Multimedia Mania/abacus-multimedia-mania.iso/dp/0024/00246.txt

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$Unique_ID{bob00246}
$Pretitle{}
$Title{Indonesia
Health and Welfare}
$Subtitle{}
$Author{Department of Information Republic of Indonesia}
$Affiliation{Embassy of Indonesia, Washington DC}
$Subject{women
health
family
planning
development
program
indonesia
services
women's
organizations
see
pictures
see
figures
see
tables
}
$Date{1990}
$Log{See Table 25.*0024601.tab
}
Title:       Indonesia
Book:        Indonesia 1990 an Official Handbook
Author:      Department of Information Republic of Indonesia
Affiliation: Embassy of Indonesia, Washington DC
Date:        1990

Health and Welfare

     The policy of health development is directed to the development of an
integrated national health system. It strives to avail better health services
to the people through Public Health Centers, hospitals as well as a more
sufficient and equitable provision of drugs which the people can afford. The
policy also covers efforts to improve public health through eradication of
contagious diseases, improvement of nutrition, clean water supply and
environmental sanitation.

     The policy of health development is formulated in the Panca Karya Husada
or the Five Efforts in Promoting Public Health which are:

strengthening and consolidating health endeavors;

     training and upgrading health personnel;

     control, providing and supervising drug supply, food and other substances
which could be hazardous to health;

     improving nutrition and environmental health and strengthening and
consolidating management and legal order relating to health.

     In The Fourth Five-Year Development Plan (REPELITA IV) achievements have
been made in efforts concerning:

     1. Health services;

     2. Eradication of contagious diseases;

     3. Improvement of nutrition;

     4. Clean water supply;

     5. Improvement of environmental health;

     6. Health guidance;

     7. Provision, control and supervision on food and drugs.

HEALTH SERVICES

     More Public Health Centers (PUSKESMAS) had been set up in order to step
up health services to the people, and with active participation of the
community on health care programs, optimum health condition can be enjoyed
by the people.

     In the last two years of the Fourth REPELITA, health-care facilities in
three PUSKESMAS, one each in the provinces of Aceh, Jambi and East Timor,
had been promoted to be able to treat in-patients and 41 Sub-PUSKESMAS had
been constructed. In the meantime the POSYANDU (the Integrated Health Services
Post) have been made available, also by active participation of the community
in 200,000 villages throughout the country. POSYANDU provides key basic
services at the community level and in 1986 the President has declared
POSYANDU as the national health strategy for the 1986-1996 Decade for
Children.

     Maternal and child health services are primarily handled by trained
midwives and paramedical personnel. In 1988/89 2,500 traditional birth
attendants had undergone training courses and another 5,000 in five provinces
obtained upgrading courses. In order to promote equitable, effective and
efficient maternal and child health services to the community, activities are
carried out together with those of UPGK's (Family Nutrition Improvement
Program) weighing posts and integrate the primary health services -- growth
monitoring and nutritional counselling (child weighing), family planning,
diarrheal disease control through ORT (oral rehydration theraphy), maternal
care and immunization -- in the POSYANDU. (Integrated Health Services Post).

     The School Health Effort (UKS) program, which aims to improve health
condition of school children, has served 8,080 schools with the assistance of
2,020 Public Health Centers (PUSKESMAS).

     Hospital services is a part of the health service network and it is
categorized in four classes. The D class hospitals are of 25 to 100 bed
capacity, the C class 100 to 400 beds with four primary medical specialists
(internal disease specialist, surgeon, gynaecologist, pediatrician), B class
has 400 to 1,000 beds and physicians of all branches of medicine. The A class
hospitals are those with more than 1,000 beds and sub-specialist doctors.

     Until 1988/89 there are 1,481 hospitals consisting of 749 general
hospitals with 23,680 bed capacity and 732 special hospitals with 13,820 bed
capacity.

     To support private hospitals in their efforts on the improvement of
health services, in the Fourth REPELITA drugs, medical equipment and
ambulances were annually provided to 70 - 90 private hospitals, particularly
those delivering more health services to the low-income group of the
community.

     Until the fifth year of the Fourth REPELITA 27 provincial medical
laboratories have been put in operation, of which 25 are representative
buildings.

     By a presidential instruction on health facilities, for 1988/89 a budget
of Rp 450 per head is allocated for medical assistance aside from an addition
of 1,300 medical doctors, 14,549 paramedical personnel and 30 housing units
for accommodation of medical doctors working at the Public Health Centers.
These doctors are also entitled to continue studies to become specialists,
when they have accomplished their term of service at the PUSKESMAS.

