percent of those whose mothers attended secondary school. It is interesting to note that the proportion of first-day breastfeeding is lowest among women who were assisted by a medical professional at delivery, and highest among women who had no assistance at delivery or were assisted by other people, e.g., friends and relatives. About 54 percent of children born at home or assisted by a traditional birth attendant at delivery started receiving breast milk within the first day of life, compared with 48 percent among children born in a health facility or assisted by a doctor or midwife. The proportion of children receiving breast milk in the first hour of life ranges from less than 1 percent in DI Yogyakarta and South Kalimantan to 20 percent in West Nusa Tenggara (see Table 13.1.2). The proportion breastfeeding in the first day of life varies from 33 percent in Maluku to 72 percent in Bali. Mothers who were currently breastfeeding were asked if they had given various types of liquids or solid foods to the child in the last 24 hours (see Table 13.2 and Figure 13. l ). Children are classified as being exclusively breastfed if they receive breast milk only. Full breastfeeding is defined as receiving plain water in addition to breast milk. Virtually all infants under 7 months were breastfed (96-98 percent). The preva- lence of breastfeeding declines to 90 percent at age 10-11 months and to 63 percent at age 22-23 months. Overall, less than half of infants under 4 months were exclusively breastfed (47 percent). The prevalence of exclusive breastfeeding declines from 58 percent for infants age under 2 months to 38 percent among those age 2-3 months to 17 percent among children 4-5 months. A small percentage of infants under 6 months of age were given plain water only in addition to breast milk. 197 Table 13.1.1 Initial breastfeeding: background characteristics Percentage of children under five who were ever breastfed, and the percentage who started breastfeeding within one hour of birth and within one day of birth, by selected background characteristics, Indonesia 1994 Percentage of children who started breastfeeding: Percentage Within Within Number Background ever 1 hour 1 day of characteristic breastfed of birth of birth t children Sex of child Male 96.3 8.1 51.1 8,737 Female 97.1 8.0 53.7 8,246 Residence Urban 95.2 8.1 50.6 4,646 Rural 97.2 8.0 53.0 12,337 Region/Residence Java-Bali 96.6 9.4 54.5 9,678 Urban 95.3 8.2 52.1 3,184 Rural 97.2 9.9 55.7 6,494 Outer Java-Bali I 96.8 6.9 49.5 5,073 Urban 95.7 9.0 46.1 995 Rural 97.1 6.3 50.4 4,077 Outer Java-Bali I1 96.9 5.0 49.3 2,233 Urban 93.5 5.5 49.8 467 Rural 97.8 4.9 49.1 1,766 Education No education 97.2 7,8 62.3 2,012 Some primary 97.1 8.9 52.0 5,246 Completed primary 96.4 8.0 51.7 5,010 Some secondary+ 96.3 7.2 49.1 4,715 Assistance at delivery Medical professional 95.7 7.4 48.3 6,198 Traditional birth attendant 97.3 8.6 54.2 10,103 Other or none 96.1 6.0 60.5 680 Place of delivery Health facility 95.2 7.3 48.1 3,890 At home 97.2 8,3 53.6 13,048 Total 96.7 8.0 52.3 16,983 Note: Includes 2 children for whom information on assistance at delivery is missing and 45 for whom place of delivery is missing. t Includes children who started breastfeeding within one hour of birth. 198 Table 13.1.2 Initial breastfeeding: region and province Percentage of children under five who were ever breastfed, and the percentage who started breastfeeding within one hour of birth and within one day of birth, by region and province, Indonesia 1994 Percentage of children who started breastfeeding: Percentage Within Within Number Region and ever 1 hour l day of province breastfed of birth of birth I children Java-Bali 96.6 9.4 54.5 9,678 DKI Jakarta 95.6 7.4 56.0 618 West Java 96.4 12,9 43.9 3,675 Central Java 96.8 2.6 54.5 2,599 DI Yogyakarta 98.1 0.0 68.1 182 East Java 96.6 12.5 67.9 2,393 Bali 97.6 10.1 72.4 210 Outer Java-Bali I 96.8 6.9 49.5 5,073 Dista Aceh 95.8 4. I 48.1 374 North Sumatra 96.6 5.1 36.7 1,298 West Sumatra 97.6 3.7 67.5 366 South Sumatra 96.6 5.5 59.6 563 Lampung 98.3 8.8 46.2 563 West Nusa Tenggara 97.8 19.7 68.5 399 West Kalimantan 94.3 5.0 47.8 380 South Kalimantan 96.8 0.6 57.3 225 North Sulawesi 98.3 16.2 63.4 203 South Sulawesi 96.6 5.6 42.7 701 Outer Java.Bali II 96.9 5.0 49.3 2,233 Riau 92.6 1.7 42.9 389 Jambi 97.6 4.0 51.3 207 Bengkulu 97.2 3.7 34.9 138 East Nusa Tenggara 98.5 2.8 58.3 361 East Timor 99.0 8.3 68.9 123 Central Kalimantan 99.7 17.3 66.0 126 East Kalimantan 96.0 10.2 49.0 215 Central Sulawesi 97.4 6.3 40.2 166 Southeast Sulawesi 98.5 2.6 36.6 149 Maluku 98.2 2.0 32.7 190 Irian Jaya 96.1 5.1 65.0 167 Total 96.7 8.0 52.3 16,983 i Includes children who started breastfeeding within one hour of birth. 199 Table 13.2 Breastfeeding status Percent distribution of living children by breastfeeding status, according to child' s age in months, Indonesia 1994 Percentage of living children who are: Breastfeeding and: Number Not Exclusively Plain of breast- breast- water Other Other Supple- living Age in months feeding fed only I liquids milk 2 merits 3 Total children <2 2.0 58.0 2.3 9.(1 9.2 19.7 100.0 478 2-3 3. l 38.0 1. I 12.7 4,5 40.6 100.0 547 4-5 3.5 16.8 3.1 3.3 1,9 71.4 I00.0 517 6-7 3.5 4.8 2.4 1.5 0,7 87.2 100.0 556 8-9 7.6 4.0 2.0 2.9 0.2 83.3 100.0 530 10-11 9.9 1.8 0.5 0.7 1.4 85.6 100.0 525 12-13 11.6 1.2 1.7 1.4 0.0 84.1 100.0 615 14-15 12.0 0.4 1.4 0.2 0.0 86.0 100.0 522 16-17 13.7 0.2 0,2 1.5 0.0 84.4 100.0 518 18-19 22.1 1.0 0.2 0.3 0,0 76.4 100.0 478 20-21 36.0 0.0 0.1 0.7 0.0 63.2 100.0 441 22-23 37.4 0.2 1.0 0.11 0.0 61.4 100.0 492 24-25 49.4 0.0 0.0 0.2 0.0 50.4 100.0 681 26-27 60.1 0.0 0.0 0.0 0.0 39.9 100,0 566 28-29 58.7 0.0 0.1 0.1 0.0 41.1 100.0 522 30-31 64.3 0.0 0.0 0.0 0.0 35.7 100.0 576 32-33 70.9 0. I 0.0 I.II 0.0 28.0 100.0 469 34-35 80.8 0.0 0.7 0.0 0.0 18.5 100.0 537 0-3 months 2.6 47.3 1.6 I 1.0 6.7 30.8 100.0 1,024 4-5 months 1.6 20.3 4,0 5.0 2.1 67.0 1 (30.0 280 6-9 months 5.5 4.4 2.2 2.2 0.5 85.3 100.0 1,086 10-11 months 9.9 1.8 0.5 0.7 1.4 85.6 100.0 525 12-15 months I 1.8 0.8 1.6 0.8 0.0 85.0 100.0 1,137 16-19 months 17.8 0.6 0.2 0.9 0.0 80.6 100.0 996 20-23 months 36.7 0. I 0.5 0.!t 0.0 62.3 100.0 933 24+ months 59.4 0.9 0.3 0,3 0.1 39.1 100.0 3,589 Note: Breastfeeding status refers to preceding 24 hours. i Receive no supplements 2 May receive other liquids 3 May receive other liquids or other milk 200 Figure 13.1 Distribution of Children by Breastfeeding (BF) Status, According to Age Percent 100 75 50 25 0 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 Age in Months 1994 IDHS Among currently breastfed children, some were given supplementary liquids such as plain water, water with sugar or honey, fruit juice, tea, starch water, and other types of milk or supplementary foods such as meat, fish, eggs, liver, mashed food or porridge. Supplementary feeding is introduced very early in infancy; 40 percent of infants under 2 months of age were given supplements consisting of plain water (2 percent), other liquids (9 percent), other milk (9 percent), and solid foods (20 percent). The proportion of infants receiving supplementary feeding increases rapidly. Solid foods are given to 41 percent of infants at age 2-3 months, 71 percent of those age 4-5 months and 87 percent of infants age 6-7 months. Table 13.3 presents data on the types of food given to breastfeeding children under 3 years, the use of a bottle with a nipple in feeding these children, and the use of a pacifier. With regard to the mode of feeding, 8 percent of infants under 2 months were fed using a bottle with a nipple. The proportion increases to 15 percent among infants age 6-7 months. Besides bottle feeding with a nipple or teat, pacifiers are frequently used to satisfy the infant's sucking demand. Among currently breastfed children, the use of pacifiers decreases with age, from about 9 percent among those under 7 months to 5 percent among those 10-11 months, to less than 2 percent among children 1 year or older (see Table 13.3). 201 Table 13.3 Types of food received Percentage of breastfeeding children under three years who received various types of food in the 24 hours preceding the interview and the percentage using a bottle with a nipple, and using a pacifier, by child's age in months, Indonesia 1994 Type of food received Meat, Using Breast fish, bottle Number Age (in milk Other Other eggs, with a Using of months) only milk liquid liver Other nipple pacifier children <2 59.1 13.2 24.2 0.4 19.9 7.6 9.3 468 2-3 39.2 10.3 34.0 2.3 41.7 9.7 9.5 530 4-5 17.4 13.9 38.9 8.3 73.0 9.5 8.7 499 6-7 5.0 20.9 58.8 31.8 90.2 14.7 9.3 537 8-9 4.3 17.2 70.1 45.0 90.1 10.2 3.9 490 10-11 2.0 24.9 75.8 56.1 94.5 14.2 4.7 473 12-13 1.4 21.0 80.6 65.1 95.1 8.9 1.8 544 14-15 0.4 24.5 77.9 70.3 96.7 8.7 1.6 459 16-17 0.2 23.0 82.7 70.8 96.8 9.7 1.3 447 18-23 0.6 25.0 83.0 81.1 97.4 6.3 2.5 962 24-29 0.0 21.3 86.8 82.4 99.6 4.6 1.8 786 30-35 0.1 18.0 84.4 80.7 97.4 6.0 1.8 445 0-3 months 48.6 11.7 29.4 1.4 31.5 8.7 9.4 998 4-6 months 13.2 17.3 44.2 15.7 78.9 11.3 7.9 751 7-9 months 4.6 17.5 67.3 40.6 90.0 11.8 6.9 775 Total 9.7 19.8 68.2 52.6 84.3 8.8 4.5 6,640 13.2 Durat ion of Breastfeeding In Indonesia, breastfeeding is not only universal, but also relatively long. The median duration of breastfeeding is estimated at 23.8 months (see Table 13.4.1 and Figure 13.2). Children who live in ntral areas are breastfed for longer durations than children in urban areas (24.8 months compared with 22.1 months). Children in Java-Bali, those whose mothers have less education and those whose mothers were assisted by a traditional birth attendant are breastfed longer than other children. The median duration of breastfeeding in Java-Bali is 25.3 months, compared with 21.4 months in Outer Java-Bali I and 22.8 months in Outer Java-Bali II. Children born to mothers with no education are breastfed for 9 months longer than those born to mothers who have secondary education. Children whose mothers were assisted by a traditional birth attendant are breastfed for slightly longer durations than children whose mothers were assisted by a medical professional or other persons (25 months compared with less than 23 months). Supplements to breastfeeding are not recommended until the infant reaches 4 months of age. However, the median durations of exclusive and full breastfeeding are 1.3 months and 1.5 months, respec- tively, which suggests that food supplements are introduced at an earlier age than recommended. Female infants are exclusively and fully breastfed longer than male infants. The duration of exclusive and full breastfeeding in the Outer Java-Bali region is longer than in Java-Bali. For example, in Outer Java-Bali II the median duration of full breastfeeding is 2.3 monlhs, com- pared with 1 month in Java-Bali. 202 Table 13.4.1 Median duration and frequency of breastfeeding: background characteristics Median duration of any breastfeeding, exclusive breastfeeding, and full breastfeeding among children under three years, and the percentage of children under 6 months of age who were breastfed six or more times in the 24 hours preceding the interview, according to background characteristics, Indonesia 1994 Children under 6 months Median duration in months j Number of Breastfed children 6+ times Any Exclusive Full under in Number Background breast- breast- breast- 3 years preceding of characteristic feeding feeding feeding 2 of age 24 hours children Sex of child Male 23.8 0,7 0.8 5,178 88.3 830 Female 23.8 1.7 1.9 4,953 92.1 711 Residence Urban 22.1 1.3 1.4 2,817 88.2 432 Rural 24.8 1.2 1.5 7,314 90.8 1,109 Region/Residence Java-Bali 25.3 0.9 1.0 5,820 89.8 885 Urban 22.4 1,2 1.2 1,944 88.9 292 Rural 26.9 0.7 0.9 3,876 90.2 592 Outer Java-Bali 1 21.4 1.6 1.9 2,992 89.9 456 Urban 22.2 1.7 1.9 583 87.3 94 Rural 21.2 1.6 1.9 2,409 90.5 362 Outer Java-Bali 11 22.8 2.2 2.3 1,319 91.8 201 Urban 19.3 1.7 1.8 290 86.0 46 Rural 23.7 2.4 2.6 1,028 93.5 155 Education No education 30.5 0.8 0.9 1,092 92.7 177 Some primary 26.9 1.7 1.8 3,004 89.9 418 Completed primary 23.1 0,7 1.3 3,015 89.5 473 Some secondary+ 21.5 1.4 1.5 3,021 89.8 473 Assistance at delivery Medical professional 22.8 1.3 1.5 4,206 90.4 682 Trad. birth attendant 25.0 1.2 1.3 5,509 90.0 802 Other or none 21.0 2.6 2.9 415 87.1 58 Total 23.8 1.3 1.5 10,131 90.1 1,542 Mean 23.9 3.0 3.3 NA NA NA Prevalence/Incidence 3 23.3 2.3 2.6 NA NA NA NA -- Not applicable JMedians and means are based on current status 2Either exclusive breastfeeding or breastfeeding and plain water only 3Prevalence-incidence mean 203 Figure 13.2 Median Duration of Any Breastfeeding INDONESIA RESIDENCE L~ Urban Rural REGION Java-Bali Outer Java-Bali I Outer Java-Bali II 23.8 22.1 24.8 ; i 21 4 ' I ' I 125.3 J22 .8 EDUCATION / No Education Some Pr mary 28 9 Completed P r i m a r y [ ~ . ~ 23.1 Some Secondary+ ~ ~ ' - . ~ 21 5 ASSISTANCE AT DELIVERY Medica l Profess onal 122.4 Tradit ional i I Other/None/ . t 21.0 Bir~h Attendant . . . . . 25.1 10 15 20 25 k~.~.~'~'~'~ 30 .5 Months 30 35 1994 IDHS It is recommended that infants under 6 months of age be breastfed frequently. Table 13.4.1 shows that 90 percent of infants under 6 months of age were breastfed 6 or more times in the 24 hours prior to the survey. Differences according to background characteristics are minimal. Breastfeeding durations range from 18 to 31 months across provinces (see Table 13.4.2). In North Sumatra, West Sumatra, and East Timor, the median duration of breastfeeding is 18 months; whereas in Central Java and Irian Jaya, the medians are 31 months and 26 months, respectively. In some provinces the median duration of exclusive and full breastfeeding is less than 1 month (Central Java, DI Yogyakarta, East Java, Dista Aceh, and South Kalimantan). The percentage of infants who were breastfed frequently shows little variation according to region. In the Java-Bali region, infants in DKI Jakarta are slightly less likely than infants in other provinces to be given breast milk frequently (83 percent compared with 90 percent for the region as a whole). In the Outer Java-Bali regions, South Kalimantan, Riau, and Irian Jaya have the lowest proportions of infants receiving breast milk more than 6 times during the 24 hours prior to the survey (83 percent or less). 204 Table 13.4.2 Median duration and frequency of breastfeeding: region and province Median duration of any breastfeeding, exclusive breastfeeding, and full breastfeeding among children under three years of age, and the percentage of children under 6 months of age who were breastfed six or more times in the 24 hours preceding the interview, according to region and province, Indonesia 1994 Children under 6 months Median duration in months I Number of Bmastfed children 6+ times Any Exclusive Full under in Number Region and breast- breast- breast- 3 years preceding of province feeding feeding feeding 2 of age 24 hours children Java-Bali 25.3 0.9 1.0 5,820 89.8 885 DKI Jakarta 21.1 1,4 1.4 372 82.8 58 West Java 25.3 1.6 1.7 2,164 84.6 334 Central Java 30.9 0.6 0.7 1,516 94.4 204 DI Yogyakarta 25.0 0.9 0.9 109 (96.4) 13 East Java 24.2 0.6 0.6 1,534 94.3 253 Bali 22.8 1.7 1.7 126 87.0 22 Outer Java-Bali I 21.4 1.6 1.9 2,992 89.9 456 Dista Aceh 20.6 0.4 0.5 216 87.2 30 North Sumatra 18.1 1.0 1.4 764 87.0 115 West Sumatra 17.9 1.8 1.8 225 93.2 36 South Sumatra 24.6 1.7 1.8 319 (96.4) 42 Lampung 21.0 3.2 3.4 349 92.4 58 West Nusa Tenggara 23.7 1.5 1.5 235 91.4 46 West Kalimantan 22.2 1.3 1.4 221 85.9 37 South Kalimantan 25.4 0.7 0.7 125 (82.5) 13 North Sulawesi 19.9 2.5 2.9 120 (93.3) 13 South Sulawesi 23.5 3.4 3.7 417 89.9 67 Outer Java-Bali II 22.8 2.2 2.3 1,319 91.8 201 Riau 22.3 1.2 1.2 214 82.2 30 Jambi 24.4 2.1 2. I 123 93.6 20 Bengkulu 23.9 2.8 3.2 82 97.9 12 East Nusa Tenggara 22.8 2.8 3.0 225 ' 96.3 32 East Timor 17.8 1.6 1.7 76 93.0 14 Central Kalimantan 20.9 1.3 2.2 69 (93.4) 10 East Kalimantan 24.7 2.1 2.2 129 93.0 22 Central Sulawesi 24.1 2.3 2.7 96 (87.5) 16 Southeast Sulawesi 24.9 4.1 4.1 91 96.2 I 1 Maluku 19.6 3.2 3.3 114 98.5 20 Irian Jaya 25.9 2.1 2.2 100 (81.5) 14 Total 23.8 1.3 1.5 10,131 90.1 1,542 Mean 23.9 3.0 3.3 NA NA NA Prevalence/Incidence 3 23.3 2.3 2.6 NA NA NA Note: Figures in parentheses are based on 25-49 children. NA = Not applicable lMedians and means are based on current status 2Either exclusive breastfeeding or breastfeeding and plain water only 3Prevalence-incidence mean 205 CHAPTER 14 MATERNAL MORTALITY In the 1994 Indonesia Demographic and Health Survey (IDHS), data were collected that allow estimation of maternal mortality using both direct and indirect techniques. For each of the respondent's siblings, information was collected on his or her survival status. If alive, the current age was recorded. If dead, the year of death and age at death were recorded. For dead sisters, additional questions were asked to determine if the death was maternity related, i.e., if the death occurred during pregnancy, during delivery, or within 42 days following a delivery or pregnancy termination. The direct approach for estimating maternal mortality uses data on the age of surviving sisters and age at death and year of death of sisters who died. For well-defined reference periods, the data are aggregated to determine the number of maternal deaths occurring in each reference period. Maternal mortality rates are then directly calculated by dividing the number of deaths by the person-years of exposure. The indirect approach for maternal mortality estimation, i.e., the original sisterhood method, has simpler data requirements than the direct method. None of the information on dates and ages related to sisters is used, and data on all sisters are used to estimate the life-time risk of maternal death. Since the estimates pertain to the life-time experience of the respondents' sisters, no well-defined calendar reference period is derived, and the estimates represent mortality conditions over the past 50 years or so. Assuming that changes in mortality over time are linear, the reference period can be said to be centered about 12-13 years before the survey date. 14.1 Data Quality Table 14.1 shows the completeness of information on respondents' siblings. Data on survivorship are missing for less than 1 percent of the siblings. The sex ratio of the siblings was 105, which is consistent with the sex ratio at birth of 106 calculated from the 1994 IDHS birth histories. For less that 1 percent of living siblings, current age was not recorded. For 2 percent of dead siblings, age at death and year of death were missing--making imputation of these data necessary. Another way to assess the quality of data used to estimate maternal mortality is to evaluate the plausibility and stability of the adult female mortality estimates. It is reasoned that if estimated rates of overall adult female mortality are plausible, rates based on a subset of these deaths, e.g., maternal deaths, are likely to be free of serious problems. Table 14.2 shows age-specific female mortality rates for women 15-49 for the periods 0-4 and 5-9 years preceding the survey, calculated by direct procedures. The results indicate that adult female mortality was slightly higher 5-9 years before the survey (1984-88) than 0-4 years before the survey (1989-94). t The imputation procedure is based on the assumption that the reported birth ordering of the siblings in the birth history is correct. The first step is to calculate birth dates. For each living sibling with a reported age and for each dead sibling with complete information on both age at death and year of death, the birth date was calculated. For a sibling missing these data, a birth date was imputed within the range defined by the birth dates of the bracketing siblings. In the case of living siblings, an age was then calculated from the imputed birth date. In the case of dead siblings, if either age at death or year of death was reported, that information was combined with the birth date to produce the missing information. If both pieces of information were missing, the age at death was imputed. This imputation was based on the distribution of the ages at death for whom the year of death was unreported, but age at death was reported. 207 Table 14.1 Dataon siblings Number of siblings reported by survey respondents and completeness of the reported data on age, age at death, and year of death, weighted, Indonesia 1994 Sibling status and completeness of reporting Sisters Brothers Total Number Percent Number Percent Number Percent All siblings 87,419 100.0 91,884 100.0 179,302 100.0 Living 73,287 83.8 76,151 82.9 149,437 83.3 Dead 13,967 16.0 15,716 17.1 29,683 16.6 Status unknown 165 0.2 17 0.0 182 0.1 Living siblings 73,287 1(30.0 76,151 100.0 149,437 100.0 Age reported 73,033 99.7 75,854 99.6 148,887 99.6 Age missing 253 0.3 297 0.4 550 0.4 Dead siblings 13,967 100.0 15,716 100.0 29,683 100.0 Age at death and year of death reported 12,625 90.4 14,402 91.6 27,027 91.1 Missing only age-at- death information 42 0.3 49 0.3 91 0.3 Missing only year-of- death information 898 6.4 1,034 6.6 1,932 6.5 Missing age-at-death and year-of-death information 401 2.9 231 1.5 632 2.1 Table 14.2 Adult female mortality rates by age Direct estimates of age-specific female mortality for women 15-49 based on the survivorship of sisters of survey respondents, Indonesia 1984-88 and 1989-94 1984-88 1989-94 Age Mortality Mortality Female Exposure rates Female Exposure rates deaths years (000) deaths years (000) 15-19 76 59,254 1.29 98 47,441 2.06 20-24 90 59.685 1.57 62 58,867 1.05 25-29 126 52,809 2.38 93 59,223 1.56 30-34 73 38,015 1.92 71 52,326 1.36 35-39 70 23,837 2.95 87 37,614 2.31 40-44 62 13,092 4.71 102 23,393 4.37 45-49 29 6,388 4.56 63 12,780 4.91 Total 526 253,080 2.42 a 576 291,644 2.19 a a Age adjusted 208 Table 14.3 presents the adult female mortality rates described in three model mortality schedules corresponding to a female under-five mortality rate of 74 per 1,000 live births) The table presents adult female mortality rates implied by the Coale-Demeny (C-D) West, East and South model life tables compared with the estimated rates) This comparison shows that the rates estimated from the 1994 IDHS data are significantly higher than those described in the C-D South model, significantly lower than those described in the C-D West model, and roughly the same as those drawn from the C-D East model. This analysis suggests that no major problem exists in quality of the data used to calculate maternal mortality, although these examinations are cursory, being relatively insensitive to all but large departures from model patterns. Table 14.3 Adult female mortality rates: direct estimates and model life table rates Direct estimates of adult female mortality based on the survivorship of sisters of survey respondents, Indonesia 1984-88 and 1989-94, and model life table rates, Indonesia 1994 Estimated female mortality rates Model life table rates t WEST EAST SOUTH Age 1984-88 1989-94 (63.3) (66.0) (69.5) 15-19 1.29 2.06 1.79 1.18 0.67 20-24 1.51 1.05 2.40 1.62 0.95 25-29 2.38 1.56 2.81 1.90 1.14 30-34 1.92 1.36 3.28 2.24 1.34 35-39 2.95 2.31 3.92 2.79 1.62 40-44 4.71 4.37 4.86 3.58 2.24 45-49 4.56 4.91 6.41 4.99 3.04 15-49 a 2.42 2.19 3.25 2.29 1.37 I Model life tables were selected at a level of mortality approximately corresponding to a probability of dying between birth and exact age 5 estimated for the period 1989-94 (i.e., ~q0 of 74 per 1,000 female births). Life expectancies at birth are presented in parentheses. a Age adjusted 14.2 Direct Estimates of Maternal Mortality Direct age specific estimates of matemal mortality from the reported survivorship of sisters are shown in Table 14.4 for the periods 0-4 and 5-9 years preceding the survey. For the period 0-4 years before the survey (1989-94), the maternal mortality rate is 0.367 matemal deaths per 1,000 woman-years of exposure. The corresponding rate for the period 5-9 years before the survey (1984-88) is 0.418 per 1,000, indicating a slight downward trend in the maternal mortality rate (not ratio). Of all female deaths occurring between ages 15 and 49 in the period 0-9 years before the survey, 20 percent were due to matemal causes. 2 The female under-five mortality rate was calculated from the 1994 IDHS data for the 0-4 years before the survey. 3 The most commonly used model life tables, and the ones used here, are the Coale-Demeny (C-D) Regional Model Life Tables. The C-D West, East, and South models are employed in this report; the North model is not presented since it closely resembles the West model at the prevailing mortality level. 209 Table 14.4 Direct estimates of maternal mortality Direct estimates of maternal mortality based on the survivorship of sisters of survey respondents, Indonesia 1984-88 and 1989-94 Age 1984-88 1989-94 Mortality Mortality Maternal Exposure rates Maternal Exposure rates deaths years (000) deaths years (000) 15-19 10 59,254 0.169 23 47,441 0.485 20-24 16 59,685 0.268 25 58,867 0,422 25-29 53 52,809 0.996 19 59,223 0.322 30-34 16 38,015 0.425 10 52,326 0.191 35 39 12 23,837 0.521 20 37,614 0.525 40-44 5 13,092 0.400 9 23,393 0.397 45-49 0 6,388 0.000 1 12,780 0.098 Total 112 253,080 0.418 a 107 291,644 0.367 a General fertility rate 116 94 Maternal mortality ratio b 360 390 a Age adjusted b Per 100,000 live births: calculated as the maternal mortality rate divided by the general fertility rate. Conversion of the maternal mortality rate to a maternal mortality ratio can be done by dividing the rate by the general fertility rate estimated for the same calendar period. In this way, the obstetrical risk of pregnancy and childbearing is underlined. By direct estimation procedures, the maternal mortality ratio is estimated at 390 maternal deaths per 100,000 live births during the period 1989-94 and 360 per 100,000 live births during the period 1984-88, indicating a slight increase in the maternal mortality ratio. A slight decrease in maternal mortality rate is not inconsistent with a slight increase in maternal mortality ratio. This can occur when fertility is declining and maternal mortality risk is spread over fewer births. 14.3 Indirect Est imates of Maternal Mortal i ty The data on the survivorship of sisters can also be used to estimate maternal mortality by the indirect method, i.e., the original sisterhood method. In this method, the data are aggregated by five-year age groups of respondents. For each age group, information on the number of maternal deaths among all sisters of respondents and on the number of "sister units" of risk is used to estimate the lifetime risk of dying from maternal causes. The method also provides an overall estimate of maternal mortality for sisters of all respondents combined, and refers to a period in time centered 12-13 years prior to the survey. The indirect estimates of maternal mortality are given in Table 14.5. When aggregating the data over all respondents, the lifetime risk of maternal death is 0.015, a risk of dying of maternal causes of about 1 in 66. The lifetime risk of maternal mortality can be converted to an estimate of the maternal mortality ratio as follows: MMR = 1 - [ I-lifetime risk]tn'~ 210 Table 14.5 Indirect estimates of maternal mortality Estimates of maternal mortality using the indirect method, Indonesia 1994 Age Sister units Lifetime risk Number of Number of Maternal Adjustment of risk of maternal respondents sisters 15+ deaths factor exposure death (a) (b) (c) (d) (e)=(b)x(d) (f)=(c)/e) 15-19 7,580 14,719 48 0.107 1,575 0.0303 20-24 6,563 12,745 52 0.206 2,625 0.0199 25-29 6,342 12,316 56 0.343 4,224 0.0132 30-34 5,964 12,231 93 0.503 6,152 0.0150 35-39 5,019 10,159 96 0.664 6,745 0.0142 40-44 3,754 7,421 68 0.802 5,952 0.0114 45-49 3,111 5,496 71 0.900 4,947 0.0143 Total 38,334 75,087 484 0.0150 IPR 4.64 children per woman MMR 326 per 100,000 live births TFR = Total fertility rate MMR = Maternal mortality ratio = (1-[ l-lifetime risk] jrr~a x 100,000, where TFR represents the total fertility rate 10-14 years preceding the survey. Note: Figures in column (b) are adjusted for age distribution of respondents' sisters (see Graham et al., 1989). By indirect estimation procedure, the maternal mortality ratio is estimated to be 326 maternal deaths per 100,000 live births, referring to a period roughly centered in the early 1980s. 14.4 Conclusion The maternal mortality ratio was estimated by direct procedure to be 390 maternal deaths per 100,000 live births applicable to the period 1989-94 and 360 per 100,000 live births applicable to the period 1984-88. By indirect procedure, the maternal mortality ratio was estimated to be 326 per 100,000, referring to a period centered in the early 1980s but extending further back in time. Since earlier estimates are lower, two explana- tions are possible: (1) a slight rise in the matemal mortality ratio, or (2) an underestimate of maternal mortality during earlier time periods. In either case, the most recent estimate of 390 maternal deaths per 100,000 live births should be taken as the most reliable estimate of maternal mortality. 211 CHAPTER 15 KNOWLEDGE OF AIDS In 1986, the Ministry of Health of Indonesia established a coordination board for control of the disease caused by the human immunodeficiency virus (HIV), i.e., acquired immunodeficiency syndrome (AIDS). Since then, various efforts for preventing transmission of the disease have been made, such as public health education through the mass media and nongovernmental organization activities. In the IDHS, ever-married women age 15-49 years were asked whether they had ever heard of AIDS, and if so, their source(s) of information concerning prevention and treatment of the disease, and their personal perception about the risk of getting the disease. Currently married women were asked about any changes they had made in sexual behavior to avoid getting AIDS, and whether they and their husbands were currently using condoms. 15.1 Source of Information about AIDS Table 15.1.1 shows the percentage of ever-married women who have heard of AIDS by source of information, according to background characteristics. In this survey, a respondent may report having heard about AIDS from more than one source. Overall, 38 percent of ever-married women have heard of AIDS: 34 percent received information from the television, 15 percent from newspaper or magazines, 12 percent from radio broadcasts, and 7 percent from friends or relatives. For women who have heard of AIDS the proportions are much higher: 89 percent for the television, 38 percent for newspaper or magazines, 32 percent for radio broadcasts, and 18 percent for friends or relatives. The percentage of women who have heard of AIDS varies by age and follows an inverted U-shaped pattern, i.e., low for the youngest age group and women age 30 years and over, and high among women 20 to 29 years. The percentage of women who have heard of AIDS is higher among currently married women (39 percent) than among those who are widowed (26 percent) or divorced (31 percent). Urban women are three times more likely to have heard about AIDS than women in the rural areas (70 vs. 25 percent). In the Java-Bali region, 40 percent of women had heard of AIDS compared with 34 to 35 percent in the Outer Java-Bali regions. The percentage of women who know of AIDS increases with level of education. While only 6 percent of women with no education have heard of AIDS, 20 percent of women with some primary education, 40 percent of those who completed primary school, and 82 percent of women with some secondary education have heard of AIDS (see Figure 15.1). With regard to the source of information about AIDS, for almost all subgroups, television is foremost, followed by newspapers or magazines and radio. The percentage of women who have heard about AIDS varies by province, from 12 percent in East Timor to 87 percent in DKI Jakarta (see Table 15.1.2). The role of television broadcasting in informing the public about AIDS is notable in DKI Jakarta (84 percent) and East Kalimantan (62 percent). Friends and relatives are an important source of information about AIDS for more than l0 percent of women in DKI Jakarta, Bali, North Sulawesi, Rian and East Kalimantan. 213 Table 15.1.1 Knowledge of AIDS and sources of AIDS information: background characteristics Percentage of ever-married women who have heard of AIDS, percentage of ever-married women who received information about AIDS from specific sources, and mean number of sources of information about AIDS, by background characteristics, Indonesia 1994 Ever heard of AIbS Background characteristic Yes No Radio TV Sources of AIDS information Com- Mean Friend/ munity Number number News- Pamph- Health Mosque/ Rela- meet- Work- of of paper let worker Church School rive ing place Other women sources Age 15-19 39.8 59.9 13.1 34.3 11.6 0.7 0.7 0.0 0.1 7.1 0.7 0.3 0.1 1,365 0.7 20-24 45.4 54.6 16.2 40.7 17.3 0.8 2.3 0.2 0.2 7.7 1.3 0.6 0.2 4,105 0.9 25-29 45.3 54.7 16.3 40.5 17.7 1.6 1.9 0.4 0.2 7.4 1.0 1.4 0.4 5,453 0.9 30-39 36.5 63.5 10.9 32.7 13.9 0.8 1.6 0.3 0.2 6.9 1.1 1.3 0.2 10,528 0.7 40-49 30.1 69.9 8.9 27.0 11.7 0.6 1.7 0.2 0.2 5.5 1.2 0.8 0.3 6,717 0.6 Marital status Married 38.9 61.1 12.6 34.8 14.8 0.9 1.8 0.3 0.2 6.8 I.I 1.1 0.2 26,186 0.7 Widowed 26.3 73.7 9.0 23.0 10.3 1.4 1.1 0.1 1.1 6.2 0.6 0.2 0.8 999 0.5 Divorced 30.5 69.5 8.4 26.5 10.3 0.2 0.9 0.4 0.1 6.2 0.7 0.7 0.1 984 0.5 Residence Urban 69.6 30.4 21.6 65.8 33.2 2.0 3.1 0.7 0.4 12.8 1.9 2.3 0.6 8,196 1.4 Rural 25.3 74.7 8.6 21.1 6.8 0.4 1.2 0.1 0.1 4.3 0.8 0.5 0.1 19,972 0.4 Region/Residence Java-Bali 40.3 59.7 13.9 36.0 15.7 0.9 1.7 0.3 0.2 7.4 1.3 1.2 0.3 17,953 0.8 Urban 68.7 31.3 22.3 64.8 33.8 1.9 3.0 0.7 0.4 12.9 1.9 2.3 0.6 5,991 1.4 Rural 26.0 73.9 9.7 21.6 6.7 0.4 1.1 0.1 0.1 4.6 1.0 0.6 0.1 11,962 0.5 Outer Java-Bali I 34.8 65.2 9.8 31.4 12.8 0.8 1.3 0.1 0.2 5.5 0.5 0.8 0.3 7,1(18 0.6 Urban 71.8 28.1 19.9 68.3 31.7 2.0 2.5 0.2 0.3 11.6 1.0 2.0 0.7 1,520 1.4 Rural 24.7 75.3 7.1 21.4 7.7 0.5 1.0 0.1 0.1 3.8 0.4 0.5 0.2 5,588 04 Outer Java~Bali II 33.6 66.4 9.2 29.1 11.0 1.0 2.7 0.6 0.5 6.5 1.1 1.0 0.3 3,106 0.6 Urban 72.3 27.7 18.5 68.5 31.0 3.1 5.1 1.6 1.2 14.7 3.1 3.3 0.3 685 1.5 Rural 22.6 77.4 6.5 17.9 5.3 0.4 2.0 0.3 0.3 4.2 0.6 0.3 0.3 2,4?.2 0 4 Education No education 5.6 94.3 1.4 4.0 0.2 0.0 0.2 0.0 0.0 1.4 0.0 0. I 0.0 4,489 0. I Some primary 19.7 80.2 4.0 16.6 2.2 0.1 0.7 0.0 0.1 4.0 0.4 0.2 0.0 8,997 0.3 Completed primary 39.7 60.3 11.4 34.5 8.6 0.2 1.1 0.1 0.0 6.0 0.8 0.3 0.2 7,904 0.6 Some secondary+ 82.3 17.7 31.8 76.7 47.1 3.4 5.0 1.0 0.8 15.0 3.1 3.7 0.8 6,7'78 1.9 Total 38.1 61.8 12.3 34.1 14.5 0.9 1.7 0.3 0.2 6.8 1.1 I.I 0.3 28,168 0.7 Ever-married women who have heard of AIDS 100.0 0.0 32.4 89.4 37.9 2.4 4.6 0.8 0.6 17.8 2.9 2.8 0.7 10,745 1.9 214 Table 15.1.2 Knowledge of AIDS and sources of AIDS information: region and province Percentage of ever-married women who have heard of AIDS, percentage of ever-married women who received information about AIDS from specific sources, and mean number of sources of information about AIDS, by region and province, Indonesia 1994 Region and irovinee Sources of AIDS information Ever heard Cam- Mesa of AIDS Friend/ munity Number number News- Pamph- Health Mosque/ Rela- meet- Work- of of Yes No Radio TV paper let worker Church School tire ing place Other women sources Java-Bali 40.3 59.7 13.9 36.0 15.7 0.9 1.7 0.3 0.2 7.4 1.3 1.2 0.3 17,953 0.8 DKI Jakarta 87.1 12.9 21.7 83.8 42.8 2.5 3.1 0.7 0.2 16.7 2.6 3.6 0.3 1,249 1.8 West Java 47.4 52.6 15.3 43.3 16.2 1.3 2.0 0.5 0.1 8.3 0.7 0.8 0.4 5,551 0.9 Central Java 28.1 71.8 14.2 24.3 10.2 0.3 1.2 0.2 0.2 5.2 2.0 1.3 0.1 4,578 0.6 D1 Yogyakarta 48.7 51.3 25.3 43.5 27.7 1.3 2.5 0.1 0.3 7.3 2.9 1.2 0.3 457 1.1 East Java 32.0 68.0 10.0 27.1 13.1 0.6 1.4 0.1 0.3 5.9 1.0 0.8 0.3 5,685 0.6 Bali 42.1 57.9 9.4 38.4 I 1.3 1.3 2.5 0.0 0.2 10.7 0.8 1.4 0.2 432 0.8 Outer Java-Bali I 34.8 65.2 9.8 31.4 12.8 0.8 1.3 0.1 0.2 5.5 0.5 0.8 0.3 7,108 0.6 Dista Aceh 30.0 70.0 4.6 28.3 12.2 0.7 1.1 0.1 0.2 5.5 0.5 0.6 0.0 522 0.5 North Sumatra 48.5 51.5 8.6 44.2 18.1 0.6 1.3 0.1 0.1 8.3 0.5 I. 1 0.2 1,446 0.8 West Sumatra 38.2 61.7 14.5 33.7 20.3 1.4 2.9 0.3 0.2 7.7 1.1 0.9 0.9 531 0.8 South Sumatra 35.2 64.8 9.5 32.8 13.4 1.2 1.4 0.0 0.1 5.9 0.6 1.6 0.3 900 0.7 Lampung 23.1 76.9 9.9 18.9 6.0 0.8 0.6 0.0 0.1 1.9 0.7 0.2 0.2 834 0.4 West Nusa Tenggara 19.9 80.1 6.9 17.3 7.1 0.9 1.6 0.1 0.3 2.2 0.4 0.6 0.2 527 0.4 West Kalimantan 34.4 65.6 11.2 31.4 12.3 0.9 1.5 0.3 0.2 7.1 0.4 0.9 0.1 519 0.7 South Kalimantan 37.9 62.1 8.9 36.1 9.8 1.1 0.8 0.2 0.1 3.5 0.8 0.8 0.5 447 0.6 North Sulawesi 55.0 45.0 15.3 48.1 21.3 1.2 3.5 0.3 0.4 14.3 0.8 0.8 0.2 333 1.1 South Sulawesi 25.4 74.6 11.3 22.7 8.7 0.2 0.6 0.0 0.1 1.8 0.1 0.6 0.1 1,049 0.5 Outer Java-Bali I1 33.6 66.4 9.2 29.1 11.0 1.0 2.7 0.6 0.5 6.5 1.1 1.0 0.3 3,106 0.6 Riau 42.3 57.7 13.9 39.3 17.1 1.2 2.6 0.5 0.5 11.9 1.9 1.1 0.1 552 0.9 Jambi 27.7 72.3 4.2 26.2 5.5 0.2 0.7 0.1 0.0 1.5 0.5 0.4 0.0 335 0.4 Bengkulu 29.3 70.7 12.0 27.3 10.8 0.5 2.0 0.0 0.3 7.3 2.8 1.0 0.2 190 0.6 East NusaTenggara 17.0 83.0 3.8 8.3 5.9 1.0 2.3 0.4 0.8 3.5 1.2 0.7 0.3 436 0.3 East Timor 12.4 87.4 4.3 10.2 4.3 0.5 1.4 0.4 0.3 2.7 0.2 0.5 0.0 124 0.2 Central Kalimantan 34.6 65.4 8.6 30.7 6.7 1.2 1.6 0.1 1.1 5.9 0.1 0.8 0.0 244 0.6 East Kalimantan 66.4 33.6 13.2 62.4 21.6 1.2 2.3 1.2 0.8 12.7 0.8 2.1 0.2 321 1.2 Central Sulawesi 28.7 71.3 7.4 23.7 8.2 1.7 2.2 1.9 0.1 1.9 0.1 0.6 0.4 238 0.5 Southeast Sulawesi 20.0 80.0 7.0 17.6 6.2 0.4 0.3 0.0 0.1 0.8 0.0 0.3 0.1 191 0.3 Maluku 37.4 62.4 11.2 31.3 12.0 1.5 4.2 1.0 0.6 9.3 2.0 1.0 0.2 225 0.7 Irian Jaya 33.2 66.8 11.6 24.6 12.8 1.5 10.4 0.9 0.3 6.8 1.7 1.9 1.9 250 0.7 Total 38.1 61.8 12.3 34.1 14.5 0.9 1.7 0.3 0.2 6.8 1.1 1.1 0.3 28,168 0.7 Ever-married women who have heard of AIDS 100.0 0.0 32.4 89.4 37.9 2.4 4.6 0.8 0.6 17.8 2.9 2.8 0.7 10,745 1.9 215 Figure 15.1 Knowledge of AIDS Among Ever-Married Women INDONESIA RESIDENCE Urbar Rural REGION Java-Bali Outer Java-Bali I Outer Java-BaH II EDUCATION No Education Some Primar Completed Primary Some Secondary+ MARITAL STATUS Married Widowed Divorced 38 70 =~==~=~=o~ 25 IS 139 10 20 30 40 50 Percent 60 70 80 90 100 1994 IDHS 15.2 Knowledge of Ways to Prevent AIDS One in five women who has heard of AIDS believes there is no way to avoid getting the disease (see Table 15.2.1). Those who said that AIDS is preventable could state more than one way to avoid il. Among these women, the most common response is that AIDS is preventable by avoiding having sex with prostitutes (23 percent) or by having sex with only one partner (20 percent). This is tree for almost all subgroups, and particularly among urban and better educated women. A small percentage of women cited avoiding having sex with homosexuals, blood transfusions, and injections (each about 4 percent) as ways to avoid getting AIDS. Three percent of women said using condoms during intercourse can prevent AIDS. The percentage of women who said that there is no way to avoid AIDS varies little by age group; however, it is slightly higher among married women and women with no education. Rural women are more likely than urban women to say that there is no way to avoid AIDS (26 percent, compared with 17 percent), and women in the Outer Java-Bali regions are more likely than women in Java-Bali to say that AIDS is unavoidable (28 to 30 percent, compared with 18 percent). However, the sharpest contrast is between women in urban and rural areas within each region. Knowledge of ways to prevent AIDS varies by province. The percentage of women who said that AIDS is not preventable varies from 11 percent in DKI Jakarta to 43 percent in Lampung and East Timor (see Table 15.2.2). In all but two provinces in Java-Bali, less than 20 percent of women said that AIDS is not preventable, while in most other provinces, the proportion ranges from 25 to 35 percent. The percentage of women who said that one way of avoiding AIDS is by having only one sexual partner varies from 10 percent in Lampung to 35 percent in Bengkulu (see Table 15.2.2). The percentage of women who cited avoiding having sex with prostitutes varies from 8 percent in Central Sulawesi to over 30 percent in DKI Jakarta, Dista Aceh, Riau, and East Kalimantan. 