Indonesia - Demographic and Health Survey - 2003

Publication date: 2003

Demographic and Health Survey Indonesia I n d o n e s i a 2 0 0 3 D e m o g r a p h i c a n d H e a l t h S u r v e y 2002-2003 World summit for children indicators, Indonesia 2002-2003 Under-five mortality rate 46 per 1,000 Infant mortality rate 35 per 1,000 Maternal mortality rate 0.24 Use of improved drinking water sources1 61.1 Use of improved sanitary means of excreta disposal 51.6 Contraceptive prevalence – currently married women 60.3 Contraceptive prevalence – ever-married women 57.3 Antenatal care2 91.5 Childbirth care 66.2 Low birth weight3 7.6 Children receiving vitamin A supplements 75.1 Mothers receiving vitamin A supplements 42.5 Night blindness in pregnant women 1.7 Exclusive breastfeeding 39.5 Continued breastfeeding at 12-15 months 82.7 Continue breastfeeding at 20-23 months 55.7 Timely complementary feeding 75.0 Tuberculosis immunization coverage 82.5 DPT immunization coverage 58.3 Polio immunization coverage 65.6 Measles immunization coverage 71.6 Children protected against neonatal tetanus 50.7 Oral rehydration therapy (ORT) 48.4 Home management of diarrhea 26.2 Treatment of ARI 61.3 Birth registration 55.1 Children's living arrangements 4.5 Orphans in households 3.2 Treatment of illness 55.8 Malaria treatment 0.7 Knowledge of preventing HIV/AIDS4 19.3 Knowledge of misconceptions of HIV/AIDS5 2.3 Knowledge of mother-to-child transmission of HIV 30.0 Women who know where to be tested for HIV 13.7 1Piped water or protected well water 2 For the last live birth in the five years preceding the survey 3For children without a reported birth weight, the proportion with low birth weight is assumed to be the same as the proportion with low birth weight in each birth size category among children who have a reported birth weight. 4Having sex with only one partner who has no other partners and using a condom every time they have sex 5They say that AIDS cannot be transmitted through mosquito bites and that a healthy-looking person can have the AIDS virus. Indonesia Demographic and Health Survey 2002-2003 Statistics Indonesia Jakarta, Indonesia National Family Planning Coordinating Board Jakarta, Indonesia Ministry of Health Jakarta, Indonesia ORC Macro Calverton, Maryland USA December 2003 This report summarizes the findings of the 2002-2003 Indonesia Demographic and Health Survey (IDHS) carried out by Badan Pusat Statistik-Statistics Indonesia (BPS). The IDHS is part of the worldwide Demographic and Health Surveys program, which is designed to collect data on fertility, family planning, and maternal and child health. The Government of Indonesia provided most of the survey costs through a loan from the World Bank. The United States Agency for International Development (USAID) provided funding for implementation of the survey in three newly established provinces and for technical assistance from ORC Macro. Additional information about the survey may be obtained from the Directorate for Population Statistics, BPS, Jalan Dr. Sutomo No. 6-8, Jakarta 10710, Indonesia (Telephone/fax 345-6285, email: kependudukan@ mailhost.bps.go.id), or the National Family Planning Coordinating Board, BKKBN, Jalan Permata 1, Halim Perdanakusumah, Jakarta 13650, Indonesia (Telephone/fax 800-8535), or the Institute for Research and Development, Ministry of Health, Jalan Percetakan Negara 29, Jakarta 10560, Indonesia (Telephone/fax 4287-1604). Additional information about the DHS program may be obtained by writing to: MEASURE DHS, ORC Macro, 11785 Beltsville Drive, Suite 300, Calverton, MD 20705, USA (Telephone 301-572-0200; Fax 301- 572-0999; email: reports@orcmacro.com). Recommended citation: Badan Pusat Statistik-Statistics Indonesia (BPS) and ORC Macro. 2003. Indonesia Demographic and Health Survey 2002-2003. Calverton, Maryland, USA: BPS and ORC Macro. CONTENTS TABLES AND FIGURES . vii PREFACES. xvii SUMMARY OF FINDINGS . xxiii MAP OF INDONESIA .xxviii CHAPTER 1 INTRODUCTION 1.1 Geography, History, and Economy.1 1.2 Population .2 1.3 Population and Family Planning Policies and Programs .3 1.4 Health Priorities and Programs .4 1.5 Objectives of the Survey .5 1.6 Organization of the Survey.5 CHAPTER 2 CHARACTERISTICS OF HOUSEHOLDS AND HOUSING CHARACTERISTICS 2.1 Household Population by Age, Sex, and Residence.9 2.2 Household Composition .9 2.3 Children’s Living Arrangements and Parental Survival.11 2.4 Educational Level of Household Population .12 2.5 Housing Characteristics and Household Possessions.17 CHAPTER 3 CHARACTERISTICS OF RESPONDENTS AND WOMEN’S STATUS 3.1 Characteristics of Survey Respondents.21 3.2 Educational Attainment.22 3.3 Literacy.24 3.4 Exposure to Mass Media .25 3.5 Employment .27 3.6 Form of Women’s Earnings .31 3.7 Control Over Women’s Earnings and Women’s Contribution to Household Expenditures .33 3.8 Women’s Empowerment .35 Contents | iii 3.9 Life Style Measures .42 CHAPTER 4 FERTILITY 4.1 Current Fertility Levels and Trends .43 4.2 Children Ever Born and Children Surviving .47 4.3 Birth Intervals.48 4.4 Age at First Birth .49 4.5 Teenage Fertility .51 CHAPTER 5 KNOWLEDGE AND EVER USE OF FAMILY PLANNING 5.1 Knowledge of Family Planning Methods.53 5.2 Exposure to Family Planning Messages .56 5.4 Discussion of Family Planning with Husband.61 5.5 Attitudes of Couples Toward Family Planning.62 5.6 Knowledge of the Fertile Period .63 5.7 Ever Use of Contraception .64 CHAPTER 6 CURRENT USE OF FAMILY PLANNING 6.1 Current Use of Family Planning.67 6.2 Trends In Contraceptive Use.70 6.3 Quality of Use .73 6.4 Informed Choice.75 6.5 Problems with Current Method.77 6.6 Cost and Accessibility of Methods .78 6.7 Source of Methods.79 6.8 Timing of Sterilization .81 CHAPTER 7 FERTILITY PREFERENCES 7.1 Desire for Additional Children .83 7.2 Need for Family Planning Services .85 7.3 Ideal Family Size.87 7.4 Unplanned and Unwanted Fertility .89 iv | Contents 7.5 Fertility Preferences by Women’s Status .90 CHAPTER 8 NONUSE AND INTENTION TO USE FAMILY PLANNING 8.1 Discontinuation Rates .93 8.2 Reasons for Discontinuation of Contraceptive Use .94 8.3 Intention to Use Contraception in the Future .96 8.4 Reasons for Nonuse .97 8.5 Preferred Method .98 CHAPTER 9 OTHER PROXIMATE DETERMINANTS OF FERTILITY 9.1 Current Marital Status .99 9.2 Age at First Marriage . 100 9.3 Recent Sexual Activity. 102 9.4 Postpartum Amenorrhea, Abstinence, and Insusceptibility. 103 9.5 Termination of Exposure . 106 CHAPTER 10 INFANT AND CHILD MORTALITY 10.1 Assessment of Data Quality. 107 10.2 Levels and Trends in Infant and Child Mortality . 109 10.3 Mortality Differentials . 110 10.4 Demographic Characteristics. 112 10.5 Mortality by Women’s Status . 114 10.6 Perinatal Mortality . 115 10.7 High-risk Fertility Behavior . 116 CHAPTER 11 MATERNAL HEALTH 11.1 Antenatal Care. 119 11.2 Delivery. 125 11.3 Postnatal Care. 133 11.4 Maternal Health Care and Women’s Status. 134 11.5 Problems in Accessing Health Care . 135 11.6 Birth Registration . 137 Contents | v CHAPTER 12 IMMUNIZATION OF CHILDREN 12.1 Immunization Coverage. 141 12.2 Immunization by Background Characteristics . 142 12.3 Hepatitis B Immunization . 145 CHAPTER 13 CHILDHOOD DISEASES 13.1 Prevalence and Treatment of Acute Respiratory Infections and Fever . 147 13.2 Disposal of Children’s Stools . 149 13.3 Prevalence of Diarrhea . 150 13.4 Knowledge of Diarrhea Care. 150 13.5 Diarrhea Treatment . 151 13.6 Feeding Practices during Diarrhea. 154 13.7 Children’s Health Care and Women’s Status . 155 13.8 Hand-Washing Practices . 156 CHAPTER 14 INFANT FEEDING 14.1 Initial Breastfeeding . 159 14.2 Age Pattern of Breastfeeding . 161 14.3 Duration and Frequency of Breastfeeding . 163 14.4 Types of Complementary Foods. 165 14.5 Frequency of Foods Consumed by Children. 166 14.6 Micronutrient Intake Among Children. 167 14.7 Micronutrient Intake Among Mothers . 169 CHAPTER 15 KNOWLEDGE OF HIV/AIDS AND OTHER SEXUALLY TRANSMITTED INFECTIONS 15.1 Knowledge of AIDS. 171 15.2 Knowledge of Ways to Avoid Contracting HIV/AIDS . 174 15.3 Knowledge of Programmatically Important Ways to Avoid Contracting HIV/AIDS. 175 15.4 Knowledge of HIV/AIDS-related Issues . 177 15.5 Discussion of HIV/AIDS. 179 vi | Contents 15.6 Social aspects of HIV/AIDS. 181 15.7 Knowledge of Symptoms of Sexually Transmitted Infections (STIs). 182 15.8 Knowledge of a Source for Male Condoms. 184 CHAPTER 16 ADULT AND MATERNAL MORTALITY 16.1 Data . 187 16.2 Direct Estimates of Adult Mortality . 188 16.3 Estimates of Maternal Mortality . 189 16.4 Trends in Maternal Mortality . 190 CHAPTER 17 FATHER’S PARTICIPATION IN FAMILY HEALTH CARE 17.1 Advice or Care during Antenatal, Delivery, and Postnatal Periods . 191 17.2 Knowledge about Children’s Immunization. 192 17.3 Contact with Health Care Providers . 193 17.4 Preparation for Delivery. 194 REFERENCES . 197 APPENDIX A PROVINCIAL TABLES. 199 APPENDIX B SAMPLE DESIGN B.1 Introduction. 267 B.2 Sample Design and Implementation. 267 B.3 Pretest . 274 B.4 Training . 274 B.5 Fieldwork. 274 B.6 Data Processing . 274 APPENDIX C ESTIMATES OF SAMPLING ERRORS . 275 APPENDIX D DATA QUALITY TABLES. 309 APPENDIX E SURVEY STAFF. 315 APPENDIX F QUESTIONNAIRES . 319 Contents | vii viii | Contents TABLES AND FIGURES CHAPTER 1 INTRODUCTION Table 1.1 Basic demographic indicators.3 Table 1.2 Results of the household and individual interviews.7 CHAPTER 2 CHARACTERISTICS OF HOUSEHOLDS AND HOUSING CHARACTERISTICS Table 2.1 Household population by age, sex, and residence.10 Table 2.2 Household composition.11 Table 2.3 Children's living arrangements and orphanhood.12 Table 2.4 Educational attainment of household population .13 Table 2.5.1 School attendance ratios: primary school .15 Table 2.5.2 School attendance ratios: secondary school .16 Table 2.6 Household characteristics .18 Table 2.7 Household durable goods .19 Figure 2.1 Population Pyramid of Indonesia .10 Figure 2.2 Housing Characteristics by Residence .19 CHAPTER 3 CHARACTERISTICS OF RESPONDENTS AND WOMEN’S STATUS Table 3.1 Distribution of respondents by background charactristics .22 Table 3.2 Educational attainment by background characteristics .23 Table 3.3 Literacy.24 Table 3.4 Exposure to mass media.26 Table 3.5.1 Employment status: women.28 Table 3.5.2 Employment status: men.29 Table 3.6.1 Occupation: women.30 Table 3.6.2 Occupation: men .31 Table 3.7 Employment characteristics .32 Tables and Figures | vii Table 3.8 Decision on use of earnings and contribution of earnings to household expenditures.34 Table 3.9 Women’s control over earnings.35 Table 3.10 Women’s participation in decisionmaking.36 Table 3.11 Women's participation in decisionmaking .37 Table 3.12 Women's attitude toward wife beating .39 Table 3.13 Women’s attitude toward refusing sex with husband.41 Table 3.14 Use of smoking tobacco.42 Figure 3.1 Employment Status of Women Age 15-49.28 Figure 3.2 Type of Earnings of Employed Women Age 15-49 .32 Figure 3.3 Number of Decisions in Which Women Participate in the Final Say.38 CHAPTER 4 FERTILITY Table 4.1 Current fertility .44 Table 4.2 Fertility by background characteristics .45 Table 4.3 Trends in age-specific fertility rates.47 Table 4.4 Children ever born and living.48 Table 4.5 Birth intervals.49 Table 4.6 Age at first birth .50 Table 4.7 Median age at first birth .51 Table 4.8 Teenage pregnancy and motherhood.52 Figure 4.1 Total Fertility Rate of Southeast Asian Countries .44 Figure 4.2 Total Fertility Rate by Province.46 Figure 4.3 Trends in the Total Fertility Rate, 1991-2003 .46 CHAPTER 5 KNOWLEDGE AND EVER USE OF FAMILY PLANNING Table 5.1 Knowledge of contraceptive methods .53 Table 5.2 Knowledge of contraceptive methods by background characteristics .55 Table 5.3 Exposure to family planning messages .57 viii | Tables and Figures Table 5.4 Exposure to family planning messages through personal contact.59 Table 5.5 Contact of nonusers with family planning providers .60 Table 5.6 Discussion of family planning between husband and wife .61 Table 5.7 Attitudes toward family planning.62 Table 5.8 Knowledge of fertile period.63 Table 5.9 Ever use of contraception.64 Table 5.10 Number of children at first use of contraception .65 Figure 5.1 Percentage of Currently Married Women Who Know Specific Modern Contraceptive Methods, Indonesia 1991 and 2003.54 CHAPTER 6 CURRENT USE OF FAMILY PLANNING Table 6.1 Current use of contraception .67 Table 6.2 Current use of contraception by background characteristics .68 Table 6.3 Trends in use of specific contraceptive methods: Indonesia 1991-2003 .70 Table 6.4 Trends in contraceptive use by province in Java 1991-2002-2003.71 Table 6.5 Current use of contraception by women’s status .73 Table 6.6 Pill use compliance .74 Table 6.7 Use of injectables.75 Table 6.8 Informed choice .76 Table 6.9 Problems with curent method of contraception.77 Table 6.10 Payment for contraceptive method and services.78 Table 6.11 Mean cost of contraceptive method and services .79 Table 6.12 Source of contraception.80 Table 6.13 Timing of sterilization.82 Figure 6.1 Percentage of Currently Married Women Age 15-49 Who Are Using a Contraceptive Method .69 Figure 6.2 Percentage of Currently Married Men Age 15-54 Who Are Using a Contraceptive Method .70 Figure 6.3 Percentage of Currently Married Women Age 15-49 Using Specific Contraceptive Methods, Indonesia 1997-2003 .71 Tables and Figures | ix Figure 6.4 Percentage of Currently Married Women Age 15-49 Using a Contraceptive Method by Province in Java, 1994-2003 .72 Figure 6.5 Distribution of Current Users of Modern Contraceptive Methods by Source of Supply, Indonesia 1997-2003 .81 CHAPTER 7 FERTILITY PREFERENCES Table 7.1 Fertility preferences .84 Table 7.2 Desire to limit childbearing .85 Table 7.3 Need for family planning .86 Table 7.4 Ideal number of children .88 Table 7.5 Mean ideal number of children by background characteristics .88 Table 7.6 Fertility planning status.89 Table 7.7 Wanted fertility rates.90 Table 7.8 Ideal number of children and unmet need by women’s status.91 Figure 7.1 Fertility Preferences of Currently Married Women Age 15-49 .84 CHAPTER 8 NONUSE AND INTENTION TO USE FAMILY PLANNING Table 8.1 First-year contraceptive discontinuation rates .93 Table 8.2 Reasons for discontinuation of contraceptive methods .95 Table 8.3 Future use of contraception .96 Table 8.4 Reason for not intending to use contraception .97 Table 8.5 Preferred method .98 Figure 8.1 Reasons for Discontinuation of Contraceptive Methods.95 CHAPTER 9 OTHER PROXIMATE DETERMINANTS OF FERTILITY Table 9.1 Current marital status . 100 Table 9.2 Age at first marriage . 100 Table 9.3 Median age at first marriage. 101 Table 9.4 Recent sexual activity. 103 Table 9.5 Postpartum amenorrhea, abstinence, and insusceptibility. 104 x | Tables and Figures Table 9.6 Median duration of postpartum insusceptibility by background characteristics . 105 Table 9.7 Menopause. 106 Figure 9.1 Median Age at First Marriage by Province in Java 1994, 1997, and 2002- 2003. 102 Figure 9.2 Percentage of Births in the Past Three Years for Which the Mother is Amenorrheic or Abstaining. 105 CHAPTER 10 INFANT AND CHILD MORTALITY Table 10.1 Early childhood mortality rates . 109 Table 10.2 Early childhood mortality rates by socioeconomic characteristics. 111 Table 10.3 Trends in infant mortality by province. 112 Table 10.4 Early childhood mortality rates by demographic characteristics. 113 Table 10.5 Early childhood mortality rates by women's status . 115 Table 10.6 Perinatal mortality. 116 Table 10.7 High-risk fertility behavior . 117 Figure 10.1 Reporting of Age at Death in Months . 108 Figure 10.2 Infant Mortality Rates, Selected Sources, Indonesia, 1971-2002. 110 CHAPTER 11 MATERNAL HEALTH Table 11.1 Antenatal care. 120 Table 11.2 Number of antenatal care visits and timing of first visit . 121 Table 11.3 Components of antenatal care . 123 Table 11.4 Tetanus toxoid injections . 124 Table 11.5 Complications during pregnancy. 125 Table 11.6 Place of delivery . 126 Table 11.7 Assistance during delivery: most qualified person. 128 Table 11.8 Assistance during delivery: least qualified person . 129 Table 11.9 Delivery characteristics . 130 Table 11.10 Preparation for delivery. 131 Tables and Figures | xi Table 11.11 Complications during delivery. 133 Table 11.12 Postnatal care by background characteristics . 134 Table 11.13 Maternal health care and women's status . 135 Table 11.14 Problems in accessing health care . 136 Table 11.15 Birth registration . 137 Table 11.16 Reason for not registering births . 138 Figure 11.1 Number of Antenatal Care Visits and Number of Months Pregnant at Time of First ANC Visit. 122 Figure 11.2 Place of Delivery and Least Qualified Delivery Assistant . 127 Figure 11.3 Discussion on Preparation for Delivery. 132 CHAPTER 12 IMMUNIZATION OF CHILDREN Table 12.1 Vaccinations by background characteristics . 143 Table 12.2 Hepatitis B vaccination coverage. 144 Figure 12.1 Percentage of Children Age 12-23 Months Vaccinated by 12 Months of Age (Based on Information from Health Cards and Mother’s Reports) . 142 Figure 12.2 Children Age 12-23 Months Who Are Fully Immunized (Based on Information from Health Cards and Mother’s Reports) . 145 CHAPTER 13 CHILDHOOD DISEASES Table 13.1 Prevalence and treatment of acute respiratory infections (ARI) and/or fever. 148 Table 13.2 Drugs taken for fever . 148 Table 13.3 Disposal of children’s stools . 149 Table 13.4 Prevalence of diarrhea . 150 Table 13.5 Knowledge of ORS packets . 151 Table 13.6 Diarrhea treatment . 152 Table 13.7 Feeding practices during diarrhea . 154 Table 13.8 Children’s health care by women’s status . 155 Table 13.9 Hand-washing practices . 157 xii | Tables and Figures Figure 13.1 Knowledge and Use of ORS Packets among Mothers Who Gave Birth in the Past Five Years, by Level of Education . 153 Figure 13.2 Trends in Knowledge and Use of ORS Packets for Treatment of Diarrhea by Mothers who Gave Birth in the Past Five Years . 153 Figure 13.3 Trends in Feeding Practices among Children Under Five with Diarrhea. 155 CHAPTER 14 INFANT FEEDING Table 14.1 Initial breastfeeding. 160 Table 14.2 Breastfeeding status by child’s age. 162 Table 14.3 Median duration of breastfeeding . 164 Table 14.4 Foods consumed by children in the day or night preceding the interview. 166 Table 14.4 Foods consumed by children in the day or night preceding the interview. 162 Table 14.5 Frequency of foods consumed by children in the day or night preceding the interview. 167 Table 14.6 Micronutrient intake among children . 168 Table 14.7 Micronutrient intake among mothers . 170 Figure 14.1 Distribution of Children by Breastfeeding (BF) Status, According to Age . 163 Figure 14.2 Median Duration of Any Breastfeeding (months) . 165 CHAPTER 15 KNOWLEDGE OF HIV/AIDS AND OTHER SEXUALLY TRANSMITTED INFECTIONS Table 15.1 Knowledge of HIV/AIDS. 172 Table 15.2 Knowledge of ways to avoid HIV/AIDS. 175 Table 15.3.1 Knowledge of programmatically important ways to avoid HIV/AIDS: women . 176 Table 15.3.2 Knowledge of programmatically important ways to avoid HIV/AIDS: men. 177 Table 15.4.1 Knowledge of HIV/AIDS-related issues: women . 178 Table 15.4.2 Knowledge of HIV/AIDS-related issues: men. 179 Table 15.5.1 Discussion of HIV/AIDS with husband. 180 Table 15.5.2 Discussion of HIV/AIDS with wife . 180 Table 15.6 Social aspects of HIV/AIDS. 182 Table 15.7.1 Knowledge of symptoms of STIs: women . 183 Tables and Figures | xiii Table 15.7.2 Knowledge of symptoms of STIs: men. 184 Table 15.8 Knowledge of source of male condoms and access to condoms . 185 Figure 15.1 Percentage of Ever-Married Women Who Have Heard of AIDS and Believe There is a Way to Avoid ADIS, Indonesia 1994-2003 . 172 Figure 15.2 Percentage of Ever-Married Women Who Have Heard of AIDS and Believe There is a Way to Avoid AIDS, By Education . 173 Figure 15.3 Percentage of Currently Married Men Who Have Heard of AIDS and Believe There is a Way to Avoid AIDS, By Education . 174 Figure 15.4 Percentage of Currently Married Women and Currently Married Men Who Discussed AIDS Prevention with Their Spouse, by Education . 181 Figure 15.5 Percentage of Ever-Married Women and Currently Married Men Who Do Not Know the Symptoms of STIs, by Level of Education . 183 CHAPTER 16 ADULT AND MATERNAL MORTALITY Table 16.1 Data on siblings . 188 Table 16.2 Adult mortality rates. 189 Table 16.3 Maternal mortality rates . 189 CHAPTER 17 FATHER’S PARTICIPATION IN FAMILY HEALTH CARE Table 17.1 Advice or care received by mother during pregnancy and delivery and after delivery. 191 Table 17.2 Specific vaccines received by children under five. 192 Table 17.3 Father’s contact with a health care provider about wife’s health and pregnancy. 194 Table 17.4 Preparation for delivery. 195 APPENDIX A PROVINCIAL TABLES Table A.3.1 Distribution of respondents by province. 199 Table A.3.2.1 Educational attainment by province: ever-married women . 200 Table A.3.2.2 Educational attainment by province: currently married men . 201 Table A.3.3.1 Literacy by province: women. 202 Table A.3.3.2 Literacy by province: men . 203 Table A.3.4.1 Exposure to mass media by province: women. 204 xiv | Tables and Figures Table A.3.4.2 Exposure to mass media by province: men . 205 Table A.3.5.1 Employment status by province: women. 206 Table A.3.5.2 Employment status by province: men. 207 Table A.3.6 Decision on use of earnings and contribution of earnings to household expenditures by province. 208 Table A.3.7 Women's participation in decisionmaking by province . 209 Table A.3.8 Women's attitude toward wife beating by province . 210 Table A.3.9 Women’s attitude toward refusing sex with husband by province. 211 Table A.4.1 Fertility by province . 212 Table A.4.2 Birth intervals by province. 213 Table A.4.3 Median age at first birth by province . 214 Table A.4.4 Teenage pregnancy and motherhood by province. 215 Table A.5.1 Knowledge of contraceptive methods by province . 216 Table A.5.2 Exposure to family planning messages by province . 217 Table A.5.3 Exposure to family planning messages through personal contact by province . 218 Table A.5.4 Contact of nonusers with family planning providers by province . 219 Table A.5.5 Discussion of family planning between husband and wife by province . 220 Table A.6.1 Current use of contraception by province . 221 Table A.6.2 Pill use compliance by province. 222 Table A.6.3 Informed choice by province . 223 Table A.6.4 Payment for contraceptive method and services by province . 224 Table A.7.1 Desire to limit childbearing by province. 225 Table A.7.2 Need for family planning by province . 226 Table A.7.3 Mean ideal number of children by province. 227 Table A.7.4 Wanted fertility rates by province . 228 Tables and Figures | xv Table A.9.1 Current marital status by province. 229 Table A.9.2 Median age at first marriage by province. 230 Table A.9.3 Recent sexual activity by province. 231 Table A.9.4 Median duration of postpartum insusceptibility by province. 232 Table A.10.1 Early childhood mortality rates by province. 233 Table A.11.1 Antenatal care by province . 234 Table A.11.2 Components of antenatal care by province . 235 Table A.11.3 Tetanus toxoid injections by province . 236 Table A.11.4 Place of delivery by province . 237 Table A.11.5 Assistance during delivery by province . 238 Table A.11.6 Delivery characteristics by province . 239 Table A.11.7 Preparation for delivery by province . 240 Table A.11.8 Postnatal care by province . 241 Table A.11.9 Problems in accessing health care by province . 242 Table A.11.10 Birth registration by province . 243 Table A.11.11 Reason for not registering births by province . 244 Table A.12.1 Vaccinations by province . 245 Table A.12.2 Hepatitis B vaccinations by province. 246 Table A.13.1 Prevalence and treatment of acute respiratory infections (ARI) and/or fever by province. 247 Table A.13.2 Disposal of children’s stools by province . 248 Table A.13.3 Prevalence of diarrhea by province . 249 Table A.13.4 Knowledge of ORS packets by province . 250 Table A.14.1 Initial breastfeeding by province. 251 xvi | Tables and Figures Table A.14.2 Median duration and frequency of breastfeeding by province . 252 Table A.14.3 Micronutrient intake among children by province . 253 Table A.14.4 Micronutrient intake among mothers by province . 254 Table A.15.1 Knowledge of HIV/AIDS by province . 255 Table A.15.2 Knowledge of programmatically important ways to avoid HIV/AIDS by province . 256 Table A.15.3 Knowledge of HIV/AIDS-related issues by province . 257 Table A.15.4 Discussion of HIV/AIDS with husband by province. 258 Table A.15.5 Social aspects of HIV/AIDS by province. 259 Table A.15.6 Knowledge of symptoms of STIs by province: women . 260 Table A.15.7 Knowledge of symptoms of STIs by province: men. 261 Table A.15.8 Knowledge of source of male condoms and access to condoms by province . 262 Table A.17.1 Advice or care on antenatal care, delivery, and postnatal care by province . 263 Table A.17.2 Specific vaccines received by children under five by province. 264 Table A.17.3 Father’s contact with a health care provider about wife’s health and pregnancy by province. 265 Table A.17.4 Preparation for delivery by province . 266 APPENDIX B SAMPLE DESIGN Table B.1 Allocation of census blocks by province . 268 Table B.2.1 Sample implementation: results of the household interview: women . 270 Table B.2.2 Sample implementation: results of the household interview: women . 271 Table B.3.1 Sample implementation: results of the household interview: men. 272 Table B.3.2 Sample implementation: results of the household interview: men. 273 APPENDIX C ESTIMATES OF SAMPLING ERRORS Table C.1 List of selected variables for sampling errors, Indonesia 2002-2003. 278 Table C.2 Sampling errors: National sample, Indonesia 2002-2003 . 279 Table C.3 Sampling errors: Urban sample, Indonesia 2002-2003. 280 Tables and Figures | xvii Table C.4 Sampling errors: Rural sample, Indonesia 2002-2003. 281 Table C.5 Sampling errors: North Sumatera sample, Indonesia 2002-2003 . 282 Table C.6 Sampling errors: West Sumatera sample, Indonesia 2002-2003 . 283 Table C.7 Sampling errors: Riau sample, Indonesia 2002-2003. 284 Table C.8 Sampling errors: Jambi sample, Indonesia 2002-2003. 285 Table C.9 Sampling errors: South Sumatera sample, Indonesia 2002-2003 . 286 Table C.10 Sampling errors: Bengkulu sample, Indonesia 2002-2003 . 287 Table C.11 Sampling errors: Lampung sample, Indonesia 2002-2003 . 288 Table C.12 Sampling errors: Bangka Belitung sample, Indonesia 2002-2003. 289 Table C.13 Sampling errors: DKI Jakarta sample, Indonesia 2002-2003 . 290 Table C.14 Sampling errors: West Java sample, Indonesia 2002-2003. 291 Table C.15 Sampling errors: Central Java sample, Indonesia 2002-2003 . 292 Table C.16 Sampling errors: DI Yogyakarta sample, Indonesia 2002-2003 . 293 Table C.17 Sampling errors: East Java sample, Indonesia 2002-2003 . 294 Table C.18 Sampling errors: Banten sample, Indonesia 2002-2003. 295 Table C.19 Sampling errors: Bali sample, Indonesia 2002-2003. 296 Table C.20 Sampling errors: West Nusa Tanggara sample, Indonesia 2002-2003 . 297 Table C.21 Sampling errors: East Nusa Tenggara sample, Indonesia 2002-2003. 298 Table C.22 Sampling errors: West Kalimantan sample, Indonesia 2002-2003 . 299 Table C.23 Sampling errors: Central Kalimantan sample, Indonesia 2002-2003 . 300 Table C.24 Sampling errors: South Kalimantan sample, Indonesia 2002-2003 . 301 Table C.25 Sampling errors: East Kalimantan sample, Indonesia 2002-2003 . 302 Table C.26 Sampling errors: North Sulawesi sample, Indonesia 2002-2003 . 303 Table C.27 Sampling errors: Central Sulawesi sample, Indonesia 2002-2003 . 304 Table C.28 Sampling errors: South Sulawesi sample, Indonesia 2002-2003 . 305 Table C.29 Sampling errors: Southeast Sulawesi sample, Indonesia 2002-2003. 306 Table C.30 Sampling errors: Gorontalo sample, Indonesia 2002-2003 . 307 APPENDIX D DATA QUALITY TABLES Table D.1 Household age distribution . 309 xviii | Tables and Figures Table D.2.1 Age distribution of eligible and interviewed women . 310 Table D.2.2 Age distribution of eligible and interviewed men. 311 Table D.3 Completeness of reporting . 311 Table D.4 Births by calendar years . 312 Table D.5 Reporting of age at death in days . 313 Table D.6 Reporting of age at death in months. 314 Tables and Figures | xix PREFACE The 2002-2003 Indonesia Demographic and Health Survey (IDHS) is the fifth 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), the second, third, and the fourth surveys were the 1991 IDHS, 1994 IDHS, and 1997 IDHS. The 2002-2003 IDHS was designed as a collaborative effort of four institutions, i.e., BPS-Statistics Indonesia (BPS), National Family Planning Coordinating Board (NFPCB), the Ministry of Health (MOH), and ORC Macro. The Government of Indonesia provided most of the survey costs through a loan from the World Bank. The U.S. Agency for International Development (USAID) provided funding for implementation of the survey in three newly established provinces and for technical assistance from ORC Macro. The BPS was responsible for conducting the survey, including survey design, fieldwork, and data processing. The 2002-2003 IDHS fieldwork was carried out from October 2002 to April 2003 in selected enumeration areas of the 26 provinces in Indonesia. Due to security reasons, four provinces were excluded: Nanggroe Aceh Darussalam, Maluku, North Maluku, and Papua. The sampling frame for this survey is the list of census blocks (CBs) developed for the 2002 National Socioeconomic Household Surveys (Susenas). The 2002-2003 IDHS sample is aimed at providing reliable estimates of key characteristics of ever-married women 15-49 and married men 15-54 in Indonesia as a whole, in urban and rural areas, and in each of the 26 provinces. The main objective of the 2002-2003 IDHS is to provide policymakers and program managers in population and health with detailed information on population, family planning, and health. In particular, the 2002-2003 IDHS collected information on the female respondents’ socioeconomic background, fertility levels, marriage and sexual activity, fertility preferences, knowledge and use of family planning methods, breastfeeding practices, childhood and adult mortality including maternal mortality, maternal and child health, and awareness and behavior regarding AIDS and other sexually transmitted infections in Indonesia. 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 World Bank, USAID and MEASURE DHS+ ORC Macro. Dr. Soedarti Surbakti Director General BPS-Statistics Indonesia Preface | xvii PREFACE Until 1997, the Indonesia Demographic and Health Surveys (IDHS) had been conducted every three years. The current survey is conducted more than five years after the last one. In the course of the global rapid development progress, there have been tremendous changes in the country’s political and socioeconomic situation, which have led to changes in the strategic environment of the Indonesian Family Planning Program. BKKBN has adopted a new Family Planning Movement (FPM) paradigm, which has moved from concentrating on demographic objectives to a people- and family-centered approach. This approach emphasizes the importance of human and family development, and strives to change reproductive health and family planning attitudes. The new paradigm also strives to provide high quality information and services, and to improve family welfare and prosperity. The new paradigm is presented in the new vision ”The Quality Family by 2015”. Under this new vision, due to continued fertility decline and widely accepted norm of a small family, the program’s future activities will be focused on the enhancing the quality of services on contraceptive methods and information, education and communication, as well as welfare programs. In addition, we have taken a stock of new knowledge and integrated this into our strategic plan on the provision of services. This is particularly true of recent landmark studies on male participation in family planning. These studies have shed light on these elusive issues and have enabled us to address them strategically. The 2002-2003 IDHS includes new features, in which use of contraception by married men and participation of women in household decision-making are also examined. I consider this report monumental not only because of the breadth of its coverage, but more importantly because it provides us with greater chances for in-depth analysis that goes into formulating it. I therefore congratulate the 2002-2003 IDHS Steering and Technical Committees for spearheading the effort to prepare this report. I would like to express my deepest gratitude to BPS- Statistics Indonesia, the Ministry of Health, and ORC Macro. Our appreciation goes to the World Bank for the funding support, without which this survey could not have been completed. Our appreciation also goes to USAID for the funding support necessary to cover the new three provinces and the technical assistance rendered through ORC Macro in collaboration with BKKBN, BPS, and the Ministry of Health. Dr. Sumarjati Arjoso, SKM Chairperson, National Family Planning Coordinating Board Preface | xix PREFACE The goal of health development is to increase the awareness, willingness, and ability of everyone to live a healthy life. To meet this goal the government of Indonesia, entering the third millennium, has reformed its health policies by the adoption of the new vision of Healthy Indonesia 2010, which provides the basis for determining the goals and strategies for health development. This health development reform will be implemented through evidence-based programming, which requires the availability of reliable health information. Surveys are one of many methods used to generate needed health information. Many health-related surveys have been and are being conducted in Indonesia to provide the health data needed by the Ministry of Health and other sectors. An attempt to integrate national surveys that collect health data to support the need for optimal health information should be carried out. The 2002-2003 Indonesia Demographic and Health Survey (IDHS), which was implemented through collaboration and partnership among many parties including the National Family Planning Coordinating Board, BPS Statistics, and the Ministry of Health, is an example of the efficient provision of survey-based data to many parties. The Ministry of Health has indeed benefited from the IDHS data. The result of the 2002-2003 IDHS together with data from various other sources will be used effectively to support evidence-based programming. I also recommend that the results of the 2002-2003 IDHS should be disseminated to decisionmakers at different administrative levels and to the community at large. Finally, I would like to extend my gratitude and appreciation to BPS Statistics, the National Family Planning Coordinating Board, the World Bank, USAID, ORC Macro in Calverton, Maryland (USA), and all other parties who have contributed to the success of the 2002-2003 IDHS. Special appreciation goes to the Steering Committee and the Technical and Survey Field Teams, without whose relentless effort and dedication the survey could not have been realized. Dr. Achmad Sujudi Minister of Health Republic of Indonesia Preface | xxi SUMMARY OF FINDINGS The 2002-2003 Indonesia Demographic and Health Survey (IDHS) is a nationally representa- tive survey of 29,483 ever-married women age 15-49 and 8,310 currently married men age 15- 54. The main purpose of the 2002-2003 IDHS is to provide policymakers and program managers with detailed information on fertility, family planning, childhood and adult mortality, mater- nal and child health, and knowledge of and atti- tudes related to HIV/AIDS and other sexually transmitted diseases. The 2002-2003 IDHS is the fifth national sample survey of its kind to be un- dertaken in Indonesia. Caution needs to be exer- cised when analyzing trends using the IDHS data sets because of differences in geographic coverage. The current survey excludes Nanggroe Aceh Darussalom, Maluku, North Malaku, and Papua provinces. Past IDHS surveys included East Timor. CURRENT STATUS AND PROGRESS FERTILITY The 2002-2003 IDHS indicates that there has been a steady decline in fertility in Indonesia from 3.0 children per woman in 1988-1991 to 2.6 children per woman in 2000-2002. The de- cline took place in most provinces. Compared with selected southeast Asian countries such as Cambodia, the Philippines, Malaysia, and Myan- mar, the TFR in Indonesia is low, although not as low as that in Singapore and Thailand. Fertility varies enormously across subgroups of women. Urban women have, on average, 0.3 children fewer than rural women (2.4 compared with 2.7, respectively). The relationship between education and fertility takes the form of an in- verted U-shape curve. Women with some pri- mary and completed primary education have the highest TFRs. There are sharp variations in TFRs by level of wealth. Women in the poorest households have significantly higher fertility than those in the richest households (4.4 births and 3.4 births, respectively). Variations across province are notable; Central Java, DI Yogyakarta, East Java, and Bali have reached or surpassed replacement level (2.1 children per woman), while East Nusa Tenggara and South Sulawesi, have the highest TFRs (4.1 and 3.6 chil- dren per woman, respectively). WHY DID FERTILITY DECLINE? The decline in fertility is brought about by, among other things, increased education among women (which delays marriage), increased age at first birth, desire for fewer children, and greater use of contraceptive methods. Better education. Women of reproductive age are increasingly better educated. In 1997, 13 percent of women age 15-49 had no education. In 2002- 2003, this figure had declined to 8 percent. Further- more, the percentage of women who have had some secondary education increased from 28 percent in 1997 to 38 percent in 2002-2003. Later marriage. The 2002-2003 IDHS shows that more Indonesian women remain single. Women who marry, do so at a later age. In 1997 half of women age 25-49 were married by age 18.6 years; in 2002-2003 the median age at marriage was 19.2 years. Later childbearing. Women are also delaying their first births. The median age at first birth for women 25-49 has increased from 20.8 years in 1997 to 21.0 years in 2002-2003. Furthermore, teenage childbearing has declined from 12 percent in the 1997 IDHS to 10 percent in the 2002-2003 IDHS. Longer birth intervals. Fertility decline can also be attributed to longer birth intervals, implying a delay in the second birth. Results of the 2002-2003 IDHS indicate that half of births occur 54 months after the previous birth, which is a much longer in- terval than that reported in the 1997 IDHS and 1994 IDHS (45 months and 42 months, respectively). Summary of Findings | xxiii Increased desire for smaller families. The IDHS data indicate that the desire to limit child- bearing continues to increase. The percentage of married women who say that they want no more children or have been sterilized increased from 50 percent in 1997 to 54 percent in 2002-2003. Gap between wanted fertility and actual fertility. Despite an increasing use of contracep- tion, the survey data show that one in ten preg- nancies were mistimed and one in fourteen were not wanted at all. If unwanted births could be prevented, the total fertility rate in Indonesia would be 2.2 births per woman instead of the actual level of 2.6. This gap remains the same as that recorded in 1997, but the fertility levels in 2002-2003 are lower than in 1997 (2.4 and 2.8 births per woman, respectively). USE OF CONTRACEPTION Contraceptive use among currently married women in Indonesia has increased from 57 per- cent in 1997 to 60 percent in 2002-2003. Most of the increase is due to an increase in the use of injectables from 21 percent to 28 percent (ac- counting for 47 percent of family planning users). Method mix. Other than injectables, popu- lar family planning methods in 2002-2003 in- clude the pill (13 percent), IUD (6 percent), and implants and female sterilization (4 percent each). The gain in the use of injectables is ac- companied by a decrease in the use of the IUD and implants of 2 percentage points each. There has been a shift in the use of specific modern family planning methods. While in 1991, 30 percent of contraceptive users used the pill, in 2002-2003 the proportion had declined to 22 percent. Use of the IUD declined from 27 percent in 1991 to 10 percent in 2002-2003. Male sterilization and condoms continue to have limited numbers of users. Large differentials in use of contracep- tion. There are large differences in the use of modern contraceptive methods across subgroups of married women. Use of modern family plan- ning methods is much higher in urban areas than in rural areas (42 and 15 percent, respectively), among women in the middle of their reproductive years (20-34), better-educated women, and women with a larger number of children. Contraceptive prevalence varies across prov- inces. It is 65 percent or higher in DI Yogyakarta, North Sulawesi, Bengkulu, East Java, Central Java, and Bangka Belitung. On the other hand, East Nusa Tenggara has the lowest level of contraceptive prevalence (35 percent). Source of supply. In Indonesia, contraceptive users are increasingly more likely to rely on private medical sources for their method. Use of govern- ment sources decreased from 43 percent in 1997 to 28 percent in 2002-2003, while use of private medi- cal sources increased from 42 percent to 63 percent, and use of other sources decreased from 15 percent to 8 percent. The substantial increase in use of pri- vate sources is mainly due to the increased use of private midwives (18 percentage points). Quality of use of contraception. In the 2002- 2003 IDHS, 90 percent of pills users were able to show a package to the interviewer and among these women, 83 percent had taken the pills in order. Among users of contraceptive injectables, only 2 to 5 percent may actually be at risk of pregnancy be- cause they did not have an injection in time Unmet need for family planning. Unmet need for family planning services is defined as the per- centage 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. The 2002-2003 IDHS data show that the total unmet need for family planning ser- vices in Indonesia is 9 percent, of which 5 percent is for limiting and 4 percent is for spacing. The level of unmet need has not changed since 1997. Overall, the total demand for family planning in Indonesia is 70 percent, of which 88 percent has been satisfied. If all of this need were satisfied, a contraceptive prevalence rate of about 68 percent could, theoretically, be expected. Comparison with the 1997 IDHS indicates that the percentage of de- mand satisfied has increased only slightly. Self-reliance in family planning. Overall, 89 percent of users pay for their contraceptives, while xxiv | Summary of Findings 11 percent receive the method and services free of charge. Injectables and pill users are most likely to pay for their contraceptive method (98 percent and 97 percent, respectively). Self- reliance is much lower for IUDs, with only 57 percent of users paying for their method. Users of contraception were more self-reliant in 2002- 2003 than in 1997. For example, the percentage of users who received family planning services from a government source free of charge has decreased from 11 percent in 1997 to 7 percent in 2002-2003. REPRODUCTIVE HEALTH Antenatal care. Nine in ten mothers re- ceived care from a medical professional during their pregnancy while 4 percent received no an- tenatal care. Coverage of K4—at least one visit in the first trimester, at least one visit in the sec- ond trimester, and at least two visits in the third trimester—is 64 percent. Mothers who live in urban areas more likely to receive antenatal care from a medical professional than those living in rural areas. Delivery care. Four in ten births in the five years preceding the survey were delivered in a health facility, 9 percent in a public facility (government hospital or health center) and 31 percent were delivered in a private health facil- ity. This is a significant change from 1997, when only two in ten births were delivered in a health facility. Medical staff (midwives and doctors) as- sisted 66 percent of births in the five years be- fore the survey while traditional birth attendant (TBA) assisted 32 percent of births. Again, this is a substantial increase from 1997, when 43 percent of deliveries were assisted by medical staff and 54 percent of births were assisted by TBAs. Postnatal care. In the 2002-2003 IDHS, women who had given birth outside a health fa- cility were asked if they had received postnatal care. Overall, eight in ten of these women re- ceived postnatal care; with 62 percent receiving postnatal care within 2 days of delivery, 13 per- cent 3-6 days after delivery, and 8 percent 7-41 days after delivery. CHILD HEALTH Childhood immunization. Information from health cards and mothers’ reports (combined) shows that 52 percent of children 12-23 months are fully immunized. This percentage is lower than the 55 percent reported in the 1997 IDHS, but higher than that reported in the 1994 and 1991 IDHS (50 percent and 48 percent, respectively). Childhood illnesses. Acute respiratory infec- tions (ARI), diarrhea and malaria are common causes of child death. In the two weeks before the survey, 8 percent of children were reported to have symptoms of ARI, of whom 60 percent were taken to a health facility. Eleven percent of children had diarrhea in the two weeks preceding the survey, 45 percent of whom were taken to a health provider. Sixty-one percent of children with diarrhea were given oral rehydration therapy, that is, oral rehydra- tion salts (ORS), a recommended homemade fluid, or increased fluids. Breastfeeding. Breastfeeding is universally practiced in Indonesia, with 98 percent of babies breastfed for at least some period of time. However, only 4 percent of babies are put to the breast within one hour of birth (as recommended), while 27 per- cent initiated breastfeeding in the first day of life. The overall median duration of any breastfeeding is 22.3 months, which is a month and a half less than in 1997 (23.9 months). Exclusive breastfeeding is not widely practiced in Indonesia. Despite the government’s recommen- dation that infants receive breast milk exclusively through the first six months of life, only 64 percent of infants under 2 months are exclusively breastfed. At age 4 to 5 months, only one in seven infants re- ceives breast milk without complementary feeding. Perceived problems in accessing health care. In the 2002-2003 IDHS, women were asked whether they have problems seeking medical advice or treatment for themselves. The main problem cited by women is economic in nature (24 percent). The next big problems are the distance to a health facility (12 Summary of Findings | xxv percent) and having to take transportation (12 percent). FATHER’S PARTICIPATION IN FAMILY HEALTH CARE In the survey, fathers were asked questions about their involvement in ensuring safe moth- erhood for the mother of their last-born child and their involvement in ensuring the health of their last-born child. The questions are in re- sponse to the newly established policies of the Indonesian government to involve men in the health care of their wives and children. The survey shows that for 87 percent of births in the five years preceding the survey the mothers are reported by their husbands to have received advice or care during pregnancy, 77 percent received care during delivery, and 71 percent received care in the six weeks after de- livery (postpartum period). Two in three fathers know their last child has been immunized. However, only four in ten fathers had any contact with a health care pro- vider during their wife’s pregnancy with that child. Most fathers discussed the preparations for their child’s delivery. The most frequently men- tioned topics of discussion were the place of de- livery and the delivery assistant (65 percent and 64 percent, respectively), followed by payment for the services (57 percent). A topic less fre- quently discussed by fathers is transportation to the place of delivery (33 percent), probably be- cause many deliveries take place at home. AWARENESS OF HIV/AIDS AND OTHER SEXUALLY TRANSMITTED INFECTIONS Knowledge of HIV/AIDS. While increas- ing, knowledge of HIV/AIDS in Indonesia is fairly low. The level of knowledge among women increased gradually from 38 percent in 1994 to 51 percent in 1997. In 2002-2003, 59 percent of ever-married women and 73 percent of married men reported having heard of HIV/ AIDS. Knowledge of the three principal ways to reduce HIV transmission—abstinence, use of condoms, and reducing the number of partners—is extremely lim- ited. One percent of women and one percent of men cited abstinence, 6 percent of women and 10 percent of men mentioned limiting the number of sexual partners, and 5 percent of women and 13 percent of men cited the use of condoms. The most common responses on ways to avoid getting AIDS were avoiding having sex with prostitutes (16 percent for women and 41 percent for men) and having sex with only one partner (14 percent for women and 18 per- cent for men). Knowledge of mother-to-child transmission. In the IDHS, respondents were asked if the virus that causes AIDS can be transmitted from a mother to a child. They were then asked if transmission occurs during pregnancy, delivery, or breastfeeding. One in three women said that HIV/AIDS can be transmitted from mother to child during all three. The corre- sponding figures for married men are 45 percent, 48 percent, and 46 percent, respectively. Knowledge of symptoms of sexually trans- mitted infections (STIs). STIs have been identified as co-factors in HIV/AIDS transmission. Knowledge of the symptoms of STIs among women in Indonesia is limited; 73 percent of ever-married women re- ported no knowledge of the symptoms associated with STIs in women and 13 percent have no knowl- edge of the symptoms of STIs in men. Knowledge of the symptoms of STIs among married men is lower than that among ever-married women. MORTALITY Childhood Mortality. The infant mortality rate in Indonesia has declined from 142 deaths per 1,000 live births in 1967 to 35 deaths in 2000. At current mortality levels, 46 of every 1,000 children born in Indonesia die before the fifth birthday. In general, there is a strong inverse relationship between wealth and mortality rates; children living in richer households have lower mortality rates than children in poorer households (17 compared with 61 deaths per 1,000 live births). Childhood mortality rates decline as the birth in- terval increases. For example, the infant mortality xxvi | Summary of Findings rate for children born less than two years after a previous birth is more than three times higher than for children born after an interval of four or more years (102 deaths compared with 31 deaths per 1,000 live births). ADULT MORTALITY The female mortality rate for the period 0-4 years before the 2002-2003 IDHS is two deaths per 1,000 population. For the same period, the male mortality rate is also two deaths per 1,000 population. For both sexes, mortality increases with age. In general, male mortality rates are slightly higher than female rates at most ages. The 2002-2003 data suggest that female adult mortality continues to decline gradually. The maternal mortality ratio estimated using direct procedures, is 307 maternal deaths per 100,000 live births for the period 1998-2002. Because maternal mortality estimates are subject to high sampling errors and wide confidence intervals, it is not possible to conclude that there has been any decline in maternal mortality levels over the past 10 to 15 years. CONTINUING CHALLENGES • Despite the increased use of family planning, increased age at first marriage, and continued decline in fertility, the 2002-2003 IDHS reveals continuing challenges. Ten per- cent of births in the five years preceding the sur- vey were wanted but at a later time and 7 per- cent were not wanted at all. This situation has not changed since 1997. • While use of family planning has been in- creasing over time, there is heavy reliance on supply methods, particularly injectables and the pill. Greater program emphasis needs to be placed on long-term methods such as the IUD, implants and sterilization. • In the maternal health sector, while selected health indicators have shown improvement, others show deterioration. The target of 90 percent of women having at least one antenatal care visit in the first trimester has not been reached. • In the area of child health, the percentage of women who have been immunized against neonatal tetanus has declined from 53 percent in 1997 to 51 percent in 2002-2003. Coverage of childhood im- munizations against the six major diseases also de- clined from 55 percent in 1997 to 52 percent in 2002-2003. • Although childhood mortality continues to decline, one in three births in Indonesia has an ele- vated mortality risk that is avoidable. These include births in which the mother is too young (under age 18) or too old (age 35 or older), the birth interval is too short (less than two years), or the mother has had too many prior births (three or more). Summary of Findings | xxvii Timor Leste Papua New Guinea Malaysia Malaysia Singapore INDONESIA xxviii | M ap o f In d o n esia Philippines 1 Nanggroe Aceh Darussalam 2 North Sumatera 3 West Sumatera 4 Riau 5 Jambi 6 South Sumatera 7 Bengkulu 8 Lampung 9 Bangka Belitung 10 DKI Jakarta 21 South Kalimantan 22 East Kalimantan 23 North Sulawesi 24 Central Sulawesi 25 South Sulawesi 26 Southeast Sulawesi 27 Gorontalo 28 North Maluku 29 Maluku 30 Papua 1 2 4 5 6 9 10 11 14 19 20 22 23 24 25 27 28 29 30 2621 16 17 18 15 13 12 8 7 3 11 West Java 12 Central Java 13 DI Yogyakarta 14 East Java 15 Banten 16 Bali 17 West Nusa Tenggara 18 East Nusa Tenggara 19 West Kalimantan 20 Central Kalimantan Brunei INTRODUCTION 1 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: Sumatera in the west; Java in the south; Kalimantan straddling the equator; Sulawesi, which resembles the letter “K”; and Irian Jaya or Papua bordering Papua New Guinea on the west. Two remaining groups of islands are Maluku and Nusa Tenggara, running from Sulawesi to Papua 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 has given rise to 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 administratively divided into provinces. Since 2001, the number of provinces was expanded from 26 to 30. The new provinces are Bangka Belitung, Banten, Gorontalo, and North Maluku. These new provinces formerly were part of South Sumatera, West Java, North Sulawesi, and Maluku province, respectively. Each province is subdivided into regencies and municipalities. Altogether, there are 302 regencies and 89 municipalities in Indonesia. The next lower administrative units are subdistricts and villages. In 2002, there were 4,918 subdistricts and 70,460 villages in Indonesia. The entire village is classified as urban or rural. Since proclaiming its independence in 1945, Indonesia has experienced several political shifts. In 1948, a rebellious movement 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 multiparty system (which resulted in political and economic instability) and rebellious uprisings 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 was oriented toward overall development. After more than 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 experienced from 1968 to 1986, when per capita income increased sharply from about US $50 to US $385. This increase 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. Per capita income has increased to approximately US $1,124 in 1996, while the economic growth was nearly 5 percent. All of these successes ended in mid-1997 when the Asian economy collapsed. The value of the currency plummeted, prices increased, and unemployment rose dramatically. In addition, parts of the country suffered from relatively long droughts and extensive forest fires. Introduction | 1 In 1998, Indonesia went through its worst economic crisis, when the economic growth rate dropped to negative 13 percent (BPS, 2003). At the same time, the political situation became unstable in several regions. President Suharto was ousted and replaced by his Vice President, B.J. Habibie. This time was known as the reformation era. Since 1998, Indonesia has had three presidents, B.J. Habibie, Abdurrahman Wahid, and Megawati Soekarnoputri. In 1999, Law No. 22 on Regional Development was enacted. The law gives full autonomy to districts (Kota/Kabupaten). With some limited exceptions, the same law also makes the local government responsible for all deconcentrated central government ministries at the province and district levels. Since 2000, the economy has recovered, with a growth rate of 5 percent in 2000 and 4 percent in 2002. However, the political situation remains unstable in several provinces such as Nanggroe Aceh Darussalam (formerly known as Dista Aceh), Maluku, and Papua. 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 2000 Population Censuses and the 2002 National Socio-Economic Survey (Susenas) show that in the past 32 years Indonesia has undergone a major improvement in the area of education. The literacy rate among persons age 10 years and older increased from 61 percent in 1971 to 91 percent in 2002. The improvement in education is most pronounced among females. Whereas in 1971 school attendance among children age 7-12 years was 62 percent for males and 58 percent for females, the corresponding rates in 2002 were 96 percent and 97 percent, respectively. From 1971 to 2002, the proportion of people who never attended school declined, while that of graduates at all levels increased. The proportion of people who finished primary school only increased from 20 percent in 1971 to 33 percent in 2002, while the proportion of those who attended junior high school or higher education increased from 7 percent in 1971 to 35 percent in 2002. At all levels, the increase in education among females has been greater than that of males (CBS, 1972; BPS 2002b). The fact that a larger number of girls are enrolled in education longer has a direct impact on the increase of the average age at first marriage. The mean age at first marriage increased from 20 years in 1971 to 22 and 23 years in 1990 and 2000, respectively (BPS, 2002a). This increase was greater in urban areas than in rural areas. The increasing level of completed education has also provided women with greater opportunity to participate in the labor force. Labor force participation among women age 10 and older increased from 33 percent in 1971 to 45 percent in 2002. Most women work in agriculture, trade, or the service industries, with the employment status mostly as an unpaid family worker and regular employee (BPS, 2002b). 1.2 POPULATION According to the 2000 Population Census, the population of Indonesia was 205.8 million in 2000 and was projected to increase to reach 211.1 million in 2002. This makes Indonesia the fourth most populous country in the world after the People’s Republic of China, India, and the United States of America. An estimated 86.5 million people (42 percent of the population) lived in urban areas in 2000, compared with 92.7 million (44 percent of the population) in 2002. In 2000, more than 88 percent of the Indonesian population was Muslim. Indonesia’s population growth rate has declined in the last two decades. Between 1980 and 1990, the average annual population growth rate was 1.98 percent, compared with 1.49 percent between 1990 and 2000 (see Table 1.1). This figure was projected to decline further to 1.25 percent between 2000 and 2002. Another characteristic of Indonesia is the uneven distribution of the population among the islands and provinces. The 2000 Population Census indicates that the population density varies not only across 2 | Introduction islands, but also among provinces of the same island. Java, which covers only 7 percent of the total area of Indonesia, is inhabited by 59 percent of the country’s population, making the population den- sity of Java (951 persons per square kilometer) higher than that of other islands. By comparison, Kalimantan has a density of 20 persons per square kilometer. Within provinces in Java, the population density ranges from 12,700 persons per square kilometer in DKI Jakarta to 726 persons per square kilometer in East Java. Population den- sity at the national level was 109 persons per square kilometer in 2000 and pro- jected to be 112 persons per square kilometer in 2002. Table 1.1 Basic demographic indicators Demographic indicators from selected souces, Indonesia 1990-2002 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1990 2000 2002 Indicators census census projection1 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Population (millions) 179.4 206.3 211.1 Growth rate (GR)2 (percent) 1.98 1.49 1.25 Density (pop/km2) 93.0 109.0 112 Percent urban 31 42 44 Reference period 1986-89 1996-99 2002 Crude birth rate (CBR)3 28 23 22 Crude death rate (CDR)4 9 8 10 Life expectancy6 Male 57.9 63.5 64.3 Female 61.5 67.3 68.2 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1 Projected based on the 1990 and 2000 Population Census 2 Calculated using compound interest formula 3 Births per 1,000 population; CBR = 9.48968 + 5.55 TFR 4 Deaths per 1,000 population; CDR = CBR – GR per 1,000 5 Estimated based on own children method 6 Estimated using indirect estimation techniques Source: BPS-Statistics Indonesia 2001 and 2003 Table 1.1 shows that Indonesia’s fertility has declined significantly since the 1980s. The crude birth rate (CBR), which was estimated at 28 births per 1,000 people in the period 1986-1989, declined to 23 per 1,000 people during 1996-1999, resulting in an annual decline of 2.1 percent. These figures suggest a more rapid decline in fertility in more recent years. The CBR in 200 The same data sources also demonst mortality levels, and life expectancy at birth expectancy increased from 57.9 years in 19 females are 61.5 years and 68.2 years, respect 1.3 POPULATION AND FAMILY PLANNING The government of Indonesia has im population-related issues since President Suh the World Leaders in 1967. In this declara l hindrance to economic development. To car several programs. Family planning is one of t Under the auspices of the Internatio Planned Parenthood Association (IPPA) init provided family planning counseling and s government established a National Family Family Planning Coordinating Board (NFPC the chairman reporting directly to the Preside family planning and has been working with promote family planning. 2 was projected to be 22 births per 1,000 people. rate that in Indonesia there has been a significant decline in for both males and females has increased. For males, life 90 to 64.3 years in 2002. The corresponding figures for ively. POLICIES AND PROGRAMS plemented many of its development programs responding to arto joined other heads of state in signing the Declaration of tion, rapid population growth was considered a potentia ry out its population policy, the government has launched he most important of these programs. nal Planned Parenthood Federation (IPPF), the Indonesian iated family planning activities in Indonesia in 1957. IPPA ervices, including maternal and child care. In 1968, the Planning Institute, which was reorganized as the National B) two years later. NFPCB is a nondepartmental body, with nt. The government of Indonesia has a strong commitment to religious and community leaders to develop programs to Introduction | 3 In less than three decades, the population policy has not only contributed to reducing the fertility rate of the country by half, but it has also helped to improve family welfare. One of the factors that contributed to the success of the family planning program in Indonesia has been the empowerment of the community in implementing the programs on the notion that family planning is more than controlling births. In Act No.10, which was passed in 1992, family planning is explicitly defined as efforts to increase the society’s concern and participation in delaying marriage, controlling births, fostering family resilience, and improving family welfare to create small, happy, and prosperous families. A new paradigm was introduced in 1999. During previous years the program’s ultimate objective was to institutionalize the small, happy, and prosperous family norm. The objective for the future is to materialize “Quality Families” by the year 2015. Parallel to this new vision is the enactment of Law number 22 in 2000 on Decentralization, which empowers district-level governments to plan and implement their respective development programs, including family planning and reproductive health. 1.4 HEALTH PRIORITIES AND PROGRAMS Health Law number 23 enacted in 1992 provides a legal basis for the health sector activities. It stipulates that the goal of the health programs and development is to increase the awareness, willingness, and ability of everyone to live a healthy life. The law emphasizes the decentralization of operational responsibility and authority to the local level as a prerequisite for successful and sustainable development. In the second 25-Year Development Plan (1994-2019), economic and human development is identified as the key to national development and self-reliance. Following the National Guidelines on State Policy issued in 1993, the strategy adopted to improve the health and nutritional status of the population is two pronged: to improve the quality of health services and make them affordable to all, and to promote a healthy lifestyle supported by adequate housing and environmental sanitation. In mid-September 1998, a new health paradigm was introduced that focuses health development more on the health promotion and prevention than on curative and rehabilitative services. The new vision is reflected in the motto “Healthy Indonesia 2010.” Year 2010 was used as a target to allow sufficient time for measuring success in achieving the set goals. To achieve Healthy Indonesia 2010, the Ministry of Health (MOH) has the following goals: • To initiate and lead a health orientation of the national development • To maintain and enhance individual, family, and public health, along with improving the environment • To maintain and enhance quality, accessible, and affordable health services • To promote public self-reliance in achieving good health. The government of Indonesia places a great emphasis on intersectoral coordination, joint responsibility of local government and the community, region-specific programs, targeting of vulnerable groups, and building a strong information and communication program. 4 | Introduction 1.5 OBJECTIVES OF THE SURVEY The 2002-2003 Indonesia Demographic and Health Survey (IDHS) follows a sequence of several previous surveys: the 1987 National Indonesia Contraceptive Prevalence Survey (NICPS), the 1991 IDHS, the 1994 IDHS, and the 1997 IDHS.1 The 2002-2003 IDHS is expanded from the 1997 IDHS by including a collection of information on the participation of currently married men and their wives and children in the health care. The 2002-2003 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/STIs to program managers, policymakers, and researchers to help them evaluate and improve existing programs • Measure trends in fertility and contraceptive prevalence rates, analyze factors that affect such changes, such as marital status and patterns, residence, education, breastfeeding habits, and knowledge, use, and availability of contraception • Evaluate achievement of goals previously set by the national health programs, with special focus on maternal and child health • Assess men’s participation and utilization of health services, as well as of their families • Assist in creating an international database that allows cross-country comparisons that can be used by the program managers, policymakers, and researchers in the area of family planning, fertility, and health in general. 1.6 ORGANIZATION OF THE SURVEY The 2002-2003 IDHS was implemented by BPS-Statistics Indonesia (BPS). The government of Indonesia provided most of the local costs for the survey through a loan from the World Bank. Additional funds were obtained from the U.S. Agency for International Development (USAID) through ORC Macro, which provided technical assistance under the auspices of the Demographic and Health Surveys (MEASURE DHS+) program. USAID also supported the implementation of the survey in three newly established provinces, Bangka Belitung, Banten, and Gorontalo. In addition to ORC Macro, other collaborating partners that were involved in questionnaire development, data analysis, and dissemination include the following: BPS, NFPCB, and MOH. A survey Steering Committee was established. This committee consists of senior representatives from BPS, NFPCB, MOH, the State Ministry for Women Empowerment, and the Demographic Institute at the University of Indonesia. A 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. BPS implemented the survey and processed the data. The directors of the provincial statistical offices were responsible for both the technical and the administrative aspects of the survey in their 1 Central Bureau of Statistics, National Family Planning Coordinating Board, and Institute for Resource Development/Westinghouse, 1989; Central Bureau of Statistics, National Family Planning Coordinating Board, Ministry of Health, and Macro International Inc., 1992; Central Bureau of Statistics, State Ministry of Population/National Family Planning Coordinating Board, Ministry of Health, and Macro International Inc., 1995; Central Bureau of Statistics, State Ministry of Population/National Family Planning Coordinating Board, Ministry of Health, and Macro International Inc., 1998. Introduction | 5 respective areas. They were assisted by field coordinators, most of whom were chiefs of the social statistics divisions in the provincial offices. The 2002-2003 IDHS used three questionnaires: the Household Questionnaire, the Women’s Questionnaire for ever-married women 15-49 years old, and the Men’s Questionnaire for currently married men 15-54 years old. The Household Questionnaire and the Women’s Questionnaire were based on the DHS Model “A” Questionnaire, which is designed for use in countries with high contraceptive prevalence. In consultation with the NFPCB and MOH, BPS modified these questionnaires to reflect relevant issues in family planning and health in Indonesia. Inputs were also solicited from potential data users to optimize the IDHS in meeting the country’s needs for population and health data. The questionnaires were translated from English into the national language, Bahasa Indonesia. The Household Questionnaire was used to list all the usual members and visitors in the selected households. Basic information collected for each person listed includes the following: age, sex, education, and relationship to the head of the household. The main purpose of the Household Questionnaire was to identify women and men who were eligible for the individual interview. In addition, the Household Questionnaire also identifies unmarried women and men age 15-24 who are eligible for the individual interview in the Indonesia Young Adult Reproductive Health Survey (IYARHS). Information on characteristics of the household’s dwelling unit, such as the source of water, type of toilet facilities, construction materials used for the floor and outer walls of the house, and ownership of various durable goods were also recorded in the Household Questionnaire. These items reflect the household’s socioeconomic status. The Women’s Questionnaire was used to collect information from all ever-married women age 15-49. These women were asked questions on the following topics: • Background characteristics, such as age, marital status, education, and media exposure • Knowledge and use of family planning methods • Fertility preferences • Antenatal, delivery, and postnatal care • Breastfeeding and infant feeding practices • Vaccinations and childhood illnesses • Marriage and sexual activity • Woman’s work and husband’s background characteristics • Childhood mortality • Awareness and behavior regarding AIDS and other sexually transmitted infections (STIs) • Sibling mortality, including maternal mortality. The Men’s Questionnaire was administered to all currently married men age 15-54 in every third household in the IDHS sample. The Men’s Questionnaire collected much of the same information included in the Women’s Questionnaire, but was shorter because it did not contain questions on reproductive history, maternal and child health, nutrition, and maternal mortality. Instead, men were asked about their knowledge and participation in the health-seeking practices for their children. As in previous surveys, data were collected by teams of interviewers. There were 94 interviewing teams, each of which consists of one team supervisor, one field editor, three female interviewers, and one male interviewer. Altogether, 530 persons, 362 women and 168 men participated in the survey as data collectors. They were trained for 16 days, from September 30 to October 17, 2002. The field supervisors and editors received additional training in supervision and editing techniques. Fieldwork took place over a five-and- a-half-month period, from October 21, 2002 to April 9, 2003. In most provinces, data collection took a break for at least one month during the Muslim fasting month, which fell in early November through early December 2002. In the Riau province, fieldwork began only in December 2002. In three provinces, Bangka Belitung, Banten, and Gorontalo, training of field staff occurred February 15 to March 6 | Introduction 4, 2003, and fieldwork took place March 7 to April 31, 2003. For more information about the fieldwork, see Appendix A. A list of persons involved in the implementation of the survey is found in Appendix D. The survey questionnaires are reproduced in Appendix E. As in previous IDHS surveys, the 2002-2003 IDHS sample was designed to produce estimates at the national, urban-rural, and provincial levels. Table 1.2 is a summary of the results of the fieldwork for the 2002-2003 IDHS from both the household and individual interviews, by urban-rural residence. In general, the response rates for both the household and individual interviews in the 2002-2003 IDHS are high. A total of 34,738 households were selected for the survey, of which 33,419 were found. Of the encountered households, 33,088 (99 percent) were successfully interviewed. In these households, 29,996 ever-married women 15-49 were identified, and complete interviews were obtained from 29,483 of them (98 percent). From the households selected for interviews with men, 8,740 currently married men 15-54 were identified, and complete interviews were obtained from 8,310 men, or 95 percent of all eligible men. The generally high response rates for both household and individual interviews (for eligible women and men) were due mainly to the strict enforcement of the rule to revisit the originally selected household if no one was at home initially. No substitution for the originally selected households was allowed. Interviewers were instructed to make at least three visits in an effort to contact the household, eligible women, and eligible men. Table 1.2 Results of the household and individual interviews Number of households, number of interviews, and response rates, according to residence, Indonesia 2002-2003 Residence Result Urban Rural Total Household interviews Households selected 14,779 19,959 34,738 Households occupied 14,152 19,267 33,419 Households interviewed 13,961 19,127 33,088 Household response rate 98.7 99.3 99.0 Interviews with women Number of eligible women 12,537 17,459 29,996 Number of eligible women interviewed 12,318 17,165 29,483 Eligible woman response rate 98.3 98.3 98.3 Interviews with men Number of eligible men 3,736 5,004 8,740 Number of eligible men interviewed 3,555 4,755 8,310 Eligible man response rate 95.2 95.0 95.1 Introduction | 7 CHARACTERISTICS OF HOUSEHOLDS AND HOUSING CHARACTERISTICS 2 This chapter presents information on some demographic and socioeconomic characteristics of the population in the sampled households. This chapter also considers the condition of the households in which the survey population lives, including source of drinking water, availability of electricity, sanitation facilities, building materials, and possession of household durable goods. Information on the characteris- tics of the households and the individual women and men interviewed is essential for the interpretation of survey findings and can provide an approximate indication of the representativeness of the Indonesia Demographic and Health Survey. For the purpose of the 2002-2003 IDHS, a household was defined as a person or a group of per- sons, related or unrelated, who live together in the same dwelling unit and share a common source of food. The Household Questionnaire (see Appendix F) was used to collect information on all usual resi- dents and visitors who spent the night preceding the survey in the household. This method of data collec- tion allows the analysis of either de jure (usual residents) or de facto (those who are there at the time of the survey) populations. 2.1 HOUSEHOLD POPULATION BY AGE, SEX, AND RESIDENCE Age and sex are important demographic variables and are the primary basis of demographic clas- sification in vital statistics, censuses, and surveys. They are also important variables in the study of mor- tality, fertility, and nuptiality. The distribution of the de facto household population in the 2002-2003 IDHS is shown in Table 2.1 by five-year age groups, according to sex and urban rural residence. The 2002-2003 IDHS households constitute a population of 142,610 persons. The data show that there is an equal proportion of women and men in the population (50 percent each). The sex composition of the population does not show significant variation by urban-rural residence. The table further depicts Indonesia as a young population, with a large proportion of the population being in the younger age groups. The population under age 15 constitutes 32 percent of the total population. The older age groups are small in comparison, as can be seen in the popu- lation pyramid (Figure 2.1). The population pyramid has a narrow top and a wide base reflecting a pattern typical of countries with relatively high fertility in the past. This type of age structure has a built-in mo- mentum for the growth of the country’s population. When the young population eventually reaches repro- ductive age, the result will be a high population growth for several years to come. The slight tapering at the base is likely to have been caused by a decline in fertility in the recent years. 2.2 HOUSEHOLD COMPOSITION Information about the composition of households by sex of the head of the household and size of the household is presented in Table 2.2. These characteristics are important because they are associated with aspects of household welfare. Female-headed households are, for example, typically poorer than male-headed households. Where households are large, there is generally greater crowding, which is usu- ally associated with unfavorable health conditions and economic hardships. The 2002-2003 IDHS data show that 12 percent of households are headed by women. This pro- portion is the same as the level observed in the 1997 IDHS (CBS et al., 1998:12). The proportion of fe- male-headed households is slightly higher in urban areas than in rural areas (12 and 11 percent, respec- tively). Characteristics of Households and Housing Characteristics | 9 Table 2.1 Household population by age, sex, and residence Percent distribution of the de facto household population by five-year age groups, according to sex and residence, Indonesia 2002-2003 Urban Rural Total Age Male Female Total Male Female Total Male Female Total <5 10.6 9.8 10.2 10.8 10.4 10.6 10.7 10.1 10.4 5-9 10.7 10.0 10.4 11.2 10.9 11.0 11.0 10.5 10.7 10-14 10.3 10.0 10.2 11.3 10.5 10.9 10.8 10.3 10.5 15-19 10.1 10.2 10.2 9.2 8.5 8.9 9.7 9.3 9.5 20-24 9.4 10.0 9.7 7.9 8.6 8.2 8.6 9.2 8.9 25-29 8.5 9.3 8.9 7.4 8.1 7.8 7.9 8.7 8.3 30-34 8.3 8.4 8.4 7.8 7.9 7.8 8.0 8.1 8.1 35-39 7.3 7.7 7.5 6.7 7.2 6.9 7.0 7.4 7.2 40-44 6.8 6.4 6.6 6.4 6.6 6.5 6.6 6.5 6.6 45-49 5.0 5.6 5.3 5.5 5.9 5.7 5.3 5.8 5.5 50-54 4.3 3.5 3.9 4.8 3.6 4.2 4.6 3.5 4.0 55-59 2.4 2.3 2.4 2.8 2.9 2.9 2.6 2.6 2.6 60-64 2.6 2.4 2.5 2.9 3.3 3.1 2.8 2.9 2.8 65-69 1.4 1.7 1.5 2.0 2.1 2.0 1.7 1.9 1.8 70-74 1.0 1.5 1.2 1.7 1.9 1.8 1.4 1.7 1.5 75-79 0.5 0.6 0.6 0.7 0.7 0.7 0.6 0.7 0.6 80 + 0.6 0.7 0.6 0.9 0.9 0.9 0.7 0.8 0.7 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number 33,543 33,720 67,264 37,629 37,718 75,346 71,172 71,438 142,610 Figure 2.1 Population Pyramid of Indonesia IDHS 2002-2003 80+ 75-79 70-74 65 69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15 -19 10-14 5-9 0-04 Age 0510 0 5 10 Male Female Percent 0-4 10 | Characteristics of Households and Housing Characteristics Table 2.2 Household composition Percent distribution of households by sex of head of house- hold and by household size, according to residence, Indonesia 2002-2003 Residence Characteristic Urban Rural Total Sex of head of household Male 87.7 88.6 88.2 Female 12.3 11.4 11.8 Total 100.0 100.0 100.0 Number of usual members 1 5.8 4.6 5.1 2 9.9 12.2 11.1 3 16.6 21.5 19.2 4 23.9 23.4 23.6 5 18.5 17.4 17.9 6 11.6 10.5 11.0 7 6.4 5.0 5.6 8 3.4 2.5 2.9 9+ 4.0 2.8 3.3 Total 100.0 100.0 100.0 Number of households 15,126 17,962 33,088 Mean size 4.5 4.2 4.3 Note: Table is based on de jure members, i.e., usual residents. Five percent of households have only one member, with urban areas having a slightly higher pro- portion of one-member households than rural areas (6 and 5 percent, respectively). However, very large households (nine persons or more) still exist in Indonesia (4 percent in urban and 3 percent in rural areas). The sex composition of the population does not show significant variations by urban-rural residence. Ta- ble 2.2 shows that the overall mean household size in Indonesia is 4.3 persons. The household size is roughly the same in rural areas (4.2 persons) and in urban areas (4.5 persons). The same pattern was ob- served in the 1997 IDHS (CBS et al., 1998:12). 2.3 CHILDREN’S LIVING ARRANGEMENTS AND PARENTAL SURVIVAL Information on children’s living arrangements, specifically fosterhood and orphanhood, is pre- sented in Table 2.3. Several aspects of the table are of interest, particularly the extent of orphanhood (i.e., the proportion of children who have lost one or both parents). In the 2002-2003 IDHS, information was collected for all persons under age 15 concerning their living arrangements and survival status of their biological parents. A large majority of children under age 15 live with both their parents (88 percent), 7 percent live with one parent, and 4 percent live with neither of their natural parents. Younger children are more likely than older children to live with both parents (for example, 93 percent of children under age 2 compared with 85 percent of those age 10-14). Male children are as likely as female children to live with both parents, while children in urban areas are slightly more likely than in rural areas to live with their parents (89 percent compared with 87 percent). Characteristics of Households and Housing Characteristics | 11 Table 2.3 Children's living arrangements and orphanhood Percent distribution of de jure children under age 15 by children's living arrangements and survival status of parents, according to back- ground characteristics, Indonesia 2002-2003 Not living with either parent Living with mother but not father Living with father but not mother Backgroud characteristic Living with both parents Father alive Father dead Mother alive Mother dead Both alive Only father alive Only mother alive Both dead Missing information on father/ mother Total Number of children Age <2 93.2 4.8 0.7 0.1 0.1 0.9 0.1 0.0 0.0 0.1 100.0 5,762 2-4 90.2 4.1 0.6 1.4 0.3 3.0 0.1 0.1 0.1 0.1 100.0 9,010 5-9 88.0 3.7 1.7 1.6 0.4 3.6 0.3 0.2 0.2 0.3 100.0 15,280 10-14 84.5 2.9 3.4 1.6 0.9 4.8 0.5 0.4 0.4 0.7 100.0 14,998 Sex Male 88.1 3.6 1.8 1.3 0.5 3.4 0.3 0.2 0.3 0.3 100.0 23,076 Female 87.7 3.7 2.1 1.4 0.4 3.7 0.3 0.2 0.2 0.4 100.0 21,974 Residence Urban 89.2 3.3 1.8 1.0 0.4 3.2 0.2 0.2 0.2 0.4 100.0 20,614 Rural 86.9 3.9 2.0 1.6 0.6 3.8 0.4 0.2 0.2 0.3 100.0 24,436 Total 87.9 3.6 1.9 1.4 0.5 3.5 0.3 0.2 0.2 0.4 100.0 45,050 2.4 EDUCATIONAL LEVEL OF HOUSEHOLD POPULATION Education is a key determinant of the lifestyle and status an individual enjoys in a society. Stud- ies have consistently shown that educational attainment has strong effects on reproductive behavior, con- traceptive use, fertility, infant and child mortality, morbidity, and attitudes and awareness related to fam- ily health and hygiene. In the 2002-2003 IDHS, information on educational attainment was collected for every member of the household. 2.4.1 EDUCATIONAL ATTAINMENT OF THE HOUSEHOLD POPULATION Table 2.4 shows the percent distribution of the de facto male and female population age six and over by the highest level of education attained, according to age and residence. Table 2.4 indicates that there are significant differences in the level of education by background characteristics. Overall, men are slightly better educated than women: 13 percent of females age six and above have never to school com- pared with only seven percent of males. In all age groups except 10-14, males are more likely to have been educated and more likely to stay in school than females. In 1994, based on President’s Instruction number 1, the government of Indonesia declared “Nine Years Compulsory Education” for children under 15. This campaign resulted in bringing equity in education for males and females. While there are small differences in the educational attainment between males and females in older ages, the gap in educational attainment is no longer visible among the youngest age cohort. These figures imply that in recent years, girls have had as much opportunity as boys to pursue education. The percentage of males and females who have never attended school increases steadily with age. Among females, this proportion increases from one percent among those age 10-14 to 68 percent in the oldest age group (65 years or older). The increase is slightly less drastic among males, from one percent to 34 percent, respectively. 12 | Characteristics of Households and Housing Characteristics Table 2.4 Educational attainment of household population Percent distribution of the de facto male and female household population age six and over by highest level of edu- cation attended or completed, according to background characteristics, Indonesia 2002-2003 Background characteristic No educa- tion Some primary Com- pleted primary1 Some second- ary Com- pleted second- ary2 More than second- ary Don't know/ missing Total Number Median number of years MALE Age 6-9 14.2 84.9 0.0 0.2 0.0 0.0 0.7 100.0 6,530 0.6 10-14 1.3 56.5 10.0 32.1 0.0 0.0 0.0 100.0 7,700 4.6 15-19 0.9 9.4 17.1 60.7 9.7 2.1 0.1 100.0 6,881 8.3 20-24 1.0 7.5 25.1 26.8 28.6 10.9 0.1 100.0 6,129 8.6 25-29 1.6 7.6 30.9 23.0 27.8 9.0 0.2 100.0 5,630 8.4 30-34 2.0 10.9 29.5 21.7 27.6 8.2 0.1 100.0 5,714 8.3 35-39 3.8 16.2 29.3 16.3 24.1 10.2 0.2 100.0 4,979 6.5 40-44 6.2 23.2 31.8 13.0 17.1 8.5 0.2 100.0 4,691 5.6 45-49 6.8 26.9 32.3 13.2 14.9 5.8 0.1 100.0 3,775 5.5 50-54 8.9 27.1 32.5 14.6 11.5 5.4 0.0 100.0 3,257 5.4 55-59 14.4 28.1 30.7 10.5 10.4 5.3 0.6 100.0 1,852 5.2 60-64 22.4 26.9 28.4 9.3 8.0 4.4 0.6 100.0 1,972 5.0 65+ 33.8 31.1 23.9 4.4 5.1 1.0 0.7 100.0 3,134 2.1 Residence Urban 4.0 23.1 17.8 24.9 20.8 9.3 0.2 100.0 29,377 7.2 Rural 9.1 33.7 26.7 19.6 8.9 1.8 0.3 100.0 32,889 5.3 Total 6.7 28.7 22.5 22.1 14.5 5.3 0.2 100.0 62,266 5.6 FEMALE Age 6-9 14.5 84.7 0.0 0.1 0.0 0.0 0.6 100.0 6,231 0.6 10-14 0.9 52.8 10.0 36.2 0.0 0.1 0.0 100.0 7,328 4.8 15-19 1.1 6.9 18.7 59.4 10.2 3.6 0.0 100.0 6,632 8.4 20-24 1.3 8.1 28.8 23.8 25.5 12.4 0.0 100.0 6,608 8.5 25-29 2.5 9.8 34.8 20.9 23.5 8.6 0.0 100.0 6,192 8.0 30-34 4.9 14.9 31.9 18.3 22.3 7.7 0.1 100.0 5,789 5.9 35-39 9.2 24.3 31.7 13.0 14.7 7.0 0.1 100.0 5,298 5.5 40-44 14.9 29.9 30.5 10.7 9.1 5.0 0.1 100.0 4,652 5.2 45-49 17.1 32.8 28.9 9.9 8.0 3.2 0.1 100.0 4,125 5.0 50-54 26.3 28.9 25.1 10.3 6.3 2.2 0.9 100.0 2,518 3.7 55-59 38.1 30.3 17.6 7.7 4.7 1.0 0.7 100.0 1,885 2.1 60-64 53.1 23.4 13.1 4.8 3.2 0.6 1.9 100.0 2,066 0.0 65+ 67.6 17.4 9.8 2.6 1.1 0.4 1.1 100.0 3,593 0.0 Residence Urban 9.0 23.3 18.8 23.9 16.8 8.0 0.1 100.0 29,786 5.9 Rural 17.2 33.5 24.6 16.9 6.0 1.5 0.4 100.0 33,159 4.8 Total 13.3 28.7 21.8 20.2 11.1 4.6 0.3 100.0 62,945 5.3 Note: Total includes 20 unweighted men and 25 unweighted women with missing information on age. 1 Completed 6th grade at the primary level 2 Completed 6th grade at the secondary level Characteristics of Households and Housing Characteristics | 13 Table 2.4 also shows that older people have less education. For example, the median duration of schooling among men age 50-54 years is 5.4 years, whereas for men age 20-24 the median is 8.6 years. The difference for women is even more striking; 3.7 years for age 50-54 years and 8.5 years for age 20- 24. Urban residents are much more likely to attend school and stay in school than rural residents. Only 4 percent of men in urban areas have never gone to school, while the proportion in rural areas is 9 percent. For women, the corresponding figures are 9 percent in the urban areas and 17 percent in the rural areas. The urban-rural difference is more pronounced at the level of secondary or higher education. The median years of schooling for urban men is 7.2 years, compared with 5.3 years for rural men. The urban-rural difference among women is less pronounced, 5.9 years and 4.8 years, respectively. 2.4.2 SCHOOL ATTENDANCE RATES The 2002-2003 IDHS collected information on school attendance among the population that al- lows the calculation of net attendance ratios (NARs) and gross attendance ratios (GARs). The NAR for primary school is the percentage of the primary school-age population (6-13 years) that is attending pri- mary school. The NAR for secondary school is the percentage of the secondary-school-age population (14-17 years) that is attending secondary school. By definition, the NAR cannot exceed 100 percent. The GAR for primary school is the total number of primary school students, of any age, expressed as the per- centage of the official primary-school-age population. The GAR for secondary school is the total number of secondary school students up to an age limit of 24 years, expressed as the percentage of the official secondary-school-age population. The GARs are almost always higher than the NARS because the GAR includes participation by those who are older or younger than the official range for that level. If there are significant numbers of overage and underage students at a given level of schooling, the GAR can exceed 100 percent. The Gender Parity Index represents the ratio of the GAR for females to the GAR for males. It is presented for both the primary and secondary levels and offers a summary measure of the extent to which there are gender differences in attendance rates. Table 2.5.1 and 2.5.2 indicate that among primary school and secondary school there are signifi- cant differences in rate of school attendance by background characteristics. Table 2.5.1 shows that in pri- mary school, the NAR and GAR are slightly higher in rural than in urban areas (88 percent compared 87 percent, and 104 percent compared 103 percent. The Gender Parity Index is 1.03 in rural areas and 0.98 in urban areas. There are no significant sex differentials in NAR and GAR by residence. Overall, the NAR and GAR for primary school in all provinces are slightly higher than for secondary school. In primary school, the NAR and GAR are lowest in Gorontalo (81.3 for NAR and 96.4 for GAR), while NAR in West Nusa Tenggara is 90.8 and GAR in Central Kalimantan it is 108.8. 14 | Characteristics of Households and Housing Characteristics Table 2.5.1 School attendance ratios: primary school Net attendance ratios (NAR) and gross attendance ratios (GAR) for the de jure household population attending primary school by sex, residence, and province, Indonesia 2002-2003 Net attendance ratio1 Gross attendance ratio2 Residence/ province Male Female Total Male Female Total Gender Parity Index3 Residence Urban 88.3 85.0 86.7 103.8 102.1 103.0 0.98 Rural 87.3 88.5 87.9 102.2 105.2 103.7 1.03 Region/province Sumatera North Sumatera 84.1 82.6 83.4 99.4 99.6 99.5 1.00 West Sumatera 87.4 89.9 88.7 104.4 103.7 104.0 0.99 Riau 88.8 86.6 87.8 103.7 103.0 103.3 0.99 Jambi 82.6 84.7 83.6 106.5 105.6 106.0 0.99 South Sumatera 85.0 86.8 85.8 100.4 102.4 101.3 1.02 Bengkulu 89.7 82.9 86.4 111.5 102.7 107.2 0.92 Lampung 91.3 89.4 90.5 107.7 105.8 106.9 0.98 Bangka Belitung 86.1 90.8 88.5 111.7 111.0 111.3 0.99 Java DKI Jakarta 86.0 87.8 86.9 109.7 104.8 107.1 0.96 West Java 86.9 88.4 87.6 99.1 103.2 101.0 1.04 Central Java 89.9 89.9 89.9 105.4 107.5 106.4 1.02 DI Yogyakarta 91.3 85.1 88.1 106.1 97.3 101.6 0.92 East Java 91.7 84.7 88.3 106.8 104.3 105.6 0.98 Banten 88.1 85.2 86.7 99.5 103.2 101.2 1.04 Bali and Nusa Tenggara Bali 84.4 84.5 84.4 104.1 105.3 104.6 1.01 West Nusa Tenggara 88.3 93.2 90.8 99.4 102.5 101.0 1.03 East Nusa Tenggara 85.7 90.2 88.0 106.2 110.2 108.3 1.04 Kalimantan West Kalimantan 82.7 86.1 84.3 105.5 106.9 106.1 1.01 Central Kalimantan 89.1 89.9 89.5 106.0 111.8 108.8 1.05 South Kalimantan 83.2 84.8 84.0 98.3 99.2 98.8 1.01 East Kalimantan 84.1 84.3 84.2 110.5 105.8 108.0 0.96 Sulawesi North Sulawesi 84.2 82.5 83.3 102.1 96.9 99.5 0.95 Central Sulawesi 84.9 89.7 86.9 104.5 111.9 107.7 1.07 South Sulawesi 88.7 81.2 85.1 101.0 97.1 99.1 0.96 Southeast Sulawesi 82.3 90.1 86.1 103.6 108.6 106.1 1.05 Gorontalo 81.0 81.7 81.3 93.8 99.4 96.4 1.06 Total 87.7 86.9 87.4 102.9 103.8 103.4 1.01 1 The NAR for primary school is the percentage of the primary-school age (6-13 years) population that is attending primary school. By definition the NAR cannot exceed 100 percent. 2 The GAR for primary school is the total number of primary school students, expressed as a percentage of the official pri- mary-school-age population. If there are significant numbers of overage and underage students at a given level of schooling, the GAR can exceed 100 percent. 3 The Gender Parity Index for primary school is the ratio of the primary school GAR for females to the GAR for males. Characteristics of Households and Housing Characteristics | 15 Table 2.5.2 School attendance ratios: secondary school Net attendance ratios (NAR) and gross attendance ratios (GAR) for the de jure household population attending secon- dary school by sex, residence, and province, Indonesia 2002-2003 Net attendance ratio1 Gross attendance ratio2 Residence/ province Male Female Total Male Female Total Gender Parity Index3 Residence Urban 65.0 63.0 64.0 77.6 76.4 77.0 0.98 Rural 41.8 45.8 43.7 51.3 53.6 52.4 1.05 Region/province Sumatera North Sumatera 61.7 63.7 62.7 76.0 77.6 76.8 1.02 West Sumatera 60.3 69.7 65.2 70.6 78.1 74.5 1.11 Riau 58.2 61.4 59.7 68.8 73.2 70.9 1.06 Jambi 48.7 45.5 47.0 66.5 56.5 61.2 0.85 South Sumatera 45.3 54.0 49.7 56.8 61.8 59.3 1.09 Bengkulu 57.1 64.9 60.8 65.2 79.3 71.9 1.22 Lampung 48.1 55.9 51.5 55.4 64.1 59.2 1.16 Bangka Belitung 43.5 49.9 46.5 56.2 60.1 58.0 1.07 Java DKI Jakarta 69.1 60.3 64.3 82.7 70.9 76.3 0.86 West Java 48.8 50.6 49.7 61.0 62.4 61.7 1.02 Central Java 54.4 56.8 55.5 66.2 67.7 66.9 1.02 DI Yogyakarta 71.1 69.7 70.4 81.6 84.6 83.1 1.04 East Java 54.5 58.2 56.2 63.8 68.9 66.2 1.08 Banten 52.1 48.6 50.3 59.6 56.7 58.1 0.95 Bali and Nusa Tenggara Bali 64.9 60.2 62.8 80.8 70.0 76.0 0.87 West Nusa Tenggara 55.1 40.1 47.2 62.9 42.7 52.2 0.68 East Nusa Tenggara 35.9 36.3 36.1 45.0 41.2 43.2 0.92 Kalimantan West Kalimantan 46.1 40.7 43.2 60.2 47.2 53.2 0.78 Central Kalimantan 46.2 45.4 45.8 55.2 58.7 56.9 1.06 South Kalimantan 43.2 41.5 42.4 50.6 49.9 50.2 0.99 East Kalimantan 60.8 60.8 60.8 73.6 74.5 74.0 1.01 Sulawesi North Sulawesi 51.2 59.5 55.4 67.6 71.1 69.3 1.05 Central Sulawesi 47.0 51.1 48.9 59.6 60.2 59.9 1.01 South Sulawesi 47.2 43.2 45.3 54.9 56.0 55.4 1.02 Southeast Sulawesi 48.3 52.5 50.4 63.3 59.8 61.6 0.95 Gorontalo 25.6 40.5 33.3 29.3 47.0 38.4 1.60 Total 53.0 54.4 53.7 64.0 65.0 64.5 1.02 1 The NAR for secondary school is the percentage of the secondary-school age (14-17 years) population that is attending secondary school. By definition the NAR cannot exceed 100 percent. 