ERADICATION OF CONTAGIOUS DISEASES PROGRAM

     Eradication of contagious diseases is focussed on the prevention and
eradication of diarrhea, malaria, lung tuberculosis, arbovirosis,
schistosomiasis as well as in keeping close surveillance on possible
epidemics.

     In 1988/89 2.5 million of diarrhea patients were treated and 4,336
PUSKESMAS implemented the Program of the Eradication of Diarrhea (P4D)

     In effort to combat malaria the spraying of pesticide has been carried
out, together with actions to collect blood samples and treatment of malaria
patients. There were 534,500 houses sprayed and 3.35 million of blood-samples
collected for laboratory tests in 1988/89.

     Prevention and eradication of lung tuberculosis are carried out through
guidance in hygiene and application of BCG vaccination to children. During the
Fourth REPELITA 15.3 million children were vaccinated, while 766,000 underwent
bacteriological lab-tests and 73.5 thousand went under treatment.

     Other contagious diseases are prevented through mass immunizations which
are particularly administered to infants, children and pregnant women.
Vaccination against diphteria, whooping-cough, tetanus, and neotorum tetanus,
polio, measles and lung tuberculosis had been stepped up. Those inoculate
against polio and measles had increased in the Fourth REPELITA and 77.9
million were children and pregnant women.

WATER SUPPLY AND ENVIRONMENT SANITATION

     Water is a critical part of personal hygiene and directly relate to the
reduction of diarrheal diseases, skin diseases, eye diseases and ectoparasitic
diseases. Since water is a community priority, it can serve as an entry point
around which other basic services such as sanitation and hygiene education can
be organized. The government has given priority to the improvement of water
supply and sanitation services.

     During the Fourth REPELITA construction had been made of a piped
distribution system from 154 water springs, 67 artesian wells, 14,943
reservoirs to collect rainwater, 163,531 hand-pumped shallow wells, more than
27,232 hand-pumped deep wells and 46,953 dug wells.

     To promote environmental sanitation, efforts are directed to check the
condition of residential environments, latrine facilities and sewer systems.
In line with this 68,587 private latrines with septic tanks have been made
available for rural households and 53,774 sewer facilities installed in the
Fourth REPELITA.

     In 1988/89 regular checkings have been made at 22,758 public sites; the
processing, storage and selling of food and drinks; the storage, using and
distribution of pesticide; 108 cases of food-poisoning have been checked out,
279 housing complexes have seen improvement in environment sanitation, 45
cases of pesticide pollution have been checked and 11,191 garbage dumping
sites and industrial areas have been put under control for sanitation
purposes.

INFORMATION ON HEALTH

     A better access to information on health has been made available during
1988/89 namely through 9,967 radio broadcasts, 333 television broadcasts,
841,325 articles in print media and one documentary film.

PROVISION, CONTROL AND SUPERVISION ON FOOD AND DRUGS

     Efforts have been made to increase the production and improve the quality
of medical equipment and domestically-made drugs to meet the demand of
consumers. In line with this, raw material for essential drugs are produced
domestically and soluble medicine containers are also domestically produced
with a capacity of three billion capsules per year.

     For intensive control on drugs and food, regular checking on production
facilities and distribution of drugs and food had been made to more than
1,500 units, while 3,500 samples of drugs, food and other pharmaceutical
supplies have been examined. Meanwhile, up to 1988/89 13,850 kinds of drugs
consumed by the community had been registered.

FAMILY PLANNING

     It is directed by the 1988 Guidelines of State Policy that the family
planning program should be further promoted and expanded to all walks of life
especially the young generation and also in transmigration areas. It is also
mentioned that participation in family planning should be increased based on
awareness and responsibility and also on a voluntary basis, taking into
consideration religious values and those of the followers of Belief in the One
and Only God as well as the social norms and morality.

     Initiated officially in 1970 under Presidential Decree No. 8 of 1970, the
family planning program is a direct effort, aimed at lowering the rate of
childbirth by the use of permanent contraceptives. It is realized that the
success or failure of the family planning program will contribute to the
success or failure of efforts to increase the prosperity of the Indonesian
nation. However great the success of the achievements in other development
efforts, the success will be to little avail if the population explosion fails
to be curbed. It would even be impossible to raise the standard of living and
the welfare of the people effectively and equally.