216 Table 15.2.1 Knowledge of ways to avoid AIDS: background characteristics Among ever-married women who have heard of AIDS, percentage who know of specific ways to avoid AIDS and percentage with misinformation, by background characteristics, Indonesia 1994 Background characteristic Ways to avoid AIDS Have Avoid Avoid Percentage No way only sex sex Avoid with any to Abstain Use one with with Avoid Avoid mos- misin- Number avoid from con- sexual prosti- homo- transfu- injec- Avoid quito forma- of AIDS sex doms partner tutes sexuals sions tions kissing bites Other tion j women Age 15-19 20.8 0.0 3.6 17.8 12.5 1.2 0.6 1.3 0.0 0.0 6.3 6.3 544 20-24 21.9 0.6 2.2 17.8 23.5 3.3 2.0 4.7 0.5 0.1 8.1 8.6 1,864 25-29 21.0 0.8 3.5 21.2 26.0 3.3 3.9 5.0 0.7 0.6 6.3 7.4 2,472 30-39 21.7 0.2 3.7 21.2 22.9 3.9 4.6 4.5 0.8 0.1 6.4 7,2 3,841 40-49 20.9 0.3 3.0 19.0 23.2 4.0 4.2 4.0 1.0 0.2 7.8 8.6 2,023 Marital status Married 21.6 0.4 3.3 20.1 23.4 3.6 3.8 4.4 0.6 0.2 6.9 7.6 10,183 Widowed 14.6 0.0 3.7 18.1 20.9 4.0 1.6 6.0 4.4 0.8 13.6 15.9 262 Divorced 18.6 1.0 2.5 20.6 19.4 2.1 3.8 3.6 0.5 0.0 3.1 3.6 300 Residence Urban 17.3 0.4 4.4 24.8 27.4 4.8 5.3 5.6 1.0 0.2 7.8 8.7 5,701 Rural 26.0 0.4 2.0 14.6 18.5 2.1 2.0 3.0 0.3 0.3 6.0 6.6 5,044 Region/Residence Java-Bali 17.6 0.5 3.9 20.5 23.7 2.5 3.6 4.5 0.8 0.2 8.8 9.6 7,229 Urban 13.8 0.5 5.0 25.2 27.7 3.8 5.2 5.7 1.1 0.0 9.5 10.4 4,114 Rural 22.7 0.6 2.6 14.4 18.3 0.9 1.6 2.8 0.4 0.4 7.8 8.4 3,115 Outer Java-Bali 1 29.6 0.2 1.5 17.7 21.4 5.5 3.4 3.5 0.5 0.3 3.1 3.7 2,474 Urban 27.9 0.2 2.1 22.8 25,0 7.3 4.3 4.1 0.8 0.4 3.1 4.0 1,092 Rural 30.9 0.2 1.0 13.7 18.5 4.1 2.8 3.0 0.3 0,2 3.0 3.5 1,382 Outer Java-Bali 11 27.7 0.3 2.8 22.3 24.8 5.7 5.3 6.0 0,6 0.4 3.7 4,4 1,042 Urban 22.6 0.4 4.2 26.3 30.4 7.2 8.2 8.5 1.1 0.6 3.8 5.1 495 Rural 32.3 0.2 1.6 18.6 19.8 4.4 2,7 3.8 0.1 0.2 3.5 3.8 547 Education No education 28.1 0,0 0.4 3.9 3.9 0.1 0.7 0.8 0.0 0.0 2.0 2.0 252 Some primary 24.4 0.1 1.0 9.3 12.4 1.0 0.8 2.1 0.2 0.0 6.1 6.4 1,777 Completed primary 23.8 0.2 1.9 12.0 16.6 1.3 1.3 2.5 0.3 0.2 5.5 5.9 3,139 Some secondary+ 18.7 0.6 4.9 28.8 31.4 5.7 6.2 6.3 1.1 0.3 8.2 9.4 5,578 Total 21.4 0.4 3.3 20.0 23,3 3.5 3.7 4.4 0.7 0.2 6.9 7.7 10,745 I Includes avoiding kissing, mosquito bites, and "other." 217 Table 15.2.2 Knowledge of ways to avoid AIDS: region and province Among ever-marr ied women who have heard of AIDS, percentage who know of specific ways to avoid A IDS and percentage with mis information, by region and province, Indonesia 1994 Region and province Ways to avoid AIDS Have Avoid Avoid Percentage No way only sex sex Avoid with any to Abstain Use one with with Avoid Avoid mos- raisin- Number avoid from con- sexual prosti- homo- transfu- injec- Avoid quito forma- of AIDS sex doms partner lules sexuals sions tions kissing bites Other tion I women Java-Bal i 17.6 0.5 3.9 20.5 23.7 2.5 3.6 4,5 0.8 0.2 8.8 9.6 7,229 DKI Jakarta 10.6 0.1 4.0 30.7 32.7 2.5 7.1 5.7 0.7 0,1 6.5 7.2 1,088 West Java 16.4 0.5 2.6 21.2 18.5 2.7 3.7 4.6 0.8 0.3 I 1.7 12.4 2,631 Central Java 32.3 1.0 6.3 14.4 27.7 3.9 2.7 3.0 1.6 0.3 1.7 3.5 1,289 DI Yogyakarta 15.2 0.2 3.0 33.4 18.2 4.6 5.2 4.5 0.0 0.0 8.3 8.3 222 East Java 13.1 0,4 4.4 16.6 23,9 1.1 1.7 4.0 0.4 0.0 11.2 11.6 1,818 Bali 23.2 0.9 4.3 16.8 20.2 2.7 6.6 10.2 0.3 0.2 5,6 6.0 182 Outer Java-Bal i I 29.6 0.2 1.5 17.7 21.4 5.5 3.4 3.5 0.5 0.3 3.1 3.7 2,474 Dista Aceh 26.1 0,0 0.7 32.0 34.4 4,7 4,4 2.8 0.0 0.0 2.4 2.4 157 North Sumatra 22.3 0,3 1.5 21.6 21.3 3.0 2.5 4.3 0.0 0.0 4.4 4.4 702 West Sumatra 26.3 0.0 2.1 17.9 20.7 9,6 3.5 5.7 0.6 0,0 6.4 7.0 203 South Sumatra 29.0 0.3 3.4 16.9 25.0 5.6 1.6 1.3 0.6 0.6 1.7 2.6 317 Lampung 42.9 0.0 0.3 9.8 l l .9 2.8 1.1 1.7 0.7 0.7 1,9 2.6 193 West Nusa Tenggara 36,1 1.5 0.0 17.8 25.0 9.8 4.3 6,8 0.0 0.5 2.4 2.9 105 West Kalimantan 34.0 0.0 0.0 12.4 21.6 2.9 2.4 3.2 0.2 0.2 2.0 2.3 178 South Kalimantan 33.5 0.0 2.0 20.0 15.3 3.7 1,9 5.6 1.6 0.6 4.2 5.8 169 North Sulawesi 36.7 0.0 0.6 13.3 14.3 7.9 6.9 1.8 1.0 0.2 2.0 3.2 183 South Sulawesi 31.3 0.0 1,6 10.2 24.1 11.1 7.9 2.7 1.0 1.0 0.9 2.8 266 Outer Java-Bal i I I 27.7 0.3 2.8 22.3 24,8 5.7 5.3 6.0 0.6 0.4 3.7 4.4 1,042 Riau 19.1 0.0 3.2 25.1 30,8 8.9 7.7 9.3 0.8 0.2 9.5 10.0 233 Jambi 32.7 0.0 1.1 19.0 25,9 4.8 4.7 8.9 0.8 0.0 0.8 1.1 93 Bengkulu 34.1 0,0 0.0 34.9 19,5 8.9 4.1 1.6 1.2 0.4 7.6 8.8 56 East Nusa Tenggara 30.8 0.0 0.0 22.4 11.2 1.4 5.0 4.4 0.7 1.5 4,3 6.5 74 East Timor 43.0 0.7 0.0 18,6 17.6 1.4 4.3 2.2 0.0 0.0 2.4 2.4 15 Central Kalimantan 37.8 1.0 3.4 29.7 26.8 6.2 2.8 0.3 0.0 0.0 0.0 0.0 84 East Kalimantan 19.8 0.2 6.1 23.5 32.1 4.6 6,8 7.8 0.0 0.0 2.3 2.3 213 Central Sulawesi 38.1 1.3 0.7 I I. 1 7,7 4.6 1.2 5.1 0.9 2.1 0.8 3.3 68 Southeast Sulawesi 29.2 0.0 2.1 20.9 18.9 5.9 3.6 4.2 1.5 0.4 0.0 1.5 38 Maluku 39,3 0.0 2.8 13.0 20.8 7.9 3.1 1.5 0.7 0.0 1.0 1.7 84 lrian Jaya 25.3 0.7 1.5 18.8 24.4 1.4 5.9 6.3 0.7 0.4 2.0 3.1 83 Total 21.4 0.4 3.3 20.0 23.3 3.5 3,7 4.4 0.7 0.2 6.9 7.7 10,745 i Includes avoiding kissing, mosquito bites, and "other." 218 15.3 Women's Perceptions of the Risk of Getting AIDS Sixty-two percent of women who have heard of AIDS believe that the disease cannot be cured, 20 percent said that it is curable, and 18 percent do not know (see Table 15.3.1 ). The proportion who know that AIDS cannot be cured varies; it is lowest among women 15-19 (48 percent) and women with no education (43 percent) and highest among women in the urban areas of Outer Java-Bali II and women who have had some secondary education (69 percent or higher). Seven in ten women believe that they have no chance of contracting AIDS, 6 percent say their chance is small, 10 percent say that they have a moderate chance and almost none believe themselves to be at great risk. Differences in the perception of AIDS risks between subgroups are small; however, women with no education are less likely than those with some secondary education to say that they have no risk of getting AIDS (63 percent, compared with 71 percent). Table 15.3.1 Perception of the risk of getting AIDS: background characteristics Percent distribution of ever-married women who have heard of AIDS by whether they believe AIDS can be cured, and their perception of the risk of getting AIDS, according to background characteristics, Indonesia 1994 Believe AIDS can be cured Perception of the risk of getting AIDS Number Background Don't No risk Don't of characteristic Yes No know at all Small Moderate Great know Total women Age 15-19 27.0 48.2 24.8 68.1 4.0 13.6 0.0 14.3 100.0 544 20-24 23.4 60.3 16.2 73.3 5.3 9.0 0.1 12.2 100.0 1,864 25-29 21.5 61.5 17.0 68.6 6.5 11.7 0.6 12.4 100.0 2,472 30-39 17.9 64.0 18.1 71.9 5.5 10.2 0.2 11.8 100.0 3,841 40-49 15.2 64.2 20.5 71.8 7.0 8.9 0.7 11.4 100.0 2,023 Marital status Married 19.9 62.1 18.0 71.2 6.1 10A 0.3 12.0 100.0 10,183 Widowed 14.5 66.0 19.6 74.0 4.2 11.2 0.2 10.4 100.0 262 Divorced 17.0 57.1 26.0 66.8 2.5 14.0 1.4 15.2 100.0 300 Residence Urban 16.9 65.8 17.3 69.7 6.9 11.7 0.5 11.0 1(30.0 5,701 Rural 22.8 57.8 19.4 72.9 4.9 8.6 0.2 13.3 100.0 5,044 Region/Residence Java-Bali 21.4 62.0 16.6 70.3 6.7 10.8 0.4 11.8 100.0 7,229 Urban 18.2 65.6 16.2 68.8 7.3 11.9 0.6 11.2 100.0 4,114 Rural 25.8 57.2 17.0 72.2 5.7 9.3 0.2 12.6 100.0 3,115 Outer Java-Bali 1 17.3 60.4 22.2 73.1 4.3 9.0 0.2 13.1 100.0 2,474 Urban 14.8 64.4 20.7 72.8 5.2 10.6 0.3 10.8 100.0 1,092 Rural 19.3 57.2 23.4 73.3 3.5 7.8 0.2 14.9 100.0 1,382 Outer Java-Bali 11 12.8 66.1 21.1 73.1 5.0 9.7 0.3 11.7 100.0 1,042 Urban 10.7 70.1 19.1 70.3 6.9 12.9 0.1 9.4 100.0 495 Rural 14.7 62.4 22.9 75.7 3.2 6.8 0.5 13.7 100.0 547 Education No education 16.7 43.3 40.0 63.4 4.2 7.2 1.4 23.8 100.0 252 Some primary 23.1 49.7 27.1 72.2 4.4 7.2 0.2 15.8 100.0 1,777 Completed primary 21.5 57.3 21.2 71.1 3.1 10.8 0.2 14.6 100.0 3,139 Some secondary+ 17.6 69.4 12.9 71.3 8.1 11.1 0.4 8.9 100.0 5,578 Total 19.6 62.0 18.3 71.2 5.9 10.3 0.4 12.1 100.0 10,745 219 Urban women are more likely than rural women to say that they have a risk of getting AIDS; in urban areas in all regions, the proportion of women who say they are not at risk is smaller than in rural areas, while the proportion who say they have a moderate risk is greater. Although the percentage of women who believe that AIDS cannot be cured varies slightly by region, there are significant differences by province, ranging from 51 percent in Central Sulawesi to 80 percent in Central Kalimantan (see Table 15.3.2). The percentage of women who considered themselves at no risk of getting AIDS varies from 54 percent in DI Yogyakarta to 85 percent or more in West Kalimantan and Central Kalimantan (see Table 15.3.2). Table 15.3.2 Perception of the risk of getting AIDS: region and province Percent distribution of ever-married women who have heard of AIDS by whether they believe AIDS can be cured, and by their perception of the risk of getting AIDS, according to region and province, Indonesia 1994 Believe AIDS can be cured Perception of the risk of getting AIDS Number Region and Don't No risk Don't of province Yes No know at all Small Moderate Great know Total women Java-Bali 21.4 62.0 16.6 70.3 6.7 10.8 0.4 I 1.8 100.0 7,229 DKI Jakarta I 1.1 67.9 21.0 59.4 7.8 13.0 0.1 19.5 1130.0 1,088 West Java 23.3 55.6 21.1 71.2 4.3 10.3 0.5 13.5 100.0 2,631 Central Java 19.9 65.3 14.8 79.0 8.9 6.4 0.0 5.7 100.0 1,289 DI Yogyakarta 24.2 70.9 4.9 54.0 14.3 27.1 0.5 4.1 100.0 222 East Java 26.7 63.5 9.8 71.3 7.1 11.4 0.8 9.4 100.0 1,818 Bali 10.8 69.5 19.7 69.2 4.4 9.1 0.3 17.1 100.0 182 Outer Java-Bali I 17.3 60.4 22.2 73.1 4.3 9.0 0.2 13.1 100.0 2,474 Dista Aceh 9.4 73.3 16.9 69.3 4.9 14.0 0.0 11.1 100.0 157 North Sumatra 25.4 52.0 22.4 78.1 2.3 10.4 0.0 9.2 100.0 702 West Sumatra 20.1 64.0 15.9 61.4 6.1 13.4 0.8 18.1 100.0 203 South Sumatra 8.4 67.2 24.4 62.2 4.3 11.0 0~2 21.8 100.0 317 Lampung 13.0 59.6 27.4 78.3 2.8 6.5 0.0 12.4 100.0 193 West Nusa Tenggara 19.2 63.3 17.5 71.4 7.4 14.6 0.0 6.5 100.0 105 West Kalimantan 24.3 58.8 16.9 85.7 3.2 4.7 0.3 5.8 100.0 178 South Kalimantan 20.3 56.8 22.8 72.9 9.8 9.0 0.2 7.9 100.0 169 North Sulawesi 6.0 66.6 27.4 79.3 0.8 1.4 0.9 16.5 100.0 183 South Sulawesi 12.5 62.3 24.9 68.2 7.0 4.6 0.4 19.3 100.0 266 Outer Java-Bali II 12.8 66.1 21.1 73.1 5.0 9.7 0.3 11.7 100.0 1,042 Riau 20.3 64.7 15.0 74.2 1.6 15.0 0.0 9.3 100.0 233 Jambi 15.2 69.6 15.2 79.3 9.7 3.1 0.4 7.2 100.0 93 Bengkulu 13.1 74.3 12.6 78.1 13.2 3.9 0.4 4.4 100.0 56 East Nusa Tenggara 22.1 53.6 24.3 68.2 4.1 10.4 1.2 16.2 100.0 74 East Timor 4.8 75.9 19.3 75.9 3.6 7.9 0.0 12.5 100.0 15 Central Kalimantan 2.9 79.5 17.2 96.2 0.0 1.8 0.0 1.7 100.0 84 East Kalimantan 10.8 69.4 19.8 61.3 8.2 14.6 0.1 15.8 100.0 213 Central Sulawesi 7.2 50.5 42.3 73.5 6.5 2.3 0.0 17.0 100.0 68 Southeast Sulawesi 9.2 68.4 22.5 71.7 3.2 12.0 1.9 I 1.1 100.0 38 Maluku IL l 60.6 28.3 77.0 3.3 9.1 0.7 8.3 100.0 84 lrian Jaya 5.5 65.1 29.4 67.1 2.5 7.2 0.4 22.8 100.0 83 Total 19.6 62.0 18.3 71.2 5.9 10.3 0.4 12.1 100.0 1(I,745 220 15.4 AIDS Prevention Behavior Currently married women who had heard of AIDS were asked if they had changed their sexual behavior to avoid getting AIDS (see Table 15.4.1). Virtually all of these women reported that they had not changed their sexual behavior after hearing about the disease (96 percent). There is little variation by background characteristics. Table 15.4.1 AIDS prevention behavior: background characteristics Among currently married women who have heard of AIDS, percentage who made specific changes in sexual behavior in order to avoid AIDS, by perception of AIDS risk and background characteristics, Indonesia 1994 Change in behavior to avoid AIDS No change Began Restricted Other Number Background in sexual Stopped using to one Fewer sexual of characteristic behavior sex condom partner partners behavior women Perception of AIDS risk Among those who believe AIDS cannot be cured or don't know No/small risk 97.3 0.0 0.1 0.7 0.0 1.0 6,322 Moderate/great risk 95.3 0.0 0.1 1.0 0.1 2.7 802 Don't know 89.4 0.0 0.0 0.4 0.1 1.2 1,037 Among those who believe AIDS can be cured or don't know No/small risk 95.9 0.0 0.0 1.3 0.3 1.8 1,551 Moderate/great risk 91.6 1.6 0.0 2.2 0.1 3.5 265 Don't know 93.6 0.0 0.0 0.6 0.0 2.0 207 Age 15-19 95.1 0.0 0.0 1.1 0.0 2.7 515 20-24 95.4 0.0 0.2 1.4 0.2 1.6 1,796 25-29 95.8 0.2 0.0 0.5 0.0 1.5 2,408 30-39 95.8 0.0 0.0 0.9 0.1 1.2 3,654 40-49 96.8 0.0 0.0 0.4 0.0 0.8 1,811 Residence Urban 96.4 0.0 0. I 0.6 0.0 1.3 5,377 Rural 95.3 0.1 0.0 1.1 0,1 1.4 4,806 Region/Residence Java-Bali 96.2 0.1 0. I 0.6 0.0 1.7 6,807 Urban 96.7 0.0 0.1 0.3 0.0 1.6 3,866 Rural 95.5 0.1 0.0 1.0 0.1 1.7 2,941 Outer Java-Bali 1 96. I 0.0 0.1 1.0 0.1 0.7 2,377 Urban 96.5 0.0 0.1 0.9 0.0 0.4 1,038 Rural 95.8 0.0 0,1 1.1 0.I 0.9 1,339 Outer Java-Bali 11 93.2 0.2 0.1 2.0 0. I 0.8 1,000 Urban 93.6 0.0 0.2 2.5 0.1 1.0 473 Rural 92.9 0.3 0,0 1.6 0.1 0.6 527 Education No education 97.0 0.0 0.0 0.2 0.0 0.0 218 Some primary 95.9 0.0 0.0 0.3 0.1 0.8 1,644 Completed primary 94.7 0.2 0.0 0.7 0.1 1.9 3,007 Some secondary+ 96.5 0.0 0.1 1. I 0.0 1.3 5,314 Total 95.9 0.1 0.1 0.8 0.1 1.3 10,183 221 Differentials by province do show some variation (see Table 15.4.2). Women in South Kalimantan, Jambi, and East Timor are slightly more likely than women in other provinces to have changed their sexual behavior, mostly by having only one sex partner (Table 15.4.2). Table 15.4.2 A IDS prevention behavior: region and province Among currently married women who have heard of AIDS, percentage who made specific changes in sexual behavior in order to avoid AIDS, by region and province, Indonesia 1994 Change in behavior to avoid AIDS No change Began Restricted Other Number Region and in sexual Stopped using to one Fewer sexual of province behavior sex condom partner partners behavior women Java-Bal i 96.2 0.1 0.1 0.6 0.0 1.7 6,807 DKI Jakarta 96.7 0.0 0.0 0. I 0.0 0.2 1,016 West Java 96. I 0.0 0.0 0.3 0.0 1.7 2,466 Central Java 97.3 0.0 0.0 1.3 0.3 0.2 1,247 DI Yogyakarta 96.3 0.0 0.0 0.2 0.0 3.4 210 East Java 95.11 0.2 0.2 0,8 0.0 3.5 1,690 Bali 979 0.0 0.0 0.6 0.0 1.1 178 Outer Java-Bal i I 96.1 0.0 0 1 1.0 0.1 0.7 2,377 Dista Aceh 98.6 0.0 0.0 0.6 0.0 0.0 149 North Sumatra 97.8 0.0 02 0.1 0. I 0.8 677 West Sumatra 97.5 0,0 0.0 0.0 0.0 0.3 195 South Sumatra 98.8 0.0 0.0 0.0 0.0 0.0 306 Lampung 93.3 0.0 0.4 0.0 0.5 0.8 191 West Nusa Tenggara 97.7 0.0 00 0.0 0.0 1.7 97 West Kalimantan 96.9 02 00 1.3 0.3 0.8 175 South Kalimantan 89.2 0.0 0.0 6.9 0,0 1.6 158 Nilrth Sulawesi 92.6 0.0 0.0 06 0.0 0.2 178 South Sttlawesi 93 2 0.0 0.0 32 0.0 0.9 251 Outer Java-Bal i 11 932 0.2 0.1 2.0 0.1 0.8 1,000 Riau 94 1 0.0 0.0 1.3 0.0 1. I 227 Jambi 89.0 0.0 0.0 6.1 0.7 0.0 91 Bengkulu 98.7 0.0 0.0 0.8 0.5 0.4 54 East Nusa Tenggara 92.0 0.0 0.0 1.3 0.0 2.4 67 East Timor 894 0.8 0.0 9.0 0.7 0.0 15 Central Kalimantan 96 1 0.0 0.0 0 6 0.0 0.0 81 East Kalimantan 92. I 0.0 06 28 0.0 0.8 203 Ccntral Sulawcsi 93.9 0.0 0.0 0.0 0.0 0.5 65 Southeast Sulawesi 95(I 0.0 0.0 0.0 0.0 0.8 37 Maluku 93.9 1.8 0.0 I 1 0.0 0.7 79 Irian Jaya 91.2 0.3 0.0 2.8 0.0 0.6 80 Total 959 0.1 0.1 0.8 0.1 1,3 10,183 222 15.5 Knowledge and Use of Condoms The great majority of currently married women who have heard of AIDS also know about condoms (92 percent) (see Table 15.5.1). The proportions are smaller for women under 20 and women who have no education (78 percent). Knowledge of condoms among women who have heard of AIDS increases with level of education. Urban women are slightly more likely than rural women to know about condoms (95 percent, compared with 88 percent). Table 15.5.1 Knowledge of condoms: background characteristics Among currently married women who have heard of AIDS, percentage who know about condoms, percentage who know a specific source for condoms, and percentage who have used condoms, by selected background character- istics, perception of AIDS risk, and whether changed sexual behavior to avoid AIDS, Indonesia 1994 Source for condoms Percentage Know Don't who have Number Background about Public Private Private Other know/ used of characteristic condoms sector medical pharmacy private Missing condoms women Age 15-19 77.9 27.9 12.5 10.0 7.6 42.1 2.5 515 20-24 92.5 33.4 11.0 24.6 8.3 22.7 4.9 1,796 25-29 91.6 33.1 12.9 28.8 7.3 17.8 8.2 2,408 30-39 92.9 35.2 10.9 29.5 9.8 14.5 15.0 3,654 40-49 93.1 39.4 12,2 25.3 10.1 13.0 15.1 1,811 Residence Urban 95.1 29.0 13.2 39.4 6.6 11.7 15.6 5,377 Rural 88.1 41.2 10.1 12.6 11.4 24.7 5.9 4,806 Region/Residence Java-Bali 91.9 28.4 11.0 31.5 9.1 20.0 12. I 6,807 Urban 95.2 24.4 12.0 44.1 6.9 12.6 17. I 3,866 Rural 87,6 33,8 9.6 14.9 12.0 29.8 5.5 2,941 Outer Java-Bali 1 92.3 44.6 15.3 19.2 7.9 13.1 9.0 2,377 Urban 94.8 37.6 17.1 30.8 5.0 9.5 11.6 1,038 Rural 90.3 50.1 13.8 10.1 10.2 15.8 7.0 1,339 Outer Java-Bali 11 89.7 54.3 8.6 12.9 10.0 14.2 8.2 1,000 Urban 94.6 48.5 13.6 20.3 8.3 9.2 11.1 473 Rural 85.3 59.6 4,0 6.2 11.5 18.7 5.5 527 Education No education 78.0 36.9 3.7 13.8 10.8 34.8 3.8 218 Some primary 85. I 36.6 9.5 17.7 10. I 26. I 6.5 1,644 Completed primary 89.3 35.8 10.7 19.0 10.5 23.9 6.8 3,007 Some secondary+ 95.8 33.5 13.3 34.5 7.5 1 I. I 15.1 5,314 Perception of AIDS risk No risk at all 91.4 35.0 12.3 25,7 9.2 17.8 10.7 7,254 Small 97.1 30.9 11.1 38,5 9.3 8.2 16.9 619 Moderate 93.8 30.8 9.8 34.6 8.6 16.2 16.0 1,033 Great 92.7 37,4 2,9 35.2 3.3 21.1 1.5 34 Don't know/Missing 89.6 37.3 10.8 20.3 7.3 24.3 5.9 1,244 Change in behavior to avoid AIDS Changed behavior 91.9 37.5 11.1 23.4 9.6 18.4 6.2 417 No change 91.8 34.6 11.8 26.9 8.9 17.8 11.2 9,763 Total 91.8 34.8 11.7 26.8 8.9 17.8 11.0 10,183 223 Thirty-five percent of women had heard of AIDS and know about condoms say they would go to a government source for condoms, 12 percent would go to a private hospital, a private family planning clinic, a doctor or a midwife, and 27 percent would go to a pharmacy. Public sources are more popular among older women, mral women, and women in the Outer Java-Bali II region. Pharmacies are a common source among women 20 years and older, urban women, women in Java-Bali, and better educated women. Overall, only 11 percent of currently married women who know of AIDS have used condoms. The use rate increases with age and education. Urban women are more than twice as likely to have used condoms as rural women (16 percent, compared with 6 percent). Women who said they have a small or moderate risk of getting AIDS are much more likely to have used condoms than women who said that they have a great risk (16 to 17 percent, compared with less than 2 percent). The percentage of women who have used condoms is higher among women who did not change their sexual behavior to avoid AIDS (11 percent) than among those who did change their sexual behavior (6 percent). The percentage of women who have heard of AIDS and know about condoms varies between 71 percent in East Timor to 99 percent in DI Yogyakarta (see Table 15.5.2). Women in Outer Java-Bali II are more likely to report a public facility as a source for condoms, while women in Java-Bali are more likely to cite a pharmacy as a source. Table 15.5.2 Knowledge of condoms: region and province Among currently married women who have heard of AIDS, percentage who know about condoms, percentage who know a specific source fbr condoms, and percentage who have used condoms, by region and province, Indonesia 1994 Source for condoms Percentage Know Don't who have Number Region and about Public Private Private Other know/ used of ~rovince condoms sector medical pharmacy private Missing condoms women Java-Bali 91.9 28.4 11.0 31.5 9.1 20.0 12.1 6,807 DKI Jakarta 97.1 25.6 11.3 53.7 2. I 7.3 9.4 1,016 West Java 89.1 24.8 14.3 30.7 4.8 25.4 12.8 2,466 Central Java 95.5 33.5 10.3 21.1 20.7 14.4 13.3 1,247 DI Yogyakarta 99.4 36.9 9.6 21.4 29.9 3.3 30.0 210 East Java 89.5 30.0 6.2 28.9 9.1 25.7 10.0 1,690 Bali 91.0 35.6 15.3 23.0 2.2 23.8 9.7 178 Outer Java-Bali I 92.3 44.6 15.3 19.2 7.9 13.1 9.0 2,377 Dista Aceh 89.0 37.3 15.4 28.7 6.7 11.9 9.0 149 North Sumatra 95.3 33.4 22.0 27.7 7.5 9.5 9.2 677 West Sumatra 96.1 46.1 14.3 19.5 6.2 13.9 12.2 195 South Sumatra 92.3 45.4 14.8 16.3 10.7 12.7 12.2 306 Lampung 94.4 48.7 21.4 10.6 12.0 7.3 8.7 191 West Nusa Tenggara 91.1 63.5 5.5 5.0 8.6 17.5 4.4 97 West Kalimantan 89.5 55.0 6.7 12.4 8.4 17.4 7.8 175 South Kalimantan 94.2 50.2 7.7 20. I 6.8 15.3 8.0 158 North Sulawesi 83.8 53.1 9.9 I 0.0 7.8 19.1 3.6 178 South Sulawesi 88.8 50.1 11.9 16.3 4.7 17.0 9.5 251 Outer Java-Bali 11 89.7 54.3 8.6 12.9 10.0 14.2 8.2 1,000 Riau 95.0 51.5 10.5 17.9 12.4 7.7 13.6 227 Jambi 84.0 42.2 11.6 19.7 4.8 21.7 8.6 91 Bengkulu 97.0 42.1 17.5 16.2 19.6 4.6 1 1.9 54 East Nusa Tenggara 89.1 63.6 7.0 1.3 9.8 18.4 4.9 67 East Timor 71.4 63.0 4.4 0.7 0.0 31.8 4.5 15 Central Kalimantan 74.5 54.7 5.6 11.7 1.3 26.8 0.9 81 East Kalimantan 97.7 51.5 8.5 16.7 15.8 7.4 9.8 203 Central Sulawesi 82.2 56.7 4.1 2.1 10.0 27.2 3.3 65 Southeast Sulawesi 91.7 69.8 2.1 9.5 7.7 10.8 4.0 37 Maluku 84.4 67.9 11.2 3.6 0.5 16.7 1.9 79 lrian Jaya 86.0 59.6 2.7 11.4 9.2 17.4 8.3 80 Total 91.8 34.8 11.7 26.8 8.9 17.8 11.0 10,183 224 CHAPTER 16 AVAILABILITY OF FAMILY PLANNING AND HEALTH SERVICES Using the Health and Family Planning Service Availability Questionnaire (SDKI 94-KKB), the 1994 Indonesia Demographic and Health Survey (IDHS) collected information about family planning and health services available to women and children in the sampled clusters. In this analysis, family planning and health services available to women and children refer to those provided at the nearest of selected types of facilities visited by the IDHS interviewers. As such, the service availability sample is representative of the nearest facility to the sampled women and children, and does not represent all facilities in the country. In the 1994 IDHS, the sample cluster came from the smallest geographic administrative unit--the desa in rural areas, and the kelurahan in urban areas. The service availability data were collected in two stages; in the first stage, an interview was held with knowledgeable residents, including the head of the sub-unit (dukuh, RT, or RW), at least one ever-married woman age 15 to 49, and other residents who were familiar with the area, to represent users of health and family planning facilities. It should be noted that although the term "area" in this survey should refer to the sampled cluster, it may be perceived by informants as covering a larger geographic entity, such as a village. Information was collected on the availability of selected family planning service providers: the family planning post (PAKBD), the family planning distribution post at the locality level (PPKBD), the family planning distribution post at the sub-locality level (sub-PPKBD), the family planning acceptors group (paguyuban KB or kelompok akseptor), and the health post (posyandu). In addition, informants were asked to identify various types of stationary facilities located in the area, or nearby, that provide health and family planning services. These facilities are the general hospital, the special hospital, the health center, the auxiliary health center, the village delivery post, the midwife assigned to the village, the private doctor, the private midwife, the pharmacy, and the traditional birth attendant. Specifically, infor- mation was recorded on the location of these facilities, distance from the cluster to the facility, most common mode of transportation, and one-way travel time. For each type of facility, a complete address was recorded. If more than one of the same type of facility was reported by informants, the interviewer was instructed to record the facility located closest to the cluster. During the interview, informants were also asked about the accessibility of subdistrict and regency/municipality offices, and visits by family plan- ning fieldworkers in the six months preceding the survey. The second stage of data collection involved visits by IDHS interviewers to selected types of facilities, namely, general hospitals, health centers, private doctors, private midwives, and pharmacies. Combined, these types of facilities supply 70 percent of modem contraceptive users (see Chapter 5). Moreover, they are the main outlets for other maternal and child health services, e.g., providing antenatal care for 70 percent of births. Hereafter, these five facilities will be referred to as principal family planning~maternal and child health (FP/MCH) outlets. Interviewers visited the nearest of each type of principal FP/MCH outlet if it was located within 10 kilometers of the cluster in urban areas and within 30 kilometers in rural areas. During the facility visit, interviews were conducted with the director or administrator of the hospital, health center and pharmacy, or the private doctor or midwife. Information was obtained from these respondents on the distance and one-way travel time between the facility and the cluster. In addition, questions were asked 225 about the availability of specific family planning methods, including the pill, IUD insertion/removal, injection, condom, Norplant insertion/removal, and male and female sterilization. For hospitals, health centers, and private doctors, information was obtained on whether the following services were available in the facility: antenatal care, postnatal care, delivery assistance, immunization of children, and child growth monitoring. For private midwives, questions were asked about antenatal care and delivery assistance. In some cases, a facility was identified as the nearest outlet of its type by community informants in more than one cluster. When this occurred, the facility was visited only once, and information on the availability of family planning methods and health services obtained during that visit was recorded for all other clusters in which the facility was named as the nearest outlet. For these other clusters, distance and travel time data were obtained from information provided by community informants, not from facility respondents. 16.1 Availability of Selected Family Planning Providers in the Area As mentioned above, in each sample cluster, knowledgeable residents were asked if specific family planning providers were available in their area (without specifying the meaning of "available.") Table 16.1.1 shows the percentage of currently married women who live in areas where these providers are available. Among currently married women, 86 percent live in clusters served by a health post (posyandu), while family planning distribution posts at the locality level (PPKBD) and sub-locality level (sub-PPKBD) are available to 57 percent and 60 percent of respondents, respectively. One in three re- spondents lives in a cluster that is served by a family planning post (PAKBD). This proportion is lower than for other services, because family planning posts are a newly established distribution network. Forty- four percent of currently married women live in clusters where a family planning acceptor group (paguyuban KB or kelompok akseptor) is available. Table 16.1.1 Availability of family planning providers in the area: background characteristics Percentage of currently married women with selected family planning providers in the area, by type of outlet and background characteristics, Indonesia 1994 Family Family Family planning planning planning distribution distribution acceptors Family post at post at group planning locality sub-locality (paguyuban Health Number Background post level level KB/keL post of characteristic (PAKBD) (PPKBD) (sub-PPKBD) akseptor) (posyandu) women Residence Urban 36.8 60.8 61.5 47.4 86.8 7,591 Rural 30.7 55.0 58.8 42.9 85.1 18,595 Region/Residence Java-Bali 32.0 52.7 56.9 46.7 83.8 16,663 Urban 37.3 60.5 61.1 48.7 86.4 5,523 Rural 29.3 48.9 54.7 45.7 82.6 11,140 Outer Java-Bali I 36.1 68.7 68.7 46.4 90.0 6,619 Urban 37.6 68.1 69.5 52.3 89.8 1,423 Rural 35.7 68.8 68.5 44.8 90.0 5,197 Outer Java-Bali 11 27.1 52.1 54.6 24.9 85.5 2,903 Urban 30.2 47.2 47.3 24.9 84.1 645 Rural 26.3 53.5 56.7 24.9 85.9 2,259 Total 32.5 56.7 59.6 44.2 85.6 26,186 226 Table 16.1.1 also shows that, according to community informants, these providers are slightly less available in rural areas than in urban areas. Women in Outer Java-Bali II are less likely than women in other areas to live close to any of the listed family planning providers. On the other hand, women in Outer Java-Bali I are more likely to be served by a PPKBD, a sub-PPKBD, and a posyandu. Looking at provincial differentials (see Table 16.1.2), between 9 percent (East Timor) and 58 percent (Bengkulu) of currently married women live in a cluster served by a PAKBD. In Bali, although sub-PPKBD are not widely available, posyandu are available to all women. In fact, posyandu are available to 90 percent or more of currently married women in 14 of the 27 provinces in Indonesia. Family planning acceptor groups are generally less common in the Outer Java-Bali II region. Table 16.1.2 Availability of family planning providers in the area: region and province Percentage of currently married women with selected family planning providers in the area, by type of outlet and region and province, Indonesia 1994 Family Family Family planning planning planning distribution distribution acceptors Family post at post at group planning locality sub-locality (paguyuban Health Number Region and post level level KB/kel. post of province (PAKBD) (PPKBD) (sub-PPKBD) akseptor) (posyandu) women Java-Bali 32.0 52.7 56.9 46.7 83.8 16,663 DK1 Jakarta 39.9 51.7 46.0 36.7 89.0 I,I 40 West Java 44.6 65.0 67.8 54.0 90.3 5,170 Central Java 24.4 45.0 50.2 55.9 90.4 4,302 DI Yogyakarta 44.4 66.5 80.9 66.5 81.5 423 East Java 23.9 44.1 55.7 33.0 69.8 5,209 Bali 20.5 77.5 9.7 38.6 100.0 418 Outer Java-Bali I 36.1 68.7 68.7 46.4 90.0 6,619 Dista Aceh 56.4 57.0 54.5 38.7 91.3 477 North Sumatra 31.7 71.9 81.1 57.5 92.8 1,374 West Sumatra 37.5 63.6 58.0 63.0 95.7 489 South Sumatra 23.0 48.1 37.8 30.6 80.3 843 Lampung 42.0 77.6 85.4 58.2 91.8 801 West Nusa Tenggara 21.0 38.1 28.5 33.6 72.0 469 West Kalimantan 25.0 85.4 81.2 45.6 89.2 489 South Kalimantan 34.7 81.3 64.9 23.4 91.8 398 North Sulawesi 41.7 89.8 97.4 57.9 95.8 318 South Sulawesi 49.9 77.2 82.0 42.5 96.0 962 Outer Java-Bali 1I 27.1 52.1 54.6 24.9 85.5 2,903 Riau 22.4 35.5 48.7 12.4 80.7 520 Jambi 35.1 63.2 60.5 37.2 95.4 316 Bengkulu 58.4 65.9 89.4 21.0 88.3 179 East Nusa Tenggara 12.9 57.9 64.6 24.0 91.3 393 East Timor 8.6 63.1 50.3 30.5 91.4 I 15 Central Kalimantan 26.1 49.1 49.7 28.2 59.5 227 East Kalimantan 22.2 40.9 61.7 23.7 85.9 304 Central Sulawesi 48.1 53.4 35.5 20.7 88.8 225 Southeast Sulawesi 50.9 85.9 73.0 34.9 98.6 178 Maluku 16.4 56.8 58.4 40. I 81.2 209 lrian Jaya 14.9 34.7 15.9 19.4 83.6 238 Total 32.5 56.7 59.6 44.2 85.6 26,186 227 16.2 Distance and Time to Selected FP/MCH Outlets Providing Family Planning Methods Additional insights into the availability of family planning services in Indonesia are provided through an examination of the data on distance (in kilometers) and one-way travel time (in minutes) from the IDHS clusters to the nearest of each of the five visited principal FP/MCH outlets, i.e., general hospitals, health centers, private doctors, private midwives and pharmacies. In examining these data, it is important to remember that facilities were visited only if they were within 10 kilometers of a cluster in urban areas and within 30 kilometers of a cluster in rural areas. The information collected on family planning was limited to whether or not the facility offered any modem contraceptive method. Table 16.2.1 presents the percent distribution of currently married women by distance to the near- est visited principal FP/MCH outlet offering modem contraceptive methods. Thirty-eight percent of cur- rently married women live in areas where family planning methods are offered at one of the outlets visited by the interviewers, a similar percentage can obtain this service at a distance of 1 to 4 kilometers, and 16 percent must travel 5 to 9 kilometers to a principal FP/MCH outlet. Urban women are generally closer to an outlet offering family planning than rural women. While virtually all urban women live within 5 kilometers of a principal FP/MCH outlet, fewer than seven in ten rural women do. Women in Java-Bali are slightly less likely than women in the other regions to have an outlet in their cluster, but are more like- ly to have one within 5 kilometers of their cluster. There are strong urban-rural differentials in all regions. Table 16.2.1 Distance to nearest principal FP/MCH outlet offering modern contraceptive methods: background characteristics Percent distribution of currently married women by distance to nearest visited principal FP/MCH outlet offering modern contraceptive methods, according to background characteristics, Indonesia 1994 Distance (kilometers) to nearest principal FP/MCH outlet offering modern methods No Number Background services of characteristic <11 1-4 50 10-14 15-29 30+ known Total women Residence Urban 69.3 28.3 2.2 0.0 0.0 0.0 0.2 100.0 7,591 Rural 24.7 41.1 21.2 6.0 5.6 0.3 1.2 100.0 18,595 Region/Residence Java-Bali 36.8 42.8 14.5 3.0 2.9 0.0 0.0 100.0 16,663 Urban 66.5 30.7 2.8 0,0 0.0 0.0 0.0 100.0 5,523 Rural 22.0 48.8 20.4 4.6 4.3 0.0 0.0 100.0 11,140 Outer Java-Bali 1 39.6 28.7 18.5 5.5 5.8 0.2 1.5 100.0 6,619 Urban 81.6 18.4 0.0 0.0 0.0 0.0 0.0 100.0 1,423 Rural 28.2 31.5 23.6 7.1 7.4 0.3 2.0 100.0 5,197 Outer Java-Bali II 38.0 26.1 15.6 8.2 6.4 1.2 4.4 100.0 2,903 Urban 66.3 29.6 1.7 0.0 0.0 0.0 2.4 100.0 645 Rural 30.0 25.1 19.6 10.6 8.2 1.6 5.0 100.0 2,259 Total 37.7 37.4 15.7 4.3 4.0 0.2 0.9 100.0 26,186 i Includes outlet located in the area 228 Distance to the nearest visited principal FP/MCH outlet offering modern contraceptive methods varies by region and province (see Table 16.2.2). In Java-Bali, the nearest principal FP/MCH outlet is within a radius of 5 kilometers for all women in DKI Jakarta, while the proportion is 83 percent or less in Central Java and East Java. Variations in distance are larger in the Outer Java-Bali regions. While 82 percent of currently married women in East Kalimantan have an outlet within 5 kilometers of their cluster, about four in ten women in Lampung, East Timor and Irian Jaya, and six in ten women in East Nusa Tenggara have to travel 5 kilometers or more to reach the nearest principal FP/MCH outlet providing family planning methods. In Central Sulawesi, Maluku, and Irian Jaya, family planning services are not known or not available in the specified distances for 8 percent or more of women. Table 16.2.2 Distance to nearest principal FP/MCH outlet offering modern contraceptive methods: region and province Percent distribution of currently married women by distance to nearest visited principal FP/MCH outlet offering modern contraceptive methods, according to region and province, Indonesia 1994 Distance (kilometers) to nearest principal FP/MCH outlet offering modern methods No Number Region and services of province <l t 1-4 5-9 10-14 15-29 30+ known Total women Java-Ball 36.8 42.8 14.5 3.0 2.9 0.0 0.0 100.0 16,663 DKI Jakarta 88.3 11.7 0.0 0.0 0.0 0.0 0.0 100,0 1,140 West Java 46.6 32.2 14.1 1.8 5.2 0.0 0.0 100.0 5,170 Central Java 23.0 46.1 20.5 7,7 2.7 0.0 0.0 100.0 4,302 DI Yogyakarta 33.3 59.7 5.4 1.6 0.0 0.0 0.0 100.0 423 East Java 27.1 55.7 14.1 1.5 1.6 0.0 0.0 100.0 5,209 Bali 41.9 44.6 12.7 0.0 0.8 0.0 0.0 100.0 418 Outer Java-Bali I 39.6 28.7 18.5 5.5 5.8 0.2 1.5 100.0 6,619 Dista Aceh 18.8 53.5 15.3 7.1 3.0 0.0 2.3 100.0 477 North Sumatra 44.2 21.3 28.8 1.9 3.7 0.0 0.0 100.0 1,374 West Sumatra 59.8 19.7 10.4 2.4 3.0 0.0 4.7 100.0 489 South Sumatra 53.1 12.5 13.9 9.8 4.2 0.0 6.4 100.0 843 Lampung 25.8 33.0 25.3 5,8 10.0 0.0 0.0 100.0 801 West Nusa Tenggara 18.0 51.6 24.0 4.5 1.9 0.0 0.0 1130.0 469 West Kalimantan 32.7 28.2 20.0 4.3 13.8 0.0 1.2 100.0 489 South Kalimantan 39.8 32.2 18.1 0.0 7.9 0.0 1.9 100.0 398 North Sulawesi 45.4 31.7 13.2 2.2 3.1 4.2 0.0 100.0 318 South Sulawesi 45.1 28.7 6.4 12.2 7.6 0.0 0.0 100.0 962 Outer Java-Bali I1 38.0 26. I 15.6 8.2 6.4 1.2 4.4 100.0 2,903 Riau 37.3 29.7 15.4 8.4 1.9 1.5 5.8 100.0 520 Jambi 46.8 28.9 12.4 3.1 4.2 0.0 4.6 100.0 316 Bengkulu 47.0 38.4 11.8 0.0 2.8 0.0 0.0 100.0 179 East Nusa Tenggara 16.0 25.5 23.8 13.5 18.9 2.3 0.0 100.0 393 East Timor 30.2 22.0 29.4 13.0 0.0 2.2 3.2 100.0 115 Central Kalimantan 55.1 9.0 17.4 5.4 5.2 1.6 6.2 100.0 227 East Kalimantan 49.7 32.4 8.9 1.5 4.9 0.0 2.6 100.0 304 Central Sulawesi 33.9 22.2 17.7 10.5 6.6 0.0 9.1 100.0 225 Southeast Sulawesi 51.6 25,3 13.9 4.6 4.6 0.0 0.0 100.0 178 Maluku 31.2 27.8 12,4 7.0 6.6 5.9 9.0 100.0 209 lrian Jaya 30.0 19.2 11.6 23.0 8.2 0.0 7.9 100.0 238 Total 37.7 37.4 15.7 4.3 4.0 0.2 0.9 100.0 26,186 t Includes outlet located m the area 229 Table 16.3 shows the percent distribution of currently married women by distance (in kilometers) to the nearest visited principal FP/MCH outlet offering modem contraceptive methods, according to type of outlet. Overall, the median distance to the nearest outlet providing family planning services (and visited by the IDHS interviewers) is 3.6 kilometers. The median distance to a private midwife or to a health center is 4.2 kilometers, while the distance to a private doctor is 4.8 kilometers. A pharmacy or hospital is 9 kilometers or more from the clusters in which women live. Table 16.3 Distance to nearest principal FP/MCH outlet offering contraceptive methods by type of outlet Percent distribution of currently married women by distance (kilometers) to nearest visited principal FP/MCH outlet offering modem contraceptive methods and by urban-rural residence, according to type of outlet, Indonesia 1994 Type of principal FP/MCH outlet Distance to Health Private Private Any nearest outlet Hospital center doctor midwife Pharmacy outlet Urban < 11 km 16.6 33.8 43.6 44.0 32.8 68.7 1-4 km 44.2 58.0 35.8 41.4 47.0 28.3 5-14 km 20.3 6.8 6.5 8.0 10.1 2.2 15+ km 0.7 0.2 0.2 0.3 0.6 0.0 Distance unknown 0.5 0.9 2.4 2.8 0.2 0.6 No nearby outlet 17.7 0.3 11.6 3.5 9.3 0.2 Total 100.0 100.0 100.0 100.0 100.0 100.0 Number 7,591 7,591 7,591 7,591 7,591 7,591 Median distance 3.5 2.3 2.3 2.4 2.5 1.9 Rural <11 km 1.3 10.8 4.2 14.7 0.1 24.7 1-4 km 5.0 42.6 30.3 35.3 6.6 41.1 5-14 km 25.8 37.0 32.3 27.2 30.3 27.2 15+ km 29.0 7.6 6.7 6.7 23.0 5.9 Distance unknown 0.0 0.0 0.6 0.2 0.9 0.0 No nearby outlet 38.9 1.9 26.0 15.9 39. I 1.2 Total 100.0 100.0 100.0 100.0 100.0 100.0 Number 18,595 18,595 18 ,595 18,595 18,595 18,595 Median distance 14.6 5.2 5.7 4.9 12.5 4.7 Total <11 km 5.7 17.5 15.6 23.2 9.6 37.5 1-4 km 16.4 47.0 31.9 37.1 18.3 37.4 5-14 km 24.2 28.3 24.8 21.6 24.5 19.9 15+ km 20.8 5.5 4.8 4.8 16.5 4.2 Distance unknown 0.1 0.3 1.1 1.0 0.7 0.2 No nearby outlet 32.8 1.4 21.8 12.3 30.5 0.9 Total 100.0 100.0 100.0 100.0 100.0 100.0 Number 26,186 26,186 26,186 26,186 26,186 26,186 Median distance 10.0 4.2 4.8 4.2 8.9 3.6 I Includes outlet located in the area 230 Table 16.4 Time to nearest principal FP/MCH outlet offering contraceptive methods by type of outlet Percent distribution of currently married women by one-way travel time (minutes) to nearest visited principal FP/MCH outlet offering modern contraceptive methods and by urban-rural residence, according to type of outlet, Indonesia 1994 Type of principal FP/MCH outlet Time to nearest Health Private Private Any outlet Hospital center doctor midwife Pharmacy outlet Urban In the area 2.2 7.2 12.8 9.5 4.6 22.1 <15 min 31.2 54,3 54.1 56.5 53.8 67.2 15-29 rain 32.9 30.6 14.5 21.4 24.1 9.2 30-59 min 10.8 6.5 4.0 5.1 7.3 0.3 60-119 min 4.4 0.3 0.1 1.0 0.3 0.0 120+ min 0.0 0.0 0.0 0.0 0.0 0.0 Time unknown 0.8 0.9 2.9 3.0 0.6 1.0 No nearby facility 17.7 0.2 11.6 3.5 9.3 0.2 Total 100.0 100.0 100.0 100.0 100.0 100.0 Number 7,591 7,591 7,591 7,591 7,591 7,591 Median time 15.4 10.8 10.3 10.5 10.6 6.6 Rural In the area 1.1 7.1 2.7 8.4 0.0 16.0 <15 min 3.9 25.6 14.6 21.1 5.1 30.1 15-29 min 15.2 34.1 30.5 29.3 18.4 29.8 30-59 min 23.8 19.7 18.2 16.8 24.4 14.8 60-119 min 14.7 8.9 5.9 6.7 10.5 6.4 120+ min 2.3 2.6 1.4 1.4 1.5 1.5 Time unknown 0.1 0.1 0.7 0.3 0.9 0.2 No nearby facility 38.9 1.9 26.0 15.9 39.1 1.2 Total 100,0 100,0 100.0 100.0 100.0 100.0 Number 18,595 18,595 18,595 18,595 18,595 18,595 Median time 30.8 20.2 20.6 16.0 30.5 15.7 Total In the area 1.4 7.1 5.7 8.7 1,3 17.8 <15 min 11.8 33.9 26.0 31.4 19.2 40.9 15-29 min 20.3 33.1 25.8 27.0 20.0 23.8 30-59 min 20.1 15.9 14.1 13.4 19.4 10.6 60-119 min 11.7 6.4 4.2 5.1 7.6 4.5 120+ min 1.7 1.9 1.0 1.0 1.1 1.1 Time unknown 0.3 0.3 1.3 1.1 0.8 0.4 No nearby facility 32.8 1.4 21.8 12.3 30.5 0.9 Total 100.0 100.0 100.0 100.0 100.0 100.0 Number 26,186 26,186 26,186 26,186 26,186 26,186 Median time 30.1 15.7 15.7 15.5 20.8 15.1 231 Women in urban areas are generally closer to any outlet offering family planning methods than rural women; the median distance to the nearest outlet is 1.9 kilometers in urban areas, and 4.7 kilometers in rural areas. In urban areas, all outlets are within 3.5 kilometers of the cluster, while in mral areas the distance varies from 4.9 kilometers for private midwives to 12.5 kilometers or more for pharmacies and hospitals. Additional insights into the relative accessibility of family planning methods can be obtained by examining the distribution of women by distance to the nearest visited principal FP/MCH outlet. While nine in ten urban women live in a cluster with a health center that provides family planning methods within a radius of 5 kilometers, only about half of rural women do. About 80 percent of urban women live within 5 kilometers of a private doctor, a private midwife, or a pharmacy offering modern contracep- tive methods. The corresponding proportion for rural women is 35 percent for a private doctor, 50 percent for a private midwife, and only 7 percent for a pharmacy. The greatest urban-rural difference is found in the accessibility of hospitals; 61 percent of urban women live within 5 kilometers of the nearest hospital providing family planning methods, while only 6 percent of rural women do. In fact, the nearesl hospital or pharmacy offering family planning methods is not available within the specified distances for nearly four in ten currently married women in rural areas. Table 16.4 presents the distribution of currently married women by one-way travel time (in minutes) to the nearest visited principal FP/MCH outlet offering contraceptive methods, according to type of outlet. The data show that, overall, women are about 15 minutes from the nearest outlet. Travel time to general hospitals (30 minutes) and pharmacies (21 minutes) is slightly longer than to health centers, private doctors, and private midwives (16 minutes each). In general, travel time to an outlet offering contraceptive methods in rural areas is at least twice that in urban areas. The median one-way travel time to the nearest outlet is 15.7 minutes in rural areas, compared with 6.6 minutes in urban areas. This pattern is true for most types of outlets investigated in the survey, i.e., general hospitals, health centers, private doctors, private midwives, and pharmacies. Pharmacies are much more available in urban areas than in rural areas. The median one-way travel time to the nearest pharmacy is 10.6 minutes in urban areas, compared with 30.5 minutes in rural areas. 