2 The GAR for secondary school is the total number of secondary school students, expressed as a percentage of the official secon- dary-school-age population. If there are significant numbers of overage and underage students at a given level of schooling, the GAR can exceed 100 percent. 3 The Gender Parity Index for secondary school is the ratio of the secondary school GAR for females to the GAR for males. 16 | Characteristics of Households and Housing Characteristics Table 2.5.2 shows that secondary school attendance ratios are much lower and differ substantially by background characteristics. The NAR and the GAR for secondary school are 54 and 65 percent, re- spectively. The secondary school attendance is substantially higher in urban areas (64 percent) than in rural areas (44 percent). There are no significant differences in the overall NAR and GAR between males and females. However, among provinces, the GPI varies from 0.68 in West Nusa Tenggara to 1.22 in Bengkulu. This means the attendance of females in secondary school is lower than of males in West Nusa Tenggara, while in Bengkulu the GPI is higher than that of males. Among provinces, the NAR and GAR are the lowest in East Nusa Tenggara (36 and 43 percent, respectively) and the highest DI Yogyakarta (70 and 83 percent, respectively). 2.5 HOUSING CHARACTERISTICS AND HOUSEHOLD POSSESSIONS In the 2002-2003 IDHS, information was collected about certain characteristics of households, including access to electricity, source of drinking water, time to water source, type of sanitation facilities, construction and flooring materials of housing, possession of various durable goods, and distance between the well and the nearest septic tank. 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. The information on housing characteristics is summarized in Tables 2.6 and 2.7. Table 2.6 shows that 91 percent of the households covered in the 2002-2003 IDHS have electric- ity, a large increase from 80 percent found in the 1997 IDHS (CBS et al., 1998:17). There are significant urban-rural differentials, with 98 percent of urban households having electricity, compared with 85 per- cent in rural areas (see Figure 2.2). Table 2.6 shows that protected wells, whether in dwelling, in yard, or public, are the main source of drinking water (42 percent). Seventeen percent of households use water that is either piped into the residence or into the yard or obtained from the public tap, this proportion being significantly higher in urban areas than in rural areas (29 and 7 percent, respectively). Other sources of drinking water include springs (12 percent), other open water such as rivers and ponds (3 percent), and bottled water (3 percent). Rural households are much more likely to use spring water than urban households (19 percent, compared with 3 percent). On the other hand, bottled water is more common in urban areas (6 percent) than in rural areas (1 percent). The urban-rural differences are also reflected in the time taken to draw water. In urban areas, 97 percent of the households are within 15 minutes of a water source, compared with 86 percent of rural households. Households without proper toilet facilities are more exposed to the risk of diseases like dysentery, diarrhea, and typhoid fever. More than half of households in the sample (54 percent) have a private toilet, a slight increase from 50 percent found in the 1997 IDHS (CBS et al., 1998:19). Eight percent of house- holds use a shared facility, and the remaining 28 percent do not have a toilet. This presents a slight de- crease from the 40 percent found in the 1997 IDHS (CBS et al., 1998:19). The urban-rural differences are significant. Seventy-four percent of households in urban areas have a private toilet, compared with 37 percent in rural areas. Table 2.6 also presents the distribution of households by the distance from the well to the nearest septic tank. Forty-one percent of households have no well. For 9 percent of the households, the nearest septic tank is less than 7 meters from their well, and for 38 percent, the nearest septic tank is 7 meters or further from the well. Wells are slightly closer to a septic tank in urban areas than in rural areas. Characteristics of Households and Housing Characteristics | 17 The type of flooring material can be considered as an economic and health indicator of the household. Some floor materials like dirt or earth pose a health problem for the household since they can act as breeding grounds for pests and insects and may be a source of dust. This kind of flooring is also more difficult to keep clean. In Indonesia, 14 percent of households have a dirt floor. More than half of households (52 percent) live in dwellings with a concrete, brick, or tile floor, while 15 percent have a wood floor. There are substantial urban-rural differen- tials by floor materials. Whereas 58 percent of urban households have a concrete, brick, or tile floor, the proportion of such households in rural areas is 47 percent. Conversely, 22 percent of rural households have a dirt floor, compared with 5 percent in urban areas. Table 2.6 Household characteristics Percent distribution of households by household characteristics, accord- ing to residence, Indonesia 2002-2003 Residence Household characteristic Urban Rural Total Electricity Yes 98.1 84.5 90.7 No 1.9 15.4 9.2 Missing 0.1 0.1 0.1 Total 100.0 100.0 100.0 Source of drinking water Piped into dwelling 22.1 4.2 12.4 Piped into yard/plot 2.9 1.4 2.1 Public tap 3.9 1.5 2.6 Open well in dwelling 5.8 3.6 4.6 Open well in yard/plot 5.8 12.4 9.4 Open public well 1.7 4.9 3.5 Protected well in dwelling 24.9 12.8 18.4 Protected well in yard/plot 11.9 18.1 15.3 Protected public well 6.0 9.8 8.0 Spring 3.2 19.1 11.8 River, stream, pond 0.3 6.0 3.4 Rainwater 1.2 3.2 2.3 Tanker truck 3.2 1.6 2.3 Bottled water 6.2 0.8 3.3 Other 0.8 0.4 0.6 Total 100.0 100.0 100.0 Time to water source Percentage <15 minutes 96.8 86.3 91.1 Sanitation facility Private with septic tank 64.6 26.6 44.0 Private with no septic tank 8.9 10.2 9.6 Shared/public 9.3 6.2 7.6 River/stream/creek 11.3 26.6 19.6 Pit 2.9 16.5 10.3 Bush/forest/yard/field/no facility 0.5 7.1 4.1 Other 2.2 6.7 4.6 Missing 0.3 0.2 0.2 Total 100.0 100.0 100.0 Distance from well to nearest septic tank No well 43.8 38.3 40.8 Less than 7 meters 11.4 7.6 9.4 7 meters or farther 36.5 39.4 38.1 Don't know/missing 8.2 14.7 11.7 Total 100.0 100.0 100.0 Flooring material Dirt/earth 4.6 21.9 14.0 Bamboo 0.5 2.3 1.5 Wood 9.0 20.0 14.9 Brick/concrete 35.0 33.1 34.0 Tile 23.1 13.5 17.9 Ceramic/marble/granite 27.4 8.7 17.2 Other 0.1 0.2 0.1 Missing 0.4 0.3 0.4 Total 100.0 100.0 100.0 Cooking fuel Electricity 0.7 0.2 0.4 LPG, natural gas 18.6 2.8 10.0 Kerosene 63.8 27.7 44.2 Coal, lignite 0.1 0.1 0.1 Charcoal 0.1 0.4 0.3 Firewood, straw 15.9 68.5 44.4 Other 0.8 0.3 0.5 Missing 0.1 0.1 0.1 Total 100.0 100.0 100.0 Number of households 15,126 17,962 33,088 The majority of the households use kerosene and firewood or straw for cooking (44 percent each), while 10 percent use liquid pro- pane gas or natural gas. There are substantial urban-rural differentials by type of cooking fuel. Whereas 64 percent of urban households use kerosene for cooking, only 28 percent of house- holds do so in rural areas. Furthermore, 19 per- cent of urban households use gas for cooking compared with 3 percent in rural areas. The presence of durable goods in the household, such as radio, television, telephone, refrigerator, motorcycle, and private car, is an- other indicator of the household's socioeconomic status. Moreover, particular goods have specific benefits. Ownership of a radio or television is a measure of access to mass media and exposure to innovative ideas; telephone ownership meas- ures access to an efficient means of communica- tion; refrigerator ownership prolongs the whole- someness of foods; and ownership of private transport means allows greater access to many services away from the local area. Table 2.7 shows that 56 percent of households have a radio, 62 percent have a tele- vision, 13 percent have a telephone, 18 percent have a refrigerator, 44 percent have a bicycle or boat, and 30 percent have a motorcycle or mo- torboat. Only 6 percent of households have a private car or truck. One in six households has none of the durable goods listed in Table 2.8. The 18 | Characteristics of Households and Housing Characteristics ownership of durable goods, except radio and bicycle or boat, has increased from that recorded in 1997 IDHS (CBS et al., 1998:20). Whereas ownership of radio has decreased since 1997 (62 to 56 percent), ownership of television has increased during the same period (48 to 62 percent). Ownership of specific durable goods varies by urban-rural residence. In general, these goods are more available in urban households than in rural households. For example, four in five urban households have a television set, while that is true for less than half of rural households (48 percent). A telephone is available in 25 percent of urban households but is almost nonexistent in rural areas. Furthermore, urban households are four times more likely to own a private car than rural households. Table 2.7 Household durable goods Percentage of households possessing various durable consumer goods, by residence, Indonesia 2002-2003 Residence Durable consumer goods Urban Rural Total Radio 64.8 48.4 55.9 Television 79.3 47.8 62.2 Telephone 25.1 2.4 12.8 Refrigerator 31.9 6.2 17.9 Bicycle/rowboat 45.6 42.9 44.2 Motorcycle/motorboat 38.7 21.9 29.6 Car/truck 9.7 2.3 5.7 None of the above 8.4 22.8 16.2 Number of households 15,126 17,962 33,088 Figure 2.2 Housing Characteristics by Residence 98 29 74 58 85 7 37 47 91 17 54 52 Electricity Piped Water Private Toilet Brick/Concrete/Tile 0 20 40 60 80 100 Urban Rural Total IDHS 2002-2003 Characteristics of Households and Housing Characteristics | 19 CHARACTERISTICS OF RESPONDENTS AND WOMEN’S STATUS 3 The purpose of this chapter is to provide a demographic and socioeconomic profile of the 2002-2003 Indonesia Demographic and Health Surveys (DHS) sample of ever-married women and cur- rently married men. Information on the basic background characteristics of the respondents in the survey is essential for the interpretation of findings presented later in the report. The chapter begins by describing basic background characteristics including age, marital status, educational level, and residential character- istics. More detailed information on education, literacy, and exposure to mass media are then discussed. This is followed by data on the employment and earnings of women, decisionmaking in the household, and attitudes on women’s position in relation to others in the household. 3.1 CHARACTERISTICS OF SURVEY RESPONDENTS Table 3.1 presents the distributions of ever-married women age 15-49 and currently married men age 15-54 interviewed in the 2002-2003 IDHS by key background characteristics, including age, marital status, urban-rural residence, and educational level. The findings show that approximately one-third of the women and one in five men are under age 30. Table 3.1 also shows that 95 percent of the women are currently married, the remaining 5 percent are split halfway, either divorced or widowed. Forty-six percent of female and 47 percent of male respon- dents live in urban areas. Eight percent of ever-married women and 4 percent of currently married men have never attended any formal schooling. More women than men completed primary school (34 and 30 percent, respec- tively). Men tend to be more highly educated than women, with 28 percent of men having completed sec- ondary or higher education, compared with 21 percent of women. Women are becoming better educated. The percentage of ever-married women with no education declined (13 percent in 1997 compared with 8 percent in 2002-2003), while the percentage of those with some secondary school increased (28 percent in 1997 compared with 38 percent in 2002-2003). Looking at religion, 90 percent of both women and men are Muslim, followed by Chris- tian/Protestant or Catholic (7 to 8 percent). The small remaining percentage are Hindus, Buddhists, or belong to other religions. Differentials of the background characteristics by province are presented in Appendix Table A.3.1. The majority of respondents live in Java (62 percent of each women and men), followed by Su- matera (20 percent of women and 21 percent of men). Kalimantan Bali and Nusa Tenggara island groups have the lowest proportion of the respondents: 6 and 5 percent of women, respectively, and 5 percent each of men. Notable is the large difference between the weighted number of men and women and the un- weighted number in some provinces. The unweighted number represents the number that were actually interviewed in the 2002-2003 IDHS survey; whereas the weighted number represents that province’s pro- portional representation in the population based on the 2002 National Household Survey. For instance, South Sumatera has only 3 percent of the national population of ever-married women age 15-49 (as repre- sented by 809 cases), but 1,242 women were actually interviewed. This is mentioned so that the reader will understand that while weighted numbers are presented throughout the rest of the report, the province estimates may be based on a significantly larger number of unweighted male or female interviews. Characteristics of Respondents and Women’s Status | 21 Table 3.1 Distribution of respondents by background characteristics Percent distribution of ever-married women and currently married men by background characteris- tics, Indonesia 2002-2003 Number of ever-married women Number of currently married men Background characteristic Weighted percent Weighted Unweighted Weighted percent Weighted Unweighted Age 15-19 3.2 956 924 0.1 11 22 20-24 13.1 3,875 3,892 5.1 426 429 25-29 18.2 5,375 5,528 14.6 1,214 1,220 30-34 18.4 5,428 5,529 17.6 1,462 1,580 35-39 17.6 5,181 5,112 18.9 1,572 1,538 40-44 15.5 4,581 4,403 16.8 1,395 1,366 45-49 13.9 4,086 4,095 14.7 1,224 1,178 50-54 na na na 12.1 1,007 977 Marital status Married 94.5 27,857 27,784 100.0 8,310 8,310 Divorced/separated 2.9 868 850 na na na Widowed 2.6 757 849 na na na Residence Urban 45.8 13,499 12,318 46.5 3,866 3,555 Rural 54.2 15,984 17,165 53.5 4,444 4,755 Education No education 7.9 2,335 2,248 4.1 341 330 Some primary 20.0 5,902 5,896 20.8 1,730 1,557 Completed primary 33.9 9,995 8,958 29.6 2,462 2,205 Some secondary 17.4 5,136 5,499 17.8 1,477 1,584 Secondary + 20.7 6,114 6,882 27.7 2,301 2,634 Religion Islam 89.7 26,447 24,528 90.0 7,480 6,898 Christian/Protestant 5.5 1,630 2,239 5.3 442 637 Catholic 2.2 643 916 1.9 160 237 Hindu 1.6 479 1,377 1.8 146 415 Buddhist 0.7 192 209 0.6 53 57 Confucian 0.1 21 47 0.1 6 14 Other 0.1 34 84 0.1 11 27 Missing 0.1 37 82 0.1 12 25 Total 100.0 29,483 29,483 100.0 8,310 8,310 Note: Education categories refer to the highest level of education attended, whether or not that level was com- pleted. na = Not applicable 3.2 EDUCATIONAL ATTAINMENT Table 3.2 shows the percent distribution of respondents by highest level of schooling attained or completed according to their age and place of residence. Young women and men are more likely to have attended school than the older generation. The distribution of respondents who have never attended school rises with increasing for both men and women. For example, 2 percent of ever-married women and 1 percent of currently married men age 20-24 have no formal education, compared with 17 percent of 22 | Characteristics of Respondents and Women’s Status women and 7 percent of men age 45-49. Similarly, 28 percent of women 20-24 completed some secon- dary school, compared with only 9 percent of women age 45-49. For the male respondents, 34 percent of men age 20-24 attended some secondary school, compared with 15 percent of men age 50-54. The IDHS data indicate that educational opportunities vary among the respondents according to their areas of residence. Urban women and men are more likely to go to school than their rural counter- parts. Five percent of urban women and 2 percent of urban men have not attended school, compared with 10 percent and 6 percent in rural areas, respectively. Comparing the median completed years of education shows a similar pattern, with urban women having a median of eight years of schooling and rural women having five years. Table 3.2 Educational attainment by background characteristics Percent distribution of women and men by highest level of schooling attended or completed, and median number of years of schooling, according to age and residence, Indonesia 2002-2003 Highest level of schooling attended or completed Age/residence No edu- cation Some primary Completed primary1 Some secondary Completed secondary2 More than secondary Total Number Median years of schooling EVER-MARRIED WOMEN Age 15-19 1.5 11.1 40.5 38.3 8.5 0.1 100.0 956 5.9 20-24 1.7 10.2 39.2 27.6 18.9 2.5 100.0 3,875 6.0 25-29 2.4 10.7 37.6 21.8 22.1 5.4 100.0 5,375 6.0 30-34 4.9 15.2 33.2 18.2 21.7 6.7 100.0 5,428 5.9 35-39 9.3 24.2 32.0 12.9 14.7 6.8 100.0 5,181 5.5 40-44 14.7 30.8 30.8 10.3 8.6 4.8 100.0 4,581 5.1 45-49 17.3 32.6 29.3 9.9 7.8 3.2 100.0 4,086 5.0 Residence Urban 5.0 13.5 28.9 20.0 24.2 8.4 100.0 13,499 8.0 Rural 10.4 25.5 38.1 15.2 8.7 2.0 100.0 15,984 5.4 Total 7.9 20.0 33.9 17.4 15.8 4.9 100.0 29,483 5.6 CURRENTLY MARRIED MEN Age 15-19 * * * * * * 100.0 11 * 20-24 0.9 7.6 37.7 33.9 18.1 1.7 100.0 426 7.8 25-29 1.7 8.9 32.6 24.9 26.8 5.2 100.0 1,214 8.2 30-34 1.0 16.3 25.6 22.6 26.7 7.9 100.0 1,462 8.2 35-39 4.3 16.7 30.0 15.9 21.7 11.4 100.0 1,572 6.0 40-44 6.0 28.9 27.1 12.6 17.0 8.3 100.0 1,395 5.6 45-49 7.0 29.5 30.5 10.1 16.5 6.4 100.0 1,224 5.4 50-54 6.5 32.0 30.6 14.7 10.4 5.8 100.0 1,007 5.4 Residence Urban 1.9 14.0 24.0 18.4 29.5 12.3 100.0 3,866 8.5 Rural 6.0 26.7 34.5 17.2 12.2 3.3 100.0 4,444 5.5 Total 4.1 20.8 29.6 17.8 20.2 7.4 100.0 8,310 5.8 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 1 Completed 6th grade at the primary level 2 Completed 6th grade at the secondary level Across provinces, differentials in educational attainment are significant (see Appendix Table A.3.2). The proportion of ever-married women who have never gone to school varies from 2 percent in Gorontalo province to 27 percent in West Nusa Tenggara. Furthermore, there are pronounced variations among provinces in the educational attainment and completion. Characteristics of Respondents and Women’s Status | 23 3.3 LITERACY The ability to read is an important personal asset allowing women and men increased opportuni- ties in life. Information on the distribution of literate population can help health and family planners to better reach their target population with their messages. In the 2002-2003 IDHS, the level of literacy is defined by the respondent’s ability to read none, part, or all of a sentence from a card in a language that the respondent is likely to be able to read. The questions assessing literacy were asked only of women and men who have not attended school or have attended only primary school. Respondents who attended at least secondary are considered literate. Table 3.3 shows that the literacy rate in Indonesia is quite high, with 86 percent of ever-married women and 93 percent of currently married men being literate. The percentage of women who cannot read at all is 13 percent compared with 7 percent of men. Younger respondents are more likely to be liter- ate than older respondents. While 96 percent of women and 98 percent of men age 20-24 are literate, the proportion drops to 72 percent for women and 88 percent for men age 45-49. Table 3.3 Literacy Percent distribution of ever-married women and currently married men by level of schooling attended and by level of literacy, and percent liter- ate, according to age and residence, Indonesia 2002-2003 No schooling or primary school Age/residence Secondary school or higher Can read a whole sentence Can read part of a sentence Cannot read at all Missing Total Number Percent literate1 EVER-MARRIED WOMEN Age 15-19 46.9 45.2 4.2 2.4 1.3 100.0 956 96.3 20-24 48.9 43.4 3.9 3.4 0.4 100.0 3,875 96.2 25-29 49.3 40.0 4.9 4.9 0.8 100.0 5,375 94.3 30-34 46.6 38.8 6.4 7.7 0.5 100.0 5,428 91.9 35-39 34.5 39.4 10.0 15.5 0.6 100.0 5,181 83.9 40-44 23.7 39.5 13.2 23.2 0.5 100.0 4,581 76.4 45-49 20.9 37.2 13.5 27.7 0.7 100.0 4,086 71.5 Residence Urban 52.6 33.0 5.9 7.9 0.6 100.0 13,499 91.5 Rural 25.9 45.6 10.5 17.3 0.6 100.0 15,984 82.1 Total 38.2 39.8 8.4 13.0 0.6 100.0 29,483 86.4 CURRENTLY MARRIED MEN Age 15-19 * * * * * 100.0 11 * 20-24 53.8 41.7 2.6 2.0 0.0 100.0 426 98.0 25-29 56.8 37.9 1.8 3.3 0.1 100.0 1,214 96.6 30-34 57.1 35.3 3.4 4.1 0.1 100.0 1,462 95.8 35-39 49.0 39.8 5.7 5.3 0.1 100.0 1,572 94.6 40-44 38.0 42.0 9.9 10.0 0.2 100.0 1,395 89.9 45-49 33.0 46.6 8.8 11.4 0.2 100.0 1,224 88.4 50-54 30.9 45.9 12.5 10.3 0.4 100.0 1,007 89.3 Residence Urban 60.1 32.7 3.9 3.2 0.1 100.0 3,866 96.7 Rural 32.7 48.1 8.9 10.1 0.2 100.0 4,444 89.7 Total 45.5 40.9 6.5 6.9 0.2 100.0 8,310 92.9 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 1 Refers to respondents who attended secondary school or higher and respondents who can read a whole sentence or part of a sentence 24 | Characteristics of Respondents and Women’s Status Urban residents have a higher level of literacy (92 percent of women and 97 percent of men) than their rural counterparts (82 and 90 percent, respectively). The variation in literacy rate by province is pre- sented in Appendix Tables A.3.3.1 and A.3.3.2. In most provinces, women are less literate than men. For women, West Nusa Tenggara has the lowest literacy rate (67 percent), while North Sulawesi has the high- est (96 percent). For men, East Nusa Tenggara has the lowest literacy rate (81 percent), whereas DKI Ja- karta province has the highest (99 percent). 3.4 EXPOSURE TO MASS MEDIA The 2002-2003 IDHS collected information on the exposure of respondents to the various com- mon mass media. Respondents were asked how often they read a newspaper, listened to the radio, or watched television in a week. This information is useful in determining the media channels to use in dis- seminating family planning program and health information to target audiences. Furthermore, it is impor- tant for knowing the likelihood of reaching the respondents by media. Table 3.4 shows that television is the most popular mass media among ever-married women and currently married men (76 and 79 percent, respectively), followed by radio with 38 percent of women and 46 percent of men listening to the radio weekly. A much lower percentage of both women and men read a newspaper at least once a week (15 percent of women and 29 percent of men). Since 1997, there has been a significant decrease in the proportion of women who are exposed to all three media from 16 percent to the current level of 9 percent based on the 2002-2003 IDHS. Women and men living in urban areas and those age 25-39 are more likely to have access to all three types of media than their rural counterparts or those in other age groups. Findings also show that education is strongly associated with mass media exposure. For instance, 26 percent of women and 37 percent of men with secondary or higher education were likely to have access to all three types of me- dia versus 2 percent and 5 percent, respectively, of women and men with some primary education. Men have greater exposure to the mass media than women. This differential applies within every population group. Appendix Tables A.3.4.1 and A.3.4.2 show the variation in media exposure of ever-married women and currently married men according to province. It is important to note that the television expo- sure is extremely important in DKI Jakarta where 91 percent of women and 94 percent of men watch tele- vision programs weekly. DI Yogyakarta has the highest proportion of women who are exposed to all three media (24 percent), while West Nusa Tenggara has the lowest (4 percent). North Sulawesi has the highest proportion of men who are exposed to all three media (45 percent), whereas Bengkulu and Southeast Su- lawesi have the lowest (7 percent). It is interesting to note that 64 percent of women and 56 percent of men in East Nusa Tenggara are not exposed to any of the three mass media. Characteristics of Respondents and Women’s Status | 25 Table 3.4 Exposure to mass media Percentage of ever-married women and currently married men who usually read a newspaper at least once a week, watch television at least once a week, and listen to the radio at least once a week, by background char- acteristics, Indonesia 2002-2003 Background characteristic Reads a newspaper at least once a week Watches television at least once a week Listens to the radio at least once a week All three media No media Number EVER-MARRIED WOMEN Age 15-19 8.9 74.9 46.3 5.5 17.9 956 20-24 14.4 79.2 41.5 8.8 15.4 3,875 25-29 17.8 80.1 41.8 11.1 15.1 5,375 30-34 18.6 78.0 40.3 10.8 16.3 5,428 35-39 16.2 75.1 36.1 9.3 19.2 5,181 40-44 12.6 74.7 34.8 7.2 20.0 4,581 45-49 11.2 70.6 31.5 6.3 23.8 4,086 Residence Urban 23.7 87.4 39.0 13.6 9.6 13,499 Rural 8.0 67.1 37.4 5.0 25.3 15,984 Education No education 0.1 51.7 24.8 0.0 40.8 2,335 Some primary 2.9 64.8 30.2 1.5 28.5 5,902 Completed primary 7.2 75.7 38.8 4.4 18.4 9,995 Some secondary 16.9 83.7 41.0 10.5 11.4 5,136 Secondary + 44.5 92.0 47.3 25.7 4.8 6,114 Total 15.2 76.4 38.1 9.0 18.1 29,483 CURRENTLY MARRIED MEN Age 15-19 * * * * * 11 20-24 25.6 85.8 51.6 17.2 10.5 426 25-29 30.7 80.1 49.4 17.5 14.5 1,214 30-34 32.5 80.1 50.5 20.0 12.3 1,462 35-39 31.9 81.8 48.6 21.3 12.6 1,572 40-44 28.6 79.0 44.0 16.5 15.0 1,395 45-49 25.4 79.9 36.3 13.3 14.8 1,224 50-54 24.6 70.5 40.2 12.2 22.2 1,007 Residence Urban 43.1 87.7 47.7 25.5 8.0 3,866 Rural 16.9 72.1 43.8 10.0 20.3 4,444 Education No education 0.9 49.2 26.3 0.7 43.9 341 Some primary 7.1 69.6 37.2 4.5 23.2 1,730 Completed primary 15.6 74.5 44.8 9.6 17.8 2,462 Some secondary 32.5 85.4 50.2 18.3 8.6 1,477 Secondary + 62.0 92.4 52.8 36.7 4.3 2,301 Total 29.1 79.3 45.6 17.2 14.6 8,310 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 26 | Characteristics of Respondents and Women’s Status 3.5 EMPLOYMENT 3.5.1 Employment Status Respondents in the 2002-2003 IDHS were asked a number of questions to elicit their employment status at the time of the survey and the continuity of their employment in 12 months prior to the survey. The measurement of women’s employment, however, is difficult. This difficulty arises largely because some of the work that women do, especially work on family farms, family businesses, or in the informal sector, is often not perceived by women themselves as employment and hence is not reported as such. To avoid underestimating women’s employment, the IDHS asked women several questions to ascertain their employment status. First, women were asked, “Aside from your own housework, are you currently work- ing?” Women who answered “no” to this question were then asked, “As you know, some women take up jobs for which they are paid in cash or kind. Others sell things, have a small business, or work on the fam- ily farm or in the family business. Are your currently doing any of these things or any other work?” Women who answered “no” to this question were asked, “Have you done any work in the last 12 months?” Women are currently employed if they answer “yes” to either of the first two questions. Women who answer “yes” to the third question are not currently employed but have worked in the past 12 months. Table 3.5.1 and Figure 3.1 show that 51 percent of ever-married women are currently employed, 2 percent were employed at some time during the past 12 months, and 47 percent of women were not em- ployed at all in the same period. Older women, women in rural areas, and women who have no education are more likely to have been employed. Moreover, women who have more children are more likely to be currently employed. Table 3.5.2 shows that almost all currently married men are currently employed (97 percent), while 1 percent were employed at some time in the past year. Appendix Tables A.3.5.1 and A.3.5.2 present the percent distribution of ever-married women and currently married men by employment status, according to province. The highest proportion of currently employed women is found in Bengkulu province (75 percent) and the lowest in Central Kalimantan (27 percent). For men, the variation in employment status by province is negligible. Characteristics of Respondents and Women’s Status | 27 Table 3.5.1 Employment status: women Percent distribution of ever-married women by employment status, according to background characteristics, Indonesia 2002-2003 Employed in the 12 months preceding the survey Background characteristic Currently employed Not currently employed Not em- ployed in the 12 months preceding the survey Total Number of women Age 15-19 25.3 3.5 71.2 100.0 956 20-24 33.0 3.4 63.6 100.0 3,875 25-29 41.0 1.6 57.3 100.0 5,375 30-34 52.7 1.5 45.9 100.0 5,428 35-39 56.2 1.7 42.1 100.0 5,181 40-44 62.3 1.5 36.2 100.0 4,581 45-49 63.9 1.1 35.0 100.0 4,086 Marital status Married 49.5 1.8 48.7 100.0 27,857 Divorced/widowed 71.6 2.1 26.3 100.0 1,626 Number of living children 0 44.7 3.8 51.5 100.0 2,422 1-2 47.7 2.0 50.2 100.0 15,344 3-4 55.7 1.3 43.0 100.0 8,418 5+ 56.5 0.9 42.6 100.0 3,299 Residence Urban 44.6 1.8 53.6 100.0 13,499 Rural 55.9 1.8 42.2 100.0 15,984 Education No education 67.0 1.4 31.5 100.0 2,335 Some primary 59.5 2.0 38.5 100.0 5,902 Completed primary 49.4 1.7 48.8 100.0 9,995 Some secondary 39.9 1.7 58.4 100.0 5,136 Secondary + 47.4 2.0 50.6 100.0 6,114 Total 50.7 1.8 47.4 100.0 29,483 IDHS 2002-2003 Figure 3.1 Employment Status of Women Age 15-49 Currently employed 51% Employed in the last 12 months, but not currently employed 2% Did not work in past 12 months 47% 28 | Characteristics of Respondents and Women’s Status Table 3.5.2 Employment status: men Percent distribution of currently married men by employment status, according to back- ground characteristics, Indonesia 2002-2003 Employed in the 12 months preceding the survey Background characteristic Currently employed Not currently employed Not em- ployed in the 12 months preceding the survey Total Number of men Age 15-19 100.0 0.0 0.0 100.0 11 20-24 93.6 3.7 2.4 100.0 426 25-29 96.5 2.1 1.4 100.0 1,214 30-34 97.7 1.9 0.4 100.0 1,462 35-39 98.0 1.2 0.7 100.0 1,572 40-44 98.7 0.3 1.0 100.0 1,395 45-49 96.9 1.1 2.0 100.0 1,224 50-54 96.5 1.3 2.2 100.0 1,007 Number of living children 0 95.1 2.8 2.1 100.0 705 1-2 97.5 1.3 1.1 100.0 4,244 3-4 97.2 1.7 1.2 100.0 2,437 5+ 98.2 0.3 1.5 100.0 925 Residence Urban 96.3 1.8 1.9 100.0 3,866 Rural 98.1 1.1 0.7 100.0 4,444 Education No education 97.1 0.3 2.6 100.0 341 Some primary 97.9 1.0 1.1 100.0 1,730 Completed primary 97.2 2.1 0.6 100.0 2,462 Some secondary 96.8 1.4 1.9 100.0 1,477 Secondary + 97.3 1.2 1.4 100.0 2,301 Total 97.3 1.4 1.3 100.0 8,310 3.5.2 Occupation Table 3.6.1 presents the percent distribution of ever-married women who were employed in the 12 months preceding the survey by occupation, according to background characteristics. The data show that 45 percent of ever-married women work in agriculture, of whom more than half (24 percent) work on their own land. The majority of women who work in the nonagricultural sector are engaged in sales and services occupations (32 percent). The respondent’s occupation varies by age; younger women who work in agriculture tend to work on family land, while older women tend to work on their own land. In the nonagricultural sector, the en- gagement of women in sales and services increases with age. Rural and less educated women are more likely to work in agriculture than other women. Urban and better educated women are much more likely to work in sales and services professions. Characteristics of Respondents and Women’s Status | 29 Table 3.6.1 Occupation: women Percent distribution of ever-married women employed in the 12 months preceding the survey by occupation, according to background characteristics, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Agricultural Nonagricultural –––––––––––––––––––––––––––––––––– –––––––––––––––––––––––––––––––––––––––––––––––––––– Pro- Someone fessional/ Sales Un- Number Background Own Family else’s Rented technical/ and Skilled skilled Agri- of characteristic land land land land managerial Clerical services manual manual culture Total women ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 23.4 15.2 16.0 0.6 0.3 0.4 21.9 18.9 0.0 0.9 100.0 276 20-24 21.2 8.1 10.5 1.6 2.9 2.3 28.9 23.5 0.1 0.7 100.0 1,411 25-29 22.3 4.6 12.5 2.1 5.2 3.7 30.6 17.0 0.4 1.3 100.0 2,291 30-34 23.1 4.5 12.6 2.0 7.4 3.8 31.3 14.2 0.0 0.9 100.0 2,939 35-39 25.0 2.7 13.9 2.2 9.3 3.0 31.2 10.6 0.0 1.7 100.0 2,998 40-44 24.7 2.7 16.7 2.2 6.7 1.8 34.1 8.9 0.2 1.8 100.0 2,925 45-49 28.5 2.8 17.2 3.3 4.9 1.9 32.7 6.5 0.0 1.8 100.0 2,656 30 Marital status Married 25.1 4.1 14.0 2.3 6.7 2.8 30.4 12.6 0.1 1.4 100.0 14,297 Divorced/widowed 15.9 3.4 17.0 1.7 2.5 1.5 44.9 11.2 0.0 1.0 100.0 1,198 Number of living children 0 16.4 5.3 12.6 1.2 8.0 6.4 30.2 17.6 0.6 0.9 100.0 1,175 1-2 21.8 4.5 13.7 1.7 6.9 3.4 31.2 15.4 0.0 1.1 100.0 7,628 3-4 27.1 3.2 14.5 2.7 6.6 1.7 32.7 9.2 0.1 2.0 100.0 4,800 5+ 33.0 3.9 16.8 4.1 2.6 0.4 31.2 6.1 0.0 1.2 100.0 1,892 Residence Urban 4.2 0.7 6.7 0.7 10.1 5.8 51.2 18.7 0.3 1.1 100.0 6,267 Rural 38.1 6.4 19.4 3.3 3.8 0.7 18.3 8.3 0.0 1.6 100.0 9,228 Education No education 31.5 3.7 31.2 2.2 0.0 0.0 24.9 4.9 0.1 1.0 100.0 1,599 Some primary 32.3 3.7 23.1 2.8 0.2 0.1 26.0 9.5 0.0 2.1 100.0 3,630 Completed primary 29.6 5.4 13.5 2.8 0.1 0.1 31.2 15.5 0.0 1.3 100.0 5,114 Some secondary 21.1 5.5 6.7 2.0 1.1 0.9 44.1 16.8 0.3 1.2 100.0 2,133 Secondary + 4.6 1.4 1.3 0.7 31.3 13.1 33.5 12.2 0.3 1.0 100.0 3,019 Total 24.4 4.1 14.3 2.2 6.3 2.7 31.6 12.5 0.1 1.4 100.0 15,495 Table 3.6.2 shows the percent distribution of currently married men who were employed in the 12 months preceding the survey by occupation, according to background characteristics. Thirty-eight per- cent of currently married men work in agriculture, with more than half (19 percent) working on their own land. In the nonagricultural sector, similarly to women, men are by far more likely to work in sales and services than in other professions (38 percent). Men show the same variations across subgroups as women. | Characteristics of Respondents and Women’s Status Table 3.6.2 Occupation: men Percent distribution of currently married men employed in the 12 months preceding the survey by occupation, according to background charac- teristics, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Agricultural Nonagricultural ––––––––––––––––––––––––––––––––––––– ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Some- Pro- one fessional/ Sales Un- Number Background Own Family else’s Rented technical/ and Skilled skilled Agri- of characteristic land land land land Missing managerial Clerical services manual manual culture Missing Total men –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 * * * * * * * * * * * * * 11 20-24 12.4 10.8 15.6 0.2 0.4 2.8 0.6 42.8 11.4 0.0 3.0 0.0 100.0 414 25-29 15.3 5.9 10.9 2.0 1.7 4.3 3.1 41.2 13.2 0.4 1.9 0.1 100.0 1,196 30-34 15.0 3.5 10.2 1.6 1.8 7.3 3.9 44.7 9.6 0.0 2.3 0.1 100.0 1,456 35-39 17.7 2.4 12.6 0.9 1.2 9.9 6.0 38.4 8.6 0.1 1.8 0.4 100.0 1,559 40-44 22.3 1.1 12.7 1.2 0.8 9.4 5.3 33.4 10.6 0.3 2.3 0.5 100.0 1,381 45-49 20.5 2.2 14.7 2.3 1.0 7.9 4.8 34.8 9.0 0.0 2.9 0.0 100.0 1,200 50-54 30.8 2.4 12.6 2.2 0.8 7.3 6.3 29.6 5.3 0.0 2.6 0.1 100.0 985 Number of living children 0 13.3 5.8 15.2 0.8 0.8 7.6 2.4 44.6 8.0 0.0 1.5 0.0 100.0 690 1-2 17.4 3.8 10.7 1.3 1.4 7.9 4.6 39.1 11.1 0.2 2.4 0.1 100.0 4,194 3-4 20.8 2.0 13.5 1.7 1.0 8.4 6.1 35.9 8.4 0.0 2.0 0.3 100.0 2,409 5+ 28.8 2.5 15.5 3.0 1.1 3.6 3.2 31.2 6.9 0.1 3.7 0.5 100.0 911 Residence Urban 3.8 0.8 5.9 0.9 1.3 11.9 6.6 52.9 13.4 0.2 2.0 0.2 100.0 3,793 Rural 32.6 5.5 18.0 2.1 1.1 3.9 3.0 24.7 6.3 0.1 2.5 0.2 100.0 4,411 Education No education 34.6 4.1 25.6 3.4 1.3 0.0 0.0 23.3 4.5 0.0 3.1 0.0 100.0 333 Some primary 29.2 3.6 23.1 1.6 0.9 0.4 0.2 30.4 7.2 0.2 3.1 0.0 100.0 1,710 Completed primary 22.8 3.5 16.5 2.2 1.8 0.6 1.6 37.9 10.6 0.0 2.6 0.1 100.0 2,446 Some secondary 18.2 4.1 5.5 1.8 0.3 3.6 3.1 49.3 11.4 0.4 1.7 0.4 100.0 1,449 Secondary + 6.6 2.3 2.4 0.4 1.4 24.2 13.1 37.9 9.8 0.0 1.6 0.4 100.0 2,266 Total 19.3 3.3 12.4 1.6 1.2 7.6 4.7 37.8 9.6 0.1 2.3 0.2 100.0 8,203 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 3.6 FORM OF WOMEN’S EARNINGS Table 3.7 shows the percent distribution of ever-married women who were employed during the 12-month period prior to the survey by type of earnings received, type of employer, and continuity of em- ployment, and how this varies by type of employment (agricultural or nonagricultural). Fifty-six percent of women receive their earnings in cash; 8 percent receive them as cash and in-kind; and 35 percent re- ceive no payment (Figure 3.2). The majority of women who work in agriculture (58 percent) receive no pay, while for those women in nonagricultural professions, only 16 percent reported no pay. Characteristics of Respondents and Women’s Status | 31 Table 3.7 Employment characteristics Percent distribution of ever-married women employed in the 12 months preceding the survey by type of earnings, type of employer, and continuity of employment, according to type of employment (agricultural or nonagri- cultural), Indonesia 2002-2003 Employment characteristic Agricultural work Non- agricultural work Total Type of earnings Cash only 29.1 79.1 56.1 Cash and in-kind 6.5 4.1 5.2 In-kind only 6.8 0.4 3.3 Not paid 57.5 16.4 35.2 Missing 0.1 0.0 0.2 Total 100.0 100.0 100.0 Type of employer Employed by family member 60.4 14.9 35.7 Employed by nonfamily member 29.4 46.1 38.4 Self-employed 9.8 38.6 25.4 Missing 0.3 0.4 0.4 Total 100.0 100.0 100.0 Continuity of employment All year 55.3 91.4 74.8 Seasonal 40.2 5.3 21.3 Occasional 3.9 3.3 3.5 Missing 0.6 0.1 0.4 Total 100.0 100.0 100.0 Number of women1 7,087 8,390 15,495 1 Total includes women with missing information on type of employment who are not shown separately. IDHS 2002-2003 Figure 3.2 Type of Earnings of Employed Women Age 15-49 Cash only 56% No payment 35% In-kind only 3% Cash and in-kind 5% 32 | Characteristics of Respondents and Women’s Status Six in 10 women who work in agriculture sector are employed by a family member, but women who work in the nonagricultural sector are more likely to be employed by a non-family member (46 per- cent) or self employed (39 percent) or. Nine in 10 women who work in nonagricultural jobs work all year, compared with about half of women in agriculture (55 percent). Forty percent of ever-married women in the agriculture sector work seasonally. 3.7 CONTROL OVER WOMEN’S EARNINGS AND WOMEN’S CONTRIBUTION TO HOUSEHOLD EXPENDITURES Employed women who earn cash for their work were asked about who the main decisionmaker is with regard to the use of their earnings. This information allows the assessment of women’s control over their own earnings. In addition, they were asked about the proportion of household expenditures met by their earnings to assess the relative importance of women’s earnings. This information not only allows an evaluation of the relative importance of women’s earnings in the household economy, but has implica- tions for the empowerment of women. It is expected that employment and earnings are more likely to empower women if they perceive their earnings as important for meeting the needs of their households. Table 3.8 shows how respondent’s degree of control over the use of their earnings and the extent to which the earnings of women meet household expenditures vary by background characteristics. Table 3.8 shows that 68 percent of ever-married women report they alone decide how their earn- ings are to be spent, and 29 percent decide jointly with someone else (mostly husbands). Only 2 percent of women reported that someone else makes the decision on how their earnings are used. The table also shows that the respondent’s degree of control over the use of their earnings varies little by background characteristics, except for marital status. Divorced, separated, or widowed women are significantly more likely to decide alone how their earning are used than women who are married (98 percent versus 65 percent). Thirty-two percent of married women report that this decision is made jointly with someone else, compared with only 1 percent of divorced, separated, or widowed women. When asked about the proportion of household expenditures that are met by their earnings, 43 percent of women reported that their earnings support all of the household expenditures and 42 percent reported that their earnings support half or more. Across subgroups, the data show that older women, those who are widowed, separated, or divorced, rural women, and those who are less educated are more likely to meet all of their household’s expenditures. Appendix Table A.3.6 shows the provincial variations of the decision on use of earnings in the household and women’s contribution to household expenditures. The proportion of women employed for cash in the past year who decide alone on how their earnings are used ranges from 88 percent in South Sulawesi to 26 percent in North Sulawesi. Women in Central Sulawesi and North Sulawesi are the least likely to fully support their households financially (12 and 15 percent, respectively), while women in West Nusa Tenggara and Bangka Belitung are the most likely to do so (62 and 60 percent, respectively). Characteristics of Respondents and Women’s Status | 33 Table 3.8 Decision on use of earnings and contribution of earnings to household expenditures Percent distribution of ever-married women employed in the 12 months preceding the survey receiving cash earnings by person who decides how earnings are to be used and by proportion of household expenditures met by earnings, according to background characteristics, Indonesia 2002- 2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Person who decides how Proportion of household earnings are used expenditures met by earnings –––––––––––––––––––––––––––––––– ––––––––––––––––––––––––––––––––––––––––– Someone Almost Less Half Number Background Self else none/ than or of characteristic only Jointly1 only2 Missing Total none half more All Missing Total women ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 68.8 18.7 7.5 5.1 100.0 4.8 7.8 43.9 43.5 0.0 100.0 142 20-24 67.2 28.5 3.0 1.3 100.0 3.6 12.5 46.2 36.0 1.7 100.0 829 25-29 65.0 32.5 1.9 0.6 100.0 3.3 14.1 44.4 37.4 0.8 100.0 1,425 30-34 67.8 29.6 2.0 0.6 100.0 2.9 12.5 46.2 37.7 0.7 100.0 1,832 35-39 66.4 31.1 0.9 1.6 100.0 2.9 10.6 40.4 45.3 0.8 100.0 1,861 40-44 69.1 28.5 1.2 1.3 100.0 2.3 7.8 39.7 49.1 1.1 100.0 1,803 45-49 72.0 25.4 1.4 1.3 100.0 2.3 8.2 38.9 50.1 0.5 100.0 1,611 Marital status Married 64.6 32.3 1.8 1.3 100.0 2.7 11.4 44.3 40.8 0.9 100.0 8,544 Divorced/widowed 98.2 1.2 0.3 0.2 100.0 4.1 4.2 24.9 66.2 0.6 100.0 959 Number of living children 0 68.7 26.5 3.9 0.9 100.0 5.0 15.9 48.3 29.1 1.8 100.0 799 1-2 68.1 29.5 1.2 1.2 100.0 2.9 10.9 44.3 41.3 0.6 100.0 4,904 3-4 66.4 31.0 1.5 1.1 100.0 2.7 9.8 39.6 46.7 1.1 100.0 2,850 5+ 71.6 23.9 2.6 1.9 100.0 1.0 7.5 34.8 55.9 0.8 100.0 950 Residence Urban 69.4 28.1 1.4 1.1 100.0 3.1 12.1 44.5 39.5 0.7 100.0 5,071 Rural 66.4 30.3 2.0 1.3 100.0 2.5 9.0 39.8 47.7 1.0 100.0 4,432 Education No education 71.1 25.9 1.6 1.3 100.0 1.6 5.3 29.4 62.7 1.0 100.0 946 Some primary 71.3 25.7 1.3 1.7 100.0 2.2 8.6 34.5 53.6 1.2 100.0 2,022 Completed primary 70.0 27.3 1.7 1.0 100.0 2.2 8.8 41.3 46.9 0.8 100.0 2,766 Some secondary 68.0 28.8 2.1 1.1 100.0 3.2 12.8 46.4 37.1 0.5 100.0 1,268 Secondary + 61.9 35.3 1.8 1.0 100.0 4.4 15.4 52.6 27.0 0.8 100.0 2,501 Total 68.0 29.1 1.7 1.2 100.0 2.8 10.7 42.3 43.3 0.9 100.0 9,503 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1 With husband or someone else 2 Includes husband Table 3.9 shows the control of currently married working women over their own earnings by the extent to which their earnings meet household expenditures. Sixty-five percent of currently married women make their own decisions on how their earnings are used. Interestingly, women who do not con- tribute any cash in the household expenditures are much more likely to make the decision on cash spend- ing alone (80 percent) compared with those who cover all of their household expenditures (67 percent). Almost all women who are not currently married make decisions on how their cash will be used by themselves (98 percent), regardless of their contribution to the household expenditures (data not shown). 34 | Cha racteristics of Respondents and Women’s Status Table 3.9 Women’s control over earnings Percent distribution of currently married women who received cash earnings for work in the past 12 months by person who decides how earnings are used, according to the proportion of household expenditures met by earnings, Indonesia 2002-2003 Contribution to household expenditures Self only Jointly with husband Jointly with someone else Husband only Someone else only Missing Total Number of women Almost none/none 80.1 17.3 0.5 0.9 0.1 1.2 100.0 230 Less than half 61.2 35.9 0.0 1.9 0.1 0.9 100.0 973 Half or more 63.4 33.2 0.1 2.4 0.2 0.8 100.0 3,782 All 66.7 30.9 0.1 0.9 0.1 1.4 100.0 3,484 Total 64.6 32.2 0.1 1.7 0.2 1.3 100.0 8,544 Note: Total includes 75 women with missing information on contribution to household expenditures 3.8 WOMEN’S EMPOWERMENT In addition to information on women’s education, employment status, and control over earnings, the 2002-2003 IDHS obtained information from both ever-married women and currently married men on some other measures of women’s status and empowerment. Specifically, questions were asked on women’s participation in specific household decisions, on their degree of acceptance of wife beating, and on their opinions about when a wife should be able to refuse sex with her husband. These data provide insights into women’s control over their lives and their environment and their attitudes toward traditional gender roles, which are important aspects of women’s empowerment relevant for understanding women’s demographic and health behaviors. 3.8.1 Women’s Participation in Decisionmaking To assess women’s decisionmaking autonomy, information was collected on women’s participa- tion in five different types of decisions: on the respondent’s own health care, on making large household purchases, on making household purchases for daily needs, on visits to family or relatives, and on what food should be cooked each day. Table 3.10 shows the percent distribution of ever-married women ac- cording to who in the household usually has the final say on each one of specified decisions. Women are considered to participate in decisionmaking if they make decisions alone or jointly with their husband or someone else. Currently married women are significantly less likely to make the specified household decisions by themselves than women who are currently not married. For instance, about half of currently married women (54 percent) decide by themselves on their own health care versus nine in ten (91 percent) of women who are not married. Characteristics of Respondents and Women’s Status | 35 Table 3.10 Women’s participation in decisionmaking Percent distribution of ever-married women by person who has the final say in making specific decisions, according to current marital status and type of decision, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Currently married women Women who are not married1 ––––––––––––––––––––––––––––––––––––––––– ––––––––––––––––––––––––––––– Jointly Decision Jointly Decision Jointly with Some not with Some- not with some- Hus- one made/ Number some- one made/ Number Self hus- one band else not of Self one else not of Decision only band else only only applicable Total women only else only applicable Total women –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Own health care 54.0 32.1 0.2 12.7 0.3 0.6 100.0 27,857 90.8 5.6 3.1 0.5 100.0 1,626 Large household purchases 13.9 66.4 0.3 17.8 0.8 0.7 100.0 27,857 76.2 11.6 7.7 4.4 100.0 1,626 Daily household purchases 82.6 13.0 0.8 2.4 0.8 0.3 100.0 27,857 87.0 6.8 5.5 0.7 100.0 1,626 Visits to family or relatives 12.5 74.2 0.2 10.8 0.3 1.9 100.0 27,857 79.4 12.4 4.0 4.1 100.0 1,626 What food to cook each day 89.8 5.9 1.3 1.3 1.1 0.5 100.0 27,857 86.5 7.3 4.8 1.2 100.0 1,626 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1 Divorced or widowed women Table 3.11 and Figure 3.3 show how women’s participation in decisionmaking varies by back- ground characteristics. The findings show that 68 percent of women have a final say (alone or jointly) in all five specific areas of decisionmaking. It is noteworthy that a large majority of women (above 80 per- cent) have a final say alone or jointly in each of the five specified areas of decisionmaking. Women’s de- cisionmaking autonomy generally increases with age. For example, while 56 percent of women age 15-19 have a final say in all the specified decisions, this is true for 72 percent of women age 45-49. Divorced, separated, or widowed women are more likely to have a final say in all specified decisions than currently married women, 83 versus 68 percent, respectively. Furthermore, women’s decisionmaking autonomy increases with their education level. Seventy-four percent of women with secondary or higher education have a final say in all the specified decisions, compared with 65 percent of women with no education. Appendix Table A.3.7 presents women’s participation in decisionmaking by province. There are significant variations in the proportion of women who have a final say in all five specified areas of deci- sionmaking, ranging from 50 percent in West Kalimantan to 91 percent in North Sulawesi. 36 | Characteristics of Respondents and Women’s Status Table 3.11 Women's participation in decisionmaking Percentage of ever-married women who say that they alone or jointly have the final say in specific decisions, by background char- acteristics, Indonesia 2002-2003 Alone or jointly have final say in: Background characteristic Own health care Making large pur- chases Making daily pur- chases Visits to family or relatives What food to cook each day All speci- fied deci- sions None of the specified decisions Number of women Age 15-19 80.8 71.8 89.3 78.3 89.5 56.0 2.4 956 20-24 85.0 78.0 95.3 85.7 95.2 63.0 0.4 3,875 25-29 86.3 80.5 95.9 87.1 96.5 67.5 0.4 5,375 30-34 87.3 83.5 97.4 87.9 97.4 68.7 0.4 5,428 35-39 87.8 82.0 97.4 88.4 98.1 70.4 0.4 5,181 40-44 87.5 82.6 96.6 86.7 97.7 71.1 0.6 4,581 45-49 88.4 80.8 96.2 88.8 97.6 71.8 0.7 4,086 Marital status Married 86.3 80.7 96.5 86.9 97.1 67.6 0.5 27,857 Divorced/widowed 96.4 87.9 93.7 91.8 93.8 83.1 1.4 1,626 Number of living children 0 85.1 77.7 92.2 84.7 90.8 62.6 1.1 2,422 1-2 87.8 82.5 97.1 87.5 97.2 69.6 0.4 15,344 3-4 86.2 80.7 96.2 87.6 97.6 68.7 0.6 8,418 5+ 85.6 77.9 95.9 86.2 97.9 66.5 0.7 3,299 Residence Urban 87.5 81.9 97.0 87.6 97.1 69.0 0.5 13,499 Rural 86.4 80.3 95.8 86.8 96.7 68.0 0.6 15,984 Education No education 83.5 77.1 95.2 86.2 97.8 64.9 0.9 2,335 Some primary 85.6 78.0 95.6 86.6 97.1 66.2 0.8 5,902 Completed primary 86.5 80.3 96.6 86.0 97.5 67.1 0.5 9,995 Some secondary 86.8 81.7 95.8 86.9 96.1 68.6 0.6 5,136 Secondary + 90.1 86.3 97.3 90.3 96.0 74.0 0.2 6,114 Employment Not employed 85.0 78.6 95.7 84.6 96.5 64.2 0.7 14,482 Employed for cash 90.6 85.1 97.9 90.7 97.3 74.2 0.2 9,105 Employed not for cash 85.7 80.9 95.5 88.2 97.3 69.9 0.6 5,834 Missing 90.1 83.3 86.7 79.0 84.2 64.1 4.7 62 Total 86.9 81.1 96.3 87.2 96.9 68.4 0.5 29,483 Characteristics of Respondents and Women’s Status | 37 Figure 3.3 Number of Decisions in Which Women Participate in the Final Say 87 81 96 87 97 68 0 1 2 3 4 5 Number of Decisions 0 20 40 60 80 100 Pe rc e n t o f W om e n IDHS 2002-2003 3.8.2 Attitude Toward Wife Beating To assess women’s degree of acceptance of wife beating, the IDHS survey asked ever-married women, “Sometimes a husband is annoyed or angered by things that his wife does. In your opinion, is a husband justified in hitting or beating his wife in the following situations?” The five situations presented to women for their opinion were: if she burns the food, if she argues with him, if she goes out without telling him, if she neglects the children, and if she refuses to have sex with him. The first five columns in Table 3.12 show how acceptance of wife beating varies for each reason. The last column gives the per- centages of women who feel that a husband beating his wife is justified for at least one of the specified reasons. Data show that younger women, those who are married, and women who live in rural areas are more likely than other women to agree with at least one of the specified reason. It is worth noting that women who have no final say in household decisions are the least likely to agree with wife-beating when compared to other women. However, women who participate in one or two household decisions are more likely to agree with at least one of the specified reasons for wife-beating than women who participate in more household decisions. According to Appendix Table A.3.8, women in West Nusa Tenggara province are the most likely to agree with at least one specified reason for a husband to beat his wife (64 percent), while women resid- ing in DKI Jakarta are the least likely to do so (13 percent). 38 | Characteristics of Respondents and Women’s Status Table 3.12 Women's attitude toward wife beating Percentage of ever-married women who agree that a husband is justified in hitting or beating his wife for specific rea- sons, by background characterisitics, Indonesia 2002-2003 Husband is justified in hitting or beating his wife if she: Background characteristic Burns the food Argues with him Goes out without telling him Neglects the chil- dren Refuses to have sex with him Agrees with at least one specified reason Number of women Age 15-19 3.6 6.8 24.9 24.3 9.2 29.9 956 20-24 3.2 5.4 21.0 22.9 7.6 28.6 3,875 25-29 3.1 5.7 22.0 23.6 7.0 29.3 5,375 30-34 2.6 4.8 17.8 18.9 6.9 24.2 5,428 35-39 3.3 4.5 15.8 17.3 6.7 22.9 5,181 40-44 2.6 5.3 16.0 17.3 7.0 22.2 4,581 45-49 2.8 5.8 15.2 16.3 5.9 20.4 4,086 Marital status Married 2.9 5.2 18.3 19.7 6.9 25.0 27,857 Divorced/widowed 4.3 7.3 16.9 16.5 7.4 21.3 1,626 Number of living children 0 3.5 6.2 21.3 19.7 7.2 26.3 2,422 1-2 2.7 4.7 17.8 19.4 6.4 24.4 15,344 3-4 2.9 5.5 17.8 18.9 7.2 24.4 8,418 5+ 4.2 6.7 19.0 21.7 8.7 26.8 3,299 Residence Urban 2.2 4.1 14.9 16.5 5.8 21.6 13,499 Rural 3.6 6.3 21.1 22.1 7.9 27.6 15,984 Education No education 3.7 8.0 18.1 18.1 8.3 22.6 2,335 Some primary 3.4 6.0 18.9 20.0 7.6 25.6 5,902 Completed primary 3.4 5.7 19.0 20.3 7.6 25.3 9,995 Some secondary 2.5 4.6 20.2 21.6 6.6 27.6 5,136 Secondary + 2.0 3.4 14.6 16.8 4.9 21.7 6,114 Employment Not employed 2.6 4.5 17.8 19.1 6.7 24.1 14,482 Employed for cash 3.0 5.5 17.1 18.2 6.3 23.5 9,105 Employed not for cash 3.8 6.9 21.1 23.0 8.5 28.7 5,834 Number of decisions in which woman has final say1 0 4.8 7.0 15.6 12.7 7.9 18.9 159 1-2 5.4 9.7 25.6 26.1 10.8 33.5 1,280 3-4 2.8 6.3 21.8 21.8 7.7 28.8 7,871 5 2.9 4.6 16.4 18.3 6.4 22.8 20,173 Total 3.0 5.3 18.2 19.6 6.9 24.8 29,483 Note: Total includes 62 women with missing information on employment 1 Either by herself or jointly with others Characteristics of Respondents and Women’s Status | 39 3.8.3 Women’s Attitude Toward Refusing Sex with Husband The extent of control women have over when and with whom they have sex has important impli- cations for demographic and health outcomes. It is also an indicator of women’s empowerment because it measures women’s degree of acceptance of norms that make women believe that they do not have the right to refuse to have sex with their husbands for any reason. In the 2002-2003 IDHS, women were asked whether a wife is justified in refusing to have sex with her husband under four circumstances: she knows her husband has a sexually transmitted disease (STD); she knows her husband has sex with other women; she has recently given birth; and she is tired or not in the mood. These four circumstances for which women’s opinions are sought have been chosen because they are effective in combining issues of women’s rights and consequences for women’s health. Table 3.13 shows the percentage of ever-married women who say that a wife is justified in refus- ing to have sex with her husband for specific reasons by background characteristics. Findings show that 62 percent of women agree that a wife is justified in refusing sex with her husband for all the specified reasons. On the other hand, 7 percent of women agree with none of the specified reasons. Respondents are most likely to agree with a woman’s right to refuse sex if she gave birth recently (91 percent). Women are the least likely to agree that a wife has a right to refuse sex to her husband if she is tired or not in the mood (69 percent). Justification for a wife to refuse sex to her husband does not have a clear pattern with women’s background characteristics, except for women’s education and employment status. Better- educated women and women who are employed for cash are more likely to agree with all of the reasons for a wife to refuse sex to her husband than other women. Appendix Table A.3.9 shows that 76 percent of women in East Java and East Kalimantan agree with all of the specified reasons for a wife to refuse sex with her husband, compared with 32 percent of women in South Sumatera. 40 | Characteristics of Respondents and Women’s Status Table 3.13 Women’s attitude toward refusing sex with husband Percentage of ever-married women who believe that a wife is justified in refusing to have sex with her husband for specific reasons, according to background characteristics, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Wife is justified in refusing sex with her husband if she: ––––––––––––––––––––––––––––––––––––––– Percentage Percentage Knows Knows who agree who agree husband has husband Is tired agree with with none a sexually has sex Has or not all of the of the Number Background transmitted with other recently in the specified specified of characteristic disease women given birth mood reasons reasons women ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 83.7 84.7 89.6 67.7 61.5 8.0 956 20-24 85.5 85.0 92.3 69.7 61.5 5.7 3,875 25-29 86.5 84.9 90.9 67.3 60.6 6.1 5,375 30-34 86.2 84.2 91.4 70.0 62.6 6.0 5,428 35-39 84.4 83.0 89.9 70.3 62.5 7.2 5,181 40-44 83.0 81.3 90.0 69.2 61.1 7.6 4,581 45-49 81.9 80.4 88.9 68.3 60.8 8.9 4,086 Marital status Married 84.9 83.4 90.9 69.2 61.5 6.6 27,857 Divorced/widowed 80.4 80.1 85.0 66.7 61.7 11.8 1,626 Number of living children 0 84.3 82.3 88.3 68.5 60.8 7.5 2,422 1-2 86.7 85.0 91.8 70.3 63.4 6.1 15,344 3-4 83.2 82.2 90.0 69.2 61.1 7.4 8,418 5+ 79.6 78.6 87.8 63.8 54.8 8.8 3,299 Residence Urban 88.5 86.0 93.1 69.2 62.9 5.0 13,499 Rural 81.4 81.0 88.4 69.0 60.4 8.5 15,984 Education No education 76.1 77.6 85.3 68.1 57.5 11.1 2,335 Some primary 78.4 79.2 87.3 68.7 60.1 9.8 5,902 Completed primary 84.0 83.3 89.8 68.2 60.4 7.2 9,995 Some secondary 89.2 86.1 93.5 70.5 63.5 4.7 5,136 Secondary + 91.3 86.8 94.3 70.1 64.7 3.8 6,114 Employment Not employed 86.0 84.6 90.8 68.2 61.5 6.6 14,482 Employed for cash 85.8 83.9 91.7 71.5 64.3 6.3 9,105 Employed not for cash 79.4 78.8 88.1 67.8 57.8 8.8 5,834 Number of decisions in which woman has final say1 0 57.6 61.1 69.0 49.9 37.6 26.3 159 1-2 71.6 73.5 80.8 58.3 45.9 13.9 1,280 3-4 83.5 81.8 91.2 69.1 60.0 6.3 7,871 5 86.2 84.6 91.1 69.9 63.3 6.5 20,173 Number of reasons wife beating is justified 0 84.9 84.2 90.3 69.7 63.4 7.7 22,166 1-2 83.9 79.6 91.5 67.6 55.8 4.4 5,247 3-4 83.0 81.8 91.1 63.9 53.4 4.8 1,590 5 87.6 83.9 88.5 74.4 68.3 6.8 479 Total 84.7 83.3 90.6 69.1 61.6 6.9 29,483 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Total includes 62 women with missing information on employment 1 Either by herself or jointly with others Characteristics of Respondents and Women’s Status | 41 3.9 LIFE STYLE MEASURES The use of tobacco in the household adversely affects the health status of all household members, including individuals who are not smoking. To assess the use of tobacco, the 2002-2003 IDHS included questions on tobacco use. Respondents were asked whether they smoke regularly, the type of tobacco they use and how much they smoked in the past 24 hours. When interpreting the data on tobacco use, it is important to recognize the fact that some respondents may have a tendency to under-report tobacco use 42 | C out of embarrassment. Table 3.14 shows that two percent of ever married women smoke tobacco regularly. Among women who smoke, 30 percent reported smoking 1-2 cigarettes and 26 percent smoked 3-5 cigarettes in the past 24 hours. It is of interest to note that 19 percent of women who smoke reported having smoked 10 or more cigarettes in the past 24 hours. Table 3.14 Use of smoking tobacco Percentage of ever-married women who smoke cigarettes or tobacco and percent distribution of cigarette smokers by number of cigarettes smoked in preceding 24 hours, according to background characteristics and maternity status, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Number of cigarettes Uses tobacco Does ––––––––––––––––––––––––––––––––––––––––––––––– ––––––––––––––––– not Number Don't Number Background Other use of know/ of characteristic Cigarettes tobacco tobacco women 0 1-2 3-5 6-9 10+ missing Total smokers –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 1.2 0.0 98.8 956 * * * * * * 100.0 11 20-34 0.9 0.0 99.0 14,679 6.6 36.9 19.7 15.7 10.9 10.3 100.0 134 35-49 3.0 0.3 96.7 13,848 1.7 26.7 29.3 18.2 22.2 2.0 100.0 418 Residence Urban 2.4 0.0 97.5 13,499 2.7 27.6 24.5 21.7 20.6 2.9 100.0 330 Rural 1.5 0.3 98.2 15,984 3.0 34.4 29.2 11.0 17.1 5.4 100.0 234 Education No education 2.3 0.4 97.3 2,335 1.8 23.5 30.6 20.0 23.7 0.4 100.0 53 Some primary 2.3 0.5 97.2 5,902 2.5 32.4 35.5 18.5 7.6 3.5 100.0 137 Completed primary 1.7 0.1 98.2 9,995 2.3 41.7 22.0 14.8 11.9 7.2 100.0 167 Some secondary 2.1 0.0 97.9 5,136 3.7 16.3 16.8 21.7 39.7 1.9 100.0 109 Secondary + 1.6 0.0 98.3 6,114 3.9 27.6 29.7 13.4 22.4 3.1 100.0 98 Maternity status Pregnant 1.0 0.0 98.9 1,627 * * * * * * 100.0 17 Breastfeeding (not pregnant) 0.6 0.1 99.2 6,017 0.3 31.4 20.6 19.3 12.0 16.5 100.0 38 Neither 2.3 0.2 97.5 21,839 2.8 30.2 27.2 17.2 20.2 2.4 100.0 509 Total 1.9 0.2 97.9 29,483 2.9 30.4 26.4 17.3 19.1 3.9 100.0 564 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. haracteristics of Respondents and Women’s Status FERTILITY 4 The 2002-2003 Indonesia Demographic and Health Survey (IDHS) collected information on cur- rent, past, and cumulative fertility. This chapter presents the results of the survey on levels, trends, and differentials in fertility based on the analysis of the birth histories collected from ever-married women age 15-49 interviewed during the survey. Women were first asked a series of questions to determine the total number of live births that occurred in their lifetime. Second, for each live birth, information was collected on the age, sex, and survival status of the child. For dead children, age at death was recorded. Information from birth history is used to assess current fertility (age-specific and total fertility) and completed fertility (number of children ever born alive to the woman), as well as to look at other fertility-related factors, such as age at first birth, birth intervals, and teenage childbearing. From population censuses and surveys in Indonesia, fertility and mortality rates have been esti- mated using indirect methods, and are based on the number of children ever born and children surviving. The fertility measures presented here are calculated directly from the birth history. There are some limi- tations with both procedures. Because interviews were conducted only with living women, there was no information on the fertility of women who have died. The fertility rates would be biased if the mortality of women of childbearing age was 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 census and the 2002-2003 IDHS collected data 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 the date of birth. Errors in underreporting of births affect the estimates 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. 4.1 CURRENT FERTILITY LEVELS AND TRENDS 4.1.1 Fertility Levels The most widely used measures of current fertility are the total fertility rates (TFRs) and the age- specific fertility rates (ASFRs).1 The TFR is calculated by summing the ASFRs and can be defined as the total number of births a woman would have by the end of her childbearing period if she were to pass through those years bearing children at the currently observed rates of age-specific fertility. To obtain the most recent estimates of fertility—without compromising the statistical precision of estimates and in an attempt to avoid possible displacement of births from five to six years before the survey—the three-year period preceding the survey is used. It corresponds roughly to the calendar period 2000-2002 . 1 Numerators of the ASFRs are calculated by summing the number of live births that occurred in the period 1 to 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 to 36 months preceding the survey. Since only women who had ever married were interviewed in the IDHS, the numbers of women in the denominators of the rates were inflated by factors calculated from information in the Household Questionnaire on populations ever married in order to produce a count of all women. Never-married women are presumed not to have given birth. Fertility | 43 Table 4.1 presents the current TFRs and ASFRs for In- donesia by urban-rural residence. The results indicate that if fertility were to remain constant at the current age-specific rates measured in the survey (for the 36 months preceding the sur- vey), a woman in Indonesia would, on average, bear 2.6 chil- dren in her lifetime. The TFRs for urban and rural areas are 2.4 and 2.7 children per woman, respectively. The TFR measured in the 2002-2003 IDHS survey is slightly lower than the corre- sponding rate of 2.8 obtained in the 1997 IDHS survey. Table 4.1 Current fertility Age-specific and cumulative fertility rates, the general fertility rate, and the crude birth rate for the three years preceding the sur- vey, by urban-rural residence, Indonesia 2002-2003 Residence Age group Urban Rural Total 15-19 41 63 51 20-24 119 144 131 25-29 143 144 143 30-34 103 95 99 35-39 64 68 66 40-44 18 21 19 45-49 2 5 4 TFR 2.4 2.7 2.6 GFR 85 93 89 CBR 22.1 21.7 21.9 Note: Rates for age group 45-49 may be slightly biased because of truncation. TFR: Total fertility rate for ages 15-49, expressed per woman GFR: General fertility rate (births divided by the number of women age 15-44), expressed per 1,000 women CBR: Crude birth rate, expressed per 1,000 population A further examination of the patterns of fertility in urban and rural areas reveals that rural fertility is higher than urban fertility at almost every age. The peak of childbearing among all women is age 25-29 (143 children per 1,000 women). Results from the 2002-2003 IDHS indicate that the age pattern of fertility is the same as that observed in the 1997 IDHS. However, increased childbearing in urban areas is lim- ited to women age 25-29, while in rural areas childbearing has increased for women age 20-29. Thus, urban women tend to start limiting their family size (or spacing births) at an earlier age than do rural women. Table 4.1 also presents the general fertility rate (GFR) and the crude birth rate (CBR) for the three years preceding the survey. The GFR is the number of live births per 1,000 women age 15-44. The CBR is the number of births per 1,000 popula- tion. In Indonesia, the GFR is 89 and the CBR is 22. Figure 4.1 shows that the TFR in Indonesia is lower than that in selected Southeast Asian coun- tries, such as Cambodia, Philippines, Malaysia and Myanmar, although not as low as that in Singapore, Thailand, or Vietnam. 4.7 4.0 3.7 2.9 2.8 2.6 2.5 1.9 1.7 1.4 Laos Cambodia Philippines Malaysia Myanmar Indonesia Brunei Vietnam Thailand Singapore 0.0 1.0 2.0 3.0 4.0 5.0 Children per Woman Figure 4.1 Total Fertility Rate of Southeast Asian Countries Source: 2003 United Nations Economic and Social Commission for Asia and the Pacific (ESCAP) Population Data Sheet, DHS reports for Cambodia, Philippines, Vietnam, and Indonesia 44 | Fertility 4.1.2 Differentials in Current and Completed Fertility Table 4.2 shows fertility differentials by urban-rural residence, education, and wealth index quintile. In the 2002-2003 IDHS, information was collected on household’s ownership of a number of consumer items, such as radio, television, or car, as well as on dwelling characteristics and sanitation facili- ties. The wealth index is constructed by as- signing a weight or factor score to each household asset through principal components analysis. These scores were summed by household, and individuals were ranked ac- cording to the total score of the household in which they resided. The sample was then di- vided into population quintiles—five groups with the same number of individuals in each. Table 4.2 shows that in addition to urban-rural differentials, some variation exists in the TFR by woman’s education and socio- economic status (measured by the wealth in- dex). Results of the 2002-2003 IDHS show an inverted U-shaped relationship between edu- cation and fertility. Women with primary edu- cation have a TFR that is somewhat higher than that of other women. A sharper variation in TFR is seen by wealth index: The TFR for women in the lowest (poorest) quintile is 3.0 births per woman, compared with 2.2 births for women in the highest (richest) quintile. Table 4.2 Fertility by background characteristics Total fertility rate for the three years preceding the survey, per- centage of women age 15-49 currently pregnant, and mean number of children ever born to women age 40-49, by back- ground characteristics, Indonesia 2002-2003 Background characteristic Total fertility rate1 Percentage currently pregnant1 Mean number of children ever born to women age 40-49 Residence Urban 2.4 3.8 4.0 Rural 2.7 4.5 4.1 Education No education 2.6 1.7 4.3 Some primary 2.7 3.2 4.4 Completed primary 2.7 4.5 4.0 Some secondary 2.5 4.1 3.7 Secondary+ 2.5 5.1 3.0 Wealth index quintile Lowest 3.0 4.8 4.4 Second 2.6 4.2 4.3 Middle 2.7 3.9 4.1 Fourth 2.5 4.1 4.0 Highest 2.2 3.7 3.4 Total 2.6 4.1 4.0 1 Women age 15-49 Table 4.2 also shows that at the time of the survey, 4 percent of women were pregnant. The pro- portions of pregnant women in urban areas, those with no education, and women in the richest quintile are lower than those for the other population subgroups. The last column of Table 4.2 shows the mean number of children ever born (CEB) to women 40-49. This 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 re- mained stable over time, the two fertility measures, TFR and CEB, would be equal or similar. The find- ings show that the mean number of children ever born to women age 40-49 (4.0 children per woman) is much higher than the TFR for the three years preceding the survey (2.6 children per woman), suggesting a substantial recent reduction in fertility. Appendix Table A.4.1 and Figure 4.2 show provincial differentials in fertility. Fertility variations across provinces are large, with TFRs ranging from 1.9 children per woman in DI Yogyakarta to 3.6 and 4.1 children per woman in Southeast Sulawesi and East Nusa Tenggara, respectively. Figure 4.2 shows the TFR levels by province in descending order. Fertility | 45 1.9 2.1 2.1 2.1 2.2 2.3 2.4 2.4 2.6 2.6 2.6 2.7 2.7 2.8 2.8 2.8 2.9 3.0 3.0 3.0 3.2 3.2 3.2 3.2 3.6 4.1 DI Yogyakarta Central Java East Java Bali DKI Jakarta South Sumatera Bangka Belitung West Nusa Tenggara Banten North Sulawesi South Sulawesi Jambi Lampung West Java East Kalimantan Gorontalo West Kalimantan North Sumatera Bengkulu South Kalimantan West Sumatera Riau Central Kalimantan Central Sulawesi Southeast Sulawesi East Nusa Tenggara Number of Children per Woman IDHS 2002-2003 Figure 4.2 Total Fertility Rate by Province 4.1.3 Trends in Fertility Besides comparing the current and completed fertility, the trend in fertility can be assessed by comparing the current TFR with estimates from previous DHS surveys. Figure 4.3 shows the TFRs for the 1991, 1994, 1997 and 2002-2003 IDHS surveys. There is a steady decline from 3.0 children per woman in 1988-1991 to 2.6 children per woman in 1999-2001. Figure 4.3 Trends in the Total Fertility Rate, 1991-2003 IDHS 1991 IDHS 1994 IDHS 1997 IDHS 2002-2003 0.0 1.0 2.0 3.0 4.0 C hi ld re n pe r W o m an Note: The 2002-2003 IDHS did not include Nanggroe Aceh Darussalam, Maluku, North Maluku, and Papua province. Previous surveys included East Timor. 3.0 2.9 2.8 2.6 46 | Fertility Further information on the fertility trends comes from analysis of the fertility of age cohorts of women in the 2002-2003 IDHS survey (i.e., by examining trends within age groups). Table 4.3 shows ASFRs for successive five-year periods preceding the survey. Because women age 50 and older were not interviewed in the survey, the rates for calendar periods preceding the survey will be increasingly trun- cated by the exclusion of the fertility experience of older women. For example, fertility rates cannot be calculated for women age 45-49 for the period five years or more preceding the survey, because women in that age group would have been 50 years or older at the time of the survey. Table 4.3 shows that over time there has been a decline in ASFRs in every age group. For all age groups, the decline is steepest between the periods 15-19 and 10-14 years preceding the survey. The re- duction in TFRs over time is due primarily to signifi- cant declines in fertility in age groups 20-24 and 25- 29. 4.2 CHILDREN EVER BORN AND CHILDREN SUR- VIVING Table 4.4 presents the distribution of ever- married women and currently married women by the number of children ever born (CEB). The table also shows the mean number of children ever born and the mean number of living children for each five-year age group. The distribution of children ever born is the outcome of lifetime fertility. It reflects the accumulation of births over the past 30 years to women inter- viewed in the IDHS. The data may be subject to some recall error, which typically is greater for older than for younger women. Table 4.3 Trends in age-specific fertility rates Age-specific fertility rates for five-year periods preced- ing the survey, by mother’s age at the time of the birth, Indonesia 2002-2003 Number of years preceding survey Mother’s age at birth 0-4 5-9 10-14 15-19 15-19 54 69 83 100 20-24 135 150 166 200 25-29 139 149 165 200 30-34 101 112 123 [139] 35-39 61 69 [87] a 40-44 19 [27] a a 45-49 [5] a a a Note: Age-specific fertility rates are per 1,000 women. Esti- mates in brackets are truncated. a Less than 125 woman-years of exposure The information on parity is useful for understanding a number of related issues. First, these re- sults show how average family size varies across age groups. They also offer insight into the impact of marital status on women’s fertility. Virtually all women in Indonesia are married by age 30 (see Table 9.1). Thus, differences in the parity between ever-married women and currently married women primarily reflect the effects of widowhood and divorce on fertility. In addition, the percentage of women in their 40s who have never had children provides an indicator of the level of primary infertility,2 or the inability to bear children. Voluntary childlessness is rare in developing countries like Indonesia; that is, married women in their late 40s with no live births are predominantly unable to bear children. Finally, a compari- son of the mean number of children ever born and surviving children among women in their 40s reflects the extent and impact of mortality on the population. Table 4.4 shows that, on average, women have given birth to less than one child by their mid-20s, more than two children by their mid-30s, and about four children by their mid- to-late 40s. Differences in the mean number of children ever born between all women and currently married women are large at the younger age groups, after which they narrow. 2 It should be pointed out here that this estimate of primary infertility does not include women who may have had one or more births but who are unable to have more children, or secondary infertility. Fertility | 47 Table 4.4 Children ever born and living Percent distribution of all women and currently married women by number of children ever born, and mean number of children ever born and mean number of living children, according to age group, Indonesia 2002-2003 Number of children ever born Age 0 1 2 3 4 5 6 7 8 9 10+ Total Number of women Mean number of chil- dren ever born Mean number of living children ALL WOMEN 15-19 91.7 7.5 0.7 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 6,531 0.09 0.09 20-24 52.0 35.0 10.7 1.9 0.3 0.0 0.0 0.0 0.0 0.0 0.0 100.0 6,593 0.63 0.61 25-29 20.0 33.6 30.9 11.6 2.6 1.0 0.2 0.1 0.0 0.0 0.0 100.0 6,234 1.47 1.39 30-34 10.7 17.0 38.5 19.2 8.8 3.4 1.7 0.5 0.2 0.1 0.0 100.0 5,767 2.20 2.05 35-39 6.6 8.4 25.4 28.0 15.3 8.1 4.4 2.0 0.9 0.7 0.2 100.0 5,342 3.01 2.78 40-44 5.5 6.0 16.9 23.5 17.8 11.0 8.2 4.5 2.9 1.7 2.1 100.0 4,679 3.78 3.37 45-49 4.9 6.2 10.2 18.0 18.9 15.5 9.8 6.4 4.9 1.9 3.2 100.0 4,168 4.30 3.74 Total 30.8 17.5 19.0 13.5 8.0 4.7 2.9 1.6 1.0 0.5 0.6 100.0 39,315 1.99 1.81 CURRENTLY MARRIED WOMEN 15-19 43.0 51.0 4.9 1.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 912 0.64 0.60 20-24 18.4 59.5 18.6 3.2 0.3 0.1 0.0 0.0 0.0 0.0 0.0 100.0 3,761 1.08 1.03 25-29 6.9 38.5 36.3 13.6 3.1 1.2 0.3 0.1 0.0 0.0 0.0 100.0 5,217 1.72 1.62 30-34 4.5 17.2 41.4 20.9 9.5 3.7 1.8 0.6 0.2 0.1 0.0 100.0 5,150 2.37 2.21 35-39 3.5 7.8 26.1 29.2 16.2 8.6 4.6 2.1 1.0 0.8 0.2 100.0 4,953 3.15 2.91 40-44 2.9 5.6 16.8 24.7 18.5 11.4 8.4 4.6 3.1 1.7 2.3 100.0 4,294 3.92 3.49 45-49 2.6 6.2 10.1 18.8 18.5 16.0 10.6 6.4 5.0 2.1 3.7 100.0 3,570 4.44 3.85 Total 7.4 23.1 25.6 18.3 10.5 6.2 3.9 2.0 1.3 0.7 0.9 100.0 27,857 2.66 2.42 4.3 BIRTH INTERVALS Information on the length of birth intervals provides insight into birth spacing patterns. Research shows that children born too soon after a previous birth are at an increased risk of dying, particularly when the interval between births is less than 24 months. Maternal health is also jeopardized when births are closely spaced. Table 4.5 shows the distribution of births in the five years preceding the survey by the number of months since the previous birth, according to background characteristics. First births have been omitted from the table. Results of 2002-2003 IDHS indicate that the overall median birth interval is 54 months, which is much higher than the median birth interval of the 1997 IDHS and 1994 IDHS (45 and 42 months, respectively). Thirteen percent of births in Indonesia occur less than 24 months after the birth of a previous child. About six in ten births (57 percent) take place four or more years after a previous birth. The 2002-2003 IDHS results indicate that birth intervals tend to be shorter for younger mothers. For example, the median number of months since preceding birth for women age 15-19 is 32 months, ver- sus 65 months for women age 40-49. Additionally, the interval between births is much lower for births after the preceding sibling has died. This relationship is largely a result of replacement fertility, whereby a mother will get pregnant again soon after the death of a child. The median birth interval length is short- ened by 25 months when the preceding sibling dies. 48 | Fertility Table 4.5 Birth intervals Percent distribution of non-first births in the five years preceding the survey by number of months since preceding birth, according to background characteristics, Indonesia 2002-2003 Months since preceding birth Background characteristic 7-17 18-23 24-35 36-47 48+ Total Number of non-first births Median number of months since preceding birth Age 15-19 20.4 13.0 33.3 16.2 17.1 100.0 61 31.8 20-29 8.0 9.0 20.9 16.8 45.2 100.0 3,706 44.7 30-39 3.9 5.8 12.8 13.4 64.1 100.0 4,962 61.2 40-49 4.7 6.4 15.7 9.9 63.2 100.0 1,083 64.7 Birth order 2-3 5.5 6.9 15.0 13.6 59.0 100.0 6,691 56.3 4-6 4.4 6.7 17.1 16.8 55.0 100.0 2,451 52.5 7+ 11.4 11.3 25.8 12.8 38.6 100.0 670 36.7 Sex of preceding birth Male 5.1 7.1 15.9 14.2 57.7 100.0 4,898 54.6 Female 6.2 7.1 16.7 14.4 55.5 100.0 4,913 53.3 Survival of preceding birth Living 4.5 6.8 15.9 14.5 58.3 100.0 9,182 55.5 Dead 21.7 12.0 22.3 11.9 32.1 100.0 629 30.9 Residence Urban 6.6 7.4 15.9 14.4 55.7 100.0 4,417 52.5 Rural 4.9 6.9 16.6 14.3 57.4 100.0 5,395 55.1 Education No education 9.0 7.2 13.8 14.2 55.8 100.0 617 54.8 Some primary 5.9 5.4 17.5 13.9 57.2 100.0 1,855 55.7 Completed primary 3.7 6.5 14.0 13.8 62.0 100.0 3,425 58.9 Some secondary 6.0 7.8 17.9 13.2 55.1 100.0 1,710 51.8 Secondary + 7.3 9.1 18.2 16.4 49.0 100.0 2,205 47.6 Total 5.6 7.1 16.3 14.3 56.6 100.0 9,811 54.2 Note: First-order births are excluded. The interval for multiple births is the number of months since the preceding pregnancy that ended in a live birth. Appendix Table A.4.2 shows that median birth intervals vary substantially across provinces, ranging from 38 months in North Sumatera and South Sulawesi to 69 months in East Java. 4.4 AGE AT FIRST BIRTH One of the factors that determine the fertility in a population is the average age at first birth. Women who marry early are typically exposed to pregnancy for a longer period. Thus, early childbearing generally leads to a large family size and is often associated with increased health risks for the mother and child. A rise in the median age at first birth is typically a sign of transition to lower fertility levels. Fertility | 49 Table 4.6 presents the percentage of women who have given birth by specified ages and the me- dian age at first birth, according to current age. The results indicate that women are delaying having their first child. The distribution is similar to that in the 1997 IDHS and shows that the prevalence of early childbearing has declined over time. While 7 percent of women age 45-49 had their first child by age 15, less than 1 percent of women age 15-19 did so. Again, the percentage of women who had their first child by age 18 years is highest among women age 45-49 (30 percent) and lowest among women age 20-24 (12 percent). The increase in the median age at first birth among Indonesian women can also be observed in the last column of Table 4.6—20.1 years for women age 45-49 to 21.9 years for women age 25-29. Table 4.6 Age at first birth Among all women, percentage who gave birth by exact age, and median age at first birth, by current age, Indonesia 2002-2003 Percentage who gave birth by exact age Current age 15 18 20 22 25 Percentage who have never given birth Number of women Median age at first birth 15-19 0.7 na na na na 91.7 6,531 a 20-24 1.3 11.9 27.5 na na 52.0 6,593 a 25-29 2.5 14.9 32.9 51.1 70.5 20.0 6,234 21.9 30-34 4.2 18.4 35.9 53.6 72.1 10.7 5,767 21.6 35-39 4.9 24.3 43.1 59.5 76.2 6.6 5,342 20.9 40-44 7.0 27.5 47.5 65.4 81.5 5.5 4,679 20.2 45-49 7.0 30.2 49.5 66.1 81.9 4.9 4,168 20.1 na = Not applicable a Omitted because less than 50 percent of women had a birth before reaching the beginning of the age group Table 4.7 presents data on differentials in median age at first birth among women age 25-49 by age, residence, and education. Results of the 2002-2003 IDHS indicate that there are wide differences in the age at which women have their first child. Overall, the median age at first birth is 21.0 years, which is slightly higher than the results of the 1997 IDHS and 1994 IDHS (20.8 and 20.3 years, respectively). Ur- ban women start childbearing two years later than their rural counterparts (22.0 years compared with 20.2 years). A positive relationship exists between educational level and median age at first birth. Women with secondary or higher education start childbearing about six years later (median age 25 years) than do women with no education or some primary education (median ages 19.4 and 19.2 years, respectively). This relationship is true for all age groups. Appendix Table A.4.3 shows the median age at first birth among women age 25-49 by province. The median age at first birth varies substantially by province, ranging from 19.8 years in West Java to 23.2 years in East Nusa Tenggara. West Java is the only province where the median age at first birth is less than 20.0 years. 50 | Fertility Table 4.7 Median age at first birth Median age at first birth among women age 25-49, by current age, residence, and education, Indonesia 2002-2003 Current age Residence/education 25-20 30-34 35-39 40-44 45-49 Women age 25-49 Residence Urban 23.2 22.9 21.8 20.7 20.7 22.0 Rural 20.7 20.5 20.0 19.8 19.6 20.2 Education No education 19.4 19.3 18.5 19.5 19.9 19.4 Some primary 19.2 18.7 19.4 19.2 19.3 19.2 Completed primary 20.1 20.2 19.7 19.8 19.4 19.9 Some secondary 21.5 21.5 21.2 20.9 20.6 21.2 Secondary + a 25.3 24.8 24.1 23.8 25.0 Total 21.9 21.6 20.9 20.2 20.1 21.0 a Omitted because less than 50 percent of the women had a birth before reaching the be- ginning of the age group 4.5 TEENAGE FERTILITY The issue of adolescent fertility is important for both health and social reasons. Adolescent child- bearing has potentially negative demographic and social consequences. Children born to very young mothers face an increased risk of illness and death. Teenage mothers themselves, especially those under age 18, are more likely to experience adverse pregnancy outcomes and maternity-related mortality than more mature women. In addition, early childbearing limits a teenager’s ability to pursue educational op- portunities and also can limit her access to job opportunities. Table 4.8 shows the percentage of women age 15-19 who are mothers or pregnant with their first child by background characteristics. Teenagers who have never married are assumed to have had no preg- nancies and no births. Findings show that 10 percent of adolescent women have started childbearing: 8 percent are already mothers, and 2 percent are currently pregnant with their first child. Since 1997, there has been a slight decrease in the proportion of adolescents who have begun childbearing—from 12 per- cent in the 1997 IDHS to the current level of 10 percent. The proportion of teenagers already on the family formation pathway rises very rapidly with age. While only 1 percent of 15-year-olds have started childbearing, 25 percent of women have had a baby or are pregnant with their first child by age 19. There is a substantial difference in fertility among teenagers who live in urban and rural areas. In rural areas the proportion of teenagers who have started childbearing is twice the proportion in urban ar- eas (14 and 7 percent, respectively). Women’s educational attainment is inversely related to the initiation of childbearing; women with less education are more likely to have begun childbearing during adolescence than women with higher education. While 14 percent of women with no formal education have become mothers, only 4 percent of women with secondary or higher education have done so. Fertility | 51 Table 4.8 Teenage pregnancy and motherhood Percentage of women age 15-19 who are mothers or pregnant with their first child, by background characteristics, Indonesia 2002-2003 Percentage who are: Background characteristic Mothers Pregnant with first child Percentage who have begun childbearing Number of women Age 15 0.7 0.5 1.2 1,223 16 1.5 1.0 2.5 1,328 17 4.2 2.4 6.6 1,254 18 13.6 2.4 16.0 1,463 19 20.9 3.8 24.7 1,263 Residence Urban 6.4 0.9 7.3 3,297 Rural 10.5 3.2 13.7 3,191 Education No education 13.5 0.1 13.6 81 Some primary 12.8 3.4 16.2 452 Completed primary 18.5 4.2 22.7 1,240 Some secondary 5.4 1.3 6.7 3,860 Secondary+ 4.0 1.6 5.7 910 Total 8.3 2.0 10.4 6,531 Variation in teenage pregnancy and motherhood also exists among provinces. Appendix Table A.4.4 shows that the highest percentage of teenagers who have begun childbearing is in Central Kaliman- tan (19 percent) and Jambi (18 percent), while the lowest is in North Sumatera (4 percent) and DKI Jakarta (5 percent). 52 | Fertility KNOWLEDGE AND EVER USE OF FAMILY PLANNING 5 5.1 KNOWLEDGE OF FAMILY PLANNING METHODS Acquiring knowledge about fertility control is an important step toward gaining access to contra- ceptive methods and using a suitable method in a timely and effective matter. In the 2002-2003 Indonesia Demographic and Health Survey (IDHS), data on knowledge of family planning methods were obtained by first asking the respondent to name the ways that a couple can use to delay or avoid a pregnancy or birth. If the respondent did not spontaneously mention a particular method, the interviewer described the method and asked the respondent if she recognized it. Descriptions were included in the questionnaire for nine modern family planning methods: female sterilization, male sterilization, the pill, intrauterine device (IUD), injectables, implants, condom, intravag/diaphragm, and lactational amenorrhea method (LAM). Information was also collected on two traditional methods: periodic abstinence and withdrawal. All other traditional or folk methods mentioned by the respondent, such as herbs (jamu) and abdominal massage (pijat), were recorded as well. Table 5.1 presents knowledge of contraceptive methods for ever-married and currently married women, as well as for currently married men. The results show that almost all ever-married and currently married women (99 percent each) know at least one method of family planning. Simi- lar proportions of ever-married women (98 percent) and currently married women (99 percent) have knowledge of at least one modern method. Knowledge of at least one contraceptive method or a modern method is almost universal among currently married men (97 and 96 percent, respectively). About four in ten of both women and men know at least one traditional method. Table 5.1 Knowledge of contraceptive methods Percentage of ever-married women, currently married women, and currently married men who know any contraceptive method, by spe- cific method, Indonesia 2002-2003 Method Ever- married women Currently married women Currently married men Any method 98.5 98.7 96.7 Any modern method 98.4 98.5 96.3 Female sterilization 63.1 63.6 44.1 Male sterilization 38.6 39.0 31.9 Pill 96.2 96.4 90.5 IUD 87.0 87.4 73.9 Injectables 96.9 97.1 90.5 Implants 86.7 87.1 63.1 Male condom 75.6 76.3 82.3 Diaphragm 12.0 12.2 8.6 Lactational amenorrhea (LAM) 20.0 20.3 12.3 Any traditional method 41.0 41.6 37.0 Periodic abstinence 33.4 33.9 30.0 Withdrawal 25.7 26.1 22.9 Folk method 7.0 7.1 3.0 Mean number of methods known 6.4 6.5 5.5 Number of women/men 29,483 27,857 8,310 The most widely known methods among both ever-married and currently married women are injectables and the pill (97 and 96 percent, respectively). The IUD and implants are also commonly known among women (87 percent each for ever- married and currently married women). LAM (20 percent) and diaphragm (12 per- cent) are the least known methods among both ever-married and currently married women. Knowledge of contraceptive methods among men shows a pattern similar to that among women. The pill and injectables are the most well-known methods among men (91 percent each), followed by the male condom (82 percent). LAM (12 percent) and the diaphragm (9 percent) are the least-known methods among currently married among men. In general, women are more knowledgeable about contraceptive Knowledge and Ever Use of Family Planning | 53 methods than men. The average number of methods known for currently married women is 6.5, compared with an average of 5.5 methods among currently married men. Figure 5.1 shows that knowledge of contraceptive methods among married women has continued to increase since 1991. Knowledge of implants increased significantly during the last decade—from 68 percent in 1991 to the current level of 87 percent. The level of knowledge of male condoms and in- jectables has also increased noticeably since the 1991 IDHS. Figure 5.1 Percentage of Currently Married Women Who Know Specific Modern Contraceptive Methods, Indonesia 1991 and 2003 88 91 83 68 64 55 30 97 96 87 87 76 64 39 Injectables Pill IUD Implants Condom Female sterilization Male sterilization 0 20 40 60 80 100 Percent 1991 IDHS 2002-2003 IDHS Note: The 2002-2003 IDHS did not include Nanggroe Aceh Darussalam, Maluku, North Maluku, and Papua province. Previous surveys included East Timor. Table 5.2 presents the percentage of currently married women and currently married men who know of at least one contraceptive method by several background characteristics. Almost all currently married women and 96 percent of currently married men know at least one modern method of family planning methods. Among married women, knowledge is slightly lower among younger and older women than among women in their 20s and 30s. This pattern is also true for knowledge of modern contraceptive methods. Among women, knowledge of at least one modern family planning method is universally high (95 percent or more) among all subgroups of currently married women and there is not much variation by background characteristics. For currently married men, knowledge of any contraceptive method and of any modern method decreases slightly with age. Moreover, rural men, those with no education or some primary education, and men in the lowest wealth index quintile have slightly lower levels of knowledge of family planning meth- ods than other men. 54 | Knowledge and Ever Use of Family Planning Table 5.2 Knowledge of contraceptive methods by background characteristics Percentage of currently married women and percentage of currently married men who know at least one contraceptive method and who know at least one modern method by background characteristics, Indonesia 2002-2003 Currently married women Currently married men Background characteristic Knows any method Knows any modern method1 Number Knows any method Knows any modern method1 Number Age 15-19 97.1 97.1 912 * * 11 20-24 99.1 99.1 3,761 97.4 97.3 426 25-29 99.4 99.4 5,217 97.6 97.5 1,214 30-34 99.4 99.3 5,150 98.3 98.0 1,462 35-39 98.8 98.6 4,953 97.6 97.4 1,572 40-44 98.0 97.7 4,294 96.5 96.0 1,395 45-49 97.1 96.9 3,570 94.6 93.8 1,224 50-54 na na 0 94.5 93.9 1,007 Residence Urban 99.3 99.2 12,765 98.4 98.2 3,866 Rural 98.1 98.0 15,093 95.3 94.6 4,444 Education No education 95.6 95.2 2,089 80.0 78.3 341 Some primary 97.5 97.3 5,435 93.7 92.8 1,730 Completed primary 98.9 98.8 9,499 97.0 96.8 2,462 Some secondary 99.3 99.3 4,902 98.8 98.6 1,477 Secondary + 99.9 99.8 5,932 99.7 99.7 2,301 Wealth index quintile Lowest 96.3 96.0 5,737 92.2 90.9 1,772 Second 98.5 98.4 5,478 96.0 95.9 1,627 Middle 99.3 99.1 5,482 97.8 97.5 1,669 Fourth 99.6 99.6 5,545 98.6 98.5 1,516 Highest 99.8 99.7 5,614 99.2 99.2 1,725 Total 98.7 98.5 27,857 96.7 96.3 8,310 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. na = Not applicable 1 Female sterilization, male sterilization, pill, IUD, injectables, implants, male condom, diaphragm, and lactational amenorrhea method (LAM) Appendix Table A.5.1 shows that there are only slight differences in contraceptive knowledge among provinces. For currently married women, the knowledge of at least one modern method ranges from 90 percent in East Nusa Tenggara to almost all women in Central Kalimantan. Among currently men, the provincial variations are slightly more pronounced, with the lowest percentage of men who know at least one modern method being in Gorontalo province (84 percent) and the highest in DKI Ja- karta (all men). Knowledge and Ever Use of Family Planning | 55 5.2 EXPOSURE TO FAMILY PLANNING MESSAGES Two important mass media means used to disseminate family planning information in Indonesia include radio and television with spot shows, dramas, reports, discussions, and regular series. The objec- tives of the information, education, and communication (IEC) component of Indonesia’s family planning program include the dissemination of knowledge about family planning in particular and the institution- alization of the “small, happy, and prosperous family” norm in general. IEC activities are conducted through the mass media and through family planning groups and workers. The use of the mass media in- cluding 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. 