     For these reasons population explosion has become an acute problem and
has to be handled seriously. In this connection the President of the Republic
of Indonesia, Soeharto, has instructed a competent organization, the National
Family Planning Coordinating Board (BKKBN) to accelerate its efforts. Soon the
board in association with both the executive units of the government and
non-government institutions works out various activities: such as recruit a
number of family planning field officers, add family planning clinics, develop
and introduce various approaches and methods, augment dissemination of related
information, maintain and replenish the availability of effective
contraceptives as well as continuously monitor and encourage eligible couples
to carry out the program.

     The result of the aforementioned drives is tangible. The country's
population growth rate declined gradually from 2.3% in the last year of the
second Five-Year Development Plan (REPELITA II) in 1978/79 to 2.2% in the last
year of REPELITA III in 1983/84, and it decreased further to 2.1% during the
final year of REPELITA IV in 1988/89. In the last year of REPELITA V the
population growth rate is expected to drop further to 1.8%, so that the
average annual growth rate in the next five years will be 1.9%. At the same
time crude birth rate declined from 33.5 births per thousand in 1983/84 to
28.7 in 1988/89, and fertility level dropped from 4.6 per woman of 15-49 age
cohort in 1980 to 3.5 in 1988. Meanwhile infant mortality rate decreased from
90.3 in 1983 to 58.0 per thousand livebirths in 1988.

     The number of family planning clinics increased from one year to another.
In 1983/84 it grew modestly from 7,064 clinics, of which 556 are privately
run, to 9,388 including 1,065 private-run clinics in 1988/89, making an
increase by 33%. The number of private-run clinics rose by 90%. Also during
the same period 290 Public Health Centers and 240 hospitals were
rehabilitated.

     To keep abreast with the increase of clinics, the number of family
planning personnel also augmented to reach 37,263 in 1988/89 against 32,715 in
1987/88 and 20,953 in 1983/84. Medical doctors increased by about
83%, midwives and nurses around 87% and administrative personnel 51%.

     In 1988/89 new eligible couples participating in family planning totalled
5,423.8 thousand comprising 3,707.5 thousand from Java and Bali and 1,716.3
thousand from outside Java and Bali. It makes the number of new eligible
couples participating in family planning total 24,679 thousand during the
period of 1984/85 to 1988/89 or 0.3% below the target set for the said period.
In 1988/89 the number of active family planning participants reached 18.8
million eligible couples, an increase of 30.1% compared with that of 1983/1984
which only numbered 14.4 million. Meanwhile, the total number of eligible
couples in 1988 was estimated at 30.0 million.

[See Table 25.: Target Achievement by New Family Planning Participants,
1985/86 - 1988/89 in thousands]

     The main supporting facility which ensures the success of the program is
the availability of contraceptives in family planning clinics. In 1988/89 the
supply of contraceptives consisted of 29.3 million cycles of family planning
pills, 254.6 thousand IUDs, 277.7 thousand gross condoms, 12.7 million vials
injectables, and 275.8 sets of implant. Meanwhile, active family planning
participants using family planning pills declined to 50.4% in 1988/1989 from
55.4% in 1983/84, those using condoms dropped to 3.8% from 4.9%. On the
contrary, active family planning by way of injections rose from 9.6% in
1983/84 to 17.2% in 1988/89.

     As the income of the average family planning participants has been
rapidly improving with the growing economy, the concept of KB Mandiri
(auto-capacity family planning) under the popular logo Lingkaran Biru (the
Blue Circle) was introduced in 1986. By this concept family planning
participants are encouraged to purchase contraceptives from private of
commercial sectors instead of using the contraceptives provided by government
clinics.

     The success of the family planning program has been widely acknowledged
by the international community. The interest of the world in the population
and family planning program of Indonesia is reflected by the willingness of
other countries and international agencies to provide aid and also the
ever-increasing number of guests from abroad who wish to see and even study on
how the population and family planning program in Indonesia is being carried
out. Moreover the Global Statement Award in Population from the
Washington-based Population Institute and the 1989 UN Population Award, both
for President Soeharto, is indeed inseparable from the country's successful
implementation of family planning program.

WOMEN IN DEVELOPMENT

LEGAL BASIS

     The 1945 Constitution makes no distinction between women and men,
securing equal rights and obligations in all fields, be it in education, law,
health, political participation or employment. Moreover, Indonesia has
ratified the 1952 United Nations Convention on the Political Rights of Women,
under which women are guaranteed equal rights to employment, to vote and stand
for election, and to hold public office. The country has also endorsed the
United Nations Convention on the Elimination of All Forms of Discrimination
Against Women.