16.3 Availability of FP/MCH Outlets Offering Maternal and Child Health Services Table 16.5 shows the percentage of currently married women for whom specific maternal and child health services are available at the nearest of three types of FP/MCH outlets. Again, it is important to note that the nearest FP/MCH outlet of each type was visited only if it was located within 10 kilometers of a cluster in urban areas or within 30 kilometers in rural areas. Almost no women live in an area where none of the MCH components included in the survey--antenatal care, tetanus toxoid (TT) immunization for pregnant women, delivery assistance, postnatal care, child growth monitoring, child immunization, and dental and mouth care Iare available. In fact, more than half of currently married women in Indonesia live in an area where the nearest hospital provides all of the services mentioned above. Except for delivery assistance, all MCH services are more likely to be available through health centers than through hospitals or private doctors; although, antenatal care and postnatal care from private doctors are available to more than 60 percent of currently married women. Less than 30 percent of women live in an area where a private doctor provides ' IT injections and child immunization. In this survey, dentists were not included among the private doctors visited; therefore, private doctors were not asked about provision of dental and mouth care. 232 Table 16.5 Availability of specific MCH services at nearest principal FP/MCH outlets offering MCH services Percentage of currently married women for whom specific maternal and child health services are available at the nearest visited principal FP/MCH outlets offering MCH services, by type of services, type of outlet, and urban-rural residence, Indonesia 1994 Type of maternal and child health services available Type of Tetanus Child Dental principal toxoid growth Child and Number FP/MCH Antenatal immuni- Delivery Postnatal moni- immuni- mouth All No of outlet care zation assistance care toring zation care services services women Urban Hospital 80.9 74.2 80.7 78.4 76.0 74.5 74.7 61.5 1.2 7,591 Health center 99. I 98.6 33.9 92.4 95.8 89.2 89.7 26.4 0.0 7,591 Private doctor 79.3 36.8 18.1 66.4 51.1 38.3 NA 11.2 10.8 7,591 Rural Hospital 60.8 58.7 60.3 58.4 57.1 54.9 58.4 48.9 0.8 18,595 Health center 97.3 96.2 60.7 92.2 95.7 89.9 78.1 45.6 0.4 18,595 Private doctor 71.1 22.8 24.0 65.4 52.6 23.0 NA 8.8 9.5 18,595 Total Hospital 66.6 63.2 66.2 64.2 62.6 60.6 63.1 52.6 0.9 26,186 Health center 97.8 96.9 53.0 92.3 95.7 89.7 81.5 40.0 0.3 26,186 Private doctor 73.5 26.9 22.3 65.7 52.1 27.4 NA 9.5 9.9 26,186 NA = Not applicable Comparing urban and rural areas, Table 16.5 indicates that, in general, urban women are closer to a visited principal FP/MCH outlet that offers MCH services than rural women. Overall, urban women are about 20 percent more likely to live in areas where MCH services are offered at the nearest principal FP/MCH outlet. This is tree for all types of services except delivery assistance; rural women are more likely to live close to a health center that provides delivery assistance than urban women. On the other hand, urban women are more likely to live close to a hospital that offers delivery assistance. 16.4 Distance and Time to Nearest FP/MCH Outlet Offering Maternal and Child Health Services As in the case of family planning services, the availability of maternal and child health services can be determined by examining the data collected on distance and one-way travel time from the IDHS cluster to each of the nearest of four principal types of FP/MCH outlets: general hospitals, health centers, private doctors, and private midwives. It is important to remember when examining these data that facili- ties were visited only if they were within 10 kilometers of a cluster in urban areas or within 30 kilometers of a cluster in rural areas. An FP/MCH outlet facility was considered to provide maternal and child health services if any of the following were offered: antenatal care, postnatal care, delivery assistance, immunization of children, and child growth monitoring. Private midwives were only asked about antenatal care and delivery assist- ance. In particular, they were asked the number of cases they had in the six months preceding the survey. Virtually all of the midwives visited in the survey reported giving antenatal care to at least one client and assisting at the delivery of at least one baby. 233 Since in the FP/MCH outlets visited in the survey the provision of family planning services is additional to the provision of basic maternal and child health services, the distribution of women by distance and one-way travel time to the nearest outlet offering MCH services is similar to that by distance to the nearest outlet offering family planning services. This is shown in Tables 16.6.1 through 16.8. Table 16.6.1 Distance to nearest principal FP/MCH outlet offering MCH services: background characteristics Percent distribution of currently married women by distance to the nearest visited principal FP/MCH outlet offering maternal and child health services, according to background characteristics, Indonesia 1994 Distance (kilometers) to nearest principal FP/MCH outlet offering MCH services No Number Background Distance services of characteristic <11 14 5-9 10-14 15-29 30+ unknown known Total women Residence Urban 66.2 30.3 2.8 0.0 0.0 0.0 0.5 0.2 100.0 7,591 Rural 24.7 40.8 21.3 6.0 5.7 0.3 0.0 1.2 100.0 18,595 Region/Residence Java-Bali 35.9 42.8 15.1 3.0 2.9 0.0 0.2 0.0 I00.0 16,663 Urban 63.9 31.8 3.7 0.0 0.0 0.0 0.6 0.0 100.0 5,523 Rural 22.1 48.3 20.8 4.6 4.3 0.0 0.0 0.0 100.0 11,140 Outer Java-Bali I 38.3 30.1 18.4 5.6 5.8 0.2 0.0 1.5 100.0 6,619 Urban 75.2 24.8 0.0 0.0 0.0 0.0 0.0 0.0 100.0 1,423 Rural 28.1 31.6 23.4 7.2 7.4 0.3 0.0 2.0 100.0 5,197 Outer Java-Bali I1 38.0 26.1 15.3 8.2 6.5 1.2 0.0 4.8 100.0 2,903 Urban 65.7 30.2 1.7 0.0 0.0 0.0 0.0 2.4 100.0 645 Rural 30.1 24.9 19.1 10.5 8.4 1.6 0.0 5.4 100.0 2,259 Total 36.8 37.8 15.9 4.3 4.0 0.2 0.1 0.9 100.0 26,186 I Includes outlet located in the area 234 Table 16.6.2 Distance to nearest principal FP/MCH outlet offering MCH services: region and province Percent distribution of currently married women by distance to the nearest visited principal FP/MCH outlet offering maternal and child health services, according to region and province, Indonesia 1994 Distance (kilometers) to nearest principal FP/MCH outlet offering MCH services No Number Region and Distance services of province <11 IM. 5-9 10-14 15-29 30+ unknown known Total women Java-Bali 35.9 42.8 15.1 3.0 2.9 0.0 0.2 0.0 100.0 16,663 DKI Jakarta 82.0 14.9 0.0 0.0 0.0 0.0 3.1 0.0 100.0 1,140 West Java 46.6 32.2 14.1 1.8 5.2 0.0 0.0 0.0 100.0 5,170 Central Java 23.0 43.8 22.8 7.7 2.7 0.0 0.0 0.0 100.0 4,302 DI Yogyakarta 29.2 63.8 5.4 1.6 0.0 0.0 0.0 0.0 100.0 423 East Java 26.0 56.8 14.1 1.5 1,6 0.0 0.0 0.0 100.0 5,209 Bali 42.9 44.9 11.5 0.0 0.8 0.0 0.0 0.0 100.0 418 Outer Java-Bali I 38.3 30.1 18.4 5.6 5.8 0.2 0.0 1.5 100.0 6,619 Dista Aceh 17.1 55.3 15.3 7.1 3.0 0.0 0.0 2.3 100.0 477 North Sumatra 40.4 25.1 28.8 1.9 3.7 0.0 0.0 0.0 100.0 1,374 West Sumatra 58.5 21.0 10.4 2.4 3.0 0.0 0.0 4.7 1(30.0 489 South Sumatra 53.1 12.5 13.9 9.8 4.2 0.0 0.0 6.4 100.0 843 Lampung 25.8 33,0 25.3 5.8 10.0 0.0 0.0 0.0 100.0 801 West Nusa Tenggara 17.0 52.7 24.0 4.5 1.9 0.0 0.0 0.0 1(30.0 469 West Kalimantan 31.3 30.0 18.1 5.7 13.8 0.0 0.0 1.2 100.0 489 South Kalimantan 39.8 32.2 18.1 0,0 7.9 0.0 0.0 1.9 100.0 398 North Sulawesi 47.3 29.9 13.2 2.2 3.1 4.2 0.0 0.0 100,0 318 South Sulawesi 43.1 30.6 6.4 12.2 7.6 0.0 0.0 0.0 100.0 962 Outer Java-Bali II 38.0 26.1 15.3 8.2 6.5 1.2 0.0 4.8 100.0 2,903 Riau 38.6 29.7 15.4 7.1 1.9 1.5 0.0 5.8 100.0 520 Jambi 43.4 30.1 12.4 3.1 6.4 0.0 0.0 4.6 100.0 316 Bengkulu 47,0 38.4 11.8 0.0 2.8 0.0 0.0 0.0 100.0 179 East Nusa Tenggara 16.0 25.5 23.8 13.5 18.9 2.3 0.0 0.0 100.0 393 East Timor 33.4 22.0 29.4 13.0 0.0 2.2 0.0 0.0 100.0 115 Central Kalimantan 57.5 9.0 15,0 5.4 5.2 1.6 0.0 6.2 100.0 227 East Kalimantan 49.7 30,9 8.9 3.0 4.9 0.0 0,0 2.6 100.0 304 Central Sulawesi 33.9 22.2 17.7 10.5 6.6 0.0 0.0 9.1 100.0 225 Southeast Sulawesi 51.6 25.3 13.9 4.6 3.4 0.0 0.0 1.1 100.0 178 Maluku 31.2 27.8 10.5 7.0 6.6 5,9 0.0 11.0 100.0 209 lrian Jaya 27.0 19.2 11.6 23.0 8.2 0.0 0.0 10.9 100.0 238 Total 36.8 37,8 15.9 4.3 4.0 0.2 0.1 0.9 100.0 26,186 I Includes outlet located in the area 235 Table 16.7 Distance to nearest principal FP/MCH outlet offering MCH services by type of outlet Percent distribution of currently married women by distance (kilometers) to nearest visited principal FP/MCH outlet offering maternal and child health services and by urban-rural residence, according to type of outlet, Indonesia 1994 Type of principal FP/MCH outlet Distance to Health Private Any nearest outlet Hospital center doctor outlet Urban <11 km 16.7 33.8 41.3 66.0 1-4 km 44.0 58.0 36.9 30.3 5-14 km 20.1 6.8 6.5 2.8 15+ km 0.7 0.2 0.5 0.0 Distance unknown 0.5 1.0 2.6 0.6 No nearby lacility 18.0 0.2 12.2 0.2 Total 100.0 100.0 104).0 100.0 Number 7,591 7,591 7,591 7,591 Median distance 3.5 2.3 2.3 2. I Rural <11 km 1.3 10.8 4.9 24.7 1-4 km 5.0 42.6 31.5 40.8 5-14 km 26.3 37.0 33.2 27.3 15+ km 29.2 7.5 7.5 5.9 Distance unknown 0.0 0.0 0.1 0.0 No nearby facility 38,3 2.1 22.8 1.2 Total 100.0 100.0 100.0 100.0 Number 18,595 18,595 18,595 18,595 Median distance 14.6 5.2 5.8 4.8 Total <l t km 5.8 17.5 15.4 36.7 I-4 km 16.3 47.0 33.1 37.8 5-14 km 24.5 28.3 25.4 20.2 15+ km 20.9 5.4 5.5 4.2 Distance unknown 0.1 0.3 0.8 0.2 No nearby facility 32.4 1.6 19.8 0.9 Total 100.0 100.0 100.0 100.0 Number 26,186 26,186 26,186 26,186 Median distance 10.1 4.2 4.9 3.8 l Includes outlet located in the area 236 Table 16.8 Time to nearest principal FP/MCH outlet oft~ring MCH services by type of outlet Percent distribution of currently married women by one-way travel time (minutes) to nearest visited principal FP/MCH outlet offering maternal and child health services and by urban-rural residence, according to type of outlet, Indonesia 1994 Type of principal FP/MCH outlet Time to nearest Health Private Any outlet Hospital center doctor outlet Urban In the area 2.3 7.2 12.8 20.4 <15 min 31.1 54.3 52.2 67.6 15-29 rain 32.7 30.6 15.3 9.4 30-59 min 10.7 6.5 4.0 1.4 60-119 rain 4.4 0.3 0.3 0.0 120+ min 0.0 0.0 0.0 0.0 Time unknown 0.8 I/.9 3.2 1.0 No nearby facility 18.0 0.2 12.2 11.2 Total 100.0 100.0 100.0 10tl.0 Number 7,591 7,591 7,591 7,591 Median time 15.4 10.8 10.4 111. I Rural In the area 1.1 7.0 3.2 16. I <15 min 3.9 25.7 15.6 31/.3 15-29 min 15.3 34.0 31.3 29. I 30-59 min 24.3 19.7 19. I 15.2 60-119 min 14.8 8.8 6.4 6.3 120+ rain 2.3 2.6 1.4 1.7 Time unknown 0.1 0.1 0.2 0.2 No nearby facility 38.3 2.1 22.8 1.2 Total 100.0 100,0 100.0 1/)1/.0 Number 18,595 18,595 18,595 18,595 Median time 30.8 20. I 20.6 15.8 Total In the area 1.4 7.1 5.9 17.3 <15 min I 1.7 34.0 26.2 41.1 15-29 min 20.3 33.0 26.6 23.4 30-59 min 20.4 15.9 14.7 I 1.2 60-119 min I 1.8 6.3 4.7 4.5 120+ min 1.7 1.9 1.0 1.2 Time unknown 0.3 0.3 1.1 0.4 No nearby facility 32.4 1.6 19.8 0.9 Total 100.0 100.0 100.0 100.0 Number 26,186 26,186 26,186 26,186 Median time 30.1 15.7 15.7 15. I 237 REFERENCES Central Bureau of Statistics (CBS) [Indonesia]. 1978. Indonesia Fertility Survey, Principal Report. 2 vols. Jakarta: CBS. Central Bureau of Statistics (CBS) [Indonesia]. 1987a. Population of Indonesia. Results of the 1985 Inter- censal Population Survey. Supas Series No. 5. Jakarta: CBS. Central Bureau of Statistics (CBS) [Indonesia]. 1987b. Population Projection of Indonesia 1985-2005 Based on Supas Results. Supas Series No. 33. Jakarta: CBS. Central Bureau of Statistics (CBS) [Indonesia]. 1992. Summary of the 1990 Population Census Results. Jakarta: CBS. Central Bureau of Statistics (CBS) [Indonesia]. 1993a. Population Projection oflndonesia by Province 1990- 2000 (Proyeksi Penduduk Indonesia Menurut Propinsi 1990-2000). Jakarta: CBS. Central Bureau of Statistics (CBS) [Indonesia]. 1993b. Statistical Yearbook of Indonesia 1992. Jakarta: CBS. Central Bureau of Statistics (CBS) [Indonesia]. 1994. Fertility, Mortality and Migration Trends (Trend Fertilitas, Mortalitas dan Migrasi). Jakarta: CBS. Central Bureau of Statistics (CBS) [Indonesia], National Family Planning Coordinating Board and Institute for Resource Development/Westinghouse (IRD). 1989. National Indonesia Contraceptive Prevalence Survey 198Z Columbia, Maryland: CBS and IRD. Central Bureau of Statistics (CBS) [Indonesia], National Family Planning Coordinating Board [NFPCB], Ministry of Health [MOH], and Macro International Inc. (MI). 1992. Indonesia Demographic and Health Survey 1991. Columbia, Maryland: CBS and MI. Graham, W., W. Brass, and R.W. Snow. 1989. Estimating Maternal Mortality: The Sisterhood Method. Studies in Family Planning 20(3): 125-135. Ministry of Health [MOH] (National Institute of Health Research and Development) [Indonesia]. 1991. The Trend Assessment of Heahh Development in Indonesia: A Study for Providing Basic Inputs to the Second Long Term Health Development Program. Jakarta: National Institute of Health Research and Development. Mosley, W.H. and L.C. Chen. 1984. An Analytical Framework for the Study of Child Survival in Developing Countries. In Child Survival: Strategies for Research, ed. W.H. Mosley and Lincoln C. Chen, 25-45. Population and Development Review 10, Supplement. New York: The Population Council. Sullivan, Jeremiah M., George T. Bicego and Shea Oscar Rutstein. 1990. Assessment of the Quality of Data Used for the Direct Estimation of Infant and Child Mortality in the Demographic and Health Surveys. In An Assessment of DHS-I Data Quality. DHS Methodological Reports No. 1. Columbia, Maryland: Institute for Resource Development/Macro Systems Inc. Westoff, Charles F. and Luis H. Ochoa. 1991. Unmet Need and the Demand for Family Planning. DHS Comparative Studies No. 5. Columbia, Maryland: Institute for Resource Development. 239 APPENDIX A SURVEY DESIGN APPENDIX A SURVEY DESIGN The main objective of the 1994 Indonesia Demographic and Health Survey (IDHS) was to provide information on fertility, family planning, maternal and child health, and maternal and child mortality that can be used by program managers and policymakers to evaluate and improve existing programs. The survey is a follow-on to the 1987 National Indonesia Contraceptive Prevalence Survey (NICPS) and the 1991 IDHS. A.1 Sample Design and Implementation Indonesia is divided into 27 provinces. For the implementation of its family planning program, the National Family Planning Coordinating Board (BKKBN) has divided these provinces into three regions as follows: Java-Bali: DKI Jakarta, West Java, Central Java, DI Yogyakarta, East Java, and Bali Outer Java-Bali I: Dista Aceh, North Sumatra, West Sumatra, South Sumatra, Lampung, West Nusa Tenggara, West Kalimantan, South Kalimantan, North Sulawesi, and South Sulawesi Outer Java-Bali II: Riau, Jambi, Bengkulu, East Nusa Tenggara, East Timer, Central Kalimantan, East Kalimantan, Central Sulawesi, Southeast Sulawesi, Maluku, and Irian Jaya The 1990 Population Census of Indonesia shows that Java-Bali accounts for 62 percent of the national population, Outer Java-Bali I accounts for 27 percent, and Outer Java-Bali II accounts for 11 percent. The sample for the 1994 IDHS was designed to produce reliable estimates of fertility, contraceptive prevalence and other important variables for each of the provinces and for urban and rural areas of the three regions. In order to meet this objective, between 1,650 and 2,050 households were selected in each of the provinces in Java-Bali, 1,250 to 1,500 households in the ten provinces in Outer Java-Bali I, and 1,000 to 1,250 households in each of the provinces in Outer Java-Bali II, for a total of 35,500 households. With an average of 0.8 ever-married women 15-49 per household, the sample was expected to yield approximately 28,000 women eligible for the individual interview. The 1994 IDHS sample is a subsample of the 1994 Susenas, a national household survey carried out annually by the Central Bureau of Statistics (CBS) to produce data on various demographic and socioeconomic indicators of the population. Fieldwork for Susenas took place in January and February 1994 and was preceded by a household listing. In March 1994, a second household listing was done as part of the Susenas Post-Enumeration Survey. This second listing was used to select households for the 1994 IDHS. The 1994 IDHS sample is stratified by province and by urban and rural domain within each province. The sample was selected in three stages. In the first stage, census enumeration areas (EAs) were selected systematically with probability proportional to population size. In each EA, segments of approximately 70 contiguous households with clear boundaries were formed, and only one segment was selected with a probability proportional to size. In the third stage, 25 households were selected from each segment using a systematic sampling; of these, half were selected for the household expenditure survey. Since the sample was designed to produce estimates at the provincial level, the households selected at the provincial level did not constitute a proportional representation at the national level. Specifically, households in Outer Java-Bali II were oversampled. The results presented in this report are based on data that were weighted to take account of differential sampling probabilities and nonresponse at both the 243 household and individual levels. The weights are used to produce estimates that are representative at the appropriate level of aggregation (e.g., provincial, regional, and national). Results of the sample implementation by region and in urban and rural residence as well as by province are shown in Tables A. 1 and A.2. As shown in Table A.1,35,510 households were selected for the 1994 IDHS. Of these, 95 percent were successfully interviewed, 2 percent were found to be vacant, and 2 percent were away during the survey fieldworkers' visit. Other reasons for not interviewing include no competent respondent in the household or the dwelling had been destroyed. The overall household response rate is 99 percent (see Table A.I for definition). The level of successful household interviews ranges from 90 percent in Southeast Sulawesi to I00 percent in East Timor. The response rates are slightly higher in rural than in urban areas. Table A.2 presents the survey coverage for the individual interview by region and type of residence. The response rates for eligible women are generally lower than household response rates, but range from less than 95 percent in Bengkulu and Southeast Sulawesi to close to 100 percent in DKI Jakarta, West Nusa Tenggara, East Timor, and Central Kalimantan. There is little variation by urban-rural residence. The eligible woman response rate for the 1994 IDHS is 98 percent. The overall response rate--which is the product of the household response rate and the eligible woman response rate--is 97 percent. A.2 Pretest The pretest for the 1994 IDHS was carried out in three provinces: Bengkulu, Central Java, and South Kalimantan. For each province, a team was trained consisting of one field coordinator, one supervisor, one field editor, and four or five interviewers. The Chief of the Population Statistics Division of the Provincial Statistics Office (PSO) in each province acted as field coordinator and was responsible for carrying out the pretest activities in his/her province. All of the fieldworkers were full time PSO staff. The pretest training began in December 1993 with training of trainers, which was conducted by the CBS staff in their central office. Fieldworker training was held for two weeks in January 1994, followed by the data collection, which lasted for two weeks. For the pretest fietdwork, a total of 300 households located in 6 urban and 6 rural sample clusters were visited. They yielded 232 ever-married women age 15-49, confirming the estimate of approximately 0.8 eligible women per household. At the request of The World Bank, the pretest household schedule included a sheet used for collecting information on the household's average monthly expenditures. During the fieldwork, it was found that the household expenditure questionnaire extended the interview time considerably. Administering it before the individual questionnaire created a serious problem for the women's questionnaire, because the respondent became fatigued even before the main interview began. Problems encountered during the pretest training and fieldwork were discussed and errors were corrected by the survey staff. It was decided that the household expenditure questionnaire would be administered separately. Based on the experience in the field trial, the service availability questionnaire was changed to include health and family planning facilities located within 10 kilometers of the sample cluster in urban areas and within 30 kilometers in rural areas. 244 TableA.I Sample implementation: results of the household interview Percent distribution of households in the DHS sample by results of the household interview and household response rates, according to region, province, and urban-rural residence, Indonesia 1994 Region and province Household present but no House- competent House- hold respond- Dwelling House- hold re- interviews ent at Post- not hold Dwelling Dwelling sponse completed home poned Refused found absent vacant destroyed Other Total rate l (C) (HP) (PP) (R) (DNF) (HA) (DV) (DD) (O) percent Number (HRR) Java-Bali 95.2 0.5 0.0 0.1 0.6 1.1 1.8 0.6 0.1 100.0 11,213 98.8 DK1 Jakarta 92.4 0.1 0.0 0.3 2.3 0.9 2.5 1.5 0.0 100.0 2,065 97.1 West Java 93.3 1.0 0.0 0.2 0.8 2.5 1.1 0.9 0.2 100.0 2,104 97.9 Central Java 97.5 0.2 0.0 0.1 0.1 1.3 0.5 0.4 0.0 100.0 1,861 99.7 DI Yogyakarta 96.2 0.7 0.1 0.0 0.1 0.5 1.9 0.1 0.4 100.0 1,658 99.1 East Java 96.6 0.4 0.0 0.1 0.1 0.9 1.4 0.5 0.1 100.0 1,875 99.5 Bali 96.1 0.3 0.0 0.0 0.1 0.1 3.3 0.1 0.0 100.0 1,650 99.6 Outer Java-Bali I 95.3 0.6 0,0 0.1 0.2 1.5 1.6 0.6 0.0 100.0 13,022 99.1 Dista Aceh 96.0 1.5 0.0 0.0 0.0 1.0 1.0 0.5 0.0 100.0 1,250 98.4 North Sumatra 95.3 0.7 0.0 0.3 0.1 0.8 1.7 0.9 0.1 100.0 1,509 98.8 West Sumatra 93.0 0.9 0.0 0,0 0.3 2.0 2.2 1.5 0.0 I (X).0 1,251 98.7 South Sumatra 95.2 0.7 0.0 0,2 0.3 0.5 2.6 0,4 0.0 100.0 1,250 98.7 Lampung 94.6 0.3 0.0 0.0 0.8 1.0 2.9 0.5 0.0 100.0 1,251 98.8 West Nusa Tenggara 97.9 0.1 0.0 0.0 0.2 0.5 1.0 0.4 0.0 100.0 1,254 99.8 West Kalimantan 96.2 0.6 0.0 0.0 0.1 2.3 0.4 0.4 0.0 100.0 1,251 99.3 South Kalimantan 96.2 0.3 0.0 0.0 0.0 1.8 1.4 0.3 0.0 100,0 1,255 99.7 North Sulawesi 92.1 0.4 0.1 0.0 0.1 5.4 0.6 1.4 0.0 100.0 1,250 99.4 South Sulawesi 96.7 0.3 0.0 0.0 0,1 0.5 2.1 0.2 0.0 100.0 1,501 99.5 Outer Java-Bali II 94.4 0,5 0.0 0.0 0.l 2.4 2.1 0.3 0.1 100.0 11,275 99.3 Riau 94.2 0.6 0.0 0.0 0.0 2.1 2.5 0.3 0.4 100.0 1,250 99.4 Jambi 96.1 0.3 0.0 0.0 0.0 1.4 1.6 0.3 0.3 100.0 1,003 99.7 Bengkulu 98.0 1.2 0.0 0.0 0.0 0.2 0.6 0.0 0.0 100.0 1,002 98.8 East Nusa Tenggara 96.1 0.4 0.0 0.1 0.0 1.7 1.2 0.5 0.0 100.0 1,006 99.5 East Timor 99.8 0.0 0.0 0.1 0.0 0.1 0.0 0.0 0.0 100.0 1,001 99.9 Central Kalimantan 94.1 0.0 0.0 0.0 0.2 4.4 0.9 0.2 0.2 100.0 1,000 99.8 East Kalimantan 92.1 0.8 0.0 0.0 0.0 1.7 4.9 0.5 0.0 100.0 1,012 99.1 Central Sulawesi 91.8 0.1 0.0 0.1 0.4 4.0 3.0 0.4 0.2 100.0 1,000 99.4 Southeast Sulawesi 89.5 1.2 0.0 0.1 0.0 6.8 1.5 0.9 0.0 100.0 1,000 98.6 Maluku 91.5 0.9 0.0 0.0 0.2 3.8 3.3 0.3 0.0 100.0 1,000 98.8 lrian Jaya 95.4 0.5 0.0 0.0 0.3 0.3 3.4 0.1 0.0 100.0 1,001 99.2 Residence Urban 93.5 0.7 0.0 0.2 0.7 1.7 2.4 0.6 0.1 100.0 I 0,401 98.3 Rural 95.6 0.5 0.0 0.0 0.1 1.7 1.5 0.5 0.1 100.0 25,109 99.4 Total 95.0 0.5 0.0 0.1 0.3 1.7 1.8 0.5 0.1 100.0 35,510 99.1 i The household response rate (HRR) is calculated as: C C+HP+R+DNF 245 Table A.2 Sample implementation: results of the individual interview Percent distribution of eligible women in the sample by results of the individual interview, eligible woman response rates, and overall response rates, according to region, province, and urban-rural residence, Indonesia 1994 Eligible Individual Partly In- woman Overall interviews Not at Post- com- capaci- response response completed home ported Refused pleted tated Other Total rate I rate 2 Region and province (C) (NH) (PP) (R) (PC) (1) (O) percent Number (EWRR) (ORR) Java-Bali 98.0 1.6 0.0 0.0 0,0 0.2 0.1 100.0 8,845 98.0 96.8 DKI Jakarta 99.8 0.2 0.0 0.0 0.0 0.0 0.0 100.0 1,809 99.8 96.9 West Java 96.4 2.8 0.0 0.1 0.0 0.4 0.3 100.0 1,589 96.4 94.4 Central Java 98.0 1.8 0.0 0.0 0.1 0.1 0.0 100.0 1,502 98.0 97.7 DI Yogyakarta 98.9 0.9 0.0 0.0 0,0 0.3 0.0 100.0 1,131 98.9 97.9 East Java 98.0 1.4 0.0 0.1 0.1 0.4 0.0 100.0 1,533 98.0 97.6 Bali 97.0 2.8 0.0 0.0 0.1 0.2 0.0 100.0 1,281 97.0 96.5 Outer Java-Bali I 98.0 1.8 0.0 0,1 0.0 0.1 0.0 100.0 10,438 98.0 97.1 Dista Aceh 98.2 1.7 0.1 0.0 0.0 0.0 0.0 100.0 1,099 98.2 96.6 North Sumatra 98.1 1.4 0.0 0.1 0.0 0.3 0.1 100.0 1,197 98.1 96.9 West Sumatra 97.3 2.1 0.0 0.1 0.0 0.4 0.0 100.0 894 97.3 96.1 South Sumatra 99.2 0.7 0.0 0.1 0.0 0.0 0.1 100.0 1,059 99.2 97.8 Lampung 99,0 0.7 0.0 0.0 0.0 0.3 0.0 I00.0 985 99.0 97.8 West Nusa Tenggara 99.5 0.4 0.0 0.0 0.0 0.1 0.0 100.0 972 99.5 99.2 West Kalimantan 98.9 1.0 0.0 0.1 0.0 0.0 0.0 100.0 1,067 98.9 98.1 South Kalimantan 98.0 1.8 0.0 0.1 0.0 0.1 0.0 100.0 1,068 98.0 97.7 North Sulawesi 96.6 3.3 0.0 0.0 0.0 0.1 0.0 100.0 859 96.6 96.0 South Sulawesi 95.5 4.4 0.0 0.1 0.0 0.1 0.0 100.0 1,238 95.5 95.0 Outer Java-Bali II 97.4 2.2 0.1 0.1 0.i 0.2 0.0 100.0 9,517 97.4 96.7 Riau 98.0 1.6 0.0 0.0 0.1 0.3 0.0 100.0 1,067 98.0 97.5 Jambi 99.0 0.7 0.0 0.0 0.0 0.3 0.0 100.0 902 99.0 98.7 Bengkulu 94.4 5.6 0.0 0.0 0.0 0.0 0.0 100.0 868 94.4 93.2 East Nusa Tenggara 98.1 1.7 0.1 0.0 0.0 0.1 0.0 100.0 827 98.1 97.6 East Timor 99.8 0.0 0.0 0.0 0.2 0.0 0.0 100.0 970 99.8 99.7 Central Kalimantan 99.9 0.1 0.0 0.0 0.0 0.0 0.0 100.0 871 99.9 99.7 East Kalimantan 96.5 2.9 0.0 0.0 0.4 0.2 0.0 100.0 853 96.5 95.7 Central Sulawesi 96.4 3.1 0.5 0.0 0.0 0.0 0.0 100.0 795 96.4 95.7 Southeast Sulawesi 93.5 5.0 0.1 0.3 0.1 1.0 0.0 100.0 735 93.5 92.1 Maluku 98.3 1.4 0.0 0.0 0.0 0.1 0.1 100.0 783 98.3 97.2 lrian Jaya 96.2 3.1 0.0 0.4 0.1 0.1 0.1 100.0 846 96.2 95.4 Residence Urban 98.0 1.7 0.0 0.1 0.0 0.2 0.0 100.0 8,111 98.0 96.3 Rural 97.7 2.0 0.0 0.0 0,0 0.2 0.0 100.0 20,689 97.7 97.1 Total 97.8 1.9 0.0 0.0 0.0 0.2 0.0 IO0.0 28,800 97.8 96.9 IThe eligible woman response rate (EWRR) is calculated as: C C+NH+PP+R+PC+I+O ~I'he overall response rate (ORR) is calculated as: HRR x EWRR. 246 A.3 Field-Staff Training Training of the survey field staff for the main survey was preceded by a course held in May 1994 in Bogor to prepare those who were to serve as instructors at the training centers, those who were responsible for the training centers, and the data processing staff. Training for the main survey took place in nine locations: Medan, Jambi, Jakarta, Salatiga, Malang, Kupang, Samarinda, and Ujung Pandang. The training lasted for 16 days, from 6 to 21 June 1994, and covered the procedures for locating the sample households, conducting an interview, and filling out the forms. Mock interviews and field practice also were included in the training. A.4 Fieldwork The 1994 IDHS data were collected by 260 interviewers, 86 field editors and 86 supervisors. Each of the 86 teams consisted of two to four interviewers, one field editor and one supervisor. As in previous DHS surveys, the number of teams in each province was determined by the number of clusters selected in the respective province and their distribution throughout the area. Due to the sensitive nature of some questions asked in the survey, all interviewers and field editors were female. However, for logistical and security reasons, male supervisors were used. Most of the survey fieldworkers were CBS staff at the province or regency/municipality level. The teams completed work in each cluster before moving to the next cluster. Generally, the teams were responsible for arranging transportation between sample points. However, in some areas local statistics offices provided transportation. PSO and CBS staff visited the field periodically to monitor the progress of the fieldwork. The main survey fieldwork began in early July in Jakarta and East Java, and in the third week of July in the remaining provinces. It was completed in November 1994. A.5 Data Processing The first stage of data editing was carried out by the field editors who checked the completed questionnaires for thoroughness and accuracy. Field supervisors then further examined the questionnaires. In many instances, the teams sent the questionnaires to CBS through the regency/municipality statistics offices. In these cases, no checking was done by the PSO. At CBS, the questionnaires underwent another round of editing, primarily for completeness and coding of responses to open-ended questions. The data were processed using 16 microcomputers and the DHS computer program, ISSA (Integrated System for Survey Analysis). Data entry and office editing were initiated immediately after fieldwork began. Simple range and skip errors were corrected at the data entry stage. Data processing was completed by November 1994, and the preliminary report of the survey was published in January 1995. 247 APPENDIX B ESTIMATES OF SAMPLING ERRORS APPENDIX B ESTIMATES OF SAMPLING ERRORS The estimates from a sample survey are affected by two types of errors: (1) nonsampling errors, and (2) sampling errors. Nonsampling errors are the results of mistakes made in implementing data collection and data processing, such as failure to locate and interview the correct household, misunderstanding of questions on the part of either the interviewer or the respondent, and data entry errors. Although numerous efforts were made during implementation of the 1994 IDHS to minimize this type of error, nonsampling errors are impossible to avoid and difficult to evaluate statistically. Sampling errors, on the other hand, can be evaluated statistically. The sample of respondents selected in the 1994 IDHS is only one of many samples that could have been selected from the same population, using the same design and expected size. Each of these samples would yield results that differ somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability between all possible samples. Although the degree of variability is not known exactly, it can be estimated from the survey results. Sampling error is usually measured in terms of the standard error for a particular statistic (mean, percentage, etc.), which is the square root of the variance. The standard error can be used to calculate confidence intervals within which the true value for the population can reasonably be assumed to fall. For example, for any given statistic calculated from a sample survey, the value of that statistic will fall within a range of plus or minus two times the standard error of that statistic in 95 percent of all possible samples of identical size and design. If the sample of respondents had been selected as a simple random sample, it would have been possible to use straightforward formulas for calculating sampling errors. However, the 1994 IDHS sample is the result of a two-stage stratified design, and, consequently, it was necessary to use more complex formulae. The computer software used to calculate sampling errors for the 1994 IDHS is the ISSA Sampling Error Module. This module uses the Taylor linearization method of variance estimation for survey estimates that are means or proportions. The Jacknife repeated replication method is used for variance estimation of more complex statistics such as fertility and mortality rates. The Taylor linearization method treats any percentage or average as a ratio estimate, r = y/x, where y represents the total sample value for variable y, and x represents the total number of cases in the group or subgroup under consideration. The variance of r is computed using the formula given below, with the standard error being the square root of the variance: var(r) - ~ mh_l Zh~- Zh h--I mh in which Zhi = Yh i - r .xh i , and z h = Yh- r .xh where h m h Yhi Xh~ f represents the stratum which varies from 1 to H, is the total number of enumeration areas selected in the h th stratum, is the sum of the values of variable y in EA i in the h th stratum, is the sum of the number of cases in EA i in the h th stratum, and is the overall sampling fraction, which is so small that it is ignored. 251 The Jacknife repeated replication method derives estimates of complex rates from each of several replications of the parent sample, and calculates standard errors for these estimates using simple formulae. Each replication considers all but one cluster in the calculation of the estimates. Pseudo-independent replications are thus created. In the 1994 IDHS, there were 1,416 non-empty clusters. Hence, 1,416 replications were created. The variance of a rate r is calculated as follows: 1 k var ( r ) - E ( r i - r) 2 k(k-1) i=l in which r i = k r - (k-1)r(0 where r re0 k is the estimate computed from the full sample of 1,416 clusters, is the estimate computed from the reduced sample of 1,415 clusters (ith cluster excluded), and is the total number of clusters. In addition to the standard error, the ISSA Sampling Error Module computes the design effect 2FT) for each estimate, which is defined as the ratio between the standard error using the given sample dt,~ign and the standard error that would result i fa simple random sample had been used. A DEFT value of 1.0 indicates that the sample design is as efficient as a simple random sample, while a value greater than 1.0 indicates the increase in the sampling error due to the use of a more complex and less statistically efficient design. ISSA also computes the relative error and confidence limits for the estimates. Sampling errors for the 1994 IDHS are calculated for selected variables considered to be of primary interest. For each variable, the type of statistic (mean, proportion, or rate) and the base population are given in Table B. 1. Tables B.2.1 to B.2.33 present the value of the statistic (R), its standard error (SE), the number of unweighted (N) and weighted (WN) cases, the design effect (DEFT), the relative standard error (SE/R), and the 95 percent confidence limits (R+2SE), for each variable. The DEFT is considered undefined when the standard error for a simple random sample is zero (when the estimate is close to 0 or 1). In the case of the total fertility rate, the number of unweighted cases is not relevant, as there is no known unweighted value for woman-years of exposure to childbearing. In general, the relative standard error for most estimates for the country as a whole is small, except for estimates of very small proportions. There are some differentials in the relative standard error for estimates of sub-populations. For example, for the variable currently using any method, the relative standard errors as a percent of the estimated mean for the whole country, for urban areas, and for rural areas are 1.1 percent, 1.6 percent, and 1.5 percent, respectively. The confidence interval (e.g., as calculated for currently using any method, can be interpreted as follows: the overall national sample proportion is 0.547 and its standard error is 0.006. Therefore, to obtain the 95 percent confidence limits, one adds and subtracts twice the standard error to the sample estimate, i.e., 0.547--_2 x 0.006. There is a high probability (95 percent) that the true contraceptive prevalence rate is between 0.535 and 0.560. The results are presented in this appendix for the country as a whole, for urban and rural areas, for each of the three regions--Java-Bali, Outer Java-Bali I, and Outer Java-Bali I I - -and for each of the 27 provinces. It should be pointed out that sampling errors of certain variables for some provinces should be used with caution. For provinces with a small number of cases, the sampling error is quite large. For example, in Central Kalimantan (Table B.2.28), the proportion of children under five who had diarrhea and 252 were treated with ORS packets is 29.2 percent, a l though the unweighted number of these ch i ldren is only 23. The sampl ing error of this proport ion is 10.4 percent, result ing in a very w ide conf idence interval . The true va lue could l ie anywhere between 8.5 percent and 50 percent. Table B.I List of selected variables for sampling errors. Indonesia 1994 Variable Description Base population Urban residence Proportion No education Proportion With secondary education or higher Proportion Currently married Proportion Children ever born Mean Children ever born to women over 40 Mean Children surviving Mean Knowing any contraceptive method Proportion Knowing any modem contraceptive method Proportion Knowing source for contraceptive method Proportion Ever used any contraceptive method Proportion Currently using any method Proportion Currently using a modem method Proportion Currently using pill Proportion Currently using IUD Proportion Currently using injections Proportion Currently using condom Proportion Currently using female sterilization Proportion Currently using Norplant Proportion Using public sector source Proportion Want no more children Proportion Want to delay at least 2 years Proportion Ideal number of children Mean Knowledge of AIDS Proportion Mothers received tetanus injection Proportion Mothers received medical care at birth Proportion Had diarrhea in the last 2 weeks Proportion Had diarrhea in the last 24 hours Proportion Treated with ORS packets Proportion Sought medical treatment Proportion Having health card Proportion Received BCG vaccination Proportion Received DPT vaccination (3 doses) Proportion Received polio vaccination (3 doses) Proportion Received measles vaccination Proportion Fully immunized Proportion Not immunized Proportion Total fertility rate (3 years) Rate Neonatal mortality rate (0-9 years) Rate Postneonatal mortality rate (0-9 years) Rate Infant mortality rate (0-9 years) Rate Child mortality rate (0-9 years) Rate Under-five mortality rate (0-9 years) Rate Ever-married women 15-49 Ever-mamed women 15-49 Ever-married women t5-49 Ever-man-led women 15-49 Currently married women 15-49 Currently married women 40-49 Currently married women 15-49 Currently married women 15-49 Currently married women 15-49 Currently married women 15-49 Currentl, married women 15-49 Currentl, married women 15-49 Currentl, mamed women 15-49 Currentl, married women 15-49 Currentl, married women 15-49 Currentl ~ married women 15-49 Currentl, married women 15-49 Currantl, married women 15-49 Currentl, married women 15-49 Current users of modem method Currently married women 15-49 Currently married women 15-49 Ever-married women 15-49 Ever-married women 15-49 Births in last 5 years Births in last 5 years Children under 5 Children under 5 Children under 5 with diarrhea in last 2 weeks Children under 5 with diarrhea in last 2 weeks Children 12-23 months Children 12-23 months Children 12-23 months Children 12-23 months Children 12-23 months Children 12-23 months Children 12-23 months Woman-years of exposure to childbearing Number of births Number of births Number of births Number of births Number of births 253 Table B.2.1 Sampling errors - National sample T Indonesia 1994 Number of cases Standard Design Relative Confidence limits Value error Unweighted Weighted effect error Variable (R) (SE) (N) (WN) (DEFT) (SE /R) R-2SE R+2SE Urban residence 0.291 0.006 28168 No education 0.159 0.006 28168 With secondary education or higher 0.241 0.007 28168 Currently married (in union) 0.930 0.003 28168 Children ever born 3.064 0.025 26220 Children ever born to women over 40 4.996 0.058 6065 Children surviving 2.700 0.021 26220 Knowing any contraceptive method 0.963 0.002 26220 Knowing any modem