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 include family plan- ning fieldworkers, fieldwork supervisors, cadres, the head and members of village and subvillage family planning posts. Family planning workers focus their efforts on providing family planning information, promoting use of family planning, and recording service statistics. They operate at the grass root level and work with community organizations such as mothers’ clubs, religious groups, women’s organizations (Pembinaan Kesejahteraan Keluarga (PKK)), and the organization for wives of civil servants (Dharma Wanita). Some of the strategies used to promote family planning awareness and use are the income- generating activities and rewards for long term users, although these strategies are not as widely used as before. In an effort to investigate which sources of family planning information are reaching the targeted population, ever-married women and currently married men in the 2002-2003 IDHS were asked a series of questions on their exposure to such information. Respondents were asked whether they heard or saw a message on family planning on the radio or television, or if they read it in a newspaper or magazine, poster or pamphlet in the six months preceding the survey. Ever-married women and currently married men were also asked whether they had received any family planning messages through personal contact. 5.2.1 Exposure to Mass Media The results are shown in Table 5.3. About half of ever-married women and currently married men have seen a family planning message on television in the past six months, while about one in five (19 percent) of both women and men heard such message on the radio. More men than women are reached by the print media, mainly because men are more literate than women. For example, 23 percent of men read a family planning message in a newspaper or magazine compared with 14 percent of women. Forty-eight percent of ever-married women and 45 percent of currently married men were not exposed to any of these media sources for obtaining family planning information in the past six months. The proportion of ever-married women who have heard family planning information varies somewhat by age. Women age 20-34 are slightly more likely to receive family planning information through any media than women in other age groups. Furthermore, as expected, women who live in rural areas are less likely to be exposed to family planning information through all sources of media than urban women. For instance, 59 percent of women in urban areas watched a family planning message on televi- sion in the last six months versus 39 percent in rural areas. 56 | Knowledge and Ever Use of Family Planning Table 5.3 Exposure to family planning messages Percentage of ever-married women and currently married men who heard or saw a family planning message on the radio or television, or in a newspaper/magazine, poster or pamphlet in the past six months, according to back- ground characteristics, Indonesia 2002-2003 Print media Background characteristic Radio Television Newspaper/ magazine Poster Pamphlet None of the specified media sources Number EVER-MARRIED WOMEN Age 15-19 18.8 52.2 9.8 10.1 3.2 43.1 956 20-24 20.4 53.8 13.2 12.8 5.8 42.4 3,875 25-29 20.9 53.8 17.1 14.9 6.6 41.7 5,375 30-34 21.4 53.0 16.4 15.3 7.8 42.1 5,428 35-39 18.3 47.1 14.0 12.3 6.7 48.6 5,181 40-44 16.7 41.7 10.6 9.1 4.3 55.3 4,581 45-49 15.3 35.3 8.8 7.4 4.0 61.6 4,086 Residence Urban 20.6 59.3 20.6 16.5 8.4 37.1 13,499 Rural 17.6 38.5 7.5 8.4 3.8 57.2 15,984 Education No education 9.1 23.1 0.7 0.8 0.2 74.2 2,335 Some primary 12.6 32.0 2.6 4.5 2.0 64.3 5,902 Completed primary 18.4 45.5 6.9 8.7 2.8 50.9 9,995 Some secondary 21.5 57.4 15.4 14.0 6.5 38.9 5,136 Secondary + 27.6 69.0 38.3 27.9 16.4 25.2 6,114 Total 19.0 48.0 13.5 12.1 5.9 48.0 29,483 CURRENTLY MARRIED MEN Age 15-19 14.4 45.1 12.5 26.3 21.1 50.9 11 20-24 20.7 52.6 17.5 13.9 6.2 42.1 426 25-29 20.5 53.5 26.4 21.3 12.2 40.5 1,214 30-34 22.2 56.7 27.5 22.3 13.5 37.0 1,462 35-39 19.9 54.6 25.3 19.7 11.2 40.1 1,572 40-44 19.1 48.2 23.0 19.1 12.2 46.0 1,395 45-49 15.5 41.3 17.6 13.8 8.0 54.6 1,224 50-54 16.3 39.8 16.2 12.5 6.3 55.9 1,007 Residence Urban 20.2 61.3 33.7 25.3 15.3 33.2 3,866 Rural 18.4 39.9 13.3 12.1 6.5 54.8 4,444 Education No education 8.0 16.1 0.3 1.4 0.8 79.5 341 Some primary 12.1 30.4 5.5 3.7 2.6 66.6 1,730 Completed primary 17.7 44.1 12.7 10.1 4.7 51.7 2,462 Some secondary 21.1 55.0 21.6 20.2 12.1 38.2 1,477 Secondary + 26.7 72.4 50.7 39.2 23.4 20.0 2,301 Total 19.2 49.9 22.8 18.3 10.6 44.8 8,310 Knowledge and Ever Use of Family Planning | 57 Women with no formal education or with lower education levels have less access to family plan- ning information through any mass media than those with higher education. For example, 69 percent of women with secondary or higher education saw a family planning message on television, while this is true for only 23 percent of women with no formal education. Thirty-eight percent of women with secon- dary or higher education read a family planning message in a newspaper or magazine in the last six months, compared with only 3 percent of women with some primary education. The pattern of exposure to family planning messages for men is similar to that by women (Table 5.3). Urban men have better access to family planning information through the mass media than rural men. Additionally, education has a positive association with access to family planning information through the media. For example, 72 percent of men with secondary or higher education saw a family planning message on television, compared with only 16 percent of men with no formal education. Appendix Table A.5.2 presents the exposure of women to family planning messages by province. Exposure to family planning messages on the radio ranges from 12 percent in Riau and South Sumatera to 40 percent in Gorontalo. The provincial variation in exposure to family planning messages through televi- sion is more pronounced; 65 percent of ever-married women in Central and East Kalimantan saw a family planning message on television in the last six months, compared with only 12 percent in East Nusa Teng- gara. Provinces with the highest proportion of women who received family planning messages from newspapers and magazines in the preceding six months are North Sulawesi and DKI Jakarta (28 percent each), and the one with the lowest proportion is West Nusa Tenggara (7 percent). Posters are most likely to be reported as a source for family planning messages by women in Bengkulu (25 percent) and the least likely in Southeast Sulawesi (1 percent). It is important to note the large proportion of ever-married women in a few provinces who have not heard or seen a family planning message in any of the media sources in the past six months. Provinces where 60 percent or more women were not exposed to any family planning messages in any of the media include the following: East Nusa Tenggara, Bangka Belitung, Jambi, South Sumatera, Riau, and South- east Sulawesi. Table 5.4 presents data on exposure to family planning messages through personal contacts. In the survey, women were asked whether they receive family planning information from various types of persons, including family planning fieldworkers, teachers, health providers, and community leaders. The proportion of ever-married women who reported receiving family planning messages from these persons is relatively low. The persons mentioned most often are nurses and midwives (11 percent), followed by family planning officers (6 percent), women’s groups (4 percent), and medical doctors (3 percent). Few women (less than 2 percent each) mention religious leaders, village leaders, teachers, and pharmacists as sources of family planning information. This may be because there is more frequent interaction between women and nurses or midwives regarding health-related matters than family planning matters. Contacts with family planning workers are mainly centered on contraceptive issues. Table 5.4 shows that the pattern of family planning dissemination through personal contact by specific persons, according to background characteristics. The pattern of family planning dissemination through personal contact does not vary much by age, except for contact by a nurse or midwife. Women age 20-34 are somewhat more likely to have received a family planning message from a nurse or midwife than women in other age groups. Moreover, rural women are slightly more likely to have received a fam- ily planning message from a family planning officer in the last six months than urban women (7 and 5 percent, respectively). Overall, women with higher education are somewhat more likely to have received family plan- ning information from various sources than less educated women. 58 | Knowledge and Ever Use of Family Planning Provincial differentials in the proportion of women who heard family planning messages through specific persons are shown in Appendix Table A.5.3. The most pronounced variation among provinces is noticed when a family planning officer or a nurse or midwife is the source of the family planning mes- sage. For example, the proportion of women who received a family planning message from a family plan- ning officer in the last six months ranges from 2 percent in North Sumatera to 22 percent in Gorontalo. Furthermore, the percentage of women who received family planning information through a nurse or midwife ranges from 8 percent in Central Java and North Sumatera to 22 percent in Bengkulu. It is nota- ble that about one in ten women in North Sulawesi (11 percent) heard a family planning message from a women’s group (PKK), while this proportion was lower in other provinces. Table 5.4 Exposure to family planning messages through personal contact Percentage of ever-married women who received (heard or saw) a family planning message as a result of contact with specific persons in the past six months, according to background characteristics, Indonesia 2002-2003 Background characteristic Family planning officer Teacher Religious leader Doctor Nurse/ midwife Village leader Women's group Pharma- cist Number of women Age 15-19 4.0 0.7 1.3 2.9 10.0 0.1 1.1 0.9 956 20-24 5.1 0.7 1.2 3.9 13.1 1.7 2.8 0.4 3,875 25-29 6.5 0.5 1.1 3.9 14.4 1.4 4.3 0.3 5,375 30-34 7.6 0.5 2.6 3.7 14.2 2.5 5.2 0.3 5,428 35-39 6.6 0.7 2.1 4.3 10.5 1.8 4.6 0.2 5,181 40-44 5.7 0.5 1.7 2.8 7.8 1.6 4.8 0.0 4,581 45-49 3.7 0.3 1.3 1.6 4.5 1.4 2.8 0.1 4,086 Residence Urban 4.6 0.5 1.6 4.2 10.5 1.2 4.1 0.2 13,499 Rural 7.2 0.6 1.8 2.7 11.4 2.1 4.1 0.3 15,984 Education No education 3.1 0.0 0.3 0.8 4.2 1.2 2.3 0.0 2,335 Some primary 4.7 0.6 1.4 2.0 7.7 1.4 2.7 0.1 5,902 Completed primary 6.7 0.4 2.0 2.7 11.0 1.7 4.7 0.2 9,995 Some secondary 7.0 0.7 1.8 3.6 14.0 2.8 5.4 0.6 5,136 Secondary + 6.2 0.7 1.9 6.7 14.1 1.3 3.9 0.2 6,114 Total 6.0 0.5 1.7 3.4 11.0 1.7 4.1 0.2 29,483 5.2.2 Dissemination of Family Planning Information 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 are generally 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). In the 2002-2003 IDHS, currently married women who were not using contraception were asked whether they were visited by a family planning worker who discussed family planning in the 12 months prior to the survey. Women were also asked whether they had visited a health facility in the last year and, if so, whether a staff person at that facility spoke to them about family planning. This information is use- ful in determining if nonusers of family planning are being reached by family planning programs and ini- tiatives in Indonesia. Knowledge and Ever Use of Family Planning | 59 Table 5.5 shows that only 4 percent of family planning nonusers were visited by a family plan- ning worker who discussed family planning and an equal proportion visited a health facility and discussed family planning with a staff person at that facility. Twenty-two percent of nonusers visited a health facil- ity but did not discuss family planning with any staff member. This is a missed opportunity and may indi- cate that family planning has not been fully integrated into the health services delivery system for women. Table 5.5 Contact of nonusers with family planning providers Percentage of women who are not using contraception who were visited by a fieldworker who discussed family planning, who visited a health facility and discussed family planning, and who visited a health facility but did not discuss family planning, in the 12 months preceding the survey, by background characteristics, Indonesia 2002- 2003 Women who visited a health facility Background characteristic Women who were visited by fieldworker who discussed family planning Discussed family planning Did not discuss family planning Women who did not discuss family planning with a fieldworker or at a health facility Number of women Age 15-19 2.0 4.3 25.9 94.3 525 20-24 4.5 5.0 31.2 91.6 1,591 25-29 5.2 6.9 32.9 90.5 2,006 30-34 4.7 6.3 27.1 91.1 1,977 35-39 4.6 3.8 18.9 92.6 1,931 40-44 2.6 2.6 15.6 95.6 2,007 45-49 3.0 1.3 11.2 96.4 2,564 Residence Urban 3.9 3.7 25.1 93.5 5,672 Rural 4.0 4.5 19.8 93.0 6,928 Education No education 1.5 1.0 10.6 97.6 1,338 Some primary 3.4 2.5 14.6 94.7 2,880 Completed primary 4.5 4.0 20.9 93.1 3,987 Some secondary 5.3 6.4 28.4 90.3 2,080 Secondary + 3.9 6.1 34.8 91.6 2,315 Total 4.0 4.1 22.2 93.2 12,600 Adolescent women (age 15-19) and women age 40-49 are slightly less likely to be visited by a fieldworker who discussed family planning with them. Women age 20-34 are slightly more likely than women in other age groups to have missed the opportunity of discussing family planning with a staff member when they visited a health facility. Moreover, women living in urban areas are somewhat more likely than rural women to have visited a health facility but not discussed family planning during their visit (25 versus 20 percent). Uneducated women are also slightly less likely to visit a health facility and discuss family planning than educated women. 60 | Knowledge and Ever Use of Family Planning The proportion of ever-married women who were visited by a fieldworker who discussed family planning with them in the past 12 months varies moderately by province (Appendix Table A.5.4), and it ranges from 2 percent in North Sumatera, Bangka Belitung, and East Java to 13 percent in Gorontalo. Similarly, women residing in North Sumatera are the least likely to have visited a health facility and have discussed family planning with a staff member (1 percent), while women in Gorontalo are the most likely to have done so (14 percent). 5.4 DISCUSSION OF FAMILY PLANNING WITH HUSBAND Although discussion between husband and wife about contraceptive use is not a precondition for adoption of contraception, its absence may be an impediment to use. Interpersonal communication is thus an important intermediate step along the path to eventual adoption and especially continuation of contra- ceptive use. Lack of discussion may reflect a lack of personal interest, hostility to the subject, or custom- ary reticence in talking about sex-related matters. To explore this subject, currently married women and currently married men in the 2002-2003 IDHS were asked whether they discussed family planning with their spouse in the past 12 months. This information is presented in Table 5.6. The data show that 56 percent of women discussed family planning with their spouse at least once in the past year. Women 20-34 are more likely to discuss family planning more frequently with their husbands than women in other age groups. Forty-three percent of currently married women never discussed family planning with their spouse in the past year. Table 5.6 Discussion of family planning between husband and wife Percent distribution of currently married women who know a contraceptive method by the number of times they discussed family planning with their husband in the past year, and percentage of currently married men who know a contraceptive method who discussed family planning with their wife in the past year, according to current age, Indonesia 2002-2003 Number of times woman discussed family planning with husband Age Never One or two times Three or more times Missing Total Number of women Men who discussed family planning with wife Number of men 15-19 40.1 49.3 9.7 0.8 100.0 886 * 10 20-24 33.2 53.7 12.5 0.7 100.0 3,727 45.6 415 25-29 33.1 53.7 12.3 0.9 100.0 5,186 55.1 1,184 30-34 35.4 51.6 12.2 0.9 100.0 5,118 54.6 1,437 35-39 43.5 46.1 9.8 0.7 100.0 4,893 53.9 1,535 40-44 52.1 39.4 7.2 1.3 100.0 4,207 43.1 1,345 45-49 66.3 28.8 3.8 1.1 100.0 3,466 34.9 1,158 50-54 na na na na 0.0 0 29.6 952 Total 42.7 46.5 9.9 0.9 100.0 27,483 46.3 8,036 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been sup- pressed. na = Not applicable It is interesting to note that women are more likely than men to say that they had discussed family planning with their spouse. Overall, 46 percent of currently married men discussed family planning with their wife in the past 12 months, compared with 56 percent of currently married women. The proportion of currently married women and currently married men who discussed family planning at least once with their spouse varies somewhat by province (Appendix Table A.5.5). For cur- rently married women, the proportion who discussed family planning with their husbands at least once in Knowledge and Ever Use of Family Planning | 61 the past 12 months ranges from 38 percent in Central Java to 77 percent in Gorontalo. Currently married men residing in Bangka Belitung (31 percent) are the least likely to have discussed family planning with their wives, while men in Central Kalimantan are the most likely to have done so (73 percent). 5.5 ATTITUDES OF COUPLES TOWARD FAMILY PLANNING When couples have a positive attitude toward family planning, they are more likely to adopt a family planning method. In the 2002-2003 IDHS survey, currently married women were asked whether they approved of couples using family planning and what they perceived as their husband’s attitude to- ward family planning. This information is important in the formulation of family planning policies since it indicates the extent to which further education and publicity are needed to increase acceptance of family planning. Table 5.7 shows that 94 percent of currently married women who know a contraceptive method approve of couples using contraception and only 4 percent disapprove. About nine in ten (88 percent) cur- rently married women reported that both they and their husband approved of family planning use by cou- ples. Disagreement between women and their husbands is low. Only 2 percent of currently married women said they approve of family planning, but think that their husbands disapprove, and just 1 percent of women disapproved of family planning while their husbands approve. Disapproval of family planning among couples in Indonesian is low (2 percent). Table 5.7 Attitudes toward family planning Percent distribution of currently married women who know of a method of family planning by approval of family planning and their per- ception of their husband's attitude toward family planning, according to background characteristics, Indonesia 2002-2003 Respondent approves of family planning Respondent disapproves of family planning Background characteristic Husband approves Husband disapproves Husband's attitude unknown, missing Husband approves Husband disapproves Husband's attitude unknown, missing Respondent unsure1 Total Number of women Age 15-19 88.1 1.3 5.0 0.7 1.5 0.3 3.1 100.0 886 20-24 90.4 1.6 3.1 0.7 2.3 0.3 1.6 100.0 3,727 25-29 89.5 2.0 2.1 1.5 2.1 0.4 2.4 100.0 5,186 30-34 90.4 1.7 2.5 1.1 2.0 0.1 2.1 100.0 5,118 35-39 87.6 2.4 3.2 1.3 2.1 0.3 3.1 100.0 4,893 40-44 86.8 2.4 4.0 1.0 2.0 0.3 3.5 100.0 4,207 45-49 83.1 2.7 4.9 0.6 4.1 0.4 4.1 100.0 3,466 Residence Urban 89.3 2.3 2.5 0.9 2.6 0.2 2.1 100.0 12,677 Rural 87.2 1.9 3.9 1.2 2.1 0.4 3.3 100.0 14,806 Education No education 78.6 2.6 6.7 1.3 3.2 0.8 6.7 100.0 1,997 Some primary 83.5 2.7 4.5 1.4 3.4 0.4 4.1 100.0 5,297 Completed primary 89.8 2.0 2.8 1.1 2.0 0.2 2.1 100.0 9,396 Some secondary 90.2 2.1 2.7 0.8 1.9 0.2 2.0 100.0 4,870 Secondary + 91.4 1.6 2.1 0.8 1.9 0.2 1.9 100.0 5,923 Total 88.2 2.1 3.2 1.1 2.3 0.3 2.8 100.0 27,483 1 Includes missing 62 | Knowledge and Ever Use of Family Planning Attitudes toward use of family planning among couples does not vary much by age and residence. However, a woman’s education level has a close relationship with the couple’s attitude toward family planning. The percentage of couples who approve of family planning ranges from 79 percent among cou- ples where the woman has no formal education to 91 percent among couples where the wife has a secon- dary or higher education. 5.6 KNOWLEDGE OF THE FERTILE PERIOD A basic knowledge of female reproductive physiology and the fertile period is useful for the suc- cessful practice of periodic abstinence. The success of periodic abstinence as a family planning method depends on women’s and men’s understanding of the monthly cycle and the days when a woman is most likely to conceive. In the 2002-2003 IDHS, ever-married women were asked about their knowledge of a woman’s fertile period. Table 5.8 presents the percent distribution of ever-married women and currently married men by knowledge of the fertile period during the ovulatory cycle, according to current use or nonuse of periodic abstinence. Table 5.8 Knowledge of fertile period Percent distribution of ever-married women and currently married men by knowledge of the fertile period during the ovulatory cycle, according to current use/nonuse of periodic abstinence, Indonesia 2002-2003 Women Men Perceived fertile period Users of periodic abstinence Nonusers of periodic abstinence All women Users of periodic abstinence Nonusers of periodic abstinence All men Just before period begins 2.8 3.4 3.4 6.5 2.2 2.2 During her period 0.5 0.3 0.3 0.0 0.2 0.2 Right after period has ended 18.5 14.1 14.2 19.0 18.1 18.1 Halfway between two periods 64.9 15.6 16.4 56.2 14.7 15.5 Other 0.0 0.0 0.0 0.0 0.0 0.0 No specific time 6.4 30.0 29.6 1.1 11.9 11.7 Don't know 6.9 36.4 36.0 16.5 52.7 52.0 Missing 0.0 0.1 0.1 0.7 0.2 0.2 Total 100.0 100.0 100.0 100.0 100.0 100.0 Number of women and men 445 29,038 29,483 164 8,146 8,310 The findings show that accurate knowledge of the reproductive cycle is generally limited, which indicates that there is still a significant need for educating women and men about mechanisms of repro- duction and the fertile period. Only 16 percent of ever-married women and currently married men gave the “correct” response that a woman has the greatest chance of becoming pregnant in the middle of her ovulatory cycle. Overall, 36 percent of ever-married women and 52 percent of currently married men do not know when a woman is most likely to conceive during the menstrual cycle. As expected, women and men who are using periodic abstinence are considerably more knowl- edgeable about the ovulatory cycle than women and men in general. Sixty-five percent of women who are using periodic abstinence have correct knowledge of the fertile period, compared with 16 percent of women who are not using such method. The corresponding figure for men is 56 percent and 15 percent, respectively. Knowledge of the fertile period among women who are using periodic abstinence is almost the same as in the 1997 IDHS (16 percent of women who were using any method and 67 percent of cur- rently married women who were using periodic abstinence gave the correct response). Knowledge and Ever Use of Family Planning | 63 5.7 EVER USE OF CONTRACEPTION All women interviewed in the 2002-2003 IDHS survey who reported that they had heard of a method of family planning were asked whether they had ever used that method. This information on ever use of contraception is useful for planning and evaluating family planning programs. Table 5.9 shows the percentage of ever-married women and currently married women who have ever used any contraceptive method, by specific method. w 7 ce fo je n ri p tr a m 64 | Knowl Findings show that 80 percent of ever-married women and 82 percent of currently married omen reported having used a method at some time. Moreover, 78 percent of ever-married women and 9 percent of currently married women reported having used a modern method at some time. The per- ntage of ever users of any method in 2002-2003 increased slightly from the level in 1997 (76 percent r ever-married women and 78 percent for currently married women). Table 5.9 Ever use of contraception Percentage of ever-married women and of currently married women who have ever used a contraceptive method, by specific method and age, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Modern method Traditional method ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– ––––––––––––––––––––––– Using Female Any Any any Any steri- Male In- Male tradi- Periodic folk Number meth- modern liza- steri- ject- Im- con- Dia- tional absti- With- meth- of Age od method tion lization Pill IUD ables plants dom phragm LAM method nence drawal od Total women –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– EVER-MARRIED WOMEN –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 15-19 59.0 58.3 0.0 0.0 24.2 1.0 43.5 1.5 1.5 0.0 0.2 2.4 0.2 1.6 0.8 100.0 956 20-24 75.3 73.8 0.0 0.1 30.6 3.1 58.9 5.1 1.7 0.0 1.6 5.2 1.7 2.9 1.2 100.0 3,875 25-29 83.2 81.7 0.3 0.1 42.1 6.5 63.6 9.2 2.8 0.2 1.9 7.6 2.6 4.6 1.6 100.0 5,375 30-34 85.4 83.1 1.5 0.5 44.5 13.9 61.1 11.0 5.1 0.4 2.3 9.0 3.9 5.2 1.2 100.0 5,428 35-39 84.8 82.7 5.2 0.6 44.2 20.5 53.8 12.2 4.6 0.3 2.6 10.2 4.9 5.0 2.2 100.0 5,181 40-44 80.1 77.4 7.8 1.3 43.2 24.1 42.4 10.5 4.9 0.4 2.5 11.2 5.3 5.3 2.7 100.0 4,581 45-49 70.7 67.8 8.4 1.2 36.4 23.0 29.6 6.2 4.3 0.3 1.7 8.4 4.4 3.8 1.8 100.0 4,086 Total 79.9 77.7 3.6 0.6 40.2 14.7 52.2 9.0 3.9 0.3 2.1 8.5 3.7 4.5 1.8 100.0 29,483 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– CURRENTLY MARRIED WOMEN –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 15-19 60.6 59.9 0.0 0.0 24.6 1.1 44.7 1.6 1.6 0.0 0.2 2.4 0.2 1.7 0.7 100.0 912 20-24 75.7 74.2 0.0 0.1 30.3 3.1 59.6 5.2 1.7 0.0 1.6 5.3 1.7 3.0 1.2 100.0 3,761 25-29 84.4 82.9 0.4 0.1 42.7 6.7 64.7 9.3 2.9 0.2 2.0 7.7 2.6 4.7 1.7 100.0 5,217 30-34 87.3 84.9 1.6 0.6 45.6 14.4 62.7 11.3 5.3 0.4 2.4 9.3 4.1 5.4 1.2 100.0 5,150 35-39 86.1 83.9 5.4 0.6 45.0 20.9 54.8 12.5 4.6 0.3 2.6 10.4 5.0 5.1 2.2 100.0 4,953 40-44 82.8 80.0 8.2 1.3 44.8 24.9 44.2 10.8 5.1 0.4 2.7 11.7 5.5 5.5 2.8 100.0 4,294 45-49 73.0 70.0 8.9 1.2 37.3 24.2 30.8 6.3 4.4 0.2 1.8 8.8 4.5 4.2 1.8 100.0 3,570 Total 81.6 79.4 3.7 0.6 41.0 15.0 53.7 9.3 4.0 0.3 2.2 8.7 3.8 4.6 1.8 100.0 27,857 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– LAM = Lactational amenorrhea method The methods most commonly used by ever-married women and currently married women are in- ctables (52 and 54 percent, respectively), followed by the pill (40 and 41 percent, respectively). The ext two most commonly used methods are the IUD (15 percent for both ever-married and currently mar- ed women) and implants (9 percent for both ever-married and currently married women). Much smaller roportions of women report having used a condom, female sterilization, or male sterilization. Use of aditional methods is limited. Overall, 9 percent of ever-married and currently married women have used traditional method at some time. Withdrawal was used by 5 percent of both ever-married and currently arried women at some time and periodic abstinence was used by 4 percent. edge and Ever Use of Family Planning There has been a slight change in ever use of contraception among ever-married women since 1997. The 1997 IDHS found that the most commonly used method among ever-married women was the pill (43 percent) followed by injectables (42 percent), while the 2002-2003 findings indicate that for ever- married women, injectables are now the most widespread method (52 percent), followed by the pill (40 percent). Table 5.10 shows the distribution of ever-married women who have ever used of contraception according to the number of living children when they first used family planning. The table is used primar- ily to identify the acceptance of the small family norm and the use of family planning as a method for spacing births. Sixty-three percent of ever-married women started using family planning before they had two children, 18 percent of women used family planning for the first time when they had two children, and 19 percent used it after they had three or more children. Younger women tend to start using family planning when they have fewer children. While less than one percent of women age 45-49 years used contraception when they did not have any children, the corresponding proportion of women age 15-19 and 20-24 is 33 percent and 16 percent, respectively. It is interesting to note that one in five women age 40-44 and one in three women age 45-49 started using contraception after had four or more children. Table 5.10 Number of children at first use of contraception Percent distribution of women who have ever used contraception by number of living children at the time of first use of contraception, according to current age, Indonesia 2002-2003 Number of living children at time of first use of contraception Current age 0 1 2 3 4+ Missing Total Number of women 15-19 32.8 65.1 2.1 0.0 0.0 0.0 100.0 564 20-24 16.4 76.7 6.1 0.6 0.1 0.1 100.0 2,918 25-29 7.5 75.3 12.7 3.7 0.8 0.1 100.0 4,473 30-34 4.5 66.2 19.2 6.1 3.9 0.1 100.0 4,637 35-39 1.9 50.8 24.5 12.6 9.8 0.4 100.0 4,394 40-44 2.6 36.2 24.2 16.1 20.8 0.1 100.0 3,671 45-49 0.7 25.4 20.1 20.8 32.7 0.2 100.0 2,888 Total 6.0 56.6 17.8 9.4 10.0 0.1 100.0 23,544 Knowledge and Ever Use of Family Planning | 65 f f p i r c c a m c u f ( CURRENT USE OF FAMILY PLANNING 6 Information on the current level of contraceptive use (or contraceptive prevalence) is important or measuring the success of the National Family Planning Movement. Contraceptive prevalence is de- ined as the proportion of currently married women age 15-49 who were using some method of family lanning at the time of the survey. This chapter presents data concerning levels, trends, and differentials n current use; sources of family planning methods; age at time of first contraceptive use; accessibility; easons for using a particular method; and some indicators of the quality of use of the pill, injectables, and ondom. 6.1 CURRENT USE OF FAMILY PLANNING Table 6.1 shows the percent distribution of ever-married and currently married women who are urrently using specific family planning methods by age. Results indicate that 57 percent of ever-married nd 60 percent of currently married women are using contraception. Furthermore, 54 percent of ever- arried and 57 percent of currently married women use modern methods. Traditional methods are not ommonly used in Indonesia; only 3 percent of ever-married and 4 percent of currently married women se any traditional methods. Among modern methods, injectables are the most commonly used method or both ever-married and currently married women (26 and 28 percent, respectively), followed by the pill 13 percent for both ever-married and currently married women). Table 6.1 Current use of contraception Percent distribution of ever-married women and of currently married women by contraceptive method currently used, according to age, Indone- sia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Modern method Traditional method ––––––––––––––––––––––––––––––––––––––––––––––––––––––––– ––––––––––––––––––––––– Using Female Any Any any Any steri- Male In- Male tradi- Periodic folk Not Number meth- modern liza- steri- ject- Im- con- tional absti- With- meth- currently of Age od method tion lization Pill IUD ables plants dom LAM method nence drawal od using Total women –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– EVER-MARRIED WOMEN –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 15-19 45.1 44.6 0.0 0.0 12.5 0.8 30.0 0.6 0.5 0.1 0.5 0.0 0.3 0.1 54.9 100.0 956 20-24 59.0 57.2 0.0 0.1 11.5 1.7 40.1 3.4 0.3 0.1 1.8 0.8 0.5 0.4 41.0 100.0 3,875 25-29 62.7 60.5 0.3 0.1 15.1 3.4 35.9 4.9 0.6 0.2 2.2 0.8 1.1 0.3 37.3 100.0 5,375 30-34 63.6 60.0 1.5 0.1 15.7 5.9 30.5 4.8 1.3 0.2 3.5 1.7 1.6 0.2 36.4 100.0 5,428 35-39 62.7 58.0 5.2 0.5 13.1 8.2 24.6 5.3 0.9 0.2 4.7 2.2 2.1 0.5 37.3 100.0 5,181 40-44 56.2 51.0 7.8 1.0 11.1 9.3 16.5 4.5 0.9 0.0 5.2 2.2 2.1 1.0 43.8 100.0 4,581 45-49 37.3 34.0 8.4 1.0 6.8 7.5 7.6 1.8 0.9 0.0 3.3 1.6 1.3 0.4 62.7 100.0 4,086 Total 57.3 53.9 3.6 0.4 12.5 5.9 26.4 4.1 0.8 0.1 3.4 1.5 1.4 0.5 42.7 100.0 29,483 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– CURRENTLY MARRIED WOMEN –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 15-19 47.3 46.8 0.0 0.0 13.2 0.9 31.5 0.7 0.5 0.1 0.5 0.0 0.4 0.1 52.7 100.0 912 20-24 60.7 58.9 0.0 0.1 11.8 1.8 41.3 3.5 0.3 0.1 1.8 0.9 0.5 0.4 39.3 100.0 3,761 25-29 64.5 62.2 0.4 0.1 15.6 3.5 36.9 5.0 0.6 0.2 2.3 0.8 1.1 0.4 35.5 100.0 5,217 30-34 66.7 63.0 1.6 0.1 16.5 6.2 32.1 4.9 1.4 0.2 3.7 1.8 1.7 0.2 33.3 100.0 5,150 35-39 65.4 60.5 5.4 0.5 13.7 8.5 25.7 5.5 0.9 0.2 5.0 2.3 2.1 0.6 34.6 100.0 4,953 40-44 59.6 54.0 8.2 1.0 11.9 9.7 17.6 4.8 0.9 0.0 5.6 2.3 2.2 1.1 40.4 100.0 4,294 45-49 41.7 38.0 8.9 1.1 7.7 8.5 8.7 2.0 1.0 0.0 3.8 1.9 1.5 0.4 58.3 100.0 3,570 Total 60.3 56.7 3.7 0.4 13.2 6.2 27.8 4.3 0.9 0.1 3.6 1.6 1.5 0.5 39.7 100.0 27,857 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: If more than one method is used, only the most effective method is considered in this tabulation. LAM = Lactational amenorrhea method Current Use of Family Planning | 67 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 (20 to 39 years). In- 68 jectables, the pill, and implants are more popular among younger women, whereas older women tend to use long-term methods such as the intrauterine device (IUD), female sterilization, and male sterilization. Compared with the 1997 Indonesia Demographic Health Survey (IDHS) data, use of injectables has increased by 7 percentage points, whereas use of IUD and implants has decreased by 2 percentage points each. Data from the 2002-2003 IDHS at the national level and for selected provinces cannot be directly compared with those collected in past IDHS surveys because of different geographical coverage. The current survey does not include Nanggroe Aceh Darussalam, Maluku, North Maluku, and Papua provinces, as well as the former province of East Timor. Furthermore, the following new provinces split off from existing provinces: Bangka-Belitung from South Sumatera, Banten from West Java, and Goron- talo from North Sulawesi. The prevalence of modern contraceptive use in the provinces covered in the 2002-2003 IDHS is 6 percentage points higher than that in the 1997 IDHS for ever-married women (57 percent versus 51 percent) and 2 percentage points higher for currently married women (57 percent versus 55 percent). Table 6.2 and Figure 6.1 show that use of family planning is virtually the same in urban and rural areas (61 and 60 percent, respectively). However, the mix of methods differs, with urban women relying more on the use of IUDs and female sterilization, and rural women relying more on the use of injectables and implants. Table 6.2 Current use of contraception by background characteristics Percent distribution of currently married women by contraceptive method currently used, according to background characteristics, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Modern method Traditional method ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– ––––––––––––––––––––––– Using Female Any Any any Any steri- Male In- Male tradi- Periodic folk Not Number Background meth- modern liza- steri- ject- Im- con- tional absti- With- meth- currently of characteristic od method tion lization Pill IUD ables plants dom LAM method nence drawal od using Total women –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Residence Urban 61.1 57.0 4.8 0.2 14.1 7.9 26.0 2.3 1.6 0.1 4.1 2.3 1.4 0.4 38.9 100.0 12,765 Rural 59.7 56.5 2.8 0.7 12.5 4.7 29.4 6.0 0.3 0.2 3.2 1.0 1.6 0.6 40.3 100.0 15,093 Education No education 47.0 44.8 3.3 0.9 9.9 5.8 19.1 5.6 0.0 0.2 2.3 0.4 0.9 1.0 53.0 100.0 2,089 Some primary 55.3 52.6 3.7 0.9 12.9 5.0 23.9 5.9 0.3 0.0 2.8 0.5 1.5 0.8 44.7 100.0 5,435 Completed primary 63.0 60.3 3.8 0.4 14.9 4.1 31.6 4.7 0.6 0.2 2.7 1.0 1.2 0.4 37.0 100.0 9,499 Some secondary 62.1 58.1 2.9 0.3 13.8 5.1 31.5 3.9 0.6 0.1 3.9 1.7 1.8 0.5 37.9 100.0 4,902 Secondary + 63.9 57.8 4.4 0.1 11.6 11.6 25.5 2.1 2.4 0.1 6.1 3.8 2.0 0.2 36.1 100.0 5,932 Number of living children 0 7.0 6.7 0.0 0.0 2.9 0.2 3.0 0.0 0.5 0.0 0.3 0.3 0.1 0.0 93.0 100.0 2,208 1-2 66.8 63.4 1.2 0.2 15.1 6.4 34.8 4.7 0.8 0.1 3.4 1.7 1.3 0.4 33.2 100.0 14,581 3-4 67.5 62.9 7.8 0.8 14.3 8.1 25.5 5.1 1.2 0.2 4.6 1.6 2.3 0.7 32.5 100.0 7,966 5+ 49.4 44.9 7.9 1.1 9.1 3.9 18.8 3.5 0.5 0.1 4.5 2.2 1.7 0.7 50.6 100.0 3,102 Wealth index quintile Lowest 52.4 48.6 1.5 0.7 12.1 3.1 24.4 6.4 0.1 0.2 3.9 1.1 1.8 0.9 47.6 100.0 5,737 Lower middle 60.1 57.9 2.8 0.6 13.2 5.1 29.6 6.4 0.1 0.2 2.2 0.7 1.2 0.3 39.9 100.0 5,478 Middle 62.9 60.0 3.4 0.4 14.2 4.7 32.4 4.2 0.6 0.1 2.9 0.9 1.6 0.4 37.1 100.0 5,482 Upper middle 63.0 59.3 4.5 0.1 15.4 4.2 31.0 2.9 1.2 0.1 3.6 1.5 1.8 0.4 37.0 100.0 5,545 Highest 63.5 58.1 6.5 0.4 11.5 13.7 22.2 1.6 2.2 0.1 5.4 3.7 1.2 0.4 36.5 100.0 5,614 Total 60.3 56.7 3.7 0.4 13.2 6.2 27.8 4.3 0.9 0.1 3.6 1.6 1.5 0.5 39.7 100.0 27,857 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: If more than one method is used, only the most effective method is considered in this tabulation. LAM = Lactational amenorrhea method | Current Use of Family Planning 60 61 60 47 55 63 62 64 7 67 68 49 INDONESIA RESIDENCE Urban Rural EDUCATION No Education Some Primary Completed Primary Some Secondary Secondary + NUMBER OF CHILDREN 0 1-2 3-4 5+ 0 20 40 60 8 Percent IDHS 2002-2003 Figure 6.1 Percentage of Currently Married Women Age 15-49 Who are Using a Contraceptive Method 0 Table 6.2 also shows that contraceptive use increases with the respondent's level of education. Forty-seven percent of currently married women with no education are using a modern method, compared with 64 percent of women with secondary or higher education. The type of contraceptive being used also varies by women's level of education. Generally, the use of any of the modern methods increases with woman’s level of education, with the exception of implants and male sterilization where the reverse is true. Contraceptive use increases rapidly with the number of living children a woman has. Use of any method ranges from 7 percent among women with no living children to 68 percent for women with three to four children, after which it declines to 49 percent for women with five or more children. The most popular family planning methods among childless women are the pill and injectables. Use of injectables increases significantly after the first child from 3 percent among childless women to 35 percent among those with one or two children. It is noticeable that the proportion of women who use female sterilization increases from one percent for women who have one or two children to 8 percent for those with three or more children. Overall, use of any method of family planning increases with increasing wealth index quintile from 52 percent for women in the lowest quintile to 64 percent for those in the highest. Appendix Table A.6.1 shows the percent distribution of currently married women by contracep- tive method, according to province. Contraceptive use varies among provinces; it ranges from 35 percent in East Nusa Tenggara to 76 percent in DI Yogyakarta. Use of modern methods is the lowest in East Nusa Tenggara (28 percent) and the highest in North Sulawesi (66 percent). The 2002-2003 IDHS also collected information about use of male methods of family planning among currently married men. Figure 6.2 shows that use of male methods of family planning in Indonesia is limited. The most popular methods are periodic abstinence (2 percent) and withdrawal (2 percent). Only 1 percent of maried men use condoms. Current Use of Family Planning | 69 Figu 6.2 TRENDS IN Table 6.3 a women who are cu 2003. Findings show in the 1991 IDHS to ern family planning use increased slight rently married wom 70 | Current Use of Family Planning re 6.2 Percentage of Currently Married Men Age 15-54 Who Are Using a Contraceptive Method 1 2 2 Condom Periodic Withdrawal 0 1 2 3 Pe rc en t abstinence IDHS 2002-2003 CONTRACEPTIVE USE nd Figure 6.3 show the trend in use of specific contraceptive methods among married rrently using a specific contraceptive method, by method, during the period 1991- that use of any method by currently married women has increased from 50 percent 60 percent in the 2002-2003 IDHS. There has been a shift in the use of specific mod- methods. In 1991, the pill was used by 15 percent of currently married women; pill ly between 1991 and 1994, and has steadily decreased since, with 13 percent of cur- en using it in the 2002-2003 IDHS. Use of the IUD has also decreased steadily Table 6.3 Trends in use of specific contraceptive methods: Indonesia 1991-2003 Percentage of currenty married women who are currently using a specific contra- ceptive methods, by method, Indonesia 1991-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– IDHS IDHS IDHS IDHS Method 1991 1994 1997 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Any method 49.7 54.7 57.4 60.3 Pill 14.8 17.1 15.4 13.2 IUD 13.3 10.3 8.1 6.2 Injectables 11.7 15.2 21.1 27.8 Condom 0.8 0.9 0.7 0.9 Implants 3.1 4.9 6.0 4.3 Female sterilization 2.7 3.1 3.0 3.7 Male sterilization 0.6 0.7 0.4 0.4 Periodic abstinence 1.1 1.1 1.1 1.6 Withdrawal 0.7 0.8 0.8 1.5 Other 0.9 0.8 0.8 0.5 Number of women 21,109 26,186 26,886 27,857 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: The 2002-2003 IDHS did not include Nanggroe Aceh Darussalam, Maluku, North Maluku, and Papua province. Previous surveys included East Timor. during the past 20 years, from 13 percent in 1991 to a current rate of 6 percent. On the other hand, use of injectables has increased significantly in the past two decades, from 12 percent in 1991 to 28 percent in 2002-2003. The pill was the most commonly used modern method by currently married women in the 1991 IDHS, while injectables are the most commonly used modern method reported by currently married women in the 2002-2003 IDHS. 15 8 21 1 6 3 0 1 1 13 6 28 1 4 4 0 2 2 Pill IUD Injectables Condom Implants Female sterilization Male sterilization Periodic abstinence Withdrawal 0 5 10 15 20 25 30 Percent 1997 IDHS 2002-2003 IDHS Figure 6.3 Percentage of Currently Married Women Age 15-49 Using Specific Contraceptive Methods, Indonesia 1997-2003 The dramatic changes that have taken place in the level and pattern of contraceptive use in Indo- nesia during the past 20 years are demonstrated in Table 6.4 and Figure 6.4. Java is presented separately because of the large concentration of population in this island, where 59 percent of the country’s popula- tion lives (approximately 125 million). Because Banten province is only recently established, data for this province cannot be analyzed separately. On the other hand, data for West Java in past IDHS surveys in- clude those for Banten province. Table 6.4 shows the trend of con- traceptive use among currently married women in each province in Java between 1991 and 2002-2003. Contraceptive use has increased steadily in all the Java provinces in the past two decades. The highest increase is noticed in Central Java (15 percentage points), followed by East Java (12 percentage points). The 2002- 2003 IDHS results show that among the Java provinces, DI Yogyakarta has the highest contraceptive prevalence (76 per- cent), while West Java has the lowest (59 percent). Table 6.4 Trends in contraceptive use by province in Java 1991- 2002-2003 Percentage of currently married women who are currently using a method of contraception, by province, Java 1991-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––– IDHS IDHS IDHS IDHS Province 1991 1994 1997 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––– DKI Jakarta 56 60 59 63 West Java1 51 57 58 59 Central Java 50 61 62 65 DI Yogyakarta 71 70 73 76 East Java 55 56 61 67 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1 In 1991, 1994, and 1997 IDHS includes Banten. In 2002-2003 West Java excludes Banten. Current Use of Family Planning | 71 60 57 61 70 56 59 58 62 73 61 63 59 65 76 67 DKI Jakarta West Java Central Java DI Yogyakarta East Java 0 20 40 60 Percent 80 1994 IDHS 1997 IDHS 2002-2003 IDHS Figure 6.4 Percentage of Currently Married Women Age 15-49 Using a Contraceptive Method by Province in Java, 1994-2003 A woman’s desire and ability to manage her fertility and her choice of contraceptive methods are in part affected by her status, self-image, and sense of empowerment. A woman who feels that she does not have much control over the basic aspects of her life may be less likely to feel that she can make and carry out decisions about her fertility. She may also feel the need to choose methods that are less obvious or that do not depend on her husband’s cooperation. Table 6.5 shows the percent distribution of currently married women by contraceptive method currently used, according to three indicators of women’s status. Use of any method and of any modern method increases significantly with increasing number of decisions in which a woman has a final say. For example, 40 percent of women who have no say in any of the five specified decisions are using a method, compared with 61 percent of women who themselves or jointly have a final say in all five decisions. Use of contraception among currently married women also increases with increasing number of reported rea- sons to refuse sexual relations with their husband. Fifty-three percent of women who give no reasons to refuse sex with their husband report using a method, compared with 61 percent of those who report 3-4 reasons. Contraceptive use is inversely related to the number of reasons that justify wife beating. For ex- ample, 61 percent of women who believe that a man is not justified in beating his wife for any reason at all are using a contraceptive method, compared with 55 percent of women who believe that wife beating is justified for five reasons. 72 | Current Use of Family Planning Table 6.5 Current use of contraception by women’s status Percent distribution of currently married women by contraceptive method currently used, according to selected indicators of women’s status, Indonesia 2002- 2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Modern method Traditional method ––––––––––––––––––––––––––––––––––––––––––––––––––––––––– ––––––––––––––––––––––– Using Female Any Any any Any steri- Male In- Male tradi- Periodic folk Not Number Women’s status meth- modern liza- steri- ject- Im- con- tional absti- With- meth- currently of indicators od method tion lization Pill IUD ables plants dom LAM method nence drawal od using Total women –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Number of decisions in which woman has final say1 0 40.4 38.0 0.8 0.0 8.5 0.7 20.8 7.0 0.2 0.0 2.5 1.2 0.0 1.3 59.6 100.0 137 1-2 51.2 47.7 2.2 0.0 11.0 4.7 24.6 4.3 0.8 0.1 3.5 1.7 1.1 0.7 48.8 100.0 1,221 3-4 59.6 56.2 3.6 0.5 13.7 5.4 28.8 3.5 0.7 0.1 3.4 1.1 1.8 0.5 40.4 100.0 7,677 5 61.3 57.7 3.9 0.5 13.2 6.6 27.7 4.6 1.0 0.1 3.7 1.8 1.4 0.5 38.7 100.0 18,822 Number of reasons to refuse sex with husband 0 52.5 50.8 3.1 0.7 10.5 6.0 23.9 6.1 0.4 0.0 1.6 0.5 0.7 0.5 47.5 100.0 1,841 1-2 57.4 54.1 4.1 0.2 13.4 4.2 27.6 3.8 0.5 0.3 3.3 1.7 1.2 0.4 42.6 100.0 2,798 3-4 61.3 57.5 3.7 0.5 13.4 6.4 28.2 4.2 0.9 0.1 3.8 1.7 1.6 0.5 38.7 100.0 23,218 Number of reasons wife beating is justified 0 60.5 57.0 4.0 0.5 12.5 6.7 28.0 4.3 1.0 0.1 3.6 1.7 1.4 0.5 39.5 100.0 20,887 1-2 60.4 56.8 2.8 0.2 16.4 4.4 27.8 4.3 0.5 0.3 3.6 1.6 1.6 0.4 39.6 100.0 5,030 3-4 58.5 54.3 3.1 0.8 13.8 4.0 27.1 4.5 0.8 0.1 4.2 1.0 2.6 0.6 41.5 100.0 1,508 5 55.4 53.5 2.6 0.1 13.3 9.3 23.7 4.2 0.2 0.2 1.9 0.5 0.5 0.9 44.6 100.0 433 Total 60.3 56.7 3.7 0.4 13.2 6.2 27.8 4.3 0.9 0.1 3.6 1.6 1.5 0.5 39.7 100.0 27,857 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: If more than one method is used, only the most effective method is considered in this tabulation. LAM = Lactational amenorrhea method 1 Either by himself or jointly with others 6.3 QUALITY OF USE 6.3.1 Pill Use Compliance Since the pill is one of the most popular modern methods used in Indonesia, it is important for program planners and managers to find out whether it is used properly. The 2002-2003 IDHS included a series of questions asked of pill users on the type of pill they are using, on the pill availability in the household at the time of the survey, and on the last time a pill was taken. This information is presented in Table 6.6. The findings indicate that the majority (69 percent) of pill users take the combined oral contra- ceptive (combined pill) and 11 percent use the progestin-only oral contraceptive (single pill). Overall, 90 percent of pills users were able to show a pill package to the interviewer. Eighty-three percent of pill users took the pill in order and 87 percent took the pill less than two days before the interview. Table 6.6 also shows that urban women are more likely than rural women to use combined pill (71 and 67 percent, respectively). There is no clear pattern in pill compliance across users. Pill users in urban areas are slightly more compliant than those in rural areas (85 versus 81 percent). Current Use of Family Planning | 73 Table 6.6 Pill use compliance Percentage of currently married women using the pill, percent distribution of pill users by type of pill, and by whether pill users could show a pill packet, and percentage of pill users who took a pill less than two days ago, according to urban-rural residence and province, Indonesia 2002-2003 Percentage of pill users who: Could show packet by type of pill Background characteristic Percent using Currently married women Combi- nation Single Other Package not seen/ missing Took pill in order Took pill <2 days ago Number of pill users Age 15-19 13.2 912 58.6 12.8 14.7 13.9 81.2 82.6 120 20-24 11.8 3,761 66.0 12.5 6.9 14.6 83.5 86.3 444 25-29 15.6 5,217 64.4 13.5 9.3 12.8 80.6 86.7 813 30-34 16.5 5,150 70.7 10.2 11.8 7.4 86.5 89.7 849 35-39 13.7 4,953 74.6 7.2 10.5 7.7 83.4 90.6 677 40-44 11.9 4,294 66.7 12.7 8.4 12.3 79.4 81.5 511 45-49 7.7 3,570 80.6 8.1 3.4 8.0 84.4 86.8 277 Residence Urban 14.1 12,765 71.1 9.9 8.8 10.2 80.9 88.6 1,802 Rural 12.5 15,093 67.4 11.9 10.0 10.6 84.9 85.9 1,889 Education No education 9.9 2,089 64.8 9.6 14.7 10.9 84.6 88.2 206 Some primary 12.9 5,435 68.0 10.4 11.2 10.4 81.6 84.4 699 Completed primary 14.9 9,499 68.4 10.7 11.2 9.7 85.1 88.3 1,419 Some secondary 13.8 4,902 71.1 11.1 4.6 13.3 77.0 83.9 676 Secondary + 11.6 5,932 71.7 12.3 7.1 8.9 85.1 90.8 690 Total 13.2 27,857 69.2 10.9 9.4 10.4 82.9 87.2 3,691 6.3.2 Quality of Use of Injectables In the 2002-2003 IDHS, women who use injectables were asked whether they use one-month or three-month injectables. Based on their response, injectable users were further asked how many weeks ago they had their injection, with the purpose to examine quality of use of this method. The overwhelm- ing majority of injectable users use the three-month type (94 percent). Table 6.7 shows that 95 percent of users of one-month injectables received an injection in the past four weeks and 98 percent of users of three-month injectables had an injection in the past three months. This means that a very small proportion of current injectable users are not using this method properly. Compliance in the use of injectables does not vary much by women’s age, urban-rural residence, and education. There are small differences in the compliance of three-month injectables by province; the proportion ranges between 92 and 100 percent (data not shown). 74 | Current Use of Family Planning Table 6.7 Use of injectables Percentage of users of one-month injectables who had an injection in the past four weeks and percentage of users of three-month injectables who had an injection in the past three months, by background characteristics, Indonesia 2002-2003 Background characteristic Percent of users of one-month injectable con- traception who had an injection in the past four weeks Number of users Percent of users of three-month injectable contra- ception who had an injection in the past three months Number of users Age 15-19 * 14 96.9 273 20-24 90.1 109 98.5 1,447 25-29 96.5 153 99.2 1,776 30-34 96.2 92 98.9 1,568 35-39 100.0 63 97.0 1,214 40-44 (90.2) 40 96.9 718 45-49 * 6 96.9 307 Residence Urban 94.9 349 98.4 2,982 Rural 94.8 127 98.1 4,321 Education No education * 3 96.7 401 Some primary (85.7) 21 98.4 1,281 Completed primary 90.7 101 98.0 2,909 Some secondary 98.3 116 98.9 1,430 Secondary + 95.9 236 98.4 1,281 Total 94.9 477 98.2 7,303 Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 6.4 INFORMED CHOICE Informed choice is an important tool for monitoring the quality of family planning services. All providers of sterilization must inform potential users that they will not be able to have any (more) chil- dren because of sterilization, and potential users must also be informed of other methods that could be used. Family planning providers should also inform all method users of potential side effects of each method and what they should do if they encounter signs of a problem. This information assists users in coping with side effects and decreases unnecessary discontinuation of temporary methods. Users of tem- porary methods should also be informed of the choices they have with respect to other methods. Table 6.8 presents the percentage of users of modern contraceptives (who adopted the current method in the five years preceding the survey) who were informed that there are potential side effects of their current method and what to do if they experience any of the side effects, by specific method, initial source of method, and background characteristics. Additionally, Table 6.8 shows the percentage of women who were sterilized in the five years preceding the survey who were informed that they would not be able to have any (more) children. The data show that about one in four (23 percent) of current users Current Use of Family Planning | 75 76 | Current Use of F Table 6.8 Informed choice Among current users of specific modern contraceptive methods who adopted the method in the five years preceding the survey, percentage who were informed about the side effects of the current method used, percentage who were informed what to do if side effects were experienced, percentage who were informed of other methods that could be used for contraception, and percentage of women who were sterilized in the five years preceding the survey who were informed that they would not be able to have any more chil- dren, by background characteristics, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Type of information ––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Informed Informed Informed of Informed about side effects what to do other methods that Method, source, and or problems of if experienced that could sterilization is background characteristic method used side effects1 be used2 permanent3 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Method Female sterilization 16.9 11.8 9.9 82.7 Pill 20.9 18.0 29.5 na IUD 19.9 19.1 19.2 na Injectables 25.1 21.7 30.7 na Implants 26.5 22.2 28.2 na Initial source of method Public sector 33.4 29.4 35.3 86.7 Government hospital 48.9 38.9 42.4 86.8 Government health center 30.7 27.5 33.5 79.3 Government clinic 77.6 71.3 70.8 100.0 FP fieldworker 33.2 34.5 46.5 na FP mobile clinic * * * na Private medical sector 32.2 27.2 39.2 85.7 Private hospital 32.9 23.7 40.3 87.0 Private clinic 35.2 33.4 38.4 95.2 Private doctor 34.3 29.2 35.4 75.0 Nurse/midwife 33.0 28.2 41.4 na Village midwife 31.7 27.0 38.6 na Pharmacy/drugstore 23.2 17.6 30.1 na Other private sector 28.6 25.0 38.7 na Delivery post 35.0 31.2 44.6 na Health post 25.3 22.6 40.1 na Family planning post 39.9 34.0 51.2 na Friends /relatives 19.1 18.0 20.3 na Shop 25.0 20.6 29.1 na Other 24.0 25.1 24.4 na Residence Urban 24.9 21.8 29.8 84.7 Rural 21.5 18.2 25.4 79.9 Education No education 11.6 8.7 12.2 84.5 Some primary 13.1 11.2 16.9 75.1 Completed primary 20.9 17.3 25.7 79.4 Some secondary 28.2 23.8 33.2 88.5 Secondary + 34.2 31.4 38.6 89.7 Total 23.1 19.9 27.4 82.7 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. na = Not applicable 1 Among users of female sterilization, pill, IUD, injectables and implants 2 Among users of female sterilization, pill, IUD, injectables, implants, diaphragm, and lactational amenor- rhea method (LAM) amily Planning 3 Sterilized women who were told that they would not be able to have any more children were informed about possible side effects or problems of the method they are using, and one in five of the current users were informed what to do if they experienced side effects. Twenty-seven percent of current users were informed of other methods that co cent) who were sterilized were informed that the operation. Among current users of various meth formed about possible side effects, about othe encountered in the use of the method. Of the three main sectors providing c of information on side effects of methods, an ever, the private sector (medical or otherwise other methods they can use. Surprisingly, there are small differenc among current users of modern contraceptive education are much more likely than users w formed about side effects or problems of the methods they can use. Variations across province in providin in Appendix Table A.6.2. In general, informa Java, Central Java, Banten, and West Kaliman Tenggara, and Central Kalimantan. Informatio Sumatera, South Sumatera, DKI Jakarta, East 6.5 PROBLEMS WITH CURRENT METHOD In the 2002-2003 IDHS, all contra- ceptive users were asked whether they had experienced any health problems with the method they were using. Table 6.9 shows that the vast majority of users of the most commonly used modern methods (pill, IUD, injectables, and implants) do not have any major health problems as a result of using the method. The most common prob- lem reported by users of the pill is headache and weight gain, while for users of the IUD, injectables, and implants it is amenorrhea. uld be used. Moreover, a large majority of women (83 per- they would not have any (more) children if they underwent ods, women who are sterilized are the least likely to be in- r methods they could use, and what to do if problems are ontraceptive methods, there is little difference in provision d actions to be taken in the event that effects occur. How- ) is more likely than the public sector to inform women of es by urban-rural residence in the level of informed choice methods. Current users of modern methods who have better ith no formal education or with little education to be in- method, what to do in case of problems, and what other g information to potential contraceptive users are presented tion about side effects is limited in Bangka-Belitung, West tan. On the other hand, it is high in DKI Jakarta, East Nusa n about other methods is more likely to be given in West Nusa Tenggara, and Central Kalimantan. Table 6.9 Problems with current method of contraception Percent distribution of current users of selected methods by the main health problem with the method, according to method, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Main problem Inject- with current method Pill IUD ables Implants –––––––––––––––––––––––––––––––––––––––––––––––––––––––––– None 83.0 84.1 76.2 82.5 Weight gain 3.4 2.6 3.3 1.9 Weight loss 0.6 0.4 0.9 0.6 Bleeding 0.4 0.7 0.6 1.0 Hypertension 0.1 0.2 0.2 0.1 Headache 5.1 1.7 5.5 3.8 Nausea 1.8 1.0 0.5 0.4 No menstruation 2.2 4.5 8.5 4.1 Weak/tired 0.3 0.2 0.6 0.3 Other 2.1 3.5 2.6 3.4 Missing 1.0 1.0 1.2 1.8 Total 100.0 100.0 100.0 100.0 Number of women 3,693 1,738 7,769 1,209 Current Use of Family Planning | 77 6.6 COST AND ACCESSIBILITY OF METHODS The Indonesian national family planning program is implemented by the government with the ac- tive involvement and participation of the community and private sectors. One of the indicators of the ex- tent and desire to use of contraception is self-reliance, measured by the proportion of users who pay for the methods and services they are using. In the 2002-2003 IDHS, current users were asked where they obtained the current method the last time and how much they paid for the method and for services. Table 6.10 shows that 28 percent of all current users obtained their method from a government service delivery point, and most of them (21 percent) paid for the method and services. Sixty-three per- cent of users obtained their current method from a private facility, and most of them (59 percent) paid for it. One in ten current users obtained their method from sources other than government or private, such as a village birth delivery post (polindes), integrated health post (posyandu), family planning post, village contraceptive distribution centers, friends, or a shop. Almost all of these users also pay for the methods and services. Overall, 89 percent of current users pay for their contraceptives. B 97 percen for their m and 71 pe T 1997 IDH governme current le governme A tive meth the highe while the (31 perce from 77 p 78 | Current Use of Fa Table 6.10 Payment for contraceptive method and services Percent distribution of current users of modern contraceptive methods by source of method and whether method is free or repondent pays for it, according to method, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Government Private Other Number –––––––––––– –––––––––––– –––––––––––– of Method Free Pay Free Pay Free Pay Total women –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Female sterilization 25.0 41.1 8.1 25.6 0.0 0.0 100.0 1,070 Male sterilization1 71.4 14.6 6.2 0.3 0.0 1.9 100.0 125 Pill 1.3 17.6 0.8 54.2 1.1 25.0 100.0 3,693 IUD 24.1 15.8 12.5 41.5 5.7 0.4 100.0 1,738 Injections 0.9 18.9 1.2 75.1 0.4 3.5 100.0 7,769 Implants 13.9 42.0 5.4 30.0 4.4 4.3 100.0 1,209 Condom 0.6 2.9 6.0 78.6 3.3 7.9 100.0 240 Total 6.7 21.2 3.2 59.2 1.5 8.0 100.0 15,843 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1 Includes users of male sterilization from a government source with missing information on type of payment y method, injectable and pill users are most likely tp pay for their contraceptive method (98 and t, respectively). Self-reliance is much lower for IUD users, with only 58 percent of users paying ethod. Eighty-six percent of men who were sterilized had the operation in a government facility rcent of these men had the operation free of charge. he level of self-reliance in the 2002-2003 IDHS is five percentage points higher than that in the S (89 versus 84 percent). The proportion of current users who received their method from a nt source decreased sharply between the two surveys, from 43 percent in the 1997 IDHS to the vel of 28 percent. The proportion of users who got their method and services for free from a nt source has also decreased significantly from 11 percent in 1997 to 7 percent in 2002-2003. ppendix Table A.6.4 shows that the level of self-reliance varies greatly by source of contracep- od and province. Among current users who obtained their method from a government source, st proportion who pay for their method and services is found in South Sulawesi (56 percent), highest proportion who receive their method and services for free is in East Nusa Tenggara nt). Among private sources, the proportion of current users who pay for their methods ranges ercent in DKI Jakarta to only 9 percent in East Nusa Tenggara. The majority of current users mily Planning who obtained their method from a source other than government or private paid for it themselves, and there is not much variation by province in the proportion of current users who are self-reliant. Table 6.11 shows the percentage of current users using specific types of sources who get their method for free, and the mean cost (in ruphias) of the method for those who pay for it, by the type of source. Overall, the 2002-2003 IDHS shows that those who rely on government sources are much more likely to get free services (24 percent) than those who use private sources (5 percent). Women who pay for their methods pay on average less at a government source than at a private source. For example, in- jectables cost Rp. 13,000 in a private source compared with with Rp. 11,000 in a government facility.1 This pattern is similar with that observed in the 1997 IDHS, yet there has been a four fold rise in the aver- age price in public service, threefold rise in private sector, and twofold rise in other sector. - tion i IUD - plants with 6.7 gram and g contr contr (63 v syand 1 The The difference in the mean cost varies greatly by method and source of services. Female steriliza s the most expensive method, while the pill is the cheapest. The cost of female sterilization and the is more than double in the private sector than in the government sector. Similarly, the cost of im from a private source is almost twice as much as that from a government (Rp. 56,000 compared Rp. 32,000). Table 6.11 Mean cost of contraceptive method and services Percentage of current users of modern contraceptive methods who get their method free and the mean cost (in 1,000 rupiahs) of the method (including services) for those who pay for it, by the type of source and method, Indo- nesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Source of contraceptive method –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Government Private Other ––––––––––––––––––––––– –––––––––––––––––––––––– ––––––––––––––––––––––– Mean Number Mean Number Mean Number cost of cost of cost of Method Free (Rp. 000) users Free (Rp. 000) users Free (Rp. 000) users –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Female sterilization 37.8 532 707 23.8 1,285 363 * * 0 Male sterilization 78.0 340 114 * * 8 * * 2 Pill 6.8 4 699 1.5 5 2,032 4.1 5 962 IUD 60.4 46 692 23.2 101 939 92.9 15 106 Injectables 4.6 11 1,536 1.5 13 5,932 10.3 10 301 Implants 24.9 32 676 15.1 56 428 50.2 28 105 Condom * * 8 7.1 9 204 * * 27 Total 24.0 85 4,433 5.2 57 9,906 15.3 37 1,504 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. SOURCE OF METHODS Information concerning sources of contraceptive methods is important for family planning pro- administrators since the family planning movement is currently directed toward self-sustainability reater use of the private sector. Table 6.12 shows the percent distribution of current users of modern aceptive methods by most recent source of method, according to specific method. Findings show that aceptive users are much more likely to rely on private medical sources than government sources ersus 28 percent). Eight percent of users obtained their methods from other sources such as po- u, polindes, family planning posts, and friends or relatives. current exchange rate for US $1.00 is approximately Rp. 8,300. Current Use of Family Planning | 79 Table 6.12 Source of contraception Percent distribution of current users of modern contraceptive methods by most recent source of method, according to specific method, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Female Male sterili- sterili- Inject- Male Source zation zation Pill IUD ables Implants condom Total –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Public sector 66.1 91.5 18.9 39.8 19.8 55.9 3.5 28.0 Government hospital 61.9 54.0 0.4 8.3 0.6 3.2 1.0 6.2 Government health center 2.0 32.1 16.3 29.2 18.2 51.3 2.3 20.3 Government clinic 2.1 2.0 0.1 0.5 0.3 0.4 0.0 0.4 FP fieldworker 0.1 0.2 1.9 0.5 0.1 0.5 0.0 0.6 FP mobile clinic 0.0 0.0 0.1 0.2 0.2 0.1 0.0 0.1 Other 0.0 3.2 0.1 1.1 0.3 0.5 0.2 0.3 Private medical sector 33.9 6.6 55.0 54.0 76.4 35.4 85.3 62.5 Private hospital 27.9 5.9 0.2 9.0 0.8 0.6 0.0 3.4 Private clinic 3.3 0.0 1.1 4.0 1.5 1.1 0.0 1.8 Private doctor 2.6 0.6 1.4 12.9 4.3 2.5 0.0 4.2 Nurse/midwife 0.0 0.0 17.0 19.5 37.8 13.3 2.8 25.7 Village midwife 0.0 0.0 15.3 8.5 30.3 17.4 0.7 20.7 - e - - - e s - , 80 | Curr Pharmacy/drug store 0.0 0.0 19.4 0.0 0.1 0.0 81.8 5.8 Other 0.0 0.0 0.5 0.1 1.6 0.6 0.0 1.0 Other source 0.0 0.0 23.1 2.7 2.6 5.2 7.7 7.5 Delivery post 0.0 0.0 0.7 1.2 1.4 1.8 0.0 1.1 Health post 0.0 0.0 7.6 1.0 1.1 2.6 2.1 2.6 FP post 0.0 0.0 2.9 0.5 0.1 0.9 0.4 0.8 Friends/relatives 0.0 0.0 1.2 0.0 0.1 0.0 0.9 0.3 Shop 0.0 0.0 10.8 0.0 0.0 0.0 4.3 2.6 Other 0.0 0.0 2.9 3.3 1.1 3.5 3.6 1.9 Don’t know 0.0 1.9 0.0 0.0 0.0 0.0 0.0 0.0 Missing 0.0 0.0 0.1 0.1 0.2 0.0 0.0 0.1 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number of women 1,070 125 3,693 1,738 7,769 1,209 240 15,843 As shown in Figure 6.5, use of government sources decreased from 43 percent in 1997 to the cur rent level of 28 percent, while use of private medical sources increased from 42 to 63 percent during th same period. Use of other sources decreased from 15 to 8 percent between the two surveys. The substan tial increase in use of private sources is mainly due to the increased use of private midwives (18 percent age points). Figure 6.5 shows that most women who obtain their family planning method through the gov ernment sector do so at a health center (20 percent). Among private sources, nurse/midwives or villag midwives are the most commonly reported sources (46 percent), while among other sources, health post and shops are the primary choices for family planning methods (3 percent each). The source of family planning varies by method. Two in three sterilized women had the operation in a government hospital and one-third in a private medical facility. Half of all implant operations and 29 percent of IUD insertions took place in a government health center. Fifty-five percent of pill users ob tained the method from the private medical sector, specifically 17 percent from a nurse or midwife 15 percent from village midwives, and 19 percent from a pharmacy or drug store. ent Use of Family Planning Figure 6.5 Distribution of Current Users of Modern Contraceptive Methods by Source of Supply, Indonesia 1997-2003 43 42 15 28 63 8 Government Medical Private Other 0 20 40 60 Pe rc en t 1997 IDHS 2002-2003 IDHS Note: The 2002-2003 IDHS did not include Nanggroe Aceh Darussalam, Maluku, North Maluku, and Papua province. Previous surveys included East Timor. Figure 6.6 Distribution of Current Users of Modern Contraceptive Methods by Source of Supply Other private 1% Nurse/midwife 26% Government health center 20% Government hospital 6% Other government 1% Private hospital/ clinic 5% Private doctor 4% Private pharmacy/ drug store 6% IDHS 2002-2003 Village midwife 20% Other 10% 6.8 TIMING OF STERILIZATION Given the importance of female sterilization as a way of preventing women in high-risk groups from becoming pregnant, the family planning movement provides information concerning this method. The program also provides services in accordance with the woman’s age and health status. It is of interest to know the trend in the level of use of the method, especially in relation to the age of the woman at the time of operation. In using these data, however, the problem of censoring must be taken into account. Current Use of Family Planning | 81 Since the survey includes ever-married women 15-49 only, sterilized women age 50 and over are not cov- ered. Table 6.13 presents the percent distribution of sterilized women by age at the time of sterilization according to the number of years since the operation. As expected, the vast majority (68 percent) of women were sterilized at age 30 or over. The median age at the time of sterilization is 31.9 years, which suggests no change since 1997 (31.8 years). Table 6.13 Timing of sterilization Percent distribution of sterilized women by age at the time of sterilization, and median age at sterilization, according to the number of years since the operation, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age at time of sterilization Number Years since ––––––––––––––––––––––––––––––––––––––––––––––––––––– of Median operation <25 25-29 30-34 35-39 40-44 45-49 Total women age1 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– <2 0.4 9.4 26.7 44.3 17.0 2.2 100.0 137 35.6 2-3 1.0 17.2 35.3 31.6 13.9 1.0 100.0 107 32.4 4-5 1.6 13.4 45.4 30.6 9.0 0.0 100.0 112 33.9 6-7 7.5 8.7 44.6 31.7 7.5 0.0 100.0 152 33.6 8-9 0.5 23.6 30.4 42.2 3.3 0.0 100.0 85 33.8 10+ 8.1 44.3 35.0 12.6 0.0 0.0 100.0 477 a Total 5.0 27.2 36.1 25.5 5.8 0.4 100.0 1,070 31.9 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1 Median ages are calculated only for women sterilized at less than 40 years of age to avoid problems of censoring. a Not calculated due to censoring 82 | Current Use of Family Planning FERTILITY PREFERENCES 7 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 2002-2003 Indonesia Demographic and Health Survey (IDHS) were asked questions concerning the following: whether they wanted more children; if so, how long they would pre- fer to wait before the next child; and if they could start afresh, how many children in all they would want. The concept of a small family, with “two children is enough,” through regulating birth intervals by using a variety of contraceptive methods, has always been an objective of the Indonesian Family Planning Pro- gram. Accordingly, the 2002-2003 IDHS provides information as to whether advocacy of “two is enough” has been rooted in the community, given the fact that the new vision and mission of the Indonesian Fam- ily Planning program is to create a small quality family by taking into account the reproductive rights of every individual. In addition, the survey added two important questions relating to the status of women and conformity of husbands’ and wives’ opinions on the ideal number of children desired. Interpretation of data on fertility preferences has always been the subject of controversy. Survey questions have been criticized on the grounds that 1) answers are misleading because they may reflect unformed, ephemeral views that 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 hus- band, who may exert a major influence on reproductive decisions. The first objection has greater force in societies where the idea of conscious reproductive choice may still be alien; preference data from these settings should be interpreted with caution. This objection may be irrelevant in Indonesia, where widespread public exposure to the family planning program has no doubt caused most people to establish opinions regarding fertility regulation. The second objection is cor- rect 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 fu- ture childbearing. For these women, the question on desire for more children was rephrased to refer to their 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 presented classified by number of liv- ing children include current pregnancy. In addition, the question on preferred waiting time before the next birth was rephrased for pregnant women to clarify that the information wanted was the preferred waiting time after the birth of the child the respondent was expecting. Data for women who have been sterilized require special analytic treatment. The general strategy in some tables in this chapter is to classify these women as wanting no more additional children. 7.1 DESIRE FOR ADDITIONAL CHILDREN Table 7.1 presents the distribution of currently married women by desire for more children, ac- cording to the number of living children. Data in the last column show that 50 percent of these women said that they wanted no more children, while 4 percent had been sterilized. Forty percent of married women said that they wanted to have additional children; 13 percent wanted the child within two years, 24 percent wanted the child after two years or more, and 3 percent were unsure about the time. Four per- cent of women were not sure whether they wanted another child (Figure 7.1). Fertility Preferences | 83 Table 7.1 Fertility preferences Percent distribution of currently married women by desire for children, according to number of living children, Indonesia 2002- 2003 Number of living children1 Desire for children 0 1 2 3 4 5 6+ Total Have another soon2 80.4 20.5 7.6 3.5 1.5 1.6 0.7 13.0 Have another later3 4.8 57.9 23.5 9.4 4.0 2.6 1.2 23.6 Have another, undecided when 2.5 5.3 3.9 2.6 1.0 1.6 0.5 3.3 Undecided 4.2 3.6 5.0 3.4 2.8 1.5 3.3 3.8 Want no more 2.8 11.0 56.1 71.2 80.4 81.4 80.6 50.0 Sterilized4 0.0 0.2 2.3 8.2 8.5 9.1 8.5 4.2 Declared infecund 5.0 1.0 0.8 1.3 1.5 1.8 5.0 1.6 Missing 0.3 0.5 0.8 0.4 0.3 0.5 0.2 0.5 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number of women 1,687 6,847 7,971 5,234 2,964 1,595 1,560 27,857 1 Includes current pregnancy 2 Wants next birth within 2 years 3 Wants to delay next birth for 2 or more years 4 Includes both female and male sterilization IDHS 2002-2003 Figure 7.1 Fertility Preferences of Currently Married Women Age 15-49 Have another undecided when 3% Undecided 4% Have another later 24% Have another soon 13% Infecund 2% Sterilized 4% Want no more 50% Table 7.2 shows the percentage of currently married women who want no more children by num- ber of living children and background characteristics. It is apparent that the desire to stop childbearing increases substantially after a woman has had two or more children. More than half of currently married women with two children want no more (additional) children or have been sterilized. Eight in ten women with three children either have been sterilized or want no more children, and nine in ten women with larger families want no more children. Findings from the 1997 IDHS show similar patterns, with slightly less desire for terminating childbearing. 84 | Fertility Preferences Table 7.2 Desire to limit childbearing Percentage of currently married women who want no more children, by number of living children and background characteristics, Indonesia 2002-2003 Number of living children1 Background characteristic 0 1 2 3 4 5 6+ Total Residence Urban 3.1 11.3 58.2 81.7 91.0 95.2 90.9 55.4 Rural 2.5 11.3 58.6 77.3 87.2 86.9 87.9 53.2 Education No education 8.9 43.0 69.7 78.0 92.0 90.9 85.8 73.9 Some primary 4.4 21.0 63.6 80.6 85.1 89.3 86.7 67.0 Completed primary 1.5 10.3 57.7 79.3 90.1 91.0 92.9 54.2 Some secondary 4.3 7.1 51.4 74.8 88.6 90.1 94.4 42.7 Secondary + 0.6 7.9 58.5 82.3 91.7 93.3 89.7 45.1 Total 2.8 11.3 58.4 79.4 88.9 90.4 89.2 54.2 Note: Women who have been sterilized are considered to want no more children. 1 Includes current pregnancy Looking at differentials by background characteristics, Table 7.2 shows that, in general, urban women are slightly more likely to want to terminate childbearing than rural women. These differentials are also evident in the 1997 IDHS. There is an interesting pattern in the data on the proportion of women who want no more children by education: At parities one to three, women with less education are more likely to want to stop childbearing than women with more education; at parities four and above, education has no relation with the desire to stop childbearing. Appendix A.7.1 shows differentials in the desire for no more children by province. The desire to stop childbearing is particularly high in DI Yogyakarta and Bali (more than 60 percent) and low in West Nusa Tenggara, South Sulawesi, and Southeast Sulawesi (42 percent or lower). The proportion of Bali- nese women who want to stop childbearing declined from 67 percent in 1994 to 64 percent in 1997 and has remained unchanged in 2002-2003. 7.2 NEED FOR FAMILY PLANNING SERVICES 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 plan- ning. Women with an unmet need for “spacing” include pregnant women whose pregnancy was mis- timed; amenorrheic women whose last birth was mistimed; and fecund women who are neither pregnant nor amenorrheic, who are not using any method of family planning, and who want to wait two or more years for their next birth. Also included in unmet need for spacing are fecund women who are not using any method of family planning and 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 preg- nancy was unwanted; amenorrheic women whose last child was unwanted; and women who are neither pregnant nor amenorrheic, 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. Women who have been sterilized are considered to want no more chil- dren. Fertility Preferences | 85 According to these criteria, in the 2002-2003 IDHS the total unmet need for family planning ser- vices in Indonesia is 9 percent, of which 5 percent is for limiting and 4 percent is for spacing (Table 7.3). The level of unmet need has remained the same as that found in the 1997 IDHS. Demand for family planning is defined as the sum of contraceptive prevalence (including cur- rently 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 70 percent, of which 88 percent has been satisfied. If all of this need were satisfied, a contraceptive preva- lence rate of about 70 percent could, theoretically, be expected. Comparison with the 1997 IDHS findings indicates that the percentage of the demand that is satisfied has slightly increased. Table 7.3 Need for family planning Percentage of currently married women with unmet need for family planning, percentage with met need for family plan- ning, and the total demand for family planning, by background characteristics, Indonesia 2002-2003 Unmet need for family planning1 Met need for family planning (currently using)2 Total demand for family planning3 Background characteristic For spacing For limiting Total For spacing For limiting Total For spacing For limiting Total Percentage of demand satisfied Number of women Age 15-19 6.4 0.4 6.8 43.5 3.8 47.3 50.1 4.2 54.3 87.4 912 20-24 7.8 1.0 8.8 53.5 7.2 60.7 62.4 8.1 70.6 87.5 3,761 25-29 7.1 2.5 9.6 42.3 22.2 64.5 50.4 24.8 75.1 87.2 5,217 30-34 4.3 4.7 9.0 28.0 38.7 66.7 33.1 43.8 77.0 88.4 5,150 35-39 2.5 7.7 10.2 10.0 55.4 65.4 13.0 63.3 76.3 86.7 4,953 40-44 1.1 7.6 8.7 3.4 56.3 59.6 4.5 64.1 68.6 87.3 4,294 45-49 0.3 4.6 4.8 0.9 40.8 41.7 1.2 45.6 46.8 89.7 3,570 Residence Urban 4.1 4.5 8.7 23.7 37.4 61.1 28.4 42.2 70.6 87.8 12,765 Rural 4.0 4.6 8.6 24.6 35.1 59.7 29.1 39.9 69.0 87.5 15,093 Education No education 3.3 7.7 11.0 7.6 39.4 47.0 11.4 47.3 58.7 81.2 2,089 Some primary 2.9 6.0 8.8 13.6 41.7 55.3 17.0 47.9 64.9 86.4 5,435 Completed primary 3.9 4.4 8.3 26.1 36.9 63.0 30.5 41.5 71.9 88.5 9,499 Some secondary 5.0 4.3 9.3 32.8 29.3 62.1 38.5 33.9 72.4 87.1 4,902 Secondary + 4.8 2.8 7.6 29.4 34.5 63.9 34.9 37.5 72.4 89.5 5,932 Total 4.0 4.6 8.6 24.2 36.2 60.3 28.8 41.0 69.7 87.6 27,857 1 Unmet need for spacing includes pregnant women whose pregnancy was mistimed, amenorrheic women who are not using family plan- ning and whose last birth was mistimed, and fecund women who are neither pregnant nor amenorrheic and who are not using any method of family planning and say they want to wait 2 or more years for their next birth. Also included in unmet need for spacing are fecund women who are not using any method of family planning and say they are unsure whether they want another child or who want another child but are unsure when to have the birth unless they say it would not be a problem if they discovered they were pregnant in the next few weeks. Unmet need for limiting refers to pregnant women whose pregnancy was unwanted, amenorrheic women whose last child was unwanted, and fecund 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 a better method of contraception). 2 Using 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. 3 Nonusers who are pregnant or amenorrheic and women whose pregnancy was the result of a contraceptive failure are not included in the category of unmet need, but are included in total demand for contraception (since they would have been using had their method not failed). 86 | Fertility Preferences Type of unmet need varies with age. Younger women are more likely to express a need for spac- ing birth, while older women more often want to limit births. There are no notable differences in the need for family planning between urban and rural women. Unmet need generally declines with increasing edu- cation; the more educated the women, the lower the percentage with unmet need. The pattern of total demand for family planning by age shows an inverted U-shaped curve: It is low among women age 15-19 (54 percent) and women age 45-49 (47 percent), and peaks among women age 30-34 (77 percent). There are little differences in total demand for family planning between urban and rural women. The percentage of demand for family planning that is satisfied is related positively with education, ranging from 81 percent for women with no education to 90 percent for women with secondary or higher education. Appendix Table A.7.2 shows that total unmet need for family planning is highest in West Nusa Tenggara and East Nusa Tenggara (16 and 17 percent, respectively), and lowest in North Sulawesi and DI Yogyakarta (each less than 5 percent). The higher level of unmet need in West Nusa Tenggara and East Nusa Tenggara may be attributed to the desire of women to space births (10 and 9 percent, respectively). The National Development Program has set a target of reducing unmet need for family planning in Indonesia from 9 percent in 1997 to 7 percent or lower in 2004. Thus far, 11 provinces have reached or surpassed that target: Jambi, South Sumatera, Bangka Belitung, DKI Jakarta, Central Java, DI Yogya- karta, East Java, Bali, Central Kalimantan, East Kalimantan, and North Sulawesi. The percentage of demand for family planning that is satisfied ranges from 68 percent in East Nusa Tenggara to 94 percent in DI Yogyakarta and North Sulawesi. 7.3 IDEAL FAMILY SIZE In the 2002-2003 IDHS, each respondent was asked to perform the difficult task of considering, abstractly and independently of her actual family size, the number of children she would choose if she could start again. Since most ever-married women in the sample are currently married, the ideal number of children for both groups is the same. Overall, the ideal family size in Indonesia remains the same as it was in the 1994 IDHS and 1997 IDHS (2.9 children) (Table 7.4). The percentage of women whose ideal number of children is one or two increased from 39 percent in 1997 to 42 percent in 2002-2003. 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 for this divergence. First, to the extent that women want to achieve their fertility desires, women who want large families tend to have large families. Second, women may rationalize their actual family size to be their ideal family size. As the actual number of children increases, their preference increases also. Further, women with large families, being on average older than women with small families, may have larger ideal 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. The difference can be taken as an indicator of sur- plus or unwanted fertility. For women with three or more surviving children, a sizeable proportion reports ideal family sizes that are smaller than the number of living children. In fact, among women with six or more children, 45 percent say that if they were to start again, they would have fewer children. Fertility Preferences | 87 Table 7.4 Ideal 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 2002-2003 Number of living children1 Desire for children 0 1 2 3 4 5 6+ Total 0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1 3.0 4.2 0.7 0.8 0.5 0.5 0.1 1.7 2 57.6 58.6 54.2 23.2 16.3 12.6 6.4 40.6 3 11.8 17.4 20.7 36.7 11.7 18.1 11.3 20.6 4 10.2 8.3 13.1 18.6 40.0 20.3 22.0 16.6 5 1.4 1.8 1.6 4.1 4.0 13.0 4.9 3.2 6+ 1.3 0.8 0.8 1.6 5.1 10.0 17.2 2.9 Non-numeric responses 14.6 8.8 9.0 15.1 22.4 25.6 38.1 14.5 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number of women 1,900 7,279 8,301 5,472 3,178 1,685 1,668 29,483 Mean ideal number of children for:2 Ever-married women 2.5 2.4 2.6 3.1 3.6 3.9 4.5 2.9 Number 1,622 6,638 7,557 4,648 2,467 1,253 1,033 25,217 Currently married women 2.5 2.4 2.6 3.1 3.6 3.9 4.5 2.9 Number 1,482 6,273 7,263 4,462 2,319 1,183 966 23,948 1 Includes current pregnancy 2 Excludes women who gave non-numeric responses. Table 7.5 presents the mean ideal number of children for all ever-married women by age and se- lected background characteristics. The ideal number of children varies across age groups; older women tend to want larger families than do younger women. Better-educated women tend to want smaller fami- lies than do women with less education; for example, the mean ideal number of children for women with no education is 3.3 children, while that for women with secondary or higher education is 2.7 children. Table 7.5 Mean ideal number of children by background characteristics Mean ideal number of children for all ever-married women, by age and background characteris- tics, Indonesia 2002-2003 Age Background characteristic 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Total Residence Urban 2.6 2.5 2.6 2.7 2.9 3.1 3.3 2.8 Rural 2.4 2.6 2.7 2.9 3.0 3.2 3.4 2.9 Education No education 1.6 2.8 2.9 3.2 3.3 3.5 3.4 3.3 Some primary 2.7 2.9 3.0 3.1 3.2 3.2 3.5 3.2 Completed primary 2.4 2.6 2.7 2.8 2.9 3.2 3.4 2.9 Some secondary 2.5 2.5 2.7 2.7 2.9 3.0 3.2 2.7 Secondary + 2.6 2.4 2.5 2.6 2.8 2.8 3.1 2.7 Total 2.5 2.6 2.7 2.8 3.0 3.2 3.4 2.9 88 | Fertility Preferences Appendix Table A.7.3 shows that variation in the ideal number of children by province is sub- stantial, ranging from a low of 2.3 children in DI Yogyakarta and North Sulawesi to a high of 3.8 children in East Nusa Tenggara. The mean ideal number of children is less than three in all provinces of Java (ex- cept Banten), and in Bali, Jambi, South Kalimantan, East Kalimantan, North Sulawesi, Central Sulawesi, and Gorontalo. 7.4 UNPLANNED AND UNWANTED FERTILITY In the 2002-2003 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 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 on fertility of the prevention of unwanted births. The IDHS questions on fertility planning are extremely demanding. The respondent is required to recall accurately her wishes at one or more points in time during the last five years and to report them honestly. The danger of rationalization is present; an unwanted conception may well have become a cher- ished child. Despite these potential problems of comprehension, recall, and truthfulness, results from pre- vious surveys have proved surprisingly plausible. Respondents are willing to report unwanted concep- tions, although some postpartum rationalization probably occurs. The result is probably an underestimate of unwanted fertility. Table 7.6 shows the percent distribution of births in the five years preceding the survey and cur- rent pregnancies by fertility planning status, according to birth order and mother’s age at birth. Eight in ten births were wanted at the time of conception, an additional 10 percent were wanted but at a later time, and only 7 percent were not wanted at all. These figures show that there is no change since 1997. Table 7.6 Fertility planning status Percent distribution of births in the five years preceding the survey (including current pregnancies), by fertility planning status, according to birth order and mother’s age at birth, Indonesia 2002-2003 Planning status of birth Birth order and mother’s age at birth Wanted then Wanted later Wanted no more Missing Total Number of births Birth order 1 94.3 4.3 0.3 1.0 100.0 5,739 2 86.2 11.7 1.2 0.9 100.0 4,788 3 77.1 13.7 8.8 0.4 100.0 2,746 4+ 61.2 12.0 25.7 1.0 100.0 3,442 Age at birth <20 91.8 6.9 0.3 1.0 100.0 1,991 20-24 88.1 9.5 1.5 0.9 100.0 4,730 25-29 84.9 10.0 4.0 1.1 100.0 4,693 30-34 78.1 11.1 10.2 0.5 100.0 3,067 35-39 65.6 9.2 24.7 0.4 100.0 1,724 40-44 52.9 9.0 37.5 0.6 100.0 456 45-49 (30.3) (3.4) (57.7) (8.6) 100.0 54 Total 82.4 9.6 7.2 0.9 100.0 16,716 Note: Figures in parentheses are based on 25-49 unweighted cases. Fertility Preferences | 89 Birth order is strongly associated with the planning status of the birth. In the 2002-2003 IDHS, the proportion of births that were wanted at the time of conception decreases with increasing birth order, while the percentage not wanted at all increases. While almost all first births were wanted at the time of conception, one in four of fourth or higher order births were unwanted (Table 7.6). The planning status of births is also associated with the age of the mother. In general, older moth- ers tend to have a smaller percentage of children who are wanted at conception. The percentage of un- wanted births increases with mother’s age: less than 1 percent among women under 20 and 38 percent among women age 40-44. The patterns of unwanted births by age and birth order are similar to the pat- terns reported in the 1997 IDHS. Table 7.7 presents wanted fertility rates of women. The rates are calculated in the same manner as conventional 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 concep- tion was less than or equal to the current ideal number of chil- dren reported by the respondent. Wanted fertility rates express the level of fertility that would theoretically result if all un- wanted births were prevented. Comparison of actual fertility rates and wanted fertility rates suggests the potential demo- graphic impact of the elimination of unwanted births. The smaller the gap is between the actual fertility rate and the wanted fertility rate, the more successful the woman is in achieving her fertility desires. Overall, the total wanted fertility rate is lower than the total fertility rate. Thus, if unwanted births could be eliminated, total fertility in Indonesia would be 2.2 births per woman, in- stead of 2.6. The total wanted fertility is lower than that re- corded in the 1997 IDHS (2.4 children per woman). Table 7.7 shows the difference between the wanted fertility rate and the actual fertility rate by background characteristics. The differ- ence is lower among urban women, better-educated women, and women in the highest wealth index quintile. For example, while the fertility gap among women with no formal education is 0.5 children, the corresponding gap among women who have completed secondary education is 0.3 children. Appendix Table A.7.4 shows the wanted and actual fertility rates by province. As in the case of actual fertility, women in DI Yogyakarta have the lowest wanted fertility rate (1.5 children), while women in East Nusa Tenggara have the highest wanted fertility rate (3.5 children). The fertility gap ranges from 0.2 children in DKI Jakarta, Bali, and Central Kalimantan to 0.7 children in Lampung and Central Sulawesi, followed by 0.6 children in East Nusa Tenggara and East Kalimantan. Table 7.7 Wanted fertility rates Total wanted fertility rates and total fertility rates for the three years preceding the sur- vey, by background characteristics, Indone- sia 2002-2003 Background characteristic Total wanted fertility rate Total fertility rate Residence Urban 2.1 2.4 Rural 2.3 2.7 Education No education 2.1 2.6 Some primary 2.4 2.8 Completed primary 2.2 2.5 Some secondary 2.3 2.6 Secondary + 2.1 2.4 Wealth index quintile Lowest 2.6 3.0 Second 2.2 2.6 Middle 2.2 2.7 Fourth 2.2 2.5 Highest 1.9 2.2 Total 2.2 2.6 Note: Rates are calculated based on births to women age 15-49 in the period 1-36 months preceding the survey. The total fertility rates are the same as those presented in Table 4.2. 