     Meanwhile, the Guidelines of State Policy has also underlined equitable
opportunities for Indonesian women to take part in national development. The
Guidelines of State Policy of 1988, for instance, states that women, as
citizens and human resources for development, possess the same rights,
obligations and opportunities as men do in all aspects of civic life and in
all development activities. While also underlining the special role of women
in family life, particularly in the care and guidance of children, the
Guidelines of State Policy emphasizes the necessity of developing
socio-cultural climate which will stimulate wider participation of women in
all fields, and of enforcing women's capabilities by enhancing their knowledge
and skills.

     Further, subsequent regulations and legislative acts have also strengthen
the guarantees set out in the 1945 Constitution and international conversions
of equality between women and men regarding workers' rights, vocational
education, safe working conditions and job security.

     Civil servant women are entitled to equal pay for work of equal value.
They are also entitled to receive full pay during pregnancy leave, leave of
absence following a miscarriage, and to time off from work at times to nurse
their infants.

THE ROLE OF WOMEN

     Favored by the country's history and cultural traditions, women in
Indonesia have for decades and even centuries taken part freely and actively
in the affairs of everyday life such as in agriculture, commerce and social
affairs. In modern Indonesia, women are represented in the legislature, the
President's Cabinet, the armed forces, police, civil service, etc. Many more
women are now participating in the labor force, the proportion of which shows
an encouraging tendency approaching a more balanced proportion. They are
easily accepted and generally well-represented in professional and technical
fields such as medicine and law. Moreover, there are now many more women
graduating from universities.

POLICY

     To drive the role of women in all fields of the national development,
principal policies have been set out:

     1. to improve the role of women as housewives in realizing healthy and
prosperous families;

     2. to escalate the role of women as labor force through the expansion of
job opportunities in the various sectors of development;

     3. to increase and develop more integratedly the role of women in various
development fields through among other things improvement of vocational
education;

     4. to enhance women's abilities, and to develop a socio-cultural climate
conducive to the participation of women in development; and

     5. to improve and develop the role of women in a more integrated way in
the various fields of development for the enhancement of the Indonesian
people's abilities to grow and develop towards the creation of a just and
prosperous society based on the Pancasila tenet.

     In line with these principal policies, in effort to enhance the role of
women, especially that of the rural women, various endeavors have been done
such as provision of guidance on marriage law, popularization of P4 (using
the simulation method), eradication of illiteracy including inability to speak
the Indonesian language, by the Family Welfare Movement (PKK) and the Women
Promotion Program towards a Healthy and Prosperous Family (P2WKSS). These
movements have encouraged and implemented programs on various farming
undertakings particularly in how to make use of the yards around the houses,
gardening of vegetables, health guidance, immunization and family planning.

     The office of the Minister of State for the Role of Women is responsible
for the planning and formulation of government policies regarding the
enhancement of the role of women in all fields of development. It also
coordinates all activities for cooperative, balanced and integrated efforts in
the overall implementation of development programs. The office coordinates
operational activities of various government agencies, non-governmental
institutions and organizations concerning programs for the enhancement of the
role of women in development, and also submits reports, information and
recommendations.

WOMEN'S ORGANIZATION

     Since they first emerged in the second decade of this century, women's
organizations have played an active role in the country's political, social
and economic life. The policies and programs adopted by these organizations
have been generally government's national development efforts oriented.

     Almost all of these organizations now promote functional literacy or
non-formal education programs of one sort or another. For instance, over 90%
of all kindergartens are managed by women's organizations. Some are even
active in formal education, from primary to university level.

     Some of these major women's organizations are:

     KOWANI (Indonesian Women's Congress), set up in 1932, is a federation of
64 nation-wide women's organizations, ranging from professional groups to
religious associations. This federation has been a member of the ASEAN
Confederation of Women's Organizations (ACWO) since 1981 and the International
Council of Women (ICW) since 1973. In 1986 it was elected as a voting member
of ICW and in 1988 as Vice-President of ICW.

     DHARMA WANITA, established in 1974, is an organization of the wives of
civil servants and has its units in the government agencies and institutions.
Its activities support government social development programs such as
functional literacy, family planning, health, nutrition, environmental
preservation and cooperatives. It also runs thousands of kindergartens,
schools for the handicapped, primary schools, junior and senior high schools,
and vocational schools at both primary and secondary levels, and is an active
supporter of charities.