method 0.961 0.002 26220 Knowing source for contraceptive method 0.950 0.003 26220 Ever used any contraceptive method 0.757 0.005 26220 Currently using any method 0.547 0.006 26220 Currently using a modern method 0.521 0.006 26220 Currently using pill O. 171 0.005 26220 Currently using IUD 0.103 0,004 26220 Currently using injections 0.152 0.005 26220 Currently using condom 0.009 0.000 26220 Currently using temale sterilization 0.031 0.002 26220 Currently using Norplant 0.049 0.004 26220 Using public sector source 0.486 0.011 12771 Want no more children 0.478 0.005 26220 Want to delay at least 2 years 0.248 0.005 26220 Ideal number of children 2.924 0.017 20497 Knowledge of AIDS 0.381 0.009 28168 Mothers received tetanus injection 0.653 0.009 18196 Mothers received medical antenatal care 0.823 0.009 18196 Mothers received medical care at birth 0.398 0.011 18196 Had diarrhea in the last 2 weeks 0.121 0.005 16997 Had diarrhea in the last 24 hours 0.032 0.002 16997 Treated with ORS packets 0.451 0.018 1783 Consulted medical personnel 0.532 0.018 1783 Having health card 0.387 0.017 3241 Received BCG vaccination 0.778 0.014 3241 Received DPT vaccination (3 doses) 0.590 0.017 3241 Received polio vaccination (3 doses) 0.599 0.017 3241 Received measles vaccination 0.625 0.016 3241 Fully immunized 0.504 0.017 3241 Not immunized 0.180 0.012 3241 Total fertility rate (3 years) 2.855 0.057 NA Neonatal mortality rate (0-9 years) 32.457 1.722 3891 I Postneonatal mortality rate (0-9 years) 33,950 1.794 38972 Infant mortality rate (0-9 years) 66.407 2.717 38976 Child mortality rate (0-9 years) 28.262 1.519 39173 Under-five mortality rate (0-9 years) 92.792 3.373 39242 28168 2.105 0.020 0.280 0.302 28168 2.782 0.038 0.147 0.171 28168 2.725 0.029 0.227 0.254 28168 1.744 0.003 0.924 0.935 26186 1.753 0.008 3.014 3.114 5855 1.692 0.012 4.880 5.112 26186 1.702 0.008 2.659 2.741 26186 2.041 0.002 0.958 11.968 26186 2.022 0.003 0.956 0.966 26186 2.248 0.003 0.944 0.956 26186 2.029 0.007 0.747 I).768 26186 1.997 0.011 0.535 0.560 26186 2.044 0.012 0.508 0.533 26186 2.240 0.030 0.161 0.182 26186 2.141 0.039 0.095 0.111 26186 2.142 0.031 0.143 0.162 26186 Und 0.000 0.009 I).009 26186 2.154 0.075 0.026 11.035 26186 2.801 0.076 0.041 11.056 13661 2.429 0,022 0.465 11.508 26186 1.709 0.011 0.468 11.489 26186 11874 0.020 0.238 0.257 22044 1.960 0.006 2.889 2.958 28168 3.187 0.024 0.363 0.400 16983 2.169 0.014 0.635 0.672 16983 2.430 0.010 0.806 0.840 16983 2.420 0.027 0.377 0.419 15883 1.826 0,040 0.111 0.131 15883 1.715 0.077 0.027 0.037 1921 1,548 0.040 0.414 0.487 1921 1.548 0.034 0.496 0.569 3065 1.935 0.044 0.353 0.422 3065 1.830 0.018 0.750 0.805 3065 1.934 0.029 0.556 01625 3065 1.871 0.028 0.566 0.632 3065 1.829 0.026 0.593 0.657 3065 1.906 0.034 0.470 0.539 3065 1.773 0.069 0.155 0.205 07581 2.162 0.020 2.742 2.968 36071 1.648 0.053 29.012 351901 36123 1.706 (I.053 30.362 37,539 36126 1.833 0.041 60.973 71.841 36299 1.619 0.054 25.224 31.299 36357 1,955 0.036 86.045 99.539 NA = Not applicable Und = Undefined 254 Table B.2.2 Sampling errors - Urban sample v Indonesia 1994 Number of cases Standard Design Relative Confidence limits Value error Unweighted Weighted effect error Variable (R) (SE) (N) (WN) (DEBT) (SE/R) R-2SE R+2SE Urban residence 1.000 0.000 7947 No education 0.076 0.008 7947 With secondary education or higher 0.464 0.018 7947 Currently married (in union) 0.926 0.005 7947 Children ever born 2.930 0.040 7393 Children ever born to women over 40 4.764 0.102 1721 Children surviving 2.685 0.035 7393 Knowing any contraceptive method 0.993 0.001 7393 Knowing any modern method 0.993 0.001 7393 Knowing source for contraceptive method 0.986 0.002 7393 Ever used any contraceptive method 0.818 0.007 7393 Currently using any method 0.602 0.010 7393 Currently using a modern method 0.558 0.010 7393 Currently using pill 0.158 0.00g 7393 Currently using IUD 0.122 0.007 7393 Currently using injections 0.168 0.007 7393 Currently using condom 0,022 0.002 7393 Currently using female sterilization 0.056 0.006 7393 Currently using Norplant 0.028 0.005 7393 Using public sector source 0.390 0.015 3962 Want no more children 0.500 0.009 7393 Want to delay at least 2 years 0.229 0.007 7393 Ideal number of children 2.794 0.022 6323 Knowledge of AIDS 0.696 0018 7947 Mothers received tetanus injection 0.774 0.010 4643 Mothers received medical antenatal care 0.954 0.007 4643 Mothers received medical care at birth 0.764 0,019 4643 Had diarrhea in the last 2 weeks 0.124 0.011 4460 Had diarrhea in the last 24 hours 0.027 0.005 4460 Treated with ORS packets 0.421 0.033 419 Consulted medical personnel 0.597 0.025 419 Having health card 0.462 0.030 843 Received BCG vaccination 0.906 0.016 843 Received DPT vaccination (3 doses) 0.766 0.024 843 Received polio vaccination (3 doses) 0.779 0.026 843 Received measles vaccination 0.762 0.021 843 Fully immunized 0.670 0.024 843 Not immunized 0.064 0.012 843 Total fertility rate (3 years) 2.310 0.071 NA Neonatal mortality rate (0-9 years) 22.935 2.444 9789 Posmeonatal mortality rate (0-9 years) 20.126 2.897 9796 Infant mortality rate (0-9 years) 43.061 4.007 9797 Child mortality rate C0 9 years) 16.183 1.920 9829 Under-five mortality rate (0-9 years) 58.548 4.777 9838 8196 Und 0.000 1.000 1.000 8196 2.837 0.111 0.059 0.092 8196 3.198 0.039 0.428 0.500 8196 1.839 0.006 0.915 0.937 7591 1.568 0.014 2.850 3.010 1750 1.635 0.021 4.560 4.967 7591 1.586 0.013 2.614 2.756 7591 Und 0.001 0.991 0.996 7591 Und 0.001 0.990 0.995 7591 1.479 0.002 0.981 0.990 7591 1.498 0.008 0.804 0.831 7591 1.693 0.016 0,582 0.621 7591 1.713 0.018 0.538 0.577 7591 1.971 0.053 0.141 0.175 7591 1.858 0.058 0.108 0.136 7591 1.650 0.043 0.153 0.182 7591 1.462 0.114 0.017 0.027 7591 2.096 0.100 0.045 0.067 7591 2.748 0.189 0.017 0.038 4248 1.911 0.038 0.360 0.419 7591 1.597 0.019 0.482 0.519 7591 1.519 0.032 0.214 0.244 6705 1.675 0.008 2.749 2.839 8196 3.476 0.026 0.660 0.732 4646 1.471 0.014 0.753 0.795 4646 1.940 0.007 0.940 0.968 4646 2.609 0.024 0.727 0.802 4472 2.182 0.091 0.101 0.146 4472 2.070 0.189 0.017 0.037 553 1.506 0.078 0.355 0.487 553 1.216 0.043 0.546 0.648 861 1.762 0.066 0.401 0.522 861 1.631 0.018 0.873 0.939 861 1.621 0.031 0.718 0.814 861 1.788 0.033 0.727 0.830 861 1.391 0.027 0.720 0.803 861 1.457 0.035 0.622 0.717 861 1.400 0.186 0.040 0.087 36538 1.792 0.031 2.168 2.452 9856 1.414 0.107 18.048 27.823 9864 1.828 0,144 14.332 25.920 9864 1.711 0.093 35.047 51.076 9900 1.527 0.119 12.342 20.024 9908 1.855 0.082 48.995 68.101 NA = Not applicable Und = Undefined 255 Table B.2.3 Sampling errors - Rural sample T Indonesia 1994 Number of eases Standard Design Relative Confidence limits Value error Unweighted Weighted effect error Variable (RI (8E) (N) (WN) (DEFt) (SE/R) R 2SE R+2SE Urban residence 0.000 0.000 20221 No education 0.194 0.008 20221 With secondary education or higher 0.149 0.006 20221 Currently married (in union) 0.93 l 0.003 20221 Children ever born 3.119 0.031 18827 Children ever born to women over 40 5.095 0,070 4344 Children surviving 2.706 0.025 18827 Knowing any contraceptive method 0.950 0.003 18827 Knowing any modern method 0.948 0.003 18827 Knowing source for contraceptive method 0.935 0.004 18827 Ever used any contraceptive method 0.733 0.007 18827 Currently using any method 0.525 0.008 18827 Currently using a modern method 0.505 0.008 18827 Currently using pill 0.177 0.006 18827 Currently using IUD 0.095 0.005 18827 Currently using injections 0.146 0.006 18827 Currently using condom 0.003 0.000 18827 Currently using female sterilization 0.020 0.002 18827 Currently using Norplant 0.057 0.005 18827 Using public sector source 0.529 0.014 8809 Want no more children 0.469 0.006 18827 Want to delay at least 2 years 0.255 0.006 18827 Ideal number of children 2.981 0.023 14174 Knowledge of AIDS 0.253 0.010 20221 Mothers received tetanus injection 0.607 0.012 13553 Mothers received medical antenatal care 0.773 0.011 13553 Mothers received medical care at birth 0.260 0.011 13553 Had diarrhea in the last 2 weeks 0.120 0.005 12537 Had diarrhea in the last 24 hours 0.035 0.003 12537 Treated with ORS packets 0.463 0.022 1364 Consulted medical personnel 0.506 0.023 1364 Having health card 0.358 0.020 2398 Received BCG vaccination 0.728 0.017 2398 Received DPT vaccination (3 doses) 0.522 0.021 2398 Received polio vaccination (3 doses) 0.529 0.019 2398 Received measles vaccination 0.572 0.020 2398 Fully immunized 0.439 0.021 2398 Not immunized 0.225 0.016 2398 Total fertility rate (3 years) 3.147 0.078 NA Neonatal mortality rate (0-9 years) 36.041 2.153 29122 Posmeonatal mortality rate (0-9 years) 39.125 2.166 29176 Infant mortality rate (0-9 years) 75.166 3.311 29179 Child mortality rate (0-9 years) 32.966 1 .931 29344 Under-five mortality rate (0-9 years) 105.654 4.096 29404 19972 Und Und 0,000 0.000 19972 2.801 0.040 0.178 0.209 19972 2.327 0.039 0.137 0.161 19972 1.702 0.003 0.925 0.937 18595 1.827 0.010 3.057 3.181 4105 1.714 0.014 4.954 5.235 18595 1.748 0.009 2.656 2.756 18595 2.102 0.004 0.944 0.957 18595 2.081 0.004 0.941 0.955 18595 2.332 0.004 0.927 0.943 18595 2.165 0.010 0.719 0747 18595 2.113 0.015 0.510 0,541 18595 2.166 0,016 0.490 0,521 18595 2.335 0.037 0.164 0.190 18595 2.281 0.051 0.085 0.104 18595 2.331 0.041 0.134 0.158 18595 Und 0.000 0.003 0.003 18595 2.204 0.112 0.016 0.024 18595 2.821 0.083 0.048 0.067 9412 2.624 0.026 0.502 0.557 18595 1.756 0.014 0.456 0.482 18595 1.996 0.025 0.242 0.268 15339 2.040 0.008 2.935 3026 19972 3.333 0.040 0.232 0273 12337 2.301 0.019 0.584 0.631 12337 2.463 0.014 0.751 0.796 12337 2.300 0.040 0.239 0.281 11411 1.654 0.043 0.109 0.130 11411 1.597 0.082 0.029 0.040 1368 1.574 0.048 0.419 0.507 1368 1.626 0.045 0.461 0.552 2204 1.988 0.057 0.318 0.399 2204 1.827 0.024 0.693 0.762 2204 1,949 0.040 0.480 0.563 2204 1.829 0.037 0.490 0.568 2204 1.885 0.035 0.532 0.611 2204 1.991 0.048 0.397 0.481 2204 1,784 0.070 0.194 0257 71038 2.303 0.025 2.992 3,303 26215 1.685 0.060 31.736 40.347 26259 1.652 0,055 34.793 43 457 26261 1,813 11.044 68.544 81.789 26399 1.613 /I.059 29.103 36828 26448 1910 0.039 97.462 113,846 NA -- Not applicable Und = Undefined 256 Table B.2.4 Sampling errors - Java-Bali 7 Indonesia 1994 Number of cases Standard Design Relative Confidence limits Value error Unweighted Weighted effect error Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE Urban residence 0.334 0.008 8672 No education 0.163 0.009 8672 With secondary education or higher 0.208 0.010 8672 Currently married (in union) 0.928 0.004 8672 Children ever born 2.848 0.036 8066 Children ever born to women over 40 4.706 0.085 1912 Children surviving 2.507 0.029 8066 Knowing any contraceptive method 0.977 0.003 8066 Knowing any modern method 0.976 0.003 8066 Knowing source for contracep0ve method 0.963 0.004 8066 Ever used any contraceptive method 0.807 0.008 8066 Currently using any method 0.584 0.009 8066 Currently using a modern method 0.564 0.009 8066 Currently using pill 0.167 0.008 8066 Currently using IUD 0.121 0.006 8066 Currently using injections 0.168 0.007 8066 Currently using condom 0.009 0.001 8066 Currently using female sterilization 0.035 0.004 8066 Currently using Norplant 0.055 0.006 8066 Using public sector source 0.463 0.015 4686 Want no more children 0.489 0.008 8066 Want to delay at least 2 years 0.256 0.007 8066 Ideal number of children 2.701 0.022 7292 Knowledge of AIDS 0.403 0.014 8672 Mothers received tetanus injection 0.721 0.015 4412 Mothers received medical antenatal care 0.863 0.014 4412 Mothers received medical care at birth 0.370 0.016 4412 Had diarrhea in the last 2 weeks 0.130 0.008 4207 Had diarrhea in the last 24 hours 0.037 0.004 4207 Treated with ORS packets 0.447 0.028 440 Consulted medical personnel 0.548 0.027 440 Having health card 0.420 0.028 825 Received BCG vaccination 0.803 0.022 825 Received DPT vaccination (3 doses) 0.613 0.028 825 Received polio vaccination (3 doses) 0.622 0.027 825 Received measles vaccination 0.658 0.026 825 Fully immunized 0.528 0.028 825 Not immunized 0.144 0.019 825 Total fertility rate (3 years) 2.603 0.082 NA Neonatal mortality rate (0-9 years) 32.523 2.801 9393 Postneonatal mortality rate (0-9 years) 33.939 2.954 9406 Infant mortality rate (0-9 years) 66.462 4.452 9406 Child mortality rate (0 9 years) 25.289 2.344 9436 Under-five mortality rate (0-9 years) 90.070 5.486 9449 17953 1.590 0.024 0.318 0.350 17953 2.309 0.056 0.145 0.182 17953 2.296 0.048 0.188 0.228 17953 1.435 0.004 0.920 0.936 16663 1.470 0.013 2.776 2.919 3654 1.416 0.018 4.536 4.877 16663 1.430 0.012 2.449 2.566 16663 1.969 0.003 0.970 0.984 16663 1.957 0.003 0.969 0.983 16663 2.062 0.004 0.954 0.972 16663 1.719 0.009 0.792 0.822 16663 1.617 0.015 0.566 0.602 16663 1.649 0.016 0.546 0.583 16663 1.855 0.046 0.152 0.183 16663 1.645 0.049 0.109 0.133 16663 1.723 0.043 0.154 0.183 16663 1.200 0.139 0.007 0.012 16663 1.717 0.101 0.028 0.042 16663 2.248 0.104 0.043 0.066 9420 2.036 0.032 0.433 0.493 16663 1.396 0.016 0.474 0.505 16663 1.535 0.029 0.241 0.271 14917 1.764 0.008 2.657 2.746 17953 2.620 0.034 0.375 0.430 9678 2.004 0.021 0.692 0.751 9678 2.299 0.016 0.836 0.891 9678 2.005 0.043 0.338 0.402 9111 1.543 0.062 0.114 0.146 9111 1.396 0.111 0.029 0.046 1187 1.278 0.062 0.392 0.502 1187 1.291 0.050 0.493 0.602 1781 1.649 0.066 0.365 0.476 1781 1.602 0.027 0.760 0.846 1781 1.685 0.046 0.557 0.669 1781 1.619 0.043 0.569 0.676 1781 1.597 0.039 0.607 0.710 1781 1.654 0.053 0.471 0.584 1781 1.579 0.131 0.106 0.182 66747 1.817 0.031 2.440 2.767 20516 1.417 0.086 26.921 38.125 20545 1.448 0.087 28.031 39.847 20545 1.572 0.067 57.557 75.366 20638 1.416 0.093 20.600 29.977 20667 1.688 0.061 79.099 101.041 NA = Not applicable 257 Table B.2.5 Sampl ing errors - Outer Java-Bali lr Indonesia 1994 Number of cases Standard Design Relalive Confidence limils Value error Unweighted Weighted effect error Variable (R) (SE) IN) (WN) (DEFT) (SE/R) R-2SE R+2SE Urban residence No education With secondary education or higher Currently married (in union) Children ever born Children ever born to women over 40 Children surviving Knowing any contraceptive method Knowing any modern method Knowing source for contraceptive method Ever used any contraceptive method Currently using any method Currently using a modern method Currently using pill Currently using IUD Currently using injections Currently using condom Currently using female sterilization Currently using Norplant Using public sector source Want no more children Want to delay at least 2 years Ideal number of children Knowledge of AIDS Mothers received tetanus injection Mothers received medical antenatal care Mothers received medical care at birth Had diarrhea in the last 2 weeks Had diarrhea in the last 24 hours Treated with ORS packets Consulted medical personnel Having health card Received BCG vaccination Received DPT vaccination (3 doses) Received polio vaccination (3 doses) Received measles vaccination Fully immunized Not immunized Total fertility rate (3 years) Neonatal mortality rate (0 9 years) Postneonatal mortality rate (0-9 years) Infant mortality rate (0-9 years) Child mortality rate (0-9 years) Under-five mortality rate (0-9 years) 0,214 0.008 10229 7108 2017 0.038 0.198 0230 0.141 0.006 10229 7108 1.664 0.041 0.130 0.152 0.304 0.010 10229 7108 2201 0.033 0.284 0.324 0.931 0.003 10229 7108 1.178 0.003 0.925 0.937 3.479 0.035 9481 6619 1.384 0.010 3.409 3549 5.516 0,070 2238 1551 1251 0.013 5.377 5.655 3.061 0.029 9481 6619 1371 (I.010 3.002 3.120 0.947 0.004 9481 6619 1661 0.004 0.940 0.955 0.946 0.004 9481 6619 1.671 0.004 0.938 0.954 0.938 0.004 9481 6619 1.738 0.005 0.930 0,947 0.684 0.008 9481 6619 1.633 0,011 0.669 0.700 0.495 0.008 9481 6619 1560 0.016 0.479 I).511 0.455 0.008 9481 6619 1.594 0.018 0.439 0.471 0.188 0.006 9481 6619 ~607 0.034 0.175 I).201 0.074 0.005 9481 6619 1.771 0.064 0.065 0084 0,119 0.004 9481 6619 1.249 0.035 0. I l l 0.127 0,008 0.001 9481 6619 Und 0.155 0.006 0.011 0,025 0.002 9481 6619 1.195 0.076 0.021 0.029 0.037 0.003 9481 6619 1.515 0.079 0.032 0.(M3 0.518 0.013 4459 3025 1.787 0.026 0.492 0.545 0.462 0.007 9481 6619 1.278 0.014 0.449 0.475 0.240 0.006 9481 6619 1.291 0.024 0.229 0,252 3.375 0.026 7068 5002 1.540 0.008 3.323 3.428 0.348 0.010 10229 7108 2.124 0,029 0.328 0.368 0.561 0.012 7028 5072 1.678 0021 0537 0.584 0.793 0.011 7028 5072 1.953 0.014 0.771 0.816 0.480 0.016 7028 5072 2.306 0.034 0447 0.512 0.113 0.005 6510 4701 1133 0.040 0.104 0 122 0.025 0.002 6510 4701 1.120 0.088 0.020 0.029 0.431 0.022 745 531 1.159 0.050 0.388 0.474 0.499 0.022 745 531 1.172 0.044 0.455 0.543 0.331 0.017 1234 890 1.252 0.050 0.298 0364 0.730 0.018 1234 890 1.404 0.024 0.695 0.765 0.530 0.018 1234 890 1.288 0.034 0.493 0.566 0.540 0.018 1234 890 1.295 0.034 I).503 0.576 0.550 0.019 1234 890 1.320 0.034 0.513 0,587 0.439 0.018 1234 890 [.262 0.040 0.404 0.475 0.241 0.018 1234 890 1489 0.075 0.205 11277 3.261 0.067 NA 28478 1.467 I).021 3.126 3396 32.637 1.992 15051 10785 1225 0.061 28.654 36621 34.160 1.957 15076 10800 1236 0.057 30.246 38.074 66.797 3,049 15079 10802 1.346 0.046 60.700 72895 32.411 2.233 15159 10859 1440 0.069 27.945 36.878 97.044 4.023 15190 10879 1.509 0.041 88.997 105091 NA = Not applicable Und = Undef ined 258 Table B.2.6 Sampling errors - Outer Java-Bali lI~ Indonesia 1994 Number of cases Standard Design Relative Confidence limits Value error Unweighted Weighted effect error Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R 2SE R+2SE Urban residence 0.220 0.007 9267 No education 0,178 0.007 9267 With secondary education or higher 0.281 0.009 9267 Currently married (in union) 0.935 0.003 9267 Children ever horn 3.360 0.036 8673 Children ever born to women over 40 5.380 0.076 1915 Children surviving 2.979 0.032 8673 Knowing any contraceptive method 0.917 0.005 8673 Knowing any modern method 0.909 0.005 8673 Knowing source for contraceptive method 0.899 0.005 8673 Ever used any contraceptive method 0.640 0.009 8673 Currently using any method 0.457 0.009 8673 Currently using a modern method 0.418 0.009 8673 Currently using pill 0.154 0.006 8673 Currently using IUD 0.060 0.005 8673 Currently using injections 0.136 0.006 8673 Currently using condom 0.006 0.001 8673 Currently using female sterilization 0.018 0.002 8673 Currently using Norplant 0.040 0.003 8673 Using public sector source 0,585 0.015 3626 Want no more children 0.452 0.007 8673 Want to delay at least 2 years 0.213 0.005 8673 Ideal number of children 3.422 0.031 6137 Knowledge of AIDS 0.336 0.010 9267 Mothers received tetanus injection 0.568 0.014 6756 Mothers received medical antenatal care 0.714 0.014 6756 Mothers received medical care at birth 0.334 0.013 6756 Had diarrhea in the last 2 weeks 0.098 0.005 6280 Had diarrhea in the last 24 hours 0.028 0.002 6280 Treated with ORS packets 0.527 0.024 598 Consulted medical personnel 0.530 0.024 598 Having health card 0.366 0.021 1182 Received BCG vaccination 0.770 0,020 1182 Received DPT vaccination (3 doses) 0.623 0.020 1182 Received polio vaccination (3 doses) 0.627 0.020 1182 Received measles vaccination 0.644 0.019 1182 Fully immunized 0.543 0.020 1182 Not immunized 0.202 0.019 1182 Total fertility rate (3 years) 3.327 0.074 NA Neonatal mortality rate (0-9 years) 31.764 2.232 14467 Postneonatal mortality rate (0-9 years) 33.520 2.001 14490 Infant mortality rate (0-9 years) 65.284 3.180 14491 Child mortality rate (0-9 years) 31.830 2.307 14578 Under-five mortality rate (0-9 years) 95.035 4.307 14603 3106 1.679 0.033 0.206 0.235 3106 1.768 0.040 0.164 0.192 3106 1.988 0.033 0.262 1/.299 3106 0.980 0.003 0.930 0.940 2903 1.366 0,011 3.289 3.431 651 1.225 0,014 5.229 5.531 2903 1.428 0.011 2.915 3043 2903 1.692 0.005 0.906 0.927 2903 1,638 0.006 0,899 0.919 2903 1.619 0.006 0.888 0909 2903 1.820 0.015 0.621 0.658 2903 1.750 0.020 0.438 0.476 2903 1.758 0.022 0.399 0.437 2903 1.443 0.036 0.143 I).165 2903 1.837 0.078 0.0511 0.069 2903 1.494 0.040 0.125 0.147 2903 Und 0.190 0,004 0.009 2903 1.229 0.098 0.014 0.02l 2903 1.602 0.084 0.034 0.047 1215 1.843 0.026 0.555 0615 2903 1.313 0.016 0.438 0.466 2903 1.186 0.024 0.203 0.224 2124 1,654 0.009 3.359 3.485 3106 2.057 0.030 0.315 0356 2233 1.903 0.024 0.540 0.595 2233 2,078 0.020 0.686 0.743 2233 1,843 0.038 0.309 0.360 2071 1.215 0.048 0.088 0.107 2071 1.119 0.086 0.023 0,032 203 1.154 0.046 0.479 0.576 203 1.153 0.046 0.481 0.578 394 1.509 0.058 0.323 0,409 394 1.611 0.026 0731 0.810 394 1.434 0.033 0.582 0.664 394 [.404 0.032 0.588 1/.667 394 1.386 0.030 0.605 0.683 394 1.364 0.037 0.503 0.583 394 1.620 0.095 0.163 0.240 12328 1.534 0.022 3.180 3.474 4770 1.341 0.070 27.299 36.229 4778 1.223 0.060 29.518 37521 4778 1.354 0.049 58.924 71.643 4802 1,435 0.072 27.215 36.444 4811 1.552 0.045 86.422 103648 NA = Not applicable Und = Undefined 259 Table B.2.7 Sampl ing errors - DK1 Jakart% Indonesia 1994 Number of cases Slandard Design Relative Confidence linfits Value error Unweighted Weighted elliot error Variable (R) (SEt IN) (WN) (DEFF) (SFJR) R-2SE R+2SE Urban residence 1.000 0.000 1805 No education 0.075 0.010 1805 With secondary education or higher 0.474 0.019 1805 Currently married (in union) 0,913 0.009 1805 Children ever born 2,821 0.063 1642 Children ever born to women over 40 4.467 0.154 414 Children surviving 2582 0.057 1642 Knowing any contraceptive method 0,999 0,000 1642 Knowing any modern method 0.999 0.000 1642 Knowing source for contraceptive method 0.998 0,001 1642 Ever used any contraceptive method 0.811 0.010 1642 Currently using any method 0.597 0.013 1642 Currently using a modern method 0.548 0.014 1642 Currently using pill 0.145 0.007 1642 Currently using IUD 11,124 0.012 1642 Currently using injections 0.190 0.014 1642 Currently using condom 0,019 0.004 1642 Currently using female sterilization 0.057 0.004 1642 Currently using Norplant 0.012 0.003 1642 Using public sector source 0.383 0,029 901 Want no more children 0.499 0.016 1642 Want to delay at least 2 years 0.207 0,013 1642 Ideal number of children 2.699 0.032 1378 Knowledge of AIDS 0.871 0.010 1805 Mothers received tetanus injection 0.733 0.018 885 Mothers received medical antenatal care 0.973 0.007 885 Mothers received medical care at birth 0.867 0.017 885 Had diarrhea in the last 2 weeks 0.069 0.010 86 I Had diarrhea in the last 24 hours 0.010 0.004 861 Treated with ORS packets 0.387 0.070 63 Consulted medical personnel 0.620 0.055 63 Having health card 0.308 0.043 157 Received BCG vaccination 1/.922 0.026 157 Received DPT vaccination (3 doses) 11.792 0.042 157 Received polio vaccination (3 doses) 0.799 0.042 157 Received measles vaccination 0.679 0.049 157 Fully immunized 0.621 0.057 157 Not immunized 0.068 0.021 157 Total fertility rate (3 years) 1.903 0.092 NA Neonatal mortality rate (0-9 years) 15.993 3.085 1904 Postneonatal mortality rate ((I-9 years) 13.782 3.020 1904 Infant mortality rate (0-9 years) 29.775 4.398 1904 Child mortality rate (0 9 years) 21.129 3179 1913 Under-five mortality rate (0-9 years) 50.275 5.493 1913 1249 Und 0.000 1000 1000 1249 1691 0.140 0054 11096 1249 1.616 0040 0436 0.512 1249 1.388 0.010 0.895 0.931 1140 1.221 0022 2.695 2.947 276 1.273 0.034 4160 4.774 1140 1276 0.022 2.468 2.695 1140 Und 0000 11.999 0.999 1140 l ind 0000 (1999 0.999 1140 I 084 0.001 11.995 1.000 1140 1 009 0.012 0.791 0.830 1140 1.070 0022 11571 0623 1140 1.152 11.026 0.519 0.576 1140 0.801 0048 I1131 0159 1140 1.428 0.094 0101 0147 1140 1432 0.073 0162 0217 11411 1104 0194 0.012 0027 1140 0.746 0075 0.049 0.066 1140 I.(105 0.229 1/.0116 0.017 625 1.767 0.075 0.325 0.440 1140 1 261 0.031 11.468 0.530 1140 1269 11.061 11.182 0.232 953 1280 0.012 2.635 2.762 1249 1.273 0012 0851 0.891 618 1.099 0 025 0 697 0.769 618 1.162 0.007 0959 0.987 618 1.370 0.020 0832 11901 601 1179 0.145 0049 0,089 601 1276 0421 0002 0019 42 I.I 13 17.181 0247 0.527 42 0.878 1/1189 0 510 0730 107 1.1611 0.140 0.222 0394 107 1.21 I 0,028 0.870 0.974 107 1,283 0.053 11.709 0.876 107 1,305 0.1153 I1715 0.883 107 1.315 0073 0580 0.778 107 1465 0.092 0507 0,736 107 102l 0305 0026 01(19 5930 1153 0.048 1719 2.087 1326 1.011 0.193 9822 22164 1326 1.102 tl.219 7.742 19821 1326 1.029 0148 20979 ~8.571 1332 1002 0 150 14772 27.486 1332 111511 0 1119 39288 01.262 NA = Not applicable UND = Undef ined 260 Table B.2.8 Sampling errors - West Java, Indonesia 1994 Number of cases Standard Design Relative Confidence limits Value error Unweighted Weighted effect error Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE Urban residence 0.350 0.021 1532 No education 0.122 0.015 1532 With secondary education or higher 0.216 0.021 1532 Currently married (in union) 0.931 0.008 1532 Children ever born 3.285 0.086 1428 Children ever born to women over 40 5.641 0.224 288 Children surviving 2.766 0.064 1428 Knowing any contraceptive method 0.977 0.008 1428 Knowing any modern method 0.976 0.008 1428 Knowing source for contraceptive method 0.962 0.009 1428 Ever used any contraceptive method 0.819 0.016 1428 Currently using any method 0.567 0.017 1428 Currently using a modern method 0.560 0.017 1428 Currently using pill 0.191 0.015 1428 Currently using IUD 0.072 0.008 1428 Currently using injections 0.210 0.015 1428 Currently using condom 0.009 0.003 1428 Currently using female sterilization 0.014 0.004 1428 Currently using Norplant 0.048 0.009 1428 Using public sector source 0.344 0.030 791 Want no more children 0.441 0.015 1428 Want to delay at least 2 years 0.289 0.014 1428 Ideal number of children 2.909 0.053 1023 Knowledge of AIDS 0.474 0.025 1532 Mothers received tetanus injection 0.711 0.028 1012 Mothers received medical antenatal care 0.820 0.029 1012 Mothers received medical care at birth 0.289 0.030 1012 Had diarrhea in the last 2 weeks 0.205 0.017 926 Had diarrhea in the last 24 hours 0.065 0.009 926 Treated with ORS packets 0.427 0.039 190 Consulted medical personnel 0.530 0.033 190 Having health card 0.374 0.047 193 Received BCG vaccination 0.732 0.042 193 Received DPT vaccination (3 doses) 0.535 0.053 193 Received polio vaccination (3 doses) 0.546 0.048 193 Received measles vaccination 0.626 0.044 193 Fully immunized 0.436 0.047 193 Not immunized 0.180 0.036 193 Total fertility rate (3 years) 3.172 0.186 NA Neonatal mortality rate (0-9 years) 43.554 4.998 2142 Posmeonatal mortality rate (0-9 years) 45.281 5.627 2145 Infant mortality rate (0-9 years) 88.835 8.295 2145 Child mortality rate (0-9 years) 33.783 4.399 216 I Under-five mortality rate (0-9 years) 119.617 10.256 2164 5551 1.693 0.059 0.309 0.391 5551 1.762 0.121 0.093 0.151 5551 2.023 0.099 0.173 0.258 5551 1.192 0.008 0.916 0.947 5170 1.287 0.026 3.112 3.458 1025 1.269 0.040 5.193 6.090 5170 1.186 0.023 2.637 2.895 5170 1.926 0.008 0.962 0.992 5170 1.905 0.008 0.961 0.992 5170 1.730 0.009 0.944 0.979 5170 1.573 0.020 0.787 0.852 5170 1.289 0.030 0.533 0.601 5170 1.310 0.031 0.526 0.595 5170 1.425 0.078 0.162 0.221 5170 1.103 0.105 0.057 0.087 5170 1.397 0.072 0.180 0.240 5170 1.048 0.296 0.004 0.014 5170 1.225 0.271 0.{R)6 0.022 5170 1.679 0.198 0.029 0.067 2901 1.771 0.087 0.284 0.403 5170 1.108 0.033 0.412 0.470 5170 1.169 0.049 0.261 0.317 3728 1.281 0.018 2.803 3.014 5551 1.979 0.053 0.423 0.524 3675 1.730 0.040 0.654 0.768 3675 2.041 0.036 0.761 0.878 3675 1.818 0.103 0.229 0.348 3352 1.254 0.084 0.171 0.240 3352 1.126 0.144 0.046 0.084 688 1.037 0.091 0.350 0.505 688 0.896 0.062 0.465 0.596 681 1.327 0.125 0.281 0.468 681 1.299 0.057 0.648 0.816 681 1.460 0.099 0.428 0.641 681 1.328 0.088 0.450 0.643 681 1.256 0.071 0.537 0.715 681 1.305 0.108 0.342 0.531 681 1.297 0.202 0.107 0.253 20422 1.556 0.059 2.800 3.544 7795 1.036 0.115 33.557 53.550 7804 1.080 0.124 34.028 56.535 7804 1.178 0.093 72.246 105.424 7864 1.067 0.130 24.986 42.581 7873 1.283 0.086 99.105 140.129 NA = Not applicable 261 Table B.2.9 Sampling errors - Central Java~ Indonesia 1994 Number of cases Standard Design Relative Confidence limits Value error Unweighted Weighted effect error Variable (R) (SE) (N) (WN) (DEFT) tSE/R/ R-2SE R+2SE Urban residence 0.251 0.012 1472 No education 0.171 0.016 1472 With secondary education or higher 0.151 0.017 1472 Currently married (in union) 0.940 0.007 1472 Children ever born 2.942 0.061 1383 Children ever born to women over 40 4.802 0.144 333 Children surviving 2.675 0.057 1383 Knowing any contraceptive method 0.994 0.002 1383 Knowing any modern method 0.994 0.002 1383 Knowing source for contraceptive method 0.987 0.003 1383 Ever used any contraceptive method 0.820 0.014 1383 Currently using any method 0.611 0.020 1383 Currently using a modern method 0.596 0.021 1383 Currently using pill 0.139 0.014 1383 Currently using IUD 0.108 0.014 1383 Currently using injections 0.190 0.015 1383 Currently using condom 0.011 0.003 1383 Currently using female sterilization 0.036 0.008 1383 Currently using Notplant 0.100 0.017 1383 Using public sector source 0.533 0.027 825 Want no more children 0.530 0.015 1383 Want to delay at least 2 years 0.261 0.015 1383 Ideal number of children 2.856 0.047 1333 Knowledge of AIDS 0.281 0.023 1472 Mothers received tetanus injection 0.791 0.026 832 Mothers received medical antenatal care 0.902 0.017 832 Mothers received medical care at birth 0.319 0.030 832 Had diarrhea in the last 2 weeks 0.078 0.012 798 Had diarrhea in the last 24 hours 0.024 0.006 798 Treated with ORS packets 0.488 0.061 62 Consulted medical personnel 0.587 0.075 62 Having health card 0.478 0.041 147 Received BCG vaccination 0.885 0.027 147 Received DPT vaccination (3 doses) 0.700 0.047 147 Received polio vaccination (3 doses) 0.693 0.048 147 Received measles vaccination 0.737 0.049 147 Fully immunized 0.633 0.059 147 Not immunized 0.081 0.024 147 Total fertility rate (3 years) 2.771 0.154 NA Neonatal mortality rate (0-9 years) 23.955 4.362 1759 Postneonatal mortality rate (0-9 years) 27.110 4.662 1761 Infant mortality rate (0-9 years) 51.065 6.699 1761 Child mortality rate (0-9 years) 25.041 4.945 1766 Under-five mortality rate (0-9 years) 74.827 9.532 1768 4578 1.048 0.047 0.228 I).275 4578 1.664 0.095 0.138 0.204 4578 1.783 0.110 0.117 0.184 4578 1.127 0,007 0.926 11954 4302 1.077 0.021 2.821 t,063 1030 1.082 11.030 4.515 5.090 4302 1.138 0.021 2.561 2.788 4302 1.010 0.002 0.990 0.998 4302 1,010 0.002 0.990 0.998 4302 1.021 0.003 0.981 0.993 4302 1.316 0.017 0.793 0.848 4302 1.546 0.033 0.570 0.651 4302 1.553 0.034 0.555 0.637 4302 1,485 0.099 O. 111 0.166 4302 1.650 0.128 0.080 0,135 4302 1.415 0.079 0.160 0.220 4302 1.051 0.272 0.005 I).017 4302 1,583 0,219 11.020 0.052 4302 2.055 0.166 0.067 0.133 2569 1.557 0.051 0.479 0.587 4302 1.130 0.029 0.500 0.561 4302 1.240 0.056 0.232 13.290 4134 1.635 0.017 2.762 2.951 4578 1.983 0.083 0.235 0.328 2599 1.646 0.032 0.740 0.842 2599 1.475 0.019 0.869 0.936 2599 1.671 /I.095 11.258 0.379 2493 1.231 O. 151 0,054 O. I 01 2493 1.095 0.258 0.012 0.037 194 0.953 0.126 0.365 0.611 194 1.195 0.128 0.436 0.738 458 0.987 0.085 0.397 0.559 458 1.045 0.031 0,830 11.940 458 1.256 0.068 0.605 0,795 458 1.275 0.070 0.596 0.790 458 1.358 0.067 0.638 0.835 458 1.479 0.093 0.515 0.750 458 1050 1/292 0.034 0.128 16846 1.283 0.056 2.464 3.079 5485 1.013 0.182 15.230 32.679 5492 1.144 0.172 17.787 36.433 5492 1.156 0.131 37.667 64.463 5508 1.201 0.197 15.151 34.930 5514 1.347 0.127 55.763 93.890 NA=Not applicable 262 Table B.2.10 Sampling errors - DI Yogyakarta~ Indonesia 1994 Variable Number of cases Standard Design Relative Confidence limits Value error Unweighted Weighted effect error (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE Urban residence 0.417 0.021 1118 No education 0.162 0.019 1118 With secondary education or higher 0.376 0.022 1118 Currently married (in union) 0.927 0.008 I 118 Children ever born 2.495 0.062 1035 Children ever born to women over 40 3.812 0.138 287 Children surviving 2.345 0.058 1035 Knowing any contraceptive method 0.998 0.001 1035 Knowing any modern method 0.998 0.001 1035 Knowing source for contraceptive method 0.997 0.002 1035 Ever used any contraceptive method 0.882 0.009 1035 Currently using any method 0.695 0.012 1035 Currently using a modern method 0.597 0.016 1035 Currently using pill 0.088 0.010 1035 Currently using IUD 0.273 0.016 1035 Currently using injections 0.123 0.010 1035 Currently using condom 0.037 0.007 1035 Currently using female sterilization 0.040 0.006 1035 Currently using Norplant 0.028 0.008 1035 Using public sector source 0.528 0.025 624 Want no more children 0.602 0.016 1035 Want to delay at least 2 years 0.200 0.010 1035 ldeal number of children 2.524 0.032 1043 Knowledge of AIDS 0.487 0.021 1118 Mothers received tetanus injection 0.884 0.022 445 Mothers received medical antenatal care 0.981 0.007 445 Mothers received medical care at birth 0.513 0.044 445 Had diarrhea in the last 2 weeks 0.046 0.011 434 Had diarrhea in the last 24 hours 0.008 0.004 434 Treated with ORS packets 0.756 0.110 20 Consulted medical personnel 0.864 0.085 20 Having health card 0.617 0.073 97 Received BCG vaccination 0.920 0.041 97 Received DPT vaccination (3 doses) 0.804 0.049 97 Received polio vaccination (3 doses) 0.804 0.049 97 Received measles vaccination 0.835 0.057 97 Fully immunized 0.762 0.052 97 Not immunized 0.058 0.038 97 Total fertility rate (3 years) 1.793 0.129 NA Neonatal mortality rate (0-9 years) 14.582 3.591 1009 Postneonatal mortality rate (0-9 years) 15.809 4.234 1010 Infant mortality rate (0-9 years) 30.391 6.233 1010 Child mortality rate (0-9 years) 4.876 2.152 1009 Under-five mortality rate (0-9 years) 35.119 6.642 1010 457 1.394 0.049 0.376 0.458 457 1.716 0.117 0.124 0.200 457 1.528 0.059 0.332 0.420 457 0.992 0.008 0.912 0.942 423 1.210 0.025 2.371 2.619 116 1.253 0.036 3.536 4.088 423 1.218 0.025 2.229 2.460 423 0.996 0.001 0.995 1.000 423 0.996 0.001 0.995 1.00fi 423 0.997 0.002 0.994 1.000 423 0.943 0.011 0.863 0.901 423 0.839 0.017 0.671 0.719 423 1.062 0.027 0.565 0.630 423 1.080 0.108 0.069 0.107 423 1.146 0.058 0.241 0.304 423 0.986 0.082 0.102 o. 143 423 1.233 0.197 0.022 0.051 423 0.928 0.141 0.029 0.051 423 1.664 0.307 0.011 0.044 254 1.275 0.048 0.477 0.579 423 1.056 0.027 0.569 0.634 423 0.774 0.048 0.181 0.219 426 1.215 0.013 2.459 2.589 457 1.423 0.044 0.445 0.530 182 1.286 0.024 0.841 0.927 182 1.127 0.007 0.966 0.995 182 1.667 0.085 0.426 0.600 178 1,048 0,229 0.025 0.067 178 1.042 0.575 0.000 0.016 8 1.145 0.145 0.536 0.976 8 1.107 0.098 0.694 1.000 40 1.468 0.118 0.471 0.762 40 1.491 0.045 0.838 1.000 40 1.213 0.061 0.706 0.902 40 1.213 0.061 0.706 0.902 40 1.502 0.068 0.722 0.949 40 1.203 0.068 0.657 0.866 40 1.607 0.655 0.000 0.135 1950 1.292 0.072 1.534 2.051 414 0.958 0.246 7.401 21.763 414 1.102 0.268 7.341 24.276 414 1.147 0.205 17.924 42.858 414 1.034 0.441 0.572 9.181 414 1.118 0.189 21.835 48.402 NA = Not applicable 263 Table B.2.11 Sampling errors - East Java~ Indonesia 1994 Standard Value error Variable (R) (SE) Number of cases Design Relative Confidence limits Unweighled Weighted effect error (N) (WN) (DEFT) (SE/R) R-2SE R+2SE Urban residence 0.237 0.009 1503 No education 0.212 0.021 1503 With secondary education or higher 0.173 0.019 1503 Currently married (in union) 0.916 0.008 1503 Children ever born 2.386 0.055 1376 Children ever born to women over 40 3.957 0.150 292 Children surviving 2. I 19 0.049 1376 Knowing any contraceptive method 0.955 0.007 1376 Knowing any modern method 0.953 0.007 1376 Knowing source for contraceptive method 0.933 0.011 1376 Ever used any contraceptive method 0.773 0.014 1376 Currently using any method 0.559 0.015 1376 Currently using a modern method 0.535 0.016 1376 Currently using pill 0.188 0.016 1376 Currently using IUD 0.145 0.013 1376 Currently using injections 0.111 0.012 1376 Currently using condom 0.004 0.002 1376 Currently using female sterilization 0.046 0.008 1376 Currently using Norplant 0.040 0.007 1376 Using public sector source 0.523 0.028 740 Want no more children 0.483 0.015 1376 Want to delay at least 2 years 0.245 0.015 1376 Ideal number of children 2.474 0.036 1398 Knowledge of AIDS 0.320 0.029 1503 Mothers received tetanus injection 0.634 0.030 634 Mothers received medical antenatal care 0.846 0.023 634 Mothers received medical care at birth 0.380 0.030 634 Had diarrhea in the last 2 weeks 0.105 0.013 606 Had diarrhea in the last 24 hours 0.023 0.006 606 Treated with ORS packets 0.470 0.055 64 Consulted medical personnel 0.546 0.072 64 Having health card 0.427 0.071 121 Received BCG vaccination 0.777 0.047 121 Received DPT vaccination (3 doses) 0.563 0.055 121 Received polio vaccination (3 doses) 0.587 0.056 121 Received measles vaccination 0.592 0.055 121 Fully immunized 0.497 0.056 121 Not immunized 0.189 0.042 121 Total fertility rate (3 years) 2.217 0.125 NA Neonatal mortality rate (0-9 years) 31.385 6.180 1339 Posmeonatal mortality rate (0-9 years) 30.668 6.327 1342 Infant mortality rate (0-9 years) 62.053 9.100 1342 Child mortality rate (0 9 years) 17.818 3.626 1345 Under-five mortality rate (0-9 years) 78.765 9.511 1348 5685 0.810 0.037 0.219 0.255 5685 2.005 0.100 0.170 0254 5685 1.910 0.108 0.136 11211 5685 1.135 0.009 0.900 0.932 5209 1.128 0.023 2.276 2.496 1102 1.102 0.038 3.656 4.258 5209 1.144 0.023 2.022 2217 5209 1.276 0.007 0.941 0.970 5209 1.273 0.008 0.939 0.968 5209 1.553 0.011 0.912 0.954 5209 1.242 0.018 0.745 0802 5209 1.140 0.027 0.528 0.589 5209 1.177 0.030 0.504 0.567 5209 1.528 0.086 I).156 0.220 5209 1.359 0.089 0.119 0.171 5209 1.362 0.104 0.088 0.134 5209 1.068 0.471 0.000 0.007 5209 1.448 0.177 0.030 0.063 5209 1.299 0.171 0.026 0.054 2793 1.534 0 054 0.467 0.580 5209 1.129 0.031 0.453 0514 5209 1.279 11.061 0.215 0.274 5288 1.466 0.015 2.402 2546 5685 2.422 0.091 11.261 0378 2393 1.407 0.047 0.574 0.694 2393 1.368 0.027 0.800 0.893 2393 1.427 0.079 0.320 0.440 2285 0.975 0.120 0.080 0.130 2285 0.926 11.264 11.011 0035 240 0.840 0.118 0.359 0.581 240 1,112 0.132 0.402 0.690 457 1.575 0.166 0.285 11.569 457 1.250 0.1361 0.682 0.872 457 1.212 0.097 0.454 0.673 457 1,260 0.096 0.474 0.700 457 1.232 0.093 0.482 0.703 457 1.237 0,113 0.384 0.610 457 1.179 0.222 0.105 0.273 20271 1.175 0.056 1.968 2.466 5070 1.200 0.197 19.024 43.746 5081 1.215 0.206 18.014 43.321 5081 1.248 0.147 43.852 80254 5093 1.019 0.203 10.566 25070 5104 1.194 0121 59.742 97.788 NA = Not applicable 264 Table B.2.12 Sampling errors - Bali t Indonesia 1994 Number of cases Standard Design Relative Confidence limits Value error Unweighted Weighted effect error Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE Urban residence 0.252 0.018 1242 No education 0.236 0.011 1242 With secondary education or higher 0.243 0.019 1242 Currently married (in union) 0.967 0.005 1242 Children ever born 2.647 0.063 1202 Children ever born to women over 40 4.122 0.141 298 Children surviving 2.386 0.054 1202 Knowing any contraceptive method 0.985 0.003 1202 Knowing any modern method 0.985 0.003 1202 Knowing source for contraceptive method 0.978 0.004 1202 Ever used any contraceptive method 0.837 0.014 1202 Currently using any method 0.684 0.020 1202 Currently using a modern method 0.665 0.021 1202 Currently using pill 0.048 0.008 1202 Currently using 1UD 0.411 0.026 1202 Currently using injections 0.120 0.013 1202 Currently using condom 0.009 0.003 1202 Currently using female sterilization 0.063 0.007 1202 Currently using Norplant 0.006 0.002 1202 Using public sector source 0.574 0.024 805 Want no more children 0.596 0.016 1202 Want to delay at least 2 years 0.147 0.010 1202 Ideal number of children 2.362 0.023 I 117 Knowledge of A1DS 0.421 0.025 1242 Mothers received tetanus injection 0.866 0.025 604 Mothers received medical antenatal care 0.916 0.025 604 Mothers received medical care at birth 0.716 0.049 604 Had diarrhea in the last 2 weeks 0.075 0.014 582 Had diarrhea in the last 24 hours 0.017 0.005 582 Treated with ORS packets 0.417 0.074 41 Consulted medical personnel 0.478 0.115 41 Having health card 0.574 0.061 110 Received BCG vaccination 0.937 0.026 110 Received DPT vaccination (3 doses) 0.864 0.032 110 Received polio vaccination (3 doses) 0.867 0.036 110 Received measles vaccination 0.837 0.043 110 Fully immunized 0.767 0.049 110 Not immunized 0.044 0.023 110 Total 12:rtility rate (3 years) 2.143 0.140 NA Neonatal mortality rate (0-9 years) 23.405 6.072 1240 Postneonatal mortality rate (0-9 years) 34.631 6.970 1244 Infant mortality rate (0-9 years) 58.036 9.749 1244 Child mortality rate (0 9 years) 5.184 1.912 1242 Under-five mortality rate (0-9 years) 62.919 9.828 1246 432 1.500 0.073 0.215 0.289 432 0.947 0.048 0.213 0.258 432 1.572 0.079 0.205 0.281 432 0.966 0.005 0.957 0.977 418 1.188 0.024 2.521 2.773 105 1.180 0.034 3.841 4.404 418 1.183 0.022 2.279 2.493 418 0.897 0.003 0.978 0.991 418 0.897 0.003 0.978 0.991 418 0.936 0.004 0.970 0.986 418 1.307 0.017 0,809 0.865 418 1.506 0.030 0.644 0.725 418 1.539 0.032 0.623 0.707 418 1.318 0.170 0.032 0.064 418 1.817 0.063 0.359 0.462 418 1.368 0.107 0.095 0.146 418 1.150 0.357 0.002 0.015 418 0.983 0.109 0.050 0.077 418 0.817 0.298 0.003 0.010 278 1.367 0.042 0.526 0.622 418 1.134 0.027 0.564 0.628 418 1.003 0.070 0.127 0.168 387 1.101 0.010 2.315 2.408 432 1.801 0.060 0.370 0.471 210 1.490 0.029 0.816 0.916 210 1.788 0.028 0.866 0.967 210 2.186 0.069 0.618 0.814 201 1.254 0.184 0.047 0.102 201 0.901 