7.5 FERTILITY PREFERENCES BY WOMEN’S STATUS An increase in women’s status and empowerment is recognized as an important factor in reducing fertility; higher status is associated with smaller desired family size and the ability to meet family-size goals through the effective use of contraception. Table 7.8 shows the mean ideal number of children and the unmet need for spacing and limiting by three indicators of women’s status: women’s participation 90 | Fertility Preferences in decisionmaking, women’s attitude toward wives refusing sex with their husbands, and women’s atti- tude toward wife beating. In the 2002-2003 IDHS, women were asked about their participation in the fol- lowing decisions: the women’s health care, making large household purchases, making daily household purchases, visits to family or relatives, and what food to be cooked every day. The data show that women’s participation in decisionmaking is slightly negatively associated with their ideal number of children. While women who have no say in the household decisionmaking process want to have 3.1 children, women who participate in all five decisions want to have 2.9 children. However, the unmet need for women who do not participate in making household decisions is higher than that for women who participate in all decisions (19 and 8 percent, respectively). The number of decisions in which a woman has the final say and the number of reasons for which wives are justified in refusing sex with their husbands are negatively associated with mean ideal number of children, but the number of reasons justifying wife beating is positively associated with mean ideal number of children. Unmet need for family planning, especially for spacing, decreases as women’s involvement in household decisionmaking increases. There is no clear relationship between unmet need for family planning and women’s attitude toward refusing sex with their husband and wife beating. Table 7.8 Ideal number of children and unmet need by women’s status Mean ideal number of children and unmet need for spacing and limiting, by women’s status indica- tors, Indonesia 2002-2003 Unmet need for family planning2 Women’s status indicator Mean ideal number of children1 Number of women For spacing For limiting Total Number of women Number of decisions in which woman has final say3 0 3.1 73 9.5 9.2 18.7 137 1-2 3.0 986 5.5 4.9 10.4 1,221 3-4 2.9 6,668 4.2 4.6 8.9 7,677 5 2.9 16,221 3.8 4.5 8.3 18,822 Number of reasons to refuse sex with husband 0 3.0 1,423 3.1 7.2 10.3 1,841 1-2 3.2 2,278 3.5 4.7 8.2 2,798 3-4 2.8 20,247 4.2 4.4 8.5 23,218 Number of reasons wife beating is justified 0 2.8 17,990 3.7 4.7 8.4 20,887 1-2 2.9 4,300 4.9 4.4 9.4 5,030 3-4 3.2 1,274 4.8 4.2 9.0 1,508 5 3.3 383 6.8 3.8 10.7 433 Total 2.9 23,948 4.0 4.6 8.6 27,857 1 Excludes women who gave non-numeric responses. 2 See Table 7.3 for definition of unmet need for family planning. 3 Alone or jointly with others Fertility Preferences | 91 NONUSE AND INTENTION TO USE FAMILY PLANNING 8 This chapter focuses on women who are not using family planning and the reasons women and men stop using contraceptive methods. Five topics are discussed: contraceptive discontinuation rates, reasons for discontinuing use of contraception, reasons for nonuse, intention to use contraception in the future, and methods potential users intend to use. 8.1 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 contraception. Reasons for discontinuation may include contraceptive failure, dissatisfaction with the method, side effects, and lack of availability. 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 8.1 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 discontinuations 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 totalled to produce a one-year rate. The reasons for discontinuation are treated as competing risks (net rates). Three reasons for discontinuation are tabulated: method failure (became pregnant while using contraception), desire to become pregnant, and side effects or health concerns. Table 8.1 First-year contraceptive discontinuation rates Percentage of contraceptive users who discontinued use of a method within 12 months after beginning its use, by reason for discontinuation and specific method, Indonesia 2002-2003 Reason for discontinuation Method Method failure Desire to become pregnant Switched to another method1 Other reason Total Pill 4.1 8.3 11.8 7.7 31.9 IUD 0.7 0.7 5.2 2.4 8.9 Injectables 1.1 3.9 8.9 4.4 18.4 Implants 0.1 0.3 1.6 0.7 2.7 Male condom 4.5 6.4 20.5 7.3 38.8 Periodic abstinence 4.0 5.0 6.1 1.4 16.5 Withdrawal 6.3 7.4 4.4 2.5 20.6 Other 2.8 8.6 3.4 4.2 19.0 All methods 2.1 4.8 9.0 4.8 20.7 Note: Table is based on episodes of contraceptive use that began 3-59 months prior to the survey. 1 Used a different method in the month following discontinuation or said they wanted a more effective method and started another method within two months of discontinuation Nonuse and Intention to Use Family Planning | 93 The discontinuation rates were calculated from information collected in the calendar portion of the 2002-2003 IDHS Women’s Questionnaire. All episodes of contraceptive use between January 1997 and the date of interview were recorded in the calendar, along with the reason for any discontinuation of use during this period. The discontinuation rates presented here refer to all episodes of contraceptive use that began during the period covered by the calendar. Specifically, the first year contraceptive discontinuation rates presented in Table 8.1 refers to the period 3-59 months prior to the interview; the month of interview and the preceding two months are ignored to avoid bias that may be introduced by unrecognized pregnancies. Overall, 21 percent of contraceptive users discontinued using a method within 12 months of starting use; 2 percent stopped using because they became pregnant while using the contraceptive method (method failure), 5 percent stopped use to become pregnant, 9 percent switched to another method, and 5 percent stopped for other reasons (including cost, inconvenience, marital dissolution/separation, and infrequent sex). The highest overall one-year discontinuation rate is for male condom (39 percent), followed by the pill (32 percent) and injectables (18 percent). The discontinuation rates for traditional methods are 21 percent for withdrawal and 17 percent for periodic abstinence. The discontinuation rates according to specific reasons vary by method. For example, the proportion of users who stopped using because they became pregnant (method failure) is highest for users of withdrawal and male condom (6 and 5 percent, respectively) and lowest for implants and the IUD (less than 1 percent). Most of pill users discontinue use because they switched to another method (12 percent), wanted to become pregnant, or for other reasons (8 percent each). 8.2 REASONS FOR DISCONTINUATION OF CONTRACEPTIVE USE Another perspective on contraceptive discontinuation is provided in Table 8.2, which shows the percent distribution of discontinuations in the five years preceding the survey by reasons for discontinuation, according to method. The most common reason for discontinuing a method remains the same as that in 1997, that is, the desire to become pregnant (34 percent). This applies to all methods, except condom and LAM, for which the common reason given for discontinuing is switching to a more effective method (28 percent for condom and 44 percent for LAM). Other reasons for discontinuing a method include side effects (14 percent), health concerns (10 percent), and method failure (10 percent) (see Figure 8.1). Side effects and health concerns are mentioned frequently by users of injectables, IUD, and implants (15-19 percent), while method failure and desire for a pregnancy are commonly cited reasons for discontinuing traditional methods. The reasons for discontinuing contraceptive methods have changed little since 1997. 94 | Nonuse and Intention to Use Family Planning Table 8.2 Reasons for discontinuation of contraceptive methods Percent distribution of discontinuations of contraceptive methods in the five years preceding the survey by main reason given by women for discontinuation, according to specific method, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Periodic Inject- Con- absti- With- All Reason Pill IUD ables Implants doms LAM nence drawal Other methods ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Became pregnant while using 15.6 8.4 5.9 1.1 12.3 5.8 28.7 28.4 16.1 10.0 Wanted to become pregnant 34.7 29.5 35.6 25.1 21.5 4.3 32.8 34.6 45.2 34.0 Husband disapproved 0.4 0.3 0.4 0.3 1.1 0.0 0.6 0.6 1.2 0.4 Side effects 10.5 15.4 18.5 15.2 0.5 11.6 2.5 0.1 1.0 14.4 Health concerns 7.6 14.4 12.2 11.6 4.2 0.2 0.4 1.2 0.1 10.1 Access/availability 0.8 1.5 0.6 3.5 0.7 0.0 0.0 0.0 6.8 0.9 Wanted a more effective method 9.1 4.8 5.5 11.2 28.3 44.9 14.6 18.1 7.7 7.9 Inconvenient to use 2.0 3.3 1.7 2.2 10.0 0.0 1.9 2.9 0.5 2.0 Infrequent sex/husband away 1.7 1.0 1.6 1.1 2.0 0.8 0.7 1.5 1.1 1.6 Cost too much 1.2 0.3 3.5 7.3 0.9 0.0 0.0 0.0 1.3 2.6 Fatalistic 0.7 0.0 0.2 0.6 0.6 0.5 0.2 1.7 0.3 0.4 Difficult to get pregnant/menopausal 1.2 4.4 0.8 0.7 1.5 0.0 1.0 0.9 1.5 1.2 Marital dissolution/separation 1.7 1.9 1.9 1.4 2.2 2.5 0.5 0.4 1.8 1.8 IUD expelled na 3.9 na na na na na na na 3.9 Other 7.4 5.5 6.8 14.7 10.8 10.7 5.2 2.4 6.6 7.6 Don't know 0.0 0.1 0.0 0.0 0.0 0.0 0.4 0.0 0.1 0.0 Missing 5.5 5.2 4.8 4.0 3.3 18.9 10.5 7.2 8.7 5.3 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number of discontinuations1 4,062 769 5,874 746 145 65 248 217 107 12,255 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– LAM = Lactational amenorrhea method na = Not applicable 1 Total includes 13 discontinuations of diaphragm IDHS 2002-2003 Figure 8.1 Reasons for Discontinuation of Contraceptive Methods Other reasons 16% Infrequent sex 2% Cost/access/ inconvenience 6% Want more effective method 8% Wanted to become pregnant 34% Health concerns 10% Side effects 14% Became pregnant 10% Nonuse and Intention to Use Family Planning | 95 8.3 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 8.3 presents the distribution of currently married women who are not using a contraceptive method by intention to use in the future, according to number of living children. According to the 2002-2003 IDHS data, 43 percent of nonusers intend to use family planning some time in the future and 42 percent do not intend to use. The remaining women are unsure about their intentions (14 percent). Table 8.3 Future use of contraception Percent distribution of currently married women and currently married men who are not using a contraceptive method by intention to use in the future, according to number of living children, Indonesia 2002-2003 Number of living children1 Intention 0 1 2 3 4+ Total CURRENTLY MARRIED WOMEN Intends to use 44.5 56.7 54.1 37.1 23.6 43.1 Unsure 23.6 13.6 9.1 12.4 13.2 13.7 Does not intend to use 31.6 28.7 35.9 49.6 62.6 42.4 Missing 0.2 0.9 0.9 0.9 0.6 0.7 Total 100.0 100.0 100.0 100.0 100.0 100.0 Number of women 1,533 2,614 2,465 1,614 2,825 11,051 CURRENTLY MARRIED MEN Intends to use 11.7 8.6 10.2 10.2 4.7 8.8 Unsure 11.6 11.5 8.2 11.9 8.1 10.1 Does not intend to use 76.6 79.5 80.0 76.5 85.9 80.2 Missing 0.0 0.4 1.7 1.4 1.3 0.9 Total 100.0 100.0 100.0 100.0 100.0 100.0 Number of men 563 588 514 395 697 2,758 1 Includes current pregnancy The intention to use a contraceptive method in the future decreases with increasing number of children, i.e., women with one child have the greatest tendency to use a method compared with women who have more than one child. Forty-five percent of women with no children intend to use a family planning method in the future. This is higher than the figure recorded in the 1997 IDHS (38 percent). Among male respondents who were not using any contraceptive method, only 9 percent said that they intend to use a method in the future, 10 percent were unsure, and 80 percent had no intention to use in the future (Table 8.3). Unlike women, for men there is little correlation between the desire not to use a contraceptive method in the future and the number of living children. 96 | Nonuse and Intention to Use Family Planning 8.4 REASONS FOR NONUSE One of the best ways of assessing obstacles to family planning programs is to ask women and men why they are not using a contraceptive method; this was done in the 2002-2003 IDHS. Table 8.4 gives the distribution of currently married nonusers who do not intend to use family planning by reason for not using contraception, according to age. For w related (58 p method will percent). For possible (16 p Table 8.4 Reason for not intending to use contraception Percent distribution of currently married women and currently married men who are not using a contraceptive method and who do not intend to use in the future by main reason for not intending to use, according to age, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Women Men –––––––––––––––––––––– ––––––––––––––––––––– Reason 15-29 30-49 Total 15-29 30-54 Total –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Fertility related reasons 35.4 60.5 57.6 28.9 24.7 25.3 Not having sex 3.9 11.6 10.7 0.8 3.3 2.8 Menopausal/had hysterectomy 0.2 23.5 20.9 0.1 5.3 4.4 Subfecund/infecund 9.5 18.0 17.0 0.4 3.0 2.5 Wants as many children as possible 21.8 7.4 9.0 27.6 13.1 15.6 Opposition to use 11.6 5.1 5.8 5.9 8.3 7.9 Respondent opposed 1.7 1.2 1.2 2.7 3.3 3.2 Husband/partner opposed 7.1 3.4 3.8 1.7 1.2 1.3 Others opposed 0.1 0.1 0.1 0.0 0.2 0.2 Religious prohibition 2.6 0.5 0.7 1.5 3.6 3.2 Lack of knowledge 1.8 0.8 0.9 7.7 6.2 6.5 Knows no method 1.3 0.7 0.8 7.7 6.2 6.5 Knows no source 0.5 0.1 0.1 0.0 0.0 0.0 Method-related reasons 36.6 24.5 25.8 25.5 24.0 24.2 Health concerns 12.8 11.6 11.7 4.5 4.5 4.5 Fear of side effects 16.2 8.9 9.7 15.5 12.9 13.4 Lack of access/too far 0.5 0.2 0.2 0.3 0.0 0.1 Costs too much 2.2 2.7 2.7 2.1 2.4 2.3 Inconvenient to use 4.3 0.9 1.3 3.2 4.0 3.8 Interfere with body's normal processes 0.5 0.2 0.2 0.0 0.2 0.1 Other 11.1 6.8 7.3 21.5 22.7 22.5 Don’t know 3.3 2.0 2.2 10.3 8.6 8.9 Missing 0.3 0.4 0.4 0.3 5.4 4.5 Total 100.0 100.0 100.0 100.0 100.0 100.0 Number 523 4,167 4,691 383 1,828 2,212 omen, the most common reason cited for not intending to use contraception is fertility ercent), followed by reasons which are related to the method, such as concerns that the affect their health, the source of service is too far away, and that the cost is too much (26 men, the major reason for not using family planning is they want as many children as ercent) and fear of side effects (13 percent). Nonuse and Intention to Use Family Planning | 97 Among women, the major reasons for not intending to use a contraceptive method are that they are menopausal or have had hysterectomy (21 percent), that they are unable to become pregnant (17 percent subfecund), or that they want to have more children (9 e more likely to cite menopause or hysterectomy, while younger e more children. Fear of side effects and health concerns are the next m contraception (10 and 12 percent, respectively). Based on thi s recommended to eliminate any misunderstanding women may e effects. Comprehensive information on available methods incl s would enable nonusers to make informed choices before decidin The reasons cited by men vary by age; younger men t e (28 percent), while older men are more likely to mention other t having sex, wife menopausal or had hysterectomy, or being sub of both younger and older men cite health-related reasons. 8.5 PREFERRED METHOD Table 8.5 presents data on currently married women t currently using family planning but intend to use in the future large proportion of women want to use injectables (56 percent), e the pill. Comparison of the results of this survey with those of the past IDHS shows that gradually larger proportions of women intend to use injectables (34 percent in 1987 to 56 percent in 2002-2003) and smaller proportions intend to use the pill (from 40 percent in 1987 to 20 percent in 2002- 2003). Table 8.5 also shows that the majority of men who intend to use a method in the future prefer condoms (52 percent). Interestingly, 14 percent of men say that they would prefer to use male sterilization, whereas among currently married women the comperative percentage is almost negligible. One in eight currently married men who intend to use a method in the future will use “other” methods, which include female methods. 98 | Nonuse and Intention to Use Family Planning percent). As expected, older women ar women are more likely to want to hav ost commonly cited reasons for not using s finding, family planning counseling i have about methods and the possible sid uding their advantages and disadvantage g on a contraceptive method to use. end to want as many children as possibl fertility reasons (12 percent), such as no fecund or infecund. However, one-fourth and currently married men who are no . Findings show that an overwhelmingly while 19 percent say that they want to us Table 8.5 Preferred method Percent distribution of currently married women and currently married men who are not using a contraceptive method but who intend to use in the future, by preferred method, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––– Preferred method Women Men ––––––––––––––––––––––––––––––––––––––– Female sterilization 2.3 a Male sterilization 0.1 13.5 Pill 19.1 a IUD 7.5 a Injectables 55.6 a Implants 7.0 a Condom 0.4 51.8 Periodic abstinence 0.7 9.4 Withdrawal 0.3 5.2 Other 2.4 11.9 Don't know 4.4 7.0 Missing 0.1 1.1 Total 100.0 100.0 Number of women/men 4,765 482 ––––––––––––––––––––––––––––––––––––––– a Method was not considered separately and is included in other methods. OTHER PROXIMATE DETERMINANTS OF FERTILITY 9 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 the exposure of women to the risk of pregnancy and, therefore, is important for understanding fertility patterns. Popula- tions in which age at marriage is low tend to be populations with early childbearing and high fertility. The chapter also includes information on several more direct measures of the beginning of expo- sure to pregnancy (age at first marriage) and the level of exposure (frequency of intercourse). Finally, measures of several other proximate determinants of fertility which, like marriage and sexual intercourse, influence exposure to the risk of pregnancy are presented: duration of postpartum amenorrhea, postpartum abstinence, and menopause. In the 2002-2003 Indonesia Demographic and Health Survey (IDHS), questions about the proxi- mate determinants of fertility were included in the individual questionnaire, which was administered only to ever-married women. However, a number of the tables in this chapter are based on all women, that is, on ever-married women and never-married women. In constructing these tables, the denominators have been expanded to represent all women by multiplying the number of ever-married women by an inflation factor equal to the ratio of all women to ever-married women reported in the Household Questionnaire. The inflation factors are calculated by single years of age, either for the population as a whole or, in cases where the results are presented by background characteristics, separately for each category of the charac- teristic in question. 9.1 CURRENT MARITAL STATUS The percent distribution of all women age 15-49 by current marital status and age is shown in Ta- ble 9.1. The data indicate that 25 percent of women have never been married, 71 percent are currently married, 2 percent are divorced, and 2 percent are widowed. The percentage never married decreases rap- idly from 85 percent among teenagers (age 15-19) to 41 percent among women age 20-24. The virtual universality of marriage is evidenced by the fact that 94 percent of women age 30 and older are married, divorced, or widowed. The proportion of women who are widowed increases steadily with age, from less than 1 percent of women under age 30, to 4 percent of women age 40-44, and then to 9 percent of women age 45-49, while the proportion divorced is highest (4 percent) among two age groups, women 30-34 and women 45-49. The distribution of women by marital status and province is shown in Appendix Table A.9.1. Among the provinces, the largest proportion of never-married women is found in South Sulawesi (39 per- cent), while West Java and Central Kalimantan have the lowest proportions never married (20 percent). The proportion of women who are married is lowest in South Sulawesi (57 percent) and highest in Central Kalimantan (78 percent). The percentage of women who are divorced ranges from less than 1 percent in Central Kalimantan, East Kalimantan, and Riau to 6 percent in West Nusa Tenggara. The extent of wid- owhood also varies across provinces, ranging from less than 1 percent in Central Kalimantan to 4 percent in Jambi. Other Proximate Determinants of Fertility | 99 Table 9.1 Current marital status Percent distribution of women by current marital status, according to age, Indone- sia 2002-2003 Marital status Age Never married Married Divorced Widowed Total Number of women 15-19 85.4 14.0 0.6 0.0 100.0 6,531 20-24 41.2 57.0 1.4 0.4 100.0 6,593 25-29 13.8 83.7 2.2 0.3 100.0 6,234 30-34 5.9 89.3 3.5 1.3 100.0 5,767 35-39 3.0 92.7 2.4 1.9 100.0 5,342 40-44 2.1 91.8 2.5 3.7 100.0 4,679 45-49 2.0 85.6 3.7 8.7 100.0 4,168 Total 25.0 70.9 2.2 1.9 100.0 39,315 9.2 AGE AT FIRST MARRIAGE Whether or not the start of marriage coincides with the initiation of sexual intercourse (and, thus, the beginning of exposure to the risk of pregnancy), the age at first marriage is an important social and demographic indicator. Women who marry early will have, on average, longer exposure to the risk of be- coming pregnant; therefore, early age at first marriage usually implies higher fertility for a society. In Indonesia, marriage is highly associated with fertility since most births occur within marriage. Thus, an understanding of trends in the age at first marriage can be important in interpreting changes in fertility patterns in Indonesia. Table 9.2 shows the proportions married before specified ages and the me- dian age at marriage for successive age groups. The median is defined as the age by which 50 percent of all women in the age group were married. It is preferred over the mean as a measure of central tendency, because, unlike the mean, it can be estimated for all cohorts where at least half of the women are ever married at the time of survey. In drawing conclusions concerning trends, the data for the oldest cohorts in Table 9.2 should be interpreted cautiously, since women may not recall marriage dates or ages with accu- racy. Table 9.2 Age at first marriage Percentage of women who were first married by specific exact age and median age at first marriage, according to current age, Indonesia 2002-2003 Percentage first married by exact age: Current age 15 18 20 22 25 Percentage never married Number Median age at first marriage 15-19 2.8 na na na na 85.4 6,531 a 20-24 4.7 24.2 42.1 na na 41.2 6,593 a 25-29 7.2 29.0 48.2 64.0 78.9 13.8 6,234 20.2 30-34 10.1 32.1 50.5 65.2 81.0 5.9 5,767 19.9 35-39 12.7 41.7 57.2 72.0 84.7 3.0 5,342 18.9 40-44 17.0 46.8 66.5 79.8 89.4 2.1 4,679 18.3 45-49 20.4 51.2 68.9 80.6 90.2 2.0 4,168 17.9 20-49 11.2 36.0 54.1 a a 13.0 32,784 19.5 25-49 12.8 39.0 57.1 71.4 84.2 5.9 26,191 19.2 na = Not applicable a Omitted because less than 50 percent of the women married for the first time before reaching the beginning of the age group 100 | Other Proximate Determinants of Fertility There has been a substantial change in the ages by which women first married across cohorts. For example, 20 percent of women age 45-49 were married by age 15, compared with 10 percent of women age 30-34 and with less than 5 percent of women age 20-24. Similarly, seven in ten women age 45-49 were married by age 20, whereas four in ten women age 20-24 were married by that age. Overall, the median age at first marriage increases rapidly across cohorts, from 17.9 years among women in the oldest age group to 20.2 years among women age 25-29. A comparison of the results from the 2002-2003 survey with those of the 1997 IDHS confirms the trend toward an increased age at marriage; the median age at first marriage among women age 25-49 was 18.6 years at the time of the 1997 survey (Central Bu- reau of Statistics et al., 1998) compared with 19.2 years in the 2002-2003 survey. Table 9.3 shows the median age at first marriage according to residence and level of education. For urban women age 25-49, the median age at first marriage is 20.3 years, whereas for rural women it is 18.3 years. Better-educated women marry at a later age than less-educated women. Among women with secondary and higher education, the median age at first marriage is 23.5 years, six years older than the age among women with no education (17.1 years). Table 9.3 Median age at first marriage Median age at first marriage among women age 25-49, by current age and background characteristics, Indonesia 2002-2003 Age Women age Background characteristic 25-29 30-34 35-39 40-44 45-49 25-49 Residence Urban 21.7 21.2 20.2 19.1 18.6 20.3 Rural 19.1 18.9 18.0 17.7 17.4 18.3 Education No education 17.7 17.4 16.8 17.4 16.9 17.1 Some primary 17.6 17.1 17.6 17.0 17.0 17.3 Completed primary 18.5 18.3 17.8 18.0 17.6 18.1 Some secondary 19.9 19.8 19.5 19.4 18.8 19.6 Secondary + 23.9 23.7 23.4 22.9 22.3 23.5 Total 20.2 19.9 18.9 18.3 17.9 19.2 Variations in age at first marriage according to province are presented in Appendix Table A.9.2. The median age at first marriage among women age 25-49 is highest in East Nusa Tenggara (21.7 years). In addition to East Nusa Tenggara, the median age at first marriage exceeds 21 years in North Sulawesi, Bali, DKI Jakarta, DI Yogyakarta, and North Sumatera. West Java has the lowest median age at first mar- riage (17.8 years), followed by South Kalimantan (18.0 years) and Lampung (18.0 years). Figure 9.1 shows that, since 1994, the median age at first marriage has increased in all provinces in Java. Other Proximate Determinants of Fertility | 101 20.1 17.0 17.9 20.3 16.7 20.6 17.4 18.5 20.7 17.8 21.4 17.8 18.8 21.1 18.8 DKI Jakarta West Java Central Java DI Yogyakarta East Java 0.0 5.0 10.0 15.0 20.0 25.0 Age at Marriage 1994 IDHS 1997 IDHS 2002-2003 IDHS Figure 9.1 Median Age at First Marriage by Province in Java 1994, 1997, and 2002-2003 a a Includes Banten b Excludes Banten a b 9.3 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. In the 2002-2003 IDHS, currently married women were asked how long ago their last sexual activity occurred. Table 9.4 provides information on the timing of last sexual intercourse, according to background characteristics. Overall, 82 percent of married women were sexually active in the four weeks preceding the survey, and almost all married women had had intercourse in the year preceding the survey. Two per- cent of married women had had their most recent sexual intercourse one or more years before the survey. There is a negative relationship between recent sexual activity and age. Older women tend to be less likely than younger women to report recent sexual activity; 80 percent or more of married women under age 35 were sexually active in the four weeks preceding the survey, compared with 64 percent of women age 45-49. Women in rural areas are slightly less likely to be sexually active in the last four weeks (81 per- cent), compared with women in urban areas (83 percent). There is a positive relationship between educa- tion and recent sexual activity. Women with no education are less sexually active than are educated women: 70 percent of women with no education are sexually active, compared with 88 percent of women with secondary or higher education. In part at least, this relationship may be due to the fact that less edu- cated women tend to be older than better educated women and recent sexual activity is closely associated with a woman’s age. As expected, women who are using a contraceptive method are more likely to be sexually active than women who are not using a method. The 2002-2003 IDHS data also suggest that the type of contra- ceptive method currently used is related to the timing of sexual activity; 81 percent of sterilized women had had sex in the four weeks prior to the survey, compared with 92 percent of women who were using the pill. Age differences between sterilized women and women who use spacing methods may partly ex- plain variation in the patterns of sexual activity. 102 | Other Proximate Determinants of Fertility Table 9.4 Recent sexual activity Percent distribution of currently married women by timing of last sexual intercourse, according to background characteristics, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Timing of last sexual intercourse –––––––––––––––––––––––––––––––––––––– Within One or Number Background the last Within more of characteristic 4 weeks 1 year1 years Missing Total women –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 84.2 13.2 0.0 2.6 100.0 912 20-24 85.5 12.8 0.1 1.5 100.0 3,761 25-29 87.1 10.7 0.9 1.3 100.0 5,217 30-34 88.3 10.2 0.5 1.1 100.0 5,150 35-39 82.7 14.4 1.6 1.3 100.0 4,953 40-44 79.1 16.9 2.9 1.1 100.0 4,294 45-49 63.4 27.9 7.7 1.1 100.0 3,570 Marital duration, married only once2 0-4 years 85.5 12.2 0.4 1.9 100.0 4,916 5-9 years 87.6 10.5 0.6 1.3 100.0 4,979 10-14 years 87.6 10.8 0.9 0.7 100.0 4,377 15-19 years 86.3 11.6 0.8 1.3 100.0 3,624 20-24 years 79.6 16.4 2.4 1.6 100.0 3,555 25+ years 67.6 26.0 5.4 0.9 100.0 3,984 Married more than once 73.1 20.1 5.5 1.2 100.0 2,422 Residence Urban 83.2 13.7 1.7 1.3 100.0 12,765 Rural 80.8 15.7 2.2 1.2 100.0 15,093 Education No education 70.1 22.3 5.6 2.1 100.0 2,089 Some primary 77.6 18.2 3.1 1.1 100.0 5,435 Completed primary 82.1 14.9 1.8 1.2 100.0 9,499 Some secondary 84.4 13.4 0.9 1.3 100.0 4,902 Secondary + 87.8 10.1 0.8 1.3 100.0 5,932 Current contraceptive method Female sterilization 80.6 16.1 3.2 0.2 100.0 1,037 Pill 91.6 7.5 0.3 0.6 100.0 3,691 IUD 83.4 15.4 1.0 0.3 100.0 1,714 Condom 93.9 4.9 0.0 1.2 100.0 240 Periodic abstinence 88.9 10.9 0.0 0.1 100.0 444 Other method 88.4 10.4 0.6 0.6 100.0 9,679 No method 72.4 21.2 4.0 2.4 100.0 11,051 Total 81.9 14.8 2.0 1.3 100.0 27,857 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1 Excludes women who had sexual intercourse within the last four weeks 2 Excludes women who are not currently married Appendix Table A.9.3 provides information on women by timing of last sexual intercourse, ac- cording to province. There are substantial variations by province in the proportion of women who were sexually active in the four weeks preceding the survey, ranging from a low of 77 percent in Central Java and East Nusa Tenggara to 91 percent in North Sulawesi. The low proportion of women who are sexually active in West Nusa Tenggara corresponds to the high proportion of women who are abstaining for other reasons, such as temporary separation. 9.4 POSTPARTUM AMENORRHEA, ABSTINENCE, AND INSUSCEPTIBILITY Among women who are not using contraception, exposure to the risk of pregnancy in the period following a birth is influenced primarily by two factors: breastfeeding and sexual abstinence. Breastfeed- ing prolongs postpartum protection from conception through its effect on the length of the period of Other Proximate Determinants of Fertility | 103 amenorrhea (the period prior to the return of menses) following a birth. More frequent breastfeeding and breastfeeding for longer durations, as well as delays in the age at which supplementary foods are intro- duced, are associated with longer periods of postpartum amenorrhea. Delaying the resumption of sexual relations following a birth also prolongs the period of postpartum protection. For purposes of the follow- ing discussion, women are defined as being insusceptible to pregnancy if they are not at risk of concep- tion, either because they are amenorrheic or abstaining following a birth. Table 9.5 shows the percentage of births in the three years preceding the survey for which the mother is postpartum amenorrheic, abstaining, and insusceptible, by the number of months since the birth. The estimates shown in Tables 9.5 are based on current status data; that is, they refer to the woman’s situation at the time of the survey. The data are grouped in two-month intervals to minimize fluctuations in the estimates. Table 9.5 Postpartum amenorrhea, abstinence, and insusceptibility Percentage of births in the three years preceding the survey for which the mother is postpartum amenorrheic, abstaining, and insusceptible, by number of months since birth, and median and mean durations, Indonesia 2002-2003 Percentage of births for which the mother is: Months since birth Amenorrheic Abstaining Insusceptible Number of births <2 92.2 91.0 97.2 445 2-3 53.9 34.0 63.7 596 4-5 43.9 10.7 47.4 566 6-7 32.8 10.2 37.6 484 8-9 25.6 4.9 27.7 442 10-11 24.2 5.6 25.4 466 12-13 28.1 4.0 30.4 599 14-15 22.2 4.3 23.4 495 16-17 15.7 3.1 18.3 524 18-19 20.6 4.6 23.7 493 20-21 12.3 2.2 13.9 439 22-23 11.7 2.7 13.8 372 24-25 15.7 1.8 17.0 484 26-27 10.4 1.7 11.9 541 28-29 10.3 2.4 12.1 529 30-31 14.8 2.1 16.4 507 32-33 13.6 1.3 14.9 562 34-35 7.4 1.6 9.0 493 Total 25.4 10.2 28.2 9,037 Median 3.8 2.2 4.6 na Mean 9.4 4.1 10.3 na Note: Estimates are based on status at the time of the survey. na = Not applicable Table 9.5 shows that almost all women are insusceptible to pregnancy in the first two months fol- lowing a birth, and both amenorrhea and abstinence contribute to their insusceptibility. However, the contribution of abstinence to the insusceptible period becomes increasingly less important from the fourth month after birth, since most women resume sexual relations by that point. The decrease in the protective effect of amenorrhea is less rapid: 54 percent of women are still amenorrheic at 2 to 3 months after birth, 28 percent are still amenorrheic at 12 to 13 months, and 16 percent are still amenorrheic at 24 to 25 months (Figure 9.2). 104 | Other Proximate Determinants of Fertility + + + + + + + + + + + + + + + + + + ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' <02 4-5 8-9 12-13 16-17 20-21 24-25 28-29 32-33 Months since Birth 0 20 40 60 80 100 Percent Amenorrheic Abstaining' + IDHS 2002-2003 Figure 9.2 Percentage of Births in the Past Three Years for Which the Mother is Amenorrheic or Abstaining <2 The median durations of postpartum amenorrhea, abstinence, and insusceptibility by background characteristics of women are shown in Table 9.6. Women under 30 years of age are insusceptible to the risk of pregnancy for one month less than women 30 years and over (4.2 and 5.3 months, respectively). The corresponding periods for urban and rural women are 4.0 and 5.4 months, respectively. Women with less education are insusceptible for a much longer period than better-educated women; the median dura- tion of insusceptibility is 9.6 months for women with no education, compared with 3.7 months for women with a secondary or higher education. The contribution of amenorrhea to the insusceptible period is greater than the contribution of abstinence for all groups. Table 9.6 Median duration of postpartum insusceptibility by background character- istics Median number of months of postpartum amenorrhea, postpartum abstinence, and postpartum insusceptibility following births in the three years preceding the survey, by background characteristics, Indonesia 2002-2003 Background characteristic Postpartum amenorrhea Postpartum abstinence Postpartum insusceptibility Number of births Age 15-29 3.6 2.3 4.2 5,410 30-49 4.4 2.0 5.3 3,627 Residence Urban 3.1 2.2 4.0 4,274 Rural 4.5 2.2 5.4 4,763 Education No education 8.3 1.8 9.6 409 Some primary 5.5 2.3 6.2 1,260 Completed primary 4.1 2.2 4.8 2,960 Some secondary 2.9 2.2 3.9 1,932 Secondary + 3.0 2.2 3.7 2,476 Total 3.8 2.2 4.6 9,037 Note: Medians are based on current status. Other Proximate Determinants of Fertility | 105 Appendix Table A.9.4 presents the differentials in postpartum amenorrhea, abstinence, and insus- ceptibility, by province. Postpartum amenorrhea ranges from less than 2 months in North Sumatera to almost 11 months in East Nusa Tenggara. Differences in the duration of abstinence tend to be less pro- nounced than differences in the duration of amenorrhea, with women in almost all provinces abstaining for a little more than 2 months following a birth. Thus, provincial differences in the duration of insuscep- tibility generally replicate the differences in the duration of amenorrhea. The median duration of insus- ceptibility is longest for women in East Nusa Tenggara and women in South Sulawesi (11.4 and 7.9 months, respectively) and shortest in Bangka Belitung (2.2 months). 9.5 TERMINATION OF EXPOSURE Another factor influencing the risk of pregnancy among women is menopause. Among women age 30 and over, the lack of a menstrual period in the preceding six months among women who are nei- ther pregnant nor postpartum amenorrheic is taken as evidence of menopause and, therefore, infecundity. Table 9.7 shows that, as expected, the proportion of women who are menopausal increases with age from 9 percent for women age 30-34 years, to 21 percent of women age 44-45, and to 47 percent for women age 48-49 years. Table 9.7 Menopause Percentage of women age 30-49 who are menopausal, by age, Indonesia 2002-2003 Age Percentage menopausal1 Number of women 30-34 8.8 5,428 35-39 9.8 5,181 40-41 10.9 1,993 42-43 11.1 1,940 44-45 20.6 1,696 46-47 29.1 1,374 48-49 47.2 1,664 Total 15.3 19,276 1 Percentage of all women who are not pregnant and not postpartum amenorrheic whose last menstrual period occurred six or more months preceding the survey 106 | Other Proximate Determinants of Fertility INFANT AND CHILD MORTALITY 10 For some time, Indonesia’s health programs have focused on reducing the high levels of infant and childhood mortality. Infant and child mortality rates are relevant not only in evaluating the progress of health programs, but also in monitoring the current demographic situation and providing 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 2002-2003 Indonesia Demographic and Health Survey (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 Perinatal mortality: the sum of stillbirths and early neonatal deaths (deaths in the first seven days of life) divided by the number of pregnancies of seven or more months. Data on infant and child mortality in the 2002-2003 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. 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 or her age at last birthday and whether the child resided with his or her mother was obtained. For children who had died, the respondent was asked to provide the age at death. 10.1 ASSESSMENT OF DATA QUALITY A retrospective birth history, such as that included in the 2002-2003 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 had 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 2002-2003 IDHS data can be examined for evidence of the existence and extent of some of these biases. With respect to the misreporting of children’s birth dates, as shown in Appendix Table D.4, there is a deficit of births in calendar year 1997 and an excess in calendar year 1996. This pattern, which has been found in previous IDHS surveys, is thought to result from interviewers’ transference of births out of the period for which the calendar and child health data were collected (i.e., January 1997 through the date of the survey) to reduce their workload. Infant and Child Mortality | 107 With regard to the reporting of children’s age at death, the most common source of error is the tendency of mothers to report the age in multiples of six months. To reduce this type of error, detailed instructions were given to the IDHS interviewers to record age at death under one month in days and the age at death under two years in months. Interviewers were also instructed to probe for exact age at death in months whenever it was reported as “one year” or “12 months.” The distribution of child deaths by the age of the child at death is shown in Appendix Table D.5. There is some evidence of overreporting of deaths at age 7 days or one week, which affects the counting of perinatal deaths. There is no evidence of heaping of deaths at age 12 months, a common error that can affect infant mortality estimates. Deaths at age 6 months and 18 months are overreported; there are also deaths reported as occurring at age “one year,” despite instructions to record in months. The heaping of age of death at 6 months and 18 months is not as serious as that recorded in the 1997 IDHS. As expected, heaping in age at death is more serious for deaths that occurred further in the past than for those that occurred more recently. As can be seen from Figure 10.1, the distribution of deaths reported for the period 0-4 years preceding the survey is smoother than the distributions for the periods 5-9 and 10-14 years before the survey. 01 3 5 7 9 11 13 15 17 19 21 23 Age at Death (Months) 0 20 40 60 80 100 N um be r o f d ea th s 0-4 5-9 10-14 IDHS 2002-2003 Figure 10.1 Reporting of Age at Death in Months Years preceding Survey 1 Another problem concerns the fact that the IDHS mortality estimates refer to the survival status of births that occurred in a given period of time (e.g., 0-4 years before the survey). However, because only women who were in the reproductive ages at the time of the survey were interviewed, women over age 49 were not interviewed and, thus, could not report the survival of any births they may have had in the period being considered. As the periods covered extend further into the past, the resulting censoring of information becomes progressively more severe. To minimize the effect of censoring, analysis of infant and child mortality trends from the 2002-2003 IDHS is limited to a period no more than 15 years prior to the survey. In discussing issues affecting IDHS mortality data, it also should be noted that, because fertility levels are low in Indonesia, the IDHS infant and child mortality estimates are based on relatively small numbers of cases. This situation can lead to unstable estimates. To reduce this problem, mortality measures based on the 2002-2003 IDHS are calculated for five- or ten-year periods. 108 | Infant and Child Mortality Finally, the mortality estimates from the IDHS surveys are computed directly from information on the deaths of children collected in the birth history table. Lacking the necessary information for producing estimates using direct methods, population censuses in Indonesia typically report indirect estimates based on the number of children ever born and children surviving. While there is no conclusive agreement whether one estimate is better than the other, the underlying assumptions used in the indirect estimates can introduce a potential bias. Studies have found that even when an appropriate mortality model is applied, the results of the indirect estimation techniques are consistently higher than that of the direct methods (Sullivan et al., 1994). Thus, in this report, only direct estimates from the IDHS are presented. 10.2 LEVELS AND TRENDS IN INFANT AND CHILD MORTALITY Table 10.1 presents estimates of childhood mortality for three five-year periods preceding the survey. The data indicate that under-five mortality has declined 42 percent during the fifteen-year period, from 79 deaths per 1,000 live births in the period 1988-1992 to 46 per 1,000 in the period 1998-2002. Infant deaths comprise the majority of under-five deaths. Also, during the fifteen-year period, post- neonatal mortality declined at a faster rate (50 percent) than the neonatal mortality rate (31 percent). As a result, the majority of infant deaths now take place during the first month of life. Table 10.1 Early childhood mortality rates Neonatal, postneonatal, infant, child, and under-five mortality rates for five-year periods preceding the survey, Indonesia 2002-2003 Years preceding the survey Approximate calendar years Neonatal mortality (NN) Postneonatal mortality (PNN)1 Infant mortality (1q0) Child mortality (4q1) Under-five mortality (5q0) 0-4 1998-2002 20 15 35 11 46 5-9 1993-1997 26 25 51 13 63 10-14 1988-1992 29 30 59 21 79 1 Computed as the difference between the infant and neonatal mortality rates Using estimates from prior surveys and censuses, Figure 10.2 shows that the infant mortality rate has declined from 142 deaths per 1,000 live births in 1967 to 35 deaths per 1,000 live births in 2000. Slight fluctuations in the estimates are expected as they were calculated using different estimation techniques. There are also differences in the geographic areas covered in the various surveys and censuses. Infant and Child Mortality | 109 & & & & & & & & & 1967 1982 1989 1995 2000 Calendar Year 0 20 40 60 80 100 120 140 160 D ea th s pe r 1 ,0 00 li ve b i rt hs Figure 10.2 Infant Mortality Rates, Selected Sources, Indonesia, 1971-2002 142(a) 112(b) 75(c) 70(d) 68(e) 57(f) 46(g) 47(h) 35(i) Source: (a) 1971 Census, (b) 1980 Census, (c) 1987 NICPS, (d) 1990 Census, (e) 1991 IDHS, (f) 1994 IDHS, (g) 1997 IDHS, (h) 2000 Census, (i) 2002-2003 IDHS 10.3 MORTALITY DIFFERENTIALS A number of socioeconomic, environmental, and biological factors influence infant and child mortality. In a framework developed for the study of child mortality in developing countries, Mosley and Chen’s (1984) outline various proximate and socioeconomic determinants of infant mortality. The proximate determinants which are factors that affect mortality directly include: maternal characteristics such as age, parity, and birth interval; environmental contamination; nutrition; injury; and personal illness. Socioeconomic factors operate through the proximate determinants. In the following section, socioeconomic and biodemographic differentials for which data were collected in the 2002-2003 IDHS are discussed. The socioeconomic determinants include place of residence, mother’s educational attainment, and wealth index quintile. The biodemographic determinants include age of the mother, parity, and birth interval. Several other variables that have been shown to be related to child health and mortality, such as birth weight, antenatal care and delivery assistance, and complications during delivery are also discussed. Table 10.2 presents early childhood mortality rates for the ten-year period preceding the survey (approximately 1993 to 2002) by socioeconomic characteristics of the mother. In general, children born to mothers living in urban areas have lower mortality rates than those born to women in rural areas. For example, the postneonatal mortality rate in urban areas is half that in rural areas (13 per 1,000 live births compared with 26 per 1,000 live births). The same pattern was found in the past IDHS surveys for all ages at death and in all areas of the country. The lower mortality rates in urban areas may be related to the greater availability of health facilities and better health-seeking practices of urban dwellers. 110 | Infant and Child Mortality Table 10.2 Early childhood mortality rates by socioeconomic characteristics Neonatal, postneonatal, infant, child, and under-five mortality rates for the 10-year period preceding the survey, by background characteristic, Indonesia 2002-2003 Background characteristic Neonatal mortality (NN) Postneonatal mortality (PNN)1 Infant mortality (1q0) Child mortality (4q1) Under-five mortality (5q0) Residence Urban 19 13 32 11 42 Rural 26 26 52 13 65 Mother’s education No education 34 33 67 25 90 Some primary 30 35 65 16 80 Completed primary 22 21 43 11 54 Some secondary 22 14 36 11 47 Secondary + 16 8 23 5 28 Wealth index quintile Lowest 28 33 61 17 77 Second 30 20 50 15 64 Middle 21 23 44 12 56 Fourth 20 16 36 9 45 Highest 13 4 17 5 22 1 Computed as the difference between the infant and neonatal mortality rates The 2002-2003 IDHS data show that mother’s educational attainment is inversely associated with childhood mortality levels; children of less-educated mothers generally have higher mortality rates than those born to better-educated mothers. For instance, the infant mortality rate for children whose mother had no education is 67 deaths per 1,000 live births, compared with 23 deaths per 1,000 live births for children whose mothers have secondary or higher education. Household wealth in the 2002-2003 IDHS questionnaire is derived from information on housing amenities and ownership of household durable goods such as radio, television, refrigerator, bicycle, motorcycle, or car. All these items were considered household assets and were used to construct a composite index. Household members were then classified into five categories (quintiles) according to the scores of their household: lowest, second, middle, fourth, and highest. There is an inverse relationship between wealth and mortality rates; children living in richer households have lower mortality. For example, the infant mortality rate for children in the lowest quintile is 61 deaths per 1,000 live births, while the corresponding rate for children in the highest quintile is only 17 deaths per 1,000 live births. Appendix Table A.10.1 shows the mortality rates for the 10-year period preceding the survey by province. Gorontalo and West Nusa Tenggara have the highest infant mortality rates (77 and 74 deaths per 1,000 live births, respectively), while Bali has the lowest infant mortality rate (14 deaths per 1,000 live births). This pattern is different from that found in past IDHS surveys, where DI Yogyakarta had consistently shown the lowest level in infant mortality rate. Looking at child mortality, Bangka Belitung, DI Yogyakarta, and Bali have the lowest rates, and West Nusa Tenggara has the highest level. Bangka Belitung and Gorontalo, have higher infant mortality than the provinces from which they were split off (South Sumatera and North Sulawesi, respectively). Infant mortality in Banten is lower than that in West Java, of which it used to be part. Table 10.3 presents the trends in infant mortality by province, from 1994 to 2003. Infant mortality has declined in almost all provinces. West Nusa Tenggara had the highest infant mortality rates throughout the period. Infant and Child Mortality | 111 Table 10.3 Trends in infant mortality by province Infant mortaliy rates (per 1,000) for the 10-year period preceding the survey, by province, 1994-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1994 1997 2002-2003 Province IDHS IDHS IDHS –––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 61 45 42 West Sumatera 68 66 48 10.4 DEMOGRAPHIC C Table 10.4 presen eristics. Rates for males are consistently hig te for males is 15 percent higher than the ra ercent higher than for females. 112 | Infant and Child Mortality Riau 72 60 43 Jambi 60 68 41 South Sumatera 60 53 30 Bengkulu 74 72 53 Lampung 38 48 55 Bangka Belitung1 na na 43 Java DKI Jakarta 30 26 35 West Java 89 61 44 Central Java 51 45 36 DI Yogyakarta 30 23 20 East Java 62 36 43 Banten1 na na 38 Bali and Nusa Tenggara Bali 58 40 14 West Nusa Tenggara 110 111 74 East Nusa Tenggara 71 60 59 Kalimantan West Kalimantan 97 70 47 Central Kalimantan 16 55 40 South Kalimantan 83 71 45 East Kalimantan 61 51 42 Sulawesi North Sulawesi 66 48 25 Central Sulawesi 87 95 52 South Sulawesi 64 63 47 Southeast Sulawesi 79 78 67 Gorontalo1 na na 77 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: The 2002-2003 IDHS did not include Nanggroe Aceh Darussalam, Maluku, North Maluku, and Papua province. Previous surveys included East Timor. na = not applicable 1 Provinces that were split off from South Sumatera, West Java, and North Sulawesi provinces, respectively HARACTERISTICS ts early childhood mortality rates by demographic charact her than for females. For example, the infant mortality ra te for females, and the child mortality rate for males is 18 p Mother’s age at birth can affect a child’s chances of survival. The table shows that neonatal mortality rates and infant mortality rates exhibit the expected U-shaped relationship with the mother’s age, high at young ages, low at middle ages, and high at old ages. For example, the infant mortality for women who gave birth at age below 20 years is 53 deaths per 1,000 live births. The rate decreases among women who gave birth at age 20-29 years and 30-39 (39 and 46 deaths per 1,000 live births, respectively) and then rises to 50 deaths per 1,000 live births for women who gave birth at age 40-49 years. The higher rates for younger and older women may be related to biological factors that lead to complications during pregnancy and delivery. The 2002-2003 IDHS results show that there is a clear positive association between birth order and the probability of dying; higher order births have higher mortality risks. For example, while the infant mortality rate for first-order births is 36 deaths per 1,000 live births, the corresponding rate for seven or higher order births is 89 deaths per 1,000 live births. Table 10.4 Early childhood mortality rates by demographic characteristics Neonatal, postneonatal, infant, child, and under-five mortality rates for the 10-year period preceding the survey, by demographic characteristics, Indonesia 2002-2003 Demographic characteristic Neonatal mortality (NN) Postneonatal mortality (PNN)1 Infant mortality (1q0) Child mortality (4q1) Under-five mortality (5q0) Child’s sex Male 24 21 46 13 58 Female 21 19 40 11 51 Mother’s age at birth <20 32 21 53 10 62 20-29 19 19 39 14 52 30-39 24 22 46 10 56 40-49 36 14 50 8 58 Birth order 1 22 15 36 8 44 2-3 20 18 37 12 48 4-6 26 29 55 15 69 7+ 44 45 89 26 112 Previous birth interval2 <2 48 54 102 27 126 2 years 22 25 47 19 65 3 years 18 12 30 9 39 4+ years 16 14 31 8 38 Birth size Small/very small 39 23 62 a a Average or larger 12 12 23 a a Antenatal care/delivery assistance Both ANC and DA 10 6 16 a a ANC only 14 15 29 a a DA only 15 4 19 a a Neither ANC nor delivery 29 28 57 a a ANC = Antenatal care DA = Delivery assistance na = Not applicable 1 Computed as the difference between the infant and neonatal mortality rates 2 Excludes first-order births Infant and Child Mortality | 113 As expected, childhood mortality rates decline as the birth interval increases. For example, the infant mortality rate for children born less than two years after a previous birth is more than three times higher than the rate for children born after an interval of four or more years (102 compared with 31 deaths per 1,000 live births). A child’s size at birth has been shown to be strongly associated with the risk of dying during infancy, particularly during the first months of life. For all children born during the five-year period before the 2002-2003 IDHS, mothers were asked whether the child was very small, small, average size, large, or very large at birth. Although subjective, the mother’s judgment has been shown to correlate closely with the actual birth weight. The 2002-2003 IDHS results confirm that mortality levels are higher among children perceived by the mother to have been small or very small at birth than among other children. Neonatal mortality rates for infants who were judged to be small or very small at birth by their mothers are, for example, more than three times higher than for infants who were reported to be average or larger at birth (39 compared with 12 deaths per 1,000 live births). Table 10.4 also shows the relationship of infant and child mortality to antenatal care and delivery assistance. As expected, childhood mortality is generally lowest for children of mothers who received antenatal care and were assisted by a medical professional at delivery and highest among women who had neither antenatal care nor assistance at delivery from a trained provider. 10.5 MORTALITY BY WOMEN’S STATUS Although there is no direct association, women’s status has been found to influence infant and child mortality levels through women’s ability to control resources and make decisions. In the 2002-2003 IDHS, women were asked about their attitudes toward certain aspects of their autonomy including the number of household decisions in which the woman participates in the final say, the number of reasons for which a woman feels a wife is justified in refusing sexual relations with her husband, and the number of reasons that justify wife beating. A woman is considered more independent if she participates in a larger number of household decisions and agrees with a greater number of reasons for a woman to refuse sex. On the other hand, the more reasons she accepts for justifying wife beating, the less independent she is. Table 10.5 presents childhood mortality rates by women’s status indicators. Based on the three indicators, there appears to be a slight relationship between women’s status and childhood mortality. The relationship between mother’s participation in decisionmaking and child mortality is generally negative; children whose mothers have more say in household decisionmaking have lower mortality. The number of reasons that justify a woman’s refusal to have sexual relations with her husband operates in the same way as decisionmaking. The more reasons a woman agrees with the more likely she is to have greater independence. Thus, children of mothers who agree with no reasons would be expected to have the highest mortality rates, and Table 10.5 shows that this is the case. Attitudes toward wife beating are another reflection of women’s status. Women who do not approve of any reasons to justify wife beating are assumed to enjoy higher status, which in turn, translates into a more favorable mortality profile for their children. Table 10.5 generally shows the expected effect. Conversely, children of mothers who agree with 3-5 reasons to justify wife beating have the least favorable mortality profile. 114 | Infant and Child Mortality Table 10.5 Early childhood mortality rates by women’s status Neonatal, postneonatal, infant, child, and under-five mortality rates for the 10-year period preceding the survey, by women’s status indicators, Indonesia 2002-2003 Women’s status indicators Neonatal mortality (NN) Postneonatal mortality (PNN)1 Infant mortality (1q0) Child mortality (4q1) Under-five mortality (5q0) Number of decisions in which woman has final say2 0 28 23 51 25 75 1-2 36 39 74 11 84 3-4 24 18 42 12 54 5 21 20 41 12 53 Number of reasons to refuse sex with husband 0 26 27 53 21 73 1-2 18 21 40 10 49 3-4 23 19 43 11 54 Number of reasons wife beating is justified 0 21 19 40 12 52 1-2 24 19 42 11 53 3-4 35 38 73 13 85 5 29 30 59 23 81 1 Computed as the difference between the infant and neonatal mortality rates 2 Alone or jointly with others 10.6 PERINATAL MORTALITY In the 2002-2003 IDHS, women were asked to report all pregnancy losses in the five years before the survey. For each such pregnancy, the duration was recorded. In this report, perinatal deaths include pregnancy losses occurring after seven completed months of gestation (stillbirths) and deaths to live births within the first seven days of life (early neonatal deaths). The perinatal mortality rate is the sum of the number of stillbirths and early neonatal deaths divided by the number of pregnancies of seven or more months’ duration. The distinction between a stillbirth and an early neonatal death may be a fine one, depending often on the observed presence or absence of some faint signs of life after delivery. The causes of stillbirths and early neonatal deaths overlap, and examining just one or the other can understate the true level of mortality around delivery. For this reason, in this report, both event types are combined and examined together. The perinatal mortality rate is a useful indicator of the state of delivery services, in terms of both the use of these services and their ability to ensure the delivery of a healthy baby. Data in Table 10.6 show that overall, 147 stillbirths and 224 early neonatal deaths were recorded in the survey, resulting in a perinatal mortality rate in Indonesia of 24 per 1,000 pregnancies. Perinatal mortality is highest among mothers who gave birth after age 40. The perinatal rate is lowest among mothers age 20-29. Table 10.6 further demonstrates that the duration of the previous pregnancy interval has a strong influence on the outcome of the index pregnancy. Pregnancies occurring within 15 months of a previous birth have the highest risk to pregnancy loss or early death (50 pregnancy losses or early deaths per 1,000 pregnancies), while the safest interval is between 15 and 26 months (14 pregnancy losses or early deaths per 1,000). Infant and Child Mortality | 115 Table 10.6 Perinatal mortality Number of stillbirths and early neonatal deaths, and the perinatal mortality rate for the five-year period preceding the survey, by background characteristics, Indonesia 2002- 2003 Background characteristic Number of stillbirths1 Number of early neonatal deaths2 Perinatal mortality rate3 Number of pregnancies of 7+ months duration Mother’s age at birth <20 14 42 30 1,869 20-29 58 123 21 8,536 30-39 57 50 25 4,355 40-49 18 8 54 475 Previous pregnancy interval in months First pregnancy 34 94 25 5,048 <15 12 18 50 607 15-26 10 15 14 1,691 27-38 16 23 25 1,580 39+ 75 74 24 6,310 Residence Urban 55 97 22 7,085 Rural 91 126 27 8,151 Mother’s education No education 8 10 25 718 Some primary 41 36 34 2,279 Completed primary 36 60 19 5,075 Some secondary 29 58 28 3,103 Secondary + 31 60 23 4,061 Total 147 224 24 15,236 1 Stillbirths are fetal deaths in pregnancies lasting seven or more months. 2 Early neonatal deaths are deaths at age 0-6 days among live-born children. 3 The sum of the number of stillbirths and early neonatal deaths divided by the number of pregnancies of seven or more months duration per 1,000. As with other childhood mortality measures, perinatal mortality rates are lower for children of women in urban areas than children of women in rural areas. While better-educated women would be expected to have lower levels of perinatal mortality, the rate for children of the most highly educated women is close to that of women with no education. The lowest perinatal mortality rate is for the children whose mothers have completed primary education. 10.7 HIGH-RISK FERTILITY BEHAVIOR There is a strong relationship between maternal fertility patterns and children’s survival risks. Generally, infants and children have been shown to have a greater probability of dying if they are born to mothers who are too young or too old, if they are born after a short birth interval, or if they are of high birth order. These factors are of particular interest since they are easily avoidable at low cost. For purposes of the analysis of high risk fertility presented in Table 10.7, a mother is classified as too young if she is less than 18 years of age and too old if she is over 34 years of age at the time of delivery. A short birth interval is defined as a birth occurring less than 24 months after the previous birth, and a child is of high birth order if the mother had previously given birth to three or more children (i.e., if the child is of birth order four or higher). Although first births are commonly associated with high 116 | Infant and Child Mortality mortality risk, even if they occurred when the mother was between 18 and 34 years old, they are not included in the high-risk category unless they occurred too early or late; instead, they are considered unavoidable. The first column in Table 10.7 shows the percentage of births occurring in the five years before the survey that fall into these various risk categories. One in three births in Indonesia has an elevated mortality risk that is avoidable, 30 percent are first births for which any risk is considered unavoidable, and 36 percent of births were not in any high-risk category. Among those who are at risk, 22 percent of births are in only one of the high-risk categories, while 12 percent are in multiple high-risk categories (due to a combination of mother’s age, birth order, and birth interval). Table 10.7 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 risk ratio, and percent distribution of currently married women by category of risk if they were to conceive a child at the time of the survey, Indonesia 2002-2003 Births in the 5 years preceding the survey Risk category Percentage of births Risk ratio Percentage of currently married women1 Not in any high risk category 35.6 1.00 31.6a Unavoidable risk category First order births between ages 18 and 34 years 30.4 0.98 5.7 Single high-risk category Mother’s age <18 4.1 1.83 0.2 Mother’s age >34 3.8 0.40 13.5 Birth interval <24 months 5.2 2.02 8.0 Birth order >3 9.4 1.31 6.7 Subtotal 22.4 1.42 28.4 Multiple high-risk category Mother’s age <18 & birth interval <24 months 2 0.2 1.38 0.1 Mother’s age >34 & birth interval <24 months 0.1 0.99 0.4 Mother’s age >34 & birth order >3 8.5 1.29 29.0 Mother’s age >34 & birth interval <24 months & birth order >3 1.1 3.48 2.2 Birth interval <24 months & birth order >3 1.8 3.89 2.7 Subtotal 11.6 1.88 34.3 In any avoidable high-risk category 34.0 1.58 62.7 Total 100.0 na 100.0 Number of births 15,089 na 27,857 Note: Risk ratio is the ratio of the proportion dead among births in a specific high-risk category to the proportion dead among births not in any high-risk category. na = Not applicable 1 Women are assigned to risk categories according to the status they would have at the birth of a child if they were to conceive at the time of the survey: current age less than 17 years and 3 months or older than 34 years and 2 months, latest birth less than 15 months ago, or latest birth being of order 3 or higher. 2 Includes the category mother’s age <18 and birth order >3 a Includes sterilized women Infant and Child Mortality | 117 The single high-risk category with the highest percentage of births is birth order three or higher; this category includes 9 percent of births. Compared with births with no elevated mortality risk, the mortality increase associated with this category is significant (31 percent). Mortality risks are most elevated for the single-risk categories of too young mothers and too short birth intervals; 4 and 5 percent of births fell in these categories, respectively. The multiple high-risk category with the largest proportion of births is high order births to older mothers; 9 percent of children fall in this category. Compared with births with no elevated risk, these births have a 29 percent greater risk of dying in early childhood. The multiple high-risk category with the highest risk ratio is the combination birth interval less than 24 months and birth order three or higher; the 2 percent of children in this category are almost four times as likely to die as children with no elevated mortality risk. The last column of Table 10.7 presents the distribution of currently married women according to category of increased risk if they were to conceive at the time of the survey. Although many women are protected from conception due to use of family planning, postpartum insusceptibility, and prolonged abstinence, for simplicity, only those who have been sterilized are included in the category for not in any high-risk. Two in three currently married women are at risk of conceiving a child with an elevated risk of dying; 28 percent of women are at risk because of a single high-risk factor, while 34 percent of women have multiple high-risk factors. The most common risk is high birth order combined with late childbearing (29 percent of currently married women). 118 | Infant and Child Mortality MATERNAL HEALTH 11 This chapter presents findings from several areas of importance to maternal health, i.e., antenatal and delivery care, complications of pregnancy and delivery, postnatal care, women’s status, and problems in accessing health care. Information on antenatal care (ANC) and postnatal care (PNC) is of great value in identifying subgroups of women who do not utilize such services, and it is useful in planning for improvements in the services. ANC is defined according to the type of provider, the number of ANC visits made, the stage of pregnancy at the time of the first visit, the number of visits, and the services and information provided during ANC, including whether tetanus toxoid injection was received. Similarly, delivery services are described according to the person assisting, the place of the delivery, and the rate of caesarean section. Information on PNC is collected for women who did not give birth in a health facility, and it describes the time since delivery when it was received, as well as from whom it was received. Coupled with information about pregnancy complications and neonatal and infant mortality rates, this information helps identify groups who are underserved. The questions about birth weight and size provide useful information to countries seeking to reduce infant mortality through a reduction in low birth weight infants. Women’s use of antenatal, delivery, and postnatal care services from health professionals is examined in relationship to their level of empowerment as measured by three indicators of women’s status. In societies where health care is widespread, women’s status may not affect access to maternal health services; in other societies, however, increased empowerment of women is likely to be associated with an increase in their ability to seek out and use health services to better meet their own health goals, including the goal of safe motherhood. 11.1 ANTENATAL CARE 11.1.1 Antenatal Care Table 11.1 shows the percent distribution of women who had a live birth in the five years preceding the survey by the provider of antenatal care received during pregnancy and background characteristics. In Indonesia, antenatal care (ANC) is defined as pregnancy-related health care provided by a medical professional (i.e., general practitioner, obstetrician, gynecologist, nurse, midwife, or village midwife). Among 29,483 ever-married women age 15-49 interviewed in the survey, 12,760 had a live birth in the five years preceding the survey. Ninety-two percent of these mothers received antenatal care from a medical professional: 81 percent received care from a nurse, midwife, or a village midwife; 10 percent received care from an obstetrician or gynecologist; and 1 percent received care from a general practitioner. Compared with data from the 1997 IDHS, data from the current survey show a slight increase in ANC provided by a nurse, midwife, or village midwife and a decrease in the percentage of women who received no ANC (Central Bureau of Statistics et al., 1998). Antenatal care coverage is slightly lower for mothers age 35 and older, who are more likely to go to a traditional birth attendant (TBA) or to not receive antenatal care. Mothers of third- or lower-order births and those living in urban areas are more likely to receive antenatal care from a medical professional than mothers of higher-order births or rural mothers. Maternal Health | 119 Table 11.1 Antenatal care Percent distribution of women who had a live birth in the five years preceding the survey by antenatal care (ANC) provider during pregnancy for the most recent birth, according to background characteristics, Indonesia 2002-2003 Background characteristic General practiti- oner Obste- trician/ Gyne- cologist Nurse/ midwife/ village midwife Traditional birth attendant/ other No one Missing Total Number of women Age at birth <20 0.8 2.9 85.1 5.3 5.6 0.3 100.0 1,498 20-34 1.5 10.6 80.9 3.2 3.4 0.2 100.0 9,474 35-49 1.2 9.6 74.6 6.1 8.4 0.2 100.0 1,789 Birth order 1 1.8 11.5 80.9 2.8 2.8 0.2 100.0 4,283 2-3 1.3 10.5 82.2 2.9 2.9 0.2 100.0 5,881 4-5 1.3 5.2 79.0 6.8 7.4 0.3 100.0 1,650 6+ 0.3 2.7 71.2 9.7 15.3 0.8 100.0 946 Residence Urban 1.7 16.0 79.0 0.9 2.2 0.2 100.0 5,970 Rural 1.2 3.9 81.9 6.5 6.3 0.3 100.0 6,791 Education No education 1.7 0.8 67.6 11.9 17.9 0.1 100.0 580 Some primary 0.6 1.6 77.4 9.7 10.4 0.4 100.0 1,849 Completed primary 1.0 2.3 88.1 4.1 4.4 0.2 100.0 4,359 Some secondary 1.8 6.4 87.4 1.9 2.3 0.2 100.0 2,614 Secondary + 2.0 27.4 69.4 0.5 0.4 0.3 100.0 3,359 Total 1.4 9.6 80.5 3.9 4.4 0.2 100.0 12,760 Note: If more than one source of ANC was mentioned, only the provider with the highest qualifications is considered in this tabulation. There is a positive relationship between mother’s education and antenatal care. Seventy percent of mothers with no education received antenatal care from medical professionals, compared with almost all mothers who had secondary or higher education. The corresponding proportions for mothers who had some primary education and who have completed primary school are 80 and 91 percent, respectively. As expected, mothers living in urban areas and those having secondary education are more likely to receive antenatal care from an obstetrician or a gynecologist than are other mothers. Appendix Table A.11.1 shows the provincial differentials in antenatal care coverage. Almost all women in DKI Jakarta and DI Yogyakarta receive antenatal care during pregnancy. Antenatal care coverage is 90 percent or higher in more than half of the provinces covered in the survey. On the other hand, antenatal care coverage is less than 70 percent in Central Kalimantan, where a large proportion of women receive antenatal care from traditional birth attendants. 11.1.2 Number of Antenatal Care Visits and Timing of First Visit The Indonesian maternal health program recommends that pregnant women have at least four antenatal care visits during pregnancy, according to the following schedule: at least one visit in the first trimester, at least one visit in the second trimester, and at least two visits in the third trimester (Ministry of Health, 2001a). Table 11.2 shows that 64 percent of mothers meet the recommended schedule. Urban mothers are more likely to have the recommended antenatal visits than rural mothers (72 percent 120 | Maternal Health compared with 57 percent). Figure 11.1 shows that 81 percent of mothers had four or more ANC visits with a medical professional, while 4 percent of mothers had no ANC visits. Table 11.2 also shows that seven in ten pregnant women had their first antenatal care visit in the first trimester, as recommended by the government. Seventy-two percent of women had one antenatal care visit in first trimester. This coverage is below the target coverage in the maternal health program (90 percent). Mothers in urban areas are more likely than those in rural areas to have their pregnancy examined in the first trimester (79 and 66 percent, respectively). Table 11.2 Number of antenatal care visits and timing of first visit Percent distribution of women who had a live birth in the five years preceding the survey by number of antenatal care (ANC) visits for the most recent birth, and by number of months pregnant at time of first visit, and whether there was at least one ANC visit in each trimester, according to residence, Indonesia 2002-2003 Residence Number and timing of ANC visits Urban Rural Total Number of ANC visits None 2.2 6.3 4.4 1 1.6 3.2 2.5 2-3 8.2 14.2 11.4 4+ 87.5 75.2 81.0 Don’t know/missing 0.4 1.1 0.8 Total 100.0 100.0 100.0 At least one visit in first trimester, at least one visit in second trimester, and at least two visits in third trimester 71.7 56.7 63.7 Number of months pregnant at time of first ANC visit No antenatal care 2.2 6.3 4.4 <4 79.4 66.3 72.4 4-5 13.6 19.2 16.6 6-7 3.7 5.5 4.7 8+ 0.7 1.9 1.3 Don't know/missing 0.3 0.9 0.6 Total 100.0 100.0 100.0 Median months pregnant at first visit (for those with ANC) 2.6 3.2 3.0 Number of women 5,970 6,791 12,760 Maternal Health | 121 Figure 11.1 Number of Antenatal Care Visits and Number of Months Pregnant at Time of First ANC Visit Number of Antenatal Care Visits IDHS 2002-2003 Number of Months Pregnant at Time of First Visit No visit 4% 1 visit 3% 2-3 visits 11% 4+ visits 81% No ANC visit 4.4% 0-3 months 72.4% 4-5 months 16.6% 6+ months 6% 11.1.3 Components of Antenatal Care In Indonesia, every pregnant woman is recommended to receive the following services: height and weight measurements, blood pressure measurement, iron tablets, tetanus toxoid immunization, and abdominal examination (Ministry of Health, 2001a). In any antenatal care visit, a woman should be informed of the signs of pregnancy complications, have her weight measured, and give blood and urine samples. Table 11.3 shows that services most often received during antenatal care visits are abdominal examination (95 percent) and measurement of weight and blood pressure (90 percent each). Less than one in three women were informed of the signs of pregnancy complications, had their height measured, or had a blood sample taken. Thirty-seven percent had a urine test. In general, older women, women with higher birth order, rural women, and less educated women are less likely to receive complete antenatal care services. The maternal health program of the Indonesian Ministry of Health recommends that pregnant women take at least 90 iron tablets during their pregnancy (Ministry of Health, 2001a). In the 2002-2003 IDHS, all women who gave birth during the five years before the survey were asked whether they had received iron tablets during their last pregnancy and, if so, how many they had taken. Of the 12,760 women who gave birth in the five years preceding the survey, 78 percent received iron tablets during pregnancy. A discussion on the number of iron supplements taken is presented in Chapter 14. Appendix Table A.11.2 shows that there are small variations by province in the components of antenatal care received by pregnant women. The percentage of mothers whose weight was measured ranges from 66 percent in Southeast Sulawesi and North Sumatera to 99 percent in DKI Jakarta and Bali. Abdominal examination was received by at least 90 percent of the women in all provinces except Central Kalimantan and Gorontalo (84 and 80 percent, respectively). The percentage of mothers whose blood pressure was measured ranges from 75 percent in North Sumatera to 98 percent in DKI Jakarta and DI Yogyakarta. The percentage that received iron tablets varies from 58 percent in Central Kalimantan to 98 percent in DI Yogyakarta. 122 | Maternal Health Table 11.3 Components of antenatal care Among women with a live birth in the five years preceding the survey who received antenatal care for the most recent birth, percentage who received specific antenatal care services and percentage of women with a live birth in the five years preceding the survey who received iron tablets for the most recent birth, according to background characteristics, Indonesia 2002-2003 Content of care among women who received antenatal care Background characteristic Informed of signs of pregnancy complications Weight measured Height measured Blood pressure measured Urine sample taken Blood sample taken Abdom- inal exami- nation Number of women Percentage of women who received iron tablets Number of women Age at birth <20 26.1 87.3 31.3 87.8 30.9 28.4 94.6 1,410 74.1 1,498 20-34 29.9 90.7 31.9 91.3 40.1 30.3 95.8 9,126 80.8 9,474 35-49 24.5 85.9 24.8 84.4 31.3 31.6 93.2 1,634 69.3 1,789 Birth order 1 32.6 91.7 35.2 92.0 43.7 33.4 96.6 4,156 82.9 4,283 2-3 29.0 91.1 30.5 91.5 38.2 30.0 95.4 5,697 81.2 5,881 4-5 24.4 84.5 25.7 85.3 27.8 24.6 95.3 1,523 70.3 1,650 6+ 14.7 78.7 21.1 76.7 23.7 26.8 88.1 794 54.5 946 Residence Urban 30.7 95.2 36.3 95.2 49.4 37.3 97.1 5,824 82.8 5,970 Rural 26.9 84.5 25.9 85.1 27.2 23.8 93.7 6,347 74.5 6,791 Education No education 10.7 72.2 19.2 68.9 18.5 21.1 91.8 476 50.4 580 Some primary 18.6 79.6 19.5 80.1 21.1 22.5 91.5 1,650 64.5 1,849 Completed primary 23.3 89.1 26.6 89.1 29.2 25.8 94.6 4,161 77.5 4,359 Some secondary 32.0 92.3 32.8 92.8 41.1 31.6 96.2 2,547 81.9 2,614 Secondary + 40.6 95.7 42.0 96.7 57.1 40.0 98.0 3,337 89.3 3,359 Total 28.7 89.6 30.9 89.9 37.8 30.3 95.3 12,170 78.4 12,760 11.1.4 Tetanus Toxoid Injections Immunization of pregnant women is a program coordinated by the Expanded Program on Immunization (EPI) and the Maternal and Child Health Care (MCH) units in the Ministry of Health. The program recommends that women receive two tetanus toxoid (TT) injections during the first pregnancy. Booster injections are given once during each subsequent pregnancy to maintain full protection. In recent years, TT immunization was also given to women before marriage, so that any pregnancy occurring within three years of their marriage would be protected against tetanus (Ministry of Health, 2000). Overall, 51 percent of women who had a live birth in the five years before the survey received two or more TT injections during pregnancy, 22 percent received one injection, and 26 percent received no injection (Table 11.4). The coverage of women who received two or more TT injections varies by age and parity. The percentage of women receiving two or more TT injections during the most recent pregnancy is slightly higher in urban areas than in rural areas (52 and 49 percent, respectively). Tetanus toxoid coverage increases with mother’s level of education: 27 percent for women with no education and 59 percent for women with secondary or higher education. The percentage of births protected against neonatal tetanus may be higher than indicated; some women may have only required a booster injection during their most recent pregnancy. Maternal Health | 123 Table 11.4 Tetanus toxoid injections Percent distribution of women who had a live birth in the five years preceding the survey by number of tetanus toxoid injections received during pregnancy for the most recent birth, according to background characteristics, Indonesia 2002-2003 Background characteristic None One injection Two or more injections Don't know/ missing Total Number of women Age at birth <20 30.0 22.4 45.6 2.1 100.0 1,498 20-34 24.1 21.4 53.1 1.5 100.0 9,474 35-49 34.1 21.3 42.2 2.5 100.0 1,789 Birth order 1 22.4 21.8 54.2 1.6 100.0 4,283 2-3 23.8 21.5 53.1 1.6 100.0 5,881 4-5 32.0 21.7 44.6 1.6 100.0 1,650 6+ 47.7 19.6 30.1 2.5 100.0 946 Residence Urban 21.7 24.2 52.3 1.8 100.0 5,970 Rural 30.1 19.1 49.2 1.6 100.0 6,791 Education No education 56.4 15.7 27.1 0.9 100.0 580 Some primary 39.8 20.9 37.1 2.2 100.0 1,849 Completed primary 26.5 21.4 50.5 1.6 100.0 4,359 Some secondary 20.5 22.6 54.9 2.0 100.0 2,614 Secondary + 17.5 22.1 59.2 1.3 100.0 3,359 Total 26.2 21.5 50.7 1.7 100.0 12,760 Tetanus toxoid coverage varies among provinces, ranging from 21 percent in North Sumatera to 71 percent in North Sulawesi (Appendix Table A.11.3). 11.1.5 Complications of Pregnancy To identify complications associated with pregnancy, respondents were asked about certain signs and symptoms that they had experienced in association with their last birth. Table 11.5 shows that 93 percent of women reported no complications during pregnancy. Among those who had complications, 2 percent had labor before nine months, 2 percent had excessive bleeding, and less than 1 percent each had fever and convulsions. While some problems that may lead to complications during labor and delivery could have been detected during ANC visits, the data show that the reported complications during pregnancy vary little by whether a woman received ANC or by the number of ANC visits she had. 124 | Maternal Health Table 11.5 Complications during pregnancy Percentage of last births in the five years preceding the survey for which the mother had complications associated with the pregnancy, by type of complications, according to maternity care indicators, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Number Maternity Premature Excessive Convul- of care indicator labor bleeding Fever sions Other None births ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Number of ANC visits None 0.3 1.7 0.5 0.0 1.8 95.9 559 1-3 times 1.6 1.9 0.7 0.2 1.9 94.6 1,768 4+ times 1.9 1.9 0.5 0.4 4.0 92.4 10,332 Missing 1.0 1.1 0.3 0.0 0.4 98.1 101 Actions taken to overcome the complications Nothing (47.9) (7.1) (6.7) (2.7) (56.7) (0.0) 28 Rest 26.2 25.4 10.3 8.5 44.6 0.0 112 Take medicine 23.9 35.7 20.5 8.4 29.1 0.0 90 Take herbs * * * * * * 17 See TBA 23.0 14.8 21.6 2.8 50.7 0.0 50 See health provider 17.6 25.1 8.3 8.0 58.8 0.0 184 See midwife 23.0 14.8 21.6 2.8 50.7 0.0 50 See a doctor 23.0 14.8 21.6 2.8 50.7 0.0 50 Other (13.0) (11.2) (1.7) (5.5) (72.9) (0.0) 56 Baby died within one month of birth 3.4 4.8 1.3 0.9 3.4 88.9 171 Delivery assisted by a health provider 2.1 2.5 0.5 0.5 5.3 90.3 5,938 Delivery by C-section 3.9 4.9 0.3 0.9 13.6 78.2 523 Total 1.8 1.9 0.5 0.4 3.6 92.9 12,760 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. Almost half of women who had premature labor reported that they took no action (48 percent). Among those who took action, one in four either went to see a TBA, a midwife, or a doctor. Women who had excessive bleeding during pregnancy are most likely to take medicine (36 percent). Others seek assistance from a midwife, doctor, or TBA (15 percent each). By residence, there are negligible differences in the percentage of births for which women had pregnancy complication (data not shown). Mothers are less likely to report problems during pregnancy for births that were assisted at delivery by a health provider or that resulted in the death of the infant within one month of birth. However, mothers of babies who died in the neonatal period are more likely to report having excessive bleeding during pregnancy. Mothers whose babies were delivered by caesarean section tend to report problems other than those specified in Table 11.5. 11.2 DELIVERY 11.2.1 Place of Delivery Four in ten births in the five years preceding the survey were delivered in a health facility, 9 percent were delivered in a public facility (government hospital or health center), and 31 percent were Maternal Health | 125 delivered in a private health facility (private hospital, clinic, private doctor/midwife, village midwife) (Table 11.6 and Figure 11.2). Caution should be exercised when comparing data from the current survey with previous IDHS data, because responses to the place of delivery have been classified differently. The 2002-2003 IDHS includes new categories under private medical: doctors, obstetricians and gynecologists, midwives and village midwives. These are health professionals who provide delivery services at their practice site. On the other hand, delivery in the home of midwives and village midwives, which in 1997 was classified as home, is currently classified under medical facility. Furthermore, health post, delivery post, and other similar facilities were classified separately in the 2002-2003 IDHS. The percentage of deliveries in a health facility (40 percent) is substantially higher than that reported in the 1997 IDHS (21 percent) (Central Bureau of Statistics et al., 1998). Table 11.6 Place of delivery Percent distribution of live births in the five years preceding the survey by place of delivery, according to background characteristics, Indonesia 2002-2003 Health facility Background characteristic Public sector Private sector Home Other Missing Total Number of births Mother's age at birth <20 8.2 21.3 69.2 0.4 0.8 100.0 1,855 20-34 9.5 33.1 56.1 0.4 0.8 100.0 11,213 35-49 8.7 24.8 65.7 0.2 0.5 100.0 2,020 Birth order 1 11.4 36.2 51.0 0.4 0.9 100.0 5,233 2-3 8.8 32.6 57.5 0.5 0.6 100.0 6,735 4-5 7.3 19.5 72.0 0.3 0.9 100.0 1,953 6+ 5.4 11.5 81.8 0.2 1.1 100.0 1,168 Residence Urban 13.1 46.5 39.5 0.3 0.6 100.0 7,029 Rural 5.9 16.6 76.1 0.5 1.0 100.0 8,059 Mother's education No education 3.3 6.3 88.8 0.2 1.4 100.0 709 Some primary 5.4 12.7 80.0 0.7 1.2 100.0 2,238 Completed primary 6.9 19.2 73.2 0.3 0.4 100.0 5,038 Some secondary 8.5 34.6 55.3 0.4 1.3 100.0 3,074 Secondary+ 15.9 55.8 27.3 0.4 0.5 100.0 4,029 Antenatal care visits1 None 2.1 6.3 91.4 0.3 0.0 100.0 559 1-3 5.0 9.8 85.1 0.1 0.0 100.0 1,768 4+ 10.5 36.4 52.6 0.5 0.0 100.0 10,332 Total 9.2 30.5 59.0 0.4 0.8 100.0 15,089 1 Includes only the most recent birth in the five years preceding the survey; total includes 101 births for which the number of antenatal care visits is missing. Births to women in high-risk age groups (younger than 20 years or 35 years and older) are more likely to take place at a home (69 percent and 66 percent, respectively) than births to women age 20-34 (56 percent). High-order births are most likely to take place at home (82 percent of sixth- and higher order births compared with 51 percent of first-order births). This implies that a relatively large proportion of high-risk births still take place at home. 126 | Maternal Health Figure 11.2 Place of Delivery and Least Qualified Delivery Assistant Place of Delivery IDHS 2002-2003 Least Qualified Delivery Assistant Private facility 31% Public facility 9% Home 59% TBA 32% Relative/other 12% Doctor 5% Nurse/midwife 50% The utilization of health facilities, private and public, for delivery is considerably higher in urban than in rural areas. Births in rural areas are almost twice as likely to be delivered at home as births in urban areas (76 and 40 percent, respectively). Births to mothers who have no education are three times as likely to be delivered at home as births to mothers who have secondary and higher education (89 and 27 percent, respectively). There is a negative association between delivery at home and the number of ANC visits; mothers with no ANC are more likely to deliver at home than mothers who had ANC. Appendix Table A.11.4 shows that there are significant variations in the place of delivery by province. More than 50 percent of births are delivered at home in all provinces, except in DKI Jakarta (11 percent), Bali (14 percent), DI Yogyakarta (27 percent), East Java (38 percent), and West Sumatera (41 percent). In all provinces, births delivered at a health facility are more likely to be delivered in a private facility than in public facility, except in West Nusa Tenggara, East Nusa Tenggara, South Kalimantan, Central Sulawesi, South Sulawesi, Southeast Sulawesi, and Gorontalo. 11.2.2 Assistance during Delivery The Ministry of Health set a target of 90 percent for births to be assisted at delivery by medical staff by year 2010 (Ministry of Health, 2001b). To measure progress toward this goal, respondents were asked about all of the persons who assisted them during delivery. Table 11.7 shows the distribution of births by the most qualified person providing assistance during delivery. This is the person to whom the woman may have been referred if she had any problems in her pregnancy. Sixty-six percent of births in the five years preceding the survey were assisted by medical staff: 55 percent by a nurse, a midwife, or a village midwife, and 11 percent by a doctor. One in three births was assisted by a TBA. Comparison with data from past IDHS surveys shows that there has been a tremendous increase in the proportion of births assisted at delivery by a medical professional. While there is a shift away from TBAs, they still have an important role in delivery assistance, especially in rural areas (42 percent), for births to mothers with no education (60 percent), and for high-order births (58 percent). Maternal Health | 127 Table 11.7 Assistance during delivery: most qualified person Percent distribution of live births in the five years preceding the survey by the most qualified person providing assistance during delivery, according to background characteristics, Indonesia 2002-2003 Background characteristic General practi- tioner Obste- trician/ Gyne- cologist Nurse/ midwife/ village midwife Traditional birth attendant/ other Relative/ other No one Missing Total Number of births Mother's age at birth <20 1.0 4.5 52.7 40.2 0.8 0.0 0.8 100.0 1,855 20-34 0.6 10.9 57.6 28.5 1.3 0.3 0.8 100.0 11,213 35-49 1.2 11.6 44.8 39.9 1.6 0.4 0.5 100.0 2,020 Birth order 1 1.0 13.5 59.7 24.3 0.7 0.0 0.9 100.0 5,233 2-3 0.6 10.5 57.4 29.6 1.1 0.3 0.5 100.0 6,735 4-5 0.7 4.0 50.4 41.8 1.9 0.3 1.0 100.0 1,953 6+ 1.1 3.9 31.7 57.5 3.9 0.7 1.2 100.0 1,168 Residence Urban 0.6 16.6 61.8 19.9 0.5 0.1 0.5 100.0 7,029 Rural 0.9 4.6 49.7 41.6 1.9 0.4 1.0 100.0 8,059 Mother's education No education 2.5 0.4 29.5 59.9 5.7 0.7 1.4 100.0 709 Some primary 0.6 2.9 36.6 56.1 2.1 0.5 1.2 100.0 2,238 Completed primary 0.5 3.7 51.1 42.7 1.3 0.3 0.4 100.0 5,038 Some secondary 0.6 8.1 66.1 22.8 1.1 0.1 1.1 100.0 3,074 Secondary + 1.0 25.5 67.3 5.4 0.2 0.1 0.5 100.0 4,029 Total 0.8 10.2 55.3 31.5 1.3 0.3 0.8 100.0 15,089 Note: If the respondent mentioned more than one person attending during delivery, only the most qualified person is considered in this tabulation. The coverage of deliveries assisted by a medical professional varies across provinces, from 94 percent in DKI Jakarta to 36 percent in East Nusa Tenggara and 42 percent in Southeast Sulawesi. TBAs continue to play an important role in assisting deliveries in East Nusa Tenggara (55 percent), Southeast Sulawesi (55 percent), Gorontalo (51 percent), and West Java (50 percent) (Appendix Table A.11.5). The highest levels of medical assistance at delivery are found in DKI Jakarta, Bali, DI Yogyakarta, and North Sulawesi provinces, where an obstetrician or a gynecologist delivers about one in four births. Relatives, especially if they are elderly or untrained persons, can introduce health risks at the time of delivery. In Indonesia, the role of relatives in assisting deliveries is small (1 percent), although in a few provinces larger percentages of births are delivered by relatives, e.g., East Nusa Tenggara (7 percent), South Sulawesi (6 percent), Central Sulawesi (4 percent), North Sumatera (3 percent), and West Nusa Tenggara (3 percent). Table 11.8 shows the distribution of births by the least qualified person providing assistance during delivery. While the assistant identified in Table 11.7 may be the person to whom the woman was referred if she had any problems with her pregnancy, Table 11.8 shows the point person in the delivery. While a medical professional was the least qualified person attending 55 percent of births, a medical professional was the most qualified person attending 66 percent of births. The difference (11 percent) suggests that some births are referred by less qualified persons to more qualified persons. It is interesting to note that while 12 percent of births were assisted by a relative or other person as the least qualified person, only 1 percent were delivered by a relative or other person as the most qualified person. 128 | Maternal Health Table 11.8 Assistance during delivery: least qualified person Percent distribution of births in the five years preceding the survey by the least qualified person providing assistance during delivery, according to background characteristics, Indonesia 2002-2003 Background characteristic General practi- tioner Obste- trician/ Gyne- cologist Nurse/ midwife/ village midwife Traditional birth attendant/ other Relative/ other No one Missing Total Number of births Mother's age at birth <20 0.3 2.4 41.9 41.0 13.7 0.0 0.8 100.0 1,855 20-34 0.2 4.5 53.3 29.7 11.2 0.3 0.8 100.0 11,213 35-49 0.3 6.3 42.2 39.2 11.1 0.4 0.5 100.0 2,020 Birth order 1 0.3 5.7 55.3 27.6 10.1 0.0 0.9 100.0 5,233 2-3 0.2 4.7 52.8 30.3 11.2 0.3 0.5 100.0 6,735 4-5 0.1 1.6 42.5 40.4 14.1 0.3 1.0 100.0 1,953 6+ 0.3 2.1 28.1 52.4 15.2 0.7 1.2 100.0 1,168 Residence Urban 0.1 7.2 63.4 19.4 9.3 0.1 0.5 100.0 7,029 Rural 0.3 2.0 39.1 43.7 13.5 0.4 1.0 100.0 8,059 Mother's education No education 0.0 0.2 22.2 60.3 15.3 0.7 1.4 100.0 709 Some primary 0.2 1.8 30.0 50.8 15.5 0.5 1.2 100.0 2,238 Completed primary 0.2 1.6 41.6 42.3 13.5 0.3 0.4 100.0 5,038 Some secondary 0.2 3.1 57.7 26.9 10.9 0.1 1.1 100.0 3,074 Secondary + 0.3 11.3 72.2 9.1 6.6 0.1 0.5 100.0 4,029 Total 0.2 4.5 50.4 32.4 11.5 0.3 0.8 100.0 15,089 Note: If the respondent mentioned more than one person attending during delivery, only the least qualified person is considered in this tabulation. The differentials in delivery assistance for the least qualified assistant by mother’s age, birth order, residence, and education follow the same pattern as those for the most qualified assistant. 