     DHARMA PERTIWI groups the four organizations of the wives of armed forces
personnel Kartika Chandra Kirana (Army), Jalasenastri (Navy), Pia Ardhya
Garini (Air Force) and Bhayangkari (Police). DHARMA PERTIWI manages basic
education classes, kindergartens, primary schools, junior and senior high
schools, vocational and technical schools as well as schools for the
handicapped. It also engages in charity activities.

     There is also the Indonesian National Commission to the Status of Women
(KNKWI), established in 1968 in response to the UN Commission on the Status of
Women to set up a national commission in the member states. Its 45 members
represent women's organizations and a number of government departments
considered relevant to their task of conducting surveys and research,
analysing and proposing recommendations pertaining to women. As a
semi-governmental autonomous body which is working towards advancement of the
status and position of the Indonesian women, both in the family and society,
KNKWI maintains cooperation with the Office of Minister of State for the Role
of Women.

     The Family Welfare Movement (PKK) is a voluntary, integrated and
organized movement for programs and activities directed to improve the welfare
of the family in which the women are the central figure. As a movement, PKK
strives for the implementation of its ten main programs which cover the major
aspects of family welfare, namely: the socialization of Pancasila and its
application in daily life, mutual self-help, nutritious food, clothing,
housing and household management, education, knowledge and skill, primary
health care, promotion of co-operatives, protection and conservation of the
environment, and appropriate domestic planning. PKK motivating teams are
formed at national, provincial and local levels, which facilitate and monitor
activities at lower levels. The Chairperson of the National PKK Motivating
Team is the wife of the Minister of Home Affairs, and this structure is
generally paralleled at lower levels, with the governor's wife heading the
province's motivating team, the bupati's wife the district team, and so on.
At village level, the PKK forms one section of the Village Development
Council (LKMD) which is responsible for enhancing community participation in
the planning and implementation of local development activities. The
chairperson of the village PKK Motivating Team also serves as the
vice-chairperson of the Village Development Council.

     In recognition of its outstanding performance in motivating the people in
development, PKK was awarded UNICEF's Maurice Pate Award and WHO's Sasakawa
Health Prize in 1988.

REGIONAL AND INTERNATIONAL FORA

     In the context of regional cooperation among ASEAN member states, the
ASEAN Women's Program (AWP) was officially set up in 1976, and a
representative from Indonesia was chairperson of ASEAN Women's Program in the
period of 1981 - 1984. Under this program, the National Scientific Information
and Documentation Centre of the Indonesian Institute of Sciences (LIPI) has
been commissioned to act as the manager of the clearing house on women in
development in ASEAN countries. In 1981, the ASEAN Confederation of Women's
Organizations (ACWO) was founded for NGO's in the ASEAN region, of which
KOWANI is a member. KOWANI had been the chairperson of ASEAN Confederation of
Women's Organizations during 1981 - 1984.

     In the 1984 ECOSOC Conference, Indonesia was elected member of the Board
of Trustees of the United Nations International Research and Training
Institute for the Advancement of Women (UN INSTRAW) for the period of
1984-1987, and re-elected for 1987-1990 period. In the United Nations
Commission on the Status of Women (UNCSW), Indonesia was a member for the
period of 1983 to 1986.

     By virtue of Act No 7 of 1984, Indonesia ratified the Convention on the
Elimination of all Forms of Discrimination Against Women, and became member
of the UN Commission on the Elimination of Discrimination Against Women (UN
CEDAW) for the period of 1986-1990.

     The Indonesian delegation attended the World Conference to Review and
Appraise the Achievements of the UN Decade for women held in Nairobi, Kenya,
from 15-26 July 1985. Also in July from the 8th to 17th, 1985 the Conference
of NGO Forum was held in which Indonesian participants coordinated by KOWANI
took part. In this forum, KOWANI presented a paper entitled "Women as a
Driving Force in Development, Why and How", with the subtitle "The Case of
Non-governmental Organizations in Indonesia".

     In 1985 KOWANI, as a member of the International Council of Women (ICW),
hosted the Asia-Pacific Seminar Training Workshops with the theme "Challenge
for the Family in a Rapidly Changing Society".

     The General Chairperson of Indonesia's Family Welfare Movement (PKK) was
elected a Senior Women Advisor of the Executive Board of the United Nations
Environment Program (UNEP).