0.286 0.007 0.026 15 0.963 0.177 0.270 0.565 15 1.490 0.240 0.248 0.708 39 1.265 0.106 0.453 0.695 39 1.127 0.028 0.885 0.989 39 0.966 0.036 0.801 0.927 39 1.122 0.042 0.794 0.939 39 1.225 0.051 0.751 0.923 39 1.223 0.064 0.668 0.865 39 1.177 0.519 0.000 0.090 1750 1.277 0.065 1.864 2.423 427 1.333 0.259 11.262 35.549 428 1.127 0.201 20.690 48.571 428 1.250 0.168 38.537 77.535 428 0.965 0.369 1.361 9.007 429 1.176 0.156 43.263 82.576 NA = Not applicable 265 Table B.2.13 Sampling errors - Dista Aceh, Indonesia 1994 Number of cases Standard Design Relative Confidence limits Value error Unweighted Weighted effect error Variable (R) (SE) iN) (WN) (DEFT) (SE/R) R-2SE R+2SE Urban residence 0.150 0.016 1079 No education 0.167 0.014 1079 With secondary education or higher 0.333 0.023 1079 Currently married (in union) 0.913 0.01 I 1079 Children ever born 3.666 0.075 987 Children ever born to women over 40 5.628 0.164 270 Children surviving 3.304 0.063 987 Knowing any contraceptive method 0.825 0.021 987 Knowing any modern method 0.822 0.021 987 Knowing source for contraceptive method 0.822 0.021 987 Ever used any contraceptive method 0.469 0.025 987 Currently using any method 0.323 0.025 987 Currently using a modern method 0.301 0.025 987 Currently using pill 0.125 0.015 987 Currently using IUD 0.022 0.007 987 Currently using injections 0.129 0.014 987 Currently using condom 0.009 0.003 987 Currently using female sterilization 0.004 0.002 987 Currently using Norplant 0.011 0.005 987 Using public sector source 0.556 0.043 306 Want no more children 0.395 0.019 987 Want to delay at least 2 years 0.272 0.016 987 Ideal number of children 3.994 0.078 591 Knowledge of AIDS 0.300 0.022 1079 Mothers received tetanus injection 0.471 0.026 775 Mothers received medical antenatal care 0.706 0.029 775 Mothers received medical care at birth 0.437 0.033 775 Had diarrhea in the last 2 weeks 0.079 0.013 736 Had diarrhea in the last 24 hours 0.018 0.006 736 Treated with ORS packets 0.455 0.069 58 Consulted medical personnel 0.428 0.076 58 Having health card 0.194 0.046 133 Received BCG vaccination 0.493 0.049 133 Received DPT vaccination (3 doses) 0.310 0.052 133 Received polio vaccination (3 doses) 0.310 0.051 133 Received measles vaccination 0.331 0.045 133 Fully immunized 0.251 0.043 133 Not immunized 0.461 0.048 133 Total fertility rate (3 years) 3.302 0.186 NA Neonatal mortality rate (0-9 years) 32.752 5.479 1698 Postneonatal mortality rate (0-9 years) 25.651 4.788 1699 Infant mortality rate (0 9 years) 58.403 7.610 1699 Child mortality rate (0-9 years) 21.927 4.081 1708 Under-five mortality rate (0-9 years) 79.050 9.109 1709 522 1.452 0,105 0.119 0.182 522 1.253 0.085 0.138 [).195 522 1.613 0.070 0.286 0.379 522 1.283 0.012 0.891 0.935 477 0.963 0.020 3.517 3.816 131 1.090 0.029 5.299 5.956 477 0.913 0.019 3.178 3.429 477 1.709 0.025 0.784 0.866 477 1.726 0.026 0.780 0.864 477 1.735 0,026 0.780 (I.864 477 1.578 0.053 0.419 0.519 477 1.674 0.077 0.273 0.373 477 1.718 0.083 0.251 0.352 477 1.424 0.120 0.095 I1.155 477 1.498 0.317 0,008 0.036 477 1.340 O. 111 O. 101 0.158 477 0.867 0.292 0.004 11.014 477 1.106 0.526 0.000 0.009 477 1.599 0.491 0.000 (I.021 145 1.494 0.076 0.471 (I.641 477 1.200 0.047 0.358 0.432 477 1.119 0.058 0.241 (I.304 283 1.191 0.020 3.838 4.151 522 1.590 0.074 0.256 0.344 374 1.191 0.055 0.419 0.523 374 1.438 0.041 0.647 (I.764 374 1.533 0.077 0.370 0.503 355 1.218 0.160 0.053 0,104 355 1.307 0.357 0.005 0.031 28 0.999 0.151 0.317 0.592 28 1.121 0.178 0.275 0.581 64 1.334 0.236 0.103 0.286 64 1.142 0.100 0.395 0.592 64 1.318 0.169 0.205 0.415 64 1.284 0.165 0.208 0.412 64 1.110 0.136 0.241 0.421 64 1.163 0.173 0.164 0.338 64 1.124 0.105 0.364 0.558 2109 1.175 0.056 2.930 3.673 817 1.230 0.167 21.794 43.711 817 1.200 0.187 16.076 35.226 817 1.228 0.130 43.184 73.623 821 1.076 0.186 13.765 3(I.088 822 1.250 0. I 15 60.832 97.267 NA=Not applicable 266 Table B.2.14 Sampling errors - North Sumatra r Indonesia 1994 Number of cases Standard Design Relative Confidence limits Value error Unweigbted Weighted effect error Variable (R) (SE) IN) (WN) (DEFT) (SF./R) R-2SE R+2SE Urban residence 0.317 0.031 1174 No education 0.037 0.009 1174 With secondary education or higher 0.402 0.029 I 174 Currently married (in union) 0.950 0.007 1174 Children ever born 3.742 0.107 1115 Children ever born to women over 40 5.717 0.197 253 Children surviving 3.323 0.088 1115 Knowing any contraceptive method 0.930 0.013 1115 Knowing any modern method 0.929 0.013 1115 Knowing source for contraceptive method 0.920 0.015 1115 Ever used any contraceptive method 0.640 0.019 1115 Currently using any method 0.470 0.021 1115 Currently using a modern method 0.402 0.023 1115 Currently using pill 0.139 0.018 1115 Currently using IUD 0.080 0.016 1115 Currently using injections 0.097 0.009 1115 Currently using condom 0.013 0.004 1115 Currently using female sterilization 0.051 0.007 1115 Currently using Norplant 0.021 0.005 1115 Using public sector source 0.504 0.048 463 Want no more children 0.473 0.017 1115 Want to delay at least 2 years 0.257 0.015 1115 Ideal number of children 3.757 0.078 983 Knowledge of AIDS 0.485 0.027 1174 Mothers received tetanus injection 0.480 0.031 1039 Mothers received medical antenatal care 0.806 0.030 1039 Mothers received medical care at birth 0.657 0.044 1039 Had diarrhea in the last 2 weeks 0.131 0.010 961 Had diarrhea in the last 24 hours 0.022 0.005 961 Treated with ORS packets 0.249 0.048 122 Consulted medical personnel 0.449 0.049 122 Having health card 0.319 0.043 183 Received BCG vaccination 0.689 0.048 183 Received DPT vaccination (3 doses) 0.505 0.044 183 Received polio vaccination (3 doses) 0.533 0.044 183 Received measles vaccination 0.494 0.049 183 Fully immunized 0.408 0.043 183 Not immunized 0.275 0.049 183 Total fertility rate (3 years) 3.882 0.185 NA Neonatal mortality rate (0-9 years) 37.946 5.862 2145 Posmeonatal mortality rate (0-9 years) 23.459 3.920 2146 Infant mortality rate (0-9 years) 61.405 8.208 2146 Child mortality rate (0-9 years) 37.771 5.685 2159 Under-five mortality rate (0-9 years) 96.857 10.621 2160 1446 2.259 0.097 0.255 0.378 1446 1.584 0.237 0.019 0.054 1446 2.023 0.072 0.345 0.460 1446 1.047 0.007 0.936 0.963 1373 1.415 0.029 3.528 3.957 307 1.168 0.034 5.323 6.110 1373 1.374 0.026 3.148 3.499 1373 1.738 0.014 0.903 0.956 1373 1.736 0.014 0.902 0.956 1373 1.858 0.016 0.889 0.950 1373 1.348 0.030 0.602 0.679 1373 1.437 0.046 0.427 0.513 1373 1.561 0.057 0.356 0.448 1373 1.758 0.131 0.102 0.175 1373 1.915 0.195 0.049 0.111 1373 1.016 0.093 0.079 0.115 1373 1.249 0.330 0.004 0.021 1373 1.032 0.133 0.037 0.065 1373 1.173 0.242 0.011 0.031 561 2.065 0.095 0.408 0.600 1373 1.128 0.036 0.439 0.507 1373 1.183 0.060 0.226 0.288 1205 1.619 0.021 3.601 3.914 1446 1.846 0.055 0.432 0.539 1298 1.590 0.064 0.418 0.542 1298 1.880 0.037 0.746 0.866 1298 2.311 0.067 0.569 0.745 1202 0.913 0.079 0.110 0.152 1202 1.036 0.222 0.012 0.032 157 1.218 0.192 0.154 0.345 157 1.048 0.109 0.351 0.547 232 1.266 0.136 0.232 0.406 232 1.372 0.070 0.593 0.785 232 1,183 0.087 0.416 0.593 232 1.170 0.082 0.446 0.620 232 1.303 0.098 0.397 0.591 232 1.185 0.106 0.322 0.494 232 1.457 0.180 0.176 0.374 6161 1.041 0.048 3.512 4.251 2651 1.146 0.154 26.222 49.669 2652 1.116 0.167 15.619 31.300 2652 1.305 0.134 44.988 77.821 2666 1.237 0.151 26.401 49.141 2667 1.448 0.110 75.616 118.098 NA = Not applicable 267 Table B.2.15 Sampling errors - West Sumatra~ Indonesia 1994 Number of cases Standard Design Relative Confidence limits Value error Unweighted Weighted effect error Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE Urban residence 0.154 0.019 No education 0.039 0.012 With secondary education or higher 0.419 0.031 Currently married (in union) 0.920 0.012 Children ever born 3.492 0.106 Children ever born to women over 40 5.358 0.220 Children surviving 3.065 0.095 Knowing any contraceptive method 0.972 0.010 Knowing any modern method 0.972 0.010 Knowing source for contraceptive method 0.956 0.011 Ever used any contraceptive method 0.667 0.035 Currently using any method 0.442 0.029 Currently using a modern method 0.411 0.029 Currently using pill 0.064 0.010 Currently using IUD 0.140 0.019 Currently using injections 0.144 0.016 Currently using condom 0.007 0.003 Currently using female sterilization 0.026 0.004 Currently using Norplant 0,031 0.011 Using public sector source 0.539 0.026 Want no more children 0.453 0.022 Want to delay at least 2 years 0,249 0.020 Ideal number of children 3.506 0.076 Knowledge of AIDS 0.382 0.028 Mothers received tetanus injection 0.562 0.046 Mothers received medical antenatal care 0.905 0.024 Mothers received medical care at birth 0.736 0.040 Had diarrhea in the last 2 weeks 0,123 0.014 Had diarrhea in the last 24 hours 0.035 0.007 Treated with ORS packets 0.560 0.066 Consulted medical personnel 0.545 0.078 Having health card 0.202 0.030 Received BCG vaccination 0.770 0.050 Received DPT vaccination (3 doses) 0.420 0.047 Received polio vaccination (3 doses) 0.402 0.051 Received measles vaccination 0.476 0.064 Fully immunized 0.284 0.052 Not immunized 0.201 0.045 Total fertility rate (3 years) 3.191 0.204 Neonatal mortality rate (0-9 years) 27.526 4.364 Postneonatal mortality rate (0-9 years) 40.043 9.199 Infant mortality rate (0-9 years) 67.569 9.777 Child mortality rate (0-9 years) 32.494 9.817 Under-five mortality rate (0-9 years) 97.867 13.257 870 531 1.525 0.121 0.117 11.192 870 531 1.893 0.320 0.014 0.063 870 531 1.871 0.075 0.356 11.481 870 531 1.287 0.013 0.897 11.944 801 489 1.221 0,030 3.279 3.705 195 119 1.188 0.041 4.918 5.798 801 489 1.301 0.031 2.875 3.256 801 489 1.690 0.010 0.952 0.992 801 489 1.690 0.010 0,952 11.992 801 489 1.555 0.012 0.933 11.978 801 489 2.093 0.052 0.598 0.737 801 489 1.663 0.066 0.384 0.501 801 489 1.669 0.071 0.353 0.470 801 489 1.103 0.149 0,045 0.083 801 489 1.518 0.133 0.102 11.177 801 489 1.283 0.110 0.112 11.176 801 489 1.006 0.433 0,001 /I.013 801 489 0.788 0.171 0.017 (}.035 801 489 1.871 0.371 0.008 11.054 336 202 0.971 0.049 0.486 (}.592 801 489 1.273 0.049 0.408 11.498 801 489 1.308 0.080 0.209 /I.289 683 418 1,440 0.022 3.354 3.658 870 531 1.723 0.074 0.325 0.439 596 366 1.903 0.081 0.471 0.654 596 366 1,658 0.026 0.857 0.953 596 366 1.872 0.055 0.656 0.817 550 336 0.933 0.111 0.095 /I.150 550 336 0.807 0.199 0.021 0.048 66 41 1.048 0.118 0.427 11.693 66 41 1.282 0.142 0.390 0.700 107 65 0.778 0.150 0.142 0.263 107 65 1.226 0.065 0.670 (}.870 107 65 1.000 0.113 0.325 0.515 107 65 1.066 0.127 0.300 0.504 107 65 1.343 0.135 0.347 (}.605 107 65 1.189 0.181 0181 0,387 107 65 1.150 0.222 0.112 0.290 NA 2265 1.324 0.064 2.784 3 598 1279 786 0.938 0.159 18.799 36.253 1282 788 1.470 0.230 21.645 58.441 1282 788 1.310 0.145 48.014 87.124 1289 792 1.635 0.302 12.860 5:!.128 1292 794 1.407 0.135 71.353 124.382 NA = Not applicable 268 Table B.2.16 Sampling errors - South Sumatra~ Indonesia 1994 Numberofc~es St~dard Design Relative Confidence limits Value error Unweighted Weighted effect error Variable (R) (SE) (N) (WN) (DEFT) /SE/R) R-2SE R+2SE Urban residence 0.253 0.012 No education 0.120 0.014 With secondary education or higher 0.272 0.032 Currently married (in union) 0.936 0.009 Children ever born 3.416 0.077 Children ever born to women over 40 5.495 0.142 Children surviving 3.037 0.074 Knowing any contraceptive method 0.966 0.006 Knowing any modern method 0.966 0.006 Knowing source for contraceptive method 0.963 0.006 Ever used any contraceptive method 0.698 0.026 Currently using any method 0.529 0,021 Currently using a modern method 0.501 0.020 Currently using pill 0.196 0,019 Curren0y using IUD 0.049 0.009 Currently using injections 0.109 0.011 Currently using condom 0.013 0.005 Currently using female sterilization 0.030 0.007 Currently using Norplant 0.100 0.016 Using public sector source 0.504 0.033 Want no more children 0.487 0.018 Want to delay at least 2 years 0.210 0.014 Ideal number of children 3.188 0.060 Knowledge of AIDS 0.352 0.03 I Mothers received tetanus injection 0566 0.030 Mothers received medical antenatal care 0.797 0.025 Mothers received medical care at birth 0.509 0.043 Had diarrhea in the last 2 weeks 0.070 0.012 Had diarrhea in the last 24 hours 0.012 0.005 Treated with ORS packets 0.486 0,069 Consulted medical personnel 0.661 0,068 Having health card 0.496 0.05 I Received BCG vaccination 0.787 0.042 Received DPT vaccination 13 doses) 0.597 0,053 Received polio vaccination (3 doses) 0.649 0.055 Received measles vaccination 0.676 0.053 Fully immunized 0.562 0.047 Not immunized 0.195 0.050 Total fertility rate (3 years) 2.870 0.156 Neonatal mortality rate (0-9 years) 25.755 4.735 Postneonatal mortality rate (0 9 years) 33.817 5.864 Infant mortality rate (0-9 years) 59.571 7.74 l Child mortality rate (0-9 years) 34.505 7.815 Under-five mortality rate (0-9 years) 92.021 10.495 1050 900 0.900 0.048 0.228 0.277 1050 900 1,407 0.117 0.092 0.149 1050 900 2.360 0.119 0.207 0.337 1050 900 1.129 0.009 0.919 0.953 985 843 1.006 0.022 3.262 3.569 247 210 0.889 0.026 5.212 5.778 985 843 1.097 0.024 2.889 3.185 985 843 1.102 0.007 0.953 0.979 985 843 1.102 0.007 0.953 0.979 985 843 1.043 0.006 0.951 0.976 985 843 1.752 0.037 0.647 0.750 985 843 1,348 0,041 0.486 0.572 985 843 1.264 0.040 0.461 0.541 985 843 1,528 0,099 0.157 0.234 985 843 1.369 0.193 0.030 0.067 985 843 1.I35 0.103 0.087 0.132 985 843 1.324 0.371 0.003 0.022 985 843 1.277 0.230 0.016 0.044 985 843 1.663 0.159 0.068 0.132 490 424 1,455 0,065 0.438 0.570 985 843 1.155 0.038 0.450 0.524 985 843 1.092 0.067 0.182 0.239 675 574 1.469 0.019 3.067 3.309 1050 900 2.124 0.089 0.290 0.415 655 563 1.356 0.053 0.506 0.627 655 563 1.368 0.031 0.747 0.847 655 563 1.887 0.084 0.423 0.595 605 521 1.195 0.177 0.045 0.094 605 521 1.175 0.435 0.002 0.022 44 36 0.891 0.141 0.349 0.623 44 36 0.934 0.103 0.525 0.797 113 98 1.099 (h 104 0.393 0.599 113 98 1.104 0.054 0.702 0.872 113 98 1.152 0.089 0.491 0.702 113 98 1.225 0.084 0.539 0.758 113 98 1.204 0.078 0.571 0.782 113 98 1.012 0.084 0.468 0.656 I 13 98 1.347 0.256 0.095 0.294 NA 3529 1.186 0.054 2.558 3.181 1446 1241 0.970 0.184 16.284 35.225 1447 1242 1.105 0.173 22.090 45.544 1447 1242 1.091 0.130 44,089 75.053 1458 1252 1.443 0.227 18.874 50.136 1459 1252 1.235 0.114 71.031 113.011 NA = Not applicable 269 Table B.2.17 Sampl ing errors - Lampung; Indonesia 1994 Number of cases Standard Design Relative Confidence limits Value error Unweighted Weighted effect error Variable (R) (SE) IN) (WN) (DEFT) (SE/R) R-2SE R+2SE Urban residence 0.079 0.016 975 No education 0.128 0.013 975 With secondary education or higher 0.185 0.022 975 Currently married (in union) 0.961 0.008 975 Children ever born 3.293 0.114 937 Children ever born to women over 40 5.470 0.207 191 Children surviving 2.998 0.108 937 Knowing any contraceptive method 0.993 0.002 937 Knowing any modern method 0.993 0.002 937 Knowing source for contraceptive method 0.990 0.003 937 Ever used any contraceptive method 0.811 0.016 937 Currently using any method 0.593 0.024 937 Currently using a modern method 0.579 0.023 937 Currently using pill 0.289 0.020 937 Currently using IUD 0.095 0.017 937 Currently using injections 0.136 0.015 937 Currently using condom 0.005 0.002 937 Currently using female sterilization 0.018 0.004 937 Currently using Norplant 0.027 0.007 937 Using public sector source 0.425 0.034 542 Want no more children 0.516 0.025 937 Want to delay at least 2 years 0.209 0.019 937 Ideal number of children 3.017 0.049 676 Knowledge of AIDS 0.231 0.029 975 Mothers received tetanus injection 0.638 0.039 660 Mothers received medical antenatal care 0.816 0.031 660 Mothers received medical care at birth 0.300 0.041 660 Had diarrhea in the last 2 weeks 0.081 0.011 632 Had dianhea in the last 24 hours 0.023 0.007 632 Treated with ORS packets 0.573 0.061 52 Consulted medical personnel 0.418 0.075 52 Having health card 0.406 0.040 109 Received BCG vaccination 0.745 0.044 109 Received DPT vaccination (3 doses) 0.588 0.053 109 Received polio vaccination (3 doses) 0.616 0.050 109 Received measles vaccination 0.573 0.050 109 Fully immunized 0.481 0.055 109 Not immunized 0.224 0.045 109 Total fertility rate (3 years) 3.447 0.198 NA Neonatal mortality rate (0-9 years) 13.304 3.073 1412 Posmconatal mortality rate (0-9 years) 24.837 4.638 1413 Infant mortality rate (0-9 years) 38.141 5.576 1414 Child mortality rate (0-9 years) 20.246 4.023 1417 Under-five mortality rate (0-9 years) 57.615 7.540 1420 834 1.832 0.200 0.047 0.111 834 1.218 0.102 0.102 11.154 834 1.736 0.117 0.141 11.228 834 1.261 0.008 0.945 0.976 801 1.525 0.035 3.065 3.520 165 1.126 0.038 5.057 5.883 801 1.648 0,036 2.781 3.214 801 0.825 0.002 0.989 0.998 801 0.825 0.002 0.989 0.998 801 0.877 0.003 0.985 0.996 801 1.213 0.019 0.780 0.842 801 1.476 0.040 0.545 0.640 801 1.422 0.040 0.534 II.625 801 1.320 0.068 0.250 0.329 801 1.726 0.174 0.062 0.128 801 1.374 0.113 0.105 11.167 801 0.904 0.436 0.001 I).009 801 0.991 0.242 0.009 11.026 801 1.332 0.263 0.013 0.041 464 1.616 0.081 0.356 11.493 801 1.517 0.048 0.466 I).565 801 1.427 0.091 0.171 0.247 574 1.200 0.016 2.919 3.114 834 2.126 0.124 0.174 0.289 563 1.771 0.061 0.561 0.716 563 1.725 0.038 0.754 11.878 563 1.959 0.135 0.219 0.381 537 0.949 0.134 0.059 0.103 537 1.224 0.318 0.008 0.038 44 0.850 0.107 0.450 [).695 44 1.023 0.179 0.268 0.567 93 0.842 0.098 0.327 0.485 93 1.041 0.058 0.658 [).832 93 1.130 0.091 0.482 [).695 93 1.075 0.082 0.515 [).716 93 1.046 0.087 0.474 0.672 93 1.148 0.114 0.371 0.591 93 1127 0.201 0.134 0.314 2988 I. 118 0.057 3.051 3.843 1208 0.848 0.231 7.158 19.449 1209 1075 0.187 15.561 34.114 1210 0.950 0.146 26.990 49.293 1213 1.033 0.199 12.199 28.293 1216 1.058 0.131 42.534 712.695 NA = Not applicable 270 Table B.2.18 Sampling errors - West Nusa Tenggara~ Indonesia 1994 Number of cases Standard Design Relative Confidence limits Value error Unweighted Weighted effect error variable (R) (SE) (N/ (WN) (DEFT) (SE /R) R-2SE R+2SE Urban residence 0.149 0.015 No education 0.377 0.029 With secondary education or higher 0.196 0.020 Currently married (in union) 0.889 0.013 Children ever born 3.600 0.080 Children ever born to women over 40 6.278 0.206 Children surviving 2.852 0.065 Knowing any contraceptive method 0.993 0.003 Knowing any modern method 0.990 0.004 Knowing source for contraceptive method 0.985 0.005 Ever used any contraceptive method 0.735 0.024 Currently using any method 0.498 0.026 Currently using a modern method 0.479 0.026 Currently using pill 0.178 0.022 Currently using IUD 0.108 0.017 Currently using injections 0.097 0.011 Currently using condom 0.001 0.001 Currently using female sterilization 0.011 0.005 Currently using Norplant 0.084 0.012 Using public sector source 0.621 0.039 Want no more children 0.387 0.018 Want to delay at least 2 years 0.335 0.016 Ideal number of children 3.360 0.082 Knowledge of AIDS 0.199 0.023 Mothers received tetanus injection 0.483 0.033 Mothers received medical antenatal care 0.712 0.034 Mothers received medical care at birth 0.161 0.028 Had diarrhea in the last 2 weeks 0.153 0.020 Had diarrhea in the last 24 hours 0.054 0.007 Treated with ORS packets 0.559 0.048 Consulted medical personnel 0.526 0.053 Having health card 0.293 0.055 Received BCG vaccination 0.811 0.045 Received DPT vaccination (3 doses) 0.537 0.064 Received polio vaccination (3 doses) 0.462 0.057 Received measles vaccination 0.640 0.063 Fully immunized 0.380 0.065 Not immunized 0.176 0.043 Total fertility rate (3 years) 3.640 0.204 Neonatal mortality rate (0-9 years) 46.005 6.508 Postneonatal mortality rate (0-9 years) 63.787 8.102 Infant mortality rate (0-9 years) 109.793 I 1.314 Child mortality rate (0-9 years) 55.856 8.203 Under-five mortality rate (0-9 years) 159.516 14.948 967 527 1.328 0.102 0.118 0.179 967 527 1.831 0.076 0.320 0.435 967 527 1.595 0.104 0.156 0.237 967 527 1.284 0.015 0.863 0.915 860 469 0.938 0.022 3.441 3.759 167 91 1.079 0.033 5.866 6.690 860 469 1.006 0.023 2.722 2.983 860 469 1.015 0.003 0.987 0.999 860 469 1.232 0.004 0.982 0.998 860 469 1.264 0.005 0.975 0.996 860 469 1.627 0.033 0.686 0.784 860 469 1.525 0.052 0.446 0.550 860 469 1.547 0.055 0.427 0.532 860 469 1.709 0.125 0.133 0.223 860 469 1.574 0.154 0.075 0.142 860 469 1.133 0.118 0.074 0.120 860 469 1.032 0.992 0.000 0.004 860 469 1.358 0.449 0.001 0.020 860 469 1.229 0.139 0.060 0.107 419 225 1.625 0.062 0.544 0.698 860 469 1.057 0.045 0.351 0.422 860 469 0.972 0.047 0.304 0.366 689 372 1.353 0.025 3.195 3.525 967 527 1.804 0.116 0.153 0.245 720 399 1.526 0.068 0.417 0.548 720 399 1.674 0.048 0.644 0.780 720 399 1.792 0.174 0.105 0.217 645 357 1.424 0.130 0.113 0.192 645 357 0.850 0.137 0.039 0.069 101 54 0.966 0.086 0.463 0.656 101 54 1.048 0.100 0.421 0.632 119 66 1.305 0.188 0.183 0.403 119 66 1.258 0.055 0.721 0.901 119 66 1.404 0.119 0.409 0.665 119 66 1.257 0.124 0.347 0.577 I 19 66 1.449 0.099 0.513 0.767 119 66 1.446 0.170 0.251 0.509 119 66 1.232 0.242 0.091 0.262 NA 1993 1.325 0.056 3.233 4.047 1551 853 1.094 0.141 32.989 59.022 1558 857 1.187 0.127 47.584 79.990 1559 857 1.321 0.103 87.164 132.422 1569 864 1.312 0.147 39.451 72.262 1578 869 1.480 0.094 129.621 189.412 NA = Not applicable 271 Table B.2.19 Sampling errors - West Kalimantan, Indonesia 1994 Number of cases Standard Design Relative Confidence limits Value error Unweighted Weighted effect error Variable /R) (SE) IN) (WN/ (DEFT) (SFJR) R-2SE R+2SE Urban residence 0.189 0.020 1055 No education 0.322 0.026 1055 With secondary education or higher 0.227 0.028 1055 Currently married (in union) 0.943 0.010 1055 Children ever born 3.488 0.098 992 Children ever born to women over 40 5.858 0.201 225 Children surviving 2.940 0.072 992 Knowing any contraceptive method 0.950 0.014 992 Knowing any modern method 0.946 0.015 992 Knowing source for contraceptive method 0.942 0.015 992 Ever used any contraceptive method 0.729 0.028 992 Currently using any method 0.506 0.028 992 Currently using a modern method 0.495 0.028 992 Currently using pill 0.252 0.027 992 Currently using 1UD 0.050 0.010 992 Currently using injections 0.150 0.015 992 Currently using condom 0.013 0.006 992 Currently using female sterilization 0.010 0.003 992 Currently using Norplant 0.016 0.006 992 Using public sector source 0.543 0.049 487 Want no more children 0.455 0.016 992 Want to delay at least 2 years 0.225 0,017 992 Ideal number of children 3.232 0.081 712 Knowledge of AIDS 0.344 0.028 1055 Mothers received tetanus injection 0.582 0.030 756 Mothers received medical antenatal care 0.756 0.028 756 Mothers received medical care at birth 0.360 0.033 756 Had diarrhea in the last 2 weeks 0.144 0.017 679 Had diarrhea in the last 24 hours 0.034 0.008 679 Treated with ORS packets 0.456 0.071 98 Consulted medical personnel 0,448 0.067 98 Having health card 0.301 0.046 127 Received BCG vaccination 0,682 0.050 127 Received DPT vaccination (3 doses) 0,488 0.046 127 Received polio vaccination (3 doses) 0.466 0.049 127 Received measles vaccination 0.507 0,046 127 Fully immunized 0.415 0.047 127 Not immunized 0.261 0.045 127 Total fertility rate (3 years) 3.341 0.155 NA Neonatal mortality rate (0-9 years) 42.900 5.474 1649 Postneonatal mortality rate (0-9 years) 53.932 8.455 1651 Infant mortality rate (0-9 years) 96.832 11.949 1651 Child mortality rate (0-9 years) 42.255 8.893 1664 Under-five mortality rate (0-9 years) 134.996 17.464 1666 519 1.639 0.105 0.149 0.229 519 1.816 0.081 0.270 0.374 519 2.133 0.121 0.172 0.282 519 1.344 0.010 0.924 0.962 489 1.235 0.028 3.292 :3.685 106 1.168 0.034 5.456 6.260 489 1.098 0.025 2.795 13.084 489 1.962 0.014 0.922 I).977 489 2.060 0.016 0.916 0.975 489 2.081 0.016 0.911 0.973 489 2.013 0.039 0.673 0.786 489 1.763 0.055 0.450 0.562 489 1.766 0.057 0.438 0.551 489 1.967 0.108 0.197 0.306 489 1.456 0.201 0.030 0.070 489 1.286 0.097 0.121 0.179 489 1.768 0.486 0.000 0.026 489 0.995 0.316 0.004 0.016 489 1.443 0.355 0.005 0.028 243 2.173 0.090 0.445 0.641 489 1.029 0.036 0.423 0488 489 1304 0.077 0.190 0.260 356 1.546 0.025 3.070 3.394 519 1.881 0.080 0.289 0.399 379 1.413 0.051 0.522 0.642 379 1.545 0.038 0.699 0.813 379 1.635 0.093 0.293 0.427 342 1.206 0.116 0.111 0.178 342 1.124 0.245 0.017 0.050 49 1.364 0.155 0.315 0.597 49 1.302 0.150 0.313 0.583 63 1.141 11154 0.208 0.393 63 1219 0074 0.582 0.783 63 1.045 0.095 0.396 0.581 63 IdOl 0.104 0.369 0.563 63 1.042 0.091 0.415 0.599 63 1071 0.112 0.322 0.509 63 1.167 0.174 0.170 0.351 1965 1.149 0.046 3.032 3.651 820 1.133 0.128 31.952 53.848 820 1.436 0.157 37.022 70.842 820 1.500 0.123 72.933 120.731 829 1752 0.210 24.470 60.041 829 1.926 0.129 100,068 169.924 NA = Not applicable 272 Table B.2.20 Sampling errors - South Kalimantan~ Indonesia 1994 Number of cases Standard Design Relative Confidence limits Value error Unweighted Weighted effect error Variable (R) (SE) (N) (WN) (DEFT) ISE /R) R-2SE R+2SE Urban residence 0.264 0.017 No education 0.107 0.013 With secondary education or higher 0.279 0.024 Currently married (in union) 0.890 0.009 Children ever born 3.024 0.099 Children ever born to women over 40 4.851 0.215 Children surviving 2.577 0.065 Knowing any contraceptive method 0.986 0.004 Knowing any modern method 0.985 0.003 Knowing source for contraceptive method 0.975 0.004 Ever used any contraceptive method 0.737 0.026 Currently using any method 0.547 0.025 Currently using a modern method 0.512 0.025 Currently using pill 0.339 0.019 Currently using IUD 0.030 0.007 Currently using ir~iections 0.076 0.010 Currently using condom 0.007 0.003 Currently using female sterilization 0.031 0.008 Currently using Norplant 0.028 0.009 Using public sector source 0.463 0.035 Want no more children 0.439 0.019 Want to delay at least 2 years 0.240 0.019 Ideal number of children 2.969 0.082 Knowledge of AIDS 0.379 0.027 Mothers received tetanus injection 0.587 0.036 Mothers received medical antenatal care 0.746 0.034 Mothers received medical care at birth 0.420 0.039 Had diarrhea in the last 2 weeks 0.129 0.016 Had diarrhea in the last 24 hours 0.014 0.006 Treated with ORS packets 0.430 0.070 Consulted medical personnel 0.458 0.061 Having health card 0.393 0.052 Received BCG vaccination 0.809 0.048 Received DPT vaccination (3 doses) 0.518 0.073 Received polio vaccination (3 doses) 0.569 0.073 Received measles vaccination 0.646 0.059 Fully immunized 0.482 0.072 Not immunized 0.168 0.046 Total t~rtility rate (3 years) 2.327 0.120 Neonatal mortality rate (0-9 years) 41.572 7.943 Postneonatal mortality rate (0-9 years) 41.372 8.127 Infant mortality rate (0-9 years) 82.944 9.529 Child mortality rate (0-9 years) 30.633 5.982 Under-five mortality rate (0-9 years) 111.036 11.642 1047 447 1.219 0.063 0.230 0.297 1047 447 1.395 0.124 0.081 0.134 1047 447 1.742 0.086 0.231 0.328 1047 447 0.957 0.010 0.872 0.909 930 398 1.301 0.033 2.827 3.221 218 94 1.220 0.044 4.420 5.281 930 398 1.046 0.025 2.446 2.708 930 398 0.942 0.004 0.978 0.993 930 398 0.830 0.003 0.978 0.992 930 398 0.884 0.005 0.966 0.984 930 398 1.777 0.035 0.685 0.788 930 398 1.508 0.045 0.498 0.597 930 398 1.534 0.049 0.461 0.562 930 398 1.205 0.055 0.301 0.376 930 398 1.283 0.238 0.016 0.045 930 398 1.112 0.127 0.056 0.095 930 398 1.122 0.425 0.001 0.014 930 398 1.348 0.249 0.015 0.046 930 398 1.625 0.315 0.010 0.045 474 204 1.513 0.075 0.394 0.533 930 398 1.191 0.044 0.400 0.478 930 398 1.386 0.081 0.201 0.279 638 278 1.381 0.027 2.805 3.132 1047 447 1.777 0.070 0.326 0.432 524 225 1.519 0.062 0.515 0.660 524 225 1.590 0.046 0.678 0.815 524 225 1.634 0.093 0.342 0.498 485 209 0.968 0.120 0.098 0.160 485 209 1.149 0.439 0.002 0.026 64 27 1.039 0.162 0.291 0.570 64 27 0.914 0.134 0.335 0.581 84 36 0.967 0.133 0.288 0.498 84 36 1.116 0.059 0.714 0.905 84 36 1.322 0.140 0.373 0.664 84 36 1.339 0.128 0.423 0.715 84 36 1.120 0.091 0.528 0.763 84 36 1.314 0.150 0.337 0.626 84 36 1.136 0.275 0.076 0.261 NA 1695 0.965 0.052 2.086 2.568 1168 496 1.148 0.191 25.687 57.457 1170 497 1.251 0.196 25.119 57.626 1170 497 1.044 0.115 63.887 102.001 1181 502 1.039 0.195 18.668 42.597 1183 503 I.I16 0.105 87.752 134.321 NA = Not applicable 273 Table B.2.21 Sampling errors - North Sulawesi~ Indonesia 1994 Number of cases Standard Design Relative Confidence thnits Value error Unweighted Weighted effect error Variable (R) (SE) (N) (WN) (DEFT) (SFJR) R-2SE R+2SE Urban residence 0.225 0.023 No education 0.024 0.006 With secondary education or higher 0.461 0.027 Currently married (in union) 0.955 0.008 Children ever born 2.802 0.083 Children ever born to women over 40 4.346 0.243 Children surviving 2.506 0.081 Knowing any contraceptive method 0.988 0.005 Knowing any modern method 0.988 0.005 Knowing source for contraceptive method 0.983 0.005 Ever used any contraceptive method 0.911 0.010 Currently using any method 0.725 0.023 Currently using a modern method 0.691 0.023 Currently using pill 0.215 0.021 Currently using IUD 0.214 0.024 Currently using injections 0.187 0.014 Currently using condom 0.000 0.000 Currently using female sterilization 0.026 0.007 Currently using Norplant 0.047 0.014 Using public sector source 0.496 0.032 Want no more children 0.566 0.020 Want to delay at least 2 years 0.146 0.017 Ideal number of children 2.425 0.037 Knowledge of AIDS 0.550 0.033 Mothers received tetanus injection 0.814 0.017 Mothers received medical antenatal care 0.922 0.014 Mothers received medical care at birth 0.543 0.033 Had diarrhea in the last 2 weeks 0.132 0.015 Had diarrhea in the last 24 hours 0.021 0.006 Treated with ORS packets 0.632 0.068 Consulted medical personnel 0.630 0.079 Having health card 0.376 0.049 Received BCG vaccination 0.863 0.027 Received DPT vaccination (3 doses) 0.702 0.044 Received polio vaccination (3 doses) 0.735 0.043 Received measles vaccination 0.781 0.034 Fully immunized 0.646 0.051 Not immunized 0.126 0.026 Total fertility rate (3 years) 2.625 0.245 Neonatal mortality rate (0-9 years) 20.681 4.412 Posmeonatal mortality rate (0-9 years) 44.964 8.498 Infant mortality rate (0-9 years) 65.644 10.477 Child mortality rate (0-9 years) 18.285 5.374 Under-five mortality rate (0-9 years) 82.729 12.255 830 333 1.579 0.102 0.179 0.271 830 333 1.095 0.244 0.012 0.035 830 333 1.555 0.058 0407 0.515 830 333 1.045 0.008 0.940 0.970 792 318 1.211 0.030 2.636 2.969 189 77 1.400 0.056 3.860 4.831 792 318 1.377 0.032 2.344 2.667 792 318 1.220 0.005 0.978 0.997 792 318 1.220 0.005 0.978 0.997 792 318 1.091 0.005 0.973 0.993 792 318 1.013 0.011 0.891 0.932 792 318 1.440 0.032 0.680 0.771 792 318 1.400 0.033 0.645 0.737 792 318 1.433 0.097 0.173 0.257 792 318 1.657 0.113 0.166 0.263 792 318 0.987 0.073 0.160 0.215 792 318 Und Und 0.000 0.000 792 318 1.175 0.257 0.012 0.039 792 318 1.878 0.300 0.019 0.075 553 220 1.516 0.065 0.432 0.561 792 318 1.111 0.035 0.526 0.605 792 318 1.322 0.114 0.113 0.179 636 255 1.109 0.015 2.351 2.499 830 333 1.933 0.061 0.483 0.617 498 203 0.869 0.021 0.779 0.849 498 203 0.961 0.015 0.895 0.949 498 203 1.289 0.060 0.478 0.609 466 189 0.904 0.114 0.102 0.162 466 189 0.936 0.288 0.009 0.034 59 25 1.122 0.108 0.496 0.768 59 25 1.148 0.126 0.472 0.789 101 40 1.000 0.129 0,278 0.473 101 40 0.783 0.031 0.810 0.917 101 40 0.962 0.063 0.613 0.790 101 40 0.965 0.058 0.650 0820 101 40 0.815 0.043 0.714 0.849 101 40 1.056 0.078 0.545 0.748 101 40 0.780 0.206 0.074 0.177 NA 1372 1.362 0.093 2.135 3.115 983 397 0.943 0.213 11.856 29.505 987 398 1.121 0.189 27.967 61.960 987 398 1.194 0.160 44.690 86,599 985 397 1.212 0.294 7.538 29.032 989 399 1.257 0.148 58.220 107.238 NA = Not applicable Und = Undefined 274 Table B.2.22 Sampling errors - South Sulawesi r Indonesia 1994 Number of c~es Standard Design Relative Confidence limits Value error Unweighted Weighted effect error Variable (R) (SE) (N) (WN) (DEFT) (SEIR) R-2SE R+2SE Urban residence 0.228 0.013 No education 0.195 0.021 With secondary education or higher 0.274 0.030 Currently married (in union) 0.917 0.008 Children ever born 3.563 0.112 Children ever born to women over 40 5.521 0.223 Children surviving 3.188 0.089 Knowing any contraceptive method 0.914 0.010 Knowing any modern method 0.910 0.011 Knowing source for contraceptive method 0.894 0.012 Ever used any contraceptive method 0.600 0.021 Currently using any method 0.426 0.020 Currently using a modern method 0.352 0.020 Currently using pill 0.165 0.015 Currently using IUD 0.031 0.008 Currently using injections 0.117 0.012 Currendy using condom 0.004 0.001 Currently using female sterilization 0.013 0.003 Currently using Norplant 0.021 0.005 Using public sector source 0.621 0.029 Want no more children 0.430 0,017 Want to delay at least 2 years 0.242 0.015 Ideal number of children 3.427 0.079 Knowledge of AIDS 0.254 0.024 Mothers received tetanus injection 0.641 0.036 Mothers received medical antenatal care 0.781 0.036 Mothers received medical care at birth 0.409 0.037 Had diarrhea in the last 2 weeks 0.106 0.013 Had diarrhea in the last 24 hours 0.023 0.006 Treated with ORS packets 0.447 0.07 I Consulted medical personnel 0.567 0.064 Having health card 0.311 0.046 Received BCG vaccination 0.765 0.050 Received DPT vaccination (3 doses) 0.610 0.054 Received polio vaccination (3 doses) 0.603 0.056 Received measles vaccination 0.562 0.047 Fully immunized 0.509 0.05 I Not immunized 0.222 0.05 I Total t~rtility rate (3 years) 2.923 0.158 Neonatal mortality rate (0-9 years) 34.142 5.275 Postneonatal mortality rate (0-9 years) 29.532 4.179 Infant mortality rate (0-9 years) 63.674 6.749 Child mortality rate (0-9 years) 23.628 4.321 Under-five mortality rate (0-9 years) 85.798 8.243 1182 1049 1.075 0.058 0.201 0.254 1182 1049 1.794 0.106 0.154 0.236 1182 1049 2.283 0.108 0.215 11.333 1182 1049 1.028 0.009 0.901 0934 1082 962 1.419 0.031 3.339 3.786 283 251 1.318 0.040 5.076 5.966 1082 962 1.291 0.028 3.011 3.365 1082 962 1.190 0.011 0.893 0.934 1082 962 1.210 0.012 0.888 0.931 1082 962 1.298 0.014 0.870 0,919 1082 962 1.388 0.034 0.559 0.642 1082 962 1.334 0.047 0.386 0.466 1082 962 1.403 0.058 0.311 0.392 1082 962 1.365 0.093 0.134 0.196 1082 962 1.457 0.247 0.016 0.047 1082 962 1.234 0.103 0.093 0.141 1082 962 0.620 0,284 0.002 0.007 1082 962 0.753 0.199 0.008 0.1II8 1082 962 1.058 0,219 0.012 0.030 389 338 1.192 0.047 0.562 11.680 1082 962 1.103 0.039 0.397 0.464 1082 962 1.115 0.060 0213 0.271 785 686 1.425 0.023 3.270 3.584 1182 1049 1.894 0.094 0.206 0.302 805 701 1.779 0.057 0.569 0.714 805 701 2.043 0.046 0.709 0.853 805 701 1.733 0.090 0.335 0.482 751 652 1.109 0,126 0,079 0.133 751 652 1.099 0.276 0.010 0.036 81 69 1.232 0.158 l).306 0.588 81 69 1.139 0.113 0.439 0.695 158 132 1.189 0.149 0.218 0.403 158 132 1.456 0.066 0.664 0.866 158 132 1.353 0.088 0.502 0.7[8 158 132 1.393 0.092 0.492 0.715 158 132 1.153 0.085 0.467 0.657 158 132 1.223 0.100 0.408 0.611 158 132 1.504 0.230 0.120 0.324 NA 4557 1.179 0.054 2,607 3.238 1720 1516 1.109 0.155 23.591 44.692 1723 1518 1.015 0.142 21.174 37.890 1724 1519 1,101 0.106 50.176 77.171 1729 1523 1.147 0.183 14.986 32271 1734 1527 1.138 0.1196 69,312 1112.283 NA = Not applicable 275 Table B.2.23 Sampling errors - Riau T Indonesia 1994 Standard Value error Variable (R) (SE) Numberofc~es Unweighted Weighted IN) (WN) Design Relative Confidence limits effect error (DEFT) (SFJR) ~2SE R+2SI~ Urban residence 0.336 No education 0.172 With secondary education or higher 0.274 Currently married (in union) 0.942 Children ever born 3.579 Children ever born to women over 40 5.597 Children surviving 3.168 Knowing any contraceptive method 0.946 Knowing any modern method 0.944 Knowing source for contraceptive method 0.927 0.023 1046 0.026 1046 0.028 1046 0.006 1046 0.091 981 0.153 242 0.081 981 0.009 981 0.010 981 0.012 981 Ever used any contraceptive method 0.609 0.031 981 Currently using any method 0.410 0.035 981 Currently using a modern method 0.386 0.033 981 Currently using pill 0.180 0.018 981 Currently using IUD 0.045 0.010 981 Currently using injections 0.110 0.018 98 I Currently using condom 0.012 0.005 981 Currently using female sterilization 0.017 0.004 981 Currently using Notplant 0.018 0.004 981 Using public sector source 0.544 0051 380 Want no more children 0.465 0.014 98 I Want to delay at least 2 years 0,190 0.009 981 Ideal number of children 3.464 0.101 661 Knowledge of AIDS 0.423 0.036 1046 Mothers received tetanus injection 0.487 0.043 726 Mothers received medical antenatal care 0.758 0.044 726 Mothers received medical care at birth 0.471 0.039 726 Had diarrhea in the last 2 weeks 0.111 0.014 674 Had diarrhea in the last 24 hours 0.026 0.005 674 Treated with ORS packets 0.540 0.075 73 Consulted medical personnel 0.451 0.046 73 Having health card 0.338 0,069 131 Received BCG vaccination 0.726 0.054 13 I Received DPT vaccination (3 doses) 0.590 0.056 131 Received polio vaccination (3 doses) 0,592 0.058 131 Received measles vaccination 11,612 0.050 131 Fully immunized 0.521 0.050 131 Not immunized 0.254 0.056 131 Total fertility rate (3 ycars) 3 102 0.161 NA Neonatal mortality rate (11-9 years) 44.152 6.054 1578 Postneonatal mortality rate (0-9 years) 27,557 5.845 1581 Infant mortality rate 10 9 years) 71.709 9.072 1581 Child mortality rate (0-9 years) 24.488 6.150 1586 Under-five mortality rate (0-9 years) 94.441 11.771 1589 552 1.602 0.070 0.289 0.382 552 2223 11151 0.120 0.224 552 2.048 0.103 0.217 0.331 552 0 885 0.007 0929 11954 520 1.113 0026 3397 3762 126 0.846 0027 5290 5.903 520 I. 139 0.026 3.006 3.33 I 520 1.302 0010 0.927 0.965 520 1.333 0.010 0.924 0.963 520 1.475 0.013 0,902 11.951 520 2014 0.051 0547 0.672 520 2.208 0.085 0.341 0.479 520 2.132 0.086 0.320 0.453 520 1456 0.099 0144 0.216 520 1.525 0225 0.025 0.065 520 1.7511 0.159 /1075 11.145 520 1.473 0 420 0.