11.2.3 Delivery Characteristics In Indonesia, caesarean sections are generally performed only for certain medical indications and for complicated deliveries (Ministry of Health, 2001c). According to the 2002-2003 IDHS, 4 percent of births were reported as delivered by caesarean section (Table 11.9). This rate has not changed since the 1997 IDHS (Central Bureau of Statistics et al., 1998). Caesarean sections are more likely to be performed for first births (5 percent) and for births to mothers with secondary or higher education (11 percent). Caesarean sections are also more common in urban areas (7 percent) than in rural areas (2 percent). Because a large proportion of deliveries take place at home, 21 percent of babies were not weighed at birth. Babies are more likely to be weighed at birth if they are born to women age 20-34, if they are first births, if the mother lives in an urban area, or if the mother is educated. For example, while 42 percent of births to women with no education were weighed at birth, the corresponding proportion for births to mothers who have completed secondary education was 94 percent. Maternal Health | 129 Table 11.9 Delivery characteristics Percentage of births in the five years preceding the survey delivered by caesarean section and percent distribution by birth weight and by mother's estimate of baby's size at birth, according to background characteristics, Indonesia 2002-2003 Birth weight Size of child at birth Background characteristic Delivery by C- section Not weighed Less than 2.5 kg 2.5 kg or more Don't know/ missing Total Very small Smaller than average Average or larger Don't know/ missing Total Number of births Mother's age at birth <20 1.4 25.1 8.2 65.7 1.0 100.0 2.9 14.5 77.5 5.1 100.0 1,855 20-34 4.3 19.4 5.1 74.3 1.2 100.0 1.9 11.1 82.6 4.4 100.0 11,213 35-49 5.2 28.6 5.7 64.9 0.8 100.0 2.3 11.6 81.8 4.3 100.0 2,020 Birth order 1 5.0 15.9 6.3 76.7 1.1 100.0 2.6 12.8 80.6 4.0 100.0 5,233 2-3 4.3 18.2 5.5 75.4 0.9 100.0 1.7 10.6 84.1 3.6 100.0 6,735 4-5 2.5 35.0 4.2 59.2 1.5 100.0 1.7 12.0 80.1 6.3 100.0 1,953 6+ 0.9 40.8 5.0 52.6 1.6 100.0 2.9 11.4 77.4 8.3 100.0 1,168 Residence Urban 6.6 10.0 6.1 83.1 0.7 100.0 1.9 11.3 84.3 2.6 100.0 7,029 Rural 1.9 31.2 5.0 62.4 1.4 100.0 2.2 11.9 79.8 6.1 100.0 8,059 Mother's education No education 0.6 56.5 4.1 37.9 1.5 100.0 2.7 11.6 71.7 13.9 100.0 709 Some primary 1.6 41.3 5.6 51.3 1.8 100.0 2.7 12.1 77.2 8.0 100.0 2,238 Completed primary 1.7 24.3 5.5 69.3 0.9 100.0 2.2 12.5 80.5 4.8 100.0 5,038 Some secondary 1.9 15.5 7.0 76.2 1.3 100.0 2.4 11.4 83.0 3.2 100.0 3,074 Secondary + 10.7 4.8 4.7 89.7 0.8 100.0 1.3 10.3 87.1 1.3 100.0 4,029 Total 4.1 21.3 5.6 72.0 1.1 100.0 2.1 11.6 81.9 4.5 100.0 15,089 Overall, 6 percent of babies were reported to weigh less than 2.5 kilograms at birth. The birth weight of babies is related to the characteristics of the mother: babies are more likely to have been weighed and have an average weight (2.5 kilograms or more) if they are born to mothers age 20-34, if they are first births, if the mother lives in an urban area, and if the mother is educated (Table 11.9). In the 2002-2003 IDHS, respondents were asked about their perception of the size of their newborn. Fourteen percent of births were perceived by their mothers as being either very small or smaller than average. Differentials in the perceived size across subgroups of births are the same as differences found in the actual weight. Babies are more likely to be perceived as average or larger if their mothers are age 20-34, if they are lower-order births, if their mother lives in an urban area, or if the mother is educated (Table 11.9). Differentials in delivery characteristics by province are shown in Appendix Table A.11.6. Delivery by caesarean section is less common in West Nusa Tenggara, Central Kalimantan, and Southeast Sulawesi. On the other hand, more than 5 percent of births were delivered by caesarean section in West Sumatera, DKI Jakarta, DI Yogyakarta, East Java, Banten, and Bali. The percentage of babies who were weighed at birth ranges from 42 percent in Southeast Sulawesi to 90 percent or higher in DKI Jakarta, DI Yogyakarta, Central Java, Bali, and East Kalimantan. The prevalence of low birth weight babies can be calculated by dividing the percentage of babies whose birth weight is less than 2.5 kilograms by the percentage of babies who were weighed. This prevalence ranges from 3 percent in Bali to 13 percent in Gorontalo. 130 | Maternal Health 11.2.4 Preparation for Delivery To ensure the safety of the mother and infant at the time of delivery, certain preparations need to be made. These include deciding who is going to assist in the delivery, where the delivery is going to take place, how the woman is going to get to this place, and how much the delivery is going to cost. In the 2002-2003 IDHS, respondents were asked whether they had discussed any of these specific topics during the pregnancy. Three in four mothers reported they had discussed at least one topic related to preparation for delivery. Table 11.10 shows that the most often discussed subjects are the place to deliver, delivery assistant, and payment for the service (61 to 65 percent). Less often discussed are the issues of transportation (38 percent) and potential blood donor (8 percent). i a p s T a o Table 11.10 Preparation for delivery Percentage of women who had a live birth in the five years preceding the survey who discussed specific topics during pregnancy for the most recent birth, by background characteristics, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Topics discussed ––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Background Place to Transpor- Delivery Blood Any No topics Number characteristic deliver tation assistance Payment donor topic discussed of births –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 55.2 28.4 58.4 51.3 2.7 65.9 34.1 543 20-24 66.2 38.2 67.7 62.8 6.9 77.2 22.8 2,855 25-29 66.0 39.7 66.3 63.3 9.0 75.6 24.4 3,665 30-34 66.8 39.0 67.8 63.7 9.3 76.8 23.2 2,868 35-39 60.6 35.5 60.6 56.1 9.1 70.1 29.9 1,891 40-44 54.1 31.6 56.1 51.2 7.2 64.5 35.5 769 45-49 54.3 29.2 62.0 55.9 1.9 69.5 30.5 171 Mother's marital status Married 64.4 37.6 65.3 61.1 8.1 74.6 25.4 12,473 Divorced/widowed 50.0 32.0 54.1 52.6 7.2 61.7 38.3 288 Residence Urban 71.8 45.7 69.0 65.0 11.5 77.9 22.1 5,970 Rural 57.3 30.3 61.6 57.3 5.1 71.0 29.0 6,791 Education No education 38.5 16.1 39.8 36.2 2.4 48.7 51.3 580 Some primary 49.8 24.2 54.4 49.8 4.4 63.8 36.2 1,849 Completed primary 58.8 32.1 61.1 58.9 6.2 71.7 28.3 4,359 Some secondary 69.0 41.5 69.7 66.2 7.9 78.5 21.5 2,614 Secondary + 79.5 52.3 76.9 69.6 13.8 84.5 15.5 3,359 Total 64.1 37.5 65.1 60.9 8.1 74.3 25.7 12,760 Mothers in urban areas and better educated mothers are more likely than other mothers to discuss ssues related to their baby’s delivery. For example, mothers with secondary or higher education are lmost twice as likely to discuss any topic related to the delivery as mothers with no education (85 and 49 ercent, respectively). Currently married men interviewed in the survey who had a child in the five years preceding the urvey were also asked whether they held any discussions regarding preparations for that child’s delivery. he findings are presented in Chapter 17. Figure 11.3 compares the responses obtained from the mothers nd the fathers. It is interesting to note that fathers are as likely as mothers to report having discussions n various aspects of their child’s birth. Maternal Health | 131 Figure 11.3 Discussion on Preparation for Delivery IDHS 2002-2003 65 33 64 57 6 77 23 64 38 65 61 8 74 26 Place of delivery Trans- portation Delivery assistant Payment Blood donor Any topic No topic 0 20 40 60 80 100 Percent Fathers Mothers The likelihood that women discuss issues related to their delivery varies substantially by province. While in many provinces, more than 80 percent of mothers had a discussion on this topic, in West Java, South Sulawesi, and Southeast Sulawesi, less than 65 percent of mothers had any discussion on the specified topics associated with preparation for delivery (Appendix Table A.11.7). 11.2.5 Complications during Delivery To identify complications associated with delivery, respondents were asked about certain signs and symptoms that they had experienced during their most recent birth in the five years prior to survey. Table 11.11 shows that 64 percent of women reported having no complications during delivery. Prolonged labor was reported for 31 percent of births, excessive bleeding was reported for 7 percent, and fever was reported for 5 percent of the births. Maternal convulsions occurred with about 1 percent of births. Women assisted by a health professional during delivery, regardless of whether they received antenatal care, are the most likely to report any complications during delivery. On the other hand, women who received antenatal care only are the least likely to have delivery complications. As expected, women who give birth by caesarean section were more likely to report complications (59 percent), mostly prolonged labor (42 percent). For babies who died within one month of birth, 39 percent of the mothers reported complications including prolonged labor (30 percent), excessive bleeding (12 percent), and fever (10 percent). There are negligible differences in the prevalence of delivery complications by urban-rural residence (data not shown). 132 | Maternal Health Table 11.11 Complications during delivery Percentage of last births in the five years preceding the survey for which the mother had complications associated with delivery, by type of complication and maternity care indicators, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Number Maternity Prolonged Excessive Convul- of care indicator labor bleeding Fever sions Other None births ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Antenatal care/delivery assistance Both ANC and DA 29.5 6.8 4.6 1.3 4.3 64.0 5,419 ANC only 26.0 6.1 3.7 1.3 1.3 69.9 2,302 DA only 37.7 12.3 7.4 1.4 7.3 50.6 519 No ANC and no DA 33.1 7.6 4.5 1.5 2.0 63.3 4,520 Baby died within one month of birth 30.2 12.4 10.3 3.4 3.4 60.7 171 Delivery by C-section 42.2 15.6 5.7 2.6 18.2 40.6 523 Total 30.5 7.2 4.5 1.4 3.1 64.3 12,760 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– ANC = Antenatal care DA = Delivery assistance by a health provider 11.3 POSTNATAL CARE Postnatal care (PNC) is important both for the mother and for the child to treat complications arising from the delivery as well as to provide the mother with important information on how to care for herself and her child. The postnatal period is defined as the time between delivery of the placenta and 42 days (6 weeks) following delivery. The timing of postnatal care is important. The first two days after delivery are critical, since most maternal and neonatal deaths occur during this period. In the 2002-2003 IDHS, women who had given birth outside a health facility were asked if they had received postnatal care. Overall, eight in ten women received postnatal care, with 62 percent receiving PNC within 2 days of delivery, 13 percent receiving PNC 3-6 days after delivery, and 8 percent receiving PNC 7-41 days after delivery (Table 11.12). Women’s age is associated with the likelihood of receiving postnatal care; younger women are slightly more likely to have a checkup after giving birth than older women. Lower order births are more likely to receive the first postnatal checkup within the first week of delivery. Women in rural areas are slightly more likely than urban women to receive the first postnatal checkup within 2 days of delivery (63 and 60 percent, respectively). PNC coverage varies by province, ranging from 90 percent or higher in Bengkulu, Lampung, DI Yogyakarta and East Java to less than 70 percent in South Sumatera and Bangka Belitung (Appendix Table A.11.8). It is interesting to note that Bangka Belitung was originally part of South Sumatera province. Maternal Health | 133 Table 11.12 Postnatal care by background characteristics Percent distribution of women who had a noninstitutional live birth in the five years preceding the survey by timing of postnatal care for the most recent noninstitutional birth, according to background characteristics, Indonesia 2002-2003 Timing of first postnatal checkup Background characteristic Within 2 days of delivery 3-6 days after delivery 7-41 days after delivery Don't know/ missing Did not receive postnatal checkup1 Total Number of women Age at birth <20 61.9 14.5 9.2 0.1 14.3 100.0 1,054 20-34 62.1 12.4 8.0 0.1 17.4 100.0 5,366 35-49 60.0 12.4 6.6 0.1 20.9 100.0 1,169 Birth order 1 67.2 12.4 7.8 0.0 12.6 100.0 2,253 2-3 62.2 13.0 8.4 0.1 16.3 100.0 3,364 4-5 57.2 13.2 8.3 0.1 21.2 100.0 1,191 6+ 51.3 11.4 5.8 0.1 31.4 100.0 781 Residence Urban 60.0 13.2 10.4 0.1 16.3 100.0 2,372 Rural 62.6 12.5 6.8 0.0 18.1 100.0 5,217 Education No education 63.0 8.6 4.0 0.0 24.4 100.0 521 Some primary 53.9 13.4 7.8 0.0 24.9 100.0 1,503 Completed primary 58.1 15.5 9.5 0.0 16.9 100.0 3,176 Some secondary 68.0 10.3 8.0 0.3 13.5 100.0 1,454 Secondary + 76.4 8.0 5.0 0.1 10.5 100.0 936 Total 61.8 12.7 7.9 0.1 17.5 100.0 7,590 1 Includes women who received the first postnatal checkup after 41 days 11.4 MATERNAL HEALTH CARE AND WOMEN’S STATUS Table 11.13 presents data on the relationship between a woman’s status and her ability to access and use maternal health services. In this report, women’s status is measured by three indicators: the number of household decisions in which a woman participates, the number of circumstances in which she believes that a wife is justified in refusing to have sex with her husband, and the number of reasons that she believes justify wife beating. Table 11.13 shows that the three women’s status indicators correlate with receiving maternal health care (antenatal care, postnatal care, and delivery care) from a medical professional. The more decisions a woman participates in, the more likely she is to receive maternal health care. The number of circumstances in which a woman believes that refusing sex is justified also has an influence on a woman’s likelihood of receiving maternal health care. Women who agree with more reasons for refusing sex are more likely to receive antenatal care, postnatal care, and delivery care from medical professionals. For example, 85 percent of women who believe that there are no justifiable reasons to refuse to have sex received antenatal care, compared with 92 percent of women who feel it justifiable to refuse to have sex for 3-4 reasons. Similarly, women who do not justify wife beating for any reason are more likely to receive postnatal care and delivery care than women who think there are reasons that justify wife beating. 134 | Maternal Health Table 11.13 Maternal health care and women's status Percentage of women with a live birth in the five years preceding the survey who received antenatal and postnatal care from a health professional for the most recent birth and percentage of births in the five years preceding the survey for which mothers received professional delivery care, by women's status indicators, Indonesia 2002-2003 Women's status indicator Percentage of women who received antenatal care from doctor, nurse/midwife/ village midwife Percentage of women who received postnatal care within the first two days of delivery1 Number of women Percentage of births for whom mothers received delivery care from doctor, nurse/midwife village midwife Number of births Number of decisions in which woman has final say2 0 63.7 70.5 64 55.9 76 1-2 84.1 69.7 580 56.0 707 3-4 91.2 71.4 3,573 60.8 4,269 5 92.3 80.3 8,544 69.3 10,037 Number of reasons to refuse sex with husband 0 84.5 64.9 830 57.6 1,009 1-2 88.1 69.3 1,215 60.0 1,460 3-4 92.4 79.1 10,716 67.6 12,620 Number of reasons wife beating is justified 0 91.9 78.8 9,243 67.9 10,867 1-2 90.9 74.9 2,571 64.5 3,072 3-4 89.2 67.8 717 55.8 871 5 87.3 69.8 229 53.4 279 Total 91.5 77.3 12,760 66.2 15,089 1 Includes mothers who delivered in a health facility 2 Either by herself or jointly with others 11.5 PROBLEMS IN ACCESSING HEALTH CARE Many factors can prevent women from getting medical advice or treatment for themselves when they need it. In this survey, all women were asked if getting medical advice or treatment for themselves was a big problem or not a big problem with respect to the following: knowing where to go, getting permission to go, getting money needed for treatment, distance to the health facility, having to take transport, not wanting to go alone, and concern that there may not be a female health provider. Table 11.14 shows the percentage of ever-married women who reported having big problems in accessing health care, by background characteristics. Seven in ten women do not report any problems in accessing health care. Younger women, women with a larger number of children, divorced or widowed women, less educated women, and women who do not a have cash income are more likely to report problems in accessing health care than other women. Maternal Health | 135 Table 11.14 Problems in accessing health care Percentage of ever-married women who reported that they have big problems in accessing health care for themselves when they are sick, by type of problem and background characteristics, Indonesia 2002-2003 Problems in accessing health care Background characteristic Knowing where to go for treatment Getting permission to go for treatment Getting money for treatment Distance to health facility Having to take transport Not wanting to go alone Concern there may not be a female provider Any of the specified problems Number of women Age 15-19 5.6 6.1 24.6 14.3 15.7 16.9 9.4 38.3 956 20-29 4.7 4.5 24.3 13.4 12.6 9.5 7.0 34.2 9,251 30-39 4.1 4.1 22.7 11.7 10.7 7.2 4.8 30.5 10,609 40-49 4.6 4.0 24.0 12.0 10.9 8.3 4.9 31.3 8,667 Number of living children 0 4.9 4.4 19.3 11.2 10.9 11.2 8.4 31.4 2,422 1-2 3.9 4.0 21.8 10.9 10.2 8.4 5.5 30.2 15,344 3-4 4.9 4.1 24.2 13.2 12.1 7.8 5.0 32.1 8,418 5+ 6.2 5.4 34.3 18.1 16.1 9.5 6.3 41.7 3,299 Marital status Married 4.4 4.3 23.1 12.3 11.3 8.6 5.7 31.8 27,857 Divorced/widowed 5.4 3.7 32.5 14.1 14.1 8.7 4.9 38.0 1,626 Residence Urban 3.1 2.7 16.0 5.1 4.3 6.0 4.4 23.0 13,499 Rural 5.7 5.5 30.1 18.5 17.5 10.8 6.8 39.8 15,984 Education No education 7.5 5.5 37.8 20.5 19.3 13.5 6.4 46.1 2,335 Some primary 5.4 5.6 31.6 16.3 15.8 10.6 7.1 40.0 5,902 Completed primary 4.5 4.2 26.5 13.9 12.7 8.3 5.4 34.2 9,995 Some secondary 4.3 4.4 19.2 9.8 8.7 6.9 5.7 28.1 5,136 Secondary + 2.7 2.5 9.8 5.2 4.7 6.5 4.4 19.1 6,114 Employment Not employed 4.8 4.5 21.9 10.9 9.9 8.5 5.5 30.3 13,988 Working for cash 3.3 2.6 21.7 9.5 8.7 7.3 5.3 29.4 9,503 Not working for cash 5.8 6.1 31.0 20.5 19.7 10.7 6.8 40.8 5,968 Total 4.5 4.2 23.7 12.4 11.5 8.6 5.7 32.1 29,483 Note: Total includes 24 women for whom employment status is missing. The main problem cited by these women is economic in nature (24 percent). Rural women are twice as likely to mention this problem as urban women (30 and 16 percent, respectively). The next big problems are the distance to a health facility (12 percent) and transportation (12 percent). Women’s problems in accessing health care vary by province. Women living in provinces with difficult terrain and limited transportation facilities are more likely to have problems. These include Central Kalimantan, East Nusa Tenggara, Central Sulawesi, Southeast Sulawesi, and Gorontalo. Appendix Table A.11.9 shows the percentage of women who reported having problems in accessing health care by province. 136 | Maternal Health 11.6 BIRTH REGISTRATION Birth registration is recognized as one of children’s rights in Indonesia. While registration is compulsory, Indonesia has never had a comprehensive registration system for either statistical or legal purposes. The Government of Indonesia has carried out initiatives on a pilot basis to revive the civil registration system in the country with no apparent success. In the 2002-2003 IDHS, for all children born since January 1997, mothers were asked if their child had been registered. Mothers who gave a positive response to this question were asked to show any records for their children, which can be one or more of the following documents: a hospital record, a record issued by the village office, a proof of birth issued by the regency or municipality office as substitute for birth certificate, and a birth certificate, a legal document issued by the civil registrar. Table 11.15 shows the distribution of births in the 5 years preceding the survey by whether it was registered and the type of certificate obtained. Table 11.15 Birth registration Percent of births in the five years before the survey that were registered and, of those registered, percent distributed by type of certificate, according to background characteristics, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Registration document –––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Percentage Number Proof Number Background of births of Not Hospital Village of Birth of births characteristic registered births seen record record birth certificate Missing Total registered ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 38.6 589 8.7 52.8 7.2 4.7 26.6 0.0 100.0 227 20-24 49.7 3,361 7.7 38.3 5.9 3.6 44.4 0.1 100.0 1,671 25-29 54.5 4,417 8.5 33.1 4.2 3.3 50.8 0.1 100.0 2,405 30-34 61.4 3,395 9.7 29.8 5.0 3.2 52.2 0.1 100.0 2,084 35-39 55.2 2,217 9.2 33.0 8.1 3.5 46.0 0.3 100.0 1,225 40-44 43.6 923 15.6 38.4 10.4 1.5 34.0 0.1 100.0 403 45-49 29.8 186 11.9 51.0 6.3 3.7 27.1 0.0 100.0 55 Residence Urban 67.3 7,029 8.6 30.8 3.3 2.8 54.3 0.2 100.0 4,730 Rural 41.4 8,059 9.9 39.1 9.3 4.0 37.6 0.1 100.0 3,340 Education No education 21.6 709 18.7 32.0 14.7 5.9 28.8 0.0 100.0 153 Some primary 34.6 2,238 10.2 48.1 15.2 3.7 22.9 0.0 100.0 774 Completed primary 46.5 5,038 10.5 39.6 8.5 4.1 37.1 0.2 100.0 2,344 Some secondary 54.9 3,074 8.0 36.0 4.1 4.4 47.6 0.0 100.0 1,687 Secondary + 77.2 4,029 8.0 25.9 1.8 1.9 62.1 0.2 100.0 3,112 Total 53.5 15,089 9.1 34.2 5.7 3.3 47.4 0.1 100.0 8,070 Overall, 54 percent of these births were reported to be registered. Registration coverage is more complete for births of mothers age 30-34 years (61 percent), live in urban areas (67 percent), and have completed secondary education (77 percent). Among births reported to have a registration document, 47 percent have a birth certificate and 34 percent have a hospital record. For 9 percent of births, although the birth was reported to be registered, the certificate was not shown to the interviewer. Few births were registered at the village office (6 percent) or have a proof of birth issued by the regency or municipality office (3 percent). Maternal Health | 137 138 | M Births in urban areas are more likely to have a birth certificate than births in rural areas (54 percent compared with 38 percent). On the other hand, births in rural areas are more likely to have a hospital record than urban births (39 percent compared with 31 percent). Mother’s education is positively related to birth registration; while only 22 percent of births of mothers with no education were registered, the corresponding proportion for those whose mothers have completed primary education is 47 percent, and the proportion of births whose mother have completed secondary education is 77 percent. Comparison of data on birth registration coverage between the 2000 Multiple Indicator Cluster Survey (MICS) and the 2002-2003 IDHS shows that the IDHS reports a higher coverage of birth certificate (47 percent compared with 31 percent). While the MICS data also show that coverage in urban areas is higher than that in rural areas, the levels recorded in the MICS are lower than those recorded in the IDHS (BPS, 2001). For example, the rates in the MICS survey are 48 percent in urban areas and 20 percent in rural areas, compared to 67 percent and 41 percent, respectively, in the IDHS. Appendix Table A.11.10 shows that there are large differentials in the coverage of registration by province. The percentage ranges from 12 percent in East Nusa Tenggara to 92 percent in DI Yogyakarta, with most provinces showing coverage between 36 percent and 64 percent. Variations in birth certificate coverage by province is not necessarily the same as that in registration. In DI Yogyakarta, where more than 90 percent of births were registered, 74 percent have a birth certificate. In North Sulawesi, on the other hand, only 43 percent of births were registered, but 74 percent of those registered have a birth certificate. Table 11.16 shows the distribution of births that were not registered by reason for not registering according to background characteristics. The most often reasons cited by the respondents have to do with cost, either because the cost is too much (28 percent) or because they do not want to pay late fee (3 percent). Cost was also the most often cited reason for not registering births in the MICS survey (47 percent). Table 11.16 Reason for not registering births Percent of births in the five years before the survey that were not registered by reason for not registering the birth, according to background characteristics, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Reason not registering birth ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Did not Late, did Did not Number Costs know child not want know of births Background too has to be to pay where to not characteristic much Too far registered fine register Other Missing Total registered –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 25.0 5.9 10.7 2.5 12.5 42.2 1.3 100.0 362 20-24 20.5 7.3 14.1 3.6 13.1 39.3 2.3 100.0 1,691 25-29 28.3 7.2 12.4 2.6 9.2 37.2 3.0 100.0 2,012 30-34 28.8 7.1 12.6 2.1 10.1 37.1 2.3 100.0 1,311 35-39 34.0 6.5 13.2 2.3 8.7 33.6 1.6 100.0 993 40-44 33.8 6.9 12.3 2.2 6.3 37.7 0.8 100.0 520 45-49 36.4 6.8 12.1 6.7 6.0 27.1 4.9 100.0 131 Residence Urban 29.4 3.3 10.2 4.0 9.4 40.9 2.9 100.0 2,299 Rural 26.9 8.8 14.2 2.1 10.5 35.5 2.0 100.0 4,720 Education No education 34.5 5.7 18.7 0.4 17.0 20.8 2.9 100.0 556 Some primary 31.4 6.6 12.0 1.8 13.2 32.8 2.2 100.0 1,464 Completed primary 31.9 7.3 13.1 3.2 9.6 33.5 1.4 100.0 2,694 Some secondary 21.4 7.4 12.5 2.6 7.8 45.4 2.8 100.0 1,387 Secondary + 14.8 7.0 10.4 4.6 6.2 53.2 3.8 100.0 917 Total 27.7 7.0 12.9 2.7 10.1 37.3 2.3 100.0 7,019 aternal Health Knowledge of mothers about the birth registration is in general limited—13 percent of women who give birth in the five years preceding the survey did not know that a child has to be registered and 10 percent did not know where to register the birth. Seven percent of women say that the registration location is too far, while 37 percent of women cite reasons other than the specified ones. Older and less educated mothers are more likely than other mothers to say that the reason for not registering birth is the cost. For example, while 35 percent of mothers with no education cite cost as a problem, the corresponding proportion for mothers who completed secondary education is 15 percent. Appendix Table A.11.11 pertains to the reason for not registering birth by province. Three in ten women in Lampung, DKI Jakarta, West Java, Banten, and North Sulawesi say that cost is a problem. In other provinces, such as West Kalimantan, Central Kalimantan, and Southeast Sulawesi, distance is considered to be the main reason for not registering births. Lack of knowledge about birth registration is high (30 percent or higher) in North Sumatera, West Nusa Tenggara, Central Kalimantan, Central Sulawesi, and South Sulawesi. Maternal Health | 139 IMMUNIZATION OF CHILDREN 12 The Expanded Program of Immunization, launched by the Indonesian Ministry of Health (MOH) in 1977, recommended that all children receive immunization against the six major preventable childhood diseases: a BCG vaccination against tuberculosis; three doses of DPT vaccine to prevent diphtheria, pertussis, and tetanus; four doses of polio vaccine; and a measles vaccination. In 1997, the immunization program was expanded to include three doses of hepatitis B (HB) vaccine. All of the recommended vaccinations should be given before children are 12 months of age (MOH, 2000). In the sixth Five-Year Development Plan (1993-94 to 1997-98), efforts to reduce childhood morbidity and mortality by improving the immunization coverage among children continued; this period included the National Mass Immunization Campaigns in 1996 and 1997. Infants brought to health centers or health posts for postnatal care are provided with a health card on which feeding, growth, and immunization information can be recorded. The type and date of vaccinations are recorded in a registration book maintained by the field vaccinators. While it is important that cards be kept by the mothers to enable them to monitor their children’s growth and to keep a record of immunization schedules, not all mothers have kept the cards. Furthermore, not all infants receive postnatal care and therefore have never received a health card. 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 (specifically, BCG, DPT, polio, measles, and HB). The recording of polio immunizations in the 2002-2003 Indonesia Demographic and Health Survey (IDHS) was different from that in the 1994 and 1997 IDHS surveys because it included polio 1 through 4, while the earlier surveys recorded polio 0 to 3. 12.1 IMMUNIZATION COVERAGE Figure 12.1 shows the percentage of children age 12-23 months who had received vaccinations against the six major preventable childhood diseases by one year of age, as recommended by the government. Overall, 44 percent of children age 12-23 months were fully immunized against these diseases before they reached their first birthday. The highest coverage is for BCG, DPT 1, and polio1, ranging from 80 to 86 percent. Children are least likely to be fully immunized against polio by age one (43 percent of children age 12-23 months have had all four doses). Sixty-three percent of children age 12-23 months received measles vaccine. Eleven percent of children age 12-23 months have not received any of the recommended vaccines. Another way to evaluate the success of an immunization program is to calculate the percentage of children who started but did not complete all of the doses of DPT and polio vaccine to achieve immunity. In this report, the dropout rate is defined as the percentage of children who received the first dose but did not receive the third dose of the series. The percentages of children who dropped out before receiving all doses of DPT and polio are 31 and 29 percent, respectively. Immunization of Children | 141 82 80 69 55 86 76 61 43 63 44 11 BCG DPT1 DPT2 DPT3 Polio 1 Polio 2 Polio 3 Polio 4 Measles All No vaccination 0 20 40 60 80 100 Percent IDHS 2002-2003 Figure 12.1 Percentage of Children Age 12-23 Months Vaccinated by 12 Months of Age (Based on Information from Health Cards and Mother’s Reports) Note: For children whose information was based on the mother’s report, the proportion of vaccinations given during the first year of life was assumed to be the same as for children with a written record of vaccination. 1 BCG, measles and three doses each of DPT and polio vaccine (excluding polio 4) All1 DPT 1 DPT 2 DPT 3 12.2 IMMUNIZATION BY BACKGROUND CHARACTERISTICS Table 12.1 shows vaccination coverage for the six major preventable childhood illnesses according to information recorded on health cards (top panel), information from mothers’ reports (middle panel), and information from both sources (bottom panel). The table shows that only 31 percent of children age 12-23 months had their health cards available at the time of interview. This finding is similar to that of the 1997 IDHS, where 31 percent of children age 12-23 months had health cards, suggesting that the proportion of health cards kept by mothers has remained the same. Among children whose health cards were seen (Table 12.1, top panel), 71 percent were fully immunized. Comparison with the levels reported in the 1997 IDHS indicates that immunization coverage for specific vaccines, as recorded on health cards, has remained the same. The highest vaccine coverage, as seen from health cards, is for BCG, DPT 1, polio 1, and polio 2 (all 90 percent or more). Immunization coverage based on mothers’ reports is considerably lower than that based on observation of health cards (Table 12.1, middle panel). For example, the percentage of children who are completely immunized is 43 percent, 28 percentage points lower than that recorded on the health card. The highest coverage of individual vaccine doses, according to mothers’ reports, was for polio 1 (84 percent), BCG (78 percent), and DPT 1 (76 percent). 142 | Immunization of Children Table 12.1 Vaccinations by background characteristics Percentage of children age 12-23 months who received specific vaccines at any time before the survey (according to health card or mother’s report), and percentage with a vaccination card, by background characteristics, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Percentage of children who received: –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Percentge DPT Polio No with a Number Background –––––––––––––– –––––––––––––––––––– vaccina- health of characteristic BCG 1 2 3 1 2 3 4 Measles All1 tions card seen children –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– HEALTH CARD –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sex Male 93.3 96.3 88.9 77.0 96.4 93.1 85.6 69.8 76.0 66.3 0.4 100.0 433 Female 92.9 91.2 87.7 84.2 95.4 91.2 90.1 71.0 81.3 75.5 0.0 100.0 432 Birth order 1 98.1 97.3 94.9 88.1 99.6 97.4 91.7 77.9 82.7 78.4 0.0 100.0 336 2-3 90.4 94.6 89.0 80.5 95.2 92.3 88.9 68.8 82.2 71.1 0.2 100.0 392 4-5 97.4 93.2 83.7 74.3 94.6 89.5 85.0 64.9 64.4 60.4 0.0 100.0 95 6+ (68.8) (58.9) (39.5) (34.9) (76.9) (54.3) (53.3) (36.5) (44.8) (31.9) 2.3 100.0 42 Residence Urban 92.9 93.6 88.9 81.3 96.6 94.3 90.9 68.1 79.5 71.0 0.0 100.0 423 Rural 93.4 94.0 87.7 80.0 95.3 90.0 85.0 72.6 77.8 70.7 0.4 100.0 441 Education No education * * * * * * * * * * * 100.0 13 Some primary 86.1 88.5 74.6 66.0 100.0 81.6 77.3 68.9 71.3 58.7 0.0 100.0 67 Completed primary 88.2 90.5 80.9 69.4 91.2 87.7 81.0 64.1 66.5 57.2 0.6 100.0 277 Some secondary 94.3 96.3 93.7 88.8 95.7 93.6 90.6 72.9 87.1 77.0 0.1 100.0 213 Secondary + 98.3 96.4 94.6 89.5 99.4 97.4 94.8 74.7 86.5 82.8 0.0 100.0 295 Total 93.1 93.8 88.3 80.6 95.9 92.1 87.9 70.4 78.6 70.9 0.2 100.0 865 ————————————————————————————————————————–——————————— MOTHER’S REPORT ————————————————————————————————————————–——————————— Sex Male 80.6 77.9 67.1 49.6 85.9 77.2 57.7 36.7 71.1 44.3 12.0 0.0 1,033 Female 74.5 73.8 59.5 47.0 80.7 70.6 55.1 34.3 65.5 41.2 17.6 0.0 921 Birth order 1 83.1 82.6 68.8 53.7 89.0 77.8 61.3 37.8 74.9 48.5 8.7 0.0 616 2-3 81.3 80.0 66.9 51.1 86.4 77.5 60.2 38.7 71.5 45.2 11.9 0.0 947 4-5 69.2 65.9 56.2 43.1 75.7 71.3 51.6 31.4 62.4 38.4 22.1 0.0 238 6+ 48.0 40.1 33.0 19.0 55.4 42.4 21.5 13.6 33.5 13.0 44.2 0.0 154 Residence Urban 86.4 83.7 71.1 56.6 90.0 79.9 64.1 40.2 76.8 49.5 8.5 0.0 902 Rural 70.4 69.3 57.1 41.4 77.8 69.1 49.9 31.6 61.3 37.2 19.9 0.0 1,052 Education No education 45.1 42.7 29.5 15.8 58.0 53.4 30.4 12.0 39.6 11.2 41.6 0.0 99 Some primary 55.9 50.7 41.2 28.6 66.9 55.5 37.3 21.9 43.2 24.6 30.6 0.0 312 Completed primary 76.2 74.8 59.7 47.2 82.9 72.6 53.1 34.9 65.7 39.5 15.7 0.0 583 Some secondary 81.6 82.0 67.9 47.8 87.7 76.7 60.4 36.0 73.3 45.0 9.2 0.0 433 Secondary + 95.4 93.5 83.9 68.1 95.2 88.4 73.2 48.5 87.9 61.7 3.3 0.0 527 Total 77.8 75.9 63.5 48.4 83.5 74.1 56.5 35.6 68.5 42.9 14.6 0.0 1,954 Continued . . . Immunization of Children | 143 Table 12.1—Continued –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Percentage of children who received: –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Percentage DPT Polio No with a Number Background –––––––––––––– –––––––––––––––––––– vaccina- health of characteristic BCG 1 2 3 1 2 3 4 Measles All1 tions card seen children –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– HEALTH CARD AND MOTHER’S REPORT –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sex Male 84.4 83.3 73.5 57.7 89.0 81.9 65.9 46.5 72.6 50.8 8.6 29.5 1,465 Female 80.4 79.3 68.5 58.9 85.4 77.1 66.2 46.0 70.5 52.2 12.0 31.9 1,353 Birth order 1 88.4 87.8 78.0 65.9 92.7 84.7 72.0 52.0 77.7 59.0 5.6 35.3 952 2-3 83.9 84.3 73.4 59.7 88.9 81.8 68.6 47.5 74.6 52.8 8.5 29.3 1,339 4-5 77.2 73.7 64.1 52.0 81.1 76.5 61.1 41.0 63.0 44.7 15.8 28.6 333 6+ 52.4 44.1 34.4 22.4 60.0 44.9 28.3 18.5 35.9 17.0 35.3 21.3 195 Residence ch lo 19 20 sli M 144 | Immu Urban 88.4 86.8 76.8 64.5 92.1 84.5 72.6 49.1 77.6 56.4 5.8 31.9 1,326 Rural 77.2 76.6 66.1 52.8 83.0 75.3 60.3 43.7 66.2 47.1 14.1 29.6 1,493 Education No education 51.2 48.2 35.9 20.6 62.9 58.4 36.7 18.7 41.9 15.9 36.8 11.5 112 Some primary 61.2 57.3 47.1 35.2 72.8 60.1 44.3 30.2 48.2 30.6 25.2 17.7 379 Completed primary 80.1 79.9 66.5 54.4 85.5 77.5 62.1 44.3 66.0 45.2 10.9 32.2 859 Some secondary 85.7 86.7 76.4 61.3 90.3 82.3 70.4 48.1 77.9 55.5 6.2 32.9 646 Secondary + 96.5 94.5 87.7 75.8 96.7 91.6 80.9 57.9 87.4 69.3 2.1 35.9 822 Total 82.5 81.4 71.1 58.3 87.3 79.6 66.1 46.2 71.6 51.5 10.2 30.7 2,819 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Two National Immunization Days took place in 2002, in September for polio vaccine and in October for polio and measles vaccines. Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 1 BCG, measles, and three doses each of DPT and polio vaccine Information from both health cards and mothers’ reports (Figure 12.2) shows that 52 percent of ildren age 12-23 months were fully immunized at some time before the interview. This percentage is wer than the 55 percent reported in the 1997 IDHS but higher than that reported in the 1994 IDHS and 91 IDHS (50 and 48 percent, respectively). Caution should be exercised in comparing data from the 02-2003 IDHS with that from the past because the household sample to be surveyed was drawn from a ghtly different set of provinces/regions. The current survey excludes Nanggroe Aceh Darussalam, aluku, and Papua, as well as the former East Timor province. nization of Children Figure 12.2 Children Age 12-23 Months Who Are Fully Immunized (Based on Information from Health Cards and Mother’s Reports) 48 50 55 52 IDHS 1991 IDHS 1994 IDHS 1997 IDHS 2002-2003 0 20 40 60 Pe rc en t IDHS 2002-2003 Note: The 2002-2003 IDHS excludes Naggroe Aceh Darussalam, Maluku, Papua, and the former East Timor provinces. Children are fully immunized if they have received BCG, measles, and three doses each of DPT and polio vaccine (excluding polio 4). According to the data recorded in Table 12.1, girls are just as likely as boys to have been fully immunized against the six preventable childhood diseases. Immunization coverage varies across background characteristics of children, other than sex. For example, the percentage of children who have been fully immunized decreases with increasing birth order, ranging from 59 percent for first borns to 17 percent for sixth or higher children. Children in urban areas are more likely than rural children to have completed the vaccination schedule (56 and 47 percent, respectively). Similarly, children whose mothers have had no education are less likely to have been fully immunized against the six preventable childhood diseases than children whose mothers have had higher education (16 percent and 69 percent, respectively). The percentage of children who have received no vaccinations also varies widely by demographic and socioeconomic background characteristics. High-order births and children whose mothers have had no education are the most likely to have missed immunizations. As much as 35 percent of children of sixth or higher birth order and 37 percent of children whose mothers have had no formal education have not received any vaccinations (Table 12.1, bottom panel). The immunization coverage varies substantially across province. Provinces with the highest coverage include DI Yogyakarta (84 percent) and Bali (80 percent), while Banten has the lowest level of full immunization coverage (25 percent). Health card coverage also varies across provinces, ranging from 13 percent in South Sumatera to 54 percent in Bali (Appendix Table A.12.1). 12.3 HEPATITIS B IMMUNIZATION As mentioned earlier, in 1997, the government of Indonesia expanded the immunization program to include three doses of hepatitis B (HB) vaccine. The government also stated that all of the vaccinations should be given before the child reaches one year of age (MOH, 2000). Immunization coverage for HB is presented in Table 12.2 and Appendix Table A.12.2 and is based on both vaccination cards and mothers’ reports. Although HB vaccination was only initiated in 1997, 71 percent of children age 12-23 months have received at least one dose of the vaccine, and 45 percent have completed the HB series. Immunization of Children | 145 Table 12.2 Hepatitis B vaccination coverage Percentage of children age 12-23 months who received hepatitis B vaccinations at any time before the survey (according to vaccination card or mother’s report), by background characteristics, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Hepatitis B vaccination Background –––––––––––––––––––––––––– Number characteristic HB1 HB2 HB3 of children –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sex Male 70.1 56.7 42.9 1,465 Female 71.8 59.6 47.9 1,353 Birth order 1 77.6 64.0 50.9 952 2-3 73.9 61.2 47.8 1,339 4-5 58.4 48.5 38.1 333 6+ 39.9 23.9 13.8 195 Residence Urban 80.4 64.3 51.5 1,326 Rural 62.6 52.5 39.9 1,493 Education No education 27.5 23.1 12.6 112 Table 12 HB. Immunizatio immunization ag three doses decre children of birth completed the va have had no edu childhood diseas respectively). HB immu for the three-dose lowest level of co 146 | Immunization of Children Some primary 42.3 30.7 21.8 379 Completed primary 68.4 51.4 40.9 859 Some secondary 76.2 64.9 50.1 646 Secondary + 88.6 77.1 61.5 822 Total 70.9 58.1 45.3 2,819 .2 shows that girls are slightly more likely than boys to have been immunized against n coverage for other background characteristics shows the same pattern as that for ainst other diseases. For example, the percentage of children who have completed the ases with increasing birth order, ranging from 51 percent for first born to 14 percent for order six or higher. Children in urban areas are more likely than rural children to have ccination schedule (52 and 40 percent, respectively). Similarly, children whose mothers cation are less likely to have been fully immunized against all of the preventable es than children whose mothers have had higher education (13 and 62 percent, nization coverage varies substantially by province. Provinces with the highest coverage series include DI Yogyakarta (91 percent) and Bali (82 percent), while Banten has the verage (28 percent) (Appendix Table A.12.2). CHILDHOOD DISEASES 13 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. For severe pneumonia, hospitalization is recommended; otherwise, ambulatory treatment with antibiotics is recommended. Early diagnosis and treatment with antibiotics can prevent many deaths caused by acute lower respiratory infection. In the 2002-2003 Indonesia Demo- graphic and Health Survey (IDHS), identification of acute respiratory infection (ARI) is based on each mother’s perception of the respiratory symptoms suffered by her child. Information about the prevalence of fever in children under five years of age was also 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 accompanied with fever are malaria, respiratory and intestinal infections, measles, and typhoid. The IDHS also recorded the prevalence of diarrhea in children under five as reported by their mothers. Contact with health providers and treatment practices help assess national programs aimed at reducing the impact of diarrhea. The treatment rates with oral rehydration therapy or increased fluids re- flect the success of programs that encourage these behaviors. 13.1 PREVALENCE AND TREATMENT OF ACUTE RESPIRATORY INFECTIONS AND FEVER Table 13.1 indicates that 8 percent of children had symptoms of ARI in the two weeks preceding the survey. The highest prevalence of ARI was found among children age 6-23 months (9 percent). The prevalence of ARI decreases slightly with age to 6 percent for children age 48-59 months. Prevalence of ARI does not vary by the child’s sex and residence, and variance by education is also small and not uni- form. Table 13.1 also shows that 26 percent of children had a fever in the two weeks preceding the sur- vey. As in the case of ARI, the highest prevalence of fever was found among children age 6-23 months (35-36 percent). Prevalence of fever follows the same pattern as the prevalence of ARI; it does not vary by the child’s sex or residence. Sixty percent of children who showed symptoms of ARI or fever were taken to a health facility for treatment. This percentage fluctuates by the child’s age, with children age 6-23 months being the most likely to be taken for treatment. Treatment-seeking behavior does not vary according to the child’s sex. Children in urban areas are more likely to be treated than those in rural areas (64 and 51 percent, respectively). Mother’s education makes a difference in the treatment of ARI and/or fever in children. While 69 percent of children whose mothers have completed secondary education were taken for treat- ment, the corresponding percentage for children of women with no education is 45 percent. Appendix Table A.13.1 shows the prevalence of ARI and fever by province. Prevalence of ARI is high in Bangka Belitung (20 percent), Banten (17 percent), Gorontalo (14 percent), and West Kalimantan (12 percent). Less than 5 percent of children were reported to have ARI in East Java, DI Yogyakarta, Lampung, Central Kalimantan, and South Sumatera. Provinces with high prevalence of ARI tend to have a high prevalence of fever. Childhood Diseases | 147 Table 13.1 Prevalence and treatment of acute r Percentage of children under five years of age w ing (symptoms of ARI), percentage of children w and percentage of children with symptoms of AR health facility or provider, by background charac –––––––––––––––––––––––––––––––––––––––– Prevalence o among chil –––––––––––––––– Percentage of children Per with of c Background symptoms characteristic of ARI f –––––––––––––––––––––––––––––––––––––––– Age in months <6 6.3 2 6-11 9.0 3 12-23 9.2 3 24-35 8.3 25.5 3,026 55.3 842 36-47 6.5 21.5 3,008 49.9 693 48-59 6.2 20.4 2,714 53.0 591 T given to an impo infancy countries fever wit in many Forty-sev during t were gi while le given an (76 perc antimala ban-rura ith type of 003 –––––– Total –––––– 0.2 0.5 76.4 3.8 47.1 0.6 15.2 7.2 148 | Childhood Dis Sex Male 7.7 25.8 7,483 56.9 2,069 Female 7.4 25.9 7,026 56.6 1,918 Residence Urban 7.6 25.1 6,830 63.6 1,855 Rural 7.6 26.5 7,680 50.9 2,133 Education No education 7.3 21.2 666 45.2 150 Some primary 9.1 29.2 2,102 46.6 653 Completed primary 7.6 26.3 4,865 52.3 1,341 Some secondary 8.0 28.1 2,947 59.7 877 Secondary+ 6.3 22.6 3,929 68.9 966 Total 7.6 25.9 14,510 56.8 3,988 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1 Exludes pharmacy, shop, and traditional practitioner able 13.2 reports the types of drugs children with fever. Since malaria is rtant contributory cause of death in and childhood in many developing , so-called “presumptive treatment” of h antimalarial medication is advocated countries where malaria is endemic. en percent of children with fever he two weeks preceding the survey ven acetaminophen or paracetamol, ss than 1 percent of children were timalarial drugs. Most of the children ent) were given a drug that was not rial (Table 13.2). Differences by ur- l residence are insignificant. Table 13.2 Drugs taken for fever Percentage of children under five years who were ill w fever during the two weeks preceding the survey, by drug taken, according to residence, Indonesia 2002-2 ––––––––––––––––––––––––––––––––––––––––––––– Residence –––––––––––––– Result Urban Rural ––––––––––––––––––––––––––––––––––––––––––––– Fansidar 0.3 0.1 Chloroquine/Nivaquine 0.5 0.5 Any non-antimalarial drug 77.2 75.7 Aspirin 2.9 4.6 Acetaminophen/paracetamol 48.0 46.4 Ibuprofen 0.6 0.5 Don't know/missing 16.0 14.6 No drug 5.2 8.9 eases espiratory infections (ARI) and/or fever ho had a cough accompanied by short, rapid breath- ho had fever in the two weeks preceding the survey, I and/or fever for whom treatment was sought from a teristics, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––– f ARI and/or fever Treatment among children with dren under five symptoms of ARI and/or fever ––––––––––––––––––– ––––––––––––––––––––––– Percentage for centage whom treatment hildren Number was sought from Number with of a health facility of ever children or provider1 children ––––––––––––––––––––––––––––––––––––––––––––– 0.1 1,570 48.1 337 5.7 1,373 66.0 508 4.5 2,819 63.2 1,016 Number of children 1,715 2,036 3,751 13.2 DISPOSAL OF CHILDREN’S STOOLS The proper disposal of children’s feces is extremely important in preventing the spread of disease. If feces are left uncontained, disease may spread by direct contact or through animal contact. Table 13.3 presents information on the disposal of children’s stools, by background characteristics, including type of toilet facilities in the household. Table 13.3 shows that only 21 percent of children under five always use a toilet/latrine, while 31 percent of mothers usually throw the stool into a toilet/latrine. Children in urban areas are more likely than rural children to have their stools contained. Overall, the percentage of urban children who always use a toilet or latrine or whose stools are thrown into a toilet/latrine or are buried is 72 percent, while for rural children it is only 41 percent. Mother’s education is related to use of a toilet/latrine; as mother’s education increases, so does the percentage of children who use a toilet/latrine or whose stools are thrown into a toilet/latrine. Table 13.3 Disposal of children’s stools Percent distribution of mothers who are living with their youngest child under five years, by way in which child's fecal matter is dis- posed of, according to background characteristics and type of toilet facilities in household, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Stools contained Stools uncontained Use diapers –––––––––––––––––––– –––––––––––––––––––––––––––– ––––––––––– Child always Thrown uses into Thrown Thrown Not Number Background toilet/ toilet/ Buried outside outside Rinsed disposed Dispos- Wash- of characteristic latrine latrine in yard dwelling yard away of able able Other Missing Total mothers ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Residence Urban 29.8 40.7 1.1 13.8 3.7 3.6 0.0 0.3 6.4 0.1 0.4 100.0 5,804 Rural 13.9 23.2 4.3 30.0 12.1 5.2 0.4 0.2 10.0 0.3 0.4 100.0 6,598 Education No education 5.7 19.7 3.6 37.9 18.3 7.4 0.3 0.0 6.3 0.3 0.6 100.0 564 Some primary 12.6 20.7 4.8 37.1 12.5 4.1 0.4 0.2 6.8 0.3 0.3 100.0 1,780 Completed primary 17.9 27.8 3.3 26.2 9.6 4.4 0.3 0.2 9.8 0.2 0.4 100.0 4,230 Some secondary 20.9 36.6 2.2 19.1 8.0 4.2 0.1 0.2 7.9 0.3 0.4 100.0 2,550 Secondary+ 33.5 40.0 1.3 9.5 2.5 4.5 0.1 0.5 7.8 0.0 0.4 100.0 3,278 Toilet facilities None 4.1 7.3 3.9 55.7 12.2 5.6 0.1 0.2 10.3 0.4 0.4 100.0 2,338 Pit latrine 16.4 33.3 2.0 23.5 9.7 5.2 0.1 0.0 8.6 0.1 1.1 100.0 1,006 Flush toilet 32.8 43.9 1.5 6.6 2.9 3.8 0.1 0.4 7.7 0.1 0.3 100.0 6,609 Other 8.7 19.7 5.6 33.2 18.0 5.0 0.9 0.1 8.1 0.5 0.3 100.0 2,422 Total 21.3 31.4 2.8 22.4 8.2 4.5 0.2 0.3 8.3 0.2 0.4 100.0 12,402 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Total includes 25 cases in which information on type of toilet facility is missing. Appendix Table A.13.2 shows the variation in the disposal of children’s stools by province. Chil- dren in DKI Jakarta are the most likely to use a toilet/latrine (45 percent), followed by Bali (30 percent) and North Sulawesi (30 percent). Less than 10 percent of children in North Sumatera, West Nusa Teng- gara, East Nusa Tenggara, Central Kalimantan, and Southeast Sulawesi use toilets or latrines. Provinces where stools are most likely thrown into a toilet/latrine are East Kalimantan and DI Yogyakarta (49 and 43 percent, respectively). Unhealthy behaviors such as throwing children’s stools outside the dwelling or yard are common in provinces such as West Nusa Tenggara (60 percent) and Bangka Belitung (54 per- cent). Childhood Diseases | 149 13.3 PREVALENCE OF DIARRHEA Table 13.4 Prevalence of diarrhea Percentage of children under five years with diarrhea in the two weeks preceding the survey, by background characteristics, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––– Diarrhea in the Number Background two weeks pre- of characteristic ceding the survey children –––––––––––––––––––––––––––––––––––––––––––––– Age in months <6 8.7 1,570 6-11 19.4 1,373 12-23 14.8 2,819 24-35 12.0 3,026 36-47 7.9 3,008 48-59 6.4 2,714 Diarrhea has been singled out for investiga- tion for two reasons. In many countries, dehydration from watery diarrhea is a major cause of death in infancy and childhood, and the condition is amenable to treatment by oral rehydration therapy. This combi- nation of a high cause-specific mortality rate and the existence of effective treatment makes diarrhea and its treatment a priority concern for health services. Table 13.4 shows the prevalence of diarrhea for children under five years by background characteristics. The reference period is the two weeks preceding the interview. This measure is affected by the reliability of the mother’s recall as to when the diarrheal episode occurred. Since the number of cases of diarrhea varies seasonally, the time of year in which the fieldwork was carried out (October 2002 to April 2003) should be taken into account in interpreting the findings. Table 13.4 shows that 11 percent of children under five had diarrhea in the two weeks preceding the survey. This figure is similar to those found in the 1994 and 1997 IDHS data (9 and 12 percent, respec- tively). The prevalence of diarrhea is highest among children age 6-11 months. Diarrhea prevalence does not vary by the child’s sex and residence. However, mother’s education is associated with the prevalence of diarrhea among their children. Children whose mothers have secondary or higher education are least likely to have diarrhea. While the difference is small, children whose source of drinking water is surface water are slightly more likely to have diarrhea than other children. Appendix Table A.13.3 shows the variation in t prevalence is highest in South Sulawesi (16 percent) and rhea prevalence is lowest in Central Kalimantan (2 percen 13.4 KNOWLEDGE OF DIARRHEA CARE Oral rehydration therapy (ORT), including a sol oral rehydration salts) and increased fluids, has been re ORT is promoted through health education and mass me fied as knowing about ORT if she reported ever hearing used, or ever seeing an ORS packet. 150 | Childhood Diseases Sex Male 10.8 7,483 Female 11.2 7,026 Residence Urban 11.2 6,830 Rural 10.8 7,680 Mother's education No education 11.9 666 Some primary 15.5 2,102 Completed primary 11.3 4,865 Some secondary 11.0 2,947 Secondary+ 8.1 3,929 Source of drinking water Piped 11.8 2,525 Protected well 10.3 5,807 Open well 11.0 2,600 Surface 13.8 2,210 Other/missing 8.0 1,368 Total 11.0 14,510 he prevalence of diarrhea by province. Diarrhea West Java (15 percent). On the other hand, diar- t) and South Sumatera (3 percent). ution prepared from ORS packets (prepackaged commended for treating diarrhea. In Indonesia, dia campaigns. In the IDHS, a mother is classi- about Oralit, the brand of ORS most commonly Table 13.5 shows the percentage of mothers who gave birth in the five years preceding the survey and who know about ORS packets. Overall, 92 percent of these mothers know about ORS packets. Knowledge about ORS packets does not vary much by respondent’s age and residence. Mother’s educa- tion is positively associated with knowledge of ORS packets, with 68 percent of mothers with no educa- tion knowing about ORS packets, compared with almost all mothers who completed secondary education. Table 13.5 Knowledge of ORS packets Percentage of mothers with births in the five years pre- ceding the survey who know about ORS packets for treatment of diarrhea, by background characteristics, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––– Percentage of mothers who know Number Background about ORS of characteristic packets mothers –––––––––––––––––––––––––––––––––––––––––– Age 15-19 85.2 543 20-24 92.1 2,855 Appendix Table A.1 packets by province. Mother’s knowledge of ORS packets is in DKI Jakarta and DI Yogya- karta (99 percent). 13.5 DIARRHEA TREATMEN Table 13.6 provides i eatment were sought for child- hood diarrheal episodes in the g the percentage of children re- ceiving various treatments for treatment with ORT, which in- cludes solutions prepared from nd increased fluids. Table 13.6 shows that ceding the survey were taken age; infants under six months ity or provider. Female child from a health provider than ot 25-29 95.1 3,665 30-34 95.2 2,868 35-49 87.9 2,831 Residence Urban 95.3 5,970 Rural 90.0 6,791 Education No education 68.1 580 Some primary 85.8 1,849 Completed primary 92.4 4,359 Some secondary 95.4 2,614 Secondary+ 98.1 3,359 Total 92.4 12,760 –––––––––––––––––––––––––––––––––––––––––– ORS = Oral rehydration salts 3.4 shows mother’s knowledge of ORS lowest in Banten (67 percent) and highest T nformation on whether medical care and tr two weeks preceding the survey, includin diarrhea. Particular attention is focused on ORS packets, recommended home fluids, a 51 percent of children under five years with diarrhea in the two weeks pre- to a health facility or provider. Treatment of diarrhea varies by the child’s and children three years or older are less likely to be taken to a health facil- ren and children in urban areas are somewhat more likely to receive care her children. Childhood Diseases | 151 Table 13.6 Diarrhea treatment Among children under five years of age who had diarrhea in the two weeks preceding the survey, percentage taken for treatment to a health pro- vider, percentage who received oral rehydration therapy (ORT), and percentage given other treatments, according to background characteristics, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Oral rehydration therapy (ORT) Other treatments ––––––––––––––––––––––––––––––––––––– –––––––––––––––––––––––––––– Percent- Oral Recom- age rehy- mended Number taken to dration home- ORS, RHF of a health salts made- Either In- or in- Pill Intra- Home No children Background facility or (ORS) fluids ORS creased creased or Injec- venous remedy/ treat- with characteristic provider1 packets (RHF) or RHF fluids fluids syrup tion solution other Missing ment diarrhea –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age in months 1 <6 24.0 15.3 13.2 26.3 25.3 39.6 30.0 0.6 0.0 17.4 0.0 41.1 137 6-11 60.0 35.5 15.4 45.2 26.3 59.2 59.9 0.7 0.4 8.9 0.0 16.6 267 12-23 59.7 35.4 22.2 51.6 29.1 60.7 60.2 1.2 0.1 10.8 0.0 12.2 417 24-35 55.2 34.7 24.7 45.5 30.3 61.5 64.6 1.1 1.7 13.9 0.0 8.2 364 36-47 39.1 40.4 23.7 51.4 24.7 62.2 51.1 0.9 0.0 11.6 2.8 12.4 237 48-59 43.7 46.6 26.4 65.1 33.4 75.3 66.3 0.0 0.0 15.0 0.0 4.3 175 Sex Male 49.0 33.0 24.1 48.0 24.9 56.3 59.9 0.6 0.9 11.1 0.0 15.3 808 Female 52.7 38.0 18.9 48.9 32.0 65.0 55.8 1.1 0.0 13.6 0.8 12.0 788 Residence Urban 54.6 35.0 21.8 48.9 29.0 62.5 59.8 0.7 0.9 10.5 0.8 12.6 767 Rural 47.3 35.9 21.3 48.0 27.9 58.9 56.1 1.0 0.0 14.1 0.0 14.7 829 Mother's education No education 31.7 39.3 16.4 48.9 34.5 57.4 43.4 0.0 0.0 19.6 0.0 23.9 79 Some primary 50.6 47.0 17.6 55.4 23.0 63.1 51.8 0.7 1.5 9.0 0.0 18.6 326 Completed primary 48.8 30.7 23.5 44.5 27.7 60.0 61.8 1.1 0.0 7.5 1.2 11.9 550 Some secondary 50.1 35.6 20.5 49.4 31.8 60.9 55.8 0.9 0.0 20.5 0.0 12.8 323 Secondary + 60.1 31.0 24.5 47.0 30.2 59.8 63.1 0.8 0.8 14.1 0.0 10.0 318 Total 50.8 35.5 21.6 48.4 28.4 60.6 57.9 0.9 0.5 12.3 0.4 13.7 1,596 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: ORT includes solution prepared from oral rehydration salt (ORS) packets, recommended homemade fluids (RHF), or increased fluids. 1 Excludes pharmacy, shop, and traditional practitioner Treatment of children with diarrhea varies by mother’s education. Children of mothers with no education are the least likely to be taken to a health facility or provider, while children whose mothers have secondary or higher education are the most likely to receive care from a health professional. How- ever, the association between treating children with diarrhea with ORS and mother’s education is less clear (Figure 13.1). 52 | Childhood Diseases IDHS 2002-2003 Figure 13.1 Knowledge and Use of ORS Packets among Mothers Who Gave Birth in the Past Five Years, by Level of Education 68 86 92 95 98 39 47 31 36 31 No education Some primary Completed primary Some secondary Secondary+ 0 20 40 60 80 100 Pe rc en t Knowledge of ORS Use of ORS Children who have diarrhea may be given a solution prepared from ORS packets, homemade flu- ids, other treatments, increased fluids, or a combination of these treatments. Although more than 90 per- cent of mothers reported that they know about ORS packets, only 36 percent of children with diarrhea were treated with ORS. This percentage is much lower than that in the 1997 IDHS (48 percent) (Figure 13.2). Overall, 22 percent of children with diarrhea were given recommended home fluids (RHF), 48 per- cent received either ORS or RHF, 58 percent were given some pill or syrup for treatment, and 12 percent were given a home remedy. While the majority of children with diarrhea were given ORS, RHF, or in- creased fluids, 14 percent of children received no treatment at all. Figure 13.2 Trends in Knowledge and Use of ORS Packets for Treatment of Diarrhea by Mothers who Gave Birth in the Past Five Years 94 48 92 36 Knows about ORS Treatment with ORS packets 0 20 40 60 80 100 Pe rc en t 1997 IDHS 2002-2003 IDHS 1 Note: The 2002-2003 IDHS did not include Nanggroe Aceh Darussalam, Maluku, North Maluku, and Papua province. Previous surveys included East Timor. 1 Children under five who had diarrhea in the two weeks preceding the survey ORS = Oral rehydration salts Childhood Diseases | 153 13.6 FEEDING PRACTICES DURING DIARRHEA The recovery of a child suffering from diarrhea may depend on the feeding practices during and between diarrhea episodes. In particular, consumption of extra fluids is essential. Table 13.7 presents data on feeding practices of children who had diarrhea in the two weeks preceding the survey. The data show that only 28 percent of children with diarrhea were given more fluids than usual, while 47 percent were given the same amount of fl hildren with diarrhea were given less fluid or none at all. Diarrheal episodes are fre akes feeding difficult be- cause the child may refuse food. T ren were given more food than usual, while 44 percent were lts of the 2002-2003 IDHS show that feeding practices of ch sistent with recommended interventions. Figure 13.3 compares feed gest that appropriate feeding prac creased fluids and increased foods children with diarrhea were given was only 28 percent. 154 | Childhood Diseases uids. It should be noted that 24 percent of c quently accompanied by vomiting, which m able 13.7 shows that only 10 percent of child given less food or none at all. Overall, resu ildren with diarrhea in Indonesia are not con Table 13.7 Feeding practices during diarrhea Percentage of children under five years who had diarrhea in the two weeks preceding the survey, by amount of fluids and food offered, compared with normal practice, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––– Feeding practices Percentage –––––––––––––––––––––––––––––––––––––– Amount of fluids offered Same as usual 46.9 More 28.4 Somewhat less 16.5 Much less 1.2 None 5.9 Don't know/missing 1.1 Total 100.0 Amount of food offered Same as usual 44.3 More 9.9 Somewhat less 38.0 Much less 2.8 None 3.4 Never gave food 0.8 Don't know/missing 0.9 Total 100.0 Number of children 1,596 ing practices during diarrhea in 1997 and 2002-2003. The figures sug- tices have deteriorated. The percentage of children who were given in- in 2002-2003 is half of that in 1997. For example, while 57 percent of increased fluids in 1997, the corresponding proportion in 2002-2003 Figure 13.3 Trends in Feeding Practices among Children Under Five with Diarrhea 26 57 15 30 20 4647 28 24 44 10 44 Same as usual Increased Decreased/ none Same as usual Increased Decreased/ none 0 20 40 60 80 100 Pe rc e n t 1997 IDHS 2002-2003 IDHS Amount of Fluids Amount of Food Note: The 2002-2003 IDHS did not include Nanggroe Aceh Darussalam, Maluku, North Maluku, and Papua province. Previous surveys included East Timor. 13.7 CHILDREN’S HEALTH CARE AND WOMEN’S STATUS The 2002-2003 IDHS investigated the relationship between children’s health care and women’s status as measured by their ability to influence household decisionmaking, the number of situations in which they believe that a woman is justified in refusing sexual relations with her husband, and the number of circumstances in which she believes that a husband is justified in beating his wife. Table 13.8 shows little relationship between women’s status and children’s health care. Although there is a slight positive relationship between women’s participation in household decisionmaking and vaccination coverage, the relationship is weaker for treatment of childhood fever and is slightly negative for the likelihood of children’s being taken for treatment when they are ill with diarrhea. As for the num- ber of reasons for which women are justified in refusing sex with their husbands, the expected relation- ship is positive, i.e., the more reasons, the higher the percentage. However, the actual relationship is not linear for any of the three child health variables. Similarly, for the number of reasons for which wife beat- ing is justifiable, the expected negative relationship is found only for the percentage of children with symptoms of ARI or fever who are taken for treatment. Childhood Diseases | 155 Table 13.8 Children’s healthcare by women’s status Percentage of children age 12-23 months who were fully vaccinated and percentages of children under five years who were ill with a fever and/or symptoms of ARI and diarrhea in the two weeks preceding the survey who were taken to a health provider for treatment, by women's status indicators, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Children with fever and/or Children age 12-23 months symptoms of ARI taken Children with diarrhea fully vaccinated1 to a health provider2 taken to a health provider2 ––––––––––––––––––––– ––––––––––––––––––––– ––––––––––––––––––––– Women’s status indicator Percentage Number Percentage Number Percentage Number –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Number of decisions in which woman has final say3 0 * 6 * 29 * 15 1-2 41.6 120 50.5 243 57.4 126 3-4 48.3 819 56.6 1,272 49.3 496 5 53.5 1,874 57.4 2,444 50.5 958 Number of reasons to refuse sex with husband 0 50.4 168 53.3 266 52.8 100 1-2 42.6 273 57.3 431 53.0 194 3-4 52.5 2,378 57.0 3,291 50.4 1,302 1 w ID al 156 | Child Number of reasons wife beating is justified 0 51.4 1,997 59.5 2,646 50.7 1,051 1-2 52.7 619 54.1 971 53.8 397 3-4 45.4 165 44.1 307 39.6 116 5 (63.4) 38 (43.6) 63 (57.7) 32 Total 51.5 2,819 56.8 3,988 50.8 1,596 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 1 Those who have received BCG, measles, and three doses each of DPT and polio vaccine (excluding polio vaccine given at birth) 2 Excludes pharmacy, shop, and traditional practitioner 3 Either alone or jointly with others 3.8 HAND-WASHING PRACTICES Many diseases are readily transmitted through contaminated food or from hand to mouth. Hand ashing minimizes the transmission of both enteric (fecal) and respiratory pathogens. In the 2002-2003 HS, respondents were asked whether they washed their hands before preparing meals for their family. Table 13.9 shows that 96 percent of women wash their hands before preparing meals. There are most no differences in the practice by background characteristics or the availability of water. hood Diseases Table 13.9 Hand-washing practices Percentage of women who washed their hands before preparing a meal for their family the last time, according to background characteristics, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Did not Never Number Background Washed wash prepared of characteristic hands hands meals Missing Total women –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 94.4 2.4 3.2 0.0 100.0 956 20-24 96.0 2.5 1.5 0.0 100.0 3,875 25-29 96.5 2.4 1.0 0.0 100.0 5,375 30-34 95.9 2.3 1.7 0.0 100.0 5,428 35+ 95.1 2.4 2.4 0.1 100.0 13,848 Residence Urban 96.7 1.6 1.7 0.1 100.0 13,499 Rural 94.7 3.1 2.2 0.0 100.0 15,984 Source of drinking water Piped 95.9 2.1 1.9 0.1 100.0 4,987 Protected well 96.4 1.9 1.6 0.0 100.0 12,291 Open well 95.6 2.6 1.7 0.1 100.0 5,150 Surface 92.4 4.1 3.6 0.0 100.0 4,541 Other 96.9 1.6 1.4 0.0 100.0 2,510 Time to get water In dwelling/yard/plot 96.4 1.9 1.7 0.1 100.0 22,428 Less than 2 minutes 98.9 1.1 0.0 0.0 100.0 153 2-4 minutes 94.8 2.5 2.7 0.0 100.0 677 5-9 minutes 95.3 3.1 1.6 0.0 100.0 2,152 10+ minutes 91.0 4.9 4.0 0.1 100.0 3,746 Total1 95.6 2.4 2.0 0.1 100.0 29,483 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1 Total includes 5 women with missing information on source of drinking water and 327 women with missing informa- tion on time to get water. Childhood Diseases | 157 INFANT FEEDING 14 Appropriate feeding practices are of fundamental importance for the survival, growth, develop- ment, health, and nutrition of infants and young children. The mother’s nutritional well being before and during pregnancy can permanently influence the health of the child at all developmental stages, and her own ability to successfully deliver the baby and breastfeed, as well as her general health. The health bene- fits of breastfeeding for both mother and child are undisputed and they are influenced by both the duration and intensity of breastfeeding and by the age at which the child receives complementary fluids and foods. To minimize morbidity and mortality of children, the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO) recommend that children should be breastfed for at least six months. Solid food should only be given at age seven months or older, and breastfeeding should continue well into the second year of life (Rutstein, 2000). In 2003, the Indonesian government changed the rec- ommended duration of exclusive breastfeeding from four months to six months (Ministry of Health, 2002c). 14.1 INITIAL BREASTFEEDING Mother and child benefit from early initiation of breastfeeding. From the child’s perspective, co- lostrum (first breast milk) is important because it is rich in antibodies, which in turn has the effect of re- ducing the risk of dying. Early initiation of breastfeeding affects the new mother’s health by causing the uterus to retract, helping to minimize postpartum blood loss. Over the longer term, a breastfeeding mother is likely to extend the length of her birth intervals, due to the suppressive effect that breastfeeding can have on the postpartum return of menses. The effect of breastfeeding on return of menses is moder- ated by both duration and intensity of breastfeeding. Longer birth intervals allow a mother’s body to re- cover from the physical depletions associated with pregnancy. In the 2002-2003 Indonesia Demographic and Health Survey IDHS, for all children born in the five years before the survey, mothers were asked how soon after birth the baby was given breast milk. They were also asked whether the child was given something other than breast milk during the first three days of life before the mother started breastfeeding regularly. Data presented in Table 14.1 confirm that breastfeeding in Indonesia is universal, with 96 percent of children born in the five years preceding the survey having been breastfed at some time. This is true for all subgroups of children. Four in ten babies are put to the breast within the recommended one hour of birth, while 62 per- cent initiate breastfeeding in the first day of life. The percentage of children who started breastfeeding within the first day of life has increased from that in 1997 (53 and 62 percent, respectively) (BPS, 1998). The timing of introduction of complementary foods in addition to breast milk has important health benefits for both the child and mother. Early introduction of foods that are low in energy and nutri- ents and prepared under unhygienic conditions can result in undernutrition, infection with foreign organ- isms, and lowered immunity to disease for the baby. At the same time, a baby receiving complementary foods will breastfeed less, thus reducing suckling frequency and quantity of milk produced. In turn, this may shorten the duration of mother’s postpartum amenorrhea period, which may result in an earlier sub- sequent pregnancy. Infant Feeding | 159 The delay in starting breastfeeding immediately is an indication that some prelacteal feed is given during the period between birth and initiation of breastfeeding. Table 14.1 shows that the percentage of children who receive a prelacteal liquid is very high (45 percent). As expected, children are more likely to receive liquid than semisolid food before they are breastfed regularly (45 and 18 percent, respectively). 160 | Infa Table 14.1 Initial breastfeeding Percentage of children born in the five years preceding the survey who were ever breastfed, and among children ever breastfed, percentage who started breastfeeding within one hour and within one day of birth, and percentage who received a prelacteal feed, by background characteristics, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Children ever breastfed ––––––––––––––––––––––– Percentage All children Percentage Percentage Percentage who –––––––––––––––––––– who started who started who received a Number Percentage Number breastfeeding breastfeeding received a prelacteal of children Background ever of within 1 hour within 1 day prelacteal feed ever characteristic breastfed children of birth of birth1 feed liquid2 nonliquid2 breastfed ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sex Male 95.8 7,787 38.4 61.1 46.0 18.6 7,459 Female 96.1 7,301 39.1 63.2 44.7 16.6 7,015 Residence Urban 95.1 7,029 36.4 59.6 52.5 16.0 6,688 Rural 96.6 8,059 40.7 64.2 39.2 19.0 7,786 Mother's education No education 98.6 709 42.3 63.2 34.1 20.9 699 Some primary 96.5 2,238 40.5 61.6 36.9 22.1 2,161 Completed primary 96.5 5,038 38.9 65.5 38.6 19.1 4,860 Some secondary 95.4 3,074 39.1 60.7 48.2 18.2 2,931 Secondary + 94.9 4,029 36.7 59.0 58.5 12.2 3,823 Assistance at delivery Health professional3 95.3 9,994 38.2 61.4 53.1 14.0 9,522 Traditional birth attendant 97.2 4,752 40.2 65.1 30.8 25.8 4,617 Other 96.2 190 50.2 63.9 38.9 11.7 182 No one (100.0) (39) (46.9) (58.7) (42.7) (3.2) 39 Place of delivery Health facility 94.3 6,002 39.3 62.2 58.0 9.2 5,658 At home 97.0 8,906 38.7 62.8 37.6 23.4 8,636 Other 98.6 60 52.0 66.9 40.2 10.2 59 Missing 99.9 121 8.1 8.2 5.3 0.1 121 Total 95.9 15,089 38.7 62.1 45.3 17.6 14,474 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Table is based on all births whether the children are living or dead at the time of interview. Figures in parentheses are based on 25-49 unweighted cases. 1 Includes children who started breastfeeding within one hour of birth 2 Children given something other than breast milk during the first three days of life before the mother started breastfeeding regu- larly 3 Doctor, nurse/midwife, or auxiliary midwife nt Feeding Rural children are less likely to receive prelacteal liquids than urban children. There is a positive association between mother’s education and the likelihood of children receiving liquid preacteal feeds. Children of women with no education are less likely to receive a liquid prelacteal feed than children of women with secondary or higher education. Similarly, children delivered at home are less likely to re- ceive liquid prelacteal feeds and more likely to receive a semisolid prelacteal feed than children delivered in health facilities. Children whose mothers were assisted by a health professional at delivery are much more likely to receive liquids before the mother’s breast milk flows regularly than children assisted by a traditional birth attendant at delivery. On the other hand, children assisted by a traditional birth attendant at delivery are more likely than those who were assisted by a health professional to be given prelacteal semisolid food (26 and 14 percent, respectively). Appendix Table A.14.1 shows that children in East Java, West Nusa Tenggara, and Central Kali- mantan are the most likely to be given breast milk within the first hour of birth (60 percent or higher) compared with other children, and children in Bengkulu, Central Java, DI Yogyakarta, South Kalimantan, and Central Sulawesi are the least likely to receive breast milk within the first hour of birth (less than 25 percent) compared with other children. Mothers in West Nusa Tenggara and North Sulawesi are by far the most likely to breastfeed within the first day of birth (80 percent or higher). Children in DKI Jakarta and Riau are the most likely to receive a liquid prelacteal feed (66 and 62 percent, respectively), while children in Gorontalo (43 percent), Bengkulu (36 percent), and Central Su- lawesi (36 percent) are the most likely to receive a semisolid prelacteal food. 14.2 AGE PATTERN OF BREASTFEEDING 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. Children are classified as being exclusively breastfed if they received breast milk only in the last 24 hours. Full breastfeeding is defined as receiving plain water only in addition to breast milk. Table 14.2 and Figure 14.1 show data on the breastfeeding status of young children from birth up to three years of age. While 55 percent of children younger than 4 months of age are exclusively breastfed, the proportion among children under 6 months is 40 percent. Past the age of six months, breast milk alone does not provide sufficient nutrition for the infant; thus children over the age of six months should not be exclusively beastfed. In Indonesia, 5 percent of infants age 6-9 months are re- ported as being exclusively breastfed. The percentage of children who no longer received breast milk starts to rise from 13 percent at age 6-7 months to 41 percent at age 20-23 months. By age 28 months, 66 percent of children have stopped receiving breast milk. Comparing these figures with those in the 1997 IDHS, there has been a slight increase in the per- centage of children under 4 months who were exclusively breastfed (52 percent in 1997 compared with 55 percent in 2002-2003). Early introduction of foods that are low in energy and nutrients or prepared under unhygienic conditions may result in undernutrition, infection with foreign organism, and lower immunity to disease for the baby (Ministry of Health, 2002a). Unfortunately, in Indonesia infant feeding supplementation starts early, which is inconsistent with the Government of Indonesia recommendation. Exclusive breast- feeding is not widely practiced. Among infants under 2 months of age, only 64 percent are given breast milk exclusively. This percentage declines to 46 percent for infants 2-3 months and 14 percent for infants 4-5 months. Hence, only one in seven infants receive breast milk exclusively at an age when all infants are recommended to be exclusively breastfed. Infant Feeding | 161 Thirteen percent of infants under 2 months were given other milk and 15 percent received com- plementary foods. By age 2-3 months, one in three children were given complementary foods. This pro- portion increases to 71 percent at age 6-7 months. Bottle-feeding can be unsanitary and is not recommended at any age. However, this practice is becoming more common in Indonesia. Table 14.2 shows that the percentage of children 2-3 months who were bottlefed increased from 12 percent in 1997 to 17 percent in 2002-2003. This percentage increases to 162 | Infan 35 percent among infants age 8-9 months. Table 14.2 Breastfeeding status by child’s age Percent distribution of youngest children under three years living with the mother by breastfeeding status, and percent- age of children under three years using a bottle with a nipple, according to age in months, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Breastfeeding and consuming: –––––––––––––––––––––––––––––––– Exclu- Water- Using Not sively Plain based Comple- Number a bottle Number breast- breast- water liquids/ Other mentary of with of living Age in months feeding fed only juice milk foods Total children a nipple1 children ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– <2 3.9 64.0 4.1 0.1 13.2 14.6 100.0 431 13.8 438 2-3 4.8 45.5 7.2 0.6 9.7 32.2 100.0 570 16.5 577 4-5 7.4 13.9 6.2 0.3 3.1 69.0 100.0 546 19.0 555 6-7 13.0 7.8 2.7 1.2 3.9 71.3 100.0 470 30.1 473 8-9 15.9 1.7 0.9 1.9 0.6 79.1 100.0 426 34.9 431 10-11 17.5 1.2 2.0 0.6 0.3 78.4 100.0 457 30.0 469 12-15 15.4 1.0 1.1 1.0 0.6 80.8 100.0 1,021 22.1 1,045 16-19 24.1 1.3 0.2 0.2 0.6 73.5 100.0 945 31.6 976 20-23 41.3 0.3 0.2 0.2 0.0 58.0 100.0 755 29.8 797 24-27 58.8 0.9 0.1 0.0 0.1 40.1 100.0 901 27.9 999 28-31 65.6 0.3 0.2 0.3 0.0 33.7 100.0 867 24.7 1,004 32-35 72.8 0.2 0.6 0.0 0.2 26.2 100.0 873 23.3 1,023 <4 4.2 55.1 7.6 0.5 12.8 19.8 100.0 1,001 16.1 1,015 <6 5.5 39.5 6.0 0.4 8.4 40.3 100.0 1,547 16.7 1,570 6-9 14.4 4.9 1.8 1.5 2.3 75.0 100.0 897 32.4 904 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Breastfeeding status refers to a 24-hour period (yesterday and last night). Children classified as breastfeeding and consuming plain water only consume no supplements. The categories of not breastfeeding, exclusively breastfed, breast- feeding and consuming plain water, water-based liquids/juice, other milk, and complementary foods (solids and semisol- ids) are hierarchical and mutually exclusive, and their percentages add to 100 percent. Thus, children who receive breast milk and water-based liquids and who do not receive complementary foods are classified in the water-based liquid cate- gory even though they may also get plain water. Any children who get complementary food are classified in that category as long as they are breastfeeding as well. 1 Based on all children under three years t Feeding Figure 14.1 Distribution of Children by Breastfeeding (BF) Status, According to Age IDHS 2002-2003 0 2 4 6 8 10 12 16 20 24 28 32 Age in Months 0 20 40 60 80 100 Percent Exclusive BF BF + Water only BF + Supplements Not BF 14.3 DURATION AND FREQUENCY OF BREASTFEEDING Table 14.3 shows the differentials in duration and frequency of breastfeeding by background characteristics. The overall median duration of any breastfeeding is 22.3 months, the median duration of exclusive breastfeeding is 1.6 months, and the median duration of predominant breastfeeding1 is 2.0 months. The overall median duration of any breastfeeding in 1997 is more than one month longer (23.9 months) than the duration reported in the 2002-2003 IDHS. 1 Includes breast milk only, breast milk and water, water-based liquids and/or juice only (excludes other milk). Infant Feeding | 163 Table 14.3 Median duration of breastfeeding Median duration of any breastfeeding, exclusive breastfeeding, and predominant breastfeeding among children born in the three years preceding the survey, percentage of breastfeeding children under six months living with the mother who were breastfed six or more times in the 24 hours preceding the survey, and mean number of feeds (day/night), by back- ground characteristics, by background characteristics, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Median duration (months) of breastfeeding1 Breastfeeding children under six months2 ––––––––––––––––––––––––––––––––––––– ––––––––––––––––––––––––––––––––––––––– Predo- Percentage Mean Mean Any Exclusive minant Number breastfed 6+ number number Number Background breast- breast- breast- of times in last of of of characteristic feeding feeding feeding3 children 24 hours day feeds night feeds children ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sex Male 21.9 1.5 1.9 4,824 95.7 6.3 4.7 748 Female 22.6 1.7 2.1 4,294 97.3 6.6 4.8 698 l r t- f - o t b - s e b - q 4 m f f 164 | Infa Residence Urban 21.2 1.4 1.9 4,315 95.0 6.3 4.6 665 Rural 23.1 1.7 2.1 4,804 97.7 6.6 4.8 782 Mother's education No education 24.8 0.7 3.6 411 95.6 6.6 4.7 56 Some primary 25.4 1.1 1.2 1,271 99.2 6.4 4.8 172 Completed primary 23.6 1.7 2.1 2,973 96.4 6.4 4.5 575 Some secondary 21.1 1.7 2.1 1,957 96.4 6.6 4.7 314 Secondary+ 19.7 1.5 1.9 2,507 95.5 6.5 5.1 328 Total 22.3 1.6 2.0 9,119 96.5 6.5 4.7 1,446 Mean for all children 22.1 3.2 3.9 na na na na na ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Median and mean durations are based on current status. na = Not applicable 1 It is assumed that non-last-born children and last born children not living with the mother are not currently breastfeed- ing 2 Excludes children who do not have a valid answer on the number of times breastfed 3 Either exclusively breastfed or received breast milk and plain water, water-based liquids, and/or juice only (excludes other milk) Whereas there are small differences in breastfeeding practices by the child’s sex and urban-rura esidence, there are variations by mother’s education. For example, the median duration of any breas eeding is 24.8 months for mothers with no education compared with 19.7 months for mothers with sec ndary or higher education (Figure 14.2). For mothers to enhance their supply of breast milk and delay the return of menstruation, frequen reastfeeding must be practiced throughout the day and night (Ministry of Health, 2002d). Data pre ented in Table 14.3 indicate that 97 percent of breastfeeding children under six months of age wer reastfed six or more times in the 24 hours preceding the interview. Children are breastfed more fre uently during the day than at night (7 and 5 times, respectively). Appendix Table A.14.2 shows that the median duration of any breastfeeding ranges from 14. onths in DKI Jakarta to 32.7 months in West Kalimantan. There are small variations in frequency o eeds across provinces. nt Feeding 22.3 21.9 22.6 21.2 23.1 24.8 25.4 23.6 21.1 19.7 INDONESIA CHILD'S SEX Male Female RESIDENCE Urban Rural EDUCATION No education Some Primary Completed Primary Some Secondary Secondary + 0.0 10.0 20.0 30.0 Months IDHS 2002-2003 Figure 14.2 Median Duration of Any Breastfeeding (months) 14.4 TYPES OF COMPLEMENTARY FOODS As mentioned above, the recommended age for introducing foods other than breast milk is 6 months. The data in Table 14.4 show that 48 percent of breastfeeding children under 6 months receive semisolid or solid foods. As expected, the percentage among children who were not breastfed is higher (76 percent). Among breastfeeding children under 6 months of age, 36 percent received cereal and 21 percent received fruits and vegetables, whereas among nonbreastfeeding children of the same age group, 48 percent received cereals and 36 percent had consumed fruits or vegetables in the day or night preced- ing the interview. Table 14.4 shows that more than 65 percent of breastfeeding children over 7 months of age and more than 75 percent of nonbreastfeeding children received foods rich in vitamin A, which incudes pumpkin, carrots, red sweet potatoes, green leafy vegetables, mangoes, papayas, jackfruit, and other lo- cally grown foods rich in vitamin A, and meats. The level of vitamin A consumption may be slightly overestimated because the “meats” category in the questionnaire includes both “meat,” which is rich in vitamin A, and “poultry, fish, shellfish, or eggs,” which are not rich in vitamin A. It was not possible to separate meat from the other foods during the analysis stage. Infant Feeding | 165 Table 14.4 Foods consumed by children in the day or night preceding the interview Percentage of children under three years of age living with the mother who consumed specific foods in the day or night preceding the interview, by breastfeeding status and age, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Solid/semisolid foods ––––––––––––––––––––––––––––––––––––––––––– Any Food Meat/ Food Fruits and solid Other Food made Food fish/ made vegetables or milk/ made Fruits/ from made shellfish/ with rich in semi Number Child’s age Infant cheese/ Other from vege- roots/ from poultry oil/fat/ vitamin solid of in months formula yogurt liquids1 grains tables2 tubers legumes eggs butter A3 food children ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– BREASTFEEDING CHILDREN ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– <2 16.3 0.1 2.7 11.1 9.0 0.0 0.3 0.5 0.0 1.4 21.1 414 2-3 17.8 0.6 6.4 25.5 14.8 0.9 1.7 4.1 1.1 5.0 38.3 543 4-5 20.0 1.0 19.0 68.1 37.8 4.0 8.8 12.9 2.2 20.0 80.1 505 6-7 26.0 4.0 26.1 79.6 56.2 10.7 12.5 28.1 5.2 45.9 87.3 409 8-9 27.4 3.8 42.6 87.5 75.4 14.4 25.7 40.7 11.3 64.6 95.5 359 10-11 22.3 9.7 48.4 88.7 77.1 19.7 47.1 57.5 26.5 73.4 95.3 377 12-15 22.4 6.3 53.5 94.4 85.4 22.4 46.9 63.3 26.8 81.2 96.9 864 16-19 24.7 9.9 62.2 95.2 89.0 21.0 51.8 70.7 38.0 83.5 98.9 717 20-23 25.2 11.0 59.4 96.5 87.9 30.0 62.4 74.4 41.6 83.4 99.1 444 24-35 17.6 17.1 67.8 94.3 88.1 27.8 60.8 70.6 43.8 82.9 99.0 908 <6 18.1 0.6 9.7 36.1 21.1 1.7 3.8 6.1 1.2 9.2 47.9 1,463 6-9 26.7 3.9 33.8 83.3 65.2 12.4 18.7 34.0 8.0 54.6 91.1 768 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– NONBREASTFEEDING CHILDREN ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 6-7 87.5 6.5 30.6 78.6 57.9 14.8 17.6 18.6 5.2 48.9 99.8 61 8-9 75.8 24.5 58.2 91.5 94.2 4.0 31.6 65.5 32.6 79.2 100.0 68 10-11 74.8 5.7 44.6 98.1 77.6 27.4 54.1 59.3 6.4 75.3 98.8 80 12-15 58.4 12.8 70.0 95.3 92.5 27.5 57.8 80.4 28.4 88.9 99.9 157 16-19 67.6 10.6 76.4 98.9 95.1 28.4 49.1 81.3 47.8 91.0 99.7 228 20-23 42.0 15.8 66.0 96.0 88.8 26.0 55.6 73.4 42.6 84.3 97.9 312 24-35 41.1 20.7 69.2 97.6 93.3 32.1 59.0 78.5 42.4 89.3 99.7 1,734 <6 76.6 5.6 23.7 48.3 36.3 4.4 10.9 4.3 0.9 16.3 75.6 85 6-9 81.4 16.0 45.1 85.4 76.9 9.2 24.9 43.2 19.6 64.8 99.9 129 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Breastfeeding status and food consumed refer to a 24-hour recall period (yesterday and last night). 1 Does not include plain water 2 Includes fruits and vegetables rich in vitamin A 3 Includes pumpkin, carrots, red sweet potatoes, green leafy vegetables, mangoes, papayas, and other locally grown fruits and vegetables that are rich in vitamin A 14.5 FREQUENCY OF FOODS CONSUMED BY CHILDREN Table 14.5 shows the number of times various foods were consumed in the 24 hours prior to the interview by youngest children under three years living with their mothers. Breastfeeding children re- ceived other liquids,2 cereal-type foods, and fruits and vegetables on average once in the 24-hour period prior to the interview. The frequency of foods consumed generally increases with the child’s age and, as would be expected, nonbreastfeeding children consume these specified foods with greater frequency than breastfeeding children. 2 Other liquids include sugar water, tea, soda, and soup broth. 166 | Infant Feeding Table 14.5 Frequency of foods consumed by children in the day or night preceding the interview Mean number of times specific foods were consumed in the day or night preceding the interview by youngest children under three years of age living with the mother, according to breastfeeding status and age, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Solid/semisolid foods –––––––––––––––––––––––––––––––––––––––––––––––––––––– Food Meat/ Food Fruits and Other Food made Food fish/ made vegetables milk/ made Fruits/ from made shellfish/ with rich in Number Child’s age Infant cheese/ Other from vege- roots/ from poultry oil/fat/ vitamin of in months formula yogurt liquids1 grains tables2 tubers legumes eggs butter A3 children –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 14. on and od blin al- ity he surv er- cen es wit ds that BREASTFEEDING CHILDREN –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– <2 0.5 0.0 0.0 0.3 0.2 0.0 0.0 0.0 0.0 0.0 414 2-3 0.6 0.0 0.1 0.6 0.3 0.0 0.0 0.1 0.0 0.1 543 4-5 0.5 0.0 0.3 1.5 1.0 0.1 0.1 0.3 0.0 0.6 505 6-7 0.8 0.1 0.5 2.0 1.8 0.2 0.2 0.5 0.1 1.3 409 8-9 1.0 0.1 0.8 2.3 2.5 0.2 0.5 0.8 0.3 1.9 359 10-11 0.6 0.1 1.0 2.3 2.7 0.4 0.8 1.1 0.5 2.1 377 12-15 0.7 0.1 1.1 2.5 3.3 0.4 0.9 1.3 0.5 2.6 864 16-19 0.7 0.2 1.3 2.6 3.4 0.3 1.0 1.3 0.8 2.6 717 20-23 0.7 0.2 1.2 2.5 3.4 0.5 1.1 1.5 0.8 2.5 444 24-35 0.5 0.3 1.5 2.6 3.4 0.4 1.2 1.3 0.9 2.5 908 <6 0.6 0.0 0.2 0.8 0.5 0.0 0.1 0.1 0.0 0.3 1,463 6-9 0.9 0.1 0.7 2.2 2.1 0.2 0.3 0.7 0.2 1.5 768 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– NONBREASTFEEDING CHILDREN –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 6-7 4.1 0.1 0.6 2.0 1.9 0.2 0.3 0.3 0.1 1.4 61 8-9 4.0 0.4 1.9 2.8 4.7 0.1 0.4 1.5 0.5 3.7 68 10-11 3.7 0.3 0.8 2.5 3.0 0.6 1.0 1.0 0.1 2.4 80 12-15 2.7 0.5 1.9 2.9 4.2 0.5 1.0 1.8 0.5 3.3 157 16-19 2.8 0.3 1.6 2.9 4.5 0.5 0.9 2.0 1.0 3.5 228 20-23 1.5 0.4 1.4 2.9 3.5 0.5 1.0 1.6 0.9 2.7 312 24-35 1.5 0.5 1.6 2.9 3.7 0.5 1.1 1.7 0.9 2.9 1,734 <6 3.3 0.1 0.3 1.2 1.0 0.1 0.1 0.1 0.0 0.3 85 6-9 4.1 0.3 1.3 2.4 3.4 0.1 0.4 0.9 0.3 2.6 129 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Breastfeeding status and food consumed refer to a 24-hour period (yesterday and last night). 1 Does not include plain water 2 Includes fruits and vegetables rich in vitamin A 3 Includes pumpkin, carrots, red sweet potatoes, green leafy vegetables, mangoes, papayas, and other locally grown fruits and vegetables rich in vitamin A 6 MICRONUTRIENT INTAKE AMONG CHILDREN Micronutrient deficiencies are of concern in Indonesia. Vitamin A is essential for normal visi enhancement of immunity. Vitamin A deficiency has been known to be the main cause of childho dness. Several reports have shown that vitamin A deficiency is also associated with increased mort and an increased severity of infectious disease (Helen Keller International, 2001). The consumption of micronutrient-rich foods and supplements in the seven days preceding t ey by children under three years living with their mothers is shown in Table 14.6. Sixty-seven p t of these children received foods rich in vitamin A. Consumption of foods rich in vitamin A increas h children’s age. Breastfeeding children are less likely than nonbreastfeeding children to receive foo are rich in vitamin A (59 and 85 percent, respectively). The relationship between consumption of Infant Feeding | 167 Table 14.6 Micronutrient intake among children Percentage of youngest children under age three living with the mother who con- sumed fruits and vegetables rich in vitamin A in the seven days preceding the survey, percentage of children age 6-59 months who received vitamin A supplements in the six months preceding the survey, by background characteristics, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Youngest children under age 36 months ––––––––––––––––––––––– Consumed Children age 6-59 months fruits and ––––––––––––––––––––––– vegetables Number Consumed Number Background rich in of vitamin A of characteristic vitamin A1 children supplements children ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age in months <6 9.6 1,547 na 0 6-9 56.1 897 58.7 904 10-11 73.8 457 79.5 469 12-23 83.8 2,722 78.6 2,819 24-35 87.1 2,642 78.0 3,026 36-47 na 0 74.5 3,008 48-59 na 0 73.4 2,714 Sex Male 66.6 4,351 74.8 6,667 Female 68.3 3,914 75.4 6,273 Birth order 1 69.3 2,768 78.9 4,579 2-3 67.0 3,845 76.2 5,754 4-5 63.6 1,081 69.9 1,637 6+ 68.1 571 59.2 970 Breastfeeding status Breastfeeding 58.7 5,540 73.7 4,589 Not breastfeeding 85.0 2,707 76.2 8,241 Residence Urban 70.0 3,918 79.5 6,089 Rural 65.0 4,347 71.1 6,851 Mother's education No education 68.5 382 57.2 608 Some primary 63.0 1,132 63.1 1,925 Completed primary 64.3 2,733 76.3 4,272 Some secondary 69.1 1,751 77.6 2,591 Secondary + 71.8 2,266 81.3 3,544 Mother's age at birth <20 64.7 918 75.3 1,617 20-24 67.1 2,283 76.8 3,631 25-29 68.9 2,378 77.2 3,640 30-34 68.8 1,481 73.7 2,351 35-49 65.3 1,205 68.5 1,702 Total 67.4 8,265 75.1 12,940 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Information on vitamin A supplements is based on mother’s recall. Total includes 18 children with missing information on breastfeeding status and 109 children with no information on consumption of vitamin A supplements. na = Not applicable 1Includes pumpkin, carrots, red sweet potatoes, green leafy vegetables, mango, papaya, and other locally grown fruits and vegetables that are rich in vitamin A 168 | Infant Feeding foods rich in vitamin A and mother’s education and mother’s age at birth is not clear. However, children in urban areas are more likely than children in rural areas to receive foods rich in vitamin A (70 and 65 percent, respectively). The table indicates that 75 percent of children age 6-59 months received vitamin A supplements in the six months preceding the survey. This proportion increases with the child's age and mother's educa- tion, but decreases with the child's birth order. While 57 percent of children whose mothers have no edu- cation received vitamin A supplements, the corresponding proportion for children whose mother have completed secondary education is 81 percent. Appendix Table A.14.3 shows the variations in vitamin A consumption and supplementation by province. Children in DI Yogyakarta are the most likely to receive foods rich in vitamin A and to receive vitamin A supplements (80 and 88 percent, respectively). Children in Southeast Sulawesi and Gorontalo are the least likely to receive foods rich in vitamin A (57 percent), and children in North Sumatera are least likely to receive vitamin A supplements (51 percent). 