(X12 0.023 520 0934 11.228 00119 0.025 520 0992 0232 0010 0.027 202 2002 (1094 0.442 0.647 520 11872 /).1)30 0.437 0492 520 0756 1/11511 0.171 0209 356 1 826 0.029 3.262 3.666 552 2.325 0.084 11.351 0.494 389 1.965 0.087 0.402 0572 389 2.176 0.058 11670 0.845 389 1.716 0082 0394 0.548 361 1.171 0127 03.)83 0.139 361 11841 0.195 0016 0.036 40 1.275 0.138 0.391 /1690 40 0.806 0101 0.360 0.543 69 1,668 11.204 1/.200 0.475 69 1.401 01175 0617 0835 69 1.294 0094 1/.479 0.701 69 1.361 0.098 0.476 1/.709 69 1.165 11.081 0513 11.711 69 1.153 I).096 0421 11.621 69 1467 0219 0143 0.365 2149 1333 0052 2,780 3,423 839 1051 0137 32,/143 56.261 841 1.237 11212 15,868 ~9246 841 1187 0.127 53565 89.853 843 1438 0251 12189 36,788 844 1420 0125 70.900 1175)83 NA = Not applicable 276 Table B.2.24 Sampling errors - Jambi~ Indonesia 1994 Number of cases Standard Design Relative Confidence limits Value error Unweighted Weighted effect error Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE Urban residence 0.191 0.024 893 No education 0.172 0.019 893 With secondary education or higher 0.274 0.023 893 Currently married (in union) 0.943 0.007 893 Children ever born 3.143 0.073 84 I Children ever born to women over 40 4.885 0.225 173 Children surviving 2.852 0.063 841 Knowing any contraceptive method 0.909 0.014 841 Knowing any modern method 0.909 0.014 841 Knowing source for contraceptive method 0.907 0.014 841 Ever used any contraceptive method 0.702 0.028 841 Currently using any method 0.551 0.027 841 Currently using a modern method 0.541 0.025 841 Currently using pill 0.245 0.019 841 Currently using IUD 0.060 0.015 841 Currently using injections 0.137 0.018 841 Currently using condom 0.007 0.003 841 Currently using female sterilization 0.006 0.003 841 Currently using Norplant 0.085 0.015 841 Using public sector source 0.602 0.028 462 Want no more children 0.506 0.021 841 Want to delay at least 2 years 0.221 0.017 841 Ideal number of children 3.244 0.069 74 I Knowledge of AIDS 0.277 0.020 893 Mothers received tetanus injection 0.509 0.038 554 Mothers received medical antenatal care 0.700 0.036 554 Mothers received medical care at birth 0.398 0.038 554 Had diarrhea in the last 2 weeks 0.109 0.017 514 Had diarrhea in the last 24 hours 0.052 0.010 514 Treated with ORS packets 0.448 0.059 57 Consulted medical personnel 0.420 0.053 57 Having health card 0.212 0.044 88 Received BCG vaccination 0.816 0.056 88 Received DPT vaccination (3 doses) 0.634 0.062 88 Received polio vaccination (3 doses) 0.644 0.058 88 Received measles vaccination 0.603 0.054 88 Fully immunized 0.538 0.048 88 Not immunized 0.175 0.056 88 Total fertility rate (3 years) 2.971 0.210 NA Neonatal mortality rate (0-9 years) 35.090 8.128 1241 Postneonatal mortality rate (0-9 years) 25.150 6.170 1240 Infant mortality rate (0-9 years) 60.241 12.883 1241 Child mortality rate (0-9 years) 29.049 10.257 1249 Under-five mortality rate (0-9 years) 87.540 19.542 1250 335 1.793 0.124 0.144 0.238 335 1.525 0.112 0.134 0.211 335 1.509 0.082 0.229 0.319 335 0.839 0.007 0.930 0.956 316 0.935 0.023 2.998 3.289 64 1.063 0.046 4.435 5.334 316 0.936 0.022 2.726 2.978 316 1.460 0.016 0.881 0.938 316 1.460 0.016 0.881 0.938 316 1.440 0.016 0.878 0.935 316 1.757 0.039 0.647 0.758 316 1.546 0.048 0.498 0.604 316 1.471 0.047 0.491 0.592 316 1.305 0.079 0.206 0.283 316 1.854 0.253 0.030 0.090 316 1.477 0.128 0.102 0.172 316 I. 170 0.472 0.000 0.014 316 I . I l l 0.505 0.000 0.012 316 1.545 0.175 0.055 0.115 171 1.232 0.047 0.546 0.658 316 1.208 0.041 0.465 0.548 316 1.155 0.075 0.188 0.254 277 1.512 0.021 3.106 3.383 335 1.309 0.071 0.238 0.317 207 1.548 0.076 0.432 0.586 207 1.520 0.052 0.628 0.773 207 1.521 0.094 0.323 0.474 193 1.280 0.159 0.075 0.144 193 1.068 0.202 0.031 0.072 21 0.886 0.132 0.330 0.565 21 0.801 0.126 0.314 0.526 32 0.990 0.206 I1.124 0.299 32 1.346 0.069 0.703 0.928 32 1.191 0.098 0.510 0.758 32 1.128 0.091 0.527 0.761 32 1.024 0.090 0.494 (I.7 [ 2 32 0.887 0,089 0.442 0.634 32 1.362 0.320 0.063 0.286 1250 1.390 0.071 2.552 3.390 470 1.305 0.232 18.834 51.346 469 1.347 0.245 12 .811 37.490 470 1.666 0.214 34.475 86,006 473 2.054 0.353 8.535 49.563 473 2.093 0.223 48.455 126.625 NA = Not applicable 277 Table B.2.25 Sampling errors - Bengkulu~ Indonesia 1994 Number of cases Standard Design Relative Confidence thnits Value error Unweighted Weighted effect error Variable (R) ISE) (N) (WN) (DEFT) ISE/R) R-2SE R+2SE Urban residence 0.196 0.014 819 No education 0.111 0.018 819 With secondary education or higher 0.325 0.026 819 Currently married (in union) 0.944 0.008 819 Children ever born 3.614 0.120 774 Children ever born to women over 40 6.165 0.180 172 Children surviving 3.019 0.088 774 Knowing any contraceptive method 0.994 0.002 774 Knowing any modern method 0,994 0.002 774 Knowing source for contraceptive method 0.991 0.003 774 Ever used any contraceptive method 0.810 0.017 774 Currently using any method 0.616 0.021 774 Currently using a modern method 0.602 0.022 774 Currently using pill 0.196 0.020 774 Currently using IUD 0.146 0.023 774 Currently using injections 0.120 0.016 774 Currently using condom 0.010 0.004 774 Currently using female sterilization 0.027 0.010 774 Currently using Norplant (I.102 0.024 774 Using public sector source 0.490 0.030 469 Want no more children 0.550 0.021 774 Want to delay at least 2 years 0.268 0.018 774 Ideal number of children 3.244 0.053 674 Knowledge of AIDS 0.293 0.027 819 Mothers received tetanus injection 0.581 0.047 584 Mothers received medical antenatal care 0.740 0.048 584 Mothers received medical care at birth 0.370 0.032 584 Had diarrhea in the last 2 weeks 0.216 0.020 529 Had diarrhea in the last 24 hours 0.069 0.014 529 Treated with ORS packets 0.593 0.045 112 Consulted medical personnel 0.545 0.070 112 Having health card 0.317 0.067 92 Received BCG vaccination 0.798 0.040 92 Received DPT vaccination (3 doses) 0.682 0.052 92 Received polio vaccination (3 doses) 0.664 0.050 92 Received measles vaccination 0.700 0.054 92 Fully immunized 0.587 0.048 92 Not immunized 0.191 0.042 92 Total fertility rate (3 years) 3.451 0.175 NA Neonatal mortality rate (0-9 years) 37.865 6.447 1218 Postneonatal mortality rate (0-9 years) 36.231 8.037 1222 Infant mortality rate (0-9 years) 74.096 10.846 1222 Child mortality rate (0-9 years) 54.156 12.519 1239 Under-five mortality rate (0-9 years) 124.240 19.709 1243 190 0.974 0.069 0.169 0.223 190 1,610 0,159 0.076 0.146 190 1.575 0.079 0.274 0.377 190 1.007 0.009 0.927 0.960 179 1.343 0.033 3.375 13.853 39 1.039 0.029 5.805 6.525 179 1249 0,029 2.843 3.194 179 0.633 0.002 0.991 0.998 179 0.633 0.002 0.991 0.998 179 0.904 0.003 0.985 0.997 179 1.174 0.020 0.777 0,844 179 1.208 0.034 0.574 0.658 179 1.233 0.036 0.559 0.646 179 1.419 0.103 0.155 0.236 179 1.818 0.158 0.099 0.192 179 1.367 0.133 0.088 0.152 179 1.088 0.385 0.002 0.018 179 1.628 0.348 0.008 0.047 179 2.172 0232 0.055 0.149 108 1.282 0.060 0.431 0.549 179 115(I 0.037 (I.509 0.591 179 1.121 0.067 0.233 0.304 156 1.168 0.016 3.137 3.350 190 1.697 0.092 (I.239 (I.347 138 2.051 0.082 0.487 0.676 138 2.279 0.064 0.645 0.835 138 1,403 0.085 I).307 (I.433 125 1.139 0.095 0.175 0.257 125 1,280 0,208 0040 0.098 27 0.982 0.076 0.502 0.684 27 1.488 0.128 0.405 0.684 21 1.384 0.211 0.183 0,451 21 0.962 0.050 0.718 0.879 21 1.070 0.076 (I,578 0.785 21 1.011 0.075 0.564 0,763 21 1.124 0.077 0.593 0.808 21 0.930 0.081 0.492 0.683 21 1.017 0.218 0.108 0.274 709 1.069 0.051 3.102 3.801 287 1,105 0.170 24.971 50.759 288 1.408 0.222 20.158 52.305 288 1.305 0.146 52.404 95.788 292 1.833 0.231 29.119 79.193 293 1.800 0.159 84.822 163.657 NA = Not applicable 278 Table B.2.26 Sampling errors - East Nusa Tenggara~ Indonesia 1994 Number of cases Standard Design Relative Confidence limits Value error Unweighted Weighted effect error Variable (R) (SE) (N) (WN) (DEFT) (SE/R/ R 2SE R+2SE Urban residence 0.091 No education 0.221 With secondary education or higher 0.170 Currently married (in union) 0.900 Children ever born 3.704 Children ever born to women over 40 5.673 Children surviving 3.219 Knowing any contraceptive method 0.948 Knowing any modern method 0.943 Knowing source for contraceptive method 0.931 0.013 811 0.020 811 0.023 811 0.007 811 0,143 731 0.240 206 0.142 731 0.014 731 0.015 731 0.015 731 Ever used any contraceptive method 0.639 0.025 731 Currently using any method 0.373 0.023 73 I Currently using a modern method 0.326 0.024 731 Currently using pill 0.032 0.008 731 Currently using 1UD 0.080 0.021 731 Currently using injections 0.138 0.015 731 Currently using condom 0.000 0.000 731 Currently using female sterilization 0.025 0.006 731 Currently using Norplant 0.040 0.012 731 Using public sector source 0.602 0.065 240 Want no more children 0.431 0.024 731 Want to delay at least 2 years 0.287 0.021 731 Ideal number of children 4.078 0.109 632 Knowledge of AIDS 0.170 0.021 811 Mothers received tetanus injection 0.605 0.043 666 Mothers received medical antenatal care 0.691 0.045 666 Mothers received medical care at birth 0.183 0.035 666 Had diarrhea in the last 2 weeks 0.110 0.014 614 Had diarrhea in the last 24 hours 0.030 0.008 614 Treated with ORS packets 0.560 0.048 68 Consulted medical personnel 0.666 0.055 68 Having health card 0.445 0.060 138 Received BCG vaccination 0.781 0.064 138 Received DPT vaccination (3 doses) 0.669 0.063 138 Received polio vaccination (3 doses) 0.678 0.058 138 Received measles vaccination 0.680 0.060 138 Fully immunized 0.570 0.064 138 Not immunized 0.147 0.058 138 Total fertility rate (3 years) 3.873 0.220 NA Neonatal mortality rate (0-9 years) 29.975 5.207 1398 Postneonatal mortality rate (0-9 years) 40.582 5.365 1401 Infant mortality rate (0-9 years) 70.558 7.902 1401 Child mortality rate (0-9 years) 39.694 6.562 1408 Under-five mortality rate (0-9 years) 107.451 10.634 1411 436 1.270 0.141 0.065 0.117 436 1.375 0.091 0.181 0.261 436 1.773 0.138 0.123 0.217 436 0.651 0.008 0.886 0.914 392 1.518 0.039 3.419 3.990 109 1.225 0.042 5.194 6.152 392 1.744 0.044 2.936 3.503 392 1.750 0.015 0.919 0.977 392 1.751 0.016 0.913 0.973 392 1.592 0.016 0.901 0.961 392 1.398 0.039 0.589 0.689 392 1.292 0.062 0.326 0.419 392 1.399 0.074 0.277 0.375 392 1.170 0.237 0.017 0.048 392 2.041 0.256 0.039 0.121 392 1.183 0.110 0.108 0.168 392 Und Und 0.000 0.000 392 0.971 0.225 0.014 0.036 392 1.665 0.302 0.016 0.064 128 2.052 0.108 0.472 0.732 392 1.331 0.057 0.383 0.480 392 1.247 0.073 0.245 0.329 338 1.533 0.027 3.861 4.296 436 1.619 0.126 0.127 0.212 361 1.899 0.071 0.518 0.691 361 2.090 0.066 0.600 0.782 361 1.902 0.191 0.113 0.253 332 1.111 0.130 0.082 0.139 332 1.078 0.253 0.015 0.046 37 0.779 0.086 0.463 0.656 37 0.895 0.082 0.557 0.775 76 1.413 0.134 0.325 0.564 76 1.772 0.082 0.654 0.909 76 1.564 0.094 0.543 0.796 76 1.450 0.086 0.561 0.794 76 1.491 0.088 0.560 0.800 76 1.514 0.112 0.441 0.698 76 1.839 0.393 0.031 0.262 1979 1.399 0.057 3.433 4.313 757 1.112 0.174 19.561 40.390 758 0.951 0.132 29.851 51.313 758 1.119 0.112 54.754 86.361 762 1.214 0.165 26.570 52.817 764 1.287 0.099 86.182 128.720 NA = Not applicable Und = Undefined 279 Table B.2.27 Sampl ing errors - East Timor~ Indonesia 1994 Value Variable (R) Number of cases St~dard Design Relative error Unweighted Weighted effect error (SE) (N) (WN) (DEFT) (SE/R) Confidence limits R-2SE R+2SE Urban residence 0.091 0.009 968 No education 0.634 0,029 968 With secondary education or higher 0.157 0.024 968 Currently married (in union) 0.925 0.013 968 Children ever born 3.463 0.081 895 Children ever born to women over 40 4.420 0.214 168 Children surviving 3.047 0.072 895 Knowing any contraceptive method 0.497 0.016 895 Knowing any modern method 0.483 0.018 895 Knowing source for contraceptive method 0.478 0.018 895 Ever used any contraceptive method 0.315 0.018 895 Currently using any method 0.226 0.016 895 Currently using a modern method 0.207 0.020 895 Currently using pill 0.020 0.004 895 Currently using IUD 0.010 0.006 895 Currently using injections 0,144 0.013 895 Currently using condom 0.002 0.002 895 Currently using female sterilization 0,O01 0.000 895 Currently using Norplant 0030 0.010 895 Using public sector source 0.759 0.051 188 Want no more children 11.231 0.020 895 Want to delay at least 2 years 0.151 0.014 895 Ideal number of children 4.417 0.123 370 Knowledge of AIDS 0,124 0.023 968 Mothers received tetanus injection 0.453 0.026 954 Mothers received medical antenatal care 0.503 0.027 954 Mothers received medical care at birth 0.170 0.026 954 Had diarrhea in the last 2 weeks 0.069 0.011 893 Had diarrhea in the last 24 hours 0.022 0.006 893 Treated with ORS packets 0.604 0.078 62 Consulted medical personnel 0.672 0.076 62 Having health card 0.292 0.045 183 Received BCG vaccination 0.650 0.044 183 Received DPT vaccination (3 doses) 0.534 0.046 183 Received polio vaccination (3 doses) 0,539 0.045 183 Received measles vaccination 0.533 0.040 183 Fully immunized 0453 0.033 183 Not immunized 0.322 0.043 183 Total fertility rate (3 years) 4.688 0.228 NA Neonatal mortality rate (0-9 years) 15.499 2.837 2008 Postneonatal mortality rate (0-9 years) 30.266 4.432 2009 Infant mortality rate (0-9 years) 45.765 5.124 2009 Child mortality rate (0-9 years) 58.802 6.977 2036 Under-five mortality rate (0-9 years) 101,876 9.114 2037 124 0.949 0.096 0.074 0.109 124 1.859 0.045 0.576 0.691 124 2.055 0.153 0.109 0.205 124 1.495 0.014 0.899 0.950 115 1.045 0.023 3.301 3624 21 0.992 0.048 3.992 4.847 115 1077 0.024 2.902 3.19 I I 15 0.977 0.033 0.464 0.530 115 1.089 0.038 0.447 0520 115 1.050 0.037 0.443 0513 115 1.181 I).058 0.278 0.352 115 1.121 0.069 0.195 0.258 115 1.444 0.095 0.168 0.246 115 0.858 0.199 0.012 0029 115 1.846 0.617 0.000 0.022 115 I , I I4 0.091 0.117 0170 115 1.317 1.001 0.000 0006 115 Und 0.000 0.001 0.001 115 1688 0.320 0.011 0050 24 1.631 0.067 0.657 0.861 115 1.442 0.088 0.190 0.272 115 1.190 0.094 0.123 0.180 46 1.379 0.028 4.170 4664 124 2.210 0.189 0.077 0.171 123 1.284 0.057 0.401 11.505 123 1.312 0.053 0,4511 0556 123 1.703 0.152 0.118 0221 115 1.277 0.163 0.046 0.1191 115 1.078 0.274 0.010 0034 8 1.196 0,129 0.448 0.760 8 1.203 0.113 0.521 0.823 23 1,326 0.153 0.203 0.381 23 1.242 0.067 0.562 11.737 23 1.250 0.086 0442 0626 23 1.235 0,084 0448 11.630 23 1.087 0.075 0.453 11.613 23 0.898 0.073 0.387 0.519 23 1.240 0.133 0.236 t1407 480 1.264 0049 4233 5.143 259 11.987 0.183 9.824 21.173 259 1.116 0.146 21.403 39130 259 1.014 0.112 35.517 56013 263 I, I 17 0. I 19 44.849 72.755 263 I , I14 0.089 83.648 ]20.104 NA = Not applicable Und = Undef ined 280 Table B.2.28 Sampling errors - Central Kalimantan, Indonesia 1994 Number of cases Standard Design Relative Confidence limits Value error Unweighted Weighted effect error Variable (R) (SE) (N) (WN) (DEFI') (SE/R) R-2SE R+2SE Urban residence 0.192 0.026 No education 0.106 0.013 With secondary education or higher 0.266 0.027 Currently married (in union) 0.933 0.010 Children ever born 2.897 0.108 Children ever born to women over 40 4.861 0.188 Children surviving 2.776 0.102 Knowing any contraceptive method 0.958 0.012 Knowing any modern method 0.957 0.012 Knowing source for contraceptive method 0.953 0.012 Ever used any contraceptive method 0.564 0.032 Currently using any method 0.445 0.023 Currently using a modern method 0.411 0.026 Currently using pill 0.264 0.023 Currently using IUD 0.015 0.008 Currently using injections 0.104 0.013 Currently using condom 0.000 0.000 Currently using female sterilization 0.004 0.003 Currently using Norplant 0.024 0.009 Using public sector source 0.722 0.043 Want no more children 0.473 0.024 Want to delay at least 2 years 0.167 0.021 Ideal number of children 3.444 0.101 Knowledge of AIDS 0.346 0.028 Mothers received tetanus injection 0.614 0,023 Mothers received medical antenatal care 0.690 0,033 Mothers received medical care at birth 0.331 0.042 Had diarrhea in the last 2 weeks 0.058 0.015 Had diarrhea in the last 24 hours 0.021 0.007 Treated with ORS packets 0.292 0.104 Consulted medical personnel 0.721 0.117 Having health card 0.259 0.065 Received BCG vaccination 0.774 0.045 Received DPT vaccination (3 doses) 0.527 0.062 Received polio vaccination (3 doses) 0.639 0.051 Received measles vaccination 0.602 0.073 Fully immunized 0.430 0.060 Not immunized 0.217 0.047 Total fertility rate (3 years) 2.306 0.159 Neonatal mortality rate (0-9 years) 7.023 2.354 Posmeonatal mortality rate (0-9 years) 9.424 2.854 Infant mortality rate (0-9 years) 16.447 4.368 Child mortality rate (0-9 years) 21.724 3.955 Under-five mortality rate (0-9 years) 37.814 5.811 870 244 1.963 0.136 0.140 0.245 870 244 1.205 0.119 0.081 0.131 870 244 1.811 0.102 0.212 0.320 870 244 1.202 0.011 0,912 0.953 812 227 1.380 0.037 2.680 3.113 189 52 1.034 0.039 4.485 5.237 812 227 1.357 0.037 2.572 2.980 812 227 1.692 0.012 0.934 0.982 812 227 1.648 0.012 0.933 0.980 812 227 1.630 0.013 0.929 0.977 812 227 1.857 0.057 0.499 0.629 812 227 1.336 0.052 0.399 0,492 812 227 1.498 0.063 0.359 0.463 812 227 1,471 0.086 0.218 0.309 812 227 1.961 0,552 0.000 0.032 812 227 1,219 0.125 0.078 0.131 812 227 Und Und 0.000 0.000 812 227 1.338 0.763 0.000 0.010 812 227 1.614 0.362 0.007 0.041 327 93 1.732 0.059 0.637 0.808 812 227 1.361 0.051 0.425 0.520 812 227 1.619 0.127 0.124 0.209 562 159 1.489 0.029 3.241 3.647 870 244 1.759 0.082 0.289 0.403 444 126 0.866 0.038 0.567 0.660 444 126 1.273 0.048 0.625 0.756 444 126 1.698 0.128 0.247 0.416 429 123 1.361 0.261 0.028 0.088 429 123 1.039 0.334 0.007 0.036 23 7 1.151 0.355 0.085 0.500 23 7 1.316 0.162 0.487 0.955 79 23 1.338 0.250 0.130 0.389 79 23 0.976 0.058 0.684 0.864 79 23 1.133 0.118 0.402 0652 79 23 0.959 0.080 0.537 0.740 79 23 1.353 0.122 0.456 0.748 79 23 1.093 0.139 0.311 0.550 79 23 1.034 0.217 0.122 0.311 NA 934 1.233 0.069 1.987 2.625 1049 292 0.848 0.335 2.314 11.732 1049 292 0.861 0.303 3.717 15.131 1049 292 1.025 0.266 7.711 25.183 1056 294 0.853 0.182 13.814 29.634 1056 294 0.851 0.154 26.191 49.436 NA -- Not applicable Und = Undefined 281 Table B.2.29 Sampling errors - East Kalimantan T Indonesia 1994 Num~rofc~es Standard Design Relative Confidence limits Value error Unweighted Weighted effect error Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE Urban residence 0.483 0.027 823 No education 0.089 0.012 823 With secondary education or higher 0.363 0.039 823 Currently married (in union) 0.948 0.008 823 Children ever born 3.053 0.122 781 Children ever born to women over 40 5.423 0.323 167 Children surviving 2.725 0.097 781 Knowing any contraceptive method 0.979 0.013 781 Knowing any modern method 0.976 0.012 78 I Knowing source for contraceptive method 0.968 0.014 781 Ever used any contraceptive method 0.811 0.020 781 Currently using any method 0.605 0.023 781 Currently using a modern method 0.547 0.023 78 I Currently using pill 0.237 0.020 78 I Currently using IUD 0.090 0.017 781 Currently using injections 0.146 0.018 781 Currently using condom 0,015 0.005 781 Currently using female sterilization 0.036 0.008 781 Currently using Noqalant 0.020 0.008 781 Using public sector source 0.432 0.047 430 Want no more children 0.461 0.026 781 Want to delay at least 2 years 0.223 0.014 781 Ideal number of children 2.891 0.074 616 Knowledge of AIDS 0.664 0.033 823 Mothers received tetanus injection 0.715 0.036 552 Mothers received medical antenatal care 0.826 0.036 552 Mothers received medical care at birth 0.566 0.051 552 Had diarrhea in the last 2 weeks 0.076 0.014 516 Had diarrhea in the last 24 hours 0.020 0.006 516 Treated with ORS packets 0.529 0.078 47 Consulted medical personnel 0.475 0.118 47 Having health card 0.469 0.060 101 Received BCG vaccination 0.883 0.036 101 Received DPT vaccination (3 doses) 0.813 0.045 101 Received polio vaccination (3 doses) 0.781 0.050 101 Received measles vaccination 0.810 0.034 101 Fully immunized 0.747 0.045 101 Not immunized 0.092 0.037 101 Total fertility rate (3 years) 3.212 0.188 NA Neonatal mortality rate (0-9 years) 29.283 5.269 1103 Posmeonatal mortality rate (0-9 years) 31.861 7.069 1106 Infant mortality rate (0-9 years) 61,144 9.303 1106 Child mortality rate (0-9 years) 16.198 4.658 1108 Under-five mortality rate (0-9 years) 76.351 12.150 I 111 321 1.577 0.057 0.428 0.538 321 1,200 0.134 0.065 0.113 321 2.311 0.107 0.286 0.441 321 1.016 0.008 0.932 0.964 304 1.411 0.040 2.809 3.297 62 1.587 0.059 4.778 6.068 304 1.340 0.036 2.531 2.919 304 2.547 0.013 0.953 1.000 304 2.219 0.013 0.951 1.000 304 2.132 0.014 0.941 0.995 304 1.461 0.025 0.771 0.852 304 1.337 0.039 0.558 0.652 304 1.278 0.042 0.502 0.593 304 1.298 0.083 0.197 0.276 304 1.619 0.184 0.057 0.123 304 1.403 0.121 0.111 0.182 304 1.121 0.323 0.005 0.025 304 1.249 0.232 0.019 0.053 304 1610 0.399 0.004 0.037 167 1.980 0.110 0.337 0.526 304 1.431 0.055 0.410 0.512 304 0919 0.061 0.195 0.250 240 1.367 0.026 2.743 3.039 321 2.001 0.050 0.598 0.730 215 1.600 0.050 0.643 0.787 215 1.743 0.044 0.753 0.898 215 2.037 0.089 0.465 0.667 202 1.107 0.180 0.049 0.103 202 0.969 0.300 0.008 0.032 15 0.923 0.147 0,373 0.685 15 1.403 0.248 0.239 0.71 I 39 1.183 0.128 0.349 0.589 39 1.107 0.040 0.812 I).954 39 1.145 0.055 0.724 0.902 39 1.199 0.063 0.682 I).880 39 0.878 0.043 (I.741 I).879 39 1.041 0.061 (I.656 I).838 39 1.296 0.406 (I.017 I).167 1229 1.240 0.059 2.836 3.589 419 0.994 0.180 18.745 39.821 420 1.088 0.222 17.722 45.999 420 1.057 0.152 42.537 79.751 421 1.126 0.288 6.881 25,515 422 1.202 0.159 52.050 101).652 NA = Not applicable 282 Table B.2.30 Sampling errors - Central Sulawesi~ Indonesia 1994 Number of cases Standard Design Relative Confidence limits Value error Unweighted Weighted effect error Variable (R) (SE) (N) (WN) (DEFY) (SE /R) R-2SE R+2SE Urban residence 0.155 No education 0.076 With secondary education or higher 0.324 Currently married (in union) 0.945 Children ever born 3.337 Children ever born to women over 40 5.576 Children surviving 2.860 Knowing any contraceptive method 0.916 Knowing any modern method 0.904 Knowing source for contraceptive method 0.879 0.009 766 0.013 766 0.024 766 0.009 766 0.088 725 0.264 163 0.087 725 0.036 725 0.037 725 0.036 725 Ever used any contraceptive method 0.708 0.030 725 Currently using any method 0.525 0.027 725 Currently using a modern method 0.483 0.032 725 Currently using pill 0.157 0.021 725 Currently using IUD 0.064 0.016 725 Currently using injections 0.209 0.022 725 Currently using condom 0.001 0.001 725 Currently using female sterilization 0.012 0.003 725 Currently using Norplant 0.040 0.008 725 Using public sector source 0.539 0.039 360 Want no more children 0.430 0.027 725 Want to delay at least 2 years 0.193 0.018 725 ldeal number of children 3,136 0.091 502 Knowledge of AIDS 0,287 0.030 766 Mothers received tetanus injection 0.547 0.060 529 Mothers received medical antenatal care 0.657 0.075 529 Mothers received medical care at birth 0.230 0.051 529 Had diarrhea in the last 2 weeks 0.093 0.013 481 Had diarrhea in the last 24 hours 0.013 0.007 48 I Treated with ORS packets 0.455 0.092 42 Consulted medical personnel 0.421 0.091 42 Having health card 0,348 0.077 86 Received BCG vaccination 0.692 0.086 86 Received DPT vaccination (3 doses) 0.473 0.063 86 Received polio vaccination (3 doses) 0.458 0.064 86 Received measles vaccination 0.531 0.071 86 Fully immunized 0.419 0.057 86 Not immunized 0.296 0.086 86 Total fertility rate (3 years) 3.077 0.226 NA Neonatal mortality rate (0-9 years) 34.078 8.757 1138 Posmeonatal mortality rate (0-9 years) 53.319 9.072 1140 Infant mortality rate (0-9 years) 87.398 14,162 1140 Child mortality rate (0-9 years) 42.860 7.548 1149 Under-five mortality rate (0 9 years) 126.512 16.461 1151 238 0.698 0.059 0.137 0.174 238 1.326 0.168 0.050 0.101 238 1.401 0.073 0.277 0.372 238 1.037 0.009 0.928 0.962 225 0.969 0.026 3.161 3.513 50 1.283 0.047 5.048 6.104 225 1.152 0.030 2.686 3.035 225 3.499 0.039 0.844 0.988 225 3.356 0.041 0.831 0.978 225 2.933 0.040 0.808 0.950 225 1.762 0.042 0.648 0.767 225 1.458 0.051 0.471 0.580 225 1.743 0.067 0.419 0.548 225 1.542 0.133 0.115 0.198 225 1.706 0.243 0.033 0.095 225 1.443 0.104 0.166 0.253 225 0.904 1.006 0.000 0.003 225 0.751 0.253 0.006 0.018 225 1.119 0.203 0.024 0.057 108 1.498 0.073 0.460 0.618 225 1.474 0.063 0.375 0.484 225 1.257 0.096 0.156 0.229 156 1.502 0.029 2.954 3.317 238 1.805 0.103 0.228 0.346 166 2.243 0.110 0.427 0.668 166 2.853 0.115 0.506 0.807 166 2.288 0.220 0.129 0.332 150 0.912 0.140 0.067 0.119 150 1.410 0.551 0.000 0.028 14 1.137 0.202 0.271 0.638 14 1.187 0.216 0.239 0.602 27 1.499 0.220 0.195 0.501 27 1.741 0.124 0.520 0.865 27 1.186 0.134 0.346 0.600 27 1.188 0.139 0.331 0.585 27 1.335 0.135 0.388 0.674 27 1.081 0.136 0.305 0.534 27 1.756 0.290 0.124 0.468 953 1.330 0.073 2.626 3.529 356 1.552 0.257 16.564 51.593 357 1.254 0.170 35.176 71.462 357 1.491 0.162 59.074 115.721 360 1.114 0.176 27.765 57.956 360 1.452 0.130 93.590 159.434 NA = Not applicable 283 Table B.2.31 Sampling errors - Southeast Sulawesi~ Indonesia 1994 Number of cases Standard Design Relative Confidence limits Value error Unweighted Weighted effect error Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE R+2SE Urban residence 0.107 No education 0.124 With secondary education or higher 0.316 Currently married (in union) 0.928 Children ever born 3.504 Children ever born to women over 40 5.447 Children surviving 3.079 Knowing any contraceptive method 0.942 Knowing any modern method 0.936 Knowing source for contraceptive method 0.936 0.014 687 0.027 687 0.036 687 0.010 687 0.136 644 0.317 129 0.101 644 0.023 644 0.023 644 0.023 644 Ever used any contraceptive method 0.622 0.054 644 Currently using any method 0.463 0.045 644 Currently using a modern method 0.418 0.048 644 Currently using pill 0.129 0.023 644 Currently using IUD 0.060 0.010 644 Currently using injections 0.166 0.022 644 Currently using condom 0.001 0.000 644 Currently using female sterilization 0.019 0.012 644 Currently using Norplant 0.042 0.010 644 Using public sector source 0.632 0.056 292 Want no more children 0.426 0.031 644 Want to delay at least 2 years 0.266 0.022 644 Ideal number of children 3.342 0.115 409 Knowledge of AIDS 0.200 0.030 687 Mothers received tetanus injection 0.685 0.034 543 Mothers received medical antenatal care 0.788 0.047 543 Mothers received medical care at birth 0.264 0.047 543 Had diarrhea in the last 2 weeks 0.090 0.013 515 Had diarrhea in the last 24 hours 0.019 0.006 515 Treated with ORS packets 0.488 0.089 42 Consulted medical personnel 0.415 0.080 42 Having health card 0.381 0.073 105 Received BCG vaccination 0.868 0.033 105 Received DPT vaccination (3 doses) 0.639 0.082 105 Received polio vaccination (3 doses) 0.654 0.074 105 Received measles vaccination 0.707 0.067 105 Fully immunized 0.599 0.088 105 Not immunized 0.109 0.023 105 Total fertility rate (3 years) 3.505 0.282 NA Neonatal mortality rate (0 9 years) 40.471 16.480 1174 Posmeonatal mortality rate (0-9 years) 38.472 7.435 1175 Infant mortality rate (0-9 years) 78.943 13.833 1175 Child mortality rate (0-9 years) 27.766 8.728 I 179 Under-five mortality rate (0-9 years) 104.518 20.076 1180 191 1.165 0.128 0.080 0.135 191 2.177 0.221 0.069 0.179 191 2.018 0.113 0.245 0.388 191 1.058 0.011 0.908 0.949 178 1.453 0.039 3.233 3.776 36 1.358 0.058 4.812 6.082 178 1.246 0.033 2.876 3.281 178 2.497 0.024 0.896 0.988 178 2.413 0.025 0.890 0.983 178 2.406 0.025 0.890 0.983 178 2.841 0.087 0.514 0.731 178 2.288 0.097 0.373 0.553 178 2.473 0.115 0.322 0.514 178 1.777 0.182 0.082 0.176 178 1.095 0.171 0.039 0.080 178 1.512 0.134 0.122 0.211 178 Und 0.000 0.001 0.001 178 2.152 0,609 0.000 0.042 178 1.240 0.233 (I.023 0.062 74 1.977 0,088 0.520 0.?44 178 1.610 0.074 0.363 0.489 178 1.282 0.084 0.221 0.310 I l l 1.716 0.034 3.111 3.572 191 1.939 0.148 0.141 0.259 149 1.398 0.049 0.618 0/752 149 2.183 0.060 0.694 0.881 149 2.067 0.178 0.170 0.357 140 1.009 0.144 0.064 0.116 140 0.969 0.311 0.007 0.031 13 1.180 0.183 0.310 0.666 13 1.079 0.192 0.256 0.575 29 1.510 0.193 0.234 0.527 29 0.976 0.038 0.803 0.934 29 1.706 0.129 0.474 0.803 29 1.548 0. I 13 0.507 0.802 29 1.515 0.095 0.572 0.842 29 1.803 0.147 0.422 0.776 29 0.734 0.207 0.064 0.154 776 1.786 0.080 2.941 4.069 325 2.246 0.407 7.51 I 73.432 326 1.311 0.193 23.601 53.1343 326 1.518 0.175 51.278 106.609 327 1.492 0.314 10.310 45.222 327 1.992 0.192 64.366 144.669 NA = Not applicable Und = Undefined 284 Table B.2.32 Sampling errors - Maluku~ Indonesia 1994 Number of cases Standard Design Relative Confidence limits Value error Unweighted Weighted effect error Variable IR) (SE) IN) (WN) (DEFT) /SE/R) R-2SE R+2SE Urban residence 0.180 0.021 770 No education 0.068 0.019 770 With secondary education or higher 0.387 0.022 770 Currently married (in union) 0.929 0.010 770 Children ever born 3.404 0.103 715 Children ever born to women over 40 5,178 0.276 146 Children surviving 3.038 0.099 715 Knowing any contraceptive method 0.953 0.014 715 Knowing any modern method 0.953 0.014 715 Knowing source for contraceptive method 0.943 0.015 715 Ever used any contraceptive method 0.548 0.023 715 Currently using any method 0.349 0.022 715 Currently using a modern method 0.334 0.020 715 Currently using pill 0.089 0.014 715 Currently using IUD 0.049 0.008 715 Currently using injections 0.142 0.013 715 Currently using condom 0.003 0.002 715 Currently using female sterilization 0.013 0.005 715 Currently using Norplant 0.033 0.010 715 Using public sector source 0.750 0.044 240 Want no more children 0.430 0.025 715 Want to delay at least 2 years 0.207 0.017 715 Ideal number of children 3.410 0.074 513 Knowledge of AIDS 0.374 0.029 770 Mothers received tetanus injection 0.494 0.036 652 Mothers received medical antenatal care 0.651 0.032 652 Mothers received medical care at birth 0,229 0.019 652 Had diarrhea in the last 2 weeks 0.037 0.009 609 Had diarrhea in the last 24 hours 0.009 0.006 609 Treated with ORS packets 0.530 0.108 23 Consulted medical personnel 0.487 0.062 23 Having health card 0.442 0.058 83 Received BCG vaccination 0.669 0.056 83 Received DPT vaccination (3 doses) 0.575 0.063 83 Received polio vaccination (3 doses) 0.527 0.068 83 Received measles vaccination 0.562 0.065 83 Fully immunized 0.458 0.068 83 Not immunized 0.305 0.059 83 Total l~rtility rate I3 years) 3.700 0.192 NA Neonatal mortality rate (0-9 years) 26,175 5.560 1352 Postneonatal mortality rate (0-9 years) 41.822 6.031 1356 Infant mortality rate (0-9 years) 67.997 8.525 1356 Child mortality rate (0-9 years) 24.519 6.021 1358 Under-five mortality rate (0-9 years) 90.849 10.005 1362 225 1.502 0.116 0.138 0.221 225 2.121 0.284 0.029 0.106 225 1.253 0.057 0.343 0.431 225 1.075 0.011 0.909 0.949 209 1.157 0.030 3.198 3.609 43 1.271 0.053 4.626 5.731 209 1.295 0.033 2.840 3.236 209 1.727 0.014 0.926 0.980 209 1.727 0.014 0.926 0.980 209 1.782 0.016 0.912 0.974 209 1.225 0.042 0.502 0.594 209 1.238 0.063 0.305 0.393 209 1.147 0.061 0.293 0.374 209 1.290 0.154 0.062 0.117 209 1.014 0.168 0.032 0.065 209 0.970 0.089 0.117 0.168 209 1.022 0.717 0.000 0.007 209 1.133 0.376 0.003 0.022 209 1.494 0.301 0.013 0.053 70 1.566 0.058 0.662 0.838 209 1.360 0.059 0.380 0.481 209 1.123 0.082 0.173 0.241 149 1.256 0.022 3.261 3.558 225 1.673 0.078 0.316 0.433 190 1.504 0.073 0.422 0.566 190 1.347 0.049 0.588 0.715 190 0.994 0.085 0.190 0.267 177 1.101 0.247 0.019 0.056 177 1.534 0.670 0.000 0.020 7 0.944 0.204 0.314 0.747 7 0.548 0.128 0.362 0.612 24 1.053 0,131 0.326 0.557 24 1.072 0.083 0.558 0.781 24 1.159 0.110 0.449 0.702 24 1.230 0.129 0.391 0.663 24 1.179 0.115 0.433 0.692 24 1.231 0.148 0.323 0.594 24 1.150 0.192 0.188 0.422 1036 1.042 0.052 3.316 4.084 395 1.078 0.212 15.054 37.295 396 1.040 0.144 29.759 53.885 396 1.118 0.125 50.946 85.047 397 1.395 0.246 12.478 36.561 398 1.132 0.110 70.839 110.858 NA = Not applicable 285 Table B.2.33 Sampling errors - lrian Jaya r Indonesia 1994 Number of cases Standard Design Relative Confidence limits Value error Unweighted Weighted effect error Variable (R) (SE) (N) (WN) (DEFT) (SE/R) R-2SE 1~.+2SE Urban residence 0,189 0.018 No education 0.367 0.022 With secondary education or higher 0.267 0.033 Currently married (in union) 0.952 0,007 Children ever born 3.067 0.088 Children ever born to women over 40 5.029 0.224 Children surviving 2.776 0.073 Knowing any contraceptive method 0.782 0.017 Knowing any modern method 0.729 0.016 Knowing source for contraceptive method 0.717 0.017 Ever used any contraceptive method 0.533 0.023 Currently using any method 0.413 0.023 Currently using a modern method 0.291 0.021 Currently using pill 0.075 0.012 Currently using IUD 0.026 0.006 Currently using injections 0.120 0.015 Currently using condom 0.009 0.004 Currently using female sterilization 0.026 0.003 Currently using Norplant 0.035 0.012 Using public sector source 0.753 0.039 Want no more children 0.449 0.021 Want to delay at least 2 years 0.137 0.017 Ideal number of children 3.223 0.090 Knowledge of AIDS 0.332 0.026 Mothers received tetanus injection 0.597 0.035 Mothers received medical antenatal care 0.755 0.036 Mothers received medical care at birth 0.348 0.050 Had diarrhea in the last 2 weeks 0.094 0.015 Had diarrhea in the last 24 hours 0.026 0.007 Treated with ORS packets 0.578 0.090 Consulted medical personnel 0.649 0.078 Having health card 0.383 0.057 Received BCG vaccination 0.778 0.079 Received DPT vaccination (3 doses) 0.584 0,05 I Received polio vaccination (3 doses) 0.604 0,05 I Received measles vaccination 0.646 0.078 Fully immunized 0.515 0.057 Not immunized 0.212 0.078 Total 12:rtility rate (3 years) 3,146 0.268 Neonatal mortality rate (0-9 years) 28.333 6.783 Postneonatal mortality rate (0-9 years) 32.966 5.456 Infant mortality rate (0-9 years) 61.299 10.154 Child mortality rate (0-9 years) 28.556 6.178 Under-five mortality rate (0 9 years) 88.105 12.089 814 250 1.340 0.097 0.152 0.226 814 250 1.305 0.060 0.323 0.411 814 250 2.149 0.125 0.201 0.334 814 250 0.932 0.007 0.938 0.966 774 238 1.109 0.029 2.890 3.244 160 49 1.165 0.044 4.582 5.477 774 238 1.045 0.026 2.630 2,922 774 238 1.145 0.022 0.748 0.816 774 238 1.011 0.022 0.697 0.761 774 238 1.031 0.023 0.684 0.750 774 238 1.294 0.044 0.487 0.580 774 238 1.294 0.056 0.367 0,459 774 238 1.277 0.072 0.250 0.333 774 238 1.285 0.163 0.050 0.099 774 238 1.123 0.246 0.013 0,039 774 238 1.288 0.125 0.090 0.150 774 238 1.123 0.429 0.001 0.016 774 238 0.516 0.114 0.020 0.031 774 238 1.781 0.338 0.011 0.058 238 69 1.382 0.051 0.676 0.831 774 238 1.182 0.047 0.406 0.491 774 238 1.382 0.125 0.103 0.171 457 135 1.493 0.028 3.044 3.402 814 250 1.564 0.078 0.280 0.383 552 167 1.380 0.058 0.528 0.667 552 167 1.623 0,047 0,683 0.826 552 167 1.924 0.144 0.248 0.448 506 153 1.053 0.156 0.065 0.123 506 153 0.949 0.278 0.011 0,040 49 14 1.145 0.155 0.399 0.757 49 14 1.035 0.120 0.493 0.805 96 30 1.123 0.148 0.270 0.496 96 30 1.852 0.101 0.621 0.935 96 30 1.012 0.088 0.481 0.687 96 30 1.011 0.084 0.502 0.705 96 30 1.581 0.120 0.491 0.801 96 30 1.096 0.110 0.402 0.628 96 30 1.866 0.367 0.056 0.368 NA 946 1.355 0,085 2,609 3.682 1208 370 1.086 0,239 14.768 41.898 1211 371 1.113 0.165 22.055 43.878 1211 371 1.307 0.166 40.990 81.608 1210 371 1.174 0.216 16 .201 40.912 1213 372 1.317 0.137 63.927 112.283 NA = Not applicable 286 APPENDIX C DATA QUALITY APPENDIX C DATA QUALITY This appendix provides an initial assessment of the quality of the 1994 IDHS data. For this purpose, misreporting of ages, respondent's recall problems and other problems encountered during data collection are investigated. Table C. 1 presents the distribution of the household population by single years of age. Contrary to expectation, the proportion of children reported to be five years of age at the time of the survey is smaller than the proportions age four and six. This phenomenon is more significant for females than for males. Additionally, heaping is observed in the reporting of ages ending with 0 and 5 after age 20 for both males and females. In particular, there is substantial overreporting of males at age 50 and, to a lesser extent, females. The overreporting of women at age 50 may reflect age displacement as well as heaping, since 49 is the upper limit of eligibility for the individual interview. Table C.I Household age distribution Single-year age distribution of the de jure household population by sex (weighted), Indonesia 1994 Males Females Males Females Age Number Percent Number Percent Age Number Percent Number Percent 0 1,717 2.3 1,509 2.0 37 865 1.2 965 1.3 1 1,521 2.0 1,572 2.1 38 849 1.1 885 1.2 2 1,687 2.2 1,656 2.2 39 832 1.1 835 1.1 3 1,766 2.3 1,596 2.1 40 1,451 1.9 1,078 1.4 4 1,619 2.2 1,568 2.1 41 769 1.0 768 1.0 5 1,494 2.0 1,447 1.9 42 799 1.1 788 1.0 6 1,737 2.3 1,771 2.3 43 641 0.9 619 0,8 7 1,875 2.5 1,788 2.4 44 645 0.9 560 0.7 8 1,996 2.7 1,717 2.3 45 950 1.3 835 1.1 9 1,974 2.6 1,762 2.3 46 541 0.7 523 0.7 10 2,098 2.8 1,844 2.4 47 451 0.6 567 0.7 11 1,945 2.6 1,773 2.3 48 453 0.6 693 0.9 12 2,225 3.0 1,967 2.6 49 568 0.8 518 0.7 13 1,895 2.5 1,821 2.4 50 920 1.2 705 0.9 14 1,890 2.5 1,684 2.2 51 504 0.7 647 0.9 15 1,795 2.4 1,711 2.3 52 614 0.8 819 I.I 16 1,551 2.1 1,529 2.0 53 445 0.6 505 0.7 17 1,595 2.1 1,548 2.0 54 552 0.7 577 0.8 18 1,448 1.9 1,590 2.1 55 698 0.9 812 1.1 19 1,249 1.7 1,337 L8 56 393 0,5 468 0.6 20 1,394 1.9 1,548 2.0 57 375 0,5 361 0.5 21 1,073 1.4 1,275 1.7 58 370 0.5 379 0,5 22 I,l 11 1.5 1,320 1.7 59 350 0.5 373 0.5 23 1,145 1.5 1,200 1.6 60 830 IA 914 1.2 24 1,151 1.5 1,260 1.7 61 251 0,3 328 0.4 25 1,505 2.0 1,589 2.1 62 404 0.5 373 0.5 26 1,044 1.4 1,138 1.5 63 300 0.4 297 0.4 27 1,048 1.4 1,129 1,5 64 300 0.4 393 0.5 28 1,046 1.4 1,262 1.7 65 498 0.7 592 0.8 29 994 1.3 1,226 1.6 66 173 0.2 200 0.3 30 1,707 2.3 1,577 2A 67 280 0.4 303 0.4 31 927 1.2 1,110 1.5 68 165 0.2 208 0.3 32 1,089 1.4 1,226 1.6 69 166 0.2 210 0.3 33 901 1.2 931 1.2 70+ 2,042 2.7 2,072 2.7 34 1,052 1.4 1,116 1.5 Don't know/ 35 1,507 2.0 1,390 1.8 Missing 11 0.0 21 0.0 36 965 1.3 976 1.3 Total 75,193 100.0 75,657 100.0 289 Table C.2 shows that during the household interview, 38,622 women age 15-49 were recorded, of which 28,324 have been married and are, therefore, eligible for the individual interview. Of these women, 27,675 were successfully interviewed, yielding a response rate of 98 percent. The five-year age distribution of women follows the expected pattern. Compared with past surveys, there is a decrease in the proportion of women 15-29 and an increase in the proportion 30-34. To investigate the possibility of bias in age reporting in the individual questionnaire, the age distribution of ever-married women (i.e., eligible women) was calculated from the household information and then compared with the age distribution of interviewed women (see Table C.2). The expected pattern of declining percentage with increasing age, seen in the household population of women, is not repeated for ever-married women. At the same time, there is virtually no difference in the age distributions of ever- married women and interviewed women. This suggests there is no bias in age reporting in these populations. Response rates vary slightly by age group; the highest response rates are among women in their 30s. Table C.2 Age distribution of eligible and interviewed women Percent distribution of the de jure household population of women age 10-54, of ever-married women age 15-49, and of interviewed women age 15-49, and the percentage of eligible women who were interviewed (weighted) by five-year age groups, Indonesia 1994 Percentage Household popu- Ever-married of eligible lation of women women Interviewed women women interviewed Age Number Percent Number Percent Number Percent (weighted) 10-14 9,089 NA NA NA NA NA NA 15-19 7,716 20.0 1,385 4.9 1,341 4.8 96.8 20-24 6,603 17.1 4,137 14.6 4,045 14.6 97.8 25-29 6,343 16.4 5,451 19.2 5,349 19.3 98.1 30-34 5,960 15.4 5,655 20.0 5,559 20.1 98.3 35-39 5,052 13.1 4,898 17.3 4,786 17.3 97.7 40-44 3,813 9.9 3,721 13.1 3,607 13.0 96.9 45-49 3,136 8.1 3,077 10.9 2,989 10.8 97.1 50-54 3,254 15-49 38,622 I00.0 28,324 100.0 27,675 100.0 97.7 Note: The de jure population includes all usual residents of the household. The number of interviewed women is calculated using the household weights in order to be comparable with the number of ever-married women in the household. Thus, the numbers differ slightly from those shown in the rest of the report, which are based on individual woman weights. NA = Not applicable Information on the completeness of reporting in connection with a set of important variables is provided in Table C.3. Among births in the 15 years preceding the survey, the percentage of cases with missing information on month and year of birth or age at death is extremely low (less than I percent). When the percentages in this table are compared with those found in the 1991 Indonesia DHS, the reporting of dates is seen to have improved slightly (see CBS et al., 1992). 