14.7 MICRONUTRIENT INTAKE AMONG MOTHERS Vitamin A deficiency can lead to increased risk of mortality and morbidity and to blindness. Ta- ble 14.7 shows the micronutrient intake among mothers by background characteristics. There are varia- tions in this percentage across subgroups of women. Women age 20-34, women with lower parity, urban women, and better-educated women are more likely to receive vitamin A after giving birth. For example, while 48 percent of urban women receive vitamin A, the corresponding proportion for rural women is 38 percent. The percentage of mothers with no education who received vitamin A dose postpartum is 26 per- cent, while for women with secondary or higher education the percentage is 54 percent. In pregnant and lactating women, vitamin A can lead to night blindness and appears to have im- plications for maternal morbidity and mortality (Helen Keller International, 2001). In the 2002-2003 IDHS, women who gave birth in the five years preceding the survey were asked if they experienced any vision problems during their pregnancy. Less than 1 percent of mothers reported having this problem. The table also indicates the percentage of mothers receiving an iron supplement during preg- nancy. Iron deficiency is the most pervasive nutritional problem in the world, and Indonesia is not an ex- ception. Fifty-five percent of women took less than 60 iron tablets during pregnancy, 8 percent took 60 to 89 tablets, and 29 percent took the recommended 90 or more tablets. Urban mothers are more likely than rural mothers to take the recommended 90 or more iron tablets (35 and 24 percent, respectively). The per- centage of women with no education who took 90 or more iron supplements is low (16 percent), but in- creases as level of education increases. Appendix Table A.14.4 shows the micronutrient intake among mothers according to province. There are wide variations in the coverage of vitamin A supplementation, night blindness, and iron sup- plementation. While in some provinces less than 30 percent of the mothers received vitamin A supple- mentation (e.g., North Sumatera, Lampung, and Bangka-Belitung), in other provinces more than 50 percent of women took vitamin A postpartum (e.g., Jambi, DKI Jakarta, East Java, East Kalimantan, North Sulawesi, and Gorontalo). Women in DI Yogyakarta are most likely to take 90 or more iron sup- plements, while women in South Sulawesi are the least likely to have taken 90 or more iron supplements (2 percent). Infant Feeding | 169 Table 14.7 Micronutrient intake among mothers Percentage of women who gave birth in the five years preceding the survey who received a vitamin A dose in the first two months after delivery, percentage who suffered from night blindness during pregnancy, and per- centage who took iron tablets for specific numbers of days, by background characteristics, Indonesia 2002- 2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Number of days took iron Received Suffered tablets during pregnancy vitamin A night blindnes –––––––––––––––––––––––––––––––––––––––– dose during pregnancy Don’t Number Background post- ––––––––––––––––– know/ of characteristic partum1 Reported Adjusted2 None <60 60-89 90+ missing women ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age at birth <20 39.2 1.3 0.0 24.7 36.1 9.8 23.6 5.7 1,498 20-24 43.3 2.1 0.3 16.5 36.1 9.0 30.5 7.9 3,544 25-29 45.6 1.3 0.4 17.3 34.5 8.2 31.8 8.2 3,569 30-34 43.4 1.9 0.6 20.1 34.5 8.1 29.3 8.0 2,361 35-49 36.3 2.2 0.4 29.1 32.9 5.5 25.2 7.2 1,789 170 | Infant Fee Number of children ever born 1 46.5 1.3 0.2 16.0 32.0 10.3 34.1 7.6 4,283 2-3 43.7 1.7 0.4 17.2 35.9 7.9 31.1 7.9 5,881 4-5 35.0 2.1 0.5 27.9 41.3 5.9 17.4 7.5 1,650 6+ 29.8 3.7 0.3 43.6 30.6 4.6 14.9 6.3 946 Residence Urban 47.6 1.4 0.3 15.8 33.8 8.0 34.7 7.6 5,970 Rural 38.0 2.1 0.4 23.9 35.9 8.4 24.2 7.6 6,791 Education No education 26.3 2.3 0.3 48.9 26.9 5.5 15.5 3.2 580 Some primary 29.6 3.1 0.2 34.2 34.4 5.9 18.5 7.0 1,849 Completed primary 39.9 1.6 0.4 21.1 38.1 8.2 25.6 7.0 4,359 Some secondary 45.3 1.7 0.5 16.2 36.4 10.1 29.4 7.9 2,614 Secondary + 53.6 1.0 0.3 9.2 31.4 8.4 41.6 9.4 3,359 Total 42.5 1.7 0.4 20.1 34.9 8.2 29.1 7.6 12,760 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: For women with two or more live births in the five-year period, data refer to the most recent birth. 1 In the first two months after delivery 2 Women who reported night blindness but did not report difficulty with vision during the day ding KNOWLEDGE OF HIV/AIDS AND OTHER SEXUALLY TRANSMITTED INFECTIONS 15 A Presidential Decree established the Indonesia National AIDS Commission in 1994. The Com- mission promotes the National AIDS Strategy, a collaborative effort by government, non-governmental organizations, the private sector, and the community. This strategy promotes a healthy lifestyle, safer sex through use of condoms, safe injections, and supports people living with HIV/AIDS. Similar programs have been designed and committees have been created at the provincial and district level to respond to the new reality of HIV/AIDS in locally appropriate ways (Ministry of Health, 2001). The data obtained in the 2002-2003 IDHS survey provide an opportunity to assess some of the factors related to HIV/AIDS and sexually transmitted infections (STIs). This chapter presents findings about current levels of knowledge (general and specific) on AIDS-related issues, such as transmission and prevention, stigma, and discrimination against people with to HIV/AIDS. Next, findings are presented on knowledge of and experience with other sexually transmitted infections that may be cofactors in HIV transmission. The chapter concludes by providing information on knowledge of and access to condoms. The principal objective of this chapter is to establish the prevalence of relevant knowledge, perceptions, and behaviors at the national and provincial level and within socioeconomic subgroups of the population. In this way, AIDS control programs and strategies can target those groups most in need of information and services and most vulnerable to the risk of HIV infection. 15.1 KNOWLEDGE OF AIDS Since there is as yet no cure for HIV/AIDS, the main strategy for combating the disease in Indo- nesia has been prevention through promotion of abstinence, being faithful to one sexual partner, and use of condoms. This strategy depends heavily on the level of knowledge of the population and their percep- tion of HIV/AIDS and its transmission and prevention. Table 15.1 shows the percentage of ever-married women and currently married men who have heard of AIDS and who believe there is a way to avoid HIV or AIDS, by background characteristics. Overall, 59 percent of ever-married women and 73 percent of currently married men say that they have heard of AIDS. The level of knowledge among ever-married women has gradually increased from 38 per- cent in 1994 and 51 percent in 1997 to the current level of 59 percent (Figure 15.1). The percentage of ever-married women who have heard of AIDS varies by age and has an in- verted U-shaped pattern, i.e., it increases steadily from 60 percent for age group 15-19 to a peak of 69 percent for age group 25-29, after which it decreases steadily to 46 percent for age group 40-49. There is a similar pattern for men. The percentage of women who have heard of AIDS is higher among currently married women than among those who are widowed or divorced (60 and 42 percent, respectively). Women and men in urban areas are much more likely to have heard about AIDS than those in ru- ral areas. For example, 74 percent of urban women have heard about AIDS compared with 46 percent of rural women. Similarly, 86 percent of urban men have heard of AIDS, compared with 61 percent of rural men. Knowledge of AIDS increases with level of education for both women and men. Knowledge of AIDS is 15 and 21 percent, respectively, for women and men with no education, compared with 94 and 98 percent, respectively, for women and men with secondary or higher education. Knowledge of HIV/AIDS and Other STIs | 171 Table 15.1 Knowledge of HIV/AIDS Percentage of ever-married women and currently married men who have heard of HIV/AIDS and percentage who believe there is a way to avoid getting AIDS, by background characteristics, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Ever-married women Currently married men ––––––––––––––––––––––––––––– –––––––––––––––––––––––––––––– Has Believes Has Believes heard there is a way Number heard there is a way Number Background of HIV/ to avoid of of HIV/ to avoid of characteristic AIDS HIV/AIDS women AIDS HIV/AIDS men –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 59.8 29.2 956 * * 11 20-24 67.3 37.9 3,875 79.6 58.7 426 25-29 68.7 41.8 5,375 79.7 61.5 1,214 30-39 61.4 37.3 10,609 78.8 59.8 3,034 40-49 45.7 22.6 8,667 66.4 48.4 2,618 50-54 na na 0 60.1 37.7 1,007 Marital status Married 59.8 34.3 27,857 72.8 53.7 8,310 Divorced/widowed 42.4 21.8 1,626 na na 0 Residence Urban 73.7 47.3 13,499 85.9 69.8 3,866 Rural 46.2 22.0 15,984 61.4 39.7 4,444 Education No education 15.2 2.7 2,335 21.2 10.7 341 172 | Knowledge o Some primary 33.5 9.4 5,902 44.6 21.3 1,730 Completed primary 52.9 20.8 9,995 67.7 41.8 2,462 Some secondary 77.9 45.9 5,136 86.7 66.6 1,477 Secondary+ 93.6 79.4 6,114 98.2 89.0 2,301 Total 58.8 33.6 29,483 72.8 53.7 8,310 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. na = Not applicable Figure 15.1 Percentage of Ever-Married Women Who Have Heard of AIDS and Believe There is a Way to Avoid AIDS, Indonesia 1994 - 2003 38 30 51 42 59 34 Has heard of AIDS Believe there is a way to avoid AIDS 0 20 40 60 Pe rc en t 1994 IDHS 1997 IDHS 2002-2003 IDHS f HIV/AIDS and Other STIs Similar patterns were found in the 2000 Multiple Indicator Cluster Survey (BPS, 2000). Accord- ing to the results of this survey, the percentage of women age 15 to 49 who have heard of AIDS is 62 per- cent, and urban women are more likely than rural women to have heard of AIDS (78 and 50 percent, re- spectively). The second indicator for HIV/AIDS knowledge presented in Table 15.1 refers to the belief about ways to avoid getting HIV/AIDS. Findings show that, overall, 34 percent of ever-married women and 54 percent of currently men say that HIV infection can be avoided. In general, the patterns for this indicator are similar to those for general knowledge and awareness of AIDS. The belief that there is a way to avoid HIV/AIDS is most widespread among women and men age 25-29 and those who live in urban areas. Dif- ferences in the belief that there is a way to avoid HIV/AIDS are more pronounced by level of education (Figures 15.2 and 15.3). For example, 79 percent of ever-married women with secondary or higher educa- tion believe that there is a way to avoid getting infected with HIV, compared with only 3 percent of women with no education. Figure 15.2 Percentage of Ever-Married Women Who Have Heard of AIDS and Believe There is a Way to Avoid AIDS, By Education IDHS 2002-2003 15 34 53 78 94 59 3 9 21 46 79 34 No education Some primary Completed primary Some secondary Secondary+ Total 0 20 40 60 80 100 Pe rc en t Women who have heard of AIDS Women who believe there is a way to avoid AIDS Knowledge of AIDS among ever-married women and currently married men by province is pre- sented in Appendix Table A.15.1. The percentage of women who have heard about AIDS ranges from 31 percent in East Nusa Tenggara to 90 percent in DKI Jakarta. The lowest proportion of men who have heard of AIDS is found in Gorontalo (29 percent), while the highest proportion is found in DKI Jakarta (96 percent). The percentage of women who say that AIDS can be avoided is also lowest in East Nusa Tenggara (18 percent) and highest in DKI Jakarta (64 percent). The proportion of men who believe that there is a way to avoid AIDS varies from 19 percent in Gorontalo to 75 percent in DI Yogyakarta and Central Kalimantan. Knowledge of HIV/AIDS and Other STIs | 173 Figure 15.3 Percentage of Currently Married Men Who Have Heard of AIDS and BelieveThere is a Way to Avoid AIDS, By Education IDHS 2002-2003 21 45 68 87 98 73 11 21 42 67 89 54 No education Some primary Completed primary Some secondary Secondary+ Total 0 20 40 60 80 100 Pe rc en t Men who have heard of AIDS Men who believe there is a way to avoid AIDS 15.2 KNOWLEDGE OF WAYS TO AVOID CONTRACTING HIV/AIDS The 2002-2003 IDHS questionnaire collected information on knowledge of ways to avoid HIV infection in two ways: first, if a respondent reported that AIDS could be avoided, an open-ended question was asked about how “a person could avoid getting the AIDS virus.” Respondents were allowed to give all the ways to avoid HIV/AIDS that they knew of (without prompting). Next, women and men were asked specific questions on whether limiting their sexual activity to just one partner and (in a separate question) condom use can reduce their chances of getting AIDS. Table 15.2 presents the survey results on AIDS prevention knowledge. The denominator or base for these estimates is all ever-married women and currently married men (including those who reported that they did not know about HIV/AIDS at all, that they did not know whether it could be avoided, or that they thought it could not be avoided). The results show that 61 percent of ever-married women and 44 percent of currently married men have not heard of AIDS or do not know if AIDS can be avoided. Six percent of women and 2 percent of men believe that AIDS cannot be avoided. Table 15.2 shows that knowledge of the most important ways to avoid HIV infection is limited in Indonesia; 1 percent each of women and men mentioned abstinence, 5 percent of women and 13 percent of men cited the use of condoms, and 14 percent of women and 18 percent of men reported limiting sex to one partner and staying faithful to one partner as ways to avoid getting AIDS. Six percent of women and 10 percent of men reported limiting the number of sexual partners as a way to avoid AIDS, and 7 percent of women and 8 percent of men cite avoiding sex with persons who have many partners. The most com- mon way reported by both men and women to avoid HIV infection is avoidance of sex with prostitutes (16 percent of ever-married women and 41 percent for currently married men). Furthermore, 8 percent of women and 5 percent of men report avoiding injections as a way to prevent HIV infection. 174 | Knowledge of HIV/AIDS and Other STIs Table 15.2 Knowledge of ways to avoid HIV/AIDS Percentage of ever-maried women and currently married men who spontaneously mentioned ways to avoid HIV/AIDS, Indo- nesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––– Percentage of Percentage of ever-married currently Ways to avoid HIV/AIDS women married men ––––––––––––––––––––––––––––––––––––––––––––––––––––– Does not know of AIDS or if AIDS can be avoided 60.7 44.0 Believes no way to avoid AIDS 5.6 2.3 Does not know specific way 0.6 0.8 Abstain from sex 1.0 0.9 Use condoms 5.3 12.6 Limit number of sexual partners 6.3 10.2 Limit sex to one partner/stay faithful to one partner 14.1 18.4 Avoid sex with prostitutes 16.2 41.1 Avoid sex with persons who have many partners 7.1 7.6 Avoid sex with homosexuals 1.5 1.6 Avoid sex with persons who inject drugs intravenously 3.7 4.7 Avoid blood transfusions 3.3 3.2 Avoid injections 7.9 4.9 Avoid sharing razor/ blades 0.4 0.5 Avoid kissing 0.6 0.8 Avoid mosquito bites 0.1 0.2 Seek protection from traditional healer 0.1 0.0 Other 1.5 5.0 Number of women/men 29,483 8,310 –––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1 Believes there is something a person can do to avoid AIDS, but cannot spontaneously mention any specific way 15.3 KNOWLEDGE OF PROGRAMMATICALLY IMPORTANT WAYS TO AVOID CONTRACTING HIV/AIDS Behavioral change programs focus on three principal means to prevent and reduce HIV transmis- sion: abstinence from sex, use of condoms, and limiting the number of sexual partners/staying faithful to one partner. Respondents’ knowledge of these three programmatically important ways to avoid contract- ing HIV/AIDS is presented in Tables 15.3.1 and 15.3.2, which show the percent distributions of ever- married women and currently married men who reported 0, 1, or 2-3 of these ways to avoid AIDS. About one in five women (21 percent) and one in four men (26 percent) know of 2-3 ways to avoid getting HIV/AIDS. Women are more likely than men to not know any ways of avoiding AIDS (69 and 48 per- cent, respectively). Knowledge of HIV/AIDS and Other STIs | 175 Table 15.3.1 Knowledge of programmatically important ways to avoid HIV/AIDS: women Percent distribution of ever-married women by knowledge of three programmatically important ways to avoid HIV/AIDS, and percentage of women who know of two specific ways to avoid HIV/AIDS, according to background characteristics, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Knowledge of programmatically Specific ways important ways to avoid HIV/AIDS to avoid HIV/AIDS –––––––––––––––––––––––––––––––– –––––––––––––––––––– Two Limit number Number Background One or three Use of sexual of characteristic None1 way ways Total condoms partners2 women –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 74.6 8.4 17.0 100.0 18.4 23.9 956 20-24 64.6 11.5 23.8 100.0 25.3 33.6 3,875 25-29 60.8 12.6 26.7 100.0 28.0 37.4 5,375 30-39 65.9 11.2 22.9 100.0 24.3 32.4 10,609 40-49 79.4 6.7 13.8 100.0 14.4 19.7 8,667 Marital status Married 68.4 10.3 21.3 100.0 22.5 30.1 27,857 Divorced/widowed 80.2 6.6 13.3 100.0 13.5 19.2 1,626 Residence Urban 56.2 13.0 30.8 100.0 32.3 41.7 13,499 Rural 79.9 7.6 12.5 100.0 13.3 19.1 15,984 Education No education 97.6 1.2 1.1 100.0 1.1 2.3 2,335 Some primary 92.0 3.3 4.7 100.0 5.0 7.5 5,902 Completed primary 81.7 7.6 10.8 100.0 11.6 17.2 9,995 Some secondary 58.4 14.5 27.1 100.0 28.6 39.7 5,136 Secondary + 24.4 20.3 55.3 100.0 57.8 72.4 6,114 Total 69.1 10.1 20.9 100.0 22.0 29.5 29,483 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Programmatically important ways are abstaining from sex, using condoms, and limiting the number of sexual partners. Abstinence from sex is measured from a spontaneous response only; using condoms and limiting the number of sexual partners is measured from spontaneous and probed responses. 1 Those who have not heard of HIV/AIDS or do not know of any programmatically important ways to avoid HIV/AIDS. 2 Refers to limiting number of sexual partners and limiting sex to one partner/staying faithful to one partner. Table 15.3.1 shows that the percentage of ever-married women who do not know any way to avoid AIDS is highest among women age 15-19 (75 percent) and 40-49 (79 percent). Divorced or sepa- rated women and rural women are much less likely than currently married women and women in urban areas to know any way to avoid getting AIDS. Furthermore, better-educated women are more likely to know a way to avoid HIV infection than uneducated women. Similar patterns are seen for currently mar- ried men (Table 15.3.2). The right half of Tables 15.3.1 and 15.3.2 show the 2002-2003 IDHS results obtained when prompting was used to ascertain whether women and men knew about condom use and limiting the num- ber of sexual partners as ways to avoid HIV infection. When women were prompted, their reported knowledge of condom use for HIV/AIDS protection rose from 5 percent (unprompted) to 22 percent. In the same way, men’s knowledge increased from 13 percent to 38 percent. When prompted, 30 percent of ever-married women and 44 percent of currently married men reported limiting the number of sexual partners as a way to avoid HIV/AIDS. 176 | Knowledge of HIV/AIDS and Other STIs Table 15.3.2 Knowledge of programmatically important ways to avoid HIV/AIDS: men Percent distribution of currently married men by knowledge of three programmatically important ways to avoid HIV/AIDS, and percentage of men who know of two specific ways to avoid HIV/AIDS, according to background characteristics, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Knowledge of programmatically Specific ways important ways to avoid HIV/AIDS to avoid HIV/AIDS –––––––––––––––––––––––––––––––– –––––––––––––––––––– Two Limit number Number Background One or three Use of sexual of characteristic None1 way ways Total condoms partners2 men –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 20-24 46.9 26.1 27.0 100.0 40.4 41.9 426 25-29 43.6 25.2 31.2 100.0 44.7 45.1 1,214 30-39 43.2 28.6 28.2 100.0 43.5 44.2 3,034 40-49 52.3 25.4 22.3 100.0 33.2 42.6 2,618 50-54 60.3 20.0 19.7 100.0 26.1 42.5 1,007 Residence Urban 32.2 30.9 36.9 100.0 52.1 56.3 3,866 Rural 62.5 21.6 15.8 100.0 26.0 32.4 4,444 Education No education 89.6 8.3 2.1 100.0 6.2 18.5 341 Some primary 78.8 15.7 5.5 100.0 10.7 27.3 1,730 Completed primary 60.2 24.0 15.8 100.0 27.7 32.5 2,462 Some secondary 37.0 33.0 30.0 100.0 46.9 47.5 1,477 Secondary + 14.1 33.8 52.1 100.0 69.0 68.5 2,301 Total 48.4 25.9 25.6 100.0 38.1 43.5 8,310 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Programmatically important ways are abstaining from sex, using condoms, and limiting the number of sexual partners. Abstinence from sex is measured from a spontaneous response only; using condoms and limiting the number of sexual partners is measured from spontaneous and probed responses. 1 Those who have not heard of HIV/AIDS or do not know of any programmatically important ways to avoid HIV/AIDS. 2 Refers to limiting number of sexual partners and limiting sex to one partner/staying faithful to one partner. Appendix A.15.2 shows the variation in women’s knowledge of ways to prevent AIDS by prov- ince. The proportion of women who say that there is no way to avoid HIV/AIDS ranges from 38 percent in DKI Jakarta to 83 percent in East Nusa Tenggara and Gorontalo. Looking at specific ways, prompted knowledge of condom use to avoid getting AIDS varies from 9 percent in East Nusa Tenggara to 49 per- cent in Central Kalimantan. The percentage of ever-married women who, when prompted, report limiting the number of sexual partners as a way to avoid HIV ranges from 16 percent in Gorontalo to 60 percent in DKI Jakarta and Central Kalimantan. 15.4 KNOWLEDGE OF HIV/AIDS-RELATED ISSUES Tables 15.4.1 and 15.4.2 show the distribution of ever-married women and currently married men by their responses to questions about important HIV/AIDS-related issues. When asked whether a “healthy-looking person can have the AIDS virus,” only 6 percent of ever-married women and 7 percent of married men correctly respond “yes.” Women and men least likely to respond correctly to this question live in rural areas and have less education. For example, urban women are twice as likely to say that a Knowledge of HIV/AIDS and Other STIs | 177 Table 15.4.1 Knowledge of HIV/AIDS-related issues: women Percentage of ever-married women who gave specific responses to questions on various HIV/AIDS-related issues, according to background characteristics, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Percentage who say HIV/AIDS can be Percentage who Percentage who transmitted from mother to child: know someone say a healthy- –––––––––––––––––––––––––––––––– personally who has looking person Through the virus that Number Background can have the During During breast- causes AIDS or has of characteristic AIDS virus delivery pregnancy feeding died of AIDS women ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 6.8 25.2 29.1 27.7 2.4 956 20-24 7.1 33.5 38.7 37.8 3.4 3,875 25-29 7.1 38.2 43.7 40.8 3.9 5,375 30-39 6.6 35.2 39.1 37.5 3.1 10,609 40-49 4.8 23.0 25.4 24.6 2.3 8,667 Marital status Married 6.4 32.3 36.3 34.7 3.0 27,857 Divorced/widowed 4.1 20.1 22.7 21.7 3.2 1,626 Residence Urban 8.6 44.3 49.6 46.9 4.5 13,499 Rural 4.3 20.9 23.7 23.2 1.8 15,984 Education No education 0.6 4.7 4.9 5.0 0.4 2,335 Some primary 2.4 10.8 12.4 12.2 1.3 5,902 Completed primary 4.1 21.7 24.7 24.0 2.3 9,995 Some secondary 7.7 44.4 48.4 46.9 3.6 5,136 Secondary + 14.4 67.4 76.4 71.7 6.5 6,114 hea 1 pe prop chil AID duri whe wom ing. mot Wo with mot rent AID 178 | Knowled Total 6.2 31.6 35.5 34.0 3.0 29,483 lthy-looking person can have AIDS as rural women (9 percent versus 4 percent). While less than rcent of women with no education say that a healthy-looking person can have the AIDS virus, the ortion among women with secondary or higher education is 14 percent. One of the objectives of the AIDS-prevention program is to reduce the incidence of mother-to- d transmission of HIV. In the 2002-2003 IDHS, respondents were asked whether they thought the S virus can be transmitted from a mother to her child during pregnancy, and (in separate questions) ng delivery and during breastfeeding. The results indicate that about one in three women said “yes” n asked about each of the three modes of mother-to-child transmission. Men are more likely than en to know that AIDS can be transmitted during pregnancy, during delivery, and through breastfeed- The patterns for women and men who know all three ways that AIDS can be transmitted from her to child are similar to the patterns seen for general awareness and knowledge of HIV/AIDS. men and men in the youngest and oldest age groups, those living in rural areas, and women and men no education or little education are least likely to know the three modes of AIDS transmission from her to child. Tables 15.4.1 and 15.4.2 also show that 3 percent of ever-married women and 2 percent of cur- ly married men report knowing someone personally who has the virus that causes AIDS or has died of S. Differences by background characteristics are negligible. ge of HIV/AIDS and Other STIs Table 15.4.2 Knowledge of HIV/AIDS-related issues: men Percentage of currently married men who gave specific responses to questions on various HIV/AIDS-related is- sues, according to background characteristics, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Percentage who say HIV/AIDS can be Percentage who Percentage who transmitted from mother to child: know someone say a healthy- –––––––––––––––––––––––––––––––– personally who has looking person Through the virus that Number Background can have the During During breast- causes AIDS or has of characteristic AIDS virus delivery pregnancy feeding died of AIDS men ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 * * * * * 11 20-24 5.1 49.0 53.6 51.9 2.2 426 25-29 9.7 50.7 55.2 53.1 4.9 1,214 30-39 9.1 51.2 55.0 52.1 4.0 3,034 40-49 6.3 39.6 43.0 40.1 2.3 2,618 50-54 2.6 29.9 32.0 29.7 0.9 1,007 Residence Urban 9.4 59.6 63.8 59.9 3.5 3,866 Rural 5.5 31.9 35.0 33.4 2.7 4,444 Education No education 1.1 9.9 10.5 10.7 1.0 341 Some primary 3.3 16.8 18.1 17.3 1.9 1,730 Completed primary 5.0 34.2 37.6 36.1 2.7 2,462 Some secondary 10.1 56.5 59.8 57.5 3.7 1,477 Secondary + 12.0 74.8 80.9 75.0 4.4 2,301 Total 7.3 44.8 48.4 45.7 3.1 8,310 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– sue hav in t to c and this wom 15. whe that cus of m bac like Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. Appendix Table A.15.3 shows the variation by province in knowledge of HIV/AIDS-related is- s among ever-married women. The proportion of women who say that a healthy-looking person can e AIDS ranges from 2 percent in South Sumatera to 21 percent in DKI Jakarta. Differences also exist he proportion of women who know each of the three ways that AIDS can be transmitted from mother hild. For example, only 18 percent of ever-married women in South Sulawesi, West Nusa Tenggara, East Nusa Tenggara know that AIDS can be transmitted from mother to child during delivery, while is true for 59 percent of women in DKI Jakarta. Variations among provinces in the proportion of en who know someone personally who has the virus that causes AIDS or has died of AIDS are small. 5 DISCUSSION OF HIV/AIDS In the 2002-2003 IDHS, currently married women and men who had heard of AIDS were asked ther they had ever discussed HIV/AIDS prevention with their spouse. Tables 15.5.1 and 15.5.2 show 16 percent of currently married women and 15 percent of currently married men reported having dis- sed HIV/AIDS prevention with their spouse. On the other hand, 43 percent of women and 58 percent en never discussed HIV/AIDS prevention with their spouse. There are substantial differences in communication between spouses about AIDS prevention by kground characteristics. For both women and men, urban and better-educated respondents are more ly than other respondents to have discussed HIV/ AIDS prevention with their spouse (Figure 15.4). Knowledge of HIV/AIDS and Other STIs | 179 T P t – B c – A R E T – N 180 | Knowledge of HIV able 15.5.2 Discussion of HIV/AIDS with wife ercent distribution of currently married men by whether they ever discussed HIV/AIDS preven- ion with their wife, according to background characteristics, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Ever Never Has not discussed discussed Don’t heard Number ackground HIV/AIDS HIV/AIDS know/ of of haracteristic prevention prevention missing AIDS Total men ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– ge 20-24 13.4 65.7 0.5 20.4 100.0 426 25-29 16.3 63.2 0.3 20.3 100.0 1,214 30-39 17.3 61.0 0.5 21.2 100.0 3,034 40-49 13.2 52.8 0.3 33.6 100.0 2,618 50-54 10.1 49.8 0.2 39.8 100.0 1,007 esidence Urban 19.8 65.7 0.4 14.1 100.0 3,866 Rural 10.4 50.6 0.4 38.6 100.0 4,444 ducation No education 0.4 20.4 0.3 78.8 100.0 341 Some primary 4.1 40.3 0.3 55.3 100.0 1,730 Completed primary 8.7 58.7 0.3 32.3 100.0 2,462 Some secondary 17.7 68.8 0.2 13.3 100.0 1,477 Secondary + 29.6 67.9 0.6 1.8 100.0 2,301 otal 14.8 57.6 0.4 27.2 100.0 8,310 Table 15.5.1 Discussion of HIV/AIDS with husband Percent distribution of currently married women by whether they ever discussed HIV/AIDS pre- vention with their husband, according to background characteristics, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Ever Never Has not discussed discussed Don’t heard Number Background HIV/AIDS HIV/AIDS know/ of of characteristic prevention prevention missing AIDS Total women ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 8.9 51.7 0.1 39.2 100.0 912 20-24 15.6 52.0 0.1 32.3 100.0 3,761 25-29 20.1 48.9 0.1 30.9 100.0 5,217 30-39 19.1 42.9 0.1 37.8 100.0 10,103 40-49 11.9 34.5 0.2 53.4 100.0 7,864 Residence Urban 22.9 51.6 0.2 25.4 100.0 12,765 Rural 11.0 36.1 0.1 52.8 100.0 15,093 Education No education 2.4 13.2 0.1 84.3 100.0 2,089 Some primary 5.1 28.7 0.1 66.1 100.0 5,435 Completed primary 9.6 43.9 0.1 46.4 100.0 9,499 Some secondary 19.9 57.9 0.4 21.8 100.0 4,902 Secondary + 40.0 53.6 0.1 6.4 100.0 5,932 Total 16.4 43.2 0.1 40.2 100.0 27,857 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– ote: There are too few married men age 15-19 to be shown separately. /AIDS and Other STIs Figure 15.4 Percentage of Currently Married Women and Currently Married Men Who Discussed AIDS Prevention with Their Spouse, by Education IDHS 2002-2003 2 5 10 20 40 16 0 4 9 18 30 15 No education Some primary Completed primary Some secondary Secondary+ Total 0 10 20 30 40 50 Pe rc en t Women Men Appendix Table A.15.4 shows the percent distribution of currently married women by whether they ever discussed HIV/AIDS prevention with their husband, according to province. The percentage ranges from 9 percent in Southeast Sulawesi and West Nusa Tenggara to 34 percent in North Sulawesi. It is interesting to note that even in provinces where knowledge and awareness of AIDS is high, the level of discussion among spouses concerning HIV/AIDS prevention is not similarly high. For example, while nine in ten ever-married women in DKI Jakarta have heard of AIDS, only one in four of currently married women in the same province discussed HIV/AIDS prevention at some point with their husband. 15.6 SOCIAL ASPECTS OF HIV/AIDS In the 2002-2003 IDHS, questions were asked to evaluate the level of stigma attached to AIDS and to persons living with HIV and AIDS. First, respondents were asked “If a person learns that she/he is infected with the virus that causes AIDS, should the person be allowed to keep this fact private or should this information be available to the community?” Table 15.6 shows that one in four women and one in five men feel that HIV-positive individuals should be allowed to keep their HIV status confidential. The sentiment does not vary much by respondents’ background characteristics. The 2002-2003 IDHS respondents were asked, “If a relative of yours became sick with AIDS would you be willing to care for her or him in your own household?” Thirty-one percent of ever-married women and 28 percent of currently married men say they would not be willing to care for a relative with AIDS at their home. Appendix Table A.15.5 shows that among ever-married women the percentage who believe that HIV positive individuals should be allowed to keep their HIV status confidential ranges from 5 percent in North Sulawesi to 38 percent in Banten. For currently married men, the provincial variation among in the proportion who believe that HIV positive individuals should be allowed to keep their HIV status confi- dential is much larger, ranging from 2 percent in Bali to 40 percent in DKI Jakarta. Gorontalo has the highest proportion of both ever-married women and currently married men who are not willing to care for a relative with AIDS at their home (50 percent and 86 percent, respectively). Knowledge of HIV/AIDS and Other STIs | 181 Table 15.6 Social aspects of HIV/AIDS Among ever-married women and currently married men who have heard of AIDS, percentage providing specific re- sponses to questions on various social aspects of HIV/AIDS by background characteristics, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Women Men –––––––––––––––––––––––––––––––––––––– ––––––––––––––––––––––––––––––––––––––– Believes Not willing Believes Not willing HIV-positive to care HIV-positive to care status of for relative Number status of for relative Background family member with AIDS of family member with AIDS Number characteristic kept secret at home women kept secret at home of men –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 26.4 25.4 572 * * 8 20-24 27.4 29.3 2,610 20.5 23.0 339 25-29 26.9 29.7 3,690 21.9 29.3 968 30-39 23.0 33.8 6,510 19.9 25.7 2,391 40-49 19.9 31.4 3,960 20.3 32.1 1,738 1 i- at - fo 6 p a w s; it al ar 182 | Know 50-54 na na 0 15.9 27.8 605 Marital status Married 24.0 31.5 16,653 20.0 28.1 6,050 Divorced/widowed 21.1 28.9 690 na na 0 Residence Urban 24.6 30.0 9,950 19.3 29.4 3,322 Rural 23.1 33.4 7,392 20.8 26.6 2,727 Education No education 22.5 42.1 354 6.8 28.9 72 Some primary 23.4 32.1 1,975 23.0 31.2 772 Completed primary 21.9 31.1 5,287 18.3 29.3 1,667 Some secondary 23.7 30.3 4,003 21.1 26.5 1,280 Secondary + 26.2 31.6 5,723 19.9 27.2 2,259 Total 23.9 31.4 17,343 20.0 28.1 6,050 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. na = Not applicable 5.7 KNOWLEDGE OF SYMPTOMS OF SEXUALLY TRANSMITTED INFECTIONS (STIS) The 2002-2003 IDHS respondents were asked whether they know any of the symptoms assoc ed with STIs (other than HIV/AIDS) in women and in men. Table 15.7.1 shows that, overall, three urths of ever-married women (73 percent) have no knowledge of STIs (Figure 15.5). Furthermore, 1 ercent know one or more STI symptoms in a man and 14 percent know one or more STI symptoms in oman. Knowledge of STI symptoms among ever-married women varies by background characteristic is lowest among youngest women, among divorced or separated women, among those residing in rur eas and among women with no or little education. ledge of HIV/AIDS and Other STIs Table 15.7.1 Knowledge of symptoms of STIs: women Percentage of ever-married women by knowledge of symptoms associated with sexually transmitted infections (STIs) in a man and in a woman, according to background characteristics, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Knowledge of symptoms Knowledge of symptoms of STIs in a man of STIs in a woman ––––––––––––––––––––––––––––––––– ––––––––––––––––––––––––––––––– No No Men- Mentioned No Men- Mentioned know- symptoms tioned two symptoms tioned two Number Background ledge men- one or more men- one or more of characteristic of STIs tioned symptom symptoms tioned symptom symptoms women ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 81.6 8.7 5.6 4.1 10.6 3.1 4.7 956 20-24 76.4 11.6 5.3 6.7 14.0 4.6 5.0 3,875 25-29 70.1 10.9 8.7 10.3 14.2 6.7 8.9 5,375 30-39 69.9 11.0 8.5 10.7 14.0 7.1 9.0 10,609 40-49 76.4 10.0 5.4 8.1 12.0 4.3 7.3 8,667 Marital status Married 72.6 10.8 7.3 9.2 13.6 5.9 7.9 27,857 Divorced/widowed 80.5 8.3 4.2 7.0 9.2 3.7 6.7 1,626 Residence Urban 64.0 13.0 9.7 13.3 16.3 8.3 11.4 13,499 Rural 80.7 8.7 5.0 5.6 10.9 3.6 4.8 15,984 Education No education 92.3 3.6 2.3 1.9 4.6 1.9 1.2 2,335 Some primary 87.5 6.6 3.3 2.6 8.0 2.5 2.0 5,902 Completed primary 83.1 8.2 4.2 4.4 9.7 3.3 3.9 9,995 Some secondary 68.2 14.5 7.8 9.5 18.0 6.1 7.7 5,136 Secondary + 39.5 18.1 16.9 25.5 23.8 14.2 22.5 6,114 Total 73.1 10.7 7.1 9.1 13.3 5.8 7.8 29,483 Figure 15.5 Percentage of Ever-Married Women and Currently Married Men Who Do Not Know the Symptoms of STIs, by Level of Education 92 88 83 68 40 73 79 61 48 29 13 39 No education Some primary Completed primary Some secondary Secondary+ Total 0 20 40 60 80 100 Pe rc en t Women Men IDHS 2002-2003 Knowledge of HIV/AIDS and Other STIs | 183 Knowledge of symptoms of STIs among ever-married women varies by province (Appendix Ta- ble A.15.6). For example, the proportion of female respondents who know two or more STI-related symp- toms in a woman varies from 2 percent in Bangka Belitung to 40 percent in Central Kalimantan. Table 15.7.2 shows that, overall, about four in ten currently married men have no knowledge of STIs. Almost half of male respondents (49 percent) know of one or more STI-related symptoms in a man. On the other hand, only 15 percent know of at least one STI symptom in a woman. Knowledge of STI symptoms among currently married men varies by background characteristics; it is generally higher among younger men, those residing in urban areas, and among better-educated men. - e 1 a i g o c 184 | Kno As for women, knowledge of STI-related symptoms among currently married men varies consid rably across provinces (Appendix Table A.15.7). Table 15.7.2 Knowledge of symptoms of STIs: men Percentage of currently married men by knowledge of symptoms associated with sexually transmitted infections (STIs) in a man and in a woman, according to background characteristics, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Knowledge of symptoms Knowledge of symptoms of STIs in a man of STIs in a woman ––––––––––––––––––––––––––––––––– ––––––––––––––––––––––––––––––––––– No No Men- Mentioned No Men- Mentioned know- symptoms tioned two symptoms tioned two Number Background ledge men- one or more men- one or more of characteristic of STIs tioned symptom symptoms tioned symptom symptoms men ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 25.3 0.0 8.3 66.4 30.4 6.5 37.8 11 20-24 38.5 10.0 15.9 35.6 50.2 5.5 5.9 426 25-29 32.0 11.3 22.1 34.5 52.7 6.5 8.8 1,214 30-39 33.7 12.3 19.9 34.0 50.0 7.3 9.0 3,034 40-49 43.4 11.1 16.4 29.1 41.5 6.1 9.0 2,618 50-54 51.2 12.7 14.0 22.0 36.8 4.7 7.2 1,007 Residence Urban 27.8 11.3 21.6 39.3 53.9 7.8 10.5 3,866 Rural 48.6 12.0 15.2 24.2 39.3 5.1 7.0 4,444 Education No education 79.1 6.7 8.6 5.5 17.0 2.7 1.2 341 Some primary 61.1 9.9 12.8 16.2 31.8 3.3 3.9 1,730 Completed primary 47.7 11.5 18.7 22.0 43.1 4.0 5.0 2,462 Some secondary 29.1 14.6 20.2 36.1 55.9 7.3 7.7 1,477 Secondary + 13.0 12.2 21.8 53.0 58.0 11.3 17.7 2,301 Total 38.9 11.7 18.2 31.2 46.1 6.4 8.6 8,310 5.8 KNOWLEDGE OF A SOURCE FOR MALE CONDOMS Condom use is one of the important programmatic approaches to avoid spreading of HIV/AIDS nd other sexually transmitted infections. Therefore, the 2002-2003 IDHS female respondents were asked f they know where they could obtain a male condom. They were also asked whether they could actually et a condom if they wanted to get one. Table 15.8 shows that four in ten ever-married women know a source for male condoms. More- ver, 27 percent of women report that they could get a male condom if they wanted to. Knowledge of a ondom source and ability to obtain a condom is higher among women age 20-39. Knowledge of a source wledge of HIV/AIDS and Other STIs Table 15.8 Knowledge of source of male condoms and access to condoms Percentage of ever-married women who know a source for male condoms, and percentage who think they themselves could get a male condom, by background characteristics, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––– Knows Could a source get Number Background for male a male of characteristic condoms condom women ––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 24.6 15.2 956 20-24 37.3 25.1 3,875 25-29 43.3 28.7 5,375 30-39 44.7 31.2 10,609 40-49 36.4 23.7 8,667 Marital status Married 40.7 27.7 27,857 Divorced/widowed 35.9 19.0 1,626 Residence Urban 53.0 36.1 13,499 Rural 29.7 19.8 15,984 Education No education 11.7 6.2 2,335 Some primary 23.4 14.9 5,902 Completed primary 33.0 21.3 9,995 Some secondary 49.1 32.9 5,136 Secondary + 72.5 52.0 6,114 Total 40.4 27.2 29,483 for male condoms is also significantly higher among urban women than among rural women (53 percent compared with 30 percent), as is the ability to get a condom if needed (36 percent versus 20 percent). The level of knowledge and ability to get a male condom is higher among married women and those who are better-educated when compared with women who are divorced or separated and women no or little educa- tion. Knowledge of source for male condoms varies from 15 percent in Gorontalo to 75 percent in DKI Jakarta (Appendix Table A.15.8). The percentage of women who could get a male condom if they wanted to ranges from 5 percent in East Nusa Tenggara to 56 percent in DI Yogyakarta. Knowledge of HIV/AIDS and Other STIs | 185 ADULT AND MATERNAL MORTALITY 16 Chapter 10 provides an assessment of mortality during the first few years of life. This chapter discusses the mortality of adults, particularly deaths among women due to maternal causes. Although the level of maternal mortality is generally considered to be one of the most important indicators of a coun- try’s health, reliable data are scarce and estimates can vary widely. In the 1994 Indonesia Demographic and Health Survey (IDHS) and 1997 IDHS, data were col- lected on adult and maternal mortality. Similar data were collected in the 2002-2003 IDHS that allow es- timation of adult and maternal mortality using a direct estimation procedure. The information concerns the survivorship of all live births to the respondent’s natural mother (i.e., the respondent’s brothers and sisters). The direct approach to estimating adult and maternal mortality maximizes use of the available data, including information on the age of surviving siblings, the age at death of siblings who died, and the number of years ago the sibling died. This allows the data to be aggregated for determining the number of person-years of exposure to mortality risk and the number of sibling deaths occurring in defined calendar periods. Rates of maternal and adult mortality are obtained by dividing maternal (or all female or male adult) deaths by person-years of exposure (Rutenberg and Sullivan, 1991). 16.1 DATA Each female respondent was first asked to give the total number of her mother’s live births. Then she was asked to provide a list of the children born to her mother, starting with the first born and includ- ing whether or not each sibling was still alive at the survey date. For living siblings, current age was col- lected; for deceased siblings, age at death and years since death were collected. Interviewers were in- structed to accept approximate answers when a respondent could not provide precise information on ages or years ago. For sisters who died at age 10 years or older, three questions were used to determine if the death was maternity related: “Was [NAME OF SISTER] pregnant when she died?” and if negative, “Did she die during childbirth?” and if negative, “Did she die within six weeks of the birth of a child or preg- nancy termination?” The estimation of adult and maternal mortality requires reasonably accurate reporting of the number of sisters and brothers the respondent ever had, the number who died, and (for maternal mortality) the number of sisters who died of maternity-related causes. Table 16.1 shows the number of siblings re- ported by the respondents and the completeness of the reported data on current age, age at death, and years since death. The sex ratio of respondents’ siblings (the ratio of brothers to sisters) is 1.09, which is considera- bly higher than the expected value of 1.02 or 1.03 and indicates either overreporting of brothers or under- reporting of sisters. IDHS respondents were highly knowledgeable about the survival status of their brothers and sisters, with only 86 out of 163,000 siblings (0.1 percent) missing this information. They also tended to know the ages of their surviving siblings, with only 0.3 percent of siblings missing this in- formation. However, as expected, respondents were not so knowledgeable about the age at death or years since death for their deceased siblings: only 81 percent of deceased siblings have both age at death and years since death reported, 17 percent are missing years since death, and 2 percent are missing both age at death and years since death. Rather than exclude the siblings with missing data from further analysis, in- formation on the birth order of siblings, in conjunction with other information, was used to impute the Adult and Maternal Mortality | 187 missing data.1 The sibling survivorship data, including cases with imputed values, were used in the direct estimation of adult and maternal mortality. Table 16.1 Data on siblings Number of siblings reported by survey respondents and completeness of the reported data on age, age at death, and year of death, Indonesia 2002-2003 Females Males Total Sibling status and completeness of reporting Percent Number Percent Number Percent Number All siblings 100.0 77,938 100.0 85,122 100.0 163,060 Living 90.2 70,333 88.7 75,491 89.4 145,823 Dead 9.7 7,556 11.3 9,595 10.5 17,151 Status unknown 0.1 50 0.0 36 0.1 86 Living siblings 100.0 70,333 100.0 75,491 100.0 145,823 Age reported 99.7 70,127 99.7 75,230 99.7 145,357 Age missing 0.3 206 0.3 261 0.3 467 Dead siblings 100.0 7,556 100.0 9,595 100.0 17,151 Age at death and year of death reported 79.8 6,027 81.0 7,775 80.5 13,802 Missing only age at death 0.4 28 0.5 46 0.4 73 Missing only year of death 18.1 1,366 15.8 1,515 16.8 2,880 Missing age at death and year of death 1.8 136 2.7 260 2.3 396 16.2 DIRECT ESTIMATES OF ADULT MORTALITY Another way to assess the quality of data used to estimate maternal mortality is to evaluate the plausibility of the adult mortality rates obtained. If the overall adult mortality rates display a generally stable, plausible pattern, it lends credence to the maternal mortality estimates. This is because maternal mortality is a subset of adult mortality. Table 16.2 presents the age-specific rates of male and female mortality (15-49 years) for the five- year period before the survey, which roughly corresponds to 1998-2002. Age-specific death rates are computed by dividing the number of deaths in each age group by the total person-months of exposure in that age group during a specified reference period. Since the number of deaths on which the rates are based is not large (518 female and 619 male deaths), the age-specific rates are subject to large sampling variation. Both female and male mortality rates are 2 deaths per 1,000 population. As expected, mortality increases with age for both sexes. In general at most ages, male mortality rates are slightly higher than female rates. Analysis of the 1994 IDHS survey indicates that there has been a slight decline in female adult mortality from 1984 to 1994. The 2002-2003 data suggest that the decline continues. 1 The imputation procedure is based on the assumption that the reported birth order of siblings in the history is cor- rect. 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 years since 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 the age at death or years since death was reported, that information was combined with the birth date to pro- duce the missing information. If both pieces of information were missing, the distribution of the age at death for siblings for whom years since death was unreported, but age at death was reported, was used as a basis for imputing the age at death. 188 | Adult and Maternal Mortality Table 16.2 Adult mortality rates Direct estimates of age-specific mortality rates for women and men age 15-49 based on the survivorship of sisters and brothers of survey respondents for the period 0-4 years prior to the survey, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Females Males ––––––––––––––––––––––––––– ––––––––––––––––––––––––––– Female Exposure Mortality Male Exposure Mortality Age deaths years rates deaths years rates –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 15-19 49 39,637 1.24 52 40,861 1.28 20-24 39 49,288 0.78 54 53,023 1.01 25-29 79 55,365 1.42 90 58,266 1.53 30-34 77 52,386 1.48 35-39 95 46,197 2.05 40-44 97 31,774 3.06 45-49 82 18,638 4.41 Total 518 293,284 1.89a ––––––––––––––––––––––––––––––––––––– a Age adjusted 16.3 ESTIMATES OF MATERNAL MORTALITY 15-19 3 39,637 0.08 20-24 9 49,288 0.19 25-29 20 55,365 0.36 30-34 8 52,386 0.16 0.31 0.44 0.23 0.2 ––––––––––––––– 0.081 307 Direct age-specific estimates of maternal mortality from the reported survivorship of sisters are shown in Table 16.3 for the five-year period before the survey. Age-specific mortality rates are calculated by dividing the number of maternal deaths by woman-years of exposure. To remove the effect of truncation bias (the upper boundary for eligibility for women interviewed in the IDHS is 49 years), the overall rate for women age 15-49 is standardized by the age distribution of the survey respondents. Maternal deaths are defined as any death that occurr birth, or within t nation of a pre deaths (73) is sm ject to very larg interpreted with to calculate one (15-49 years). F survey, the rate ernal deaths per 1,000 woman-ye en age 15-49. The ma d expressed per 100,000 live bir time period. In this way, the ob timation proce- dures, the mater irths for the pe- riod 1998-2002. 2 This definition ancy, even if the death is due to no f maternal deaths because most dea likely to be underr 35-39 15 46,197 40-44 14 31,774 45-49 4 18,638 15-49 73 293,284 –––––––––––––––––––––––––––––––––– General fertility rate Maternal mortality ratio ed during pregnancy, during child- wo months after the birth or termi- gnancy.2 The number of maternal all, so age-specific rates are sub- e sampling errors and should be caution. The preferred approach is estimate for all childbearing ages or the period 0-4 years before the of deaths due to causes related to pregnancy and childbearing is 0.24 mat ars of exposure. Maternal deaths represent 14 percent of all deaths of wom ternal mortality rate can be converted to a maternal mortality ratio an ths by dividing the rate by the general fertility rate (0.081) for the same stetrical risk of pregnancy and childbearing is highlighted. By direct es nal mortality ratio is estimated as 307 maternal deaths per 100,000 live b includes all deaths that occurred during pregnancy and two months after pregn nmaternal causes. However, this definition is unlikely to result in overreporting o ths of women in the specified period are eported than overreported. 88 56,612 1.55 102 49,557 2.07 117 33,933 3.46 116 19,939 5.83 619 312,191 2.16a ––––––––––––––––––––––––––––––––– Table 16.3 Maternal mortality rates Maternal mortality rates for the period 0-4 years prior to the survey, based on the survivorship of sisters of survey respondents, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––– Maternal Exposure Mortality Age deaths (woman-years) rates –––––––––––––––––––––––––––––––––––––––––––––––––– due to maternal causes and maternal deaths are more Adult and Maternal Mortality | 189 16.4 TRENDS IN MATERNAL MORTALITY Analysis of results from the 1994 IDHS showed that the maternal mortality ratio for the five-year period prior to the survey (approximately 1990-94) was 390 deaths per 100,000 births. Unpublished analysis of data from the 1997 IDHS implied a slight decline to 334 deaths per 100,000 births for the pe- riod 1993-1997. However, because maternal mortality rates and ratios are associated with high sampling errors, the confidence intervals around both figures overlap, making it impossible to conclude that there had been a decline. The maternal mortality ratio of 307 measured in the 2002-2003 IDHS would seem to add to the evidence of a decline. However, the figures from all three surveys are subject to high sampling errors and the 95 percent confidence intervals surrounding the figures overlap. Even at a somewhat more relaxed level of confidence (67 percent), the intervals around the 1994 and 2002-2003 figures still overlap, mak- ing it difficult to conclude with confidence that there has been any decline in the level of maternal mortal- ity over the past 10 to 15 years in Indonesia. 190 | Adult and Maternal Mortality FATHER’S PA FAMILY HEAL 17 One of the n involve men in the health care of their w ecisions and taking actions regarding fam ren’s immunization and nutrition (Minis n’s involvement in ensuring safe mother 17.1 ADVICE OR C S In the 2002- child since January 1997 were asked sev last-born child and the health care of the years preceding the survey for which mot ring the pregnancy, RTICIPATION IN TH CARE ewly established policies of the Indonesian government is to ives and children. Men are expected to be involved in making d ily planning, antenatal care, preparation for delivery, and child try of Health, 2001). This section presents information on me hood for his wife and proper health care for his children. ARE DURING ANTENATAL, DELIVERY, AND POSTNATAL PERIOD 2003 IDHS, currently married men who have had at least one eral questions regarding the pregnancy care of the mother of the child. Table 17.1 shows the percentage of last births in the five hers received advice or care from a doctor or a health provider du Table 17.1 Advice or care received by mother during pregnancy and delivery and after delivery Percentage of last births in the five years preceding the survey for which mothers received advice or care from a health care provider (based on father’s report), by type of advice or care and father’s background characteristics, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Received advice or care –––––––––––––––––––––––––––––– During the six weeks Number Background During During after of characteristic pregnancy delivery delivery fathers ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 * * * 4 20-24 86.0 69.5 60.9 248 25-29 86.6 78.1 71.5 831 30-34 90.3 80.6 75.2 965 35-39 88.9 79.9 75.1 790 40-44 82.2 73.8 67.6 529 45-49 82.3 70.4 59.8 188 50-54 76.3 65.5 49.7 96 Residence Urban 90.8 83.3 76.0 1,764 Rural 83.3 71.6 66.0 1,889 Father’s education No education 62.7 57.3 47.8 93 Some primary 77.4 61.3 55.5 553 Completed primary 82.1 67.0 65.7 1,009 Some secondary 89.9 80.8 69.0 800 Secondary + 95.2 92.4 85.2 1,197 Total 86.9 77.2 70.8 3,653 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. Father’s Participation in Family Health Care | 191 delivery, o preceding the survey 7 percent received ery. This proportion y that the mother of or during the six-we re better- educated a re during pregnancy A eding the survey for ging from 73 percen gyakarta, and Bali. province. On the ba half (51 percent) o almost all mothers ( more, the percentage ce or care during the ara to 98 percent in 17.2 K C the survey 17.2 show five years percent, p 192 | Father’s Participa r during the six-week period after delivery. For 87 percent of births in the five years , men report that the child’s mother received advice or care during pregnancy, 7 care during delivery, and 71 percent received care in the six weeks after deliv varies somewhat by men’s age; fathers in their thirties are the most likely to sa the last-born child wives received advice or care during pregnancy, during delivery, ek period after delivery. As expected, fathers residing in urban areas and those who a re more likely to report that the mother of the last-born child received advice or ca , during delivery, or during the six-week period after delivery. ppendix Table A.17.1 shows that the percentage of last births in the five years prec which mothers received advice or care during the pregnancy varies by province, ran t in Bangka-Belitung and Central Kalimantan to 99 percent in North Sulawesi, DI Yo Advice or care during delivery and during the six weeks after delivery also varies by sis of men’s reporting, mothers received advice or care during delivery for only f last births in the five years preceding the survey in East Nusa Tenggara, while 99 percent) of such births in North Sulawesi received advice or care. Further of last births in the five years prior to the survey for which the mother received advi six weeks following delivery varies from 47 percent in Jambi and East Nusa Tengg DI Yogyakarta. NOWLEDGE ABOUT CHILDREN’S IMMUNIZATION urrently married men were also asked if their last living child born in the five years preceding has been immunized against tuberculosis (BCG), polio, DPT, measles, and hepatitis B. Table s that according to fathers’ reports, the following percentages of the last children born in the preceding the survey have received the specific vaccine noted: 78 percent, BCG vaccine; 82 olio vaccine; 73 percent, DPT vaccine; 64 percent, measles; and 65 percent, hepatitis B vaccine. Table 17.2 Specific vaccines received by children under five Percentage of last living children born in the five years preceding the survey who received specific vaccines (based on father’s report), by father’s background characteristics, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Background Hepa- Number characteristic BCG Polio DPT Measles titis B of fathers –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 * * * * * 4 20-24 77.2 78.8 67.5 61.2 58.7 228 25-29 74.0 79.5 67.7 57.6 62.7 813 30-34 81.4 84.9 77.8 69.5 67.8 956 35-39 84.8 88.1 79.2 70.5 70.1 784 40-44 71.5 76.1 68.7 59.8 60.7 523 45-49 70.0 76.6 63.9 67.5 60.1 187 50-54 64.3 70.1 59.3 40.6 49.7 92 Residence Urban 81.7 84.3 77.0 68.5 69.2 1,735 Rural 73.9 79.6 68.4 60.1 60.3 1,851 Father’s education No education 49.2 59.9 40.9 40.6 42.7 91 Some primary 63.9 71.0 61.1 54.6 47.8 546 Completed primary 76.3 79.8 69.2 62.0 60.7 994 Some secondary 75.2 78.5 69.3 60.7 62.6 778 Secondary + 88.9 92.6 85.4 74.6 78.7 1,177 Total 77.6 81.9 72.6 64.2 64.6 3,587 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. tion in Family Health Care Children’s immunization varies by father’s background characteristics. In general, children of fathers age 30-39, children of those who live in urban areas, and children of better educated fathers are more likely than other children to be immunized with each of the vaccines. For example, on the basis of fathers’ reports, 82 percent of children whose fathers reside in urban areas have received the BCG vaccine, compared with 74 percent of children whose fathers reside in rural areas. Furthermore, 49 percent of children born to men with no education have received the BCG vaccine, compared with 89 percent of children of men with secondary or higher education. Appendix Table A.17.2 shows that the percentage of children immunized with each vaccine varies significantly by the province where the father resides. For example, 58 percent of children whose fathers live in Lampung and West Sumatera have received the BCG vaccine, while the corresponding proportions in DI Yogyakarta and Bali are 100 and 97 percent, respectively. 17.3 CONTACT WITH HEALTH CARE PROVIDERS In the 2002-2003 IDHS, men’s involvement in his wife’s pregnancy and care is measured by asking male respondents whether they talked to a health care provider about the pregnancy care or the health of the mother of their last child in the five years preceding the survey. Men were also asked specifically about the topics they discussed during such contacts with a doctor of health provider. This information is presented in Table 17.3. Findings show that during their wife’s last pregnancy, only four in ten fathers talked to a health care provider about the pregnancy care and health of their wife. Of these men, 35 percent talked with a health care provider about the types of foods his wife should eat during pregnancy, 36 percent talked about how much rest she should have during pregnancy, and 37 percent talked about the types of health problems for which she should get immediate medical attention. Fathers in their thirties, urban fathers, and those who are better educated are more likely than other fathers are to talk with a health care provider about their wife’s health and care during pregnancy. Appendix Table A.17.3 shows the variation by province in the level of contact between fathers and health care providers concerning their wife’s pregnancy and health. Overall, as well as for each topic, East Nusa Tenggara has the lowest proportion of fathers who talked to a health care provider about their wife’s health or pregnancy, while Bali has the highest. For example, while only 12 percent of fathers in East Nusa Tenggara talked with a health care provider about their wife’s pregnancy and health, virtually all fathers in Bali did (99 percent). Father’s Participation in Family Health Care | 193 Table 17.3 Father’s contact with a health care provider about wife’s health and pregnancy Percentage of last births in the five years preceding the survey whose father discussed with a health care provider about the health of the mother or the pregnancy, and among these, percentage who discussed specific topics, according to father’s background characteristics, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Topics of discussion –––––––––––––––––––––––––––––––––– Type of health problems for How which she Talked Type much rest should get with a of foods she should immediate Number Background health care eat during have during medical of characteristic provider pregnancy pregnancy attention fathers ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 17.4 PREPA For th be taken. These include person to assist with the livery, and identifying a p In the ivery with anyone during he survey. This informat discussed with someone e place of delivery (65 ervice (57 percent). A to , probably because most delivery is dis 194 | Father’s Participation Age 15-19 * * * * 4 20-24 26.0 21.9 22.6 24.0 248 25-29 39.0 33.4 33.8 36.7 831 30-34 46.1 41.5 42.0 42.4 965 35-39 43.0 40.1 40.3 40.5 790 40-44 35.7 29.8 30.0 32.1 529 45-49 30.5 24.7 28.5 28.7 188 50-54 27.2 25.0 25.4 26.1 96 Residence Urban 47.1 42.5 43.0 44.0 1,764 Rural 32.6 28.0 28.5 30.0 1,889 Father’s education No education 22.8 22.1 21.9 22.4 93 Some primary 24.2 20.9 21.1 21.7 553 Completed primary 25.8 23.0 23.3 23.8 1,009 Some secondary 39.1 35.6 35.3 36.6 800 Secondary+ 60.0 52.2 53.8 55.9 1,197 Total 39.6 35.0 35.5 36.8 3,653 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. RATION FOR DELIVERY e safety and well-being of mothers and their newborn babies, certain steps need to making decisions on various aspects of delivery, such as deciding the place and delivery, transportation to the place of the delivery, cost associated with the de ossible blood donor, if needed. 2002-2003 IDHS, fathers were asked whether they discussed these aspects of del the pregnancy of the mother of their last born child in the five years preceding t ion is presented in Table 17.4. Results show that, overall, 77 percent of fathers any of the topics related to delivery. The most often discussed topics are th percent) and delivery assistance (64 percent), followed by payment for the s pic discussed less by fathers is transportation to the place of delivery (33 percent) deliveries in Indonesia take place at home. Identification of a potential blood donor during cussed by only 6 percent of the fathers. in Family Health Care The preparation for delivery varies by father’s background characteristics. Younger men are slightly more likely to discuss with someone any of the topics related to delivery. Urban men and those with higher education are significantly more likely to discuss with someone the various aspects of delivery than are rural men or those with no or lower education. Appendix Table A.17.4 presents the variation in fathers’ level of discussion with preparation for the birth of their child across provinces. While 98 percent of fathers in West Sumatera discussed any of the topics related to delivery with someone, 55 percent of fathers residing in Lampung have done so. Table 17.4 Preparation for delivery Percentage of last births born in the five years preceding the survey whose father discussed specific topics about delivery, according to father’s background characteristics, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Topics discussed ––––––––––––––––––––––––––––––––––––––––––––––––––––––– Background Place to Transpor- Delivery Blood Any No topics Number characteristic deliver tation assistance Payment donor topic discussed of fathers –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 * * * * * * * 4 20-24 66.6 33.1 59.5 63.5 6.5 82.6 17.4 248 25-29 64.8 30.0 64.1 56.6 4.5 78.1 21.9 831 30-34 68.9 37.5 68.0 60.5 7.6 78.0 22.0 965 35-39 68.3 30.8 63.4 54.3 6.7 78.8 21.2 790 40-44 60.9 32.0 58.5 58.1 6.3 73.0 27.0 529 45-49 57.1 32.5 64.4 48.4 8.9 69.9 30.1 188 50-54 46.0 22.3 54.4 38.9 3.2 60.7 39.3 96 Residence Urban 72.9 39.3 65.4 62.5 7.0 81.7 18.3 1,764 Rural 58.2 26.4 62.0 51.8 5.8 72.5 27.5 1,889 Father’s education No education 41.9 21.4 49.6 41.6 8.9 54.2 45.8 93 Some primary 53.5 30.4 59.6 49.2 5.0 66.3 33.7 553 Completed primary 64.4 30.1 59.0 60.6 4.1 77.8 22.2 1,009 Some secondary 63.8 27.0 62.0 55.7 4.5 76.3 23.7 800 Secondary+ 74.3 40.3 71.6 59.5 10.1 83.2 16.8 1,197 Total 65.3 32.6 63.6 57.0 6.4 76.9 23.1 3,653 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 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Columbia, Maryland: Institute for Resource Development. 198 | References Appendix A | 199 PROVINCIAL TABLES Appendix A CHAPTER 3 CHARACTERISTICS OF RESPONDENTS AND WOMEN’S STATUS Table A.3.1 Distribution of respondents by province Percent distribution of women and men by province, Indonesia 2002-2003 Number of ever-married women Number of currently married men Province Weighted percent Weighted Unweighted Weighted percent Weighted Unweighted Sumatera North Sumatera 7.4 2,177 1,399 8.0 663 417 West Sumatera 2.4 705 1,106 2.2 182 285 Riau 2.2 660 1,139 2.4 199 335 Jambi 1.3 382 1,017 1.4 114 300 South Sumatera 2.7 809 1,242 3.1 259 390 Bengkulu 0.5 159 871 0.5 44 241 Lampung 3.3 984 1,050 3.1 261 271 Bangka-Belitung 0.4 128 647 0.5 40 196 Java DKI Jakarta 3.5 1,024 1,882 3.7 310 561 West Java 19.7 5,797 1,641 19.4 1,614 458 Central Java 14.4 4,234 1,569 13.9 1,155 425 DI Yogyakarta 1.2 367 1,030 1.2 103 290 East Java 18.2 5,367 1,505 18.8 1,560 429 Banten 4.7 1,396 1,383 4.8 396 378 Bali and Nusa Tenggara Bali 1.6 465 1,371 1.7 138 404 West Nusa Tenggara 2.0 583 954 1.8 145 239 East Nusa Tenggara 1.6 460 839 1.5 122 217 Kalimantan West Kalimantan 1.6 477 921 1.4 119 227 Central Kalimantan 1.0 297 909 1.2 97 289 South Kalimantan 1.6 470 1,010 1.3 109 241 East Kalimantan 1.5 447 826 1.4 115 227 Sulawesi North Sulawesi 1.1 310 1,067 1.1 95 325 Central Sulawesi 1.2 347 1,018 1.4 114 322 South Sulawesi 3.5 1,033 1,071 2.9 237 262 Southeast Sulawesi 0.9 251 1,023 0.9 77 316 Gorontalo 0.5 153 993 0.5 41 265 Total 100.0 29,483 29,483 100.0 8,310 8,310 200 | Appendix A Table A.3.2.1 Educational attainment by province: ever-married women Percent distribution of women by highest level of schooling attended or completed, and median number of years of schooling, according to province, Indonesia 2002-2003 Highest level of schooling attended or completed Province No education Some primary Completed primary1 Some secondary Completed secondary2 More than secondary Total Number Median years of schooling Sumatera North Sumatera 3.8 14.5 28.3 22.6 26.0 4.7 100.0 2,177 8.0 West Sumatera 2.6 17.0 22.0 22.6 23.6 12.3 100.0 705 8.3 Riau 4.5 18.7 27.1 22.2 22.0 5.5 100.0 660 6.0 Jambi 7.2 19.2 33.5 16.4 18.3 5.3 100.0 382 5.7 South Sumatera 4.1 22.4 39.5 16.2 12.8 5.1 100.0 809 5.6 Bengkulu 5.9 22.9 24.7 23.4 16.8 6.4 100.0 159 5.8 Lampung 5.2 27.9 34.2 15.3 13.7 3.7 100.0 984 5.5 Bangka-Belitung 9.3 32.8 27.4 13.1 13.5 3.9 100.0 128 5.3 Java DKI Jakarta 3.4 10.4 25.5 23.1 25.8 11.8 100.0 1,024 8.4 West Java 7.7 18.3 44.4 14.9 11.9 2.9 100.0 5,797 5.5 Central Java 10.1 21.1 38.5 15.8 10.7 3.8 100.0 4,234 5.5 DI Yogyakarta 6.3 14.6 25.2 23.2 19.9 10.7 100.0 367 8.0 East Java 8.1 21.5 32.4 16.5 16.0 5.5 100.0 5,367 5.6 Banten 8.9 25.0 28.4 15.3 15.7 6.6 100.0 1,396 5.6 Bali and Nusa Tenggara Bali 12.5 13.4 28.5 13.8 23.7 8.1 100.0 465 5.8 West Nusa Tenggara 26.6 25.0 23.5 14.5 8.9 1.5 100.0 583 4.6 East Nusa Tenggara 9.0 19.5 44.3 15.0 9.6 2.5 100.0 460 5.5 Kalimantan West Kalimantan 20.6 22.8 21.1 18.2 13.0 4.4 100.0 477 5.3 Central Kalimantan 3.8 22.4 30.0 24.0 15.1 4.7 100.0 297 5.8 South Kalimantan 8.5 24.6 33.6 16.9 13.5 2.9 100.0 470 5.5 East Kalimantan 4.6 17.3 26.3 23.0 21.8 7.0 100.0 447 6.7 Sulawesi North Sulawesi 0.8 18.8 20.1 24.8 28.6 6.8 100.0 310 8.2 Central Sulawesi 5.2 19.2 34.6 20.9 15.4 4.5 100.0 347 5.7 South Sulawesi 10.3 23.8 24.0 18.4 18.0 5.5 100.0 1,033 5.6 Southeast Sulawesi 10.3 15.7 29.7 22.9 18.1 3.3 100.0 251 5.8 Gorontalo 2.2 26.3 30.8 20.8 16.6 3.3 100.0 153 5.7 Total 7.9 20.0 33.9 17.4 15.8 4.9 100.0 29,483 5.6 1 Completed 6th grade at the primary level 2 Completed 6th grade at the secondary level Appendix A | 201 Table A.3.2.2 Educational attainment by province: currently married men Percent distribution of men by highest level of schooling attended or completed, and median number of years of schooling, according to province, Indonesia 2002-2003 Highest level of schooling attended or completed Province No education Some primary Completed primary1 Some secondary Completed secondary2 More than secondary Total Number Median years of schooling Sumatera North Sumatera 1.4 14.5 24.0 22.9 30.0 7.2 100.0 663 8.4 West Sumatera 3.8 21.1 22.7 20.7 22.3 9.4 100.0 182 6.4 Riau 3.1 11.0 27.0 22.5 25.7 10.7 100.0 199 8.4 Jambi 2.4 14.7 33.1 22.0 21.2 6.7 100.0 114 6.0 South Sumatera 3.0 16.8 35.3 18.5 21.3 5.1 100.0 259 5.9 Bengkulu 2.8 16.0 25.2 23.5 21.9 10.6 100.0 44 7.6 Lampung 2.9 20.4 31.7 22.9 15.2 7.0 100.0 261 5.8 Bangka-Belitung 3.5 24.7 32.3 16.9 18.8 3.7 100.0 40 5.7 Java DKI Jakarta 0.8 4.6 21.0 18.9 38.9 15.7 100.0 310 11.1 West Java 2.9 21.7 41.0 13.1 17.4 3.8 100.0 1,614 5.6 Central Java 6.5 22.8 35.2 18.5 12.5 4.4 100.0 1,155 5.6 DI Yogyakarta 2.9 13.4 21.8 20.5 26.6 14.8 100.0 103 8.5 East Java 4.9 26.5 25.5 17.8 16.0 9.3 100.0 1,560 5.7 Banten 1.1 21.3 23.9 13.8 29.3 10.5 100.0 396 8.1 Bali and Nusa Tenggara Bali 5.9 9.3 26.3 14.8 31.3 12.4 100.0 138 8.6 West Nusa Tenggara 12.7 27.8 22.2 14.7 14.3 8.3 100.0 145 5.4 East Nusa Tenggara 8.0 18.5 30.5 18.1 19.0 5.9 100.0 122 5.7 Kalimantan West Kalimantan 12.4 30.3 18.3 15.6 18.8 4.6 100.0 119 5.4 Central Kalimantan 3.1 14.4 30.6 25.7 21.4 4.9 100.0 97 7.1 South Kalimantan 4.5 22.1 25.8 21.0 20.6 6.1 100.0 109 5.9 East Kalimantan 2.9 15.6 19.1 16.2 32.2 13.9 100.0 115 8.7 Sulawesi North Sulawesi 0.2 18.5 15.1 26.9 28.4 10.9 100.0 95 8.5 Central Sulawesi 2.2 11.7 32.4 23.2 23.8 6.7 100.0 114 7.9 South Sulawesi 8.5 30.8 14.0 13.6 19.3 13.8 100.0 237 5.7 Southeast Sulawesi 3.8 20.5 24.9 18.3 25.3 7.3 100.0 77 6.0 Gorontalo 1.4 39.2 26.9 18.8 12.9 0.9 100.0 41 5.4 Total 4.1 20.8 29.6 17.8 20.2 7.4 100.0 8,310 5.8 1 Completed 6th grade at the primary level 2 Completed 6th grade at the secondary level 202 | Appendix A Table A.3.3.1 Literacy by province: women Percent distribution of ever-married women by level of schooling attended and by level of literacy, and percent literate, according to province, Indonesia 2002-2003 No schooling or primary school Province Secondary school or higher Can read a whole sentence Can read part of a sentence Cannot read at all Missing Total Number Percent literate1 Sumatera North Sumatera 53.4 35.3 2.8 7.4 1.1 100.0 2,177 91.5 West Sumatera 58.5 29.9 2.7 8.8 0.2 100.0 705 91.1 Riau 49.7 32.2 6.3 9.2 2.6 100.0 660 88.2 Jambi 40.0 33.6 12.8 13.4 0.1 100.0 382 86.5 South Sumatera 34.0 48.0 10.8 6.1 1.1 100.0 809 92.8 Bengkulu 46.6 38.9 4.0 10.3 0.2 100.0 159 89.4 Lampung 32.7 46.0 8.8 12.4 0.1 100.0 984 87.5 Bangka-Belitung 30.5 40.4 16.2 12.1 0.7 100.0 128 87.1 Java DKI Jakarta 60.7 28.7 4.8 5.3 0.6 100.0 1,024 94.2 West Java 29.6 49.8 9.7 10.3 0.7 100.0 5,797 89.1 Central Java 30.3 43.1 9.9 16.5 0.2 100.0 4,234 83.3 DI Yogyakarta 53.8 30.1 6.1 9.8 0.1 100.0 367 90.1 East Java 37.9 35.7 9.3 16.7 0.3 100.0 5,367 83.0 Banten 37.7 40.1 7.2 13.6 1.4 100.0 1,396 85.0 Bali and Nusa Tenggara Bali 45.6 34.2 6.6 13.0 0.6 100.0 465 86.4 West Nusa Tenggara 24.9 35.0 6.7 33.0 0.3 100.0 583 66.7 East Nusa Tenggara 27.1 43.7 12.3 14.0 2.8 100.0 460 83.1 Kalimantan West Kalimantan 35.5 29.8 7.6 27.0 0.1 100.0 477 72.9 Central Kalimantan 43.8 39.3 10.3 6.0 0.5 100.0 297 93.5 South Kalimantan 33.3 45.9 8.6 11.8 0.4 100.0 470 87.7 East Kalimantan 51.8 32.4 7.7 8.1 0.0 100.0 447 91.9 Sulawesi North Sulawesi 60.3 33.1 3.1 2.8 0.7 100.0 310 96.4 Central Sulawesi 40.9 39.5 9.0 10.6 0.1 100.0 347 89.3 South Sulawesi 41.9 30.9 9.9 16.9 0.4 100.0 1,033 82.7 Southeast Sulawesi 44.3 30.2 9.7 14.9 0.9 100.0 251 84.2 Gorontalo 40.7 37.6 11.5 8.4 1.8 100.0 153 89.9 Total 38.2 39.8 8.4 13.0 0.6 100.0 29,483 86.4 1 Refers to respondents who attended secondary school or higher and respondents who can read a whole sentence or part of a sentence Appendix A | 203 Table A.3.3.2 Literacy by province: men Percent distribution of currently married men by level of schooling attended and by level of literacy, and percent literate, according to province, Indonesia 2002-2003 No schooling or primary school Province Secondary school or higher Can read a whole sentence Can read part of a sentence Cannot read at all Missing Total Number Percent literate1 Sumatera North Sumatera 60.1 35.5 1.6 2.1 0.7 100.0 663 97.2 West Sumatera 52.4 35.9 2.6 9.0 0.1 100.0 182 90.8 Riau 58.9 30.9 4.8 4.5 0.9 100.0 199 94.6 Jambi 49.9 41.7 2.7 5.4 0.3 100.0 114 94.3 South Sumatera 44.9 42.3 8.6 4.0 0.2 100.0 259 95.8 Bengkulu 55.9 38.9 2.8 2.0 0.4 100.0 44 97.6 Lampung 45.0 35.0 13.3 6.8 0.0 100.0 261 93.2 Bangka-Belitung 39.4 46.3 7.5 6.7 0.0 100.0 40 93.3 Java DKI Jakarta 73.6 23.7 2.0 0.5 0.2 100.0 310 99.3 West Java 34.3 55.4 7.3 3.1 0.0 100.0 1,614 96.9 Central Java 35.4 46.5 9.5 8.6 0.0 100.0 1,155 91.4 DI Yogyakarta 61.9 30.1 1.8 6.3 0.0 100.0 103 93.7 East Java 43.1 37.9 7.5 11.5 0.0 100.0 1,560 88.5 Banten 53.6 36.2 5.1 3.9 1.1 100.0 396 95.0 Bali and Nusa Tenggara Bali 58.4 30.8 6.2 4.5 0.1 100.0 138 95.4 West Nusa Tenggara 37.3 42.7 2.4 17.7 0.0 100.0 145 82.3 East Nusa Tenggara 43.0 27.2 10.7 19.1 0.0 100.0 122 80.9 Kalimantan West Kalimantan 39.0 38.5 8.1 14.5 0.0 100.0 119 85.5 Central Kalimantan 52.0 38.1 5.3 4.5 0.2 100.0 97 95.3 South Kalimantan 47.6 37.8 9.6 4.9 0.0 100.0 109 95.1 East Kalimantan 62.4 29.9 1.2 6.5 0.1 100.0 115 93.5 Sulawesi North Sulawesi 66.3 25.0 5.8 2.7 0.2 100.0 95 97.1 Central Sulawesi 53.8 37.1 3.9 5.2 0.0 100.0 114 94.8 South Sulawesi 46.7 32.2 5.5 15.6 0.0 100.0 237 84.4 Southeast Sulawesi 50.8 36.8 4.9 7.5 0.0 100.0 77 92.5 Gorontalo 32.6 45.3 10.4 11.7 0.0 100.0 41 88.3 Total 45.5 40.9 6.5 6.9 0.2 100.0 8,310 92.9 1 Refers to respondents who attended secondary school or higher and respondents who can read a whole sentence or part of a sentence 204 | Appendix A Table A.3.4.1 Exposure to mass media by province: women Percentage of ever-married women who usually read a newspaper at least once a week, watch television at least once a week, and listen to the radio at least once a week, by province, Indonesia 2002-2003 Province Reads a newspaper at least once a week Watches television at least once a week Listens to the radio at least once a week All three media No media Number Sumatera North Sumatera 14.1 68.2 27.0 7.0 28.1 2,177 West Sumatera 22.5 74.1 37.3 12.5 19.9 705 Riau 21.5 79.4 31.1 10.5 15.3 660 Jambi 17.1 77.8 35.2 10.6 16.6 382 South Sumatera 18.1 68.1 41.9 11.8 24.3 809 Bengkulu 25.9 76.8 51.1 17.5 16.1 159 Lampung 15.7 80.1 53.2 8.6 10.4 984 Bangka-Belitung 14.5 76.7 20.1 4.5 19.2 128 Java DKI Jakarta 36.5 90.7 36.6 20.3 7.2 1,024 West Java 11.4 79.8 35.3 6.6 15.4 5,797 Central Java 11.5 78.6 44.9 8.4 16.4 4,234 DI Yogyakarta 31.6 87.2 69.0 23.7 5.2 367 East Java 12.7 80.8 35.9 7.8 15.4 5,367 Banten 24.4 79.5 29.2 10.2 16.1 1,396 Bali and Nusa Tenggara Bali 16.5 83.5 43.1 10.5 13.6 465 West Nusa Tenggara 6.0 51.4 40.2 4.3 35.6 583 East Nusa Tenggara 11.9 20.0 25.0 5.9 64.2 460 Kalimantan West Kalimantan 17.6 67.2 42.0 10.5 24.4 477 Central Kalimantan 8.9 69.5 49.7 6.0 19.2 297 South Kalimantan 15.7 79.2 59.7 12.0 11.5 470 East Kalimantan 25.1 84.4 22.6 7.7 10.9 447 Sulawesi North Sulawesi 28.2 77.5 41.4 19.7 18.0 310 Central Sulawesi 13.3 57.0 30.4 8.7 36.0 347 South Sulawesi 13.9 74.1 45.7 10.3 18.7 1,033 Southeast Sulawesi 9.2 53.9 47.0 5.8 30.1 251 Gorontalo 14.8 55.1 42.8 12.5 37.1 153 Total 15.2 76.4 38.1 9.0 18.1 29,483 Appendix A | 205 Table A.3.4.2 Exposure to mass media by province: men Percentage of currently married men who usually read a newspaper at least once a week, watch television at least once a week, and listen to the radio at least once a week, by province, Indonesia 2002-2003 Province Reads a newspaper at least once a week Watches television at least once a week Listens to the radio at least once a week All three media No media Number Sumatera North Sumatera 32.6 71.5 38.5 19.4 23.9 663 West Sumatera 35.3 86.0 38.2 17.3 10.7 182 Riau 33.3 85.2 43.1 19.3 11.0 199 Jambi 20.3 84.5 43.6 13.7 8.3 114 South Sumatera 26.1 75.3 56.3 16.1 18.7 259 Bengkulu 17.2 69.4 35.1 6.6 24.4 44 Lampung 25.0 76.7 48.0 13.9 14.9 261 Bangka-Belitung 28.5 93.3 41.3 15.7 3.1 40 Java DKI Jakarta 65.4 94.1 55.1 42.3 3.4 310 West Java 27.4 75.0 48.1 16.8 16.0 1,614 Central Java 22.7 78.6 43.5 11.7 15.7 1,155 DI Yogyakarta 43.9 90.9 66.9 27.8 2.9 103 East Java 25.6 87.4 41.2 14.6 9.3 1,560 Banten 38.2 89.1 47.4 20.1 6.9 396 Bali and Nusa Tenggara Bali 44.5 87.5 66.2 40.3 8.5 138 West Nusa Tenggara 14.5 73.1 51.4 9.7 18.4 145 East Nusa Tenggara 19.9 27.0 32.9 12.7 56.4 122 Kalimantan West Kalimantan 27.3 64.9 43.7 11.8 21.9 119 Central Kalimantan 20.9 74.9 57.5 18.3 15.0 97 South Kalimantan 28.4 83.9 48.0 17.4 12.1 109 East Kalimantan 42.8 90.6 30.3 15.0 7.7 115 Sulawesi North Sulawesi 56.5 90.4 58.9 44.7 6.6 95 Central Sulawesi 18.2 63.6 38.9 14.9 31.4 114 South Sulawesi 25.8 75.5 52.7 12.1 12.9 237 Southeast Sulawesi 11.0 57.1 38.0 6.6 31.9 77 Gorontalo 24.1 61.7 58.9 21.7 29.1 41 Total 29.1 79.3 45.6 17.2 14.6 8,310 206 | Appendix A Table A.3.5.1 Employment status by province: women Percent distribution of ever-married women by employment status, according to province, Indonesia 2002-2003 Employed in the 12 months preceding the survey Province Currently employed Not currently employed Not employed in the 12 months preceding the survey Total Number of women Sumatera North Sumatera 58.9 1.5 39.6 100.0 2,177 West Sumatera 57.5 2.4 40.1 100.0 705 Riau 41.2 1.8 56.9 100.0 660 Jambi 48.7 1.3 49.9 100.0 382 South Sumatera 59.6 2.9 37.6 100.0 809 Bengkulu 74.7 1.8 23.4 100.0 159 Lampung 57.5 2.0 40.5 100.0 984 Bangka-Belitung 41.0 2.5 56.5 100.0 128 Java DKI Jakarta 44.4 2.9 52.7 100.0 1,024 West Java 37.6 2.1 60.3 100.0 5,797 Central Java 61.2 1.4 37.4 100.0 4,234 DI Yogyakarta 73.7 3.1 23.2 100.0 367 East Java 52.3 1.3 46.4 100.0 5,367 Banten 39.4 1.6 58.9 100.0 1,396 Bali and Nusa Tenggara Bali 65.3 2.6 32.1 100.0 465 West Nusa Tenggara 72.2 3.3 24.5 100.0 583 East Nusa Tenggara 80.3 2.8 16.9 100.0 460 Kalimantan West Kalimantan 60.4 2.0 37.6 100.0 477 Central Kalimantan 27.0 0.4 72.4 100.0 297 South Kalimantan 54.5 1.6 43.9 100.0 470 East Kalimantan 36.1 1.9 62.0 100.0 447 Sulawesi North Sulawesi 37.2 0.4 62.4 100.0 310 Central Sulawesi 60.4 2.2 37.4 100.0 347 South Sulawesi 34.3 1.8 63.8 100.0 1,033 Southeast Sulawesi 52.6 1.4 46.0 100.0 251 Gorontalo 35.5 1.5 62.9 100.0 153 Total 50.7 1.8 47.4 100.0 29,483 Appendix A | 207 Table A.3.5.2 Employment status by province: men Percent distribution of currently married men by employment status, according to province, Indonesia 2002-2003 Employed in the 12 months preceding the survey Province Currently employed Not currently employed Not employed in the 12 months preceding the survey Total Number of men Sumatera North Sumatera 97.2 2.1 0.7 100.0 663 West Sumatera 95.5 2.7 1.8 100.0 182 Riau 96.8 1.2 1.3 100.0 199 Jambi 97.5 1.5 1.0 100.0 114 South Sumatera 99.5 0.2 0.3 100.0 259 Bengkulu 99.6 0.2 0.2 100.0 44 Lampung 98.6 1.0 0.5 100.0 261 Bangka-Belitung 97.6 0.6 1.8 100.0 40 Java DKI Jakarta 96.0 1.8 2.2 100.0 310 West Java 96.5 1.9 1.6 100.0 1,614 Central Java 97.3 1.0 1.7 100.0 1,155 DI Yogyakarta 98.5 1.3 0.2 100.0 103 East Java 99.1 0.4 0.5 100.0 1,560 Banten 92.8 3.7 3.5 100.0 396 Bali and Nusa Tenggara Bali 95.9 1.0 3.2 100.0 138 West Nusa Tenggara 94.3 4.5 1.2 100.0 145 East Nusa Tenggara 97.7 1.1 1.1 100.0 122 Kalimantan West Kalimantan 98.3 1.1 0.6 100.0 119 Central Kalimantan 97.3 1.0 1.1 100.0 97 South Kalimantan 97.8 1.0 1.2 100.0 109 East Kalimantan 95.0 2.5 2.5 100.0 115 Sulawesi North Sulawesi 99.4 0.0 0.6 100.0 95 Central Sulawesi 98.3 1.0 0.7 100.0 114 South Sulawesi 97.7 1.9 0.3 100.0 237 Southeast Sulawesi 98.1 0.7 1.0 100.0 77 Gorontalo 99.6 0.0 0.4 100.0 41 Total 97.3 1.4 1.3 100.0 8,310 208 | Appendix A Table A.3.6 Decision on use of earnings and contribution of earnings to household expenditures by province Percent distribution of ever-married women employed in the 12 months preceding the survey receiving cash earnings by person who decides how earnings are to be used and by proportion of household expenditures met by earnings, according to province, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Person who decides how Proportion of household earnings are used expenditures met by earnings –––––––––––––––––––––––––––––––– ––––––––––––––––––––––––––––––––––––––––– Someone Almost Less Half Number Self else none/ than or of Province only Jointly1 only2 Missing Total none half more All Missing Total women ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 59.0 37.9 1.9 1.2 100.0 7.8 10.8 40.2 40.8 0.3 100.0 748 West Sumatera 68.1 28.2 3.7 0.0 100.0 8.3 7.7 36.9 47.0 0.1 100.0 247 Riau 49.1 47.7 2.1 1.0 100.0 3.1 9.2 45.5 38.3 3.9 100.0 180 Jambi 62.6 30.5 2.2 4.7 100.0 0.9 17.1 44.2 37.8 0.0 100.0 78 South Sumatera 68.1 27.9 0.9 3.1 100.0 1.7 23.3 46.8 27.3 0.9 100.0 161 Bengkulu 62.1 35.2 0.3 2.4 100.0 4.1 20.1 40.2 34.7 0.8 100.0 41 Lampung 62.0 34.5 2.0 1.5 100.0 4.4 15.7 52.2 27.4 0.2 100.0 246 Bangka-Belitung 71.3 26.8 1.2 0.8 100.0 3.2 3.9 31.0 60.4 1.6 100.0 35 Java DKI Jakarta 81.5 16.7 1.1 0.7 100.0 6.1 9.4 40.7 42.7 1.1 100.0 433 West Java 73.8 21.8 2.6 1.8 100.0 1.3 7.4 45.0 45.9 0.4 100.0 1,647 Central Java 66.4 32.4 0.5 0.7 100.0 0.7 7.4 34.1 57.6 0.2 100.0 1,575 DI Yogyakarta 71.0 27.3 1.4 0.4 100.0 2.0 14.3 53.0 30.8 0.0 100.0 193 East Java 70.2 27.8 1.2 0.7 100.0 2.8 8.1 41.8 46.2 1.1 100.0 2,047 Banten 79.8 15.8 1.3 3.2 100.0 2.6 18.7 56.7 18.8 3.2 100.0 432 Bali and Nusa Tenggara Bali 43.8 54.1 1.9 0.2 100.0 1.6 30.3 46.5 19.8 1.8 100.0 267 West Nusa Tenggara 61.0 35.6 3.0 0.4 100.0 1.1 8.0 28.3 62.1 0.5 100.0 279 East Nusa Tenggara 47.5 45.3 5.9 1.2 100.0 6.1 15.3 41.0 36.3 1.2 100.0 60 Kalimantan West Kalimantan 62.8 29.6 5.7 1.8 100.0 4.3 2.7 46.7 46.1 0.1 100.0 119 Central Kalimantan 48.9 48.7 1.2 1.2 100.0 2.2 8.9 30.8 55.7 2.4 100.0 43 South Kalimantan 60.6 34.3 1.3 3.9 100.0 1.6 9.4 37.8 51.2 0.0 100.0 143 East Kalimantan 71.4 27.4 1.0 0.2 100.0 6.4 22.6 46.8 22.7 1.6 100.0 131 Sulawesi North Sulawesi 26.1 66.2 6.0 1.7 100.0 2.8 19.9 61.2 14.6 1.6 100.0 58 Central Sulawesi 59.4 36.8 2.3 1.4 100.0 3.9 43.5 39.5 11.5 1.6 100.0 85 South Sulawesi 87.8 11.9 0.0 0.3 100.0 0.7 12.3 57.7 28.6 0.6 100.0 169 Southeast Sulawesi 76.6 19.8 1.8 1.8 100.0 3.9 19.9 47.1 21.1 8.0 100.0 49 Gorontalo 72.6 24.6 2.1 0.7 100.0 3.5 8.4 63.2 24.9 0.0 100.0 36 Total 68.0 29.1 1.7 1.2 100.0 2.8 10.7 42.3 43.3 0.9 100.0 9,503 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1 With husband or someone else 2 Includes husband Appendix A | 209 Table A.3.7 Women's participation in decisionmaking by province Percentage of ever-married women who say that they alone or jointly have the final say in specific decisions, by province, Indonesia 2002-2003 Alone or jointly have final say in: Province Own health care Making large purchases Making daily purchases Visits to family or relatives What food to cook each day All specified decisions None of the specified decisions Number of women Sumatera North Sumatera 83.7 86.6 95.0 89.5 96.2 70.2 0.3 2,177 West Sumatera 77.8 75.5 92.4 84.7 95.3 58.7 1.6 705 Riau 82.2 83.6 91.7 90.1 92.9 68.0 2.8 660 Jambi 88.0 87.4 97.3 85.2 94.6 77.8 0.3 382 South Sumatera 91.2 76.9 94.8 78.3 89.2 66.0 1.0 809 Bengkulu 81.7 76.2 92.2 84.6 96.3 67.1 0.7 159 Lampung 80.9 75.4 96.0 87.1 98.0 60.7 0.7 984 Bangka-Belitung 80.0 72.4 91.6 84.0 95.6 62.1 3.1 128 Java DKI Jakarta 97.3 85.0 96.9 90.6 94.6 76.6 0.1 1,024 West Java 83.2 68.9 96.3 84.5 98.2 57.5 0.5 5,797 Central Java 93.3 85.1 98.2 93.3 98.7 79.6 0.1 4,234 DI Yogyakarta 89.5 82.6 97.6 92.2 95.7 70.5 0.1 367 East Java 88.7 87.0 97.5 82.3 97.1 69.2 0.3 5,367 Banten 84.7 80.7 95.8 87.9 96.4 65.8 0.9 1,396 Bali and Nusa Tenggara Bali 89.4 77.5 94.7 89.2 92.2 67.8 1.3 465 West Nusa Tenggara 82.4 76.3 96.0 82.3 96.4 60.0 0.7 583 East Nusa Tenggara 83.1 85.1 91.8 91.0 94.8 74.6 2.1 460 Kalimantan West Kalimantan 64.6 70.2 90.0 85.6 96.1 49.7 0.9 477 Central Kalimantan 97.3 81.0 97.1 89.1 98.3 72.1 0.4 297 South Kalimantan 91.5 87.6 93.7 91.4 96.0 77.8 0.9 470 East Kalimantan 89.3 85.5 97.3 92.2 96.4 74.9 0.6 447 Sulawesi North Sulawesi 95.8 96.9 98.6 96.7 98.7 91.0 0.4 310 Central Sulawesi 91.0 89.1 97.1 92.0 98.1 78.1 0.0 347 South Sulawesi 87.0 91.0 97.7 92.3 97.8 77.6 0.5 1,033 Southeast Sulawesi 85.7 87.4 98.4 85.8 98.9 72.5 0.0 251 Gorontalo 82.6 74.8 93.2 86.7 96.1 60.8 0.9 153 Total 86.9 81.1 96.3 87.2 96.9 68.4 0.5 29,483 210 | Appendix A Table A.3.8 Women's attitude toward wife beating by province Percentage of ever-married women who agree that a husband is justified in hitting or beating his wife for specific reasons, by province, Indonesia 2002-2003 Husband is justified in hitting or beating his wife if she: Province Burns the food Argues with him Goes out without telling him Neglects the children Refuses to have sex with him Percentage who agree with at least one speci- fied reason Number of women Sumatera North Sumatera 2.3 4.4 17.0 24.2 4.9 29.1 2,177 West Sumatera 4.6 8.0 33.5 32.8 9.1 43.1 705 Riau 5.4 7.8 36.4 36.7 12.7 44.0 660 Jambi 1.6 3.3 11.5 12.3 5.4 15.6 382 South Sumatera 3.5 4.9 14.4 22.7 10.9 28.0 809 Bengkulu 4.4 13.0 44.3 45.5 15.4 54.3 159 Lampung 2.0 5.4 21.6 23.3 7.3 28.6 984 Bangka-Belitung 10.1 13.6 45.2 44.6 17.4 57.1 128 Java DKI Jakarta 0.5 1.2 7.4 10.4 3.2 13.2 1,024 West Java 2.2 3.4 16.8 17.4 8.4 23.1 5,797 Central Java 1.2 2.2 9.2 9.6 3.2 14.1 4,234 DI Yogyakarta 0.3 3.5 11.9 16.2 3.2 20.2 367 East Java 0.8 3.3 15.8 14.0 3.1 18.7 5,367 Banten 3.2 3.9 12.5 12.1 6.0 16.0 1,396 Bali and Nusa Tenggara Bali 8.6 10.7 13.5 14.4 9.6 15.8 465 West Nusa Tenggara 7.6 31.5 55.1 56.4 30.2 64.3 583 East Nusa Tenggara 13.7 26.9 35.5 37.2 16.4 43.2 460 Kalimantan West Kalimantan 3.0 5.6 26.4 31.6 8.7 35.8 477 Central Kalimantan 3.0 1.5 11.2 44.6 1.8 45.0 297 South Kalimantan 2.7 9.0 31.2 33.3 11.9 39.5 470 East Kalimantan 2.6 1.9 18.9 20.5 3.4 26.6 447 Sulawesi North Sulawesi 2.5 4.4 9.7 12.1 3.0 14.2 310 Central Sulawesi 13.5 12.5 35.7 35.6 10.5 46.0 347 South Sulawesi 12.0 14.3 27.9 28.4 15.4 34.7 1,033 Southeast Sulawesi 14.7 5.3 39.8 35.8 10.0 48.0 251 Gorontalo 1.3 4.2 25.4 22.8 2.4 34.0 153 Total 3.0 5.3 18.2 19.6 6.9 24.8 29,483 Appendix A | 211 Table A.3.9 Women’s attitude toward refusing sex with husband by province Percentage of ever-married women who believe that a wife is justified in refusing to have sex with her husband for specific reasons, by province, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Wife is justified in refusing sex with her husband if she: –––––––––––––––––––––––––––––––––––––––––– Percentage Percentage Knows Knows who agree who agree husband has husband Is tired agree with with none a sexually has sex Has or not all of the of the Number transmitted with other recently in the specified specified of Province disease women given birth mood reasons reasons women ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 85.5 81.4 91.2 58.7 50.4 5.9 2,177 West Sumatera 74.9 74.9 91.9 59.8 46.8 6.5 705 Riau 72.3 75.7 88.6 61.6 47.3 8.8 660 Jambi 84.2 84.2 89.5 73.2 69.0 9.5 382 South Sumatera 65.8 60.8 72.4 41.3 32.0 18.6 809 Bengkulu 80.5 83.0 93.3 59.7 51.7 4.4 159 Lampung 85.0 85.5 91.7 65.2 59.7 6.6 984 Bangka-Belitung 84.0 79.7 88.4 68.0 58.9 8.6 128 Java DKI Jakarta 95.2 91.3 98.2 70.8 67.5 1.2 1,024 West Java 85.1 83.6 90.0 57.0 51.6 7.4 5,797 Central Java 85.9 87.3 94.5 81.9 73.7 3.7 4,234 DI Yogyakarta 90.7 91.1 95.5 79.2 70.4 1.5 367 East Java 88.2 84.4 91.6 84.1 75.5 6.5 5,367 Banten 85.4 87.5 94.1 66.4 58.7 5.0 1,396 Bali and Nusa Tenggara Bali 76.3 74.5 77.7 69.6 66.3 20.9 465 West Nusa Tenggara 75.4 78.5 81.3 58.5 49.1 12.6 583 East Nusa Tenggara 75.0 74.3 79.0 63.0 52.2 15.7 460 Kalimantan West Kalimantan 81.4 88.0 88.8 74.1 62.8 6.8 477 Central Kalimantan 92.5 81.8 89.5 76.0 64.8 4.9 297 South Kalimantan 79.9 75.2 91.2 51.4 41.7 3.6 470 East Kalimantan 94.9 90.8 96.7 80.7 75.5 1.8 447 Sulawesi North Sulawesi 75.1 77.6 82.0 62.1 54.9 13.6 310 Central Sulawesi 92.1 85.6 96.7 74.7 69.1 2.4 347 South Sulawesi 85.6 82.7 86.7 70.6 66.1 9.3 1,033 Southeast Sulawesi 80.4 80.5 84.6 64.5 60.0 13.3 251 Gorontalo 84.5 84.9 86.2 75.7 69.5 9.7 153 Total 84.7 83.3 90.6 69.1 61.6 6.9 29,483 212 | Appendix A CHAPTER 4 FERTILITY Table A.4.1 Fertility by province Total fertility rate for the three years preceding the survey, percentage of women age 15-49 currently pregnant, and mean number of children ever born to women age 40-49, by province, Indonesia 2002-2003 Province Total fertility rate1 Percentage currently pregnant1 Mean number of children ever born to women age 40-49 Sumatera North Sumatera 3.0 4.0 4.4 West Sumatera 3.2 5.7 4.8 Riau 3.2 5.0 4.7 Jambi 2.7 6.7 4.5 South Sumatera 2.3 2.5 4.4 Bengkulu 3.0 4.2 4.8 Lampung 2.7 4.4 4.8 Bangka-Belitung 2.4 2.9 4.1 Java DKI Jakarta 2.2 3.8 3.5 West Java 2.8 4.4 4.8 Central Java 2.1 3.4 3.7 DI Yogyakarta 1.9 3.3 2.9 East Java 2.1 3.5 3.0 Banten 2.6 4.3 4.5 Bali and Nusa Tenggara Bali 2.1 3.8 3.1 West Nusa Tenggara 2.4 5.9 4.9 East Nusa Tenggara 4.1 6.0 4.2 Kalimantan West Kalimantan 2.9 3.9 4.6 Central Kalimantan 3.2 5.5 4.1 South Kalimantan 3.0 4.3 4.3 East Kalimantan 2.8 6.1 4.5 Sulawesi North Sulawesi 2.6 3.9 2.8 Central Sulawesi 3.2 6.0 4.1 South Sulawesi 2.6 3.8 4.1 Southeast Sulawesi 3.6 6.7 4.7 Gorontalo 2.8 6.8 4.0 Total 2.6 4.1 4.0 1 Women age 15-49 Appendix A | 213 Table A.4.2 Birth intervals by province Percent distribution of non-first births in the five years preceding the survey by number of months since preceding birth, according to background characteristics, Indonesia 2002-2003 Months since preceding birth Province 7-17 18-23 24-35 36-47 48+ Total Number of non-first births Median number of months since preceding birth Sumatera North Sumatera 8.7 13.0 24.6 15.5 38.2 100.0 1,009 39.1 West Sumatera 7.7 8.6 24.2 20.5 39.1 100.0 310 41.8 Riau 5.6 9.4 22.3 15.4 47.2 100.0 279 45.9 Jambi 4.3 3.9 20.7 15.7 55.5 100.0 125 52.6 South Sumatera 6.2 4.9 17.5 16.9 54.4 100.0 262 51.0 Bengkulu 5.2 5.8 16.2 14.8 58.0 100.0 64 53.5 Lampung 5.9 6.5 17.0 17.6 53.0 100.0 360 52.2 Bangka-Belitung 7.3 3.4 11.0 13.5 64.8 100.0 46 56.9 Java DKI Jakarta 6.4 5.2 16.1 15.9 56.5 100.0 266 53.1 West Java 4.0 5.6 11.8 12.7 65.9 100.0 2,131 62.3 Central Java 4.3 5.8 11.8 12.1 66.0 100.0 1,080 63.6 DI Yogyakarta 6.1 5.0 10.6 14.5 63.9 100.0 82 61.4 East Java 7.1 5.2 11.4 10.0 66.2 100.0 1,194 68.9 Banten 4.1 4.9 14.3 14.8 61.9 100.0 491 58.9 Bali and Nusa Tenggara Bali 3.0 6.8 13.4 13.2 63.6 100.0 120 57.7 West Nusa Tenggara 3.4 8.1 19.4 12.9 56.1 100.0 199 55.1 East Nusa Tenggara 6.5 13.5 23.7 22.8 33.4 100.0 277 38.1 Kalimantan West Kalimantan 5.5 5.5 17.2 19.2 52.7 100.0 215 49.5 Central Kalimantan 6.3 7.4 11.5 17.0 57.8 100.0 116 55.7 South Kalimantan 2.2 5.2 14.1 13.3 65.2 100.0 161 61.1 East Kalimantan 7.6 7.1 11.9 18.3 55.0 100.0 166 51.8 Sulawesi North Sulawesi 4.7 7.4 18.2 13.7 56.0 100.0 91 52.0 Central Sulawesi 8.1 7.4 18.5 19.0 46.9 100.0 154 44.0 South Sulawesi 5.3 11.2 29.5 14.0 40.0 100.0 425 39.3 Southeast Sulawesi 8.8 9.2 25.0 17.1 40.0 100.0 127 39.8 Gorontalo 7.1 7.4 22.2 17.3 45.9 100.0 61 44.9 Total 5.6 7.1 16.3 14.3 56.6 100.0 9,811 54.2 Note: First-order births are excluded. The interval for multiple births is the number of months since the preceding pregnancy that ended in a live birth. 214 | Appendix A Table A.4.3 Median age at first birth by province Median age at first birth among women age 25-49, by current age and province, Indonesia 2002-2003 Current age Province 25-20 30-34 35-39 40-44 45-49 Women age 25-49 Sumatera North Sumatera 23.1 23.9 23.0 21.9 22.2 22.8 West Sumatera 24.8 23.2 21.9 22.0 20.7 22.5 Riau 22.7 22.0 21.0 19.8 20.2 21.4 Jambi 20.9 21.2 19.7 19.3 19.8 20.4 South Sumatera 21.4 21.2 19.9 20.5 20.1 20.6 Bengkulu 21.0 20.3 20.8 20.3 19.3 20.3 Lampung 20.9 20.6 20.0 19.7 19.3 20.1 Bangka-Belitung 21.7 21.4 20.4 21.3 22.5 21.4 Java DKI Jakarta a 23.8 22.7 20.9 21.7 23.0 West Java 20.2 20.5 19.4 19.4 18.8 19.8 Central Java 21.7 21.0 20.0 20.2 19.7 20.7 DI Yogyakarta 24.4 23.6 21.8 21.8 21.1 22.5 East Java 22.3 21.8 21.0 19.9 19.7 20.9 Banten 21.3 20.8 20.2 18.6 20.4 20.5 Bali and Nusa Tenggara Bali 23.7 23.7 23.8 21.9 21.3 22.9 West Nusa Tenggara 21.4 20.1 20.0 19.9 20.2 20.4 East Nusa Tenggara 22.9 24.3 23.2 22.3 22.4 23.2 Kalimantan West Kalimantan 21.7 21.0 21.5 20.1 20.5 21.1 Central Kalimantan 20.8 20.9 20.9 20.4 22.7 20.9 South Kalimantan 21.1 20.4 19.8 20.0 19.5 20.2 East Kalimantan 22.4 21.9 22.6 20.2 20.1 21.8 Sulawesi North Sulawesi 22.2 22.6 22.9 22.2 22.0 22.4 Central Sulawesi 21.1 21.9 21.3 20.8 19.9 21.0 South Sulawesi 24.7 23.1 21.8 21.1 21.4 22.6 Southeast Sulawesi 20.5 20.4 21.7 20.6 20.6 20.6 Gorontalo 21.7 22.2 21.2 21.1 22.4 21.7 Total 21.9 21.6 20.9 20.2 20.1 21.0 a Omitted because less than 50 percent of the women had a birth before reaching the beginning of the age group Appendix A | 215 Table A.4.4 Teenage pregnancy and motherhood by province Percentage of women age 15-19 who are mothers or pregnant with their first child, by province, Indonesia 2002-2003 Percentage who are: Province Mothers Pregnant with first child Percentage who have begun childbearing Number of women Sumatera North Sumatera 3.5 0.7 4.2 592 West Sumatera 5.9 1.9 7.9 201 Riau 7.3 1.1 8.5 146 Jambi 11.3 6.3 17.6 70 South Sumatera 3.5 1.9 5.5 231 Bengkulu 10.2 3.6 13.8 41 Lampung 6.8 1.7 8.4 182 Bangka-Belitung 4.7 1.1 5.8 37 Java DKI Jakarta 4.4 0.9 5.3 278 West Java 12.6 2.1 14.7 1,154 Central Java 7.6 1.5 9.1 900 DI Yogyakarta 3.8 2.1 5.9 96 East Java 7.7 3.2 10.9 1,039 Banten 7.3 1.9 9.2 356 Bali and Nusa Tenggara Bali 4.0 2.5 6.5 73 West Nusa Tenggara 10.4 1.8 12.1 161 East Nusa Tenggara 8.0 2.6 10.6 121 Kalimantan West Kalimantan 7.8 1.5 9.3 94 Central Kalimantan 16.9 1.7 18.6 63 South Kalimantan 9.1 3.4 12.5 99 East Kalimantan 10.4 3.6 14.0 110 Sulawesi North Sulawesi 6.2 3.8 10.0 50 Central Sulawesi 13.2 2.1 15.2 73 South Sulawesi 12.9 0.7 13.6 317 Southeast Sulawesi 12.5 1.5 14.0 58 Gorontalo 10.9 5.3 16.2 26 Total 8.3 2.0 10.4 6,531 216 | Appendix A CHAPTER 5 KNOWLEDGE AND EVER USE OF FAMILY PLANNING Table A.5.1 Knowledge of contraceptive methods by province Percentage of currently married women and percentage of currently married men who know at least one contraceptive method and who know at least one modern method by province, Indonesia 2002-2003 Women Men Province Knows any method Knows any modern method1 Number Knows any method Knows any modern method1 Number Sumatera North Sumatera 95.2 94.6 2,071 95.7 93.3 663 West Sumatera 97.3 97.1 668 95.8 95.6 182 Riau 99.2 99.2 636 96.4 96.4 199 Jambi 99.2 99.2 353 97.0 96.8 114 South Sumatera 99.9 99.9 772 98.1 98.1 259 Bengkulu 99.8 99.8 150 97.9 97.9 44 Lampung 99.7 99.7 946 99.3 99.3 261 Bangka-Belitung 97.6 97.6 122 97.5 97.1 40 Java DKI Jakarta 99.8 99.8 919 100.0 100.0 310 West Java 99.6 99.6 5,539 98.7 98.5 1,614 Central Java 99.0 98.9 4,031 95.7 95.7 1,155 DI Yogyakarta 99.8 99.8 350 97.5 97.2 103 East Java 99.1 99.1 5,034 96.9 96.9 1,560 Banten 98.4 98.4 1,301 95.9 95.9 396 Bali and Nusa Tenggara Bali 98.9 98.9 446 97.3 97.3 138 West Nusa Tenggara 99.6 99.5 518 96.5 95.9 145 East Nusa Tenggara 90.6 89.6 427 92.3 88.2 122 Kalimantan West Kalimantan 98.0 97.7 445 96.2 96.2 119 Central Kalimantan 100.0 100.0 291 99.0 99.0 97 South Kalimantan 99.9 99.9 437 94.0 94.0 109 East Kalimantan 99.6 99.3 430 93.0 91.7 115 Sulawesi North Sulawesi 99.4 99.4 298 98.7 98.7 95 Central Sulawesi 98.1 97.7 329 95.4 95.4 114 South Sulawesi 96.5 96.2 961 89.6 88.9 237 Southeast Sulawesi 95.3 94.9 239 94.1 91.0 77 Gorontalo 99.2 99.2 143 84.7 83.7 41 Total 98.7 98.5 27,857 96.7 96.3 8,310 1 Female sterilization, male sterilization, pill, IUD, injectables, implants, male condom, diaphragm, and lactational amenorrhea method (LAM) Appendix A | 217 Table A.5.2 Exposure to family planning messages by province Percentage of ever-married women who heard or saw a family planning message on the radio or television, or in a newspaper/magazine, poster or pamphlet in the past few months, according to province, Indonesia 2002-2003 Print media Province Radio Television Newspaper/ magazine Poster Pamphlet None of the specified media sources Number Sumatera North Sumatera 14.7 39.1 11.8 14.9 13.7 56.1 2,177 West Sumatera 17.6 42.5 20.8 18.6 7.3 53.2 705 Riau 11.8 33.9 12.7 9.1 3.6 60.4 660 Jambi 12.8 31.0 9.0 5.5 3.0 64.4 382 South Sumatera 12.3 33.4 10.5 5.0 2.0 62.0 809 Bengkulu 20.0 50.7 14.0 24.5 11.2 42.5 159 Lampung 17.9 50.9 8.9 11.3 6.0 44.9 984 Bangka-Belitung 13.8 31.2 12.3 5.1 3.0 66.4 128 Java DKI Jakarta 15.2 47.6 27.7 20.6 6.0 41.7 1,024 West Java 21.9 64.2 13.1 14.3 7.3 33.5 5,797 Central Java 23.4 38.4 7.7 8.0 2.7 57.7 4,234 DI Yogyakarta 21.8 38.9 16.8 16.3 7.5 50.1 367 East Java 13.8 46.9 14.4 12.9 4.9 50.2 5,367 Banten 22.8 59.7 23.1 15.4 8.7 37.5 1,396 Bali and Nusa Tenggara Bali 22.7 60.0 17.1 10.7 4.2 37.9 465 West Nusa Tenggara 21.6 36.6 6.9 8.8 4.6 56.1 583 East Nusa Tenggara 13.7 12.2 10.4 3.6 1.9 77.6 460 Kalimantan West Kalimantan 13.9 37.9 12.5 11.8 5.1 58.1 477 Central Kalimantan 38.7 64.8 8.8 8.4 0.8 27.0 297 South Kalimantan 20.7 50.1 10.7 9.0 5.7 46.2 470 East Kalimantan 14.3 64.5 19.5 14.3 9.4 31.6 447 Sulawesi North Sulawesi 27.3 58.2 28.2 12.4 9.9 37.3 310 Central Sulawesi 23.1 55.4 17.4 8.5 3.8 42.3 347 South Sulawesi 21.3 43.8 13.6 9.2 2.6 53.8 1,033 Southeast Sulawesi 24.7 32.3 8.9 1.4 0.8 59.9 251 Gorontalo 39.6 53.5 20.4 17.6 13.7 38.3 153 Total 19.0 48.0 13.5 12.1 5.9 48.0 29,483 218 | Appendix A Table A.5.3 Exposure to family planning messages through personal contact by province Percentage of ever-married women who received (heard or saw) a family planning message as a result of contact with specific persons in the past six months, according to background characteristics, Indonesia 2002-2003 Province Family planning officer Teacher Religious leader Doctor Nurse/ midwife Village leader Women's group Pharma- cist Number of women Sumatera North Sumatera 1.9 0.1 0.6 2.8 8.3 0.6 0.7 0.1 2,177 West Sumatera 5.5 1.1 1.4 3.4 10.2 1.3 2.6 0.5 705 Riau 4.0 0.7 2.1 4.2 9.7 1.3 2.9 0.0 660 Jambi 5.6 1.0 1.2 2.7 10.2 3.4 6.3 0.6 382 South Sumatera 3.5 0.3 2.6 2.4 18.0 0.6 2.9 0.3 809 Bengkulu 13.7 0.9 3.1 4.8 22.0 5.9 5.8 0.1 159 Lampung 6.1 0.3 0.7 2.6 14.2 0.6 2.5 0.0 984 Bangka-Belitung 7.2 0.3 1.0 4.0 10.8 0.8 1.6 0.1 128 Java DKI Jakarta 3.5 0.1 0.7 5.4 13.6 0.2 1.2 0.4 1,024 West Java 6.6 0.7 3.3 3.1 9.8 1.5 4.3 0.4 5,797 Central Java 4.6 0.5 0.9 2.4 8.0 2.5 7.4 0.2 4,234 DI Yogyakarta 8.8 0.0 2.1 2.9 13.3 4.0 9.1 0.1 367 East Java 6.2 0.8 1.6 4.4 12.2 1.7 5.7 0.2 5,367 Banten 7.6 0.5 0.3 4.4 10.8 1.6 1.9 0.2 1,396 Bali and Nusa Tenggara Bali 7.5 0.2 0.1 1.9 9.4 0.1 0.5 0.2 465 West Nusa Tenggara 8.3 0.2 1.3 2.0 11.0 2.2 2.3 0.0 583 East Nusa Tenggara 7.1 0.3 1.4 1.9 17.4 1.5 0.7 0.0 460 Kalimantan West Kalimantan 8.4 0.4 1.4 4.0 11.1 0.8 1.5 0.4 477 Central Kalimantan 8.0 0.3 0.3 0.4 10.3 0.7 0.9 0.0 297 South Kalimantan 4.9 0.5 2.1 2.4 12.0 3.2 3.1 0.0 470 East Kalimantan 7.4 0.5 1.6 4.5 12.8 0.8 1.8 0.4 447 Sulawesi North Sulawesi 8.7 1.0 8.6 8.6 12.0 12.3 10.5 0.4 310 Central Sulawesi 11.8 0.1 1.3 4.3 18.3 2.1 2.2 0.2 347 South Sulawesi 5.0 0.6 1.2 4.0 8.6 1.0 1.3 0.1 1,033 Southeast Sulawesi 14.7 0.3 0.8 2.7 16.6 1.9 3.8 0.1 251 Gorontalo 21.9 1.0 2.7 4.2 17.7 5.7 7.4 0.3 153 Total 6.0 0.5 1.7 3.4 11.0 1.7 4.1 0.2 29,483 Appendix A | 219 Table A.5.4 Contact of nonusers with family planning providers by province Percentage of women who are not using contraception who were visited by a fieldworker who discussed family planning, who visited a health facility and discussed family planning, and who visited a health facility but did not discuss family planning, in the 12 months preceding the survey, by province Indonesia 2002-2003 Women who visited a health facility Province Women who were visited by fieldworker who discussed family Discussed family planning Did not discuss family planning Women who did not discuss family planning with a fieldworker or at a health facility Number of women Sumatera North Sumatera 1.7 1.4 20.5 97.0 1,087 West Sumatera 6.3 6.8 38.9 88.1 352 Riau 4.1 4.1 24.7 92.1 290 Jambi 4.4 3.5 10.8 93.5 172 South Sumatera 2.9 3.7 18.7 94.9 335 Bengkulu 9.1 10.1 30.1 85.1 56 Lampung 4.4 6.4 26.5 92.0 401 Bangka-Belitung 2.0 3.5 18.1 95.1 48 Java DKI Jakarta 2.6 3.3 22.0 94.5 436 West Java 4.9 4.0 17.2 92.8 2,509 Central Java 2.8 2.8 25.4 95.2 1,597 DI Yogyakarta 3.8 10.8 42.1 86.5 100 East Java 2.3 3.1 23.9 95.5 1,987 Banten 4.0 3.8 19.6 93.6 627 Bali and Nusa Tenggara Bali 9.4 5.3 29.4 89.7 191 West Nusa Tenggara 4.8 8.9 31.4 88.1 306 East Nusa Tenggara 6.8 11.8 32.0 85.6 312 Kalimantan West Kalimantan 3.2 4.1 17.1 93.7 219 Central Kalimantan 3.3 2.7 7.0 94.4 111 South Kalimantan 3.4 4.6 14.3 93.1 218 East Kalimantan 6.3 5.1 31.2 89.4 205 Sulawesi North Sulawesi 5.3 4.4 20.7 92.3 100 Central Sulawesi 7.0 10.0 21.4 86.3 167 South Sulawesi 4.8 2.4 16.0 93.5 560 Southeast Sulawesi 8.0 8.7 18.6 87.5 134 Gorontalo 13.2 14.3 13.6 78.0 78 Total 4.0 4.1 22.2 93.2 12,600 220 | Appendix A Table A.5.5 Discussion of family planning between husband and wife by province Percent distribution of currently married women who know a contraceptive method by the number of times they discussed family planning with their husband in the past year, and percentage of currently married men who know a contraceptive method who discussed family planning with their wife in the past year, according to province, Indonesia 2002-2003 Number of times woman discussed family planning with hustand Province Never One or two times Three or more times Missing Total Number of women Men who discussed family planning with wife Number of men Sumatera North Sumatera 44.0 43.8 11.0 1.2 100.0 1,972 41.9 635 West Sumatera 37.7 47.5 14.6 0.1 100.0 650 38.0 174 Riau 36.2 50.8 11.3 1.6 100.0 631 46.7 192 Jambi 35.1 55.9 8.7 0.3 100.0 350 33.0 111 South Sumatera 25.0 59.4 14.3 1.4 100.0 771 52.5 254 Bengkulu 27.9 60.2 11.5 0.5 100.0 150 67.6 44 Lampung 35.1 42.9 21.8 0.3 100.0 943 42.0 259 Bangka-Belitung 36.8 44.8 17.1 1.3 100.0 120 30.5 39 Java DKI Jakarta 35.1 58.7 6.1 0.1 100.0 918 59.9 310 West Java 42.0 48.5 8.0 1.5 100.0 5,517 54.9 1,593 Central Java 61.7 33.6 4.4 0.3 100.0 3,989 35.6 1,105 DI Yogyakarta 41.6 49.7 8.7 0.1 100.0 349 45.3 101 East Java 45.7 44.5 8.6 1.1 100.0 4,991 37.5 1,511 Banten 29.0 50.8 19.2 1.0 100.0 1,280 53.1 380 Bali and Nusa Tenggara Bali 37.2 57.0 5.2 0.7 100.0 441 58.3 134 West Nusa Tenggara 40.8 53.3 5.8 0.1 100.0 516 58.9 140 East Nusa Tenggara 33.5 49.8 16.0 0.7 100.0 387 58.8 113 Kalimantan West Kalimantan 44.8 47.4 7.5 0.3 100.0 436 39.8 115 Central Kalimantan 24.0 64.8 9.4 1.7 100.0 291 72.9 96 South Kalimantan 29.0 57.6 13.3 0.1 100.0 437 45.3 103 East Kalimantan 38.7 42.4 17.9 1.0 100.0 428 51.6 107 Sulawesi North Sulawesi 21.9 49.6 25.8 2.8 100.0 296 62.9 94 Central Sulawesi 34.0 51.1 13.2 1.7 100.0 323 53.9 108 South Sulawesi 45.7 45.6 8.3 0.5 100.0 927 42.5 212 Southeast Sulawesi 32.8 54.2 12.6 0.4 100.0 228 57.0 73 Gorontalo 22.1 49.3 27.6 1.0 100.0 142 54.1 34 Total 42.7 46.5 9.9 0.9 100.0 27,483 46.3 8,036 Appendix A | 221 CHAPTER 6 CURRENT USE OF FAMILY PLANNING Table A.6.1 Current use of contraception by province Percent distribution of currently married women by contraceptive method currently used, according to province, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Modern method Traditional method ––––––––––––––––––––––––––––––––––––––––––––––––––––––––– ––––––––––––––––––––––– Using Female Any Any any Any steri- Male In- Male tradi- Periodic folk Not Number meth- modern liza- steri- ject- Im- con- tional absti- With- meth- currently of Province od method tion lization Pill IUD ables plants dom LAM method nence drawal od using Total women –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 52.5 43.2 6.4 0.3 13.1 3.3 15.9 2.5 1.6 0.1 9.4 3.2 5.4 0.8 47.5 100.0 2,071 West Sumatera 52.9 46.2 3.4 0.0 9.1 6.1 22.1 4.6 0.8 0.2 6.7 2.8 3.7 0.2 47.1 100.0 668 Riau 57.8 55.7 1.3 0.0 17.6 2.6 30.2 2.6 1.3 0.0 2.1 1.0 0.9 0.2 42.2 100.0 636 Jambi 59.0 57.9 0.9 0.1 15.4 4.6 28.7 7.5 0.7 0.0 1.1 0.4 0.4 0.4 41.0 100.0 353 South Sumatera 61.4 58.6 4.6 0.1 9.9 2.4 30.2 10.9 0.5 0.0 2.8 1.9 0.6 0.3 38.6 100.0 772 Bengkulu 68.2 64.0 3.5 0.1 13.0 6.3 30.4 8.9 1.7 0.1 4.2 1.5 2.4 0.3 31.8 100.0 150 Lampung 61.4 58.9 1.8 0.3 13.6 4.2 31.1 7.6 0.1 0.1 2.6 1.1 0.8 0.6 38.6 100.0 946 Bangka-Belitung 65.1 63.3 2.1 0.0 27.1 1.6 26.9 4.3 1.3 0.0 1.9 1.3 0.4 0.2 34.9 100.0 122 Java DKI Jakarta 63.2 57.4 2.8 0.1 12.6 10.0 27.5 1.4 3.1 0.0 5.8 3.5 1.4 0.9 36.8 100.0 919 West Java 59.0 57.5 2.3 1.0 15.8 3.6 32.6 1.7 0.4 0.0 1.5 0.7 0.8 0.0 41.0 100.0 5,539 Central Java 65.0 62.2 5.3 0.8 8.8 6.1 32.5 7.2 1.2 0.4 2.8 1.5 1.2 0.0 35.0 100.0 4,031 DI Yogyakarta 75.6 63.2 6.1 0.4 7.6 19.3 22.8 3.2 3.6 0.1 12.5 6.3 5.3 0.9 24.4 100.0 350 East Java 67.0 63.2 6.0 0.2 13.2 10.9 26.7 5.3 0.8 0.2 3.8 1.7 1.1 1.0 33.0 100.0 5,034 Banten 58.6 57.3 1.7 0.9 11.0 5.0 34.7 2.8 1.1 0.1 1.2 1.1 0.2 0.0 41.4 100.0 1,301 Bali and Nusa Tenggara Bali 61.2 58.9 4.5 0.2 3.4 26.4 22.0 0.5 1.8 0.0 2.4 1.3 0.9 0.1 38.8 100.0 446 West Nusa Tenggara 53.5 52.5 1.6 0.0 10.9 4.3 28.7 6.9 0.0 0.1 1.0 0.2 0.1 0.6 46.5 100.0 518 East Nusa Tenggara 34.8 27.5 1.6 0.4 3.2 5.4 14.8 1.8 0.1 0.2 7.3 3.7 0.8 2.8 65.2 100.0 427 Kalimantan West Kalimantan 57.8 55.7 1.0 0.3 15.5 2.6 30.8 5.1 0.4 0.0 2.1 0.6 0.8 0.6 42.2 100.0 445 Central Kalimantan 63.9 62.9 0.4 0.0 33.4 0.5 26.0 2.3 0.3 0.0 1.0 0.7 0.0 0.3 36.1 100.0 291 South Kalimantan 57.6 56.2 1.5 0.2 26.7 1.4 23.3 2.7 0.4 0.1 1.4 0.2 0.2 1.0 42.4 100.0 437 East Kalimantan 56.2 52.3 3.2 0.5 19.5 5.5 21.8 1.4 0.3 0.2 3.8 1.6 0.8 1.4 43.8 100.0 430 Sulawesi North Sulawesi 70.1 66.4 2.3 0.0 19.9 12.2 23.7 8.3 0.0 0.0 3.7 2.2 1.1 0.4 29.9 100.0 298 Central Sulawesi 54.6 49.8 2.9 0.0 19.2 4.9 17.2 5.6 0.0 0.1 4.8 1.7 1.5 1.6 45.4 100.0 329 South Sulawesi 49.1 42.4 1.7 0.0 13.5 1.2 23.1 2.8 0.1 0.1 6.6 1.1 4.5 1.1 50.9 100.0 961 Southeast Sulawesi 48.6 40.9 1.8 0.0 10.8 1.3 21.7 4.9 0.3 0.0 7.7 2.3 4.9 0.5 51.4 100.0 239 Gorontalo 52.0 48.2 0.6 0.0 17.1 5.6 15.6 9.1 0.1 0.2 3.8 3.2 0.0 0.6 48.0 100.0 143 Total 60.3 56.7 3.7 0.4 13.2 6.2 27.8 4.3 0.9 0.1 3.6 1.6 1.5 0.5 39.7 100.0 27,857 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: If more than one method is used, only the most effective method is considered in this tabulation. LAM = Lactational amenorrhea method 222 | Appendix A Table A.6.2 Pill use compliance by province Percentage of currently married women using the pill, percent distribution of pill users by type of pill, and by whether pill users could show a pill packet, and percentage of pill users who took a pill less than two days ago, according to province, Indonesia 2002-2003 Percentage of pill users who: Type of pill (packet seen) Province Percentage of currently married women using the pill Currently married women Combi- nation Single Other Packet not seen/ missing Took pill in order Took pill <2 days ago Number of pill users Sumatera North Sumatera 13.1 2,071 76.9 16.1 3.4 3.6 89.4 89.4 271 West Sumatera 9.1 668 80.8 5.5 1.1 12.6 84.3 85.1 61 Riau 17.6 636 78.1 7.4 2.6 11.8 83.1 90.2 112 Jambi 15.4 353 46.2 20.0 11.7 22.1 74.0 90.8 54 South Sumatera 9.9 772 66.1 28.3 0.0 5.6 90.9 91.2 77 Bengkulu 13.0 150 62.2 17.8 8.6 11.4 82.2 78.3 19 Lampung 13.6 946 81.3 5.9 1.5 11.3 83.5 82.0 129 Bangka-Belitung 27.1 122 80.7 2.0 13.1 4.2 87.1 86.6 33 Java DKI Jakarta 12.6 919 69.2 22.4 1.0 7.5 86.9 90.0 116 West Java 15.8 5,539 70.9 10.8 5.3 13.0 80.5 88.3 877 Central Java 8.8 4,031 66.5 9.1 18.4 6.1 86.5 83.4 354 DI Yogyakarta 7.6 350 81.4 2.5 6.2 9.8 87.2 93.6 27 East Java 13.2 5,034 57.7 6.2 20.5 15.5 75.8 83.2 663 Banten 11.0 1,301 53.1 21.0 20.5 5.4 78.1 85.7 143 Bali and Nusa Tenggara Bali 3.4 446 31.4 53.0 10.8 4.8 95.2 86.7 15 West Nusa Tenggara 10.9 518 81.9 3.3 8.5 6.2 87.8 89.2 57 East Nusa Tenggara 3.2 427 59.4 28.2 6.4 6.0 89.0 83.0 14 Kalimantan West Kalimantan 15.5 445 76.7 6.5 7.2 9.5 85.8 90.6 69 Central Kalimantan 33.4 291 80.4 5.1 2.5 12.0 87.2 90.9 97 South Kalimantan 26.7 437 80.2 6.2 5.8 7.8 91.4 90.4 117 East Kalimantan 19.5 430 75.0 14.0 0.8 10.1 79.1 85.9 84 Sulawesi North Sulawesi 19.9 298 79.6 5.9 7.2 7.4 89.1 94.0 59 Central Sulawesi 19.2 329 67.4 19.2 1.5 11.9 85.3 87.6 63 South Sulawesi 13.5 961 83.6 5.7 6.1 4.6 90.2 95.1 130 Southeast Sulawesi 10.8 239 49.9 34.9 5.0 10.1 86.8 88.2 26 Gorontalo 17.1 143 63.0 21.1 13.3 2.6 91.0 90.5 24 Total 13.2 27,857 69.2 10.9 9.4 10.4 82.9 87.2 3,691 Appendix A | 223 Table A.6.3 Informed choice by province Among current users of specific modern contraceptive methods who adopted the method in the five years preceding the survey, percentage of women who were sterilized in the five years preceding the survey who were informed that they would not be able to have any more children, percentage who were informed about the side effects of the current method used, percentage who were informed what to do if side effects were experienced, and percentage who were informed of other methods that could be used for contraception, by province, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Type of information –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Informed Informed Informed of Informed about side effects what to do other methods that or problems of if experienced that could sterilization is Province method used side effects1 be used2 permanent3 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 28.6 23.0 34.4 81.5 West Sumatera 33.2 26.6 40.7 80.2 Riau 24.2 18.3 33.1 96.1 Jambi 22.2 17.2 32.8 100.0 South Sumatera 38.0 32.9 47.6 93.5 Bengkulu 23.9 22.0 33.5 89.3 Lampung 23.2 22.1 30.2 84.1 Bangka-Belitung 17.2 15.9 24.8 78.4 Java DKI Jakarta 42.5 36.1 42.3 91.5 West Java 18.0 13.8 23.8 96.9 Central Java 17.0 12.6 18.2 69.6 DI Yogyakarta 29.2 26.9 35.0 82.3 East Java 23.2 22.3 21.5 81.7 Banten 16.9 15.7 37.8 95.0 Bali and Nusa Tenggara Bali 23.6 21.9 27.5 81.1 West Nusa Tenggara 34.1 31.2 35.3 90.6 East Nusa Tenggara 39.0 36.7 44.0 80.5 Kalimantan West Kalimantan 18.0 14.1 24.8 65.7 Central Kalimantan 44.5 41.2 46.9 100.0 South Kalimantan 27.5 25.3 30.1 80.8 East Kalimantan 27.0 24.7 36.8 90.0 Sulawesi North Sulawesi 23.9 18.7 35.1 81.6 Central Sulawesi 26.8 22.7 34.3 88.1 South Sulawesi 18.5 20.1 23.2 85.8 Southeast Sulawesi 27.5 27.5 35.3 97.2 Gorontalo 24.2 21.5 34.5 100.0 Total 23.1 19.9 27.4 82.7 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1 Among users of female sterilization, pill, IUD, injectables and implants 2 Among users of female sterilization, pill, IUD, injectables, implants, diaphragm, and lactational amenorrhea method (LAM) 3 Sterilized women who were told that they would not be able to have any more children 224 | Appendix A Table A.6.4 Payment for contraceptive method and services by province Percent distribution of current users of modern contraceptive methods by type of payment, by source of method, according to province, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Government Private Other Number –––––––––––– –––––––––––– –––––––––––– of Province Free Pay Free Pay Free Pay Total women ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– North Sumatera 11.2 16.9 3.0 65.9 0.7 2.2 100.0 894 West Sumatera 12.7 16.1 6.9 54.5 4.4 5.4 100.0 308 Riau 3.6 29.0 2.4 54.5 1.2 9.1 100.0 356 Jambi 7.6 34.5 2.4 45.6 4.9 4.7 100.0 206 South Sumatera 4.8 22.8 2.5 64.4 1.7 3.6 100.0 453 Bengkulu 10.9 15.2 3.4 51.7 1.6 17.2 100.0 96 Lampung 3.7 17.9 2.5 67.8 0.6 7.2 100.0 557 Bangka-Belitung 3.4 16.0 1.8 65.1 1.1 12.7 100.0 78 Java DKI Jakarta 4.2 12.8 3.8 76.7 1.0 1.5 100.0 535 West Java 3.6 15.3 2.9 70.0 0.3 7.8 100.0 3,205 Central Java 8.0 19.8 2.7 60.7 1.5 7.3 100.0 2,509 DI Yogyakarta 16.8 22.9 2.0 49.7 3.7 4.7 100.0 222 East Java 7.3 23.2 4.5 54.4 1.9 8.7 100.0 3,180 Banten 4.4 11.9 2.3 74.1 0.9 6.0 100.0 751 Bali and Nusa Tenggara Bali 7.8 25.2 4.4 60.8 0.5 1.3 100.0 264 West Nusa Tenggara 9.5 32.8 1.9 32.2 3.4 19.5 100.0 272 East Nusa Tenggara 30.8 45.2 1.2 9.0 8.4 5.4 100.0 117 Kalimantan West Kalimantan 4.8 33.1 0.6 42.7 1.5 17.0 100.0 249 Central Kalimantan 2.6 25.4 4.3 37.1 2.6 27.8 100.0 184 South Kalimantan 5.0 20.3 1.9 45.9 2.0 24.9 100.0 246 East Kalimantan 5.1 26.3 8.7 46.4 2.1 11.4 100.0 225 Sulawesi North Sulawesi 9.0 24.0 5.4 55.6 1.0 4.9 100.0 199 Central Sulawesi 11.7 35.3 2.5 33.5 1.3 15.6 100.0 164 South Sulawesi 5.4 55.6 1.4 30.8 0.2 6.7 100.0 408 Southeast Sulawesi 10.7 22.7 4.0 33.6 7.9 21.1 100.0 98 Gorontalo 9.0 34.9 2.3 34.4 1.9 17.6 100.0 69 Total 6.7 21.2 3.2 59.2 1.5 8.0 100.0 15,843 Appendix A | 225 CHAPTER 7 FERTILITY PREFERENCES Table A.7.1 Desire to limit childbearing by province Percentage of currently married women who want no more children, by number of living children and province, Indonesia 2002-2003 Number of living children1 Province 0 1 2 3 4 5 6+ Total Sumatera North Sumatera 0.0 11.0 44.3 75.6 87.8 89.4 91.9 58.1 West Sumatera 0.0 7.7 37.1 59.5 86.0 83.0 88.4 49.4 Riau 2.9 7.3 37.8 65.4 85.8 79.0 84.8 47.6 Jambi 2.7 7.4 53.2 75.1 90.4 82.6 89.9 49.7 South Sumatera 0.0 8.3 52.8 81.9 83.8 93.7 76.4 58.1 Bengkulu 0.0 6.4 50.5 76.7 93.4 88.0 93.2 58.6 Lampung 0.0 6.6 47.5 77.6 94.6 94.7 89.3 54.9 Bangka-Belitung 3.7 10.3 53.0 75.4 86.5 90.7 78.3 53.6 Java DKI Jakarta 3.2 10.7 65.3 86.6 92.0 97.7 90.3 53.8 West Java 5.8 10.5 52.5 78.0 93.0 91.4 89.8 54.5 Central Java 1.2 9.3 65.0 90.4 94.5 100.0 96.1 57.5 DI Yogyakarta 9.3 17.6 85.8 94.4 97.2 92.2 84.9 65.4 East Java 3.6 17.3 78.6 90.9 96.0 98.9 100.0 58.7 Banten 3.3 9.4 43.6 70.5 83.9 86.9 90.2 48.0 Bali and Nusa Tenggara Bali 2.6 24.2 80.2 92.7 85.5 94.5 86.1 64.3 West Nusa Tenggara 0.6 5.0 32.4 58.9 81.6 80.0 89.5 39.3 East Nusa Tenggara 3.5 5.2 28.0 53.5 68.0 71.8 85.5 42.8 Kalimantan West Kalimantan 0.0 8.6 43.7 72.0 87.2 84.6 85.7 49.9 Central Kalimantan 4.5 8.4 38.3 83.5 91.8 91.6 90.5 48.9 South Kalimantan 2.2 13.6 41.4 67.0 80.6 62.7 93.9 44.5 East Kalimantan 0.0 8.9 48.7 77.0 93.6 97.9 90.7 49.9 Sulawesi North Sulawesi 2.2 11.4 71.6 81.8 88.5 93.8 88.5 54.9 Central Sulawesi 1.3 7.2 42.1 69.8 72.5 74.4 70.8 46.2 South Sulawesi 0.0 4.1 37.0 55.8 70.1 89.2 65.9 41.5 Southeast Sulawesi 0.0 2.2 26.7 55.3 73.3 86.7 92.0 41.5 Gorontalo 12.0 12.7 52.7 79.1 88.5 93.4 99.2 53.1 Total 2.8 11.3 58.4 79.4 88.9 90.4 89.2 54.2 Note: Women who have been sterilized are considered to want no more children. 1 Includes current pregnancy 226 | Appendix A Table A.7.2 Need for family planning by province Percentage of currently married women with unmet need for family planning, percentage of met need for family planning, and the total demand for family planning, by province, Indonesia 2002-2003 Unmet need for family planning1 Met need for family planning (currently using) 2 Total demand for family planning3 Province For spacing For limiting Total For spacing For limiting Total For spacing For limiting Total Percentage of demand satisfied Number of women Sumatera North Sumatera 6.0 7.0 13.0 15.9 36.7 52.5 22.4 43.9 66.2 80.4 2,071 West Sumatera 5.9 6.4 12.3 22.6 30.2 52.9 29.0 36.8 65.8 81.4 668 Riau 4.9 5.5 10.4 27.6 30.2 57.8 33.2 35.8 69.0 84.9 636 Jambi 3.2 2.9 6.1 24.7 34.4 59.0 28.3 37.3 65.6 90.7 353 South Sumatera 2.7 4.2 6.8 19.9 41.5 61.4 23.1 45.8 68.9 90.1 772 Bengkulu 3.5 4.4 8.0 24.7 43.5 68.2 28.9 48.5 77.4 89.7 150 Lampung 2.5 4.8 7.3 27.5 34.0 61.4 30.7 39.8 70.4 89.6 946 Bangka-Belitung 3.2 2.4 5.6 27.3 37.9 65.1 30.7 40.2 70.9 92.1 122 Java DKI Jakarta 3.4 3.4 6.9 25.9 37.3 63.2 29.8 41.2 71.0 90.3 919 West Java 3.8 6.1 9.9 25.5 33.5 59.0 29.8 39.8 69.7 85.9 5,539 Central Java 3.2 3.3 6.5 24.2 40.7 65.0 27.9 44.1 72.0 91.0 4,031 DI Yogyakarta 1.8 3.0 4.8 21.0 54.7 75.6 23.3 58.3 81.7 94.1 350 East Java 2.8 2.8 5.6 23.0 43.9 67.0 26.3 47.0 73.3 92.3 5,034 Banten 4.9 4.8 9.7 30.3 28.2 58.6 36.5 33.3 69.8 86.1 1,301 Bali and Nusa Tenggara Bali 4.1 2.8 6.9 12.9 48.4 61.2 17.7 51.2 68.9 90.1 446 West Nusa Tenggara 9.8 6.3 16.0 30.4 23.1 53.5 41.3 29.4 70.7 77.3 518 East Nusa Tenggara 8.8 7.9 16.7 16.4 18.4 34.8 25.7 26.3 52.0 68.0 427 Kalimantan West Kalimantan 4.8 5.3 10.1 27.0 30.8 57.8 32.5 36.1 68.6 85.3 445 Central Kalimantan 2.3 4.5 6.8 30.1 33.9 63.9 32.9 38.3 71.2 90.5 291 South Kalimantan 4.4 4.9 9.3 32.0 25.6 57.6 37.2 30.7 67.8 86.4 437 East Kalimantan 3.9 3.2 7.0 24.7 31.4 56.2 29.2 34.6 63.7 88.9 430 Sulawesi North Sulawesi 2.2 2.2 4.4 26.6 43.5 70.1 29.3 45.8 75.1 94.2 298 Central Sulawesi 5.2 5.0 10.2 24.5 30.1 54.6 30.6 35.6 66.2 84.7 329 South Sulawesi 6.9 4.9 11.8 27.3 21.8 49.1 34.6 26.9 61.5 80.8 961 Southeast Sulawesi 8.6 4.7 13.4 24.4 24.2 48.6 33.6 29.0 62.6 78.7 239 Gorontalo 4.0 7.0 11.0 22.6 29.5 52.0 27.3 36.9 64.1 82.8 143 Total 4.0 4.6 8.6 24.2 36.2 60.3 28.8 41.0 69.7 87.6 27,857 1 Unmet need for spacing includes pregnant women whose pregnancy was mistimed, amenorrheic women who are not using family planning and whose last birth was mistimed, and fecund women who are neither pregnant nor amenorrheic and who are not using any method of family planning and say they want to wait 2 or more years for their next birth. Also included in unmet need for spacing are fecund women who are not using any method of family planning and say they are unsure whether they want another child or who want another child but are unsure when to have the birth unless they say it would not be a problem if they discovered they were pregnant in the next few weeks. Unmet need for limiting refers to pregnant women whose pregnancy was unwanted, amenorrheic women whose last child was unwanted, and fecund 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 a better method of contraception). 2 Using 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. 3 Nonusers who are pregnant or amenorrheic and women whose pregnancy was the result of a contraceptive failure are not included in the category of unmet need, but are included in total demand for contraception (since they would have been using had their method not failed). Appendix A | 227 Table A.7.3 Mean ideal number of children by province Mean ideal number of children for all ever-married women, by age and province, Indonesia 2002-2003 Age Province 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Total Sumatera North Sumatera 3.5 3.0 3.0 3.3 3.7 3.9 3.9 3.5 West Sumatera 3.2 2.8 3.0 3.1 3.4 3.6 4.0 3.3 Riau 2.8 2.8 3.0 3.0 3.5 3.8 3.8 3.2 Jambi 2.5 2.6 2.7 2.7 2.9 3.6 3.7 2.9 South Sumatera 2.7 2.6 2.8 3.0 3.3 3.7 3.8 3.2 Bengkulu 2.6 2.5 2.8 2.9 3.3 3.5 4.2 3.1 Lampung 2.4 2.8 2.8 3.0 3.2 3.3 3.5 3.0 Bangka-Belitung 2.3 2.7 2.7 3.0 3.0 3.3 3.5 3.0 Java DKI Jakarta 2.4 2.4 2.5 2.6 2.6 2.9 3.1 2.6 West Java 2.6 2.5 2.7 2.8 3.0 3.5 3.5 2.9 Central Java 2.3 2.6 2.6 2.6 2.8 2.9 3.2 2.8 DI Yogyakarta 1.9 2.1 2.1 2.2 2.3 2.4 2.7 2.3 East Java 2.1 2.2 2.3 2.4 2.5 2.5 2.7 2.4 Banten 2.7 2.9 3.0 3.1 3.2 3.8 3.7 3.2 Bali and Nusa Tenggara Bali 1.9 2.2 2.3 2.4 2.4 2.6 2.9 2.5 West Nusa Tenggara 2.7 2.8 2.8 3.2 3.4 3.5 4.1 3.1 East Nusa Tenggara 3.4 3.7 3.7 3.7 3.8 3.7 4.7 3.8 Kalimantan West Kalimantan 2.3 2.7 2.9 3.3 3.2 3.6 3.4 3.1 Central Kalimantan 3.1 3.1 3.0 3.3 3.6 3.9 3.7 3.3 South Kalimantan 2.5 2.4 2.7 3.2 3.2 3.2 3.7 2.9 East Kalimantan 2.6 2.5 2.7 2.7 2.7 3.4 3.7 2.9 Sulawesi North Sulawesi 2.3 2.1 2.2 2.3 2.4 2.5 2.6 2.3 Central Sulawesi 2.1 2.3 2.6 2.7 3.0 3.3 3.5 2.8 South Sulawesi 2.5 2.8 3.0 3.0 3.5 3.8 4.0 3.2 Southeast Sulawesi 3.0 2.9 3.4 3.7 3.5 3.8 3.8 3.4 Gorontalo 2.0 2.3 2.6 2.7 3.0 3.3 3.0 2.8 Total 2.5 2.6 2.7 2.8 3.0 3.2 3.4 2.9 228 | Appendix A Table A.7.4 Wanted fertility rates by province Total wanted fertility rates and total fertility rates for the three years preceding the survey, by province, Indonesia 2002-2003 Province Total wanted fertility rate Total fertility rate Sumatera North Sumatera 2.6 3.0 West Sumatera 2.9 3.2 Riau 2.7 3.2 Jambi 2.4 2.7 South Sumatera 2.0 2.3 Bengkulu 2.5 3.0 Lampung 2.0 2.7 Bangka-Belitung 2.1 2.4 Java DKI Jakarta 2.0 2.2 West Java 2.4 2.8 Central Java 1.8 2.1 DI Yogyakarta 1.5 1.9 East Java 1.8 2.1 Banten 2.3 2.6 Bali and Nusa Tenggara Bali 1.9 2.1 West Nusa Tenggara 2.1 2.4 East Nusa Tenggara 3.5 4.1 Kalimantan West Kalimantan 2.4 2.9 Central Kalimantan 3.0 3.2 South Kalimantan 2.6 3.0 East Kalimantan 2.2 2.8 Sulawesi North Sulawesi 2.2 2.6 Central Sulawesi 2.5 3.2 South Sulawesi 2.2 2.6 Southeast Sulawesi 3.1 3.6 Gorontalo 2.3 2.8 Total 2.2 2.6 Note: Rates are calculated based on births to women age 15-49 in the period 1-36 months preceding the survey. The total fertility rates for Indonesia are the same as those presented in Table 4.2. Appendix A | 229 CHAPTER 9 OTHER PROXIMATE DETERMINANTS OF FERTILITY Table A.9.1 Current marital status by province Percent distribution of women by current marital status, according to province, Indonesia 2002-2003 Marital status Province Never married Married Divorced Widowed Total Number of women Sumatera North Sumatera 31.2 65.5 1.6 1.8 100.0 3,162 West Sumatera 30.7 65.6 1.3 2.4 100.0 1,018 Riau 25.7 71.7 0.9 1.7 100.0 888 Jambi 20.5 73.5 2.2 3.8 100.0 481 South Sumatera 30.1 66.7 1.1 2.1 100.0 1,157 Bengkulu 23.4 72.3 1.6 2.7 100.0 207 Lampung 22.2 74.8 1.2 1.8 100.0 1,264 Bangka-Belitung 32.1 65.1 1.2 1.6 100.0 188 Java DKI Jakarta 34.5 58.8 4.3 2.4 100.0 1,564 West Java 19.6 76.8 2.5 1.1 100.0 7,207 Central Java 24.0 72.3 1.8 1.9 100.0 5,573 DI Yogyakarta 32.0 64.9 1.9 1.2 100.0 539 East Java 21.3 73.8 2.6 2.3 100.0 6,823 Banten 25.8 69.2 2.5 2.6 100.0 1,880 Bali and Nusa Tenggara Bali 24.4 72.4 2.1 1.1 100.0 616 West Nusa Tenggara 25.5 66.1 5.9 2.5 100.0 783 East Nusa Tenggara 31.8 63.2 3.1 1.9 100.0 675 Kalimantan West Kalimantan 27.0 68.0 1.9 3.0 100.0 655 Central Kalimantan 20.2 78.3 0.8 0.8 100.0 372 South Kalimantan 23.0 71.6 2.8 2.6 100.0 611 East Kalimantan 27.6 69.5 0.9 2.0 100.0 618 Sulawesi North Sulawesi 21.4 75.6 2.0 1.0 100.0 394 Central Sulawesi 22.9 73.1 1.3 2.7 100.0 450 South Sulawesi 38.9 56.8 2.1 2.2 100.0 1,691 Southeast Sulawesi 21.2 75.1 1.6 2.0 100.0 318 Gorontalo 20.6 74.2 2.2 3.0 100.0 193 Total 25.0 70.8 2.2 1.9 100.0 39,327 230 | Appendix A Table A.9.2 Median age at first marriage by province Median age at first marriage among women age 25-49, by current age and province, Indonesia 2002-2003 Age Province 25-29 30-34 35-39 40-44 45-49 Women age 25-49 Sumatera North Sumatera 21.9 22.1 21.5 20.1 20.4 21.2 West Sumatera 23.2 22.0 20.7 19.9 19.1 20.9 Riau 21.0 20.6 19.7 18.4 17.8 19.8 Jambi 19.3 19.7 18.0 17.5 17.7 18.8 South Sumatera 20.0 19.6 18.4 19.1 18.3 19.0 Bengkulu 19.7 19.0 18.7 19.1 17.7 19.0 Lampung 19.4 18.9 17.7 17.4 16.5 18.0 Bangka-Belitung 20.7 19.9 19.0 19.7 20.6 19.9 Java DKI Jakarta 23.5 22.1 21.2 19.3 19.9 21.4 West Java 18.7 18.6 17.4 17.4 16.5 17.8 Central Java 20.2 19.5 18.3 18.4 17.4 18.8 DI Yogyakarta 22.8 22.4 20.6 20.2 19.6 21.1 East Java 20.1 20.1 18.9 17.7 17.1 18.8 Banten 19.7 18.8 18.4 16.0 16.9 18.3 Bali and Nusa Tenggara Bali 22.4 22.6 22.3 20.3 20.1 21.5 West Nusa Tenggara 19.7 18.4 18.6 18.4 18.2 18.7 East Nusa Tenggara 21.6 23.0 22.3 20.8 21.2 21.7 Kalimantan West Kalimantan 20.3 19.2 19.5 19.0 18.9 19.5 Central Kalimantan 19.3 19.4 19.4 18.8 20.2 19.4 South Kalimantan 19.4 18.5 17.5 17.4 16.5 18.0 East Kalimantan 20.7 20.0 21.1 17.9 18.0 19.8 Sulawesi North Sulawesi 21.4 21.9 21.8 21.4 20.9 21.5 Central Sulawesi 19.5 20.1 19.0 18.9 18.0 19.1 South Sulawesi 23.0 21.0 20.5 18.8 18.8 20.8 Southeast Sulawesi 19.0 19.5 19.6 18.9 18.9 19.2 Gorontalo 20.2 20.9 19.6 19.3 20.8 20.2 Total 20.2 19.9 18.9 18.3 17.9 19.2 Appendix A | 231 Table A.9.3 Recent sexual activity by province Percent distribution of currently married women by timing of last sexual intercourse, according to province, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Timing of last sexual intercourse –––––––––––––––––––––––––––––––––––––– Within One or Number Background the last Within more of characteristic 4 weeks 1 year1 years Missing Total women ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 86.6 10.7 0.9 1.8 100.0 2,071 West Sumatera 85.6 10.8 2.3 1.3 100.0 668 Riau 83.5 14.5 1.1 1.0 100.0 636 Jambi 83.3 14.6 1.8 0.4 100.0 353 South Sumatera 82.9 14.5 1.6 0.9 100.0 772 Bengkulu 85.3 11.9 1.3 1.5 100.0 150 Lampung 79.9 17.0 2.1 0.9 100.0 946 Bangka-Belitung 84.0 12.5 1.2 2.3 100.0 122 Java DKI Jakarta 86.5 11.8 0.7 0.9 100.0 919 West Java 81.2 15.0 2.2 1.6 100.0 5,539 Central Java 76.8 20.0 2.2 0.9 100.0 4,031 DI Yogyakarta 82.0 15.1 2.4 0.5 100.0 350 East Java 81.2 15.2 2.5 1.1 100.0 5,034 Banten 85.4 12.3 1.4 0.9 100.0 1,301 Bali and Nusa Tenggara Bali 83.4 13.6 1.8 1.2 100.0 446.0 West Nusa Tenggara 78.0 15.7 4.3 1.9 100.0 518.0 East Nusa Tenggara 76.8 16.3 4.4 2.5 100.0 427.0 Kalimantan West Kalimantan 80.3 15.9 2.3 1.5 100.0 445 Central Kalimantan 90.0 9.4 0.2 0.4 100.0 291 South Kalimantan 87.9 9.5 1.1 1.5 100.0 437 East Kalimantan 82.7 13.2 2.1 2.0 100.0 430 Sulawesi North Sulawesi 90.7 6.7 0.9 1.7 100.0 298 Central Sulawesi 83.7 14.1 1.3 0.9 100.0 329 South Sulawesi 83.4 13.5 1.3 1.8 100.0 961 Southeast Sulawesi 83.9 12.3 2.4 1.4 100.0 239 Gorontalo 83.5 12.9 2.3 1.2 100.0 143 Total 81.9 14.8 2.0 1.3 100.0 27,857 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1 Excludes women who had sexual intercourse within the last four weeks 232 | Appendix A Table A.9.4 Median duration of postpartum insusceptibility by province Median number of months of postpartum amenorrhea, postpartum abstinence, and postpartum insusceptibility following births in the three years preceding the survey, by province, Indonesia 2002-2003 Province Postpartum amenorrhea Postpartum abstinence Postpartum insusceptibility Number of births Sumatera North Sumatera 1.9 2.0 2.8 804 West Sumatera 2.9 2.2 3.8 279 Riau 3.6 2.3 4.1 273 Jambi 3.7 2.1 4.6 124 South Sumatera 4.5 2.0 7.1 218 Bengkulu 5.3 2.3 6.1 52 Lampung 3.7 2.9 4.1 311 Bangka-Belitung 2.2 1.5 2.2 42 Java DKI Jakarta 2.4 2.4 3.0 318 West Java 4.9 2.1 5.4 1,837 Central Java 3.7 2.7 4.2 1,047 DI Yogyakarta 3.2 2.3 3.8 86 East Java 2.7 2.3 4.0 1,229 Banten 5.5 2.0 5.9 436 Bali and Nusa Tenggara Bali 3.5 2.0 4.3 121 West Nusa Tenggara 4.1 3.2 5.6 183 East Nusa Tenggara 10.8 4.1 11.4 239 Kalimantan West Kalimantan 3.1 2.3 3.9 185 Central Kalimantan 3.3 2.0 3.9 117 South Kalimantan 3.9 2.0 4.5 160 East Kalimantan 6.5 1.9 6.6 162 Sulawesi North Sulawesi 3.3 1.9 3.4 97 Central Sulawesi 3.8 2.1 4.3 133 South Sulawesi 7.7 2.3 7.9 417 Southeast Sulawesi 4.3 2.1 4.8 114 Gorontalo 3.6 2.2 3.9 53 Total 3.8 2.2 4.6 9,037 Note: Medians are based on current status. Appendix A | 233 CHAPTER 10 INFANT AND CHILD MORTALITY Table A.10.1 Early childhood mortality rates by province Neonatal, postneonatal, infant, child, and under-five mortality rates for the 10-year period preceding the survey, by province, Indonesia 2002-2003 Province Neonatal mortality (NN) Postneonatal mortality (PNN)1 Infant mortality (1q0) Child mortality (4q1) Under-five mortality (5q0) Sumatera North Sumatera 24 18 42 16 57 West Sumatera 28 19 48 12 59 Riau 26 17 43 18 60 Jambi 14 28 41 10 51 South Sumatera 19 12 30 19 49 Bengkulu 27 25 53 17 68 Lampung 24 31 55 10 64 Bangka-Belitung 28 15 43 4 47 Java DKI Jakarta 18 17 35 6 41 West Java 25 19 44 6 50 Central Java 19 17 36 8 44 DI Yogyakarta 17 3 20 4 23 East Java 28 14 43 10 52 Banten 16 21 38 19 56 Bali and Nusa Tenggara Bali 9 5 14 5 19 West Nusa Tenggara 24 51 74 31 103 East Nusa Tenggara 31 28 59 15 73 Kalimantan West Kalimantan 24 23 47 17 63 Central Kalimantan 22 18 40 8 47 South Kalimantan 23 22 45 12 57 East Kalimantan 20 22 42 9 50 Sulawesi North Sulawesi 16 9 25 9 33 Central Sulawesi 24 28 52 20 71 South Sulawesi 12 35 47 26 72 Southeast Sulawesi 36 31 67 27 92 Gorontalo 24 54 77 21 97 1 Computed as the difference between the infant and neonatal mortality rates 234 | Appendix A CHAPTER 11 MATERNAL HEALTH Table A.11.1 Antenatal care by province Percent distribution of women who had a live birth in the five years preceding the survey by antenatal care (ANC) provider during pregnancy for the most recent birth, according to province, Indonesia 2002-2003 Province General practi- tioner Obstetrician/ Gyne- cologist Nurse/ midwife/ village midwife Traditional birth attendant/ other No one Missing Total Number of women Sumatera North Sumatera 1.4 8.4 75.9 5.0 8.7 0.5 100.0 1,012 West Sumatera 3.1 16.8 74.9 3.8 1.5 0.0 100.0 368 Riau 3.8 12.2 74.3 4.8 4.2 0.6 100.0 342 Jambi 2.2 7.7 72.3 13.7 4.0 0.1 100.0 168 South Sumatera 0.4 11.3 82.0 2.7 3.5 0.2 100.0 311 Bengkulu 0.5 9.8 81.6 3.4 4.8 0.0 100.0 76 Lampung 1.2 8.9 82.9 4.3 2.6 0.0 100.0 442 Bangka-Belitung 0.4 5.2 83.2 3.4 6.6 1.2 100.0 57 Java DKI Jakarta 1.2 19.9 77.7 0.6 0.6 0.0 100.0 436 West Java 1.3 5.2 87.1 2.1 4.1 0.2 100.0 2,705 Central Java 1.6 8.0 86.5 0.4 3.5 0.0 100.0 1,612 DI Yogyakarta 0.4 13.8 85.1 0.0 0.6 0.0 100.0 128 East Java 1.0 14.0 75.9 5.0 3.8 0.3 100.0 1,878 Banten 0.2 9.8 75.8 8.8 5.1 0.3 100.0 640 Bali and Nusa Tenggara Bali 0.7 25.1 71.9 0.8 1.3 0.2 100.0 171 West Nusa Tenggara 1.4 2.1 87.0 2.8 6.7 0.0 100.0 280 East Nusa Tenggara 2.2 1.4 84.1 4.4 7.8 0.2 100.0 275 Kalimantan West Kalimantan 1.0 8.9 72.9 7.1 9.5 0.6 100.0 247 Central Kalimantan 0.3 0.6 65.7 21.9 9.5 1.9 100.0 153 South Kalimantan 2.4 5.7 80.6 7.7 3.4 0.2 100.0 220 East Kalimantan 3.1 14.5 73.6 3.1 5.5 0.2 100.0 209 Sulawesi North Sulawesi 3.1 32.3 61.4 1.1 1.0 1.1 100.0 128 Central Sulawesi 1.0 9.0 72.4 10.2 7.2 0.2 100.0 171 South Sulawesi 1.2 8.4 84.7 2.3 3.0 0.4 100.0 521 Southeast Sulawesi 1.7 5.7 77.5 9.2 5.8 0.1 100.0 136 Gorontalo 4.2 7.8 75.9 5.7 6.2 0.3 100.0 75 Total 1.4 9.6 80.5 3.9 4.4 0.2 100.0 12,760 Note: If more than one source of ANC was mentioned, only the provider with the highest qualifications is considered in this tabulation. Appendix A | 235 Table A.11.2 Components of antenatal care by province Among women with a live birth in the five years preceding the survey who received antenatal care for the most recent birth, percentage who received specific antenatal care services, and percentage of women with a live birth in the five years preceding the survey who received iron tablets or syrup for the most recent birth, according to province, Indonesia 2002-2003 Components of care among women who received antenatal care Province Informed of signs of pregnancy complications Weight measured Height measured Blood pressure measured Urine sample taken Blood sample taken Abdominal exami- nation Number of women Received iron tablets Number of women Sumatera North Sumatera 26.1 66.8 10.2 75.0 34.6 14.5 95.6 918 59.1 1,012 West Sumatera 38.2 86.4 38.8 89.8 26.4 31.3 96.5 363 85.2 368 Riau 27.9 79.5 20.9 90.8 45.8 35.5 94.5 326 71.2 342 Jambi 25.4 81.2 20.7 78.2 31.4 21.8 93.5 161 59.4 168 South Sumatera 32.4 88.8 26.8 88.7 19.8 16.8 95.3 300 79.4 311 Bengkulu 34.3 84.5 21.1 91.8 23.6 11.9 97.9 73 84.6 76 Lampung 20.8 92.1 12.1 88.3 41.0 21.0 98.4 430 80.7 442 Bangka-Belitung 27.8 89.3 25.6 88.8 34.4 41.3 97.6 53 66.0 57 Java DKI Jakarta 34.8 99.2 51.8 97.7 78.8 70.5 99.6 433 91.3 436 West Java 15.6 95.2 23.3 93.0 33.1 24.8 91.0 2,591 76.4 2,705 Central Java 37.1 98.0 29.7 94.5 36.2 35.1 98.8 1,556 89.3 1,612 DI Yogyakarta 35.6 97.4 45.7 98.2 61.0 41.1 99.3 127 97.6 128 East Java 38.4 92.8 36.5 92.6 46.9 26.5 97.6 1,800 87.9 1,878 Banten 25.8 84.6 29.5 87.0 34.4 27.4 97.4 606 59.5 640 Bali and Nusa Tenggara Bali 18.8 99.0 41.2 95.0 41.6 22.8 98.2 169 88.5 171 West Nusa Tenggara 35.0 87.8 49.7 91.5 23.2 23.2 97.5 261 86.6 280 East Nusa Tenggara 33.8 86.6 39.5 83.2 19.1 47.3 93.0 253 77.8 275 Kalimantan West Kalimantan 35.7 84.0 38.6 86.5 36.9 43.7 90.7 222 66.4 247 Central Kalimantan 50.9 68.0 36.2 76.2 7.9 15.9 83.6 135 58.3 153 South Kalimantan 38.4 84.1 31.7 89.4 32.3 20.1 93.8 212 83.5 220 East Kalimantan 37.2 93.1 43.9 92.2 43.2 44.1 97.5 197 81.9 209 Sulawesi North Sulawesi 34.6 82.7 39.9 89.1 43.0 51.8 97.4 125 91.6 128 Central Sulawesi 31.3 80.6 29.7 77.2 26.1 29.7 92.1 158 65.1 171 South Sulawesi 14.9 92.8 65.9 90.8 54.6 59.4 96.4 504 73.0 521 Southeast Sulawesi 26.2 65.6 19.5 81.5 14.5 20.9 89.8 128 72.2 136 Gorontalo 30.3 82.7 51.9 84.9 19.9 31.7 80.3 70 77.8 75 Total 28.7 89.6 30.9 89.9 37.8 30.3 95.3 12,170 78.4 12,760 236 | Appendix A Table A.11.3 Tetanus toxoid injections by province Percent distribution of women who had a live birth in the five years preceding the survey by number of tetanus toxoid injections received during pregnancy for the most recent birth, according to province, Indonesia 2002-2003 Province None One injection Two or more injections Don't know/ missing Total Number of women Sumatera North Sumatera 63.6 12.1 21.0 3.4 100.0 1,012 West Sumatera 27.3 21.2 51.2 0.3 100.0 368 Riau 33.5 17.1 44.6 4.8 100.0 342 Jambi 36.9 21.2 41.3 0.6 100.0 168 South Sumatera 24.4 23.1 51.9 0.5 100.0 311 Bengkulu 19.9 18.2 61.7 0.3 100.0 76 Lampung 25.4 28.1 44.5 2.0 100.0 442 Bangka-Belitung 28.0 21.0 44.5 6.5 100.0 57 Java DKI Jakarta 23.0 26.3 49.3 1.4 100.0 436 West Java 24.5 20.0 54.0 1.5 100.0 2,705 Central Java 15.6 22.2 61.5 0.7 100.0 1,612 DI Yogyakarta 10.2 22.7 66.9 0.2 100.0 128 East Java 22.4 23.4 52.2 2.0 100.0 1,878 Banten 30.4 22.4 46.0 1.2 100.0 640 Bali and Nusa Tenggara Bali 18.1 24.3 55.6 2.1 100.0 171 West Nusa Tenggara 26.7 21.8 49.0 2.5 100.0 280 East Nusa Tenggara 14.8 19.5 63.7 1.9 100.0 275 Kalimantan West Kalimantan 31.9 11.2 55.8 1.1 100.0 247 Central Kalimantan 38.5 17.9 40.2 3.4 100.0 153 South Kalimantan 27.3 18.3 53.3 1.0 100.0 220 East Kalimantan 21.0 19.3 58.1 1.6 100.0 209 Sulawesi North Sulawesi 7.3 19.5 71.3 2.0 100.0 128 Central Sulawesi 24.3 18.0 55.6 2.0 100.0 171 South Sulawesi 12.9 38.9 47.1 1.0 100.0 521 Southeast Sulawesi 25.6 19.7 54.4 0.3 100.0 136 Gorontalo 22.9 31.2 44.6 1.3 100.0 75 Total 26.2 21.5 50.7 1.7 100.0 12,760 Appendix A | 237 Table A.11.4 Place of delivery by province Percent distribution of live births in the five years preceding the survey by place of delivery, according to province, Indonesia 2002-2003 Health facility Province Public sector Private sector Home Other Missing Total Number of births Sumatera North Sumatera 7.3 25.7 65.3 0.0 1.6 100.0 1,372 West Sumatera 14.2 44.5 40.6 0.7 0.1 100.0 464 Riau 8.3 29.1 59.8 0.7 2.1 100.0 430 Jambi 11.4 25.4 62.3 0.0 0.9 100.0 198 South Sumatera 7.9 30.1 61.6 0.0 0.4 100.0 382 Bengkulu 5.0 8.0 85.0 1.3 0.6 100.0 90 Lampung 6.8 34.8 58.1 0.0 0.3 100.0 530 Bangka-Belitung 5.7 27.3 64.9 0.0 2.2 100.0 69 Java DKI Jakarta 17.8 71.3 10.9 0.0 0.0 100.0 514 West Java 5.2 23.4 70.6 0.0 0.8 100.0 3,090 Central Java 8.0 32.6 59.1 0.0 0.2 100.0 1,784 DI Yogyakarta 18.7 52.3 27.2 1.8 0.0 100.0 144 East Java 10.1 50.4 38.1 0.4 0.9 100.0 2,101 Banten 4.6 37.7 56.8 0.1 0.9 100.0 736 Bali and Nusa Tenggara Bali 23.8 61.1 13.7 0.2 1.2 100.0 194 West Nusa Tenggara 21.8 5.6 64.2 7.9 0.4 100.0 327 East Nusa Tenggara 9.4 3.6 85.4 1.0 0.6 100.0 376 Kalimantan West Kalimantan 7.4 17.6 72.8 1.0 1.2 100.0 301 Central Kalimantan 1.4 1.6 94.2 0.0 2.9 100.0 178 South Kalimantan 5.9 3.1 90.2 0.1 0.6 100.0 251 East Kalimantan 12.7 32.3 53.3 0.0 1.7 100.0 260 Sulawesi North Sulawesi 16.9 31.7 48.7 0.5 2.1 100.0 153 Central Sulawesi 12.1 4.6 82.0 1.0 0.4 100.0 217 South Sulawesi 20.3 15.1 63.9 0.3 0.3 100.0 652 Southeast Sulawesi 3.6 2.5 93.0 0.0 0.8 100.0 183 Gorontalo 11.7 3.2 83.7 1.2 0.2 100.0 93 Total 9.2 30.5 59.0 0.4 0.8 100.0 15,089 1 Includes only the most recent birth in the five years preceding the survey 238 | Appendix A Table A.11.5 Assistance during delivery by province Percent distribution of live births in the five years preceding the survey by the most qualified person providing assistance during delivery, according to province, Indonesia 2002-2003 Province General practi- tioner Obstetrician/ Gyne- cologist Nurse/ midwife/ village midwife Traditional birth attendant/ other Relative/ other No one Missing Total Number of births Sumatera North Sumatera 0.4 6.7 72.8 15.4 2.5 0.6 1.6 100.0 1,372 West Sumatera 2.5 13.9 63.4 18.0 1.8 0.3 0.1 100.0 464 Riau 2.4 10.0 61.6 22.8 0.7 0.4 2.1 100.0 430 Jambi 0.7 8.9 60.9 28.3 0.3 0.0 0.9 100.0 198 South Sumatera 0.0 9.1 67.3 22.5 0.3 0.4 0.4 100.0 382 Bengkulu 1.3 5.9 61.4 29.5 1.0 0.3 0.6 100.0 90 Lampung 1.2 8.1 53.1 37.1 0.2 0.0 0.3 100.0 530 Bangka-Belitung 0.5 3.4 62.9 30.6 0.5 0.0 2.2 100.0 69 Java DKI Jakarta 0.3 25.3 68.7 5.7 0.1 0.0 0.0 100.0 514 West Java 0.3 6.5 41.9 50.4 0.2 0.0 0.8 100.0 3,090 Central Java 0.8 10.3 56.1 32.2 0.3 0.0 0.2 100.0 1,784 DI Yogyakarta 1.5 24.4 59.3 14.8 0.0 0.0 0.0 100.0 144 East Java 0.4 18.1 62.2 17.0 1.0 0.6 0.6 100.0 2,101 Banten 1.5 10.2 51.2 35.7 0.6 0.0 0.9 100.0 736 Bali and Nusa Tenggara Bali 1.7 25.3 60.8 9.6 1.6 0.2 0.8 100.0 194 West Nusa Tenggara 2.8 3.1 44.2 46.5 3.0 0.0 0.4 100.0 327 East Nusa Tenggara 0.5 1.8 34.1 54.9 6.9 1.3 0.5 100.0 376 Kalimantan West Kalimantan 1.3 5.4 57.0 33.3 1.8 0.0 1.2 100.0 301 Central Kalimantan 0.4 0.9 44.8 48.8 2.2 0.0 2.9 100.0 178 South Kalimantan 0.2 4.2 53.0 40.3 1.0 0.6 0.6 100.0 251 East Kalimantan 1.7 11.8 65.7 17.9 0.5 0.6 1.8 100.0 260 Sulawesi North Sulawesi 1.6 24.4 59.7 12.0 0.0 0.2 2.0 100.0 153 Central Sulawesi 0.9 6.8 46.3 41.4 4.1 0.0 0.5 100.0 217 South Sulawesi 0.2 6.5 55.5 31.2 5.7 0.5 0.3 100.0 652 Southeast Sulawesi 0.6 2.9 38.5 54.5 1.8 0.9 0.8 100.0 183 Gorontalo 0.6 5.2 43.0 50.6 0.4 0.0 0.2 100.0 93 Total 0.8 10.2 55.3 31.5 1.3 0.3 0.8 100.0 15,089 Note: If the respondent mentioned more than one person attending during delivery, only the most qualified person is considered in this tabulation. Appendix A | 239 Table A.11.6 Delivery characteristics by province Percentage of births in the five years preceding the survey delivered by caesarean section, and percent distribution by birth weight and by mother's estimate of baby's size at birth, according to province, Indonesia 2002-2003 Birth weight Size of child at birth Province Delivery by C-section Not weighed Less than 2.5 kg 2.5 kg or more Don't know/ missing Total Very small Smaller than average Average or larger Don't know/ missing Total Number of births Sumatera North Sumatera 4.0 31.2 3.1 63.5 2.1 100.0 2.6 8.2 83.5 5.6 100.0 1,372 West Sumatera 6.4 15.1 6.2 78.0 0.8 100.0 1.9 14.2 80.3 3.6 100.0 464 Riau 4.6 21.8 3.5 72.0 2.7 100.0 0.8 10.4 78.2 10.6 100.0 430 Jambi 1.6 31.1 2.4 65.3 1.2 100.0 1.4 9.3 82.2 7.1 100.0 198 South Sumatera 3.6 19.1 5.6 74.7 0.5 100.0 1.1 11.9 83.2 3.8 100.0 382 Bengkulu 2.3 25.5 4.0 69.6 0.9 100.0 2.0 11.1 84.6 2.4 100.0 90 Lampung 1.9 29.6 3.9 66.2 0.3 100.0 2.0 8.3 88.5 1.2 100.0 530 Bangka-Belitung 3.2 18.8 7.2 71.9 2.2 100.0 0.8 12.6 79.6 7.0 100.0 69 Java DKI Jakarta 10.5 2.4 7.7 89.8 0.2 100.0 4.0 12.7 82.7 0.6 100.0 514 West Java 3.4 21.8 6.4 70.6 1.2 100.0 1.3 12.2 83.6 2.9 100.0 3,090 Central Java 3.2 7.0 6.6 86.0 0.4 100.0 2.9 11.1 84.7 1.3 100.0 1,784 DI Yogyakarta 6.3 4.3 6.7 88.9 0.0 100.0 2.3 15.3 82.4 0.0 100.0 144 East Java 6.4 13.6 5.9 79.8 0.7 100.0 1.7 12.4 81.5 4.4 100.0 2,101 Banten 6.1 24.7 6.3 67.5 1.6 100.0 0.9 10.3 80.2 8.6 100.0 736 Bali and Nusa Tenggara Bali 11.7 7.1 2.9 88.6 1.4 100.0 1.4 6.2 89.4 3.0 100.0 194 West Nusa Tenggara 0.5 27.7 5.2 65.5 1.6 100.0 0.5 12.7 78.7 8.0 100.0 327 East Nusa Tenggara 1.3 51.3 4.0 42.9 1.7 100.0 2.4 7.6 81.6 8.4 100.0 376 Kalimantan West Kalimantan 2.1 33.2 5.8 59.3 1.7 100.0 1.7 11.0 74.3 13.1 100.0 301 Central Kalimantan 0.4 40.0 4.5 52.1 3.5 100.0 2.1 9.7 81.9 6.3 100.0 178 South Kalimantan 2.5 23.4 4.6 71.2 0.8 100.0 0.9 14.8 80.3 4.0 100.0 251 East Kalimantan 3.2 8.0 5.1 85.0 1.9 100.0 2.7 9.6 85.2 2.5 100.0 260 Sulawesi North Sulawesi 4.4 18.9 3.1 75.0 3.0 100.0 6.1 8.9 73.7 11.3 100.0 153 Central Sulawesi 1.5 35.3 6.1 58.2 0.5 100.0 3.8 15.0 74.6 6.6 100.0 217 South Sulawesi 2.2 31.2 7.3 61.0 0.5 100.0 3.3 18.7 73.5 4.5 100.0 652 Southeast Sulawesi 0.1 56.9 2.7 38.9 1.5 100.0 5.9 8.1 71.8 14.2 100.0 183 Gorontalo 1.4 54.8 5.6 39.1 0.5 100.0 6.3 26.0 67.4 0.3 100.0 93 Total 4.1 21.3 5.6 72.0 1.1 100.0 2.1 11.6 81.9 4.5 100.0 15,089 240 | Appendix A Table A.11.7 Preparation for delivery by province Percentage of women who had a live birth in the five years preceding the survey for which mothers discussed specific topics during pregnancy for the most recent birth, by province, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Topics discussed ––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Place to Transpor- Delivery Blood Any No topics Number Province deliver tation assistance Payment donor topic discussed of births –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 60.1 23.7 62.8 52.6 3.3 71.1 28.9 1,012 West Sumatera 76.3 55.1 70.5 68.5 23.6 81.5 18.5 368 Riau 67.7 41.9 67.0 59.2 13.9 73.6 26.4 342 Jambi 61.9 38.2 68.0 60.1 16.0 75.5 24.5 168 South Sumatera 74.5 39.5 80.2 81.3 9.9 88.6 11.4 311 Bengkulu 58.5 27.0 62.5 55.1 7.0 67.5 32.5 76 Lampung 59.6 30.4 60.5 56.3 3.9 74.1 25.9 442 Bangka-Belitung 60.3 33.3 64.0 62.3 3.2 75.1 24.9 57 Java DKI Jakarta 74.0 40.9 66.8 56.2 11.3 78.5 21.5 436 West Java 53.7 29.2 52.4 51.3 7.3 62.9 37.1 2,705 Central Java 61.2 31.2 62.1 61.7 5.7 74.0 26.0 1,612 DI Yogyakarta 78.9 52.7 84.0 72.2 10.4 88.6 11.4 128 East Java 79.4 54.5 82.0 78.0 6.5 88.2 11.8 1,878 Banten 61.7 45.4 68.3 69.3 14.1 74.5 25.5 640 Bali and Nusa Tenggara Bali 77.8 65.4 76.3 76.7 31.1 83.4 16.6 171 West Nusa Tenggara 56.2 29.2 52.0 52.9 3.2 66.1 33.9 280 East Nusa Tenggara 68.1 43.1 78.2 58.4 3.5 84.7 15.3 275 Kalimantan West Kalimantan 57.4 35.4 60.3 48.8 6.2 68.4 31.6 247 Central Kalimantan 61.0 10.3 73.7 58.3 2.8 80.6 19.4 153 South Kalimantan 63.7 33.8 69.3 61.1 5.2 77.4 22.6 220 East Kalimantan 76.0 54.4 74.0 64.0 14.8 82.0 18.0 209 Sulawesi North Sulawesi 75.8 45.3 73.1 62.5 25.0 78.9 21.1 128 Central Sulawesi 62.8 46.2 61.1 58.6 7.4 69.5 30.5 171 South Sulawesi 56.1 32.3 54.7 47.8 5.3 64.2 35.8 521 Southeast Sulawesi 48.1 24.8 52.6 51.2 4.0 63.5 36.5 136 Gorontalo 73.0 52.3 78.4 76.9 12.6 88.0 12.0 75 Total 64.1 37.5 65.1 60.9 8.1 74.3 25.7 12,760 Appendix A | 241 Table A.11.8 Postnatal care by province Percent distribution of women who had a noninstitutional live birth in the five years preceding the survey by timing of postnatal care for the most recent noninstitutional birth, according to province, Indonesia 2002-2003 Timing of first postnatal checkup Province Within 2 days of delivery 3-6 days after delivery 7-41 days after delivery Don't know/ missing Did not receive postnatal checkup1 Total Number of women Sumatera North Sumatera 58.9 5.7 6.6 0.3 28.5 100.0 666 West Sumatera 72.0 5.9 2.5 0.0 19.6 100.0 148 Riau 64.3 9.1 5.1 0.3 21.3 100.0 216 Jambi 69.3 12.1 1.7 0.0 16.9 100.0 104 South Sumatera 48.1 13.3 7.2 0.0 31.5 100.0 196 Bengkulu 88.3 1.8 1.6 0.0 8.2 100.0 67 Lampung 90.8 3.8 1.8 0.0 3.6 100.0 261 Bangka-Belitung 42.2 16.2 2.4 0.7 38.6 100.0 38 Java DKI Jakarta 46.2 10.1 27.6 1.6 14.5 100.0 47 West Java 34.0 29.3 17.5 0.0 19.1 100.0 1,923 Central Java 82.7 4.2 2.0 0.0 11.0 100.0 943 DI Yogyakarta 70.1 10.1 15.2 0.0 4.5 100.0 38 East Java 86.5 3.3 1.9 0.0 8.3 100.0 748 Banten 44.5 19.6 15.1 0.0 20.8 100.0 361 Bali and Nusa Tenggara Bali 75.1 0.9 0.8 0.0 23.2 100.0 25 West Nusa Tenggara 60.5 13.3 10.0 0.0 16.3 100.0 200 East Nusa Tenggara 61.5 3.7 5.7 0.1 29.0 100.0 236 Kalimantan West Kalimantan 54.0 21.7 7.4 0.3 16.5 100.0 188 Central Kalimantan 78.3 2.7 0.4 0.2 18.5 100.0 148 South Kalimantan 73.6 9.5 5.1 0.0 11.8 100.0 199 East Kalimantan 79.2 3.3 3.1 0.0 14.4 100.0 114 Sulawesi North Sulawesi 78.8 3.2 4.0 0.5 13.4 100.0 62 Central Sulawesi 76.5 6.6 2.0 0.0 14.9 100.0 141 South Sulawesi 76.1 3.2 1.4 0.0 19.3 100.0 330 Southeast Sulawesi 69.5 4.5 2.4 0.2 23.4 100.0 127 Gorontalo 73.7 2.7 5.6 0.6 17.4 100.0 64 Total 61.8 12.7 7.9 0.1 17.5 100.0 7,590 1 Includes women who received the first postnatal checkup after 41 days 242 | Appendix A Table A.11.9 Problems in accessing health care by province Percentage of ever-married women who reported that they have big problems in accessing health care for themselves when they are sick, by type of problem and province, Indonesia 2002-2003 Problems in accessing health care Province Knowing where to go for treatment Getting permission to go for treatment Getting money for treatment Distance to health facility Having to take transport Not wanting to go alone Concern there may not be a female provider Any of the specified problems Number of women Sumatera North Sumatera 6.7 6.6 33.9 21.0 20.9 10.5 9.5 46.1 2,177 West Sumatera 5.3 3.8 15.9 9.7 8.9 8.2 7.1 31.4 705 Riau 4.1 2.2 12.8 9.7 10.2 9.1 5.9 24.9 660 Jambi 5.6 4.7 20.8 18.7 19.6 8.9 5.1 31.0 382 South Sumatera 3.5 4.7 36.0 20.1 18.7 9.0 3.1 41.4 809 Bengkulu 1.9 0.7 18.9 7.4 6.9 4.0 4.8 27.9 159 Lampung 4.1 7.9 34.0 17.0 16.5 7.2 9.2 44.0 984 Bangka-Belitung 8.8 5.2 20.8 13.5 11.7 9.6 5.7 31.4 128 Java DKI Jakarta 0.8 0.6 15.4 2.0 1.6 3.2 4.5 20.9 1,024 West Java 3.1 1.9 20.8 10.3 6.3 6.2 4.1 26.9 5,797 Central Java 3.3 1.8 22.3 11.1 11.4 6.2 7.4 28.8 4,234 DI Yogyakarta 2.8 2.4 16.2 4.6 4.2 5.4 5.2 24.8 367 East Java 3.1 4.9 14.1 4.8 4.9 8.2 5.4 22.5 5,367 Banten 3.6 2.0 22.8 11.4 10.2 18.3 3.0 36.9 1,396 Bali and Nusa Tenggara Bali 4.5 4.4 22.9 9.2 10.4 5.7 1.1 27.9 465 West Nusa Tenggara 2.3 7.2 47.3 20.3 18.9 7.0 4.8 54.9 583 East Nusa Tenggara 6.8 3.1 31.3 27.3 29.1 9.2 6.2 45.9 460 Kalimantan West Kalimantan 6.8 5.2 27.3 20.3 18.8 12.2 9.2 41.1 477 Central Kalimantan 10.5 7.0 48.1 35.7 37.4 20.6 1.6 53.1 297 South Kalimantan 7.7 7.2 27.1 18.7 16.8 16.1 9.7 36.1 470 East Kalimantan 6.9 3.4 18.2 19.0 18.6 14.6 4.8 32.3 447 Sulawesi North Sulawesi 7.5 3.9 34.2 16.4 16.4 5.2 5.6 40.4 310 Central Sulawesi 16.4 18.4 38.9 23.4 24.7 19.6 2.9 46.9 347 South Sulawesi 13.0 14.5 38.5 19.7 20.1 10.9 5.4 43.6 1,033 Southeast Sulawesi 7.6 5.9 46.5 28.6 26.2 8.3 2.7 57.2 251 Gorontalo 18.7 11.6 49.7 27.7 26.1 16.7 6.7 60.2 153 Total 4.5 4.2 23.7 12.4 11.5 8.6 5.7 32.1 29,483 Appendix A | 243 Table A.11.10 Birth registration by province Percentage of births in the five years before the survey that were registered and percent distribution of registered births by type of registration document, according to province, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Registration document –––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Percentage Number Proof Number of births of Not Hospital Village of Birth of births Province registered births seen record record birth certificate Missing Total registered ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 43.6 1,372 19.3 50.6 12.6 4.8 12.7 0.0 100.0 599 West Sumatera 63.1 464 10.2 52.6 0.3 7.8 29.2 0.0 100.0 293 Riau 64.6 430 2.9 59.7 2.6 4.6 29.4 0.7 100.0 278 Jambi 46.1 198 8.8 3.3 0.0 2.4 85.4 0.0 100.0 91 South Sumatera 64.1 382 10.9 58.7 0.9 7.7 21.8 0.0 100.0 245 Bengkulu 57.0 90 10.9 33.8 0.0 0.8 54.2 0.4 100.0 51 Lampung 57.7 530 6.9 56.1 0.0 2.6 34.4 0.0 100.0 306 Bangka-Belitung 64.5 69 5.3 33.0 5.3 1.0 55.4 0.0 100.0 44 Java DKI Jakarta 88.3 514 2.0 24.1 1.8 3.4 68.8 0.0 100.0 454 West Java 41.5 3,090 12.9 32.6 1.8 3.7 49.0 0.1 100.0 1,282 Central Java 73.7 1,784 6.2 26.0 20.5 4.4 42.8 0.0 100.0 1,314 DI Yogyakarta 91.8 144 3.1 18.3 3.9 1.2 73.5 0.0 100.0 132 East Java 69.7 2,101 2.2 33.4 2.7 1.7 59.7 0.3 100.0 1,463 Banten 50.9 736 6.6 18.2 0.2 0.5 74.5 0.0 100.0 375 Bali and Nusa Tenggara Bali 52.5 194 25.6 20.6 0.0 3.4 50.4 0.0 100.0 102 West Nusa Tenggara 11.9 327 48.3 8.7 0.0 0.0 43.0 0.0 100.0 39 East Nusa Tenggara 24.1 376 39.5 34.0 2.0 4.0 19.2 1.3 100.0 91 Kalimantan West Kalimantan 40.3 301 5.5 27.7 4.9 0.5 61.1 0.4 100.0 121 Central Kalimantan 36.3 178 10.1 47.6 18.4 1.6 22.3 0.0 100.0 65 South Kalimantan 36.4 251 15.1 26.7 1.0 0.3 56.6 0.3 100.0 92 East Kalimantan 70.4 260 8.2 38.5 2.8 2.2 48.2 0.0 100.0 183 Sulawesi North Sulawesi 43.1 153 8.0 12.4 1.0 4.3 74.3 0.0 100.0 66 Central Sulawesi 24.1 217 7.0 18.8 2.2 3.7 68.4 0.0 100.0 53 South Sulawesi 40.8 652 23.7 33.6 0.7 2.1 39.4 0.5 100.0 266 Southeast Sulawesi 21.6 183 13.2 8.5 2.5 0.0 75.4 0.4 100.0 39 Gorontalo 27.8 93 12.2 55.4 0.5 3.9 27.6 0.4 100.0 26 Total 53.5 15,089 9.1 34.2 5.7 3.3 47.4 0.1 100.0 8,070 244 | Appendix A Table A.11.11 Reason for not registering births by province Percent distribution of births in the five years before the survey that were not registered by reason for not registering the birth, according to province, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Reason not registering birth ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Did not Late, did Did not Number Costs know child not want know of births too has to be to pay where to not Province much Too far registered fine register Other Missing Total registered –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 13.5 2.0 32.6 1.1 5.0 41.9 3.9 100.0 773 West Sumatera 10.0 4.3 18.3 0.0 8.5 57.6 1.2 100.0 171 Riau 7.9 9.1 16.1 2.0 11.9 39.8 13.2 100.0 152 Jambi 17.0 18.0 6.8 3.4 5.7 47.4 1.7 100.0 106 South Sumatera 23.9 13.2 6.5 5.2 8.8 41.1 1.2 100.0 137 Bengkulu 19.8 1.1 10.4 1.5 7.4 56.2 3.6 100.0 39 Lampung 31.7 4.2 10.1 1.6 5.3 46.0 1.1 100.0 224 Bangka-Belitung 14.9 8.6 7.4 0.0 10.4 51.6 7.0 100.0 24 Java DKI Jakarta 46.9 3.0 0.8 1.5 5.3 42.5 0.0 100.0 60 West Java 47.0 4.3 7.6 4.6 7.6 26.9 2.1 100.0 1,807 Central Java 21.3 2.7 10.1 0.9 10.3 53.0 1.8 100.0 470 DI Yogyakarta (12.4) (9.9) (1.9) (17.5) (0.0) (58.4) (0.0) 100.0 12 East Java 21.0 5.4 9.6 5.9 13.3 42.6 2.1 100.0 638 Banten 36.2 3.3 7.9 1.7 4.7 43.0 3.1 100.0 361 Bali and Nusa Tenggara Bali 27.6 11.8 7.4 3.2 7.0 40.3 2.8 100.0 92 West Nusa Tenggara 22.0 5.9 17.2 0.4 23.7 30.4 0.5 100.0 288 East Nusa Tenggara 20.3 17.1 12.1 0.8 14.2 35.0 0.6 100.0 286 Kalimantan West Kalimantan 14.8 22.5 18.2 1.1 14.0 27.1 2.3 100.0 180 Central Kalimantan 12.0 29.6 28.2 1.0 12.7 12.5 4.0 100.0 113 South Kalimantan 16.4 11.6 14.4 2.7 13.8 39.8 1.3 100.0 160 East Kalimantan 23.8 7.3 13.2 0.6 13.7 35.5 5.7 100.0 77 Sulawesi North Sulawesi 47.6 9.4 2.5 3.3 1.6 31.6 3.9 100.0 87 Central Sulawesi 17.3 16.3 16.9 0.6 14.0 34.3 0.5 100.0 165 South Sulawesi 24.8 4.4 11.0 0.5 19.2 39.6 0.6 100.0 386 Southeast Sulawesi 17.6 21.2 8.7 4.1 17.0 30.3 1.0 100.0 143 Gorontalo 19.2 13.6 1.7 6.7 4.8 53.2 0.8 100.0 67 Total 27.7 7.0 12.9 2.7 10.1 37.3 2.3 100.0 7,019 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Figures in parentheses are based on 25-49 unweighted cases. Appendix A | 245 CHAPTER 12 IMMUNIZATION OF CHILDREN Table A.12.1 Vaccinations by province Percentage of children age 12-23 months who received specific vaccines at any time before the survey (according to a vaccination card or the mother’s report), and percentage with a health card, by province, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Percentage of children who received: Percent- ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– age DPT Polio with Number ––––––––––––––– ––––––––––––––––––––––– health of Province BCG 1 2 3 0 1 2 3 Measles All1 None card children ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 74.2 71.1 59.6 41.9 77.5 67.5 53.3 31.4 56.3 36.5 18.1 22.4 289 West Sumatera 84.0 80.1 75.7 66.5 89.3 82.9 76.2 60.6 66.0 58.6 10.7 43.9 80 Riau 83.6 85.1 78.2 63.3 90.4 80.0 70.0 47.9 75.4 57.2 9.6 35.2 81 Jambi 84.7 77.8 66.8 51.6 83.7 72.6 56.8 34.8 73.2 50.6 13.3 32.1 32 South Sumatera 88.2 84.9 76.4 56.0 90.3 84.5 70.3 28.6 78.2 50.7 8.1 12.5 59 Bengkulu 93.6 88.5 85.5 76.3 93.6 89.9 84.9 71.9 82.3 69.2 6.4 51.2 20 Lampung 87.7 85.4 78.3 61.0 93.1 90.2 71.5 52.8 79.8 46.3 6.1 40.2 103 Bangka-Belitung 77.9 81.4 74.7 67.5 85.0 84.5 72.8 67.5 71.4 64.9 14.3 48.7 13 Java DKI Jakarta 95.2 92.6 89.3 76.0 93.6 91.2 85.5 46.1 80.4 67.0 3.9 28.6 96 West Java 79.1 82.0 62.8 48.3 89.1 80.1 58.1 38.0 71.7 41.4 8.2 29.6 552 Central Java 87.1 86.8 81.1 73.6 93.2 88.6 78.7 61.5 75.9 63.5 5.0 36.9 323 DI Yogyakarta 100.0 98.6 96.4 91.0 100.0 100.0 96.0 80.9 91.1 84.2 0.0 49.0 31 East Java 84.6 83.2 74.2 66.6 86.5 74.9 67.9 56.4 76.5 64.2 11.0 30.2 360 Banten 69.3 61.1 47.8 35.0 79.6 62.6 44.3 22.9 44.0 25.4 18.1 23.0 136 Bali and Nusa Tenggara Bali 88.1 93.4 90.9 87.0 92.4 91.4 88.5 76.0 82.7 80.3 6.6 53.7 38 West Nusa Tenggara 88.6 89.9 70.4 44.6 94.5 85.7 56.1 40.2 80.9 42.5 3.8 18.1 62 East Nusa Tenggara 92.7 91.6 85.7 70.1 95.7 93.9 81.1 54.7 88.6 62.7 4.3 28.1 83 Kalimantan West Kalimantan 70.2 66.5 58.0 46.3 74.9 59.8 47.2 40.2 61.0 38.3 22.5 30.0 66 Central Kalimantan 76.8 73.7 65.2 56.2 76.4 74.8 65.2 43.6 58.9 49.0 23.0 28.2 37 South Kalimantan 79.1 75.5 70.9 59.4 81.9 73.2 62.6 39.8 69.8 52.2 14.8 28.1 52 East Kalimantan 85.9 87.6 81.7 71.0 89.3 87.1 77.7 57.6 80.9 66.6 10.1 31.1 49 Sulawesi North Sulawesi 90.1 87.3 86.4 77.9 88.2 86.6 81.7 65.1 73.6 68.6 8.8 41.5 31 Central Sulawesi 86.7 85.6 81.5 69.2 87.5 85.6 73.8 60.2 84.1 66.5 11.5 22.8 42 South Sulawesi 80.3 78.8 68.7 49.9 80.7 78.8 66.4 38.5 71.0 43.7 16.8 30.0 132 Southeast Sulawesi 84.2 83.5 77.0 68.1 87.5 78.1 69.3 36.6 70.3 52.8 11.4 40.1 34 Gorontalo 87.7 80.6 70.3 58.4 86.4 77.3 64.1 49.9 75.5 56.6 8.9 27.3 17 Total 82.5 81.4 71.1 58.3 87.3 79.6 66.1 46.2 71.6 51.5 10.5 30.7 2,819 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Two National Immunization Days took place in 2002, in September for polio vaccine and in October for polio and measles vaccines. Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fwer than 25 unweighted cases and has been suppressed. 1 BCG, measles, and three doses each of DPT and polio vaccine 246 | Appendix A Table A.12.2 Hepatitis B vaccinations by province Percentage of children age 12-23 months who received hepatitis B vaccines at any time before the survey (according to vaccination card or mother's report), by province, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Hepatitis B –––––––––––––––––––––––––– Number Province 1 2 3 of children –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 55.4 44.1 31.7 289 West Sumatera 78.0 67.6 59.7 80 Riau 70.4 61.2 49.7 81 Jambi 69.7 55.4 42.5 32 South Sumatera 71.8 55.7 35.8 59 Bengkulu 79.1 65.2 39.9 20 Lampung 69.5 60.6 47.2 103 Bangka-Belitung 80.6 75.9 60.6 13 Java DKI Jakarta 84.1 74.7 49.5 96 West Java 67.6 49.4 34.9 552 Central Java 82.6 75.1 65.2 323 DI Yogyakarta 98.8 97.2 91.3 31 East Java 77.3 63.5 56.9 360 Banten 45.7 38.6 28.4 136 Bali and Nusa Tenggara Bali 88.6 87.8 81.7 38 West Nusa Tenggara 64.6 41.3 21.2 62 East Nusa Tenggara 74.8 57.5 34.3 83 Kalimantan West Kalimantan 55.9 46.7 33.2 66 Central Kalimantan 71.4 65.7 48.0 37 South Kalimantan 66.9 53.8 46.9 52 East Kalimantan 85.1 77.3 65.2 49 Sulawesi North Sulawesi 74.6 67.0 50.7 31 Central Sulawesi 79.6 73.8 54.0 42 South Sulawesi 73.0 44.7 33.8 132 Southeast Sulawesi 77.4 72.3 49.6 34 Gorontalo 65.4 51.0 43.1 17 Total 70.9 58.1 45.3 2,819 Appendix A | 247 CHAPTER 13 CHILDHOOD DISEASES Table A.13.1 Prevalence and treatment of acute respiratory infections (ARI) and/or fever by province Percentage of children under five years of age who had a cough accompanied by short, rapid breathing (symptoms of ARI), percentage of children who had fever in the two weeks preceding the survey, and percentage of children with symptoms of ARI and/or fever for whom treatment was sought from a health facility or provider, by province, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Prevalence of ARI and/or fever Treatment among children with among children under five symptoms of ARI and/or fever ––––––––––––––––––––––––––––––––––– ––––––––––––––––––––––– Percentage Percentage for of children Percentage whom treatment with of children Number was sought from Number symptoms with of a health facility of Province of ARI fever children or provider1 children ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 10.2 28.0 1,325 46.9 389 West Sumatera 11.7 39.0 445 56.6 187 Riau 7.1 22.7 413 66.6 103 Jambi 6.1 13.5 189 (60.8) 28 South Sumatera 3.5 11.4 368 68.8 49 Bengkulu 9.7 27.7 86 (60.1) 27 Lampung 3.7 18.9 509 55.2 103 Bangka-Belitung 20.3 44.7 66 63.3 33 Java DKI Jakarta 6.8 21.5 497 75.4 117 West Java 9.0 31.1 2,969 50.3 957 Central Java 5.2 19.8 1,731 66.2 369 DI Yogyakarta 3.2 23.3 142 (82.3) 34 East Java 2.8 20.8 2,022 64.5 446 Banten 16.5 33.8 713 67.7 261 Bali and Nusa Tenggara Bali 6.2 15.8 191 (77.4) 34 West Nusa Tenggara 8.4 34.4 307 46.4 107 East Nusa Tenggara 8.1 28.0 359 53.7 105 Kalimantan West Kalimantan 12.3 34.1 291 41.9 108 Central Kalimantan 4.2 7.0 171 * 14 South Kalimantan 8.1 31.6 241 46.9 80 East Kalimantan 8.0 28.7 249 57.1 75 Sulawesi North Sulawesi 6.5 24.0 147 (60.2) 37 Central Sulawesi 9.7 24.9 204 48.2 54 South Sulawesi 6.1 27.5 620 58.7 189 Southeast Sulawesi 8.9 28.9 170 35.1 52 Gorontalo 13.8 32.6 84 (41.0) 30 Total 7.6 25.9 14,510 56.8 3,988 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 1 Exludes pharmacy, shop, and traditional practitioner 248 | Appendix A Table A.13.2 Disposal of children’s stools by province Percent distribution of mothers who are living with their youngest child under five years, by way in which child's fecal matter is disposed of, according to province, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Stools contained –––––––––––––––––––– Child Stools uncontained always Thrown –––––––––––––––––––––––––––––– Use diapers uses into Thrown Thrown Not ––––––––––– Number toilet/ toilet/ Buried outside outside Rinsed disposed Dispos- Wash- of Province latrine latrine in yard dwelling yard away of able able Other Missing Total mothers ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 7.4 35.2 7.1 21.2 5.4 14.6 0.1 0.3 8.0 0.3 0.4 100.0 992 West Sumatera 19.3 24.4 6.1 27.4 3.8 2.7 0.0 0.5 15.8 0.0 0.0 100.0 359 Riau 18.0 39.9 2.4 12.2 6.4 12.5 0.0 0.6 4.0 0.8 3.3 100.0 333 Jambi 18.9 41.4 1.2 27.4 5.2 3.4 0.0 0.0 2.0 0.0 0.5 100.0 164 South Sumatera 15.7 23.0 2.1 24.8 5.8 9.5 0.0 0.4 18.6 0.0 0.2 100.0 308 Bengkulu 27.8 23.7 1.4 22.6 7.1 6.8 0.5 0.1 8.8 0.4 0.8 100.0 74 Lampung 28.8 26.7 0.7 14.8 10.3 3.3 0.0 0.7 14.4 0.2 0.0 100.0 433 Bangka-Belitung 14.2 18.7 4.7 48.9 5.2 4.0 0.0 0.3 3.4 0.0 0.6 100.0 57 Java DKI Jakarta 44.6 39.8 0.1 9.4 1.6 1.6 0.1 0.4 2.4 0.0 0.0 100.0 414 West Java 26.4 38.5 1.3 19.8 4.5 4.3 0.0 0.0 4.7 0.1 0.6 100.0 2,628 Central Java 20.4 26.2 1.3 23.6 13.1 0.9 0.0 0.4 13.9 0.0 0.2 100.0 1,575 DI Yogyakarta 27.7 43.0 6.4 11.3 6.4 1.7 0.0 0.0 3.1 0.4 0.0 100.0 126 East Java 27.1 30.4 2.2 24.9 7.5 1.7 0.0 0.0 6.2 0.0 0.0 100.0 1,813 Banten 22.1 34.1 0.7 25.3 9.9 1.9 0.0 0.0 4.4 0.8 0.8 100.0 618 Bali and Nusa Tenggara Bali 30.0 28.0 0.6 13.2 7.5 1.4 1.8 1.3 15.5 0.4 0.4 100.0 167 West Nusa Tenggara 6.2 13.8 9.7 45.6 14.4 0.4 1.5 0.0 5.5 2.6 0.4 100.0 266 East Nusa Tenggara 6.3 21.2 6.3 18.7 32.2 1.3 6.5 0.2 6.8 0.0 0.5 100.0 267 Kalimantan West Kalimantan 19.7 21.2 0.6 38.5 7.4 5.9 0.6 1.1 4.8 0.0 0.2 100.0 243 Central Kalimantan 6.9 15.5 1.5 45.4 1.6 13.3 0.0 0.0 14.3 0.1 1.5 100.0 148 South Kalimantan 11.0 27.9 1.1 33.0 2.4 12.1 0.0 0.2 12.3 0.0 0.0 100.0 212 East Kalimantan 21.9 49.4 0.2 7.9 5.3 2.0 0.0 1.7 10.1 0.5 0.9 100.0 208 Sulawesi North Sulawesi 30.1 28.8 7.5 10.5 2.0 3.3 0.3 0.3 15.9 0.8 0.4 100.0 125 Central Sulawesi 16.3 14.6 13.5 27.7 8.2 6.3 0.0 0.0 12.6 0.5 0.4 100.0 166 South Sulawesi 10.1 31.8 5.0 18.5 17.0 5.5 0.0 0.5 11.2 0.4 0.0 100.0 509 Southeast Sulawesi 9.1 23.5 8.7 27.7 15.8 9.2 0.1 0.1 5.7 0.0 0.1 100.0 131 Gorontalo 11.5 14.7 8.1 27.5 23.1 0.8 0.0 0.5 13.6 0.0 0.2 100.0 66 Total 21.3 31.4 2.8 22.4 8.2 4.5 0.2 0.3 8.3 0.2 0.4 100.0 12,402 Appendix A | 249 Table A.13.3 Prevalence of diarrhea by province Percentage of children under five years with diarrhea in the two weeks preceding the survey, by province, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––– Diarrhea in the Number two weeks pre- of Province ceding the survey children –––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 12.3 1,325 West Sumatera 14.3 445 Riau 6.1 413 Jambi 8.1 189 South Sumatera 3.3 368 Bengkulu 8.2 86 Lampung 9.2 509 Bangka-Belitung 9.4 66 Java DKI Jakarta 7.8 497 West Java 15.1 2,969 Central Java 7.9 1,731 DI Yogyakarta 5.2 142 East Java 9.8 2,022 Banten 12.5 713 Bali and Nusa Tenggara Bali 11.9 191 West Nusa Tenggara 13.5 307 East Nusa Tenggara 12.9 359 Kalimantan West Kalimantan 8.3 291 Central Kalimantan 2.4 171 South Kalimantan 9.9 241 East Kalimantan 11.1 249 Sulawesi North Sulawesi 9.5 147 Central Sulawesi 6.4 204 South Sulawesi 15.5 620 Southeast Sulawesi 9.0 170 Gorontalo 12.2 84 Total 11.0 14,510 250 | Appendix A Table A.13.4 Knowledge of ORS packets by province Percentage of mothers with births in the five years preceding the survey who know about ORS packets for treatment of diarrhea, by province, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––– Percentage of mothers who know Number about ORS of Province packets mothers –––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 89.5 1,012 West Sumatera 92.7 368 Riau 94.1 342 Jambi 92.6 168 South Sumatera 98.1 311 Bengkulu 96.4 76 Lampung 92.1 442 Bangka-Belitung 90.7 57 Java DKI Jakarta 99.0 436 West Java 98.1 2,705 Central Java 93.2 1,612 DI Yogyakarta 99.1 128 East Java 93.3 1,878 Banten 67.0 640 Bali and Nusa Tenggara Bali 95.7 171 West Nusa Tenggara 92.3 280 East Nusa Tenggara 85.6 275 Kalimantan West Kalimantan 87.0 247 Central Kalimantan 87.1 153 South Kalimantan 94.3 220 East Kalimantan 95.9 209 Sulawesi North Sulawesi 93.9 128 Central Sulawesi 88.7 171 South Sulawesi 89.0 521 Southeast Sulawesi 90.9 136 Gorontalo 90.0 75 Total 92.4 12,760 –––––––––––––––––––––––––––––––––––––––––––– ORS = Oral rehydration salts Appendix A | 251 CHAPTER 14 INFANT FEEDING Table A.14.1 Initial breastfeeding by province Percentage of children born in the five years preceding the survey who were ever breastfed, and among children ever breastfed, percentage who started breastfeeding within one hour and within one day of birth, and percentage who received a prelacteal feed, by province, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Children ever breastfed ––––––––––––––––––––––– Percentage All children Percentage Percentage Percentage who –––––––––––––––––––– who started who started who received a Number Percentage Number breastfeeding breastfeeding received a prelacteal of children Background ever of within 1 hour within 1 day prelacteal feed ever characteristic breastfed children of birth of birth1 feed liquid2 nonliquid2 breastfed –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 98.0 1,372 35.2 44.3 54.8 12.4 1,344 West Sumatera 97.3 464 24.9 71.3 61.0 19.3 451 Riau 96.1 430 27.1 37.5 62.2 31.2 414 Jambi 97.5 198 26.2 55.0 49.8 18.6 193 South Sumatera 95.6 382 31.2 72.1 52.9 9.2 365 Bengkulu 97.7 90 21.7 45.8 60.7 36.0 88 Lampung 95.5 530 34.7 53.7 45.5 23.5 507 Bangka Belitung 95.2 69 40.5 56.7 59.7 1.5 65 Java DKI Jakarta 94.2 514 40.5 57.5 65.7 12.5 484 West Java 97.1 3,090 33.9 67.4 33.4 22.3 3,001 Central Java 95.8 1,784 22.9 59.7 45.1 29.5 1,709 DI Yogyakarta 98.5 144 14.0 71.8 58.1 11.3 142 East Java 91.7 2,101 61.8 74.4 42.6 7.2 1,926 Banten 95.4 736 53.3 62.8 39.9 18.5 702 Bali and Nusa Tenggara Bali 97.4 194 55.6 78.5 31.9 2.4 189 West Nusa Tenggara 98.7 327 66.2 86.4 26.6 17.5 322 East Nusa Tenggara 97.9 376 51.6 67.3 35.7 5.2 369 Kalimantan West Kalimantan 93.7 301 40.0 59.7 44.3 14.7 282 Central Kalimantan 98.1 178 62.9 78.1 59.0 2.6 175 South Kalimantan 95.7 251 21.5 59.4 54.8 18.5 241 East Kalimantan 95.8 260 47.6 64.2 54.1 17.7 249 Sulawesi North Sulawesi 97.3 153 59.9 80.7 34.1 1.9 149 Central Sulawesi 98.0 217 24.2 39.5 58.6 35.9 213 South Sulawesi 96.5 652 30.7 38.3 60.8 10.3 630 Southeast Sulawesi 97.6 183 38.3 59.1 29.3 17.8 178 Gorontalo 95.3 93 34.4 76.1 29.0 43.2 88 Total 95.9 15,089 38.7 62.1 45.3 17.6 14,474 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Table is based on all births whether the children are living or dead at the time of interview 1 Includes children who started breastfeeding within one hour of birth 2 Children given something other than breast milk during the first three days of life before the mother started breastfeeding regularly 252 | Appendix A Table A.14.2 Median duration and frequency of breastfeeding by province Median duration of any breastfeeding, exclusive breastfeeding, and predominant breastfeeding among children born in the three years preceding the survey, percentage of breastfeeding children under six months living with the mother who were breastfed six or more times in the 24 hours preceding the survey, and mean number of feeds (day/night), by background characteristics, by province, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Median duration (months) of breastfeeding1 Breastfeeding children under six months2 ––––––––––––––––––––––––––––––––––––– ––––––––––––––––––––––––––––––––––––––– Predo- Percentage Mean Mean Any Exclusive minant Number breastfed 6+ number number Number breast- breast- breast- of times in last of of of Province feeding feeding feeding3 children 24 hours day feeds night feeds children ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 19.4 2.0 2.0 807 89.2 6.7 5.1 117 West Sumatera 21.5 0.6 0.7 281 98.5 7.1 5.0 49 Riau 22.7 0.7 1.0 278 100.0 6.8 5.7 39 Jambi 21.8 3.9 4.3 125 98.8 7.3 5.2 25 South Sumatera 22.4 2.0 2.7 222 100.0 6.6 5.8 44 Bengkulu 21.4 2.2 2.8 53 100.0 7.3 5.0 8 Lampung 20.3 2.5 3.9 318 97.2 6.5 4.1 49 Bangka-Belitung 22.5 1.4 1.7 42 100.0 5.4 5.7 6 Java DKI Jakarta 14.4 0.6 1.5 326 89.8 6.5 5.2 46 West Java 24.0 1.6 1.9 1,855 96.5 6.2 4.2 384 Central Java 24.6 0.7 0.7 1,054 98.5 6.5 5.1 149 DI Yogyakarta 22.3 0.8 0.8 86 93.8 6.0 5.5 11 East Java 22.8 0.7 0.7 1,242 97.7 7.3 4.4 155 Banten 24.8 1.7 2.2 436 93.6 6.4 4.9 59 Bali and Nusa Tenggara Bali 21.7 1.0 1.4 122 97.5 5.5 5.0 19 West Nusa Tenggara 22.3 3.2 3.2 184 97.6 6.0 5.0 25 East Nusa Tenggara 21.3 2.1 2.9 241 94.6 6.2 4.4 35 Kalimantan West Kalimantan 32.7 1.2 1.5 185 96.6 6.0 4.8 20 Central Kalimantan 23.5 1.9 2.0 117 98.3 5.7 3.8 15 South Kalimantan 26.3 2.3 3.6 161 99.5 6.0 4.3 31 East Kalimantan 21.4 1.8 2.2 163 94.7 5.5 4.8 30 Sulawesi North Sulawesi 17.9 2.2 2.3 97 100.0 6.6 5.5 14 Central Sulawesi 21.2 2.7 2.9 134 98.7 5.8 4.5 21 South Sulawesi 17.4 3.8 4.6 419 99.7 6.7 5.3 66 Southeast Sulawesi 23.9 3.1 3.8 115 100.0 6.2 4.2 22 Gorontalo 25.3 1.5 2.0 54 81.5 4.6 4.1 8 Total 22.3 1.6 2.0 9,119 96.5 6.5 4.7 1,446 Mean for all children 22.1 3.2 3.9 na na na na na ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Median and mean durations are based on current status. na = Not applicable 1 It is assumed that non-last-born children and last born children not living with the mother are not currently breastfeeding 2 Excludes children who do not have a valid answer on the number of times breastfed 3 Either exclusively breastfed or received breast milk and plain water, water-based liquids, and/or juice only (excludes other milk) Appendix A | 253 Table A.14.3 Micronutrient intake among children by province Percentage of youngest children under age three living with the mother who consumed fruits and vegetables rich in vitamin A in the seven days preceding the survey, and percentage of children age 6-59 months who received vitamin A supplements in the six months preceding the survey, by province, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Youngest children under age 36 months ––––––––––––––––––––––– Consumed Children age 6-59 months fruits and ––––––––––––––––––––––– vegetables Number Consumed Number Background rich in of vitamin A of characteristic vitamin A1 children supplements children ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 67.4 701 50.8 1,201 West Sumatera 59.2 248 72.2 395 Riau 67.8 239 73.2 366 Jambi 58.8 114 76.0 164 South Sumatera 70.4 206 77.9 321 Bengkulu 71.4 48 80.8 78 Lampung 68.0 283 77.6 455 Bangka Belitung 58.0 38 71.2 59 Java DKI Jakarta 76.2 290 73.5 443 West Java 63.7 1,724 77.3 2,547 Central Java 72.1 978 79.4 1,580 DI Yogyakarta 80.1 80 87.6 131 East Java 72.2 1,121 83.4 1,844 Banten 68.9 402 69.9 647 Bali and Nusa Tenggara Bali 65.7 113 79.9 172 West Nusa Tenggara 65.8 165 88.9 281 East Nusa Tenggara 59.2 215 79.5 322 Kalimantan West Kalimantan 68.1 172 76.2 268 Central Kalimantan 64.3 111 57.4 154 South Kalimantan 61.7 147 78.4 207 East Kalimantan 63.1 145 73.7 215 Sulawesi North Sulawesi 64.3 89 80.4 131 Central Sulawesi 67.1 115 58.2 182 South Sulawesi 67.7 377 77.3 554 Southeast Sulawesi 56.6 97 73.1 146 Gorontalo 56.9 43 83.6 76 Total 67.4 8,265 75.1 12,940 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Information on vitamin A supplements is based on mother’s recall. Total includes 18 children with missing information on breastfeeding status and 109 children with no information on consumption of vitamin A supplements 1Includes pumpkin, carrots, red sweet potatoes, green leafy vegetables, mango, papaya, and other locally grown fruits and vegetables that are rich in vitamin A 254 | Appendix A Table A.14.4 Micronutrient intake among mothers by province Percentage of women who gave birth in the five years preceding the survey who received a vitamin A dose in the first two months after delivery, percentage who suffered from night blindness during pregnancy, and percentage who took iron tablets or syrup for specific numbers of days, by province, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Number of days women took iron Received Suffered tablets or syrup during pregnancy vitamin A night blindnes –––––––––––––––––––––––––––––––––––––––– dose during pregnancy Don’t Number post- ––––––––––––––––– know/ of Province partum1 Reported Adjusted2 None <60 60-89 90+ missing women ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 29.1 2.8 1.0 34.4 46.4 2.1 3.2 13.8 1,012 West Sumatera 40.7 3.9 0.7 13.9 43.6 12.5 26.6 3.5 368 Riau 44.7 1.7 0.7 24.1 33.6 9.9 19.8 12.7 342 Jambi 51.9 1.8 0.5 40.3 33.1 7.9 14.1 4.6 168 South Sumatera 38.5 0.7 0.3 17.1 31.9 10.1 20.1 20.9 311 Bengkulu 34.1 1.7 0.4 15.1 33.7 15.6 32.0 3.6 76 Lampung 25.9 1.3 0.7 18.4 53.3 6.4 11.3 10.5 442 Bangka-Belitung 29.2 4.7 0.8 31.2 32.4 8.5 19.8 8.1 57 Java DKI Jakarta 51.9 0.4 0.3 6.2 14.5 11.5 60.5 7.3 436 West Java 42.2 1.6 0.3 22.8 43.6 8.8 22.9 1.9 2,705 Central Java 38.2 1.4 0.1 10.7 26.3 10.7 51.1 1.1 1,612 DI Yogyakarta 49.0 1.0 0.0 2.2 13.0 14.8 69.8 0.3 128 East Java 59.1 0.7 0.1 11.7 15.9 6.6 50.4 15.5 1,878 Banten 33.8 1.5 0.1 38.8 26.1 2.8 22.4 9.9 640 Bali and Nusa Tenggara Bali 35.3 0.7 0.5 10.6 32.8 20.2 32.8 3.6 171 West Nusa Tenggara 41.8 1.8 0.0 12.4 45.0 12.1 25.7 4.7 280 East Nusa Tenggara 45.1 5.9 0.9 21.1 34.8 7.2 25.4 11.6 275 Kalimantan West Kalimantan 38.1 3.1 0.8 32.2 36.7 7.7 18.6 4.8 247 Central Kalimantan 37.4 0.3 0.3 33.5 28.9 16.7 7.8 13.0 153 South Kalimantan 36.0 4.2 1.5 15.5 37.3 16.2 29.6 1.3 220 East Kalimantan 55.2 3.7 0.2 17.1 23.1 10.1 41.5 8.2 209 Sulawesi North Sulawesi 50.6 1.1 0.3 6.3 54.6 8.8 11.2 19.1 128 Central Sulawesi 31.8 1.7 0.5 33.5 44.0 3.9 4.4 14.3 171 South Sulawesi 41.7 2.0 0.1 26.3 62.8 1.4 2.2 7.3 521 Southeast Sulawesi 45.4 1.0 0.0 27.1 54.4 7.2 7.8 3.4 136 Gorontalo 54.9 3.8 1.0 21.5 50.0 12.7 13.3 2.5 75 Total 42.5 1.7 0.4 20.1 34.9 8.2 29.1 7.6 12,760 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: For women with two or more live births in the five-year period, data refer to the most recent birth. 1 In the first two months after delivery 2 Women who reported night blindness but did not report difficulty with vision during the day Appendix A | 255 CHAPTER 15 KNOWLEDGE OF HIV/AIDS AND OTHER SEXUALLY TRANSMITTED INFECTIONS Table A.15.1 Knowledge of HIV/AIDS by province Percentage of ever-married women and currently married men who have heard of HIV/AIDS and percentage who believe there is a way to avoid getting AIDS, by background characteristics, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Ever-married women Currently married men ––––––––––––––––––––––––––––– –––––––––––––––––––––––––––––– Has Believes Has Believes heard there is a way Number heard there is a way Number of HIV/ to avoid of of HIV/ to avoid of Province AIDS HIV/AIDS women AIDS HIV/AIDS men ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 58.9 34.1 2,177 75.3 56.0 663 West Sumatera 67.6 45.4 705 74.9 43.4 182 Riau 67.4 38.8 660 79.9 59.5 199 Jambi 45.9 22.8 382 80.5 43.5 114 South Sumatera 48.8 27.3 809 64.3 57.7 259 Bengkulu 60.1 38.8 159 67.6 50.1 44 Lampung 53.8 31.1 984 74.0 43.8 261 Bangka-Belitung 65.4 28.6 128 89.0 67.7 40 Java DKI Jakarta 89.5 63.9 1,024 95.8 67.9 310 West Java 63.2 30.3 5,797 70.0 50.7 1,614 Central Java 53.4 30.6 4,234 73.0 50.5 1,155 DI Yogyakarta 75.5 60.5 367 83.8 75.4 103 East Java 60.3 34.2 5,367 70.1 55.3 1,560 Banten 53.8 34.4 1,396 74.4 62.3 396 Bali and Nusa Tenggara Bali 49.5 28.5 465 78.9 68.8 138 West Nusa Tenggara 34.8 18.9 583 61.4 38.7 145 East Nusa Tenggara 30.6 18.0 460 48.0 33.4 122 Kalimantan West Kalimantan 51.8 31.6 477 71.3 50.0 119 Central Kalimantan 71.2 61.5 297 82.4 74.6 97 South Kalimantan 59.3 33.1 470 73.6 46.8 109 East Kalimantan 79.7 54.1 447 86.8 72.2 115 Sulawesi North Sulawesi 74.2 43.2 310 89.5 70.8 95 Central Sulawesi 55.4 24.2 347 68.8 30.4 114 South Sulawesi 46.4 26.7 1,033 73.2 55.8 237 Southeast Sulawesi 43.2 21.5 251 57.5 43.6 77 Gorontalo 48.6 25.0 153 29.3 19.3 41 Total 58.8 33.6 29,483 72.8 53.7 8,310 256 | Appendix A Table A.15.2 Knowledge of programmatically important ways to avoid HIV/AIDS by province Percent distribution of ever-married women by knowledge of three programmatically important ways to avoid HIV/AIDS, and percentage of women who know of two specific ways to avoid HIV/AIDS, according to province, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Knowledge of programmatically Specific ways important ways to avoid HIV/AIDS to avoid HIV/AIDS ––––––––––––––––––––––––––––––– –––––––––––––––––––– Two Limit number Number One or three Use of sexual of Province None1 way ways Total condoms partners2 women –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 68.6 10.0 21.4 100.0 22.5 30.1 2,177 West Sumatera 58.8 17.7 23.5 100.0 24.7 39.7 705 Riau 64.0 13.5 22.5 100.0 22.7 34.1 660 Jambi 79.7 7.7 12.6 100.0 14.2 18.7 382 South Sumatera 74.4 9.5 16.1 100.0 16.5 25.0 809 Bengkulu 64.6 12.0 23.4 100.0 24.4 34.2 159 Lampung 69.6 11.3 19.1 100.0 18.2 29.7 984 Bangka-Belitung 75.5 9.4 15.1 100.0 16.7 22.9 128 Java DKI Jakarta 37.8 20.2 42.1 100.0 44.0 60.3 1,024 West Java 75.7 8.3 16.0 100.0 17.9 22.1 5,797 Central Java 71.5 8.8 19.7 100.0 20.8 27.3 4,234 DI Yogyakarta 40.5 18.9 40.6 100.0 41.8 57.7 367 East Java 66.1 7.9 25.9 100.0 26.2 33.1 5,367 Banten 69.8 12.4 17.9 100.0 21.7 26.1 1,396 Bali and Nusa Tenggara Bali 71.6 6.2 22.3 100.0 23.5 27.0 465 West Nusa Tenggara 82.2 6.5 11.3 100.0 10.9 17.7 583 East Nusa Tenggara 82.8 8.7 8.5 100.0 8.8 16.9 460 Kalimantan West Kalimantan 70.9 12.8 16.3 100.0 17.5 26.7 477 Central Kalimantan 38.3 11.7 49.6 100.0 49.4 60.0 297 South Kalimantan 67.9 9.3 22.8 100.0 23.3 31.6 470 East Kalimantan 50.8 19.9 29.3 100.0 32.7 44.9 447 Sulawesi North Sulawesi 63.0 17.2 19.7 100.0 21.9 34.6 310 Central Sulawesi 79.0 9.6 11.4 100.0 12.0 20.1 347 South Sulawesi 75.3 10.7 14.0 100.0 14.5 24.2 1,033 Southeast Sulawesi 79.5 7.2 13.3 100.0 13.7 20.0 251 Gorontalo 82.8 5.4 11.8 100.0 12.6 16.4 153 Total 69.1 10.1 20.9 100.0 22.0 29.5 29,483 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Programmatically important ways are abstaining from sex, using condoms, and limiting the number of sexual partners. Abstinence from sex is measured from a spontaneous response only; using condoms and limiting the number of sexual partners is measured from spontaneous and probed responses. 1 Those who have not heard of HIV/AIDS or do not know of any programmatically important ways to avoid HIV/AIDS. 2 Refers to limiting number of sexual partners and limiting sex to one partner/staying faithful to one partner. Appendix A | 257 Table A.15.3 Knowledge of HIV/AIDS-related issues by province Percentage of ever-married women who gave specific responses to questions on various HIV/AIDS-related issues, according to province, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Percentage who say HIV/AIDS can be Percentage who Percentage who transmitted from mother to child: know someone say a healthy- –––––––––––––––––––––––––––––––– personally who has looking person Through the virus that Number can have the During During breast- causes AIDS or has of Province AIDS virus delivery pregnancy feeding died of AIDS women ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 4.4 28.4 35.9 33.8 1.5 2,177 West Sumatera 10.1 42.6 49.0 45.8 2.6 705 Riau 6.5 41.3 45.8 43.3 2.1 660 Jambi 2.9 26.6 28.9 24.3 3.5 382 South Sumatera 1.5 20.4 22.0 20.1 0.7 809 Bengkulu 4.6 31.6 38.1 33.9 1.0 159 Lampung 7.5 24.6 32.0 29.3 1.6 984 Bangka-Belitung 6.9 37.2 40.8 38.5 3.0 128 Java DKI Jakarta 21.0 58.8 63.1 64.3 5.5 1,024 West Java 5.1 28.1 32.1 30.5 3.7 5,797 Central Java 5.2 32.3 35.5 32.5 2.7 4,234 DI Yogyakarta 6.4 47.4 55.4 50.9 1.2 367 East Java 8.3 33.1 35.9 35.7 3.9 5,367 Banten 5.1 35.5 38.9 38.2 5.1 1,396 Bali and Nusa Tenggara Bali 2.9 36.0 36.3 35.6 3.0 465 West Nusa Tenggara 3.0 18.2 18.2 18.5 0.9 583 East Nusa Tenggara 4.3 17.7 19.0 18.3 2.0 460 Kalimantan West Kalimantan 3.8 33.5 38.5 36.9 2.0 477 Central Kalimantan 4.7 51.0 50.0 62.6 0.6 297 South Kalimantan 4.7 23.7 29.5 27.8 2.6 470 East Kalimantan 6.7 47.7 53.5 45.0 1.9 447 Sulawesi North Sulawesi 6.8 42.5 43.0 42.8 2.8 310 Central Sulawesi 5.6 24.2 27.8 26.0 2.9 347 South Sulawesi 5.1 18.0 23.8 22.3 3.2 1,033 Southeast Sulawesi 3.7 21.8 24.7 23.6 2.3 251 Gorontalo 6.9 20.8 22.8 23.5 5.6 153 Total 6.2 31.6 35.5 34.0 3.0 29,483 258 | Appendix A Table A.15.4 Discussion of HIV/AIDS with husband by province Percent distribution of currently married women by whether they ever discussed HIV/AIDS prevention with their husband, according to province, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Ever Never Has not discussed discussed Don’t heard Number HIV/AIDS HIV/AIDS know/ of of Province prevention prevention missing AIDS Total women –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 15.0 44.4 0.5 40.2 100.0 2,071 West Sumatera 26.8 42.5 0.0 30.8 100.0 668 Riau 20.6 46.7 0.6 32.2 100.0 636 Jambi 13.4 33.8 0.0 52.8 100.0 353 South Sumatera 10.8 39.0 0.1 50.1 100.0 772 Bengkulu 22.6 38.1 0.0 39.3 100.0 150 Lampung 16.7 38.1 0.1 45.2 100.0 946 Bangka-Belitung 25.6 40.2 0.1 34.2 100.0 122 Java DKI Jakarta 24.5 66.9 0.0 8.6 100.0 919 West Java 13.4 50.2 0.2 36.1 100.0 5,539 Central Java 14.6 39.9 0.0 45.4 100.0 4,031 DI Yogyakarta 26.0 50.1 0.0 23.9 100.0 350 East Java 17.7 43.5 0.0 38.8 100.0 5,034 Banten 19.8 35.3 0.2 44.7 100.0 1,301 Bali and Nusa Tenggara Bali 16.6 33.5 0.0 49.9 100.0 446 West Nusa Tenggara 9.2 27.0 0.0 63.8 100.0 518 East Nusa Tenggara 12.1 19.6 0.1 68.3 100.0 427 Kalimantan West Kalimantan 16.3 36.0 0.2 47.5 100.0 445 Central Kalimantan 14.2 56.1 1.5 28.1 100.0 291 South Kalimantan 19.3 40.3 0.0 40.4 100.0 437 East Kalimantan 23.3 56.2 0.2 20.4 100.0 430 Sulawesi North Sulawesi 34.4 40.5 0.2 24.9 100.0 298 Central Sulawesi 16.7 38.9 0.1 44.3 100.0 329 South Sulawesi 13.9 33.9 0.0 52.2 100.0 961 Southeast Sulawesi 8.5 35.2 0.1 56.3 100.0 239 Gorontalo 20.4 29.2 0.0 50.4 100.0 143 Total 16.4 43.2 0.1 40.2 100.0 27,857 Appendix A | 259 Table A.15.5 Social aspects of HIV/AIDS by province Among ever-married women and currently married men who have heard of AIDS, percentage providing specific responses to questions on various social aspects of HIV/AIDS, by province, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Women Men –––––––––––––––––––––––––––––––––––––– ––––––––––––––––––––––––––––––––––––––– Believes Not willing Believes Not willing HIV-positive to care HIV-positive to care status of for relative Number status of for relative Number family member with AIDS of family member with AIDS of Province kept secret at home women kept secret at home men –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 18.5 30.5 1,283 11.3 27.2 500 West Sumatera 36.5 22.5 477 26.3 9.6 136 Riau 19.3 19.2 445 14.1 24.2 159 Jambi 17.5 30.0 176 16.3 10.6 92 South Sumatera 22.9 25.2 395 26.5 13.5 166 Bengkulu 27.3 21.2 95 28.1 21.0 30 Lampung 26.4 22.8 529 25.7 19.7 193 Bangka-Belitung 17.5 37.4 83 11.1 20.1 35 Java DKI Jakarta 18.1 22.0 917 39.8 15.7 297 West Java 18.6 24.5 3,666 9.9 47.8 1,129 Central Java 34.0 38.9 2,261 24.7 17.9 843 DI Yogyakarta 21.5 23.3 277 13.6 37.6 87 East Java 29.3 35.3 3,236 27.5 21.5 1,093 Banten 38.1 40.0 752 28.9 28.9 295 Bali and Nusa Tenggara Bali 7.1 47.3 230 1.9 41.2 109 West Nusa Tenggara 26.0 43.5 203 37.9 40.7 89 East Nusa Tenggara 14.5 41.1 141 7.4 22.6 59 Kalimantan West Kalimantan 23.3 36.3 247 20.5 25.8 85 Central Kalimantan 21.5 14.6 212 11.3 10.8 80 South Kalimantan 22.3 32.3 279 25.6 19.0 80 East Kalimantan 24.0 36.2 356 21.9 13.0 100 Sulawesi North Sulawesi 5.4 43.9 230 3.1 75.4 85 Central Sulawesi 6.8 41.3 192 7.2 36.0 78 South Sulawesi 11.4 41.7 479 9.7 29.6 173 Southeast Sulawesi 8.3 38.4 108 2.5 79.2 44 Gorontalo 14.1 49.6 74 8.0 85.8 12 Total 23.9 31.4 17,343 20.0 28.1 6,050 260 | Appendix A Table A.15.6 Knowledge of symptoms of STIs by province: women Percentage of ever-married women by knowledge of symptoms associated with sexually transmitted infections (STIs) in a man and in a woman, according to province, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Knowledge of symptoms Knowledge of symptoms of STIs in a man of STIs in a woman ––––––––––––––––––––––––––––––––– ––––––––––––––––––––––––––––––––––– No No Men- Mentioned No Men- Mentioned know- symptoms tioned two symptoms tioned two Number ledge men- one or more men- one or more of Province of STIs tioned symptom symptoms tioned symptom symptoms women ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 70.9 10.1 4.9 14.0 12.6 5.3 11.3 2,177 West Sumatera 68.5 15.5 7.4 8.6 19.7 5.7 6.2 705 Riau 69.9 13.0 7.8 9.3 17.5 6.9 5.7 660 Jambi 87.3 7.1 2.6 3.0 9.5 1.6 1.7 382 South Sumatera 72.1 6.3 7.2 14.5 7.4 6.9 13.7 809 Bengkulu 71.2 13.4 5.5 9.9 16.3 6.3 6.2 159 Lampung 68.4 14.8 8.2 8.6 17.8 6.3 7.6 984 Bangka-Belitung 69.2 18.7 6.7 5.4 22.3 6.2 2.3 128 Java DKI Jakarta 65.4 9.9 11.4 13.2 12.2 10.7 11.7 1,024 West Java 85.5 6.3 4.3 3.9 7.4 3.8 3.3 5,797 Central Java 76.1 11.2 6.7 6.0 12.1 5.6 6.2 4,234 DI Yogyakarta 57.3 9.8 9.6 23.3 15.5 6.4 20.7 367 East Java 61.4 15.9 9.9 12.8 21.1 6.5 10.9 5,367 Banten 77.0 10.9 7.7 4.4 12.8 6.4 3.9 1,396 Bali and Nusa Tenggara Bali 70.0 11.0 9.3 9.7 14.3 7.3 8.3 465 West Nusa Tenggara 87.0 5.0 2.0 6.0 6.8 1.8 4.4 583 East Nusa Tenggara 80.1 7.0 7.0 5.8 7.9 6.0 5.9 460 Kalimantan West Kalimantan 68.9 14.8 7.0 9.3 17.0 6.8 7.3 477 Central Kalimantan 53.1 1.1 5.5 39.9 1.7 4.6 40.2 297 South Kalimantan 70.5 11.0 7.3 11.2 17.4 5.2 6.9 470 East Kalimantan 54.4 21.0 13.9 10.8 27.1 12.5 6.0 447 Sulawesi North Sulawesi 51.5 14.6 15.7 18.1 18.7 12.5 17.1 310 Central Sulawesi 76.4 12.6 5.7 5.3 13.4 5.1 5.1 347 South Sulawesi 82.1 2.8 6.8 8.4 6.0 5.2 6.7 1,033 Southeast Sulawesi 76.9 6.6 3.7 12.8 10.7 2.0 10.4 251 Gorontalo 71.6 10.2 11.3 7.0 12.8 9.7 6.0 153 Total 73.1 10.7 7.1 9.1 13.3 5.8 7.8 29,483 Appendix A | 261 Table A.15.7 Knowledge of symptoms of STIs by province: men Percentage of currently married men by knowledge of symptoms associated with sexually transmitted infections (STIs) in a man and in a woman, according to background characteristics, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Knowledge of symptoms Knowledge of symptoms of STIs in a man of STIs in a woman ––––––––––––––––––––––––––––––––– ––––––––––––––––––––––––––––––––––– No No Men- Mentioned No Men- Mentioned know- symptoms tioned two symptoms tioned two Number ledge men- one or more men- one or more of Province of STIs tioned symptom symptoms tioned symptom symptoms men ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 48.8 7.8 22.3 21.1 27.4 12.0 11.8 663 West Sumatera 35.5 21.5 9.1 33.9 52.7 5.1 6.7 182 Riau 39.6 19.6 9.5 30.3 47.9 3.9 7.5 199 Jambi 49.1 15.6 13.7 21.7 40.2 6.6 4.1 114 South Sumatera 32.8 6.2 5.8 55.2 28.9 3.7 34.7 259 Bengkulu 40.9 25.3 11.8 22.0 40.0 8.5 10.6 44 Lampung 37.7 27.1 12.2 23.1 55.4 4.8 2.1 261 Bangka-Belitung 42.1 20.3 15.1 22.5 53.3 2.1 2.4 40 Java DKI Jakarta 18.1 5.5 29.7 46.7 74.3 3.2 4.4 310 West Java 50.5 3.4 21.5 24.7 39.8 4.6 5.2 1,614 Central Java 40.6 15.3 16.7 27.4 45.8 7.2 6.3 1,155 DI Yogyakarta 31.4 23.4 11.3 33.9 48.4 7.2 13.0 103 East Java 29.4 12.4 20.1 38.0 60.8 6.7 3.1 1,560 Banten 35.5 19.0 18.8 26.6 48.5 5.5 10.4 396 Bali and Nusa Tenggara Bali 27.5 3.3 25.2 43.8 11.4 18.6 42.4 138 West Nusa Tenggara 36.9 25.5 18.9 18.8 60.3 1.1 1.8 145 East Nusa Tenggara 67.2 6.2 6.8 19.3 24.5 2.8 5.0 122 Kalimantan West Kalimantan 28.6 24.4 16.4 30.3 58.0 6.7 6.4 119 Central Kalimantan 25.3 0.8 6.7 67.2 13.5 11.3 49.8 97 South Kalimantan 27.4 21.9 17.5 33.1 53.9 3.0 15.6 109 East Kalimantan 18.4 15.8 23.3 42.6 52.1 18.8 10.7 115 Sulawesi North Sulawesi 27.7 14.3 18.9 39.2 60.5 2.9 8.9 95 Central Sulawesi 39.8 17.9 15.5 26.8 49.5 4.9 5.9 114 South Sulawesi 38.8 7.1 12.6 41.5 38.9 2.7 19.7 237 Southeast Sulawesi 63.6 3.6 10.4 22.4 18.2 5.0 13.3 77 Gorontalo 55.2 6.9 14.6 23.4 11.8 14.9 18.1 41 Total 38.9 11.7 18.2 31.2 46.1 6.4 8.6 8,310 262 | Appendix A Table A.15.8 Knowledge of source of male condoms and access to condoms by province Percentage of ever-married women who know a source for male condoms, and percentage who think they themselves could get a male condom, by background characteristics, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––– Knows Could a source get Number for male a male of Province condoms condom women ––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 49.3 38.9 2,177 West Sumatera 52.5 39.5 705 Riau 41.5 26.4 660 Jambi 32.5 25.8 382 South Sumatera 65.0 41.9 809 Bengkulu 52.9 38.7 159 Lampung 34.8 25.9 984 Bangka-Belitung 38.4 20.3 128 Java DKI Jakarta 74.6 45.6 1,024 West Java 29.5 18.6 5,797 Central Java 41.2 26.6 4,234 DI Yogyakarta 72.7 55.9 367 East Java 43.3 31.5 5,367 Banten 41.5 28.5 1,396 Bali and Nusa Tenggara Bali 34.2 25.1 465 West Nusa Tenggara 18.3 7.5 583 East Nusa Tenggara 15.7 4.7 460 Kalimantan West Kalimantan 30.9 16.6 477 Central Kalimantan 53.9 28.7 297 South Kalimantan 35.4 27.5 470 East Kalimantan 53.8 29.3 447 Sulawesi North Sulawesi 32.7 19.3 310 Central Sulawesi 24.9 17.4 347 South Sulawesi 32.3 19.5 1,033 Southeast Sulawesi 33.3 15.5 251 Gorontalo 14.5 7.6 153 Total 40.4 27.2 29,483 Appendix A | 263 CHAPTER 17 FATHER’S PARTICIPATION IN FAMILY HEALTH CARE Table A.17.1 Advice or care on antenatal care, delivery, and postnatal care by province Percentage of last births in the five years preceding the survey for which mothers received advice or care from a health care provider (based on father’s report), according to province, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Mother received advice or care ––––––––––––––––––––––––––––––– During the six weeks Number During During after of Province pregnancy delivery delivery fathers ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 83.3 85.1 68.6 309 West Sumatera 89.4 82.5 71.1 94 Riau 81.6 76.4 55.6 111 Jambi 82.5 73.7 46.6 49 South Sumatera 96.5 87.3 74.2 97 Bengkulu 87.6 82.0 80.4 22 Lampung 88.8 68.8 70.9 123 Bangka-Belitung 73.3 69.6 54.0 17 Java DKI Jakarta 92.4 89.2 84.4 147 West Java 81.3 64.3 65.3 732 Central Java 87.8 82.7 72.9 456 DI Yogyakarta 99.4 97.7 98.4 34 East Java 94.2 83.4 75.8 563 Banten 83.1 84.1 77.8 179 Bali and Nusa Tenggara Bali 98.6 97.0 96.8 47 West Nusa Tenggara 92.3 77.0 74.6 83 East Nusa Tenggara 79.6 51.0 47.1 77 Kalimantan West Kalimantan 86.1 72.8 60.4 62 Central Kalimantan 73.4 75.0 60.6 51 South Kalimantan 83.6 75.5 53.4 48 East Kalimantan 87.7 81.6 79.1 58 Sulawesi North Sulawesi 99.1 98.9 97.0 41 Central Sulawesi 77.8 72.5 75.4 62 South Sulawesi 88.6 65.0 72.3 130 Southeast Sulawesi 83.7 65.1 62.9 43 Gorontalo 95.6 80.3 71.2 20 Total 86.9 77.2 70.8 3,653 264 | Appendix A Table A.17.2 Specific vaccines received by children under five by province Percentage of last living children born in the five years preceding the survey who received specific vaccines (based on father’s report), according to province, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Number of Province BCG Polio DPT Measles Hepatitis fathers –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 67.4 75.4 59.0 54.2 52.0 304 West Sumatera 57.7 68.7 48.9 49.3 45.0 92 Riau 77.6 81.7 73.8 71.2 73.3 109 Jambi 81.3 84.8 72.8 68.9 67.6 48 South Sumatera 89.9 83.2 79.8 70.6 65.9 96 Bengkulu 84.2 86.6 80.7 78.5 73.4 22 Lampung 57.6 70.4 54.6 56.8 42.4 119 Bangka-Belitung 78.0 81.6 77.1 72.3 73.6 16 Java DKI Jakarta 92.6 89.4 85.1 79.1 85.1 147 West Java 73.7 75.0 66.2 59.0 56.9 708 Central Java 89.0 91.9 87.2 78.4 77.0 454 DI Yogyakarta 100.0 100.0 97.6 88.8 94.4 34 East Java 82.6 86.9 80.4 63.6 77.0 554 Banten 70.4 81.8 66.4 55.6 49.0 178 Bali and Nusa Tenggara Bali 97.3 96.2 94.8 83.9 94.0 47 West Nusa Tenggara 86.2 86.3 78.4 77.0 72.7 80 East Nusa Tenggara 78.2 83.1 57.7 48.4 38.9 75 Kalimantan West Kalimantan 70.6 80.0 63.4 64.5 61.9 62 Central Kalimantan 75.5 72.0 70.6 55.2 60.0 49 South Kalimantan 66.5 78.6 59.8 52.0 39.7 48 East Kalimantan 73.7 75.9 71.1 59.8 61.9 58 Sulawesi North Sulawesi 93.0 92.6 90.2 74.6 83.1 39 Central Sulawesi 77.7 91.4 80.6 63.2 66.8 61 South Sulawesi 62.2 73.9 63.9 55.3 54.1 126 Southeast Sulawesi 81.9 87.5 80.6 77.0 78.5 42 Gorontalo 71.3 75.8 65.9 64.4 59.6 19 Total 77.6 81.9 72.6 64.2 64.6 3,587 Appendix A | 265 Table A.17.3 Father’s contact with a health care provider about wife’s health and pregnancy by province Percentage of last births born in the five years preceding the survey whose father discussed with a health care provider about the health of the mother or the pregnancy, and among these, percentage who discussed specific topics, according to province, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Topics of discussion ––––––––––––––––––––––––––––––––––––––––––––––––––– How much Type of health Talked Type of rest she problems for with a foods to should have which she should Number health care eat during during get medical of Province provider pregnancy pregnancy attention fathers –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 41.4 36.6 35.7 40.5 309 West Sumatera 48.2 41.8 42.8 45.4 94 Riau 47.7 41.0 43.0 39.0 111 Jambi 26.9 23.3 22.9 24.2 49 South Sumatera 48.7 44.7 44.8 47.1 97 Bengkulu 41.0 35.8 37.5 37.8 22 Lampung 27.6 21.2 22.2 24.1 123 Bangka-Belitung 54.1 52.9 52.9 54.1 17 Java DKI Jakarta 47.9 44.8 46.4 44.0 147 West Java 33.7 30.2 30.6 32.1 732 Central Java 43.6 40.6 39.9 41.9 456 DI Yogyakarta 52.8 50.7 45.2 49.8 34 East Java 39.2 32.8 34.5 37.6 563 Banten 42.7 38.4 40.6 40.7 179 Bali and Nusa Tenggara Bali 99.2 98.0 97.8 96.2 47 West Nusa Tenggara 23.8 16.4 20.9 15.1 83 East Nusa Tenggara 12.1 9.9 9.9 11.4 77 Kalimantan West Kalimantan 30.2 30.0 29.0 28.9 62 Central Kalimantan 22.8 14.0 12.8 13.9 51 South Kalimantan 29.6 19.5 18.1 19.8 48 East Kalimantan 68.7 63.4 65.8 68.1 58 Sulawesi North Sulawesi 74.6 64.7 64.7 66.1 41 Central Sulawesi 35.1 29.9 31.7 34.6 62 South Sulawesi 29.7 26.6 27.6 19.7 130 Southeast Sulawesi 43.8 40.7 41.0 39.6 43 Gorontalo 39.6 20.1 15.0 21.4 20 Total 39.6 35.0 35.5 36.8 3,653 266 | Appendix A Table A.17.4 Preparation for delivery by province Percentage of last births born in the five years preceding the survey whose father discussed specific topics about delivery, according to province, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Topics of discussion ––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Number Place to Transpor- Delivery Blood Any No topics of Province deliver tation assistance Payment donor topic discussed fathers ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sumatera North Sumatera 37.9 19.1 65.5 48.0 2.2 73.5 26.5 309 West Sumatera 83.1 61.4 94.3 70.1 7.1 97.6 2.4 94 Riau 67.0 40.3 71.0 57.5 12.3 76.2 23.8 111 Jambi 49.1 34.8 58.3 47.6 8.6 61.9 38.1 49 South Sumatera 76.7 50.2 88.9 78.4 13.1 96.4 3.6 97 Bengkulu 54.7 30.0 63.5 55.2 11.5 68.7 31.3 22 Lampung 45.7 14.9 46.5 37.0 1.5 55.1 44.9 123 Bangka-Belitung 79.6 34.9 80.8 70.2 9.9 88.5 11.5 17 Java DKI Jakarta 88.6 57.9 62.7 71.8 1.4 90.7 9.3 147 West Java 75.9 33.6 60.8 73.0 2.7 83.3 16.7 732 Central Java 66.6 34.0 55.1 52.8 11.6 74.6 25.4 456 DI Yogyakarta 72.3 43.6 75.7 60.5 5.2 87.9 12.1 34 East Java 65.2 24.0 59.1 40.2 4.3 69.5 30.5 563 Banten 62.4 30.0 70.2 59.7 14.5 82.6 17.4 179 Bali and Nusa Tenggara Bali 84.3 38.0 77.3 58.9 11.8 90.3 9.7 47 West Nusa Tenggara 53.7 39.6 58.8 57.0 1.2 63.4 36.6 83 East Nusa Tenggara 73.4 31.6 71.4 62.7 0.0 82.7 17.3 77 Kalimantan West Kalimantan 42.0 22.6 55.0 38.1 8.8 59.2 40.8 62 Central Kalimantan 48.1 18.9 59.1 42.8 4.8 69.9 30.1 51 South Kalimantan 51.8 12.0 71.2 52.3 3.6 77.2 22.8 48 East Kalimantan 70.1 49.3 72.3 57.0 9.7 77.1 22.9 58 Sulawesi North Sulawesi 87.7 40.3 69.6 57.0 24.3 88.5 11.5 41 Central Sulawesi 59.1 18.2 71.2 50.8 15.6 72.2 27.8 62 South Sulawesi 56.7 47.2 69.9 61.2 6.7 70.5 29.5 130 Southeast Sulawesi 61.4 39.0 59.9 64.3 9.8 72.3 27.7 43 Gorontalo 71.7 22.9 70.3 57.7 10.4 89.6 10.4 20 Total 65.3 32.6 63.6 57.0 6.4 76.9 23.1 3,653 Appendix B | 267 SURVEY DESIGN Appendix B B.1 INTRODUCTION The 2002-2003 IDHS obtained data from representative samples of ever-married women 15-49 and currently married men 15-54 to: · estimate demographic rates, particularly fertility and under-five mortality rates; · measure the level of contraceptive knowledge and practice · look at key child health indicators including the level of immunizations; the prevalence and treatment of diarrhea and other diseases; and child feeding practices; · assess the coverage of maternity care services; · explore men’s involvement in reproductive health; · investigate the direct and indirect determinants that influence the maternal and child health situation. The survey provides estimates at the national and provincial level for all of the above indicators. In each of the five districts in Central Java and the five districts in East Java which are covered in the Safe Motherhood Project, the sample was expanded to allow for estimates with acceptable precision for all of the main variables derived from the household and individual woman interviews. B.2 SAMPLE DESIGN AND IMPLEMENTATION Administratively, Indonesia is divided into 30 provinces. Each province is subdivided into districts (regency in areas mostly rural and municipality in urban areas). Districts are subdivided into subdistricts and each subdistrict is divided into villages. The entire village is classified as urban or rural. The primary objective of the 2002-2003 IDHS is to provide estimates with acceptable precision for the following domains: · Indonesia as a whole; · Each of 26 provinces covered in the survey. The four provinces excluded due to political instability are Nanggroe Aceh Darussalam, Maluku, North Maluku and Papua. These provinces cover 4 percent of the total population. · Urban and rural areas of Indonesia; · Each of the five districts in Central Java and the five districts in East Java covered in the Safe Motherhood Project (SMP), to provide information for the monitoring and evaluation of the project. These districts are: in Central Java: Cilacap, Rembang, Jepara, Pemalang, and Brebes. in East Java: Trenggalek, Jombang, Ngawi, Sampang and Pamekasan. 