290 Table C.3 Completeness of reporting Percentage of observations missing information for selected demographic and health questions (weighted), Indonesia 1994 Percentage Number missing of Subject Reference group information cases Birth date Births in last 15 years Month only 11.34 54,856 Month and year 0.04 54,856 Age at death Deaths to births in last 15 years 0.16 5,301 Age/date at first union I Ever-married women 0.03 28,168 Respondent's education All women 0.00 28,168 Child's size at birth Births in last 59 months 1.18 8,331 Diarrhea in last 2 weeks Living children age 0-59 months 0.64 15,883 1Both year and age missing The figures presented in Table C.4 also suggest that the reporting of children's date of birth is more complete in 1994 than in 1991. For example, the percentage of surviving children with known month and year of birth is 85 percent in 1994, compared with 82 percent in 1991 (CBS et al., 1992). For dead children, the percentages are 54 and 49 percent, respectively. Sex ratios vary year by year without any indication of bias. However, women seem to have better recall of dead male children than of dead female children, as indicated by the higher sex ratios for dead children. Observing the calendar ratios, there seems to be a deficit of births in 1989 and a surplus in 1988 (see Figure C.I). For all births, the ratio of births in 1989 to the average of the two adjoining years is 0.91 ; for births in 1988, the ratio is 1.03. The phenomenon is more serious among dead children (0.88 in 1989 and 1.13 in 1988). These numbers may represent a deliberate attempt by some interviewers to reduce their workloads, in particular to shorten the interview by skipping the health sections that contain extensive questions about children under five. 291 t,,3 bo Table C.4 Births by calendar years Distribution of births by calendar years for l iving (L), dead (D), and all (T) children, according to reporting completeness, sex ratio at birth, and ratio of births by calendar year, Indonesia 1994 Percentage with Sex ratio Number of births complete birth date I at birth 2 Calendar ratio 3 Male Female Year L D T L D T L D T L D T L D T L D T 94 2,035 99 2,133 10O.0 100.0 100.0 115.8 156.4 1174 NA NA NA 1,092 60 1.152 943 38 93 3,193 190 3,383 99.9 99.4 99,9 101.7 116.1 102.4 120.5 1273 120.8 1,610 102 1,712 1,583 88 92 3,267 199 3,466 100.0 959 99.7 98.4 140.1 100.4 101.8 90.3 101.1 1.620 116 1,737 1,646 83 91 3,225 252 3,477 99.4 991 99.4 111.3 132.0 112.7 99.6 111.2 100.4 1,699 144 1,842 1,526 109 90 3.206 254 3,460 99.3 96.1 991 98.5 129.5 1005 103.9 952 1032 1,591 144 1,735 1,615 I11 89 2.947 282 3.229 995 96.9 99.3 105.5 1378 1080 909 881 90.7 1,513 163 1,677 1,434 119 88 3,277 386 3.663 89.0 66.1 86.6 99.0 148.0 103.2 102.2 112.8 103.3 1,631 230 1,861 1,647 155 87 3,463 402 3.865 88.9 56.0 85.4 102.2 102.2 102.2 102.4 98.9 102.0 1,751 203 1,954 1.713 199 86 3,486 427 3,913 884 535 846 1117 111 1 111.7 1016 98.1 101.2 1,840 225 2,064 1.646 202 85 3,401 468 3,869 86.5 626 83.6 106.7 135.1 109.8 NA NA NA 1,756 269 2,025 1.645 199 98l 1,671 1,729 1,635 1,725 1,553 1,802 1,911 1,848 1,844 All 75,454 10,468 85,922 852 53 9 814 106.1 121 0 107.8 NA NA NA 38.842 5,731 44.573 36,611 4.737 41,349 NA - Not applicable JBoth year and month of birth given 2(Bm/Bf)x 100. where B m and Bf ale the numbers of male and female births, respectively 3[2Bx/IB~ l+Bx.l)]x 10~, where B x is the number of births in calendar year x 90-94 14,925 995 15,919 99.7 97.8 996 104.1 1319 105 6 NA NA NA 7.612 566 8.177 7,313 429 7,742 85-89 16,575 1,963 18,539 90.2 64 9 87.5 105.0 124.7 106.9 NA NA NA 8.490 1,090 9.580 8,085 874 8,959 80-84 17,293 2.251 19,544 84.2 53 2 80.6 111 4 124.8 112.8 NA NA NA 9.111 1,250 10,361 8,182 1,001 9,183 75-79 13,274 2,190 15.464 795 45.8 747 105.0 1185 1068 NA NA NA 6,799 1,188 7,987 6,475 1,002 7,477 <75 13,387 3,069 16,456 69.6 390 639 104.2 1144 106,0 NA NA NA 6,831 1.638 8,468 6,556 1,431 7,988 Figure C.1 Calendar Birth Ratios for Living, Dead, and All Children Per too Births 130 120 110 100 go 80 w 1992 1991 1990 1989 1988 Calendar Year of Birth i 1987 1986 1994 IOHS 293 Table C.5 shows that the proportion of early neonatal deaths among all neonatal deaths is consistent with declining infant mortality rates. The same conclusion can be drawn from higher proportions of neonatal deaths among all infant deaths (see Table C.6). Table C.6 shows heaping in age at death in multiples of six months. Table C.5 Reporting of age at death in days Distribution of reported deaths under one month of age by age at death in days and the percentage of neonatal deaths reported to occur at ages 0-6 days, for five-year periods preceding the survey (weighted), Indonesia 1994 Number of years preceding the survey Age at death Total (in days) 0-4 5-9 10-14 15-19 0-19 <1 123 144 151 117 535 1 109 105 105 103 421 2 29 36 20 19 104 3 19 49 38 36 142 4 15 9 14 7 44 5 20 29 32 24 105 6 32 17 42 22 112 7 42 112 144 125 423 8 15 3 16 28 63 9 15 12 16 16 59 10 16 6 37 29 88 11 6 2 3 6 16 12 I 2 4 16 22 13 6 7 8 1 21 14 I1 19 8 10 49 15 I1 18 16 7 52 16 4 6 1 1 12 17 0 5 12 7 23 18 6 11 1 8 26 19 2 9 4 0 15 20 7 14 6 22 49 21 7 I 5 8 20 22 2 0 3 0 5 23 3 0 1 0 4 24 1 0 4 0 5 25 3 3 7 9 22 26 0 1 0 0 1 27 1 6 8 4 19 28 5 2 2 6 14 29 0 0 2 1 2 30 2 2 2 0 7 31+ 0 I 2 2 5 Total 0-30 510 630 711 631 2,481 Percent early neonatal t 67,9 61.7 56.6 51.9 59.0 1(0-6 days/0-30 days) × 100 294 Table C.6 Reporting of age at death in months Distribution of reported deaths under two years of age by age at death in months and the percentage of infant deaths reported to occur at ages under one month, for five-year periods preceding the survey (weighted), Indonesia 1994 Number of years preceding the survey Age at death Total (in months) 0-4 5-9 10-14 15-19 0-19 <1 a 510 631 713 633 2,486 1 83 122 141 113 459 2 69 117 111 99 395 3 49 101 83 110 344 4 31 79 70 52 233 5 22 50 57 37 165 6 45 71 37 62 215 7 43 66 73 61 243 8 21 53 49 46 169 9 14 53 42 47 156 10 I1 24 18 33 86 11 8 17 25 22 72 12 40 124 145 139 449 13 6 9 19 24 57 14 18 10 3 13 44 15 2 9 12 9 31 16 7 9 7 4 28 17 1 5 3 2 II 18 31 19 62 25 137 19 5 7 1 4 16 20 2 8 2 5 16 21 0 0 1 1 2 22 3 1 3 4 12 23 0 4 0 1 5 Total 0-11 904 1,384 1,419 1,315 5,021 Percent neonatal b 56.4 45.6 50.2 48.1 49.5 alncludes deaths under 1 month reposed in days b(Under 1 month/under 1 year) × 100 295 APPENDIX D PERSONS INVOLVED IN THE 1994 INDONESIA DEMOGRAPHIC AND HEALTH SURVEY APPENDIX D PERSONS INVOLVED IN THE 1994 INDONESIA DEMOGRAPHIC AND HEALTH SURVEY STEERING COMMITTEE Dr. Haryono Suyono, Minister of Population/ Chairman, National Family Planning Coordinating Board (NFPCB) Prof. Dr. Sujudi, Minister of Health (MOH) Drs. Azwar Rasjid, Director General, Central Bureau of Statistics (CBS) dr. P. P. Sumbung, MPH NFPCB Sugito, MA CBS Drs. M. Soedarmadi NFPCB Dr. Soemarmo Poorwo Soedarmo MOH Soekayat Darmosuwito, MA CBS Dr. Rohadi Haryanto, MSc NFPCB Drs. Soetedjo Moeljodihardjo NFPCB Dr. Abduliah Cholil, MPH NFPCB Drs. Sardin Pabbadja NFPCB Dr. Sahala Pandjaitan, SKM NFPCB dr. Loet Affandi NFPCB dr. S. Leimena, MPH MOH dr. Hadi M. Abednego, SKM MOH Soemarsono, SKM NFPCB dr. Ratna Tjaja, SKM NFPCB Dr. Pudjo Rahardjo NFPCB Dr. H. Edeng H. Abdurrachman NDPB Dr. Djuhari Wirakartakusumah DI-UI Dr. Sri Harijati Hatmadji DI-UI Dr. Aris Ananta DI-UI Dr. Si Gde Made Mamas CBS Toto E. Sastrasuanda, MS CBS Sri Budianti, MS CBS Dr. Sudarti Surbakti CBS M. Abdulmadjid CBS Ir. Sri Soewasti Soesanto, MPH MOH dr. Nyoman Kumara Rai, MPH, DTPH MOH Abdul Muhid Meliala, SKM MOH dr. L. Ratna Budiarso, MSc PH MOH Soeharsono Soemantri, Ph.D MOH Drs. Soegeng Waloeyo, MPH NFPCB TECHNICAL TEAM Soekayat Darmosuwito, MA CBS Drs. M. Soedarmadi NFPCB Dr. Soemarrno Poorwo Soedarmo MOH Toto E. Sastrasuanda, MS CBS Sri Budianti, MS CBS Drg. Kusnadi Satjawinata, SKM NFPCB Dr. Rohadi Haryanto, MSc NFPCB M. Abdulmadjid CBS Dr. Si Gde Made Mamas CBS Drs. Soegeng Waloeyo, MPH NFPCB lr. Sri Soewasti Soesanto, MPH MOH dr. L. Ratna Budiarso, MSc PH MOH Soeharsono Soemantri, Ph.D MOH Dr. Sudarti Surbakti CBS Dr. Pudjo Rahardjo NFPCB Drs. A. Muchyi NFPCB Dr. H. Hasan M. Husni, MPH NFPCB Drs. Tohir Diman, MA NFPCB Ir. Maesuroh, MS CBS Happy Hardjo, SE, MSc CBS Pudji Hastutiningsih, MSc CBS Drs. Suharno, MSc CBS Karsidik, BSt CBS Djamal, MSc CBS Drs. Eri Hastoto CBS Dra. Kasmiyati, MSc NFPCB Drs. Asaad Malik NFPCB Drs. Razali Ritonga, MA CBS lr. Wien Kusdiatmono CBS Togi Siahaan, DP.Sc CBS Dra. Suwartiningsih NFPCB Ir. Siti Fatonah, MPH NFPCB Yohandarwati, MA NDPB Ir. Laely Sugiono CBS Suryanto, BSc CBS Nurringsih CBS Herwati Suci W. CBS AlfredoAliaga Elizabeth Britton Trevor Croft Anne Cross DHSSTAFF Sri Poedjastoeti Kia Reinis Martin Wulfe 299 Ir. Maesuroh, MS Drs. Suharno, MSc. Karsidik, BSt. Happy Hardjo, SE, MSc Pudji Hastutiningsih, MSc Ir. Wien Kusdiatmono Drs. Razali Ritonga, MA Togi Siahaan, DPSc Ir. Laely Sugiono Drs. Syafi'i Nur Muhammad Taufiq Awaludin Apriyanto Aan Sujanah CBS CBS CBS CBS CBS CBS CBS CBS CBS INSTRUCTORS Ir. Djoko Yuwono Ir. S Gultom Ir. Lies Rosdiyanti Ir. Diah Utami Yusuf Muharram, MA Tri Sudiati, MA Martini, BA Djusni Meirida DATA PROCESSING STAFF (CBS) lka Luswara Theodora H. S. Heru Birowo Tri Windiarto CBS CBS CBS CBS CBS CBS CBS NFPCB DIAceh Chie~ Statistics Office Field coordinator Supervisors Field Editors Interviewers SURVEY FIELD STAFF BY PROVINCE North Sumatra Moch. Machin Ervan Hera Hendra Permana Chief, Statistics Office Field Coordinator Munir Kastabuan Daud Muh. Saichudin Aidawati Ummi Salamah Siti Rodiah Rosni Cut Mahani Mimi Sumarni Ir. Farida Husna Yulita Israwati Zahniar Abdullah Malahayati Sudarni Sakdiah Supervisors Field Editors Interviewers A. K. Hasibuan M. Nasir Syarbaini Poltak Manurung M. Yahya Lubis Mangasal Sirait Rasyuddin Tanjung Nurmauli L. Gaol Julia Daratea Zulaidar Lisnawati Rosmeri Brahmana Ellen Tampubolon Deliana D. Bulele Nina Inda Masta Juwita Sugiarti Tuti Hidayati Enni Nuryani Rika Pentina Diana Aulia A. T. Meiza Inaya Sri Andriani 300 West Sumatra Chief, Statistics office Field coordinator Supervisors Field editors Interviewers Jambi Chief, Statistics office Field coordinator Supervisors Field editors Interviewers Armuni Umar Bambang Yuniadi Joni Suryadi Bakhtiar Aspul Marusin Lisayanti Devy Deswati Reniwati Rahayu Erni Sulastri Afnita Roza Dani Ilhamiwitri Harlinda Yanti Yuslinar Indrawati Dewi Rahmawati Yuni Marlita Hellyan Zulfaris Daz Hendi Budiman Ismail Amshal Budi Hardiono A. Fauzie Dewi Handayani Supri Handayani Setiawati Emi Lestari Rahmawati Yuniar Nurnizawati Asnidar Iin Saniah Eloen Madjid Herlina Aisah Riau Chief, Statistics office Field coordinator Supervisors Field editors Interviewers South Sumatra Chief, Statistics office Field coordinator Supervisors Field editors Interviewers Soetedjo Martohandoyo Azwar Thalib Anwar Pane Yusup Isnandar H. Mohd. Lubis Dewi Kristiani Hartini Ida Rofina Gusmaniar Sriani Astuti Rozalinda Nina Martini Rita Susanti Murni Eva Indriani Normah Nurhayati Th. Suprono M. Sairi A. Rahman YS Sukarno Rahman Hodirman Zubaidah Supardindiyah Rinahayati Evi Salvidar Sarinah Siti Badariah Niswati Andriana Ade YP Rosilawati Ningsih Netty Simanjuntak Prilly Hutapea Yeni Dwi Sartika Nurbaiti 301 Bengkulu Chief, Statistics office Field coordinator Supervisors Field editors Interviewers DKI Jakarta Chief, Statistics office Field coordinator Supervisors Field editors Interviewers Kitab Bangun Hamdani Siswojo Panca Nugraha Yuliam Efendi M. Zen Dewi Handayani Eka Prihartini Elfa Trimulyani Yuni Marliana Srining Karyani Sukiswati Chamsiah Hidayani Erni Herawati Amalela Netty Nurlaisa Elya Sumarni Litra Debora Poniman Suhartono Abdul Manaf Johanes Ginting Misbach Subandi Asril Kuswoto Yahya Endang Esti Ratih Gandari A. Sardjijem Pudji P. Prayekti Nurika P. Suwarni Yulianti Sushinta P. Retno P. S. Zahrowati Rochmani Luky W. Yuyun Sri R. Titik Rubaah M. A. Rayati Sri Hastuti Ely Marlina Maryani Yohmawati Winda Tri Lestari Nurokhmien Siti Rohana Sosiawati Zaitun Z. Rama Purba Aulia Mufrida Juariyah Lampung Chief, Statistics office Field coordinator Supervisors Field editors Interviewers West Java Chief, Statistics Office Field coordinator Supervisors Field editors Interviewers Slamet Mukeno M. Haslani Haris Paulus S. Wildan M. Saparudin Sriyatun Taulina A. Sri Wahyuni Elvisari Ana S. Hayati Hasmaryati Mardianah Siti Soiman Sartini Tri Evi Apriani Farida Iryani Heny Cahyawati Wagiyem Moch. Asta Lukman Ismail Asep Riyadi Sugiri Sutardi Endang Syamsudin Warso Suryana Rini Apsari Ati Dermawati Bana Bodri Enung Asih G Sumaryati Ida Nurchaida Susanti Ipoy Yulianawati Heni Hendaryani Rumitha Priska Any Heryani Noneng Komara Martina Yuning Sugiharti Tuti L. Iboh H. S. Sinta 302 Central Java Chief, Statistics office Field coordinator Supervisors Field editors Interviewers EastJava ChieL Statistics Office Field coordinator Supervisors Field editors Interviewers Samadi Wagiyo Eddy Susilo Sapto H. Warjuli W. Rusdiarto H. S. Sajoga Adelina Yuslinar Sutirin Sri Martini Yuyun Wiendyawati Sri Astuti Sri Martini Siti Maisaroh Sri Hartini Gani Sri Anawati Sulastri Putriyani Tri Setyowati Susilowati Sri Wahyuti Umi Agustin Suwondo Hp. Ida KomangWisnu Sutikno Suhermanto S. Hafidz Supatno Sri Kadarwati Kuswahyuniati Peni Candraningtias Maria Eny M. Dwi Irnawati Endang Sulastri Endang Widiarti Doko Endah S. Agustina Martha Sri Wahyuni Anik Hidayati Endang Susilaningrum Lilis Srihardewi Wahyu Furqundari lndarwati Eny Indiastuti Irina Wijayanti DIYogyakarta Chie~ Statistics office Field coordinator Supervisors Field editors Interviewers Bali Chie~ Statistics office Field coordinator Supervisors Field editors Interviewers Soeharto D. Syarifah Tohirman Surachman Sudarmo Sussiarti Mimy Sumardi Sri Budi R. Chrisdiana W. W. L. Sumartini Nanik Rumilah Triatmi T. H. Aviantri Nurul Huda Rinarti Iswanti D. A. Widyanti T.H. Kristianti Mulyono Muah Ibram Syahbudin I Wayan Panta A Ngurah Wijaya Ketut Gama Nugrahini Widyawati Ida Ayu Komang W. A Raka Suryaningsih Ni G. A. Ngh. Suryati Ni Nyoman Rusni Ni Nyoman Surati Ni Made Ratmini Ni Made Wartini Luh Putu Srinadi A Sagung Mas Rani Ni Putu Minarni Komang Yuniarti Ni Ketut Mudawati 303 West Nusa Tenggara Chief, Statistics office Field coordinator Supervisors Field editors Interviewers East Timor Chief, Statistics office Field coordinator Supervisors Field editors Interviewers Moch. Kosim Zaini Afin Zainudin Syamsuddin Jayeng Wahyu Kuncoro Raehatul Jannah B. Enny Sukriani Wahyudiarti Erniwati SP Nur Widyawati Ida Ayu Nyoman WI Hurun Ratnawati Umilailah Ni Luh A. Utariyani Etty Mulyati Zaini Afein Mardiana Ni Nengah Ayu H. Ni Made Tirtha Sri Yudiati T. Yulianto Indrat Mojo Simson Sianipar Nyoman Santa W. R. Anamilo Elisabet P. M. Rochmawati Nanci R. Rea Alawiyah Duro Emelia D. J. Emiyati Yane Eva Fernandes Levina E. S. Maria F. I. Juliana S. M. Celestina De Silva East Nusa Tenggara Chief, Statistics office Field coordinator Supervisors Field editors Interviewers West Kalimantan Chief, Statistics office Field coordinator Supervisors Field editors Interviewers Saudin H. Sitorus Rusman Desiar Y. Ganggar Johanes Bauk Moch Batik Matamira B. Kale Mariana S. Parera M. Immaculata S. Kristina K. R. B. Feliksia P. K. S. Yuliana Esther Sunami Katharina Unab Dorce Welmau B. B. da Gomes Y. Teorilde Toa Bergita Limun Sunardi AS Willy Hendria Rosihan Anwar Hasyuan Minarni Parmiatun Samiati Leila Ayu Z. Elly Nurmawati Lice Novianti Ika Novia Sutiana Jamilah Sri Mulyani Gusmiati Ida Royani S. Suratini Agustinah Tri Setiani Ida Royani 304 Central Kalimantan Chief, Statistics office Field coordinator Supervisors Field editors Interviewers East Kalimantan Chief, Statistics office Field coordinator Supervisors Field editosr Interviewers Sudjana Sumirdja Djarih Soelaiman Ruslan D. W. Agus Berlin N. Isbandi Yatim Yulatriska Yohana Ningsih Elda Sri Waryani Yuliati Sitti Aisyah Iswahyuni Anisah Raihana Agustina S. W. Endang Sunari Sarwono Nyoto Widodo Masiran Subagio Ismail Basiran Suwandi Rosdaniar Lilis Suryani Siti Fariansyah Yana Rapinah Asfi Amanah Mursinah Yuyun Jurniah Aloha Noor Rusdiana Vivi Aswar Ida Nurhayati Dwi Roswita South Kalimantan Chief, Statistics office Field coordinator Supervisors Field editors Interviewers North Sulawesi Chief, Statistics office Field coordinator Supervisors Field editors Interviewers Mukadi Hadiwidjojo Loekito Praptoprijoko Abdul Sani Hariyadi Ishak Ahmad Siti Mulia E. Renida Rismadewi Sukasih Kartini Noor Kaila Norjanah Elly Mariana K. Muhdiati Lilik Astiari Zainatul Saniah Rusmiati Sri Harmini Noor Hasanah Sri Murniani Thaib M. Datau Djumed Cholid Lempo Tambeo M. Tenggehi B. Igir Ruida Liputo A. Katuuk Rosye Kussoy Sylvana Datau Beby Usman Aisah Datau Ningsih P. Ismail F. Tampemawa Agustin Pusung Sylfia Pelealu Fitri Buhang Sevelin Paseki Santje Prang Meiske Rumawir 305 Central Sulawesi Chief, Statistics office Field coordinator Supervisors Field editors Interviewers Southeast Sulawesi Chief, Statistics office Field coordinator Supervisors Field editors Interviewers Kaharso Kamdin Kiamas Oce Djanggola Dede Trinovie Rawung Alimun P. Latasad Selvy Tokare Yasli H. Tansala Rahmi Gayanda Sri Irianai H. Yohana Ambatoding Yuniar Tololo Waode Maliani Marni Samudin Ramlah Tangahu Yeni Datau Magna Sidiki Gamar Butudoka Soehandono Saleh Sunadi Laode Muh Mufti Abd.Rahman M. Siti Marwiyah Sumarni Saadah Budianti Kadida Surianti Taor Wd. Sirimarjanawati Titik Nurbaity Siti Maswiyah Nuralisa Saribulan Nuriaty South Sulawesi Chief, Statistics office Field coordinator Supervisors Field editors Interviewers Maluku ChieL Stastistics office Field coordinator Supervisors Field editors Interviewers Mahmudi Gunadi Supena Ilham Hasanuddin Agip Djunaidi Mansyur M. Henny T. Hasimi Murniati A. lnsana Rosiana Rosmiati Sahari B. Ari Prihandini Hermin M. Asma Asnidar Nani Ishak Andi Asmarani Pasainu Nuraisah A. Hermin Halijah Astiah Ardief Achmad Stevanus Nanlohy M. Sapakoly Djohar Layn R. Lopulalan A. Sahetapy S. de Lima N. Togubu H. Holle R. Salawane J. Oppier J. Pupela A. Riuwpassa J. Marlissa Mardiana Mahmud Maryam Salim I. Pattipeilohay 306 Irian Jaya Chief, Statistics office Field coordinator Supervisors Field editors Interviewers Mansyur Siradz Soaloon Siahaan Pudjiono Arifuddin Syarkardi Kahar Abd. Gani Beti Ayu Yuningsih Sitti Rahmawati Eko Mardiana Adriana Carolina Netty M. Siregar Magdalena Matuan Yuliana Sanaki Nelly Brendina Patongloan Endang Budi Rahayu Martina Pasang Sisca Titaley 307 APPENDIX E QUESTIONNAIRES INDONESIA Confidential DEMOGRAPHIC AND HEALTH SURVEY 1994 HOUSEHOLD SCHEDULE i. 2. 3. 4. 5. 6. 7. 8. 9. L0. Ll. IDHS 1994 SAMPLE CODE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HOUSEHOLD NUMBER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NAME OF HOUSEHOLD HEAD IDENT IF ICAT ION CODE PROVINCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . EEQENCY/ ICIPALITY *I . I . SUB-DISTR ICT V ILLAGE AREA . . . . . . . . . . . . . . . URBAN 1 . . . . . . . . . . RURAL 2 ) LARGE C ITY -1 /SMALL C ITY -2 /TOWN -3 /COUNTRYSIDE -4*) ENUMERATION AREA NUMBER SUSENAS 1994 SAMPLE CODE . . . . . . . . . . . . . . . . . . . . . . . . . . . ii INTERVIEWER V IS ITS 2 INTERVIEW DATE . . . . . . . . INTERVIEWER'S NAME . RESULT ***) . . . . . . . . . . . NEXT V IS IT : DATE T IME ,°,,,°,,,o,,.,,,,, ,of,°°°,,°.,.°°,°, ,.i°°,,i°i.° . o,°o,,,,o.o.°, . °oo.,,°,o,o,o,o,,, °,o,o,o,,,o,o,o,,, o.°,°,.,°.,°,°.,, °i.l,o.°,.°°.°,. °,°,°,o,o,°°o,°°,, F INAL V IS IT MONTH YEAR INTERVIEWER F INAL RESULT TOTAL NUMBER OF I I V IS ITS ***) RESULT CODES: 1 COMPLETED 2 NO HOUSEHOLD MEMBER AT HOME OR NO COMPETENT RESPONDENT AT HOME AT T IME OF V IS IT 3 ENT IRE HOUSEHOLD ABSENT FOR EXTENDED PERIOD 4 POSTPONED 5 REFUSED 6 DWELL ING VACANT OR ADDRESS NOT A DWELL ING 7 DWELL ING DESTROYED 8 DWELL ING NOT FOUND 9 OTHER (SPECIFY) F IELD EDITOR SUPERVISOR OFF ICE EDITOR NUMBER OF HOUSEHOLD MEMBERS TOTAL EVER- ~ MARRIED WOMEN 15-49 NAME DATE CODE KEYED BY CODE *) Cross out category not used **) C i rc le se lec ted category 3]] ***) Choose su i tab le resu l t HOUSEHOI .D Now I would like some int~)rmation about USUAL RESIDENTS RELATIONSHIF TO HEAD OF HOUSEHOLD PLease g ive me the names ~hat is th( of The persons who usua l ly re la t ion - [~ve |n your household, sh ip of s ta r t ing with the head of (NAME) to or the household, the head ol female? the house- hold? * (2) TICK HERE IF CONTINUATION SHEET USED EDUCATION FOR ALL PERSONS AGED 5 OR OLDER Is How o ld Has What i s the IF AGE (NAME) i s (NAME) h ighest Level LESS male (NAME)? ever of school THAN been ( NAME ) 25 To : attended? YEARS school? What is The Is h ighest Grade (RANE) (NANE) s t i l l i n completed at school? that Level?** (3) I (4) I (5) I (6) I (7) (8) N F YEARS I YES NO LEVEL GRADE YES NO , , . • • J i i • i i • • i L F] i • i i • • i i I 2 I 2 1 2 • • J i F]q N , , , • • i i , Fq ,2 fq ,2 • | i i N , 2 • | i i , | • i i [] Just TO make sure That I have a complete L i s t ing : I) Are there any other persons such as small ch i ld ren or in fants that we have not l i s ted? 2) Are there any other people who may not be members of your fami ly , l i ke servants, f r iends , lodgers, but who usua l ly Live here? 3) Are there any other guests or v i s i to rs who have been temporar i ly s tay ing wi th you for The past 6 months or more? 4) Are there any persons who usua l ly l i ve here who have been away for tess than 6 months? 5) Are there any persons we have l i s ted who have been away for the pest s ix months? * ) COOES FO~ COLL~4N (3) RELATIONSHIP TO HEAD OF HOUSEHOLD: 01= HEAD 05 = GRANDCHILD 02: WIFE OR HUSBAND 06= PARENT 03= SON OR DAUGHTER 07= PARENT'IN-LAW 04= SON OR DAUGHTER'IN'LAW 08= BROTHER OR S%STER 312 09: OTHER RELAT%VE 10: ADC~TED/FOSTER CHILD 11: STEPCHILD 12: ROT RELATED 98: DON~T KNOW SCHEDULE the people who usually live in your household. PARENTAL SURVIVORSHIP AND RESIDENCE FOR PERSONS LESS THAN 15 YEARS OLD Is (NAME)'s natura l mother a l i ve? (9) YES NO OK 1 2 B 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 IF ALIVE Does (NAME)'s natura l mother L ive in th i s household? IF YES: What i s her name? RECORO MOTHER'S LINE NU'RBER (10) [-N Is (NAHE)fs natura l fa ther a f i re? (11) YES NO DK 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 Z 8 1 2 8 1 2 6 1 2 8 1 2 8 1 2 8 1 2 8 I f ALIVE Does (NAME)~s natura l fa ther Live in th i s household? iF YES: What is h is name? RECORD FATHER'S LINE NUMBER (12) n-1 MARITAL STATUS FOR WOHEN AGE 10 YEARS AND ABOVE HBS (NAME) ever been married? (13) YES NO 1 2 1 2 ELIGIBILITY CIRCLE LINE NUMBER OF ALL EVER'MARRIED WOMEN AGE 15"49 FOR INDIVIDUAL INTERVIEW (14) 01 02 1 2 03 1 2 04 1 2 05 1 2 06 1 2 07 1 2 08 1 2 09 1 2 10 1 2 11 1 2 12 1 2 13 1 2 14 1 2 15 TOTAL NL~4BER OF ELIGIBLE ~EN YES ~ > ENTER EACH IN TABLE YES ~ > ENTER EACH IN TABLE YES [~-> ENTER EACH IN TABLE YES [ ~ > ENTER EACH %N TABLE YES [~-> DELETE NAMES FRed TABLE NO[] NO [ ] NO [ ] NO [ ] NO [ ] ** ) CQOES FOR COLLq4g (7) LEVEL OF EDUCATION: 1= PRIMARY SCHOOL 2= JUNIOR HIGH SCHOOL S = SENIOR HIGH SCHOOL 4= ACADEMY 5= UNIVERSITY 8= DON'T KNOW GRADE: 7=COHPLETED 8=DON'T KNO~ 313 NO. PERTANYAAN DAN SARINGAN 15 ~at is the main source oF dr ink ing water for members of your household? TERUS KOOE I KE PIPED INTO RESIDENCE . . . . . . . . . . . 11 P%PED INTO YARD OR PlOT . . . . . . . . 12 />17 PUBLIC TAP . . . . . . . . . . . . . . . . . . . . . 13 PUMP . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 PROTECTED ~ELL . . . . . . . . . . . . . . . . . 22 UNPROTECTED WELL . . . . . . . . . . . . . . . 23 PROTECTED SPRING . . . . . . . . . . . . . . . ]1 UNPROTECTED SPRING . . . . . . . . . . . . . 32 RIVER . . . . . . . . . . . . . . . . . . . . . . . . . . 33 RAINWATER . . . . . . . . . . . . . . . . . . . . . . 41 OTHER 96 (SPECIFY) 16 How Long does i t take to go there, get mater MINUTES . . . . . . . . . . . . . . . . . J i l l and come back? ON PREMISES . . . . . . . . . . . . . . . . . . . 996 I 18 19 17 What kind of to i le t fac i l i ty does your household have? CHECK 15 (CODES 21 ,2~:~)~ V How far is the distance between the welt and the nearest cesspool? 20 (IN METER) PRIVATE WITH SEPTIC TANK . . . . . . . . . . . . . . . . . . . 11 PRIVATE WITH NO SEPTIC TANK . . . . . . . . . . . . . . . . 12 SHARED/PUBLIC . . . . . . . . . . . . . . . . . . 21 RIVER . . . . . . . . . . . . . . . . . . . . . . . . . . 31 OTHER 96 (SPECIFY) OTHER CODES I ] >20 DISTANCE . . . . . . . . . . . . I i t METERS DON rT KNOW . . . . . . . . . . . . . . . . 98 Does your household have: E lec t r i c i ty? A radio or tape recorder? A te levis ion? A gas stove? A kerosene stove? An e lec t r i c stove? A ref r igerator? YES NO ELECTRICITY . . . . . . . . . . . . . . 1 2 RADIO OR TAPE RECORDER.1 2 TELEVISION . . . . . . . . . . . . . . . 1 2 GAS STOVE . . . . . . . . . . . . . . . . 1 2 KEROSENE STOVE . . . . . . . . . . . 1 2 ELECTRIC STOVE . . . . . . . . . . . I 2 REFRIGERATOR . . . . . . . . . . . . . 1 2 21 Does any me~nber of your household own: 22 A bicycle/rowboat? A motorcycte/mo¢orboat? A c l r? MAiN MATERIAL OF THE FLOOR (RECORD OBSERVATION) What is the FLoor area of your bui ld ing? (IN SQUARE METERS) I YES NO I BICYCLE/ROWBOAT . . . . . . . . . . 1 2 MOTORCYCLE/MOTORBOAT . . . . . 1 2 CAR . . . . . . . . . . . . . . . . . . . . . . 1 2 I . I BAHBO0 . . . . . . . . . . . . . . . . . . . . . . . . . 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 CONCRETE/BRICK . . . . . . . . . . . . . . . . . 31 T%LE . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 CERAMIC/MARBLE/GRANITE . . . . . . . . . 33 OTHER 96 (SPECIFY) r ~ AREA . . . . . . . . . . . . . . . . I I I I M2 DON'T K N (Y,J . . . . . . . . . . . . . . . 998 24 ° isthePri Yc°nstruci°n eraL°f he er IB COTEROBAB . . . CSPECFY 632 I 25 What is the primary construct ion material of the roof? I CONCRETE . . . . . . . . . . . . . . . . . . . . . . . O i l ~/0OO . . . . . . . . . . . . . . . . . . . . . . . . . . . 02 TILE . . . . . . . . . . . . . . . . . . . . . . . . . . . O] ASBESTOS/ZINC . . . . . . . . . . . . . . . . . . LEAVES . . . . . . . . . . . . . . . . . . . . . . . . . OTHER (SPECIFY) 26 What is the ownership status of your bui ld ing? | OI4N . . . . . . . . . . . . . . . . . . . . . . . . . . . . 01 I I MORTGAGE . . . . . . . . . . . . . . . . . . . . . . . 02 I CONTRACT . . . . . . . . . . . . . . . . . . . . . . . O] RENT . . . . . . . . . . . . . . . . . . . . . . . . . . . D4 OFFICIAL . . . . . . . . . . . . . . . . . . . . . . . 05 OTHER .96 (SPECIFY) 3]4 ] INDONESIA DEMOGRAPHIC AND HEALTH SURVEY ]994 iNDIVIDUAL QUESTIONNAIRE Confidential IDENTIFICATION CODE i. PROVINCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. REGENCY/MUNICIPALITY *) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. SUB-DISTRICT 4. VILLAGE 5. AREA . . . . . . . . . . . . URBAN - i . RURAL - 2 **) 6. LARGE CITY -1/SMALL CITY -2/TOWN -3/CODI~RYSIDE -4*) 7. EhV3MERATION AREA NL~BER 8. SUSENAS 1994 SAMPLE CODE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F 9. IDHS 1994 SAMPLE CODE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [0, HOUSEHOLD ~ER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [i. NAME OF HOUSEHOLD HEA/~ L2. LINE NI~4BER OF WOM/~N FROM HOUSEHOLD SCHEDULE . . . . . . . . . . . . . . . . . . . . . . . L3. N~J4E OF WOMAN INTERVIEWER V IS ITS 1 2 3 FINAL VIS IT MONTH INTERVIEW DATE. YEAR INTERVIEWER' S NAME . INTERVIEWER ~ " ' " RESULT ***) . FINAL RESULT NEXT VISIT: DATE ::::::::::::::::::: . 11 o, . i . J . J . . . , . . . ,o , ° . TOTAL NUMBER o,,,.,o,o,.,.,.,. TIME ::::::::::::::::::: OF VISITS ,,,,,.°.°,,.,,,,oo ***) RESULT CODES: 1 COMPLETED 2 NOT AT HOME 3 POSTPONED 4 REFUSED 5 PARTLY COMPLETED 6 INCAPACITATED 7 OTHER NAME DATE *) **) FIELD EDITOR I SUPERVISOR I OFFICE EDITOR ~ I Cross out category not used Circle selected category Choose suitable result 315 (SPECIFY) KEYED BY CODE 316 NO. 101 RECORD THE TIME. 102 F i rst I would l i ke to ask some questions about you. For most of the time unt i l you were 12 years old, d id you l ive in a c i ty , in a town, or in a v i l lage? I SECYIOII 1. RESPOMDENT'S BACIEC, RQUND I QUESTIONS AND FILTERS COOING CATEGORIES HM,~,RuI~IIIIIIIIIIIIIIIIIIII~ CITY . . . . . . . . . . . . . . . . . . . . . . . . . . . I TOWN . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 VILLAGE . . . . . . . . . . . . . . . . . . . . . . . . . 3 SKIP TO I 105 In what month and year were you born? WRITE MONTH IF NOT IN WESTERN CALENDAR MONTH: MONTH . FT~I DON'T KNOW MONTH . . . . . . . . . . . . . . . 9B YEAR . . . . . . . . . . . . . . . . . . . . . . . ~ DON'T KNOW YEAR . . . . . . . . . . . . . . . . 98 COMPARE AND CORRECT 105 AND/OR 106 IF INCONSISTENT, IO6AI Are you now married, divorced or widowed? J MARRIED WIDOWED DIVORCED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2 l J ,0,I ovo i . ,i NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 >114 I - . primary, jun ior high, senior high, academy, or JUNIOR HIGH SCHOOL . . . . . . . . . . . . . . 2 university? SENIOR HIGH SCHOOL . . . . . . . . . . . . . . 3 ACADEMY . . . . . . . . . . . . . . . . . . . . . . . . . 4 UNIVERSITY . . . . . . . . . . . . . . . . . . . . . . 5 I I 109 I What is the highest (GRADE, YEAR) you completed I I at that Level? I COMPLETED = 7 I 110 I CHECK 106: AGE LESS AGE 25 THAN 25 [~ OR ABOVE L~ v B E 111 I Are you current ly attending school? I I I GRADE/YEAN . [~[ I .>113 YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I~I>113 NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 I I 112 113 114 What was the main reason you stopped attending school? RECORD ALL MENTIONED CHECK 108: JUNIOR HIGH PRIMARY ~ OR HIGHER [~ V Can you read and understand a Letter or newspaper I easi ly, with d i f f i cu l ty , or not at a l l ? I GOT PREGNANT . . . . . . . . . . . . . . . . . . . . 01 GOT MARRIED . . . . . . . . . . . . . . . . . . . . . 02 TO CARE FOR CHILDREN . . . . . . . . . . . . 03 FAMILY NEEDED HELP ON FARM OR IN BUSINESS . . . . . . . . . . . . . . . . 04 COULD NOT PAY SCHOOL FEES . . . . . . . 05 NEEDED TO EARN MONEY . . . . . . . . . . . . 06 GRADUATED/HAD ENOUGH SCHOOLING.O7 DID HOT PASS EXAMS . . . . . . . . . . . . . . 08 DID NOT LIKE SCHOOL . . . . . . . . . . . . . 09 SCHOOL NOT ACCESSIBLE/TOO FAR.IO OTHER _96 (SPECIFY) DK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 )115 i EASILY . . . . . . . . . . . . . . . . . . . . . . . . . . 1 I WITH DIFFICULTY . . . . . . . . . . . . . . . . . 2 I NOT AT ALL . . . . . . . . . . . . . . . . . . . . . . 3-->116 317 2 No I QUESTIONS AND FILTERS l 115 I Do you usuaLLy read a newspaper or magazine at least I once a week? CODING CATEGORIES YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 SKIP TO 116 I 0o you usual ly Listen to a radio every day? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 I NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 117 i Do you usual ly watch te lev is ion at Least YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 | I once a week? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 I What religion are you? MUSLIM . . . . . . . . . . . . . . . . . . . . . . . . . . I PROTESTANT/CHRISTIAN . . . . . . . . . . . . 2 CATHOLIC . . . . . . . . . . . . . . . . . . . . . . . . 3 HINDU . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 BUDDHIST . . . . . . . . . . . . . . . . . . . . . . . . $ OTHER 6 (SPECIFY) 119 What i s the Language used at home? I INDONESIAN . . . . . . . . . . . . . . . . . . . . . 01 - ->201 JAVANESE . . . . . . . . . . . . . . . . . . . . . . . 02 | SUNDANESE . . . . . . . . . . . . . . . . . . . . . . 03 I BATAR . . . . . . . . . . . . . . . . . . . . . . . . . . 04 MINANG . . . . . . . . . . . . . . . . . . . . . . . . . 05 BUGINESE . . . . . . . . . . . . . . . . . . . . . . . 06 OTHER 96 (SPECIFY) 120 I Can you speak Bahasa Indonesia? IF INTERVIEW IS IN SAHASA INDONESIA, DON'T ASK THIS QUESTION. CIRCLE CODE 1. I YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I I NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 318 RO. I 201 ] QUESTIONS AND fILTERS NOW I would like to ask about all the births you have had during your l i fe. Have you ever given birth? I SECTION 2. REPI~DOUCTIOll I SKIP COOING CATEGORIES J TO m m YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I l I NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-->206 I 202 0o you have any sons or daughters to whom you have given birth who are now living with you? ::::::::::::::::::::::::::::::::::::::: I 203 How many sons live with you? And how many daughters tire with you? I f NONE, ENTER '00'. 204 Do you have any sons or daughters to who~ you have given birth who are alive but do not Live with you? I YES . I l ! NO . . 2 - ->206 ! 205 I How many sons are ative but do not live with you? And how many daughters are alive but do not live with you? IF NONE ENTER tO0~. DAUGHTERS ELSEWHERE. 206 Have you ever given birth to a boy or a girt who was burn alive but tater died? IF NO, PROBE: Any baby who cried or showed any sign of life but survived only a few hours or days? I YES . I l I NO . 2 I >208 207 208 209 210 In all, how many boys have died? And how many girls have died? IF NONE, ENTER '00'. SUM ANSWERS TO 203, 205, AND 207, AND ENTER TOTAL. IF NONE, ENTER '00'. GIRLsSOYS gEAgDEAD. . iiiiiiiiiiiiii TOTAL . . . . . . . . . . . . . . . . . . . . . . CHECK 208: Just to make sure that I have this right: you have had in TOTAL your life. Is that correct? YES [~ NO F~ • PROBE AND CORRECT 201-208 AS NECESSARY / V l ive births during CHECK 208: ONE OR MORE m LIVE BIRTH V NO LIVE BIRTHS ~] i >223 1 319 211 NO~ I WouLd Like to record the r~s of e l l your b i r ths , whether st iLL a l i ve or not, s ta r t in9 with the f i r s t one you had. RECORD MAMES OF ALL THE BIRTHS IN 212. RECORD TWINS AND TRIPLETS OR SEPARATE LINES 320 212 213 I.that name was Were Is In what ~ronth I s (NN4E) HOW o ld was I s (MANE) g iven to your any o f INANE) and year was s t i l e (NAME) a t [ i v in g ( f i r s t , next ) these I boy (NAME) born? a l i ve? h i s /her w i th you? D~by? b i r ths Or a {ast tw ins? ] i r [ ? b i r thday? !14 215 216 217 218 219 220 IF ALIVE: IF ALIVE: IF DEAD: INTERVAL CHECK: How o ld WaS he /she CALCULATE THE ~en he~she died? DIFFERENCE BETWEEN THE YEAR IF "1 YEAR", PROBE: OF BIRTH OF HOW n~ny nK~lths (NN4E) AND THE PROBE: old WaS (NAME)? YEAR OF THE PRE What i s h i s / RECORD AGE CEDING BIRTH: her b i r thday? IW COMPLE- RECORD DAYS IF LESS IF 4 YEARS OR TED YEARS THAN 1 MONTH; MONTHS MORE. ASK: IF LESS THAN TWO YEARS, OR YEARS IF Were there any TWO YEARS OR ABOVE. o ther l i ve IF LESS THAN ONE b i r th~ between DAY, WRITE 'DO ~ IN the b i r th o f DAYS BOX. (NAME) AND (NAME OF PRECED%MG BIRTH] . j . _ _ . . . . . . . . . . j 08] SINGLE.1 tOY.1 MONTH. YES, . . .1 AGE IN YES 1 DAYS 1 YES 1 YEARS - - - - MULT . . . .2 ; ]RL .2 YEAR. . NO. . . . .2 NO . . . . . . . . 2 MONTHS.2 [ ~ NO . . . . . . . . . . . 2 (NAME) I (TO 220) • . . . . YEARS. . ,S (GO TO < 219 - - - - NEXT BIRTH) (NAME) $[NGLE.1 laY. . 1 MONTH. ~ YES. . .1| AGEyEARsIN YES . . . . . . . .~2 DAYS . . . . . 1 t-.~_ YES . . . . . . . . . . .~ NO . . . . . . . . . . . 2 MOLT. . . .2 ~IRL.2 YEAR. . NO. . . . .2 NO . . . . . . . . 2 MONTHS.2 (TO 220) • 4 - - v YEARS. . . . ] | (GO TO • 219 ~ - - NEXT BIRTH) (NAME) (NAME) N INANE) YEARS / -- - - MULT . . . .2 ; IRL.E YEAR,. NO. . . . . 2 ~ NO . . . . . . . . 2 MONTHS.2 NO . . . . . . . . . . . 2 | r l l (TO 220) < - - - - v YEARS. . . .3 (GO TO < 219 - - - - NEXT BIRTH) - - z~- - - . 4 L SINGLE.1 laY . .1 MONTH. YES . . . .1 AGE IN YES . . . . . . . 1 DAYS . . . . . I YES . . . . . . . . . . 1 YEARS - - - - MULT . . . .2 ; ]RL .2 YEAR. . NO. . . . .2 ~ NO . . . . . . . . 2 MONTHS.E NO . . . . . . . . . . . 2 (TO 220) • - - - - v YEARS. . . .3 (GO TO < 219 - - - - NEXT BIRTH) SINGLE.1 IOY. . ) MONTH., YES . . . .1 AGE IN YES . . . . . . . 1 DAYS . . . . . 1 YES . . . . . . . . . . I YEARS - - - - MULT. . . .E 3]RL.2 YEAR. . NO. . . . .E ~ NO . . . . . . . . 2 HONTHS,.E NO . . . . . . . . . . . 2 (TO 22R) <-- - - - - v YEARS. . . . ] (GO TO < 219 - - - - NEXT . . . . . . . BIRTH) 221 ! CALCULATE THE DIFFERENCE BETWEEN THE YEAR OF INTERVIEW AND THE YEAR OF THE LAST BIRTH. YES . . . . . . . . . . . . . . . . 1 IF 4 YEARS OR MORE, ASK: Were there any o ther l i ve b i r ths a f te r (NAME OF LAST CHILD)? NO . . . . . . . . . . . . . . . . . 2 222 COt~PARE 208 WITH NUMBER OF BIRTHS ABOVE AND MARK: NUMBERS ~ NUMBERS ARE ARE SANE ~ DIFFERENT ~ > (PROBE AND RECONCILE) v CHECK: FOR EACH LIVE BIRTH ( .0215) : YEAR OF BIRTH IS RECORDED FOR EACH LIVING BIRTH (0 .217) : CURRENT AGE IS RECORDED FOR EACH DEAD BIRTH (0 .219) : AGE AT DEATH IS RECORDED FOR AGE AT DEATH 12 MONTH OR ONE YEAR (0 .219) : PROSE TO DETERMINE EXACT NUMBER OF MONTHS 223 | CHECK 215: RECORD NUMBER OF BIRTHS SINCE JANUARY 1989, I IF NONE, RECORD "0" . [] AT THE BOTTC~4 OF THE CALENDAR S ENTER THE NAME AND BIRTH DATE OF THE LAST CHILD B(~N PRIOR TO JANUARY 1989, IF APPLICABLE. 321 6 SKIP NO. I QUESTIONS ANO FILTERS I c~,N° CATEOOR,ES I re Re . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 TAKE CARE WHEN ASKING THIS QUESTION TO DIVORCED OR WIDOWED WOMERI UNSURE . . . . . . . . . . . . . . . . . . . . . . . . . . 8 >229 I 227 I I 228 I At the tlme you ~came pregnant, did you want to become I pregnant then, did you want to wait unfit tater, or dLd yo~t want to l:~cOele pregnant at all? i 229 I Have you ever had a pregnancy that miscarried, I was abor ted , or ended in a s t i t tb i r th? I How many months pregnant are you? MONTH . . . . . . . . . . . . . . . . . . . . . . I I ~NTER "H" IN COLO.NI OF CALENgAR ,N MON'H U' ,NTERVIE. ANO ,N EAC" PREDE"NO MON,. PREGNANT I I g I I g THEN . . . . . . . . . . . . . . . . . . . . . . . . . . . . I l LATER . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 I NOT AT ALL . . . . . . . . . . . . . . . . . . . . . . 3 I YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I I NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 ---)235 ! ,,o .h.°°,.,,e,.,,u.,°.°.°cy.o, I 231 CHECK 230: I LAST PREGNANCY ENDED LAST PREGRANCY ENDED SINCE JANUARY 1989 i~ EFORE JANUARY 1989 ~L >235 I V 2S2 HOW many months pregnant were you when that pregnancy ended7 MONTHS [ ] . i 232A ENTER "K" IN COLUMN I OF CALENDAR IN THE MONTH THAT THE PREGNANCY TERMINATED, AND "H" FOR THE REMAINING NUMBER OE COMPLETED MONTHS. 233 234 235 Hove you ever had any o ther p regnanc ies wh ich d id not resu l t in a ( i re b i r th? YES . . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . 2-- 1231 I ASK FOR DATE AND DURAT[ON Of ALL PREGNANC[ES THAT RESULTED IN MISCARRIAGE, WERE ABORTEG OR I ENDED IN A STILLBIRTH SINCE JANUARY 1989. ENTER l'N" IN COLUMN I OF CALENDAR IN THE MONTH I THAT THE PREGNANCY TERMINATED, AND "H" IN EACH PRECEDING MONTH PREGNANT. When dld your Last menst rua l per iod ~tar t? DAYS AGO . . . . . . . . . . . . . . . . . 1 WEE~S AGO 2 MONTHS AGO . . . . . . . . . . . . . . . ] YEARS AGO . . . . . . . . . . . . . . . . 4 ~__ IN MENOPAUSE . . . . . . . . . . . . . . . . . . 994 gEFORE LAST PREGNANCY . . . . . . . . . 995 NEVER MENSTRUATED . . . . . . . . . . . . . 996 322 I SECTIOM 3 : KNOJLEDGF AMD PRACTICE OF FAMILY PLA/~NING i I 301 m Now [ Wou ld l i ke to ta lk about fami ly p lann ing - the var ious ways e l mt ' thods that a COup le can use to I de lay , avo id o r er'~d a pregnancy or a b i r th . Which o f these ways o r methods have you heard about? CIRCLE COOE I IN 302 FOR EACH METHOD MENTIONED SPONTANE{TJSLY. THEN PROCEED DEYvJN THE COLUMN, READING THE NAME AND DESCRIPTION OF EACH METHOd) NOT MENTIONED SPONTANEOUSLy. CIRCLE COOE 2 IF METHO0 IS RECOGNIZED. AND COOE 3 )F NOT RECOGNIZED. THEN, FOR EACH METHOD VJITH C~E I OR 2 CIRCLED IN 302, ASK 303 304 BEFORE PROCEEDING [0 THE NEXT METHO0. 302 Have you ever 303 Have you ever 304 Where would you go i f heard of (METHO0)? used (METHO0)? you wanted to use (METHO0)? READ DESCRIPTION OF EACH METHOD. (USE CODES BELOW)* l J. Pill ,,o . . . . . . takoo p , . YES/SPONT . . . . . . . . . . . . . . . . . . . T YES . . . . . . . . . . . . . . . , [ i ] •m every day" , YES/PROBED . . . . . . . . . . . . . . . . . . 2 - NO . . . . . . . . . . . . . . . . . . . . . . . . . . 31 NO . . . . . . . . . . . . . . . . 2 OIHER __ . v i r l 121 ]LJD "w . . . . . . . h . . . . l oop or YES/SPONr . . . . . . . . . . . . . . . . . . . % YES . . . . . . . . . . . . . . . 1 i , I I COil p laced inside them by a YES/PROBED . . . . . . . . . . . . . . . . . . 2 I i doctor o r a nurse" . NO . . . . . . . . . . . . . . . . . . . . . . . . . . 3~ NO . . . . . . . . . . . . . . . . 2 OTHER . . . . . . . . . . . v , .~ , . JECT lO .$ ,,o . . . . . . . h . . . . . Y ,S /SPONT . . . . . . . . . . . . . . . . . . . ' YES . . . . . . . . . . . . . . . , , , - , - ] in jec t ion by a doctor o r nurse YES/PROBED . . . . . . . . . . . . . . . . . . 2 I ] I which s tops them f rom becoming NO . . . . . . . . . . . . . . . . . . . . . . . . . . 31 NO . . . . . . . . . . . . . . . . 2 pregnant for 1, 2 or 3 months". I OTHER . . . . . . . . . . . . . . . . . . v I . . . . . . . . . . . . . ,~j 'NT"~O/O,A~.AGM.ELL.~OA. YES/SPON~ . ' I~EB . ~ E l i "Wonwen carl place a tissue or a YES/PROBED . . . . . . . . . . . . . . . . . . 2 diaphragm or cream in the NO . . . . . . . . . . . . . . . . . . . . . . . . . . 31 I NO . . . . . . . . . . . . . . . . 2 vagina before intercourse". I OTHER . . . . . . . . . . . v ' ,~ coNo~ ". . . . . . . . . . . . bber YES/SPONT . , .E. . , [IITLI sheath during sexual inter YES/PROBED . 2 course". NO . . . . . . . . . . . . . . . . . . . . . . . . . . 31 NO . . . . . . . . . . . . . . . . 2 OTHER . . . . . . L~2] )6~ NORPLANT/IMPLANT .,women can get YESISPONT . . . . . . . . . . . . . . . . . . . I YES . . . . . . . . . . . . . . . I 6 rod~ under the sk in i n the YES/PROBED . . . . . . . . . . . . . . . . . . 2 upper arm to prevent pregnancy" NO . . . . . . . . . . . . . . . . . . . . . . . . . .31 NO . . . . . . . . . . . . . . . . 2 OTHER . . . . . . . . . . . . . . v . . . . . . . . . . . . . ~. "MALE S,~ILI,A, ION/TOB~CT~y Y~S/$OONT . . . . . . . . . . . . . . . . . . . ' Have y . . . . . . hada~ I i l I i ] "wc~nen can have an operat ion YES/PROBED . . . . . . . . . . . . . . . . . . 2 o l~rat ion to avo id to avoid having any more NO . . . . . . . . . . . . . . . . . . . . . . . . . . 3 hav ing any m<)re ch i tdren", ch { Ldren? OTHER YES . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . 2 J . . . . . . . . v . . . . . . . . . . . . . . . . )BJ MALE STER 1 L , ,AT , ON/VASECTOMY Y ES/SPONT . . . . . . . . . . . . . . . . . . . I H"" your husb .~ ~] - - ) "Men can have an operation to YES/PROBED . . . . . . . . . . . . . . . . . . 2 had an operation to avo id hav ing any more NO . . . . . . . . . . . . . . . . . . . . . . . . . . 31 to avo id hav ing ch i ld r en" , / ch i [d ren? OTHER YES . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . 2 o91 PERIOOIC ABSTINENCE/CALENDAR YES/SPONT . . . . . . . . . . . . . . . . . . . I v YES . . . . . . . . . . . . . . . I Do you know where a person SYSTEM "Couples can ovoid YES/PROBED . . . . . . . . . . . . . . . . . . 2 can obtain advlee on how to becc~ne cer ta in hav ing the woman pregnant" , sexua l daysis more o f in teFc°urse the l i keLy month towhen on NO . . . . . . . . . . . . . . . . . . . . . . . . . . ] . . . . . . . . . . . . . . . V !0] WITHDRAWAL "Men can be careful YESISPONT . . . . . . . . . . . . . . . . . . . I and pu l l out before climax". YES/PROBED . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . . . . . . 3 I . . . . . . . . . . . . . v 1J ABORTION/MENSTRUAL REGULATION "Women can do son.thing or have someone do somethinQ to end a pregnancy". I~ ANY OTHER METHOOS? "Have you -~ heard of any o ther ways o r methods that women or fr~n can use to avoid pregnancy?". (SPECIFY) 2 (SPECIFY) 3 (SPECIFY) YES/SPONT . . . . . . . . . . . . . . . . . . . 1 YES/PROBED . . . . . . . . . . . . . . . . . .2 NO . . . . . . . . . . . . . . . . . . . . . . . . . . 311 . . . . . . v YES/SPONT . . . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . . . . . . . . . . . 3~ CHECK 302: IS THERE CODE I OR 2 YES NO D ~ V GO TO 303 NO . . . . . . . . . . . . . . . . 2 use per iod ic ~b~t inence? OT"ER I~] YES . . . . . . . . . . . . . . . 11_ ! i l i i!i ~!i i i ; ~ ! i i ~ii i i i . NO . . . . . . . . . . . . . . . . 2 ,E, . . . . . . . . . . . . . . . T~ il ]11 NO . . . . . . . . . . . . . . . . 2 I OTHER I * CODES FOR 304 ~OVEHkWqENT HOSPITAL . . . . . . . . . . . . . . . . . . . 11 HEALTH CENTER . . . . . . . . . . . . . . 12 FP FIELDWX3RKER . . . . . . . . . . . . . 13 FP MOBILE UNIT . . . . . . . . . . . . . 14 YES . . . . . . . . . . . . . . . I OTHER 15 NO . . . . . . . . . . . . . . . . ~ (SPECIFY) P'RIVAIE YES . . . . . . . . . . . . . . . I HOSPITAL . . . . . . . . . . . . . . . . . . . ~ I NO . . . . . . . . . . . . . . . . 2 FP CL IN IC . . . . . . . . . . . . . . . . . . 22 DOCTOR . . . . . . . . . . . . . . . . . . . . . 23 YES . . . . . . . . . . . . . . . % MIDWIFE . . . . . . . . . . . . . . . . . . . . 24 NO . . . . . . . . . . . . . . . . 