268 | Appendix B The census blocks (CBs) are the primary sampling unit for the 2002-2003 IDHS. CBs were formed during the preparation of the 2000 Population Census. Each CB includes approximately 80 households. In the master sample frame, the CBs are grouped by province, by regency/municipality within a province, and by subdistricts within a regency/municipality. In rural areas, the CBs in each district are listed by their geographical location. In urban areas, the CBs are distinguished by the urban classification (large, medium and small cities) in each subdistrict. BPS-Statistics Indonesia (BPS) maintains the list of CBs, which is used as a frame to draw samples for various surveys. The sample developed for the 2002 National Socio- economic Survey (Susenas) was used as a frame for the selection of the 2002-2003 IDHS sample. Household listing was done in all CBs covered in the 2002 Susenas. This eliminates the need to conduct a separate household listing for the 2002-2003 IDHS. A minimum of 40 CBs per province has been imposed in the 2002-2003 IDHS design. Since the sample was designed to provide reliable indicators for each province, the number of CBs in each province was not allocated proportional to the population of the province nor proportional by urban-rural classification. Therefore, a final weighing adjustment procedure was done to obtain estimates for all domains. The 2002-2003 IDHS sample is selected using a stratified two-stage design consisting of 1,592 CBs. Once the number of households was allocated to each province by urban and rural areas, the number of CBs was calculated based on an average sample take of 25 selected households. All ever-married women age 15-49 in these households are eligible for individual interview. Eight households in each CB selected for the women sample were selected for male interview. All currently married men age 15-54 identified in the selected households were interviewed. This sample is designed to provide estimates for the following domains: · Indonesia as a whole; · Urban and rural areas of Indonesia; · Province, for key indicators in the majority of provinces. In each province, the selection of CBs in urban and rural areas was done using multistage stratified sampling. In urban areas, in the first stage, CBs were selected using systematic sampling. In each selected CB, 25 households were randomly selected. In rural areas, the household selection was done in three stages. In the first stage, subdistricts were selected with probability proportional to the number of households. In the second stage, from each selected subdistrict, CBs were selected using systematic sampling. In the third stage, in each cluster, 25 households were randomly selected. Table B.1 Allocation of census blocks by province Province Number of census blocks 1. North Sumatera 60 2. Riau 50 3. West Sumatera 50 4. Jambi 40 5. South Sumatera 50 6. Bengkulu 40 7. Lampung 50 8. Bangka-Belitung 40 9. DKI Jakarta 82 10. West Java 84 11. Central Java 5 SMP Districts Remaining districts 100 74 12. DI Yogyakarta 66 13. East Java 5 SMP Districts Remaining districts 100 74 14. Banten 66 15. Bali 66 16. West Nusa Tenggara 50 17. East Nusa Tenggara 40 18. West Kalimantan 50 19. Central Kalimantan 40 20. South Kalimantan 50 21. East Kalimantan 40 22. North Sulawesi 50 23. Central Sulawesi 40 24. South Sulawesi 60 25. Southeast Sulawesi 26. Gorontalo 40 40 Total 1,592 Appendix B | 269 In each of the 10 districts in Central Java and East Java, clusters were selected systematically with probability proportional to the number of households. In the second stage, in each CB, 25 households were randomly selected. Results of the household sample implementation by urban-rural residence, by province as well as by male and female subsample are shown in Tables B.2.1 and B.2.2. As shown in Table B.2.1, 34,738 households were selected for the 2002-2003 IDHS. Of these, 95 percent were successfully interviewed, 2 percent were not interviewed because there were found to be vacant, and 2 percent were away during the survey fieldworkers’ visit. Other reasons for not interviewing households include having no competent respondent in the household, the dwelling was not found or the dwelling had been destroyed. The overall household response rate is 99 percent (see Table B.2.1 for definition). The level of successful household interviews ranges from 88 percent in West Kalimantan to 99 percent in Riau. The response rate is slightly higher in rural than in urban areas. Tables B.2.2 presents the survey coverage for women interviews. Of 29,996 women eligible for individual interview, 98 percent were successfully interviewed, 1 percent were not interviewed because they were not at home (see Table B.2.2 for definition). Urban women are as likely as rural women to be interviewed in the survey. The response rate does not vary much by province. The lowest rate is in West Kalimantan (96 percent), while in North Sumatera, South Sumatera, Central Kalimantan, North Sulawesi, and Central Sulawesi it is almost 100 percent. Table B.3.1 shows 10,877 households were selected for male subsample of the 2002-2003 IDHS. This is approximately one in three households selected for the women sample. Ninety-five percent of those households were successfully interviewed, 2 percent were not interviewed because the dweling was vacant and 2 percent were absent during the fieldworkers’ visit. The overall response rate is 99 percent, ranging from under 88 percent in West Kalimantan to 99-100 percent in Riau, Central Kalimantan, and Central Sulawesi. Table B.3.2 shows that 8,740 eligible men were identified for individual interview and of these, completed interviews were conducted with 8,310 men, yielding a response rate of 95 percent. The principal reason for nonresponse among eligible men was the failure to find them at home despite repeated visits to the household. The lower response rate for men was due to the more frequent and longer absence of men from the household. The level of successful household interviews among the provinces ranges from less than 90 percent in West Kalimantan, South Kalimantan, East Kalimantan, and South Sulawesi to 99-100 percent in North Sumatera, West Nusa Tenggara, Central Kalimantan, and Central Sulawesi. 270 | Appendix B Table B.2.1 Sample implementation: results of the household interview: women Percent distribution of households by results of the household interview, and household response rate, according to urban-rural residence and province, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Household present Dwelling but no vacant/ Number competent Dwell- House- address of Household Com- respondent ing not hold not a Dwelling sampled response Residence pleted at home Refused found absent dwelling destroyed Other house- rate and province (C) (HP) (R) (DNF) (HA) (DV) (DD) (O) Total holds (HRR)1 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Residence Urban 94.5 0.4 0.2 0.7 1.4 2.4 0.3 0.2 100.0 14,779 98.7 Rural 95.8 0.4 0.0 0.3 1.7 1.4 0.3 0.1 100.0 19,959 99.3 Sumatera North Sumatera 96.7 0.2 0.4 0.3 1.2 1.1 0.2 0.0 100.0 1,502 99.1 West Sumatera 97.8 0.3 0.0 0.2 1.1 0.5 0.0 0.1 100.0 1,250 99.5 Riau 99.1 0.4 0.1 0.0 0.3 0.1 0.0 0.0 100.0 1,230 99.5 Jambi 98.4 0.1 0.0 0.0 0.7 0.8 0.0 0.0 100.0 1,000 99.9 South Sumatera 98.2 0.0 0.2 0.3 0.1 0.8 0.3 0.1 100.0 1,247 99.4 Bengkulu 96.2 0.1 0.0 0.0 1.4 2.3 0.0 0.0 100.0 998 99.9 Lampung 96.8 0.2 0.0 0.0 1.1 1.6 0.3 0.0 100.0 1,248 99.8 Bangka-Belitung 89.9 0.3 0.2 0.9 3.2 4.7 0.7 0.1 100.0 1,000 98.5 Java DKI Jakarta 94.3 0.2 0.1 1.2 1.1 2.5 0.2 0.3 100.0 2,049 98.3 West Java 93.2 0.6 0.4 0.4 1.8 2.8 0.5 0.2 100.0 2,102 98.5 Central Java 97.6 0.3 0.0 0.3 0.5 1.0 0.3 0.0 100.0 1,848 99.4 DI Yogyakarta 94.5 1.0 0.0 0.1 1.0 3.1 0.2 0.1 100.0 1,648 98.8 East Java 97.1 0.1 0.1 0.2 1.1 1.2 0.2 0.0 100.0 1,842 99.7 Banten 93.0 0.3 0.3 1.8 0.5 3.7 0.4 0.1 100.0 1,650 97.5 Bali and Nusa Tenggara Bali 94.7 0.5 0.1 0.4 2.1 1.3 0.4 0.5 100.0 1,650 99.0 West Nusa Tenggara 95.9 0.1 0.1 0.3 0.8 2.5 0.2 0.1 100.0 1,249 99.5 East Nusa Tenggara 97.6 0.3 0.2 0.1 1.2 0.4 0.1 0.1 100.0 990 99.4 Kalimantan West Kalimantan 87.9 2.7 0.1 0.1 3.7 4.8 0.7 0.0 100.0 1,245 96.8 Central Kalimantan 98.3 0.1 0.0 0.2 0.5 0.6 0.1 0.2 100.0 1,000 99.7 South Kalimantan 91.4 0.3 0.1 0.6 3.5 2.6 1.0 0.4 100.0 1,250 98.9 East Kalimantan 93.5 0.3 0.4 0.9 3.6 1.1 0.2 0.0 100.0 997 98.3 Sulawesi North Sulawesi 94.0 0.2 0.0 1.6 1.5 1.1 0.8 0.8 100.0 1,253 98.2 Central Sulawesi 98.2 0.0 0.1 0.4 0.2 0.8 0.0 0.3 100.0 998 99.5 South Sulawesi 92.3 0.3 0.0 0.2 4.6 2.1 0.4 0.1 100.0 1,494 99.4 Southeast Sulawesi 97.5 0.0 0.0 0.0 2.5 0.0 0.0 0.0 100.0 998 100.0 Gorontalo 95.4 0.2 0.1 0.9 1.2 1.9 0.3 0.0 100.0 1,000 98.8 Total 95.3 0.4 0.1 0.5 1.5 1.8 0.3 0.1 100.0 34,738 99.0 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1 Using the number of households falling into specific response categories, the household response rate (HRR) is calculated as: 100 * C ——————————— C + HP + P + R + DNF Appendix B | 271 Table B.2.2 Sample implementation: results of the household interview: women Percent distribution of eligible women by results of the individual interview, and eligible women and overall response rates, according to urban-rural residence and province, Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Eligible Partly women Overall Com- Not com- Incapaci- Number response response Residence pleted at home Refused pleted tated Other of rate rate and province (C) (EWNH) (R) (EWPC) (EWI) (EWO) Total women (EWRR)1 (ORR)2 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Residence Urban 98.3 1.2 0.2 0.1 0.1 0.1 100.0 12,537 98.3 96.9 Rural 98.3 1.1 0.1 0.1 0.2 0.2 100.0 17,459 98.3 97.6 Sumatera North Sumatera 99.7 0.1 0.0 0.1 0.1 0.1 100.0 1,403 99.7 98.8 West Sumatera 97.9 1.9 0.1 0.1 0.0 0.0 100.0 1,130 97.9 97.4 Riau 97.4 1.8 0.2 0.0 0.3 0.4 100.0 1,170 97.4 96.9 Jambi 98.3 0.6 0.0 0.7 0.1 0.4 100.0 1,035 98.3 98.2 South Sumatera 99.6 0.4 0.0 0.0 0.0 0.0 100.0 1,247 99.6 99.0 Bengkulu 99.1 0.9 0.0 0.0 0.0 0.0 100.0 879 99.1 99.0 Lampung 98.5 1.2 0.3 0.0 0.0 0.0 100.0 1,066 98.5 98.3 Bangka-Belitung 97.6 1.1 0.6 0.0 0.0 0.8 100.0 663 97.6 96.1 Java DKI Jakarta 99.0 0.7 0.2 0.0 0.1 0.0 100.0 1,901 99.0 97.3 West Java 97.7 1.5 0.4 0.1 0.4 0.0 100.0 1,680 97.7 96.2 Central Java 98.1 1.2 0.1 0.1 0.1 0.3 100.0 1,599 98.1 97.5 DI Yogyakarta 98.8 1.1 0.2 0.0 0.0 0.0 100.0 1,043 98.8 97.6 East Java 97.9 1.4 0.1 0.1 0.4 0.1 100.0 1,537 97.9 97.6 Banten 98.9 0.6 0.1 0.0 0.2 0.1 100.0 1,398 98.9 96.5 Bali and Nusa Tenggara Bali 98.8 0.9 0.2 0.0 0.1 0.0 100.0 1,388 98.8 97.8 West Nusa Tenggara 98.7 0.5 0.3 0.3 0.1 0.1 100.0 967 98.7 98.2 East Nusa Tenggara 98.0 1.2 0.0 0.0 0.0 0.8 100.0 856 98.0 97.4 Kalimantan West Kalimantan 96.0 2.2 0.8 0.1 0.6 0.2 100.0 959 96.0 93.0 Central Kalimantan 99.7 0.0 0.0 0.1 0.0 0.2 100.0 912 99.7 99.4 South Kalimantan 97.2 2.3 0.2 0.0 0.2 0.1 100.0 1,039 97.2 96.1 East Kalimantan 97.2 2.4 0.1 0.0 0.4 0.0 100.0 850 97.2 95.5 Sulawesi North Sulawesi 99.7 0.1 0.0 0.1 0.0 0.1 100.0 1,070 99.7 97.9 Central Sulawesi 99.7 0.0 0.3 0.0 0.0 0.0 100.0 1,021 99.7 99.2 South Sulawesi 95.5 3.5 0.2 0.1 0.5 0.2 100.0 1,121 95.5 95.0 Southeast Sulawesi 98.9 0.4 0.0 0.0 0.0 0.7 100.0 1,034 98.9 98.9 Gorontalo 96.6 2.2 0.2 0.0 0.5 0.5 100.0 1,028 96.6 95.4 Total 98.3 1.1 0.2 0.1 0.2 0.2 100.0 29,996 98.3 97.3 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1 Using the number of eligible women falling into specific response categories, the eligible woman response rate (EWRR) is calculated as: 100 * C ———————————————————————— EWC + EWNH + EWP + EWR + EWPC + EWI + EWO 2 The overall response rate (ORR) is calculated as: ORR = HR * EWRR/100 272 | Appendix B Table B.3.1 Sample implementation: results of the household interview: men Percent distribution of households selected for the male subsample by results of the household interview, and household response rates, according to urban-rural residence and province Indonesia 2002-2003 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Household present Dwelling but no vacant/ Number competent Dwell- House- address of Household Com- respondent ing not hold not a Dwelling sampled response Residence pleted at home Refused found absent dwelling destroyed Other house- rate and province (C) (HP) (R) (DNF) (HA) (DV) (DD) (O) Total holds (HRR)1 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Residence Urban 94.8 0.5 0.2 0.4 1.4 2.5 0.2 0.1 100.0 4,642 99.0 Rural 95.8 0.3 0.0 0.2 1.6 1.5 0.4 0.1 100.0 6,235 99.4 Sumatera North Sumatera 96.8 0.0 0.4 0.2 1.3 1.1 0.2 0.0 100.0 465 99.3 West Sumatera 98.0 0.0 0.0 0.3 1.0 0.8 0.0 0.0 100.0 394 99.7 Riau 99.5 0.5 0.0 0.0 0.0 0.0 0.0 0.0 100.0 389 99.5 Jambi 97.8 0.3 0.0 0.0 0.6 1.3 0.0 0.0 100.0 318 99.7 South Sumatera 98.2 0.0 0.0 0.3 0.3 1.0 0.3 0.0 100.0 393 99.7 Bengkulu 95.4 0.0 0.0 0.0 2.3 2.3 0.0 0.0 100.0 303 100.0 Lampung 96.2 0.3 0.0 0.0 1.5 1.5 0.5 0.0 100.0 390 99.7 Bangka-Belitung 90.3 0.3 0.0 0.3 4.1 4.7 0.3 0.0 100.0 319 99.3 Java DKI Jakarta 94.7 0.0 0.0 0.6 1.3 3.0 0.2 0.2 100.0 624 99.3 West Java 93.9 0.4 0.3 0.1 2.4 2.5 0.3 0.0 100.0 671 99.1 Central Java 98.3 0.5 0.0 0.0 0.2 0.7 0.3 0.0 100.0 583 99.5 DI Yogyakarta 94.3 0.8 0.0 0.0 1.0 3.2 0.8 0.0 100.0 524 99.2 East Java 97.1 0.0 0.2 0.0 1.1 1.4 0.2 0.0 100.0 555 99.8 Banten 93.5 0.4 0.0 1.7 0.4 3.4 0.4 0.2 100.0 523 97.8 Bali and Nusa Tenggara Bali 93.8 1.5 0.2 0.2 1.7 1.5 0.4 0.6 100.0 518 98.0 West Nusa Tenggara 95.2 0.0 0.0 0.5 0.8 2.9 0.5 0.0 100.0 377 99.4 East Nusa Tenggara 96.4 0.7 0.3 0.0 1.6 0.7 0.0 0.3 100.0 305 99.0 Kalimantan West Kalimantan 88.4 2.8 0.0 0.0 2.6 5.4 0.8 0.0 100.0 389 96.9 Central Kalimantan 99.4 0.0 0.0 0.0 0.3 0.3 0.0 0.0 100.0 317 100.0 South Kalimantan 91.3 0.3 0.0 0.5 3.3 3.1 1.3 0.3 100.0 390 99.2 East Kalimantan 92.7 0.6 0.3 0.9 3.8 1.3 0.3 0.0 100.0 317 98.0 Sulawesi North Sulawesi 97.2 0.0 0.0 0.0 0.8 1.3 0.3 0.5 100.0 389 100.0 Central Sulawesi 99.4 0.0 0.3 0.3 0.0 0.0 0.0 0.0 100.0 318 99.4 South Sulawesi 90.9 0.0 0.0 0.4 4.7 3.2 0.6 0.2 100.0 471 99.5 Southeast Sulawesi 97.5 0.0 0.0 0.0 2.5 0.0 0.0 0.0 100.0 316 100.0 Gorontalo 96.9 0.0 0.0 0.9 1.3 0.9 0.0 0.0 100.0 319 99.0 Total 95.4 0.4 0.1 0.3 1.5 1.9 0.3 0.1 100.0 10,877 99.2 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1 Using the number of households falling into specific response categories, the household response rate (HRR) is calculated as: 100 * C ——————————— C + HP + P + R + DNF Appendix B | 273 Table B.3.2 Sample implementation: results of the household interview: men Percent distribution of eligible men by results of the individual interview, and eligible men and overall response rates, according to urban- rural residence and province, Indonesia 2002-2003 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Eligible Partly men Overall Com- Not Post- com- Incapaci- Number response response Residence pleted at home poned Refused pleted tated Other of rate rate and province (C) (EMNH) ((EMP) (R) (EMPC) (EMI) (EMO) Total men (EMRR)1 (ORR)2 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Residence Urban 95.2 3.5 0.0 0.4 0.0 0.1 0.9 100.0 3,736 95.2 94.2 Rural 95.0 4.0 0.0 0.2 0.0 0.2 0.5 100.0 5,004 95.0 94.4 Sumatera North Sumatera 99.3 0.0 0.0 0.0 0.5 0.0 0.2 100.0 420 99.3 98.6 West Sumatera 88.0 12.0 0.0 0.0 0.0 0.0 0.0 100.0 324 88.0 87.7 Riau 94.1 5.1 0.0 0.0 0.0 0.3 0.6 100.0 356 94.1 93.6 Jambi 98.0 1.3 0.0 0.3 0.0 0.0 0.3 100.0 306 98.0 97.7 South Sumatera 98.5 0.5 0.0 0.0 0.0 0.0 1.0 100.0 396 98.5 98.2 Bengkulu 94.5 2.7 0.0 0.4 0.4 0.0 2.0 100.0 255 94.5 94.5 Lampung 92.5 6.8 0.0 0.3 0.0 0.3 0.0 100.0 293 92.5 92.2 Bangka-Belitung 91.6 4.7 0.0 0.5 0.0 0.0 3.3 100.0 214 91.6 91.0 Java DKI Jakarta 98.2 0.9 0.2 0.4 0.0 0.0 0.4 100.0 571 98.2 97.6 West Java 94.4 4.7 0.0 0.4 0.0 0.0 0.4 100.0 485 94.4 93.5 Central Java 96.4 3.6 0.0 0.0 0.0 0.0 0.0 100.0 441 96.4 95.9 DI Yogyakarta 94.5 5.5 0.0 0.0 0.0 0.0 0.0 100.0 307 94.5 93.7 East Java 97.9 1.8 0.0 0.2 0.0 0.0 0.0 100.0 438 97.9 97.8 Banten 95.2 3.8 0.0 0.0 0.0 0.0 1.0 100.0 397 95.2 93.1 Bali and Nusa Tenggara Bali 98.5 1.2 0.0 0.0 0.0 0.2 0.0 100.0 410 98.5 96.5 West Nusa Tenggara 99.6 0.4 0.0 0.0 0.0 0.0 0.0 100.0 240 99.6 99.0 East Nusa Tenggara 91.9 5.5 0.4 0.8 0.0 0.0 1.3 100.0 236 91.9 91.0 Kalimantan West Kalimantan 87.6 9.7 0.0 0.0 0.0 1.9 0.8 100.0 259 87.6 84.9 Central Kalimantan 99.3 0.0 0.0 0.0 0.0 0.0 0.7 100.0 291 99.3 99.3 South Kalimantan 88.3 8.8 0.0 0.7 0.0 0.4 1.8 100.0 273 88.3 87.5 East Kalimantan 87.0 10.3 0.0 0.8 0.0 0.0 1.9 100.0 261 87.0 85.2 Sulawesi North Sulawesi 98.8 1.2 0.0 0.0 0.0 0.0 0.0 100.0 329 98.8 98.8 Central Sulawesi 99.7 0.0 0.0 0.0 0.0 0.0 0.3 100.0 323 99.7 99.1 South Sulawesi 84.5 11.6 0.3 2.6 0.0 0.6 0.3 100.0 310 84.5 84.1 Southeast Sulawesi 98.4 0.9 0.0 0.0 0.0 0.0 0.6 100.0 321 98.4 98.4 Gorontalo 93.3 2.8 0.0 0.4 0.0 1.1 2.5 100.0 284 93.3 92.4 Total 95.1 3.8 0.0 0.3 0.0 0.2 0.6 100.0 8,740 95.1 94.3 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1 Using the number of eligible men falling into specific response categories, the eligible man response rate (EWRR) is calculated as: 100 * C ———————————————————————— EMC + EMNH + EMP + EMR + EMPC + EMI + EMO 2 The overall response rate (ORR) is calculated as: ORR = HR * EMRR/100 274 | Appendix B B.3 PRETEST BPS piloted the questionnaire, control form, and manuals in August 2002 to detect any possible problems in the translations or flow of the questionnaire, as well as to gauge the length of time required for interviews. Another important objective of the pretest was to gain experience in field operations and interviewing men, because for the first time IDHS included individual interviews with men. The pretest took place in two provinces, Jambi and South Kalimantan. Pretest training took place from August 1-18, 2002 with the last day spent to train the supervisors and editors to perform their tasks. The training was conducted following the IDHS training procedures, including class presentations, mock interviews, field practice and tests. The training included practice interviews using the questionnaire in Bahasa Indonesia and the local dialect. In each province, 12 people were trained, forming two teams, each consisting of one male supervisor, one female field editor, three female interviewers and one male interviewer. All trainees were employees of BPS field offices. Pretest fieldwork lasted for a week (August 22-30, 2002). Fieldwork was conducted in both urban and rural settings. In South Kalimantan, one urban and two rural census blocks were visited. In each census block, 25 households were selected. These households were interviewed using the Household Questionnaires, where all ever-married women age 15-49 and currently married males age 15- 54 were identified. In all selected census blocks, a total of 150 households were visited, 75 in Jambi and 75 in South Kalimantan. The survey instruments were finalized following discussions with the National Family Planning Coordinating Board and and the Ministry of Health. B.4 TRAINING A total of 530 persons, 362 women and 168 men, participated in the main survey training for interviewers. Training for 23 provinces took place September 30 through October 17, 2002, while for the three new provinces, training was held in February 2003. The training was conducted following the DHS training procedures including class presentations, mock interviews, and tests. All of the participants were trained using the Women’s Questionnaire. Once the materials for the women interview were completed, the male participants were trained in conducting an interview using the Men’s Questionnaire. The training included practice interviews in Bahasa Indonesia and participant’s local language. B.5 FIELDWORK The 2002-2003 IDHS data was collected by 94 interviewing teams. Each team consisted of one team supervisor, one field editor, three female interviewers and one male interviewer. Field operations took place over a five-and-a-half-month period, from October 21, 2002 to April 9, 2003. In most provinces, data collection took a break for at least one month during the Muslim fasting month, which fell in early November through early December 2002. In Riau, fieldwork began only in December 2002. In three provinces, Bangka-Belitung, Banten, and Gorontalo, training of field staff was in March 2003 and data collection took place in April and May 2003. B.6 DATA PROCESSING All completed questionnaires for IDHS, accompanied by their control forms, were returned to the BPS central office in Jakarta for data processing. This process consisted of office editing, coding of open-ended questions, data entry, verification, and editing computer-identified errors. A team of about 40 data entry clerks, data editors, and two data entry supervisors processed the data. Data entry and editing started on November 4, 2002 using a computer package program called CSPro, which was specifically designed to process DHS-type survey data. To prepare the data entry programs, two BPS staff spent three weeks in ORC Macro offices in Calverton, Maryland in April 2002. ESTIMATES OF SAMPLING ERRORS Appendix C 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 the questions on the part of either the interviewer or the respondent, and data entry errors. Although numerous efforts were made during the implementation of the 2002-2003 Indonesia Demographic and Health Survey (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 2002-2003 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. A 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 2002-2003 IDHS sample is the result of a multi-stage stratified design, and, consequently, it was necessary to use more complex formulae. The computer software used to calculate sampling errors for the 2002-2003 IDHS is the ISSA Sampling Error Module. This module used the Taylor linearization method of variance estimation for survey estimates that are means or proportions. The Jackknife 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: ∑ ∑ = =− ⎥⎥⎦ ⎤ ⎢⎢⎣ ⎡ ⎟⎟⎠ ⎞ ⎜⎜⎝ ⎛ −−== H h h h m i hi h h m z z m m x frvarrSE h 1 2 1 2 1 2 2 1)()( in which hihihi rxyz −= , and hhh rxyz −= Appendix C | 275 where h represents the stratum which varies from 1 to H, mh is the total number of clusters selected in the hth stratum, yhi is the sum of the weighted values of variable y in the ith cluster in the hth stratum, xhi is the sum of the weighted number of cases in the ith cluster in the hth stratum, and f is the overall sampling fraction, which is so small that it is ignored. The Jackknife 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 2002-2003 IDHS, there were 1,392 non-empty clusters. Hence, 1,391 replications were created. The variance of a rate r is calculated as follows: SE r var r k k r r i k i 2 1 21 1 ( ) ( ) ( ) ( )= = − −=∑ in which )()1( ii rkkrr −−= where r is the estimate computed from the full sample of 1392 clusters, r(i) is the estimate computed from the reduced sample of 1391 clusters (ith cluster excluded), and k is the total number of clusters. In addition to the standard error, ISSA computes the design effect (DEFT) for each estimate, which is defined as the ratio between the standard error using the given sample design and the standard error that would result if a 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 2002-2003 IDHS are calculated for selected variables considered to be of primary interest for woman’s survey and for man’s surveys, respectively. The results are presented in this appendix for the country as a whole, for urban and rural areas, and for each of the 26 provinces. For each variable, the type of statistic (mean, proportion, or rate) and the base population are given in Table C.1. Tables C.2 to C.30 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 considering 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 child-bearing. The confidence interval (e.g., as calculated for children ever born to women aged 40-49) can be interpreted as follows: the overall average from the national sample is 4.024 and its standard error is 0.054. Therefore, to obtain the 95 percent confidence limits, one adds and subtracts twice the standard error to the sample estimate, i.e., 4.024±2×0.054. There is a high probability (95 percent) that the true average number of children ever born to all women aged 40 to 49 is between 3.915 and 4.133. Sampling errors are analyzed for the national woman sample and for two separate groups of estimates: (1) means and proportions, and (2) complex demographic rates. The relative standard errors (SE/R) for the means and proportions range between 0.1 percent and 7.4 percent with an average of 2.8 percent; the highest relative standard errors are for estimates of very low values (e.g., women currently using periodic abstinence). If estimates of very low values (less than 10 percent) were removed, then the average drops to 2.2 percent. So in general, the relative standard error for most estimates for the country 276 | Appendix C as a whole is small, except for estimates of very small proportions. The relative standard error for the total fertility rate is small, 1.8 percent. However, for the mortality rates, the average relative standard error is much higher, 8.2 percent. There are differentials in the relative standard error for the estimates of sub-populations. For example, for the variable want no more children, the relative standard errors as a percent of the estimated mean for the whole country, and for the urban areas are 1.1 percent and 2.0 percent, respectively. For the total sample, the value of the design effect (DEFT), averaged over all variables, is 2.05 which means that, due to multi-stage clustering of the sample, the average standard error is increased by a factor of 2.05 over that in an equivalent simple random sample. Appendix C | 277 Table C.1 List of selected variables for sampling errors, Indonesia 2002-2003 Variable Estimate Base population WOMEN Urban residence Proportion Ever-married women 15-49 Literate Proportion Ever-married women 15-49 No education Proportion Ever-married women 15-49 Secondary education or higher Proportion Ever-married women 15-49 Currently married (in union) Proportion Ever-married women 15-49 Currently pregnant Proportion All women 15-49 Children ever born Mean Currently married women 15-49 Children surviving Mean Currently married women 15-49 Children ever born to women over 40 Mean Women aged 40-49 Knowing any contraceptive method Proportion Currently married women 15-49 Ever used any contraceptive method Proportion Currently married women 15-49 Currently using any method Proportion Currently married women 15-49 Currently using a modern method Proportion Currently married women 15-49 Currently using pill Proportion Currently married women 15-49 Currently using IUD Proportion Currently married women 15-49 Currently using female sterilization Proportion Currently married women 15-49 Currently using periodic abstinence Proportion Currently married women 15-49 Using public sector source Proportion Current users of modern method Want no more children Proportion Currently married women 15-49 Want to delay at least 2 years Proportion Currently married women 15-49 Ideal number of children Mean Ever-married women 15-49 Mothers received tetanus injection Proportion Last birth in 5 years Mothers received medical care at birth Proportion Births in last 5 years Had diarrhea in the last 2 weeks Proportion Children under 5 Treated with ORS packets Proportion Children under 5 with diarrhea in last 2 weeks Sought medical treatment Proportion Children under 5 with diarrhea in last 2 weeks Having health card Proportion Children 12-23 months Received BCG vaccination Proportion Children 12-23 months Received DPT vaccination (3 doses) Proportion Children 12-23 months Received polio vaccination (3 doses) Proportion Children 12-23 months Received measles vaccination Proportion Children 12-23 months Received all vaccinations Proportion Children 12-23 months Total fertility rate (3 years) Rate Women-years of exposure to childbearing Perinatal mortality (0-4 years) Ratio Number of pregnancies of 7+ months Neonatal mortality rate (10 years)1 Rate Children exposed to the risk of mortality Postneonatal mortality rate (10 years)1 Rate Children exposed to the risk of mortality Infant mortality rate (10 years)1 Rate Children exposed to the risk of mortality Child mortality rate (10 years)1 Rate Children exposed to the risk of mortality Under-five mortality rate (10 years)1 Rate Children exposed to the risk of mortality MEN Urban residence Proportion Currently married men 15-54 No education Proportion Currently married men 15-54 Secondary education or higher Proportion Currently married men 15-54 Know any contraceptive method Proportion Currently married men 15-54 Know any modern contraceptive method Proportion Currently married men 15-54 1 5 years for national sample 278 | Appendix C Table C.2 Sampling errors: National sample, Indonesia 2002-2003 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ 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 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ WOMEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.458 0.011 29483 29483 3.679 0.023 0.436 0.479 Literate 0.864 0.005 29483 29483 2.719 0.006 0.853 0.875 No education 0.079 0.004 29483 29483 2.625 0.052 0.071 0.087 With secondary or higher education 0.382 0.008 29483 29483 2.745 0.020 0.366 0.397 Currently married 0.945 0.002 29483 29483 1.808 0.003 0.940 0.950 Currently pregnant 0.041 0.002 39667 39315 1.674 0.042 0.038 0.045 Children ever born 2.659 0.026 27784 27857 2.195 0.010 2.608 2.711 Children surviving 2.421 0.021 27784 27857 2.043 0.009 2.380 2.463 Children ever born to women over 40 4.024 0.054 8674 8848 2.236 0.014 3.915 4.133 Know any contraceptive method 0.987 0.001 27784 27857 1.817 0.001 0.984 0.989 Ever used any contraceptive method 0.816 0.005 27784 27857 2.213 0.006 0.806 0.826 Currently using any method 0.603 0.007 27784 27857 2.433 0.012 0.589 0.618 Currently using pill 0.132 0.005 27784 27857 2.317 0.036 0.123 0.142 Currently using IUD 0.062 0.003 27784 27857 2.236 0.052 0.055 0.068 Currently using female sterilization 0.037 0.003 27784 27857 2.347 0.072 0.032 0.043 Currently using periodic abstinence 0.016 0.001 27784 27857 1.578 0.074 0.014 0.018 Using public sector source 0.280 0.010 15413 15843 2.696 0.035 0.260 0.299 Want no more children 0.500 0.006 27784 27857 1.877 0.011 0.489 0.512 Want to delay at least 2 years 0.236 0.005 27784 27857 1.778 0.019 0.227 0.245 Ideal number of children 2.878 0.022 25300 25217 2.938 0.008 2.835 2.922 Mothers received tetanus injection 0.721 0.009 13349 12760 2.269 0.012 0.703 0.739 Mothers received medical care at birth 0.662 0.013 16206 15089 2.948 0.019 0.637 0.688 Had diarrhea in the last two weeks 0.110 0.006 15505 14510 2.064 0.051 0.099 0.121 Treated with ORS packets 0.355 0.020 1526 1596 1.638 0.058 0.314 0.396 Sought medical treatment 0.508 0.019 1526 1596 1.473 0.038 0.469 0.547 Having health card 0.307 0.017 3097 2819 1.934 0.055 0.273 0.340 Received BCG vaccination 0.825 0.014 3097 2819 1.976 0.017 0.796 0.853 Received DPT vaccination (3 doses) 0.583 0.015 3097 2819 1.652 0.026 0.552 0.614 Received polio vaccination (3 doses) 0.661 0.016 3097 2819 1.758 0.024 0.629 0.692 Received measles vaccination 0.716 0.016 3097 2819 1.867 0.022 0.684 0.748 Received all vaccinations 0.515 0.016 3097 2819 1.649 0.030 0.483 0.546 Total fertility rate 0-3 years 2.566 0.047 NA 112529 2.008 0.018 2.471 2.661 Perinatal mortality (0-4 years) 24.308 1.999 16367 15236 1.526 0.082 20.31 28.31 Neonatal mortality 0-4 years 19.591 1.861 16299 15220 1.587 0.095 15.868 23.314 Post-neonatal mortality 0-4 years 15.130 1.563 16312 15229 1.510 0.103 12.003 18.257 Infant mortality 0-4 years 34.720 2.426 16314 15233 1.547 0.070 29.869 39.572 Infant mortality 5-9 years 50.758 3.504 16278 15605 1.793 0.069 43.751 57.765 Infant mortality 10-14 years 58.677 3.750 15210 14982 1.749 0.064 51.176 66.178 Child mortality 0-4 years 11.296 1.315 16384 15291 1.506 0.116 8.667 13.926 Under-five mortality 0-4 years 45.624 2.634 16401 15309 1.469 0.058 40.356 50.893 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ MEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.465 0.010 8310 8310 1.873 0.022 0.445 0.486 No education 0.041 0.004 8310 8310 1.807 0.096 0.033 0.049 With secondary or higher education 0.455 0.011 8310 8310 2.000 0.024 0.433 0.476 Know any contraceptive method 0.967 0.003 8310 8310 1.499 0.003 0.961 0.973 Know any modern contraceptive method 0.963 0.003 8310 8310 1.472 0.003 0.957 0.969 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ NA = Not applicable Appendix C | 279 Table C.3 Sampling errors: Urban sample, Indonesia 2002-2003 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ 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 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ WOMEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 1.000 0.000 12318 13499 NA 0.000 1.000 1.000 Literate 0.915 0.006 12318 13499 2.240 0.006 0.904 0.926 No education 0.050 0.004 12318 13499 1.940 0.077 0.042 0.057 With secondary or higher education 0.526 0.013 12318 13499 2.779 0.024 0.501 0.551 Currently married 0.946 0.004 12318 13499 1.809 0.004 0.938 0.953 Currently pregnant 0.038 0.003 17529 19335 1.553 0.066 0.033 0.043 Children ever born 2.624 0.037 11568 12765 2.063 0.014 2.549 2.698 Children surviving 2.420 0.030 11568 12765 1.915 0.012 2.360 2.480 Children ever born to women over 40 3.992 0.084 3730 4068 2.259 0.021 3.823 4.160 Know any contraceptive method 0.993 0.001 11568 12765 1.885 0.001 0.990 0.996 Ever used any contraceptive method 0.831 0.008 11568 12765 2.326 0.010 0.815 0.847 Currently using any method 0.611 0.009 11568 12765 1.887 0.014 0.594 0.628 Currently using pill 0.141 0.008 11568 12765 2.384 0.055 0.126 0.157 Currently using IUD 0.079 0.005 11568 12765 2.100 0.067 0.068 0.089 Currently using female sterilization 0.048 0.005 11568 12765 2.419 0.100 0.038 0.057 Currently using periodic abstinence 0.023 0.002 11568 12765 1.604 0.097 0.019 0.027 Using public sector source 0.243 0.015 6568 7295 2.800 0.061 0.213 0.273 Want no more children 0.505 0.010 11568 12765 2.155 0.020 0.485 0.525 Want to delay at least 2 years 0.230 0.007 11568 12765 1.874 0.032 0.215 0.244 Ideal number of children 2.835 0.033 10903 11633 3.104 0.012 2.768 2.901 Mothers received tetanus injection 0.765 0.014 5511 5970 2.355 0.018 0.738 0.792 Mothers received medical care at birth 0.790 0.019 6570 7029 3.357 0.024 0.751 0.828 Had diarrhea in the last two weeks 0.112 0.009 6371 6830 2.217 0.083 0.094 0.131 Treated with ORS packets 0.350 0.032 632 767 1.699 0.092 0.286 0.415 Sought medical treatment 0.546 0.029 632 767 1.439 0.052 0.489 0.603 Having health card 0.319 0.023 1295 1326 1.712 0.072 0.273 0.365 Received BCG vaccination 0.884 0.019 1295 1326 2.110 0.022 0.846 0.923 Received DPT vaccination (3 doses) 0.645 0.024 1295 1326 1.763 0.038 0.596 0.694 Received polio vaccination (3 doses) 0.726 0.024 1295 1326 1.845 0.033 0.679 0.774 Received measles vaccination 0.776 0.023 1295 1326 1.944 0.030 0.730 0.823 Received all vaccinations 0.564 0.024 1295 1326 1.678 0.043 0.516 0.612 Total fertility rate 0-3 years 2.446 0.060 NA 55099 1.793 0.025 2.326 2.567 Perinatal mortality (0-4 years) 21.591 2.734 6637 7085 1.459 0.127 16.12 27.06 Neonatal mortality last 10 years 18.854 1.859 12936 14188 1.517 0.099 15.136 22.573 Post-neonatal mortality last 10 years 13.038 1.651 12941 14197 1.560 0.127 9.735 16.340 Infant mortality last 10 years 31.892 2.669 12942 14199 1.597 0.084 26.555 37.229 Child mortality last 10 years 10.749 1.858 12974 14232 1.982 0.173 7.034 14.465 Under-five mortality last 10 years 42.299 3.329 12981 14244 1.744 0.079 35.642 48.956 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ MEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 1.000 0.000 3555 3866 NA 0.000 1.000 1.000 No education 0.019 0.004 3555 3866 1.684 0.203 0.011 0.027 With secondary or higher education 0.601 0.017 3555 3866 2.103 0.029 0.566 0.636 Know any contraceptive method 0.984 0.004 3555 3866 1.733 0.004 0.976 0.991 Know any modern contraceptive method 0.982 0.004 3555 3866 1.727 0.004 0.975 0.990 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ NA = Not applicable 280 | Appendix C Table C.4 Sampling errors: Rural sample, Indonesia 2002-2003 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ 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 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ WOMEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.000 0.000 17165 15984 NA NA 0.000 0.000 Literate 0.821 0.008 17165 15984 2.896 0.010 0.804 0.838 No education 0.104 0.007 17165 15984 2.903 0.065 0.091 0.118 With secondary or higher education 0.259 0.009 17165 15984 2.667 0.034 0.242 0.277 Currently married 0.944 0.003 17165 15984 1.796 0.003 0.938 0.951 Currently pregnant 0.045 0.003 21562 19903 1.760 0.056 0.040 0.050 Children ever born 2.690 0.036 16216 15093 2.322 0.014 2.617 2.762 Children surviving 2.422 0.029 16216 15093 2.151 0.012 2.365 2.480 Children ever born to women over 40 4.061 0.071 4930 4769 2.204 0.017 3.919 4.203 Know any contraceptive method 0.981 0.002 16216 15093 1.861 0.002 0.977 0.985 Ever used any contraceptive method 0.803 0.007 16216 15093 2.109 0.008 0.790 0.816 Currently using any method 0.597 0.011 16216 15093 2.867 0.019 0.575 0.619 Currently using pill 0.125 0.006 16216 15093 2.192 0.046 0.114 0.137 Currently using IUD 0.047 0.004 16216 15093 2.371 0.084 0.039 0.055 Currently using female sterilization 0.028 0.003 16216 15093 2.077 0.096 0.023 0.034 Currently using periodic abstinence 0.010 0.001 16216 15093 1.315 0.103 0.008 0.012 Using public sector source 0.311 0.013 8845 8548 2.630 0.042 0.285 0.337 Want no more children 0.497 0.006 16216 15093 1.542 0.012 0.485 0.509 Want to delay at least 2 years 0.242 0.006 16216 15093 1.663 0.023 0.231 0.253 Ideal number of children 2.916 0.029 14397 13585 2.846 0.010 2.857 2.974 Mothers received tetanus injection 0.683 0.012 7838 6791 2.143 0.017 0.660 0.706 Mothers received medical care at birth 0.551 0.016 9636 8059 2.703 0.029 0.519 0.584 Had diarrhea in the last two weeks 0.108 0.007 9134 7680 1.858 0.061 0.095 0.121 Treated with ORS packets 0.359 0.026 894 829 1.540 0.071 0.308 0.411 Sought medical treatment 0.473 0.027 894 829 1.525 0.057 0.420 0.527 Having health card 0.296 0.025 1802 1493 2.142 0.083 0.246 0.345 Received BCG vaccination 0.772 0.020 1802 1493 1.940 0.026 0.731 0.812 Received DPT vaccination (3 doses) 0.528 0.020 1802 1493 1.570 0.037 0.488 0.567 Received polio vaccination (3 doses) 0.603 0.020 1802 1493 1.662 0.034 0.562 0.644 Received measles vaccination 0.662 0.021 1802 1493 1.787 0.032 0.620 0.705 Received all vaccinations 0.471 0.020 1802 1493 1.618 0.043 0.430 0.511 Total fertility rate 0-3 years 2.700 0.072 NA 57041 2.096 0.027 2.556 2.844 Perinatal mortality (0-4 years) 26.669 2.876 9730 8151 1.577 0.108 20.92 32.42 Neonatal mortality last 10 years 26.201 2.465 19607 16607 1.831 0.094 21.270 31.131 Post-neonatal mortality last 10 years 26.192 2.042 19634 16624 1.528 0.078 22.108 30.276 Infant mortality last 10 years 52.392 3.587 19635 16626 1.856 0.068 45.219 59.566 Child mortality last 10 years 13.014 1.172 19679 16650 1.337 0.090 10.671 15.357 Under-five mortality last 10 years 64.725 3.848 19708 16671 1.801 0.059 57.029 72.420 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ MEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.000 0.000 4755 4444 NA NA 0.000 0.000 No education 0.060 0.007 4755 4444 1.912 0.110 0.047 0.074 With secondary or higher education 0.327 0.014 4755 4444 2.118 0.044 0.298 0.356 Know any contraceptive method 0.953 0.004 4755 4444 1.444 0.005 0.944 0.962 Know any modern contraceptive method 0.946 0.005 4755 4444 1.412 0.005 0.937 0.956 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ NA = Not applicable Appendix C | 281 Table C.5 Sampling errors: North Sumatera sample, Indonesia 2002-2003 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ 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 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ WOMEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.462 0.038 1399 2177 2.830 0.082 0.386 0.537 Literate 0.915 0.012 1399 2177 1.596 0.013 0.891 0.939 No education 0.038 0.011 1399 2177 2.091 0.280 0.017 0.060 With secondary or higher education 0.534 0.026 1399 2177 1.961 0.049 0.481 0.586 Currently married 0.952 0.010 1399 2177 1.686 0.010 0.932 0.971 Currently pregnant 0.040 0.005 2078 3162 0.976 0.121 0.030 0.050 Children ever born 3.134 0.084 1323 2071 1.438 0.027 2.966 3.303 Children surviving 2.914 0.068 1323 2071 1.312 0.023 2.778 3.050 Children ever born to women over 40 4.391 0.160 503 785 1.674 0.036 4.072 4.711 Know any contraceptive method 0.952 0.007 1323 2071 1.216 0.008 0.938 0.966 Ever used any contraceptive method 0.682 0.020 1323 2071 1.562 0.029 0.642 0.722 Currently using any method 0.525 0.019 1323 2071 1.348 0.035 0.488 0.562 Currently using pill 0.131 0.017 1323 2071 1.873 0.133 0.096 0.165 Currently using IUD 0.033 0.006 1323 2071 1.262 0.188 0.021 0.045 Currently using female sterilization 0.064 0.009 1323 2071 1.319 0.139 0.046 0.082 Currently using periodic abstinence 0.032 0.007 1323 2071 1.358 0.205 0.019 0.045 Using public sector source 0.282 0.034 566 894 1.778 0.119 0.215 0.350 Want no more children 0.514 0.017 1323 2071 1.267 0.034 0.479 0.549 Want to delay at least 2 years 0.206 0.014 1323 2071 1.297 0.070 0.177 0.235 Ideal number of children 3.466 0.072 1206 1856 1.837 0.021 3.322 3.609 Mothers received tetanus injection 0.330 0.028 659 1012 1.530 0.085 0.274 0.387 Mothers received medical care at birth 0.799 0.033 910 1372 1.909 0.041 0.733 0.864 Had diarrhea in the last two weeks 0.123 0.018 873 1325 1.463 0.144 0.088 0.159 Treated with ORS packets 0.234 0.064 113 163 1.409 0.274 0.106 0.363 Sought medical treatment 0.486 0.052 113 163 0.981 0.107 0.382 0.591 Having health card 0.224 0.050 183 289 1.625 0.222 0.125 0.323 Received BCG vaccination 0.742 0.051 183 289 1.580 0.068 0.641 0.843 Received DPT vaccination (3 doses) 0.419 0.040 183 289 1.100 0.095 0.340 0.499 Received polio vaccination (3 doses) 0.533 0.041 183 289 1.108 0.076 0.452 0.615 Received measles vaccination 0.563 0.052 183 289 1.421 0.092 0.460 0.667 Received all vaccinations 0.365 0.038 183 289 1.076 0.104 0.289 0.441 Total fertility rate 0-3 years 3.040 0.138 NA 8164 1.607 0.046 2.764 3.317 Perinatal mortality (0-4 years) 17.552 4.368 916 1378 1.000 0.249 8.815 26.29 Neonatal mortality last 10 years 23.930 4.206 1851 2745 1.106 0.176 15.517 32.343 Post-neonatal mortality last 10 years 17.861 3.997 1852 2747 1.245 0.224 9.866 25.855 Infant mortality last 10 years 41.791 6.301 1852 2747 1.247 0.151 29.189 54.392 Child mortality last 10 years 16.365 3.539 1860 2762 1.197 0.216 9.286 23.443 Under-five mortality last 10 years 57.471 8.480 1861 2763 1.445 0.148 40.511 74.432 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ MEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.460 0.039 417 663 1.590 0.084 0.383 0.538 No education 0.014 0.005 417 663 0.807 0.329 0.005 0.024 With secondary or higher education 0.601 0.031 417 663 1.290 0.052 0.539 0.663 Know any contraceptive method 0.957 0.011 417 663 1.130 0.012 0.935 0.980 Know any modern contraceptive method 0.933 0.012 417 663 0.976 0.013 0.909 0.957 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ NA = Not applicable 282 | Appendix C Table C.6 Sampling errors: West Sumatera sample, Indonesia 2002-2003 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ 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 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ WOMEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.396 0.030 1106 705 2.066 0.077 0.335 0.457 Literate 0.911 0.010 1106 705 1.130 0.011 0.891 0.930 No education 0.026 0.005 1106 705 1.082 0.200 0.015 0.036 With secondary or higher education 0.585 0.028 1106 705 1.903 0.048 0.529 0.641 Currently married 0.947 0.007 1106 705 1.022 0.007 0.934 0.961 Currently pregnant 0.057 0.007 1810 1018 0.895 0.125 0.043 0.072 Children ever born 3.102 0.126 1041 668 1.818 0.041 2.850 3.354 Children surviving 2.817 0.102 1041 668 1.710 0.036 2.613 3.021 Children ever born to women over 40 4.763 0.223 348 231 1.725 0.047 4.317 5.208 Know any contraceptive method 0.973 0.011 1041 668 2.250 0.012 0.950 0.995 Ever used any contraceptive method 0.763 0.029 1041 668 2.198 0.038 0.705 0.821 Currently using any method 0.529 0.036 1041 668 2.317 0.068 0.457 0.600 Currently using pill 0.091 0.020 1041 668 2.191 0.215 0.052 0.130 Currently using IUD 0.061 0.009 1041 668 1.150 0.140 0.044 0.078 Currently using female sterilization 0.034 0.009 1041 668 1.563 0.259 0.016 0.051 Currently using periodic abstinence 0.028 0.008 1041 668 1.547 0.282 0.012 0.044 Using public sector source 0.288 0.023 491 308 1.103 0.078 0.243 0.333 Want no more children 0.460 0.017 1041 668 1.111 0.037 0.426 0.494 Want to delay at least 2 years 0.244 0.022 1041 668 1.620 0.088 0.201 0.287 Ideal number of children 3.304 0.117 857 559 2.408 0.036 3.069 3.539 Mothers received tetanus injection 0.724 0.039 583 368 2.090 0.054 0.646 0.802 Mothers received medical care at birth 0.798 0.039 734 464 2.210 0.048 0.721 0.875 Had diarrhea in the last two weeks 0.143 0.017 703 445 1.238 0.118 0.109 0.177 Treated with ORS packets 0.408 0.067 105 64 1.278 0.164 0.274 0.541 Sought medical treatment 0.555 0.053 105 64 1.021 0.096 0.449 0.661 Having health card 0.439 0.066 129 80 1.483 0.151 0.306 0.571 Received BCG vaccination 0.840 0.049 129 80 1.507 0.059 0.741 0.939 Received DPT vaccination (3 doses) 0.665 0.056 129 80 1.315 0.084 0.553 0.776 Received polio vaccination (3 doses) 0.762 0.046 129 80 1.218 0.061 0.669 0.855 Received measles vaccination 0.660 0.056 129 80 1.313 0.085 0.548 0.771 Received all vaccinations 0.586 0.056 129 80 1.267 0.096 0.474 0.698 Total fertility rate 0-3 years 3.228 0.138 NA 2614 1.097 0.043 2.952 3.504 Perinatal mortality (0-4 years) 35.643 5.969 747 475 0.848 0.167 23.71 47.58 Neonatal mortality last 10 years 28.400 6.407 1487 925 1.370 0.226 15.586 41.214 Post-neonatal mortality last 10 years 19.156 6.682 1491 928 1.624 0.349 5.792 32.521 Infant mortality last 10 years 47.556 8.281 1491 928 1.370 0.174 30.995 64.118 Child mortality last 10 years 11.764 3.216 1489 926 1.029 0.273 5.332 18.197 Under-five mortality last 10 years 58.761 9.911 1493 929 1.415 0.169 38.940 78.583 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ MEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.376 0.041 285 182 1.437 0.110 0.293 0.459 No education 0.038 0.012 285 182 1.081 0.322 0.014 0.063 With secondary or higher education 0.524 0.046 285 182 1.552 0.088 0.432 0.616 Know any contraceptive method 0.958 0.016 285 182 1.327 0.017 0.926 0.989 Know any modern contraceptive method 0.956 0.016 285 182 1.314 0.017 0.925 0.988 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ NA = Not applicable Appendix C | 283 Table C.7 Sampling errors: Riau sample, Indonesia 2002-2003 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ 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 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ WOMEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.495 0.040 1139 660 2.701 0.081 0.414 0.575 Literate 0.882 0.016 1139 660 1.718 0.019 0.849 0.915 No education 0.045 0.011 1139 660 1.728 0.236 0.024 0.066 With secondary or higher education 0.497 0.035 1139 660 2.338 0.070 0.428 0.567 Currently married 0.964 0.005 1139 660 0.859 0.005 0.954 0.973 Currently pregnant 0.050 0.006 1541 888 1.072 0.121 0.038 0.062 Children ever born 2.898 0.119 1093 636 1.915 0.041 2.660 3.135 Children surviving 2.672 0.101 1093 636 1.806 0.038 2.471 2.874 Children ever born to women over 40 4.687 0.196 301 172 1.506 0.042 4.296 5.078 Know any contraceptive method 0.992 0.003 1093 636 0.946 0.003 0.986 0.997 Ever used any contraceptive method 0.819 0.016 1093 636 1.372 0.020 0.787 0.851 Currently using any method 0.578 0.021 1093 636 1.402 0.036 0.536 0.620 Currently using pill 0.176 0.016 1093 636 1.404 0.092 0.144 0.209 Currently using IUD 0.026 0.005 1093 636 0.997 0.185 0.016 0.036 Currently using female sterilization 0.013 0.005 1093 636 1.376 0.358 0.004 0.023 Currently using periodic abstinence 0.010 0.003 1093 636 1.092 0.329 0.003 0.017 Using public sector source 0.328 0.026 598 356 1.347 0.079 0.276 0.380 Want no more children 0.462 0.016 1093 636 1.065 0.035 0.430 0.494 Want to delay at least 2 years 0.261 0.016 1093 636 1.171 0.060 0.230 0.292 Ideal number of children 3.230 0.057 896 509 1.317 0.018 3.116 3.345 Mothers received tetanus injection 0.617 0.030 578 342 1.518 0.049 0.557 0.678 Mothers received medical care at birth 0.740 0.034 716 430 1.801 0.046 0.672 0.809 Had diarrhea in the last two weeks 0.061 0.008 682 413 0.866 0.134 0.045 0.077 Treated with ORS packets 0.349 0.072 49 25 0.957 0.207 0.205 0.494 Sought medical treatment 0.559 0.070 49 25 0.880 0.125 0.420 0.698 Having health card 0.352 0.052 134 81 1.274 0.146 0.249 0.456 Received BCG vaccination 0.836 0.032 134 81 1.031 0.039 0.772 0.901 Received DPT vaccination (3 doses) 0.633 0.052 134 81 1.277 0.082 0.529 0.737 Received polio vaccination (3 doses) 0.700 0.041 134 81 1.065 0.059 0.617 0.783 Received measles vaccination 0.754 0.045 134 81 1.240 0.060 0.663 0.844 Received all vaccinations 0.572 0.045 134 81 1.061 0.078 0.483 0.661 Total fertility rate 0-3 years 3.208 0.200 NA 2503 1.445 0.062 2.809 3.608 Perinatal mortality (0-4 years) 21.676 4.521 718 431 0.808 0.209 12.634 30.717 Neonatal mortality last 10 years 25.937 4.781 1427 845 1.068 0.184 16.375 35.499 Post-neonatal mortality last 10 years 16.914 7.585 1430 848 2.078 0.448 1.744 32.085 Infant mortality last 10 years 42.851 7.827 1430 848 1.288 0.183 27.198 58.504 Child mortality last 10 years 18.085 4.131 1435 850 1.270 0.228 9.822 26.348 Under-five mortality last 10 years 60.161 8.885 1438 853 1.303 0.148 42.392 77.931 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ MEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.532 0.038 335 199 1.381 0.071 0.456 0.607 No education 0.031 0.011 335 199 1.129 0.343 0.010 0.053 With secondary or higher education 0.589 0.035 335 199 1.306 0.060 0.519 0.659 Know any contraceptive method 0.964 0.019 335 199 1.819 0.019 0.927 1.001 Know any modern contraceptive method 0.964 0.019 335 199 1.819 0.019 0.927 1.001 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ NA = Not applicable 284 | Appendix C Table C.8 Sampling errors: Jambi sample, Indonesia 2002-2003 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ 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 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ WOMEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.280 0.030 1017 382 2.096 0.106 0.220 0.339 Literate 0.865 0.018 1017 382 1.701 0.021 0.829 0.902 No education 0.072 0.012 1017 382 1.441 0.162 0.049 0.095 With secondary or higher education 0.400 0.040 1017 382 2.595 0.100 0.320 0.480 Currently married 0.924 0.015 1017 382 1.754 0.016 0.895 0.953 Currently pregnant 0.067 0.014 1324 481 2.020 0.207 0.039 0.094 Children ever born 2.558 0.122 932 353 1.883 0.048 2.314 2.803 Children surviving 2.361 0.111 932 353 1.963 0.047 2.138 2.583 Children ever born to women over 40 4.465 0.236 266 100 1.794 0.053 3.992 4.937 Know any contraceptive method 0.992 0.005 932 353 1.603 0.005 0.982 1.001 Ever used any contraceptive method 0.773 0.023 932 353 1.664 0.030 0.728 0.819 Currently using any method 0.590 0.024 932 353 1.500 0.041 0.542 0.639 Currently using pill 0.154 0.016 932 353 1.344 0.103 0.122 0.186 Currently using IUD 0.046 0.009 932 353 1.351 0.201 0.028 0.065 Currently using female sterilization 0.009 0.003 932 353 1.030 0.359 0.002 0.015 Currently using periodic abstinence 0.004 0.002 932 353 0.809 0.420 0.001 0.007 Using public sector source 0.422 0.040 534 206 1.891 0.096 0.341 0.502 Want no more children 0.486 0.034 932 353 2.065 0.070 0.419 0.554 Want to delay at least 2 years 0.264 0.026 932 353 1.793 0.098 0.213 0.316 Ideal number of children 2.931 0.087 880 333 2.086 0.030 2.756 3.105 Mothers received tetanus injection 0.625 0.041 455 168 1.777 0.065 0.544 0.707 Mothers received medical care at birth 0.705 0.060 537 198 2.671 0.085 0.586 0.824 Had diarrhea in the last two weeks 0.081 0.023 513 189 1.827 0.285 0.035 0.127 Treated with ORS packets 0.525 0.077 40 15 0.941 0.147 0.370 0.679 Sought medical treatment 0.360 0.178 40 15 2.230 0.495 0.003 0.717 Having health card 0.321 0.101 94 32 1.997 0.316 0.118 0.523 Received BCG vaccination 0.847 0.049 94 32 1.247 0.058 0.749 0.944 Received DPT vaccination (3 doses) 0.516 0.077 94 32 1.412 0.148 0.363 0.670 Received polio vaccination (3 doses) 0.568 0.082 94 32 1.526 0.145 0.404 0.732 Received measles vaccination 0.732 0.060 94 32 1.255 0.083 0.611 0.853 Received all vaccinations 0.506 0.078 94 32 1.435 0.154 0.350 0.662 Total fertility rate 0-3 years 2.739 0.193 NA 1457 1.581 0.071 2.352 3.125 Perinatal mortality (0-4 years) 14.785 5.832 541 199 1.118 0.394 3.122 26.449 Neonatal mortality last 10 years 13.957 4.700 1121 411 1.041 0.337 4.558 23.356 Post-neonatal mortality last 10 years 27.536 9.740 1125 413 1.854 0.354 8.056 47.015 Infant mortality last 10 years 41.493 9.976 1125 413 1.493 0.240 21.540 61.445 Child mortality last 10 years 9.973 4.075 1124 412 1.281 0.409 1.824 18.122 Under-five mortality last 10 years 51.052 9.922 1128 414 1.343 0.194 31.207 70.897 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ MEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.279 0.034 300 114 1.296 0.121 0.211 0.346 No education 0.024 0.009 300 114 1.048 0.387 0.005 0.043 With secondary or higher education 0.499 0.045 300 114 1.548 0.090 0.409 0.588 Know any contraceptive method 0.970 0.011 300 114 1.152 0.012 0.947 0.993 Know any modern contraceptive method 0.968 0.012 300 114 1.183 0.012 0.944 0.992 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ NA = Not applicable Appendix C | 285 Table C.9 Sampling errors: South Sumatera sample, Indonesia 2002-2003 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ 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 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ WOMEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.300 0.037 1242 809 2.871 0.125 0.225 0.374 Literate 0.928 0.013 1242 809 1.824 0.014 0.901 0.955 No education 0.041 0.010 1242 809 1.828 0.249 0.021 0.062 With secondary or higher education 0.340 0.027 1242 809 1.995 0.079 0.286 0.394 Currently married 0.954 0.006 1242 809 1.059 0.007 0.941 0.967 Currently pregnant 0.025 0.004 1788 1157 0.995 0.154 0.017 0.033 Children ever born 3.076 0.071 1187 772 1.204 0.023 2.934 3.218 Children surviving 2.865 0.059 1187 772 1.110 0.021 2.746 2.983 Children ever born to women over 40 4.364 0.139 445 289 1.396 0.032 4.085 4.643 Know any contraceptive method 0.999 0.001 1187 772 0.869 0.001 0.998 1.001 Ever used any contraceptive method 0.782 0.015 1187 772 1.220 0.019 0.752 0.811 Currently using any method 0.614 0.018 1187 772 1.261 0.029 0.578 0.650 Currently using pill 0.099 0.015 1187 772 1.680 0.147 0.070 0.128 Currently using IUD 0.024 0.006 1187 772 1.320 0.243 0.012 0.036 Currently using female sterilization 0.046 0.007 1187 772 1.179 0.157 0.031 0.060 Currently using periodic abstinence 0.019 0.007 1187 772 1.718 0.360 0.005 0.032 Using public sector source 0.276 0.033 708 453 1.963 0.120 0.210 0.342 Want no more children 0.535 0.016 1187 772 1.075 0.029 0.504 0.566 Want to delay at least 2 years 0.176 0.016 1187 772 1.448 0.091 0.144 0.208 Ideal number of children 3.175 0.051 934 598 1.312 0.016 3.073 3.277 Mothers received tetanus injection 0.750 0.034 476 311 1.737 0.046 0.682 0.819 Mothers received medical care at birth 0.763 0.047 573 382 2.339 0.061 0.670 0.857 Had diarrhea in the last two weeks 0.033 0.012 554 368 1.487 0.376 0.008 0.057 Treated with ORS packets 0.371 0.137 17 12 1.116 0.369 0.097 0.644 Sought medical treatment 0.510 0.141 17 12 1.095 0.277 0.228 0.792 Having health card 0.125 0.040 91 59 1.131 0.315 0.046 0.204 Received BCG vaccination 0.882 0.035 91 59 1.040 0.040 0.812 0.953 Received DPT vaccination (3 doses) 0.560 0.081 91 59 1.531 0.145 0.398 0.722 Received polio vaccination (3 doses) 0.703 0.058 91 59 1.205 0.083 0.586 0.820 Received measles vaccination 0.782 0.046 91 59 1.055 0.059 0.690 0.874 Received all vaccinations 0.507 0.077 91 59 1.443 0.152 0.353 0.662 Total fertility rate 0-3 years 2.298 0.176 NA 2931 1.449 0.076 1.947 2.649 Perinatal mortality (0-4 years) 24.686 7.621 576 383 1.208 0.309 9.445 39.927 Neonatal mortality last 10 years 18.937 6.057 1267 853 1.489 0.320 6.824 31.051 Post-neonatal mortality last 10 years 11.539 3.092 1269 854 1.002 0.268 5.354 17.724 Infant mortality last 10 years 30.476 7.262 1269 854 1.415 0.238 15.952 45.001 Child mortality last 10 years 18.679 6.079 1276 861 1.572 0.325 6.521 30.838 Under-five mortality last 10 years 48.587 9.135 1278 863 1.453 0.188 30.316 66.857 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ MEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.280 0.041 390 259 1.794 0.146 0.198 0.361 No education 0.030 0.010 390 259 1.112 0.320 0.011 0.049 With secondary or higher education 0.449 0.033 390 259 1.301 0.073 0.383 0.515 Know any contraceptive method 0.981 0.008 390 259 1.181 0.008 0.965 0.997 Know any modern contraceptive method 0.981 0.008 390 259 1.181 0.008 0.965 0.997 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ NA = Not applicable 286 | Appendix C Table C.10 Sampling errors: Bengkulu sample, Indonesia 2002-2003 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ 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 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ WOMEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.310 0.042 871 159 2.663 0.135 0.226 0.393 Literate 0.894 0.015 871 159 1.447 0.017 0.864 0.925 No education 0.059 0.012 871 159 1.486 0.201 0.035 0.083 With secondary or higher education 0.466 0.035 871 159 2.061 0.075 0.396 0.536 Currently married 0.944 0.007 871 159 0.956 0.008 0.929 0.959 Currently pregnant 0.042 0.008 1152 207 1.408 0.197 0.025 0.058 Children ever born 3.092 0.092 822 150 1.343 0.030 2.909 3.276 Children surviving 2.731 0.078 822 150 1.370 0.029 2.576 2.887 Children ever born to women over 40 4.809 0.217 259 47 1.766 0.045 4.375 5.243 Know any contraceptive method 0.998 0.002 822 150 0.948 0.002 0.995 1.001 Ever used any contraceptive method 0.889 0.009 822 150 0.862 0.011 0.870 0.908 Currently using any method 0.682 0.020 822 150 1.233 0.029 0.642 0.723 Currently using pill 0.130 0.014 822 150 1.155 0.104 0.103 0.157 Currently using IUD 0.063 0.016 822 150 1.877 0.252 0.031 0.095 Currently using female sterilization 0.035 0.007 822 150 1.046 0.192 0.021 0.048 Currently using periodic abstinence 0.015 0.006 822 150 1.308 0.365 0.004 0.027 Using public sector source 0.261 0.023 528 96 1.188 0.087 0.215 0.306 Want no more children 0.549 0.022 822 150 1.246 0.039 0.506 0.593 Want to delay at least 2 years 0.252 0.017 822 150 1.121 0.067 0.218 0.286 Ideal number of children 3.111 0.052 744 137 1.167 0.017 3.006 3.216 Mothers received tetanus injection 0.798 0.033 413 76 1.705 0.042 0.731 0.865 Mothers received medical care at birth 0.686 0.069 484 90 2.877 0.101 0.547 0.825 Had diarrhea in the last two weeks 0.082 0.013 465 86 0.989 0.155 0.056 0.107 Treated with ORS packets 0.255 0.074 40 7 1.054 0.292 0.106 0.403 Sought medical treatment 0.509 0.081 40 7 0.997 0.160 0.346 0.672 Having health card 0.512 0.057 103 20 1.172 0.111 0.398 0.625 Received BCG vaccination 0.936 0.028 103 20 1.212 0.030 0.879 0.992 Received DPT vaccination (3 doses) 0.763 0.047 103 20 1.118 0.061 0.670 0.857 Received polio vaccination (3 doses) 0.840 0.036 103 20 0.989 0.043 0.768 0.913 Received measles vaccination 0.823 0.044 103 20 1.172 0.054 0.734 0.912 Received all vaccinations 0.683 0.044 103 20 0.964 0.064 0.595 0.770 Total fertility rate 0-3 years 2.963 0.206 NA 586 1.517 0.069 2.552 3.375 Perinatal mortality (0-4 years) 22.937 7.549 489 91 1.092 0.329 7.840 38.035 Neonatal mortality last 10 years 27.497 6.610 991 181 1.220 0.240 14.277 40.718 Post-neonatal mortality last 10 years 25.248 6.286 993 182 1.187 0.249 12.675 37.821 Infant mortality last 10 years 52.745 7.362 993 182 0.973 0.140 38.021 67.470 Child mortality last 10 years 16.608 3.704 999 183 0.926 0.223 9.200 24.016 Under-five mortality last 10 years 68.477 7.456 1001 183 0.874 0.109 53.565 83.390 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ MEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.299 0.046 241 44 1.548 0.153 0.207 0.390 No education 0.028 0.012 241 44 1.084 0.411 0.005 0.051 With secondary or higher education 0.559 0.047 241 44 1.479 0.085 0.465 0.654 Know any contraceptive method 0.979 0.016 241 44 1.711 0.016 0.947 1.011 Know any modern contraceptive method 0.979 0.016 241 44 1.711 0.016 0.947 1.011 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ NA = Not applicable Appendix C | 287 Table C.11 Sampling errors: Lampung sample, Indonesia 2002-2003 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ 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 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ WOMEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.275 0.030 1050 984 2.173 0.109 0.215 0.335 Literate 0.875 0.012 1050 984 1.190 0.014 0.851 0.899 No education 0.052 0.008 1050 984 1.228 0.162 0.035 0.068 With secondary or higher education 0.327 0.035 1050 984 2.385 0.106 0.258 0.396 Currently married 0.961 0.007 1050 984 1.214 0.008 0.947 0.976 Currently pregnant 0.044 0.007 1440 1264 1.126 0.154 0.031 0.058 Children ever born 2.991 0.078 1006 946 1.169 0.026 2.834 3.148 Children surviving 2.737 0.073 1006 946 1.218 0.027 2.590 2.884 Children ever born to women over 40 4.814 0.182 307 282 1.317 0.038 4.449 5.178 Know any contraceptive method 0.997 0.001 1006 946 0.633 0.001 0.995 0.999 Ever used any contraceptive method 0.860 0.016 1006 946 1.467 0.019 0.828 0.892 Currently using any method 0.614 0.021 1006 946 1.338 0.033 0.573 0.656 Currently using pill 0.136 0.018 1006 946 1.707 0.136 0.099 0.173 Currently using IUD 0.042 0.009 1006 946 1.377 0.208 0.024 0.059 Currently using female sterilization 0.018 0.005 1006 946 1.236 0.289 0.008 0.028 Currently using periodic abstinence 0.011 0.005 1006 946 1.601 0.474 0.001 0.022 Using public sector source 0.218 0.037 611 557 2.210 0.170 0.144 0.292 Want no more children 0.528 0.019 1006 946 1.180 0.035 0.490 0.565 Want to delay at least 2 years 0.278 0.020 1006 946 1.439 0.073 0.237 0.319 Ideal number of children 3.038 0.067 936 876 1.888 0.022 2.904 3.172 Mothers received tetanus injection 0.726 0.021 477 442 1.003 0.028 0.685 0.767 Mothers received medical care at birth 0.624 0.048 572 530 2.122 0.077 0.528 0.719 Had diarrhea in the last two weeks 0.092 0.020 549 509 1.551 0.218 0.052 0.132 Treated with ORS packets 0.303 0.075 52 47 1.117 0.247 0.153 0.452 Sought medical treatment 0.428 0.089 52 47 1.206 0.207 0.251 0.606 Having health card 0.402 0.088 106 103 1.818 0.219 0.226 0.579 Received BCG vaccination 0.877 0.029 106 103 0.924 0.033 0.819 0.935 Received DPT vaccination (3 doses) 0.610 0.053 106 103 1.082 0.087 0.505 0.716 Received polio vaccination (3 doses) 0.715 0.052 106 103 1.194 0.073 0.610 0.819 Received measles vaccination 0.798 0.057 106 103 1.398 0.071 0.685 0.912 Received all vaccinations 0.463 0.062 106 103 1.264 0.134 0.338 0.587 Total fertility rate 0-3 years 2.670 0.219 NA 3477 1.399 0.082 2.232 3.108 Perinatal mortality (0-4 years) 47.987 9.138 583 543 0.954 0.190 29.711 66.263 Neonatal mortality last 10 years 23.511 6.080 1199 1112 1.366 0.259 11.351 35.671 Post-neonatal mortality last 10 years 31.394 8.301 1201 1114 1.617 0.264 14.791 47.996 Infant mortality last 10 years 54.905 11.061 1202 1116 1.587 0.201 32.783 77.026 Child mortality last 10 years 9.968 3.031 1202 1113 1.075 0.304 3.906 16.031 Under-five mortality last 10 years 64.325 11.674 1206 1120 1.563 0.181 40.978 87.673 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ MEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.257 0.029 271 261 1.097 0.114 0.198 0.315 No education 0.029 0.010 271 261 0.987 0.347 0.009 0.049 With secondary or higher education 0.450 0.044 271 261 1.442 0.097 0.363 0.538 Know any contraceptive method 0.993 0.005 271 261 1.027 0.005 0.983 1.003 Know any modern contraceptive method 0.993 0.005 271 261 1.027 0.005 0.983 1.003 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ NA = Not applicable 288 | Appendix C Table C.12 Sampling errors: Bangka Belitung sample, Indonesia 2002-2003 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ 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 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ WOMEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.498 0.047 647 128 2.367 0.094 0.405 0.591 Literate 0.871 0.015 647 128 1.104 0.017 0.842 0.901 No education 0.093 0.010 647 128 0.865 0.106 0.073 0.113 With secondary or higher education 0.305 0.029 647 128 1.589 0.094 0.248 0.363 Currently married 0.959 0.007 647 128 0.952 0.008 0.944 0.974 Currently pregnant 0.029 0.005 935 188 0.940 0.186 0.018 0.039 Children ever born 2.782 0.090 616 122 1.167 0.032 2.602 2.962 Children surviving 2.594 0.069 616 122 0.983 0.026 2.457 2.731 Children ever born to women over 40 4.132 0.165 198 36 1.033 0.040 3.803 4.462 Know any contraceptive method 0.976 0.009 616 122 1.487 0.009 0.958 0.995 Ever used any contraceptive method 0.829 0.021 616 122 1.391 0.025 0.786 0.871 Currently using any method 0.651 0.031 616 122 1.630 0.048 0.589 0.714 Currently using pill 0.271 0.057 616 122 3.177 0.210 0.157 0.385 Currently using IUD 0.016 0.006 616 122 1.209 0.380 0.004 0.028 Currently using female sterilization 0.021 0.006 616 122 1.040 0.289 0.009 0.033 Currently using periodic abstinence 0.013 0.005 616 122 1.141 0.401 0.003 0.023 Using public sector source 0.194 0.030 382 78 1.467 0.153 0.134 0.253 Want no more children 0.515 0.022 616 122 1.099 0.043 0.471 0.559 Want to delay at least 2 years 0.198 0.014 616 122 0.860 0.070 0.170 0.226 Ideal number of children 2.977 0.077 563 109 1.438 0.026 2.823 3.130 Mothers received tetanus injection 0.655 0.032 289 57 1.147 0.049 0.591 0.719 Mothers received medical care at birth 0.667 0.051 348 69 1.854 0.076 0.565 0.769 Had diarrhea in the last two weeks 0.094 0.020 333 66 1.207 0.218 0.053 0.135 Treated with ORS packets 0.491 0.092 33 6 0.961 0.188 0.307 0.676 Sought medical treatment 0.492 0.113 33 6 1.186 0.231 0.265 0.719 Having health card 0.487 0.056 63 13 0.849 0.115 0.375 0.598 Received BCG vaccination 0.779 0.063 63 13 1.165 0.081 0.652 0.905 Received DPT vaccination (3 doses) 0.675 0.065 63 13 1.093 0.097 0.544 0.806 Received polio vaccination (3 doses) 0.728 0.065 63 13 1.140 0.090 0.597 0.859 Received measles vaccination 0.714 0.062 63 13 1.064 0.087 0.591 0.838 Received all vaccinations 0.649 0.069 63 13 1.144 0.107 0.510 0.787 Total fertility rate 0-3 years 2.418 0.190 NA 491 1.122 0.079 2.038 2.798 Perinatal mortality (0-4 years) 30.409 9.488 349 69 0.962 0.312 11.433 49.385 Neonatal mortality last 10 years 27.760 6.778 712 144 1.040 0.244 14.205 41.315 Post-neonatal mortality last 10 years 14.992 4.756 713 144 1.133 0.317 5.479 24.504 Infant mortality last 10 years 42.752 8.728 713 144 1.147 0.204 25.297 60.208 Child mortality last 10 years 4.280 2.334 713 144 0.948 0.545 0.000 8.948 Under-five mortality last 10 years 46.850 9.277 714 144 1.158 0.198 28.295 65.404 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ MEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.495 0.050 196 40 1.389 0.100 0.396 0.595 No education 0.035 0.015 196 40 1.166 0.438 0.004 0.066 With secondary or higher education 0.394 0.040 196 40 1.153 0.102 0.314 0.475 Know any contraceptive method 0.975 0.015 196 40 1.375 0.016 0.944 1.006 Know any modern contraceptive method 0.971 0.015 196 40 1.232 0.015 0.941 1.000 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ NA = Not applicable Appendix C | 289 Table C.13 Sampling errors: DKI Jakarta sample, Indonesia 2002-2003 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ 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 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ WOMEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 1.000 0.000 1882 1024 NA 0.000 1.000 1.000 Literate 0.942 0.007 1882 1024 1.350 0.008 0.927 0.956 No education 0.034 0.006 1882 1024 1.312 0.161 0.023 0.045 With secondary or higher education 0.607 0.019 1882 1024 1.669 0.031 0.569 0.645 Currently married 0.898 0.012 1882 1024 1.730 0.013 0.874 0.922 Currently pregnant 0.038 0.003 2800 1564 0.817 0.082 0.032 0.045 Children ever born 2.333 0.042 1694 919 1.017 0.018 2.248 2.417 Children surviving 2.190 0.037 1694 919 0.994 0.017 2.115 2.264 Children ever born to women over 40 3.468 0.117 598 311 1.394 0.034 3.233 3.703 Know any contraceptive method 0.998 0.002 1694 919 1.759 0.002 0.994 1.002 Ever used any contraceptive method 0.861 0.008 1694 919 1.006 0.010 0.844 0.878 Currently using any method 0.632 0.013 1694 919 1.097 0.020 0.606 0.658 Currently using pill 0.126 0.010 1694 919 1.235 0.079 0.106 0.146 Currently using IUD 0.100 0.012 1694 919 1.686 0.123 0.075 0.124 Currently using female sterilization 0.028 0.005 1694 919 1.204 0.173 0.018 0.038 Currently using periodic abstinence 0.035 0.005 1694 919 1.038 0.132 0.026 0.044 Using public sector source 0.170 0.018 960 535 1.515 0.108 0.133 0.206 Want no more children 0.509 0.016 1694 919 1.322 0.032 0.477 0.542 Want to delay at least 2 years 0.257 0.014 1694 919 1.352 0.056 0.228 0.286 Ideal number of children 2.646 0.034 1702 924 1.513 0.013 2.578 2.714 Mothers received tetanus injection 0.756 0.017 785 436 1.134 0.023 0.722 0.791 Mothers received medical care at birth 0.942 0.015 921 514 1.573 0.016 0.913 0.971 Had diarrhea in the last two weeks 0.078 0.012 891 497 1.279 0.156 0.054 0.102 Treated with ORS packets 0.465 0.071 71 39 1.110 0.152 0.324 0.607 Sought medical treatment 0.588 0.061 71 39 0.976 0.105 0.465 0.711 Having health card 0.286 0.038 174 96 1.130 0.134 0.209 0.363 Received BCG vaccination 0.952 0.023 174 96 1.449 0.024 0.906 0.999 Received DPT vaccination (3 doses) 0.760 0.033 174 96 1.038 0.044 0.693 0.826 Received polio vaccination (3 doses) 0.855 0.032 174 96 1.214 0.038 0.791 0.920 Received measles vaccination 0.804 0.039 174 96 1.293 0.048 0.727 0.881 Received all vaccinations 0.670 0.040 174 96 1.118 0.059 0.591 0.749 Total fertility rate 0-3 years 2.215 0.106 NA 4120 1.294 0.048 2.003 2.427 Perinatal mortality (0-4 years) 17.370 6.584 925 516 1.332 0.379 4.202 30.537 Neonatal mortality last 10 years 17.525 4.278 1706 950 1.192 0.244 8.968 26.082 Post-neonatal mortality last 10 years 17.007 3.491 1706 950 1.121 0.205 10.024 23.990 Infant mortality last 10 years 34.532 6.008 1706 950 1.298 0.174 22.516 46.548 Child mortality last 10 years 6.437 2.294 1709 951 1.122 0.356 1.850 11.024 Under-five mortality last 10 years 40.747 6.466 1709 951 1.290 0.159 27.815 53.678 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ MEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 1.000 0.000 561 310 NA 0.000 1.000 1.000 No education 0.008 0.003 561 310 0.814 0.383 0.002 0.014 With secondary or higher education 0.736 0.022 561 310 1.203 0.030 0.691 0.781 Know any contraceptive method 1.000 0.000 561 310 NA 0.000 1.000 1.000 Know any modern contraceptive method 1.000 0.000 561 310 NA 0.000 1.000 1.000 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ NA = Not applicable 290 | Appendix C Table C.14 Sampling errors: West Java sample, Indonesia 2002-2003 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ 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 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ WOMEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.555 0.028 1641 5797 2.252 0.050 0.500 0.611 Literate 0.891 0.012 1641 5797 1.600 0.014 0.866 0.915 No education 0.077 0.011 1641 5797 1.667 0.143 0.055 0.099 With secondary or higher education 0.296 0.017 1641 5797 1.520 0.058 0.262 0.330 Currently married 0.955 0.005 1641 5797 1.035 0.006 0.945 0.966 Currently pregnant 0.044 0.006 2125 7207 1.271 0.142 0.032 0.057 Children ever born 2.857 0.083 1567 5539 1.498 0.029 2.691 3.023 Children surviving 2.553 0.067 1567 5539 1.468 0.026 2.419 2.688 Children ever born to women over 40 4.785 0.193 446 1565 1.613 0.040 4.399 5.170 Know any contraceptive method 0.996 0.002 1567 5539 0.965 0.002 0.993 0.999 Ever used any contraceptive method 0.862 0.016 1567 5539 1.789 0.018 0.831 0.893 Currently using any method 0.590 0.024 1567 5539 1.937 0.041 0.542 0.638 Currently using pill 0.158 0.014 1567 5539 1.480 0.086 0.131 0.186 Currently using IUD 0.036 0.007 1567 5539 1.582 0.207 0.021 0.051 Currently using female sterilization 0.023 0.004 1567 5539 1.034 0.169 0.016 0.031 Currently using periodic abstinence 0.007 0.003 1567 5539 1.387 0.423 0.001 0.013 Using public sector source 0.190 0.017 906 3205 1.297 0.089 0.156 0.224 Want no more children 0.511 0.015 1567 5539 1.167 0.029 0.482 0.541 Want to delay at least 2 years 0.232 0.011 1567 5539 1.074 0.049 0.209 0.255 Ideal number of children 2.915 0.050 1296 4387 1.584 0.017 2.815 3.015 Mothers received tetanus injection 0.740 0.023 743 2705 1.440 0.031 0.694 0.785 Mothers received medical care at birth 0.486 0.042 846 3090 2.284 0.087 0.402 0.571 Had diarrhea in the last two weeks 0.151 0.021 809 2969 1.643 0.140 0.108 0.193 Treated with ORS packets 0.350 0.047 109 448 1.081 0.134 0.256 0.444 Sought medical treatment 0.530 0.050 109 448 1.064 0.094 0.430 0.630 Having health card 0.296 0.054 167 552 1.488 0.184 0.187 0.404 Received BCG vaccination 0.791 0.043 167 552 1.338 0.055 0.704 0.878 Received DPT vaccination (3 doses) 0.483 0.042 167 552 1.056 0.087 0.398 0.567 Received polio vaccination (3 doses) 0.581 0.051 167 552 1.297 0.088 0.478 0.683 Received measles vaccination 0.717 0.050 167 552 1.393 0.070 0.616 0.817 Received all vaccinations 0.414 0.042 167 552 1.079 0.103 0.329 0.499 Total fertility rate 0-3 years 2.790 0.133 NA 22844 1.197 0.048 2.523 3.057 Perinatal mortality (0-4 years) 23.749 6.312 851 3110 1.122 0.266 11.125 36.374 Neonatal mortality last 10 years 24.795 5.046 1784 6609 1.264 0.204 14.703 34.887 Post-neonatal mortality last 10 years 18.907 4.003 1784 6610 1.036 0.212 10.901 26.913 Infant mortality last 10 years 43.702 7.570 1785 6612 1.316 0.173 28.563 58.841 Child mortality last 10 years 6.474 2.101 1785 6614 1.140 0.325 2.271 10.677 Under-five mortality last 10 years 49.893 8.185 1787 6618 1.327 0.164 33.523 66.262 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ MEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.570 0.026 458 1614 1.139 0.046 0.518 0.623 No education 0.029 0.009 458 1614 1.149 0.309 0.011 0.048 With secondary or higher education 0.343 0.023 458 1614 1.033 0.067 0.297 0.389 Know any contraceptive method 0.987 0.005 458 1614 1.001 0.005 0.977 0.998 Know any modern contraceptive method 0.985 0.006 458 1614 1.002 0.006 0.974 0.997 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ NA = Not applicable Appendix C | 291 Table C.15 Sampling errors: Central Java sample, Indonesia 2002-2003 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ 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 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ WOMEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.408 0.022 1569 4234 1.769 0.054 0.364 0.452 Literate 0.833 0.016 1569 4234 1.651 0.019 0.802 0.864 No education 0.101 0.012 1569 4234 1.639 0.124 0.076 0.126 With secondary or higher education 0.303 0.021 1569 4234 1.777 0.068 0.262 0.344 Currently married 0.952 0.006 1569 4234 1.135 0.006 0.940 0.964 Currently pregnant 0.034 0.005 2039 5573 1.034 0.133 0.025 0.043 Children ever born 2.509 0.066 1493 4031 1.406 0.026 2.377 2.641 Children surviving 2.304 0.051 1493 4031 1.247 0.022 2.203 2.406 Children ever born to women over 40 3.693 0.147 527 1394 1.624 0.040 3.400 3.987 Know any contraceptive method 0.990 0.003 1493 4031 1.155 0.003 0.984 0.996 Ever used any contraceptive method 0.830 0.011 1493 4031 1.118 0.013 0.808 0.852 Currently using any method 0.650 0.018 1493 4031 1.484 0.028 0.613 0.686 Currently using pill 0.088 0.012 1493 4031 1.654 0.138 0.063 0.112 Currently using IUD 0.061 0.008 1493 4031 1.326 0.134 0.045 0.078 Currently using female sterilization 0.053 0.007 1493 4031 1.206 0.132 0.039 0.067 Currently using periodic abstinence 0.015 0.003 1493 4031 0.923 0.191 0.010 0.021 Using public sector source 0.278 0.025 934 2509 1.680 0.089 0.229 0.328 Want no more children 0.514 0.014 1493 4031 1.111 0.028 0.486 0.543 Want to delay at least 2 years 0.247 0.016 1493 4031 1.441 0.065 0.215 0.280 Ideal number of children 2.766 0.075 1491 4025 2.748 0.027 2.617 2.915 Mothers received tetanus injection 0.837 0.030 586 1612 1.980 0.036 0.777 0.897 Mothers received medical care at birth 0.673 0.047 648 1784 2.368 0.070 0.579 0.766 Had diarrhea in the last two weeks 0.079 0.012 629 1731 0.998 0.148 0.055 0.102 Treated with ORS packets 0.312 0.070 48 136 1.019 0.225 0.172 0.453 Sought medical treatment 0.687 0.062 48 136 0.873 0.090 0.564 0.810 Having health card 0.369 0.059 120 323 1.335 0.160 0.251 0.487 Received BCG vaccination 0.871 0.052 120 323 1.694 0.060 0.767 0.975 Received DPT vaccination (3 doses) 0.736 0.049 120 323 1.206 0.066 0.638 0.833 Received polio vaccination (3 doses) 0.787 0.045 120 323 1.168 0.057 0.697 0.876 Received measles vaccination 0.759 0.052 120 323 1.316 0.068 0.656 0.862 Received all vaccinations 0.635 0.055 120 323 1.235 0.087 0.525 0.745 Total fertility rate 0-3 years 2.144 0.141 NA 15677 1.206 0.066 1.862 2.426 Perinatal mortality (0-4 years) 22.520 5.755 654 1802 1.007 0.256 11.010 34.031 Neonatal mortality last 10 years 18.763 3.728 1363 3749 1.028 0.199 11.306 26.220 Post-neonatal mortality last 10 years 17.446 3.388 1365 3756 0.948 0.194 10.669 24.223 Infant mortality last 10 years 36.209 4.670 1365 3756 0.934 0.129 26.870 45.549 Child mortality last 10 years 7.939 3.359 1364 3753 1.300 0.423 1.220 14.657 Under-five mortality last 10 years 43.860 5.181 1366 3760 0.933 0.118 33.498 54.223 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ MEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.412 0.030 425 1155 1.269 0.074 0.351 0.473 No education 0.065 0.013 425 1155 1.060 0.195 0.040 0.091 With secondary or higher education 0.354 0.030 425 1155 1.285 0.084 0.294 0.414 Know any contraceptive method 0.957 0.011 425 1155 1.131 0.012 0.934 0.979 Know any modern contraceptive method 0.957 0.011 425 1155 1.131 0.012 0.934 0.979 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ NA = Not applicable 292 | Appendix C Table C.16 Sampling errors: DI Yogyakarta sample, Indonesia 2002-2003 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ 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 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ WOMEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.557 0.030 1030 367 1.907 0.053 0.498 0.616 Literate 0.901 0.013 1030 367 1.432 0.015 0.874 0.927 No education 0.063 0.009 1030 367 1.165 0.139 0.046 0.081 With secondary or higher education 0.538 0.020 1030 367 1.301 0.038 0.498 0.579 Currently married 0.955 0.006 1030 367 0.895 0.006 0.943 0.966 Currently pregnant 0.033 0.005 1530 539 1.050 0.147 0.023 0.042 Children ever born 2.173 0.054 985 350 1.275 0.025 2.064 2.281 Children surviving 2.063 0.050 985 350 1.267 0.024 1.963 2.163 Children ever born to women over 40 2.906 0.076 386 134 1.063 0.026 2.753 3.058 Know any contraceptive method 0.998 0.001 985 350 0.968 0.001 0.996 1.001 Ever used any contraceptive method 0.910 0.011 985 350 1.164 0.012 0.888 0.931 Currently using any method 0.756 0.016 985 350 1.202 0.022 0.724 0.789 Currently using pill 0.076 0.010 985 350 1.145 0.127 0.057 0.096 Currently using IUD 0.193 0.022 985 350 1.759 0.115 0.149 0.238 Currently using female sterilization 0.061 0.013 985 350 1.662 0.207 0.036 0.087 Currently using periodic abstinence 0.063 0.009 985 350 1.207 0.148 0.044 0.082 Using public sector source 0.398 0.023 622 222 1.153 0.057 0.352 0.443 Want no more children 0.589 0.016 985 350 1.024 0.027 0.557 0.621 Want to delay at least 2 years 0.219 0.012 985 350 0.920 0.055 0.195 0.244 Ideal number of children 2.317 0.026 1015 361 1.203 0.011 2.264 2.370 Mothers received tetanus injection 0.897 0.024 367 128 1.517 0.027 0.848 0.945 Mothers received medical care at birth 0.852 0.026 416 144 1.411 0.030 0.801 0.903 Had diarrhea in the last two weeks 0.052 0.014 410 142 1.241 0.279 0.023 0.080 Treated with ORS packets 0.523 0.147 20 7 1.277 0.281 0.229 0.816 Sought medical treatment 0.709 0.120 20 7 1.175 0.169 0.469 0.949 Having health card 0.490 0.083 90 31 1.518 0.168 0.325 0.655 Received BCG vaccination 1.000 0.000 90 31 NA 0.000 1.000 1.000 Received DPT vaccination (3 doses) 0.910 0.020 90 31 0.650 0.022 0.869 0.950 Received polio vaccination (3 doses) 0.960 0.009 90 31 0.415 0.009 0.943 0.978 Received measles vaccination 0.911 0.034 90 31 1.106 0.037 0.843 0.979 Received all vaccinations 0.842 0.037 90 31 0.930 0.043 0.769 0.915 Total fertility rate 0-3 years 1.902 0.135 NA 1372 1.243 0.071 1.632 2.172 Perinatal mortality (0-4 years) 21.262 5.977 422 146 0.843 0.281 9.308 33.217 Neonatal mortality last 10 years 16.985 4.605 839 295 1.037 0.271 7.775 26.196 Post-neonatal mortality last 10 years 2.555 1.490 839 295 0.854 0.583 0.000 5.535 Infant mortality last 10 years 19.541 4.733 839 295 0.996 0.242 10.074 29.007 Child mortality last 10 years 3.623 1.816 841 295 0.873 0.501 0.000 7.255 Under-five mortality last 10 years 23.093 5.191 841 295 1.011 0.225 12.710 33.475 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ MEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.554 0.036 290 103 1.233 0.065 0.482 0.626 No education 0.029 0.009 290 103 0.894 0.304 0.011 0.047 With secondary or higher education 0.619 0.030 290 103 1.056 0.049 0.558 0.679 Know any contraceptive method 0.975 0.012 290 103 1.341 0.013 0.951 1.000 Know any modern contraceptive method 0.972 0.013 290 103 1.311 0.013 0.946 0.997 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ NA = Not applicable Appendix C | 293 Table C.17 Sampling errors: East Java sample, Indonesia 2002-2003 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ 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 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ WOMEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.428 0.035 1505 5367 2.729 0.081 0.358 0.497 Literate 0.830 0.021 1505 5367 2.159 0.025 0.788 0.872 No education 0.081 0.014 1505 5367 1.991 0.173 0.053 0.109 With secondary or higher education 0.379 0.028 1505 5367 2.204 0.073 0.324 0.434 Currently married 0.938 0.009 1505 5367 1.435 0.010 0.920 0.956 Currently pregnant 0.035 0.005 1936 6823 1.260 0.149 0.024 0.045 Children ever born 2.126 0.054 1408 5034 1.351 0.025 2.017 2.234 Children surviving 1.959 0.041 1408 5034 1.173 0.021 1.876 2.041 Children ever born to women over 40 3.038 0.107 475 1676 1.323 0.035 2.825 3.251 Know any contraceptive method 0.991 0.004 1408 5034 1.684 0.004 0.983 1.000 Ever used any contraceptive method 0.831 0.014 1408 5034 1.377 0.017 0.803 0.858 Currently using any method 0.670 0.020 1408 5034 1.603 0.030 0.630 0.710 Currently using pill 0.132 0.014 1408 5034 1.573 0.108 0.103 0.160 Currently using IUD 0.109 0.011 1408 5034 1.373 0.104 0.087 0.132 Currently using female sterilization 0.060 0.012 1408 5034 1.833 0.194 0.037 0.083 Currently using periodic abstinence 0.017 0.003 1408 5034 0.986 0.199 0.010 0.024 Using public sector source 0.305 0.030 901 3180 1.925 0.097 0.245 0.364 Want no more children 0.525 0.020 1408 5034 1.500 0.038 0.485 0.565 Want to delay at least 2 years 0.204 0.012 1408 5034 1.115 0.059 0.180 0.228 Ideal number of children 2.407 0.051 1371 4913 2.153 0.021 2.305 2.508 Mothers received tetanus injection 0.755 0.027 529 1878 1.426 0.035 0.702 0.809 Mothers received medical care at birth 0.808 0.037 589 2101 2.126 0.046 0.733 0.882 Had diarrhea in the last two weeks 0.098 0.015 569 2022 1.139 0.149 0.069 0.128 Treated with ORS packets 0.361 0.073 55 199 1.125 0.203 0.214 0.507 Sought medical treatment 0.416 0.052 55 199 0.782 0.126 0.311 0.521 Having health card 0.302 0.055 108 360 1.198 0.181 0.193 0.412 Received BCG vaccination 0.846 0.052 108 360 1.458 0.062 0.741 0.951 Received DPT vaccination (3 doses) 0.666 0.063 108 360 1.333 0.094 0.541 0.791 Received polio vaccination (3 doses) 0.679 0.062 108 360 1.326 0.091 0.556 0.802 Received measles vaccination 0.765 0.059 108 360 1.407 0.078 0.646 0.884 Received all vaccinations 0.642 0.062 108 360 1.302 0.097 0.517 0.766 Total fertility rate 0-3 years 2.088 0.140 NA 20296 1.278 0.067 1.808 2.368 Perinatal mortality (0-4 years) 26.690 7.447 596 2131 1.064 0.279 11.795 41.585 Neonatal mortality last 10 years 28.193 6.307 1192 4254 1.139 0.224 15.580 40.807 Post-neonatal mortality last 10 years 14.448 4.577 1192 4254 1.158 0.317 5.293 23.603 Infant mortality last 10 years 42.641 9.443 1192 4254 1.266 0.221 23.756 61.526 Child mortality last 10 years 9.761 2.753 1196 4264 0.969 0.282 4.255 15.268 Under-five mortality last 10 years 51.986 9.931 1196 4264 1.243 0.191 32.124 71.848 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ MEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.430 0.028 429 1560 1.162 0.065 0.375 0.486 No education 0.049 0.014 429 1560 1.368 0.290 0.021 0.078 With secondary or higher education 0.431 0.039 429 1560 1.646 0.091 0.352 0.510 Know any contraceptive method 0.969 0.008 429 1560 0.921 0.008 0.953 0.984 Know any modern contraceptive method 0.969 0.008 429 1560 0.921 0.008 0.953 0.984 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ NA = Not applicable 294 | Appendix C Table C.18 Sampling errors: Banten sample, Indonesia 2002-2003 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ 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 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ WOMEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.604 0.029 1383 1396 2.167 0.047 0.547 0.661 Literate 0.850 0.019 1383 1396 2.019 0.023 0.812 0.889 No education 0.089 0.016 1383 1396 2.134 0.184 0.056 0.122 With secondary or higher education 0.377 0.033 1383 1396 2.527 0.087 0.311 0.442 Currently married 0.932 0.010 1383 1396 1.467 0.011 0.912 0.952 Currently pregnant 0.043 0.004 1888 1880 0.867 0.098 0.034 0.051 Children ever born 2.808 0.091 1302 1301 1.577 0.032 2.626 2.991 Children surviving 2.488 0.070 1302 1301 1.455 0.028 2.348 2.628 Children ever born to women over 40 4.506 0.244 342 373 1.825 0.054 4.018 4.993 Know any contraceptive method 0.984 0.005 1302 1301 1.533 0.005 0.973 0.995 Ever used any contraceptive method 0.833 0.011 1302 1301 1.097 0.014 0.811 0.856 Currently using any method 0.586 0.020 1302 1301 1.472 0.034 0.545 0.626 Currently using pill 0.110 0.012 1302 1301 1.348 0.106 0.087 0.134 Currently using IUD 0.050 0.013 1302 1301 2.121 0.257 0.024 0.075 Currently using female sterilization 0.017 0.004 1302 1301 1.216 0.258 0.008 0.026 Currently using periodic abstinence 0.011 0.002 1302 1301 0.870 0.233 0.006 0.016 Using public sector source 0.162 0.027 737 751 1.960 0.164 0.109 0.216 Want no more children 0.455 0.017 1302 1301 1.202 0.036 0.421 0.488 Want to delay at least 2 years 0.286 0.017 1302 1301 1.375 0.060 0.251 0.320 Ideal number of children 3.176 0.063 1165 1148 1.553 0.020 3.050 3.302 Mothers received tetanus injection 0.684 0.035 654 640 1.898 0.051 0.614 0.755 Mothers received medical care at birth 0.629 0.044 756 736 2.225 0.070 0.540 0.717 Had diarrhea in the last two weeks 0.125 0.018 728 713 1.447 0.146 0.088 0.161 Treated with ORS packets 0.332 0.066 99 89 1.301 0.200 0.199 0.465 Sought medical treatment 0.459 0.071 99 89 1.318 0.155 0.317 0.601 Having health card 0.230 0.052 139 136 1.424 0.225 0.127 0.333 Received BCG vaccination 0.693 0.042 139 136 1.064 0.061 0.608 0.777 Received DPT vaccination (3 doses) 0.350 0.045 139 136 1.099 0.129 0.260 0.440 Received polio vaccination (3 doses) 0.443 0.060 139 136 1.396 0.135 0.323 0.562 Received measles vaccination 0.440 0.039 139 136 0.914 0.089 0.362 0.518 Received all vaccinations 0.254 0.041 139 136 1.092 0.161 0.172 0.335 Total fertility rate 0-3 years 2.611 0.107 NA 5465 1.175 0.041 2.398 2.824 Perinatal mortality (0-4 years) 22.592 6.018 764 743 1.110 0.266 10.556 34.628 Neonatal mortality last 10 years 16.494 3.719 1560 1510 1.145 0.226 9.055 23.933 Post-neonatal mortality last 10 years 21.010 4.147 1560 1510 1.058 0.197 12.717 29.303 Infant mortality last 10 years 37.504 5.619 1560 1510 1.081 0.150 26.265 48.743 Child mortality last 10 years 19.306 3.882 1565 1514 1.060 0.201 11.542 27.070 Under-five mortality last 10 years 56.086 7.570 1565 1514 1.131 0.135 40.946 71.227 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ MEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.673 0.038 378 396 1.573 0.057 0.597 0.749 No education 0.011 0.010 378 396 1.958 0.963 0.000 0.032 With secondary or higher education 0.536 0.034 378 396 1.309 0.063 0.469 0.604 Know any contraceptive method 0.959 0.011 378 396 1.028 0.011 0.938 0.980 Know any modern contraceptive method 0.959 0.011 378 396 1.028 0.011 0.938 0.980 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ NA = Not applicable Appendix C | 295 Table C.19 Sampling errors: Bali sample, Indonesia 2002-2003 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ 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 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ WOMEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.522 0.036 1371 465 2.679 0.069 0.449 0.594 Literate 0.864 0.016 1371 465 1.757 0.019 0.831 0.896 No education 0.125 0.015 1371 465 1.717 0.122 0.095 0.156 With secondary or higher education 0.456 0.026 1371 465 1.939 0.057 0.403 0.508 Currently married 0.958 0.010 1371 465 1.826 0.010 0.939 0.978 Currently pregnant 0.038 0.009 1777 616 1.903 0.237 0.020 0.055 Children ever born 2.221 0.085 1325 446 2.022 0.038 2.052 2.391 Children surviving 2.097 0.076 1325 446 1.982 0.036 1.946 2.249 Children ever born to women over 40 3.079 0.160 480 155 1.982 0.052 2.760 3.398 Know any contraceptive method 0.989 0.003 1325 446 0.911 0.003 0.984 0.994 Ever used any contraceptive method 0.812 0.019 1325 446 1.747 0.023 0.775 0.850 Currently using any method 0.612 0.025 1325 446 1.900 0.042 0.562 0.663 Currently using pill 0.034 0.006 1325 446 1.124 0.164 0.023 0.045 Currently using IUD 0.264 0.020 1325 446 1.626 0.075 0.225 0.304 Currently using female sterilization 0.045 0.008 1325 446 1.344 0.170 0.030 0.061 Currently using periodic abstinence 0.013 0.004 1325 446 1.210 0.284 0.006 0.021 Using public sector source 0.330 0.036 843 264 2.224 0.109 0.258 0.402 Want no more children 0.596 0.027 1325 446 1.995 0.045 0.542 0.649 Want to delay at least 2 years 0.134 0.016 1325 446 1.707 0.119 0.102 0.166 Ideal number of children 2.467 0.062 1255 427 2.549 0.025 2.344 2.590 Mothers received tetanus injection 0.799 0.037 516 171 2.061 0.046 0.725 0.872 Mothers received medical care at birth 0.878 0.029 596 194 1.944 0.033 0.820 0.936 Had diarrhea in the last two weeks 0.119 0.020 587 191 1.383 0.167 0.079 0.159 Treated with ORS packets 0.408 0.064 77 23 1.022 0.157 0.280 0.536 Sought medical treatment 0.441 0.065 77 23 1.047 0.148 0.310 0.571 Having health card 0.537 0.068 116 38 1.426 0.126 0.401 0.672 Received BCG vaccination 0.881 0.042 116 38 1.379 0.048 0.796 0.966 Received DPT vaccination (3 doses) 0.870 0.036 116 38 1.123 0.041 0.798 0.942 Received polio vaccination (3 doses) 0.885 0.032 116 38 1.060 0.036 0.821 0.949 Received measles vaccination 0.827 0.045 116 38 1.247 0.054 0.737 0.917 Received all vaccinations 0.803 0.048 116 38 1.273 0.060 0.706 0.899 Total fertility rate 0-3 years 2.108 0.147 NA 1669 1.412 0.069 1.815 2.401 Perinatal mortality (0-4 years) 8.781 4.069 598 195 1.047 0.463 0.643 16.918 Neonatal mortality last 10 years 9.500 2.799 1211 390 0.931 0.295 3.903 15.097 Post-neonatal mortality last 10 years 4.589 2.035 1211 390 1.012 0.443 0.520 8.658 Infant mortality last 10 years 14.089 3.591 1211 390 0.998 0.255 6.907 21.270 Child mortality last 10 years 5.069 1.788 1214 391 0.845 0.353 1.493 8.645 Under-five mortality last 10 years 19.086 4.048 1214 391 0.977 0.212 10.989 27.183 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ MEN ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ Urban residence 0.554 0.038