2 PHARMACY/DRUGSTORE . . . . . . . . . ~5 OTHER 26 (SPECIFY) OTHE~ DELIVERY POST . . . . . . . . . . . . . . 31 HEALTH POST . . . . . . . . . . . . . . . . 32 FP POST . . . . . . . . . . . . . . . . . . . . )3 TRADIT[ONAL HEALER . . . . . . . . . 34 FRIENDS/RELATIVES . . . . . . . . . . ~5 OTHER 96 (SPECIFY) DON T KNOW . . . . . . . . . . . . . . . . . 98 323 8 NO. I QUESTIONS AND FILTERS ]06 J Have ~OU ever used anything or t r ied In any way to I de lay or avo id get t ing pregnant? 307 ENTER "0" IN COLUMN 1 OF CALENDAR IN EACH BLANK MONTH What have you used or done? (SPECIFY) SKIP CODING CATEGORIES I TO YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 >307 NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 -330B I CORRECT 303-305 (AND ASK 302 IF NECESSARY) (SPECIFY) 308 NOW I would L ike to ask you about the f i r s t t i l~ that P[LL . . . . . . . . . . . . . . . . . . . . . . . . . . . . 01 1 you dld s~ethiDg or used a method to delay a pregnancy IUO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 02 I el avold gett+ng pregnant? INJECFIONS . . . . . . . . . . . . . . . . . . . . . . 03 IMPLANFS/NORPLANI . . . . . . . . . . . . . . . 04 What Is the f i r s t th ing yeu ever did o¢ inethod you [NTRAVAG/DIAPHRAGM/FOAM/JELLY.05 ever used to de lay or avo id get t ing pregnant? CONDOM . . . . . . . . . . . . . . . . . . . . . . . . . . 06 FEMALE S I fR I t lZA I ION . . . . . . . . . . . . 07 MAkE STERILIZAI]OR . . . . . . . . . . . . . . OB 308A Where dld you go to get thls ow~thc.d the first time? PLRIODIC ABSIINENGE . . . . . . . . . . . . 09 OTHER WIIHDRAWAL . . . . . . . . . . . . . . . . . . . . . . 96 10 t >308B (SPECIFY) C.01/IFRNNENT HOSPITAL . . . . . . . . . . . . . . . . . . . . . . . 11 HEALTH CENTER . . . . . . . . . . . . . . . . . . 12 FP FIELDWORKER . . . . . . . . . . . . . . . . . 13 FP MOBILE UNIT . . . . . . . . . . . . . . . . . 14 OTHER 15 (SPECIFY) pRIVATE iK )Sp I IA~ . . . . . . . . . . . . . . . . . . 21 IP CE IN IC . . . . . . . . . . . . . . . . . . . . . . 22 DOEIOR . . . . . . . . . . . . . . . . . . . . . . . . 23 MIDWIFE . . . . . . . . . . . . . . . . . . . . . . . . 24 pHARMAEY/DRUGSIORE . . . . . . . . . . . . . 25 OTHER (SPECIFY) OTHER VILLAGE DELIVERY POST . . . . . . . . . . 31 [NIEGRAIED HEALTH POST . . . . . . . . . 32 FP POST . . . . . . . . . . . . . . . . . . . . . . . . 33 TRADITIONAL HEALER . . . . . . . . . . . . . 34 FRIENDS/RELATIVES . . . . . . . . . . . . . . 35 OTHER 96 (SPECIFY) DON'T KNOW . . . . . . . . . . . . . . . . . . . . . 98 300B H . . . . . y I ,v iao c , , Id ren O,d yea , . . . . t t ,o t " . . i f any? NUMBER OF CHILDREN . . . . . . . . . IF NONE, ENTER '00 ' , WOMAN STERILIZED I~[ >312A 309 CHECK 303 ITEM 07 WOMAN NOT stERIL IzED [ i ] V ~0 CHECK 22~: NDT PREGNANT OR UNSURE [ ? V 310A I CHECK I06A: MARRIED --] CURRENTLY ~1 V i 311 I Are you cur rent ly do ing Something oc us ing any method I to de lay or avo id getting pregnant? ]12 Which n~thod are you uslng? 312A CIRCLE '07' FOR FEMALE STERILIZATION, PREGNANT [~ . . . . . . >328 DIVORCED/ WIDOWED L~L - - - >33oH YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 >330B PILL . . . . . . . . . . . . . . . . . . . . . . . . . . . 01 IUD . . . . . . . . . . . . . . . . . . . . . . . . . . . . 02 >317 INJECTIONS . . . . . . . . . . . . . . . . . . . . . OS >316H [MPLANT/NORPLANT . . . . . . . . . . . . . . . 04 >317 [NTRAVAG/DIAPHRAGM/FOAM/JELLY.O5 >317 CONDOM . . . . . . . . . . . . . . . . . . . . . . . . . Ofi-->316K FEMALE STERILIZATION . . . . . . . . . . . 07 MALE STERILIZATION . . . . . . . . . . . . . OB >317 PERIODIC ABSTINENCE . . . . . . . . . . . . 09 OTHER WITHDRAWAL . . . . . . . . . . . . . . . . . . . . . 9 ~ 10 >328 (SPECIFY) I 9 324 NO. QUESTIONS AND FILTERS 315A At the t l r~ you f i r s t started using the p i t t , did you consult a doctor or a midwife? 315B Do you have a package of p i l l s in the house? SKIP COOING CATEGORIES TO YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 DK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2- -->316 I 315C Please show me the packa9e of p i l l s you PACKAGE SEEN . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . (RECORD NAMEin'OF BRAN°) BRAND N A M E : >316A PACKAGE NOT SEEH . . . . . . . . . . . . . . . . . 2 316 Why don ' t you have a package of p i ( l s in RAN OJf . . . . . . . . . . . . . . . . . . . . . . . . . . . l - - the house? COST TOO MUCH . . . . . . . . . . . . . . . . . . . . . 2---. 4 ffUSBANO AWAY . . . . . . . . . . . . . . . . . . . . . . 3---~>3160 HAS PERIO0 . . . . . . . . . . . . . . . . . . . . . . . . 4 OTHER 6 (SPECIFY) I I 316A CHECK PACKET FOR PILL USE AND MARK PILLS MISSING IN ORDER . 1 >316E A CORRECT COOE* PILLS "'SS,.G C~JT OF ORDER . . . . . . . . 2 m NO PILLS MISSING . . . . . . . . . . . . . . . . . . 3 I I 316B Why i s i t that you have not taken the DOESN'T KNOW WHAT TO O0 . . . . . . . . . . . 1 p i l l s ( in order)? HEALTH REASONS . . . . . . . . . . . . . . . . . . . . ' ] FOLLOUING FP FIELDWXSRKER'S ~_ >316E INSTRUC][ON . . . . . . . . . . . . . . . . . . . . . . 3 NEg PACKET . . . . . . . . . . . . . . . . . . . . . . . . 4 MENSTRUATING . . . . . . . . . . . . . . . . . . . . . . S--- OTHER (SPECIFY) m I 316DI SHOW BRAND CHART FOR PILLS: I Please te l l me which of these is the brand of p i ( t s that you are using. (RECORD NAME OF BRAND) NAME-- DOESN ~ T KNOW . . . . . . . . . . . . . . . . . . . . . 98 316E I When was the Last time you took a p i l l ? MORE THAN TWO DAYS AGO V 316G I Why aren' t you taking the p i l l these days? I 316H I When did you last have an injection? I ! 3161 CHECK 316H: 316] I MORE THAN THREE MONTHS AGO ~ V | 31bJ| Why haven't you had an in ject ion recently? [ OA,SAGO: MORE THAN OWE MONTH AGO . . . . . . . . . TWO DAYS AGO OR LESS ~L | HUSBAND AWAY . . . . . . . . . . . . . . . . . . . . . . 01 FORGO] . . . . . . . . . . . . . . . . . . . . . . . . . . . . 02 HEALTH REASONS . . . . . . . . . . . . . . . . . . . . O] - - COST TOO MUCH . . . . . . . . . . . . . . . . . . . . . 04 -- NO NEED TO TAKE OAILY . . . . . . . . . . . . . 05- RAN OUT . . . . . . . . . . . . . . . . . . . . . . . . . . . 06-- HAS PERIOD . . . . . . . . . . . . . . . . . . . . . . . . 07 OTHER 9& (SPECIFY) MOUTHS AGO . . . . . . . . . . . . . . . . . THREE MONTHS AGO OR LESS >317 >317 HUSBAND AWAY . . . . . . . . . . . . . . . . . . . . . . . I~ FORGOT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 HEALTH REASONS . . . . . . . . . . . . . . . . . . . . . S- >317 COST TOO MUCH . . . . . . . . . . . . . . . . . . . . . . 4-- OTHER 6 10 325 NO, QUESTIONS AND FILTERS 31~ Please show rite the package of condoms that your husband is using. (RECORD NAHE OF BRAND) 316L 316M S17 SKIP COOING CATEGORIES I TO BRAND NARE: E ~ I >317 NOT~.L-~ T~ $H0¢4 . . . . . . . . . . . . . . , . .98 I Why canSt you show me the package of condoms that your husband is using? HUSBAND KEEPS . . . . . . . . . . . . . . . . . . . . . 1 RAN OUT . . . . . . . . . . . . . . . . . . . . . . . . . . . E OTHER 6 (SPECIFY) SHOW gRAND CHART FOR CONDOMS: Please te l l me which of these is the brand of condor~ that your husband is using. BRAND NAME: [ ~ e DOESNT KNO~ . . . . . . . . . . . . . . . . . . . . . 98 How ~Jch does (d id ) i t cost you fo r : 1 cyc le (packet) of p i l l s the IUD I an in jec t ion the imptant/Norptant intravag/diaphra@mJfoam/jetty a package of coP¢lo~ (col~tains 3 pieces) the s ter i l i za t ion operat ion I How much was the serv ice and reg is t ra t ion fee, i f any? METHOD FREE METHO0 . . . . . . . . . . . . . . 9999995 PACKAGE . . . . . . . . . . . . . . . . . . 9~4 SERVICE c°S'(RP" I I j I I I U FREE SERVICE . . . . . . . . . . . . . 9999996 FREE METHOD AND SERVICE.99999'97 - - - DON'T KNOW . . . . . . . . . . . . . . . 9999998 - - >317B 317AI In obta in ing (METHOD) d id you pay a t l j part~ or nothing? YES, ALL . . . . . . . . . . . . . . . . . . . . . . . . 1 - ->317B YES~ PART . . . . . . . . . . . . . . . . . . . . . . . 2 I NOTHING . . . . . . . . . . . . . . . . . . . . . . . . . 3 I DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . 8~->317B 317A21 ~:1o paid fo r the fami ly planning method you are using? 317B I CHECK 312: CIRCLE FOR HETHO0: ] ITC | In what month and year d id you obta in (METHC~) the last [ t in~? 517Cll CHECK 312: IMPLANT/NORPLANT I COMPANY/INSURANCE . . . . . . . . . . . . . . . I OFFICE . . . . . . . . . . . . . . . . . . . . . . . . . . 2 FAMILY . . . . . . . . . . . . . . . . . . . . . . . . . . S OTHER 6 (SPECIFY) DONST KNO~ . . . . . . . . . . . . . . . . . . . . . . 8 PILL . . . . . . . . . . . . . . . . . . . . . . . . . . . 01 IUO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 02 INJECTIONS . . . . . . . . . . . . . . . . . . . . . 83 ]MPLANT/NORPLANT . . . . . . . . . . . . . . . 04 INIRAVAG/D]APNRAGN/FOAM/JELLY,.05 CONDOI4 . . . . . . . . . . . . . . . . . . . . . . . . . 06 FEMALE STERILIZATION . . . . . . . . . . . 07 MALE STERILIZATION . . . . . . . . . . . . . O~>317E Y iiiiiiiiiiiiiiiiiiiiiiiii OTHER CHECK 317C: BEFORE JANUARY 1989 SINCE JANUARY 1989 11 326 NO. QUESTIONS AND FILTERS 317C3 k~hy d id you not obta in another imptant /Norptant? COOING CATEGORIES MENOPAUSE . . . . . . . . . . . . . . . . . . . . . . 01 HUSBAND AWAY . . . . . . . . . . . . . . . . . . . 02 AFRAID . . . . . . . . . . . . . . . . . . . . . . . . . 03 FORGOT . . . . . . . . . . . . . . . . . . . . . . . . . 04 NOT FOUND . . . . . . . . . . . . . . . . . . . . . . 05 COST TOO MUCB . . . . . . . . . . . . . . . . . . 06 AVAILABILITY . . . . . . . . . . . . . . . . . . . 07 OTHER 96 (SPECIFY) D~'T KNOtg . . . . . . . . . . . . . . . . . . . . . 98 SKIP TO 317D Where d id you obta in (HETBO0) the las t tirile? RECORD NAME OF METHOD SOURCE. PROBE TYPE Of METHOO SOURCE AND CIRCLE CORRECT CODE. (NAME OF PLACE) GOVIERIJqEMT HOSPITAL . . . . . . . . . . . . . . . . . . . . . . . 11 HEALTH CENTER . . . . . . . . . . . . . . . . . . 12 FP FIELDIJORKER . . . . . . . . . . . . . . . . . 13 FP MOBILE UNIT . . . . . . . . . . . . . . . . . 141 OTHER 15 (SPECIFY) PRIVATE HOSPITAL . . . . . . . . . . . . . . . . . . . . . . . 21 FP CLINIC . . . . . . . . . . . . . . . . . . . . . . 22 DOCTOR . . . . . . . . . . . . . . . . . . . . . . . . . 23 MIDI,/I FE . . . . . . . . . . . . . . . . . . . . . . . . 24 PHARMACY/DRUGSTORE . . . . . . . . . . . . . 35 OTHER 26 (SPECIFY) OTHER VILLAGE DELXVERY POST . . . . . . . . . . 31 INTEGRATED HEALTH POST . . . . . . . . . 33 FP POSY . . . . . . . . . . . . . . . . . . . . . . . . 33 TRAD[TIONAL HEALER . . . . . . . . . . . . . 34 FR]ENDE/RELATIVES . . . . . . . . . . . . . . 35 OTHER 96 (SPEC[FY) DONfT KN(7~ . . . . . . . . . . . . . . . . . . . . . 98 317E ghat is the main reason you decided to use (CURRENT METHO0 IN 312) ra ther than some other methods of fami ly p lanning? RECOPA4EMDATION OF FAMILY PLANNING WORKER . . . . . . . . 01 RECOMMENDATION OF FRIENDS/RELATIVES . . . . . . . . . . . . . 02 SIDE EFFECTS OF OTHER HETHUDS.O3 CONVENIENCE . . . . . . . . . . . . . . . . . . . . O4 ACCESS/AVAILABILITY . . . . . . . . . . . . 05 LO~ER COST . . . . . . . . . . . . . . . . . . . . . O6 WANTED PERMANENT METHOD . . . . . . . . 07 HUSBAND PREFERRED . . . . . . . . . . . . . . 08 WANTED MORE EFFECTIVE METBO0.O9 OTHER 96 (SPECIFY) DON'T KNOt# . . . . . . . . . . . . . . . . . . . . . 98 31TF Are yc~ having any hea l th problems in us ing YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 (CURRENT METHOD IN 312)? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2- - - ->317H 317G What is the main hea l th problem (CURRENT METHOD IN 312)? WEIGHT GAIN . . . . . . . . . . . . . . . . . . . . 01 WEIGHT LOSS . . . . . . . . . . . . . . . . . . . . 02 BLEEDING . . . . . . . . . . . . . . . . . . . . . . . 03 HYPERTENSION . . . . . . . . . . . . . . . . . . . 04 HEADACHE . . . . . . . . . . . . . . . . . . . . . . . 05 QUEASY . . . . . . . . . . . . . . . . . . . . . . . . . Q6 AMENORRHEA . . . . . . . . . . . . . . . . . . . . . Q7 MEAK/TIRED . . . . . . . . . . . . . . . . . . . . . 08 OTHER 96 (SPECIFY) OON~T KNOI4 . . . . . . . . . . . . . . . . . . . . . 98 317H Are you having any other problems in us ing YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 (CURRENT METHOD IN 312)? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 - ->317 J 317[ What is the main probL~? HUSBAND DI~PPR~ES . . . . . . . . . . . . 01 ACCESSIOILITY/AVAILABILITY . . . . . 02 COST T~ MUCH . . . . . . . . . . . . . . . . . . 03 INE~VENIENT TO USE . . . . . . . . . . . . 04 SIERILIZED~ BUT WANTS CHILDREN*D5 OTHER (SPECIFY) O~'T KN~ . . . . . . . . . . . . . . . . . . . . . RESPONDENT/HUSBAND STERILIZED NEITHER STERILIZED ~ ~323 12 327 NO. QUESTIONS AND FILTERS 318 Where d id the s ter i l i za t ion take pLace? WRITE THE NAME OF PLACE. PROBE TO IDENTIFY THE TYPE OF PLACE AND CIRCLE THE APPROPRIATE CODE. SKIP COOING CATEGORIES TO GOVERNMENT HOSPITAL . . . . . . . . . . . . . 11 HEALTH CENTER . . . . . . . . . . . . . . . . . . . 12 PRIVATE HOSPITAL . . . . . . . . . . . . . . . . 21 PRIVATE CLINIC . . . . . . . . . . . . . . . . . . 28 PRIVATE DOCTOR . . . . . . . . . . . . . . . . . . 23 O1HER 96 (SPECIFY) (NAME OF PLACE) DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . 98 319 Do you regret that (YC4J/YC4JR HUSBAND) had the operat ion YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 not to have any (mere) ch i ld ren? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Z >321 320 Why do (YOU/YOUR HUSBAND) regret the operat ion? RESPONDENT ~ANTS ANOTHER CHILD. . . .1 HUSBAND WANTS ANOTHER CHILD . . . . . . . Z SiDE EFFECTS . . . . . . . . . . . . . . . . . . . . . . 3 CHILD DiED . . . . . . . . . . . . . . . . . . . . . . . . 4 OTHER 6 (SPECIFY) 321 32Z 323 In ~dlat ¢onth and year was the s ter i l i za t ion performed? CHECK: 321 STERILIZED BEFORE JANUARY 1989 ENTER CODE FOR STERILIZATION (COOE 7 OR 81 IN MONTH OF INTERVIEW IN COLUMN 1 OF THE CALENDAR AND EACH NONTff SACK TO JANUARY 1989 STERILIZED SINCE JANUARY 1989 [~ ENTER COOE FOR STERILIZATION (COOE 7 OR 8) IN MONTH OF INTERVIEW OF THE CALENDAR AND IN EACH MONTH BACK TO THE DATE OF THE OPERATION. GO TO 330B, Peop le se lec t the pLace where they get fami ly p~anning serv ices for var ious reasons, The p lace i s se lec ted may be more conven ient or g ive bet ter serv ices or i s cheaper . In your case r what was the main reason you went to the p lace you d id ra ther than to some other p laces? RECORD RESPONSE AND CIRCLE CODE. Any other reasons? RECORD RESPONSE AND CIRCLE CODE. MAIN OTXET REASOI~ REASO~ ACCESS- RELATED REASOIIS CLOSER TO HONE . . . . . . . . . . 01 81 CLOSER TO ~RK . . . . . . . . . . OZ 02 AVAILABILITY OF TRANSPORT . . . . . . . . . . . . . . 03 03 LONGER HOURS OF OF OPERATION . . . . . . . . . . . 04 OR USE OTHER SERVICES AT THE FACILITY . . . . . . . . 05 05 SERVICE-RELATED REASONS STAFF MORE COHPETENT/ FRIENDLY . . . . . . . . . . . . . . . 06 06 CLEANER . . . . . . . . . . . . . . . . . 07 07 OFFERS MORE PRIVACY . OB 08 SHORTER WAITING T IME. . . .09 09 LO~tER COST . 10 Ig WANTED ANONYMITY . . . . . . . . . 11 11 OTHER 96 (SPECIFY) NO OTHER REASON . . . . . . . . . . . . . . . . . 12 OTHER 96 (SPECIFY) DON ST KNOt~ . . . . . . . . . . . . . . . 08 328 Between the f i r s t day o f a wocPan's per iod and the YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 f i r s t day o f her next per iod , are there cer ta in NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 - - t imes when she has a greater chance Of bec~Alting pregnant OON'T KNOI~ . . . . . . . . . . . . . . . . . . . . . . . BE than o ther t imes? BZaA Dur ing which t i cks o f the month ly cyc le does a Woman DURING HER PERIO0 . . . . . . . . . . . . . . . . . 1! have the greates t chance o f becomin B pregnant? ZBA11 CHECK 312: PER]O0]C ABSTINENCE OR WITHDRAWAL [~ V B 3zBBI Do you absta in from sex on days Hhen you are cer ta in I that you have a greater chance o f becoming pregnant? 328C l How do you determine xh ich days o f your ~onthLy I cyc(e not to have sexua l re la t ions? 328 I RIGHT AFTER HER PERIOD HAS ENDED . . . . . . . . . . . . . . . . . . . . . . . . Z IN THE NIBBLE OF THE CYCLE . . . . . . . . B JUST BEFORE HER PERIOD BEGINB. . . . ,4 OTHER 6 DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . 8 OTHER HETHOOS [~ >330A >3301 13 (SPECIFY) NO SPEC[FIC SYSTEM . . . . . . . . . . . . . 05 BASED ON CALENDAR . . . . . . . . . . . . . . 01 BASED ON BOOY TEMPERATURE . . . . . . OZ BASED ON CERVICAL MUCUS (BiLLiNGS METHO0) . . . . . . . . . . . . 03 BASED ON BQOY TEMPERATURE AND CERVICAL MUCUS . . . . . . . . . . . 04 OTHER 96 YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 - ->330A NO. 33OR 33oe QUESTIONS AND FILTERS I COOING CATEGORIES ENTER METHOD COOE FROM 312 IN CURRENT MONTH IN COLUMN 1 OF CALENDAR. THEN DETERMINE WHEN SHE STARTEO USING THIS METRO0 THIS TIME, ENTER NETHO0 COOE IN EACH MONTH OF USE. ILLUSTRATIVE QUESTIONS: " When d id you s tar t us ing th i s methed cont inuous ly? " MOW tong have you been using th i s method cont inuous ly? SKIP TO ] wou ld L ike to ask some quest ions about at[ of the nletheds you used to avo id Get t ing pregnant in the las t f i ve years . USE CALENDAR TO PROSE FOR EARLIER PERIOOS OF USE AND NONUSE, STARTING WITH MOST RECENT USE, BACK TO JANUARY 1989. USE NAMES OF CHILDREN, DATES OF BIRTH, AND PERIOOS OF PREGNANCY AS REFERENCE POINTS. ]N EACH MONTH, ENTER CGOE FOR METHO0 OR "O" FOR NONUSE IN COLUMN 1. IN COLUMN 2, ENTER COOEE FOR DISCONTINUATION NEXT TO LAST MONTH OF USE. NLIMBER OF COOEG ENTERED IN COLUMN 2 MUST @E THE SAME AS THE NUMBER OF ]NTERRUPTIORS OF CONTRACEPTIVE USE IN COLUMN 1, ASK WHY SHE STOPPED USING THE METHO0. IF A PREGNANCY FOLLC~JED, ASK WHETHER SHE BECN4E PREGNANT UN]NTENTIONALLY WHILE USING THE METHO0 OR DELIBERATELY STOPPED TO GET PREGNANT. ILLUSTRATIVE QUESTIONS: COLUMN I: -~hen was the Last time you used 8 method? Which l~thed was that? "When d id you s tar t us ing that method? How lon H a f te r the b i r th o f (NAME)? -HOW Long d id you use the method then? COLUMN 2: -Why d id you s top us ing the (METHO0)? "Did you become pregnant wh i le us ing (METHOD), or d id you s top to get p regnant , or s top fo r some other reason? IF DELIBERATELY STOPPED TO BECOME PREGNANT, ASK: "How many months d id it take you to get pregnant a f te r you s topped us ing (METHOD)? ENTER "O" IN EACH SUCH MONTH IN COLUMN 1. 330C Did you be long to a group which i s re la ted to YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 fami ly p lann ing? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2- - - ->33~ 330C1 What i s the name o f grouo which you a t tend the [as t t i ce? NAME (SPECIFY) 330C2 ghen d id the las t t i re you a t tend that g roup ls meet ing? 330C3 Does the group co l lec t money fo r use in the fami ly YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 p lann ing ac t iv i t ies? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 33OD Have you ever seen a s ign or heard about B lue C i rc le? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 - DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . 8 - ->330E 33001 Can you teLL me what i t i s? PRIVATE FAMILY PLANNING SERVICE.) I OTHER 2 I (SPECIFY) DON'T KNOE~ . . . . . . . . . . . . . . . . . . . . . . . 8 33DE Have you ever seen a s ign or heard about Golden C i rc le? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 I NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 DON'T KNO~¢ . . . . . . . . . . . . . . . . . . . . . . . 8 - -~>331 330E1 Can you te l l tee what i t i s? PRIVATE FAMILY PLANNING SERVICE.1 OTHER 2 CHECK 226:PREGNANF[~ Have you contacted~ever been contacted by a fami ly p lann ing worker dur ing the s ix months be fore you became pregnant? NOT PREGNANT OR UNSURE . Have you contacted/ever been Contacted by a family planning worker dur ing the past s ix s ix monthsT CHECK 226; NOT PREGNANT OR ~] PREGNANT[~ UNSURE I Have you ever v i s i ted Have you ever v i s i ted a hea l th fac i l i ty dur ing a hea l th fac i l i ty dur ing the s ix months be fore you the pest s ix months? became pregnant? 331 331A (SPECIFY) DON*T KN~ . . . . . . . . . . . . . . . . . . . . . . . 8 YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2- - 331B Did anyone at the hea l th fac i l i ty speak to you about YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 fami ly p lann ing methods? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 332 SOme women th ink that b reast feed ing can a f fec t the i r chance o f becomin H pregnant . Do you th ink a woman's chance o f becoming pregnant i s increased, decreased. or no r a f fec t#d? INCREASED . . . . . . . . . . . . . . . . . . . . . . . . 1 DECREASED . . . . . . . . . . . . . . . . . . . . . . . . 2 NOT AFFECTED . . . . . . . . . . . . . . . . . . . . . 3 DEPENDS . . . . . . . . . . . . . . . . . . . . . . . . . . 4 >33Z DON~T KNOW . . . . . . . . . . . . . . . . . . . . . . . 8~>335 329 14 SKIP ,o I QUESTIONS AND FILTERS I COOING CATEGORIES I , o NO BIRTHS r~ ONE OR HORE f IRTHS I V i0o,oo n°* " "ng O*n or ooo pr . - - . . . . ° 1 ' . I NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 >335 334Am Do you beL ieve that b reast feed ing can be used to de lay I or avo id pregnancy? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Z 3358 CHECK 106A: CURRENTLY [~ MARRIED V CHECK 312: NOT ASKED/HOT U$JNG A MODERN METBO0 V What Ls the ~ in reason you are not us ing a cont racept ive method to avo id pregnancy? Any o ther reasons? RECORD HA]N AND OTHER REASON IN SEPARATE COLUHNS. DIVORCED/ I WIDOgED L~ ->337 CURRENTLY USING A HETBOO >337 MAIN OTHER I REASON REAS~ LACK ~ K~EOG~: DON*T KNOW METH-O0 . . . . . . . . 01 01 DON rT KH(T=/ SOURCE . . . . . . . . 02 02 OPFO~I I ION lO USE ~ E O . . . . . . . 03 03 HUSBAND OPPOSED . . . . . . . . . . 04 04 OTHERS OPPOSED . . . . . . . . . . . 05 05 RELIGIOUS PROHIB IT ION. . . .06 06 FERTILUY-RELATED REA93NS >337 NENOPAUSAL/HYSTERECTQ@IY . .O~ SUBFECUND/]NFECUND . . . . . . . 08 08 POSTPARTUN/BREASTFEED]NG.09 09 iNFREQUENT SEX . . . . . . . . . . . 10 10 gANT CHILDREN . . . . . . . . . . . . 11 11 NETII(]D-RELATED REASONS HEALTH CONCERNS . . . . . . . . . . 12 12 FEAR OF SJDE EFFECTS . . . . . 13 13 LACK OF ACCESS/TO0 FAR. . .14 14 COST TOO MUCH . . . . . . . . . . . . 15 15 INCONVENIENT TO USE . . . . . . 16 16 Cd~[N/LOSE WEIGHT . . . . . . . . . 17 17 PREGNAN1 . . . . . . . . . . . . . . . . . . 18 18 NO OTHER REASON . . . . . . . . . . . . . . . . . 19 OTHER 96 (SPEC]FY) OTHER 96 (SPECIFY) DON IT KNOW . . . . . . . . . . . . . . . 98 336A Oo you in tend to use a fami ly pLann ing r i~thod to de lay YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ( - - ->336C or avo id pregnancy w i th in the next 12¢onths? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 | DOHeT KH(~W . . . . . . . . . . . . . . . . . . . . . . 8 I 3368 Do you in tend to use a fami ly p lann ing ~thod to de lay YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 m or avo id pregnancy a t any t ime in the fu ture? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 >336D DONJT KNOW . . . . . . . . . . . . . . . . . . . . . . 8 - ->337 336C green you use a method, which ~thnd WOULd yo~J pre fer to use? PiLL . . . . . . . . . . . . . . . . . . . . . . . . . . . 01 | IUO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 02 I INJECTIONS . . . . . . . . . . . . . . . . . . . . . 03 IMPLAN1/NORPLAHT . . . . . . . . . . . . . . . 04 [NTRAVAG/DIAPHRAGN/FOAM/JELLY.,05 CONDOM . . . . . . . . . . . . . . . . . . . . . . . . . 06 FEMALE STERILIZATION . . . . . . . . . . . 07 MALE STERILIZATION . . . . . . . . . . . . . 08 PERIO0]C ABSTINENCE . . . . . . . . . . . . 09 - - WITHDRAWAL . . . . . . . . . . . . . . . . . . . . . 1 ~ OTHER 9 >337 UNSURE . . . . . . . . . . . . . . . . . . . . . . . . . 9 336C1 Where w i l t you go to obta in the (METHO0)? 330 GGVERffiENT HOSPITAL . . . . . . . . . . . . . . . . . . . . . . . 11 - HEALTH CENTER . . . . . . . . . . . . . . . . . . 12 - FP F[ELOkORKER . . . . . . . . . . . . . . . . . 13 - FP HOBZLE UN]T . . . . . . . . . . . . . . . . . 14 - OTHER .15 (SPECIFY) PRIVATE HOSP]TAL . . . . . . . . . . . . . . . . . . . . . . . 21 FP CLINIC . . . . . . . . . . . . . . . . . . . . . . 22 - OOCTOR . . . . . . . . . . . . . . . . . . . . . . . . . 23 ->337 M]DW[FE . . . . . . . . . . . . . . . . . . . . . . . . 24 - PHARMACY/DRUGSTORE . . . . . . . . . . . . . 25- OTHER _26- (SPECIFY) OTHER DELKVERY POST . . . . . . . . . . . . . . . . . . 31 HEALTH POST . . . . . . . . . . . . . . . . . . . . 32 FP POST . . . . . . . . . . . . . . . . . . . . . . . . 33 - TRAOIT[ONAL HEALER . . . . . . . . . . . . . 34 - FRIENDS/RELATIVES . . . . . . . . . . . . . . 35 - OTHER _96- (SPECIFY) DON'T KNOig . . . . . . . . . . . . . . . . . . . . . 9~ 15 NO. QUEST IONSANDFILTERS 3360 ~hat i s the main reason you are not using a fami ly p lann ing method? Any o ther reasons? RECORD MAIN AND OTHER REASONS IN SEPARATE COLUMNS. SK IP COOING CATEGORIES TO MAIN OTHER REASON REASON LAO( OF KNOEq.BDGE pOHIT KNOW METHO0 . . . . . . . . 01 01 DON'T KNOiJSOURCE . . . . . . . . 02 02 OP~IT[OMTOUSE RESPONDENT OPPOSED . . . . . . . 03 03 HUSBAND OPPOSED . . . . . . . . . . 04 04 OTHERS OPPOSED . . . . . . . . . . . 05 OS RELIGIOUS PROHIB IT IONI . I .06 06 FERTIL ITV-RELATEO ~ S SUBFECUND/INFECUND . . . . . . . 07 07 POSTPARTUM/BREASTFEED[NG,00 08 INFREQUENT SEX . . . . . . . . . . . 09 09 WANT CHILDREN . . . . . . . . . . . . 10 10 NETHOD'RELATED REASONS HEALTH CONCERNS . . . . . . . . . . 11 11 FEAR OF SIDE EFFECTS. , . . .12 12 LACK OF ACCESS/TO0 FAR. . . I ] tS COST TOO NUCH . . . . . . . . . . . . 14 14 INCONVENIENT TO USE . . . . . . 15 15 GAIN/LOSE WE]GHT . . . . . . . . . 16 16 NO OTHER REASON . . . . . . . . . . . . . . . . . 17 OIHER 96 (SPECIFY) OTHER 96 (SPECIFY) DON JT KNO~ . . . . . . . . . . . . . . . 98 337 In the las t s ix th months , have you ever heard Bbout fami ly pLann ing in fo rmat ion f rom: Rad io? Television? Newspaper / l l tagaz ine? Pos ter? Pem~: l te t /b rochure$? FamiLy pLann ing f ie ld Norker? Teacher? CO¢lnun(ty l eader? ReL ig ious reader? Doctor? M idwi fe? V i t ta9e Leader? Wc~n group (PKK)? Pharmacy? YES NO RADIO . . . . . . . . . . . . . . . . . . . . . 1 TELEVIS ION . . . . . . . . . . . . . . . . 1 NEWSPAPER/MAGAZINE . . . . . . . . 1 POSTER . . . . . . . . . . . . . . . . . . . . 1 PAMPHLET/BROCHURE . . . . . . . . . 1 FP OFFICER . . . . . . . . . . . . . . . . 1 TEACHER . . . . . . . . . . . . . . . . . . . 1 COFa4UNITY LEADER . . . . . . . . . . I RELIGIOUS LEADER . . . . . . . . . . 1 DOCTOR . . . . . . . . . . . . . . . . . . . . 1 MIDWIFE . . . . . . . . . . . . . . . . . . . 1 V ILLAGE LEADER . . . . . . . . . . . . 1 kX]4EN GROUP . . . . . . . . . . . . . . . 1 PHARMACy . . . . . . . . . . . . . . . . . . 1 337A Of the sources I ~ go ing to ment ion , which do you th ink a re an appropr ia te source for family p lann ing in fo rmat i~? READ RESPONSES. YES RAOIO . . . . . . . . . . . . . . . . . . . . . I TELEVIS ION . . . . . . . . . . . . . . . . I NEWSPAPER/MAGAZINE . . . . . . . . 1 POSTER . . . . . . . . . . . . . . . . . . . . 1 PAMPHLET . . . . . . . . . . . . . . . . . . 1 FP OFFICER . . . . . . . . . . . . . . . . 1 TEACHER . . . . . . . . . . . . . . . . . . . 1 C(~4MUN[TY LEADER . . . . . . . . . . 1 RELIGIOUS LEADER . . . . . . . . . . 1 DOCTOR . . . . . . . . . . . . . . . . . . . . 1 HIDWIFE . . . . . . . . . . . . . . . . . . . 1 V ILLAGE LEADER . . . . . . . . . . . . 1 h~qEN GROUP . . . . . . . . . . . . . . . 1 PHARMACY . . . . . . . . . . . . . . . . . . 1 NO 337B Dur ing the las t s ix r~nths , have you ever ta lked YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I about f~i ly p lan ing pract i ce w i th your f r iends o r fek~i ty? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 - - >33T0 337C Wi th whom? Anyone e lse? HUSBAND . . . . . . . . . . . . . . . . . . . . . . . . . A MOTHER . . . . . . . . . . . . . . . . . . . . . . . . . . E FATHER . . . . . . . . . . . . . . . . . . . . . . . . . . C SISTER . . . . . . . . . . . . . . . . . . . . . . . . . . D BROTHER . . . . . . . . . . . . . . . . . . . . . . . . . E DAUGHTER . . . . . . . . . . . . . . . . . . . . . . . . F PARENT- IN -LA~ . . . . . . . . . . . . . . . . . . . G FRIEND/NEIGHBOR . . . . . . . . . . . . . . . . . H OTHER X CIRCLE EACH MENTIONED. (SPECIFY) 337~ In your op in ion , among the ever -marr ied ~ you MOST . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 know, a re most o f the111, some o f them, o r none o f them SOME . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 us ing a fami ly p lann ing r re thod? NONE . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 DONIT KNOiJ . . . . . . . . . . . . . . . . . . . . . . O 337E Have you ever recommended fami ly p tann in9 to your YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 f r iends , famiLy , o r anyone? NO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 16 331 I SJECTIad /d~. PREI~AII~Y AMD BRF.ASTFEEOING I 601 I CHECK 215: ONE OR MORE LIVE BIRTHS NO LIVE BIRTHS SINGE JANUARY 1989 SINCE JANUARY 1989 I I V 408 ENTER 1HE L[NE NUMBER, NAME, ANO SURVIVAL STATUS OF EACH BIRTH SINCE JANUARY 1989 IN THE TABLE. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN ~]TH IHE LAST BIRTH. ( I F THERE ARE MORE THAN 3 BIRTHS, USE ADDITIONAL FORMS). Now I wou ld L ike to ask you sc~e quest ions =bout the heaLth o f a l l your ch i ld ren born in the past f i ve years , We w iL l ta lk about one ch i ld a t a t ime. ~O2A kO28 ~02C ~03 • (SKIP TO 481) LIME NUNBER FRI~4 O. 212 FRGH O. 212 FROf4 g . 216 At the t ime you became pregnant =wi th (MANE), d id you want to become pregnant then . d id yo~ want to wa i t ~nt i [ La ter o r d id you want no more ch i ld ren a t a l l ? r ~ L[NE ML~4BER . . . . . . . . [ _ _~J NAME AL[VE THEN . . . . . . . . . . . . . . . . . . . . . 1 (SKIP TO 405)< LATER . . . . . . . . . . . . . . . . . . . . 2 NO MORE . . . . . . . . . . . . . . . . . . (S~IP 10 405)< l LINE NUMBER . . . . . . . . [ ~ ] THEN . . . . . . . . . . . . . . . . . . . . . 1 (SKIP TO 405)< LATER . . . . . . . . . . . . . . . . . . . . 2 NO MORE . . . . . . . . . . . . . . . . . . 3~ (SKIP TO 60~)< / FT-~ LINE NUMBER . . . . . . . . ~ J NEXT-TO-LAST-BIRTH NAHE ALQE? OEO?. THEN . . . . . . . . . . . . . . . . . . . . . 1 1 (SK IP TO ~)< l LATER . . . . . . . . . . . . . . . . . . . . 2 NO MORE . . . . . . . . . . . . . . . . . . ~" • (S~[P TO 605)< F ~ to have wa i ted? [ ] YEAR . . . . . . . . . . . . . . 2 YEAR . . . . . . . . . . . . . . 2 YEAR . . . . . . . . . . . . . . 2 DON~T KNO¢~ . . . . . . . . . . . . . 998 DONJT KNOI~ . . . . . . . . . . . . . ¢~98 DON'T KN(Td . . . . . . . . . . . . . 998 ~.05 HEALTH PROFESSIONAL 405A DOCTOR . . . . . . . . . . . . . . . . . A NURSE/M[OWIFE . . . . . . . . . . B AUXILIARY NURSE/ MIDWIFE . . . . . . . . . . . . . . . C OTHER FERSOM TRADITIONAL HEALER. . . , .D OTHER X (SPECIFY) NEVER . . . . . . . . . . . . . . . . . . . Y-- (SRIP TO 409)< GOVERNMENT HOSP ITAL . . . .11 HEALTH CENTER . . . . . . . . . . 12 VILLAGE DELIVERY POST.13 [NTEG. HEALTH POST . . . . . 16 PRIVATE HOSPITAL . . . . . . . 21 PRIVATE CLINIC . . . . . . . . . 22 PRIVATE DOCTOR . . . . . . . . . 23 MIDWIFE/AUXILIARY MIDWIFE . . . . . . . . . . . . . . . 24 OTHER 96 (SPECIFY) When you were pregnant w i th (NAME), d id you see anyoPe fo r antenata l care fo r th i s p regnancy? IF YES; ~thomdid you see? HEALTNFqlBDFESSICRAL 90CTOR . . . . . . . . . . . . . . . . . A NURSE/MIDWIFE . . . . . . . . . . B AUXILIARY NURSE/ MIDWIFE . . . . . . . . . . . . . . . C OTHER PEESON TRADITIONAL HEALER. . . . .D OTHER X (SPECIFY) NEVER . . . . . . . . . . . . . . . . . . . Y (.¢d([p 10 4nfg)< / GOVERNMENT HOSP ITAL . , , .11 HEALIN CENTER . . . . . . . . . . 12 VILLAGE DELIVERY POST. . (3 [NTEG. HEALTH POST . . . . . 14 PRIVATE HOSPITAL . . . . . . . 21 PRIVATE CLINIC . . . . . . . . . 22 PRIVATE DOCTOR . . . . . . . . . 23 MIDWIFE/AUXILIARY MIDWIFE . . . . . . . . . . . . . . . 24 OTHER 96 (SPECIFY) Anyone e l se? ~ere d id you go fo r antenata l care fo r th i s p regnancy? HEALTN PROFESSIONAL DOCTOR . . . . . . . . . . . . . . . . . A NURSE/MIOWIFE . . . . . . . . . . B AUXILIARY NURSE/ MIOWIFE . . . . . . . . . . . . . . . C 01MER PERSOH TRADITIONAL HEALER. , . . .O OTHER X (SPECIFY) NEVER . . . . . . . . . . . . . . . . . . . Y (SI(IP TO 409)< GOVERNMENT HOSP ITAL . . . .11 HEALTH CENTER . . . . . . . . . . 12 VILLAGE DELIVERY POST. .1 ] IMTEG. HEALTH POST . . . . . 14 PRIVATE HOSPITAL . . . . . . . 81 PRIVATE CLINIC . . . . . . . . . Z2 PRIVATE DOCTOR . . . . . . . . . 23 MiDWIFE/AUXILIARY MIDWIFE . . . . . . . . . . . . . . . 24 OTHER 96 (SPECIFY) /*06 Were you g iven an antenata l YES . . . . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . . . . . 1 card (KMS) fo r p regnant ~others fo r th i s p regnancy? NO . . . . . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . . . 8 NO . . . . . . . . . . . . . . . . . . . . . . . OON'T ~N(3¢~ . . . . . . . . . . . . . . . 8 DONST KN()~ . . . . . . . . . . . . . . . 8 DONnT KNC4~ . . . . . . . . . . . . . . . . ,0 , H . . . . , othspregnant . . . . MONTR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,=TH . . . . . . . . . . . . . . . you when yc~ f i r s t rece ived i i J t i i antenata l care? DON'T KNC4,/ . . . . . . . . . . . . . . 98 DON*T KNOW . . . . . . . . . . . . . . 96 DON'T KN(Td . . . . . . . . . . . . . . 98 , o8 H . . . . y . . s O i d y . . . . . . ve T IMES . . . . . . . . . . . . . . . .M S . . . . . . . . . . . . . . . T ,ES . . . . . . . . . . . . . . . antenata l care dur ing th i s i i i i i i i l l p regna~y? DONIT KNOW . . . . . . . . . . . . . . 98 DOn'T KNO~4 . . . . . . . . . . . . . . 98 DON'T KNOW . . . . . . . . . . . . . . 98 4O9 bl~en you uere pregnant w i th (NAME) were you g iven an in jec t ion in the arm to prevent the baby f rom get t ing te tanus , that i s , convu ls ions a f te r b i r th? (CHECK HEALTH CARD) YES . . . . . . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . . . . . . . . 2 (~d£lP 1"0 410A)< DON'T KNOt~ . . . . . . . . . . . . . . . E YES . . . . . . . . . . . . . . . . . . . . . . NO . . . . . . . . . . . . . . . . . . . . . . . 2 (SK IP TO 41GA)< DON'T KNC~t . . . . . . . . . . . . . . . 8 YES . . . . . . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . . . . . . . . (SK IP TO 41QA)<- OONST KMOi.f . . . . . . . . . . . . . . . 332 17 ;10 ;IOA &lOB &lOC ~12 412A How many t imes d id you get th i s in jec t ion? RECORD NUMBER OF INJECTION FROM HEALTH CARD, IF AVAILABLE Have you ever rece ived i ron p i l l s ( inc reas ing bLood) when you ~ere pregnant with (HA~E)? HOW i~ny i ron p i~ts d id you take dur ing your p regnancy w i th (NAME)? Now r~ny days dur ing the las t month d id you take the i ron p i t t~? Where d id you g ive b i r th to (NAME)? Who ass i s ted w i th the de l ivery o f (NAME)? AnyOne e l se? PR(]BE FOR THE TYPE OF PERSON AND RECORD ALL LAST BIRTH SECOND-FROM-LAST - BIRTH NEXT - TO- LAST -MIRTH NAME NANE NAME T INES . . . . . . . . . . . . . . . . . . [ ] TIMES . . . . . . . . . . . . . . . . . . [ ] TIMES . . . . . DONeT KNOW . . . . . . . . . . . . . . . ~ DON'T KNON . . . . . . . . . . . . . . . 8 DONtT KNO~ . . . . . . . . . . . . . . . 8 YES . . . . . . . . . . . . . . . . . . . . . . 1 NO . . . . . . . . . . . . . . . . . . . . . . . 2 (SKIP TO A l l )<~ TIDAK yOUR NONE . . . . . . . . . . . . . . 11 OTHER HOME . . . . . . . . . . . . . 12 ~em~NT HOSPITAL . . . . . . . . . . . . . . . 21 HEALTH CENTER . . . . . . . . . . 22 VILLAGE DELIVERY POST,.23 OTHER 24 {SPECIFY) PRIVATE HOSPITAL . . . . . . . . . . . . . . . 31 CLINIC . . . . . . . . . . . . . . . . . 32 OTHER 33 (SPECIFY) DOCTOR . . . . . . . . . . . . . . . . . . . A MIDWIFE . . . . . . . . . . . . . . . . . . B TRADITIONAL BIRTH ATTENOANT . . . . . . . . . . . . . . . C RELATIVE . . . . . . . . . . . . . . . . . O OTHER X (SPECIFY) m~e YOUR HOME . . . . . . . . . . . . . . 11 OTHER HOME . . . . . . . . . . . . . 12 ~IERIIICENT . . . . . . . . . . 21 HEALTH CENTER . . . . . . . . . . 22 POST. .E ] OTHER 24 (SPECIFY) PRIVATE HOSPITAL . . . . . . . . . . . . . . . 31 CLINIC . . . . . . . . . . . . . . . . . 32 OTHER ]3 (SPECIFY) DOCTOR . . . . . . . . . . . . . . . . . . . A MIDWIFE . . . . . . . . . . . . . . . . . . B TRADITIONAL BIRTH ATTENDANT . . . . . . . . . . . . . . . C RELATIVE . . . . . . . . . . . . . . . . . D OTHER X (SPEC[FY) yOUR ,11 OTHER HOME . . . . . . . . . . . . . 12 ~Rm'~NT HOSPITAL . . . . . . . . . . . . . . . 21 HEALTH CENTER . . . . . . . . . . 22 VILLAGE DELIVERY POST, .2 ] OTHER 26 (SPECIFY) FEtIVATE HOSPITAL . . . . . . . . . . . . . . . ]1 CLINIC . . . . . . . . . . . . . . . . . 32 OTHER 3] (SPECIFY) DOCTOR . . . . . . . . . . . . . . . . . . . A M[OWIFE . . . . . I TRADITIONAL BIRTH ATTENDANT . . . . . . . . . . . . . . . C RELATIVE . . . . . . . . . . . . . . . . . D OTHER X (SPECIFY) PERSONS ASSIST]NG. NO ONE . . . . . . . . . . . . . . . . . . . Y A t the t ime o f the b i r th o f (NAME), d id you have : Labor , that i s the s t rong and regu lar cont rac t ions Las t ing more than one day & one n ight? A Lot more vag ina l b leed ing than normal FoL lowing ch i ld - b i r th (~re than 3 c lo ths )? A h igh fever and fou l scet~ ing vag ina l d i scharge? Convu ls ions ~ i th Loss o f consc iousness7 Any o ther co t~p l i ca t ions? IF YES, DON'T YES NO KNOW 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 NO O~qE . . . . . . . . . . . . . . . . . . . Y I Was (NAME) we ighed YES . . . . . . . . . . . . . . . . . . . . . . 1 a t b i r th? NO . . . . . . . . . . . . . . . . . . . . . . . 2 (SKIP TO 418)<- - OON'T YES NO KNO&# 1 1 1 1 NO ONE . . . . . . . . . . . . . . . . . . . Y DOgUT YES NO KNOW 2 8 1 2 8 2 8 1 2 8 2 8 1 2 8 2 8 1 2 8 2 8 1 2 8 (SPECIFY) - - (SPECIFY) - - - (SPECIFY) 613 Was (NAME) born on t ime ON TIME . . . . . . . . . . . . . . . . . . 1 ON TIME . . . . . . . . . . . . . . . . . . 1 ON TIME . . . . . . . . . . . . . . . . . . 1 o r p remature ly? PREMATURELY . . . . . . . . . . . . . . 2 PREMATURELY . . . . . . . . . . . . . . 2 PREMATURELY . . . . OONJT KNOW . . . . . . . . . . . . . . . B DON eT KNOW . . . . . . . . . . . . . . . 8 DON'T KNO~J . . . . . . . . . . . . . . . 8 414 Was (NAME) de l ivered YES . . . . . . . . . . . . . . . . . . . . . . f YES . . . . . . . . . . . . . . . . . . . . . . I YES . . . . . . . . . . . . . . . . . . . . . . 1 by caesarean sect ion? NO . . . . . . . . . . . . . . . . . . . . . . . R NO . . . . . . . . . . . . . . . . . . . . . . . R NO . . . . . . . . . . . . . . . . . . . . . . . 415 When (NAME) was born , was he /she : very la rge . VERY LARGE . . . . . . . . . . . . . . . 1 VERY LARGE . . . . . . . . . . . . . . . 1 VERY LARGE . . . . . . . . . . . . . . . I l a rger than average j LARGER THAN AVERAGE . . . . . . 2 LARGER THAN AVERAGE . . . . . . Z LARGER THAN AVERAGE . . . . . . 2 average , AVERAGE . . . . . . . . . . . . . . . . . . ] AVERAGE . . . . . . . . . . . . . . . . . . ] AVERAGE . . . . . . . . . . . . . . . . . . ] sma lLer than average , SMALLER THAN AVERAGE. . . . .& SMALLER THAN AVERAGE. . . . .4 SMALLER THAN AVERAGE. . . . .G Or very snla~t? VERY SMALL . . . . . . . . . . . . . . . 5 VERY SMALL . . . . . . . . . . . . . . . 5 VERY SMALL . . . . . . . . . . . . . . . 5 DON'T KNOW . . . . . . . . . . . . . . . 8 DONtT ENOk# . . . . . . . . . . . . . . . 8 DON'T KNOW . . . . . . . . . . . . . . . 0 416 YES . . . . . . . . . . . . . . . . . . . . . . NO . . . . (SKIP TO 419)<- - YES . . . . . . . . . . NO . . . . . . . . . . . . . . . . . . . . . . . E (SKIP TO 419)" 333 18 417 418 Howmuch d id (NAME) weigh? RECORD WEIGHT FR(~4 HEALTH CARD, IF AVAILABLE D id your per iod re turn s ince the b i r th o f (NAME)7 LAST BIRTH SECOND+FROM-LAST B[RTH NAME NAME GRAMS FROM ~ GRAMS FROM cAR0 . . . . . . . ' , , , , .11111 CARD . . . . . . . GRAMS FROM GRAMS FROM RECALL ' ' ' ' ' 2 ~ RECALL'''' ,~ ~ j - - ] ~ I DOn'T WN~ . . . . . . . . . . . . 9998 i DON'T KNOW . . . . . . . . . . . . 99~B NEXT-TO-LAST-BIRTH NAME GRAMS FRO#4 CARD . . . . . . . ' q l l l GRAMS FROM RECALL ' ' ' ' '~ [ ~ DON~T KNOW . . . . . . . . . . . . 9998 419 DiQ your period return between the birth of (NAME) en~ the ne~t pregnancy? 6~0 | For hOW n~ny months after I the b i r th o f (NAME) d id you not have a per t o d? YES . . . . . . . . . . . . . . . . . . . . . 1 (SKIP TO k~)< NO . . . . . . . . . . . . . . . . . . . . . . . 2 (,Td(lp TO 421)< ] ~H~],~H;~ H~: ~ ~ ~ ~ ~ ~ ~: H~ ::J~:~] ~ .H~ ~ ~ ¸ I i DON, T KNOW . . . . . . . . . . . . . . 9B YES . . . . . . . . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . . . . . . . . I NO . . . . . . . . . . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . . . . . . . . . . 2- (SKIP 10 423) ( -~ (SKIP TO 423)<- - - - MONTH . . . . . . . . . . . . . . . ~ - ~ MONTH . . . . . . . . . . . . . . . ~ DOttel KNOW . . . . . . . . . . . . . . 9B DONIT KNOW . . . . . . . . . . . . . . 98 421 I CHECK 226: I RESPONDENT PREGNANT? NOT PREGNANT PREGNANT~ OR UNSURE [~V (SKIP TO 4Z] ) 422 H