The relation of economic class and fertility: An analysis of some Indonesian data

Summary Many recent fertility studies in developing societies put forward the hypothesis of a negative relation between economic class and fertility. Data showing a positive relationship are frequently dismissed a priori as resulting from the reporting errors of illiterate women. This study draws on data from Indonesia's 1971 Census, a 1973 sample survey of fertility and mortality, and an intensive community study in Java, to argue that an observed positive relation between class and fertility is real, and is related to differences in patterns of marital disruption, postpartum abstinence, and fecundity. The positive relation may be reversed in the future as changes in these patterns, and the impact of the national family planning programme, affect the family structure of each class differently. Had the positive relation in this context been attributed offhand to reporting errors, these important socio-economic changes would have been misunderstood, and possibly ignored.

Male circumcision and penis enhancement in Southeast Asia: matters of pain and pleasure

This paper reviews some uniquely male sexual health concerns in Southeast Asia, with particular attention to Indonesia. These include various forms of male circumcision, different types of 'penis enhancement' carried out across the region and the use of dry sex by women. These practices appear to be motivated by specific notions of sexual pleasure, based on indigenous gender constructs. Although they may or may not pose a serious public health problem, as markers of misguided or exploitative gender relations they do reveal important aspects of social psychology related to sexuality and sexual health. Male circumcision provides an ideal opportunity to consider male reproductive health needs and risks in Indonesia, Malaysia and the Philippines. Practices that involve cutting the male genitals need to be addressed in ways that stress the importance of sexual relationships based on mutual respect and open communication. Penis implants and inserts and other penis augmentation devices, as well as dry sex practices, are potentially dangerous to both men and women, and of questionable value in bringing pleasure to either, and should be discouraged.

Continuing demographic transitions in Asia

"This article updates the literature survey on demographic trends and policies published in the May 1987 issue of this journal. It reports substantial adjustments in earlier population projections, suggesting slower decline in population growth rates for China and several other Asian countries. It gives an account of recent trends and policies in the Asian-Pacific region, especially China, Vietnam, Indonesia, the Philippines and Singapore."

Institutional constraints to building social science capability in public health research: a case study from Indonesia

The promotion of social sciences capabilities in public health research in universities frequently encounters unexpected barriers. This paper argues that, in Indonesia, historic factors and institutional structures of public health research have created constraints to success in public health research and international technical assistance. Donors are often frustrated by apparent inconsistencies between agreed intentions and the subsequent behaviour of recipient colleagues, thus resulting in poor relations and failure of collaborative links. For social sciences to be integrated into public health research, assistance is needed in graduate education, library development, computerisation, and research methodology. Contributions in these areas may be ineffectual if they are not preceded or accompanied by efforts by recipients to reform or circumvent existing institutional weaknesses. Some important barriers to the development of research capabilities in Indonesia are beyond the control of individual faculties of public health, or even universities, and are affected by regulations and budgeting procedures of the National Department of Education and Culture, or the civil service administration. There are, however, changes that can be made at faculty or university level to encourage a more productive 'research culture' and promote linkages between the social and health sciences.

Induced abortion in Indonesia

Induced abortion is one of the most difficult sociomedical problems facing the Indonesian government. While well-known in traditional society, the practice was discouraged by all Indonesian religious groups, and forbidden by the Dutch colonial authorities. Although abortion was technically illegal under the criminal code, a judicial interpretation in the early 1970s permitted medical professionals to offer the procedure so long as they were discreet and careful. The numbers of medical abortions carried out in Indonesia rose dramatically, and there was evidence of matching declines in the incidence of morbidity and mortality caused by dangerous illegal procedures. Medical and community groups campaigned for a more liberal abortion law to protect legal practitioners and stamp out illegal traditional practices. Their efforts appeared to bear fruit in the draft Health Law, but when the law was passed by the legislature in late 1992, the issue was again clouded by contradictions and inconsistencies.

Fertility trends in Indonesia, 1967-1985

Fertility trends in Indonesia for the period 1967-1985 are analyzed. Data are from the Indonesian censuses of 1971 and 1980 and from the 1985 Intercensal Survey (SUPAS 85); they concern fertility rates by province, marital status, and for the general population. An overview of the sociocultural factors that affect data reliability and a discussion of the effectiveness of the date of last birth method are included. The authors conclude that the evidence "has confirmed the existence of a major fertility decline throughout Indonesia. The pace of the decline has been faster in 1980-85 than during the 70s. On present trends, it should be possible to reach the ambitious target of halving fertility between 1979 and 1990."

Population problems in Austronesia

The author examines population issues facing countries in Oceania and Southeastern Asia. "Analysis is based on recently released population projections from the United Nations Population Division. There are great differences among the countries.... There are nonetheless important areas of commonality: all nations are facing the problem of raising levels of schooling in line with parents' aspirations and economic needs, all face problems of caring for a rising proportion of aged, and all have difficulties with the monitoring and control of international migration. Also, since minority groups in many countries are majority polities in neighbouring states, there is potential for establishing international dialogues aimed at relieving internal tensions." Consideration is given to the role of Australia in promoting international cooperation to deal with these issues.

Multivariate analysis of infant and child mortality in Java and Bali

Application of a multivariate analytical technique to the World Fertility Survey data for Java and Bali indicates that demographic variables, particularly the length of the preceding birth interval, are more important in explaining infant and child mortality differentials than are such social variables as education of parents or urban–rural residence. These findings are weakened to some extent by the lack of satisfactory data on household economic status which might have provided a better base for indirectly discerning the effects of nutrition and sanitation on mortality at young ages.

Estimation of fertility in Indonesia 1980 from last live birth data

A method of estimating current fertility from information on last live births is presented. The technique is developed from one proposed by Hull for estimating fertility rates for Indonesia using 1976 intercensal survey data and does not depend on conditions of stable fertility or on assumptions about past mortality. "The estimates of [the] total fertility rate for Indonesia 1980 are 4.40, 3.87 and 4.28 for the rural, urban and the total areas respectively, and compare well with the estimates derived by the 'Own Children' method." A comment by Aris Ananta (pp. 49-53) is included. (summary in IND)

A note on estimating the cause of death structure in high mortality populations

Strategies for reducing mortality should be based on an informed assessment of the underlying structure of causes of death. In the absence of an adequate vital registration scheme, cause of death information is generally derived from fragmentary data which are often limited to specific sectors of the population. Using the previous mortality experience of industrialized countries at higher levels of mortality and the cause of death returns of contemporary developing societies with reasonably accurate and complete mortality data, a linear model has been developed to estimate the cause-structure of mortality in a population from knowledge of the crude death rate alone. Through an appropriate weighting of age-cause-specific mortality rates, emphasis is placed on those causes of death likely to be of greatest concern in high mortality populations. Using the model parameters derived in this fashion, the technique is applied to estimate the cause-structure of mortality in Java. The resulting distribution of deaths differs markedly from that suggested by an older age-standard and is much more in accord with epidemiological opinion about likely causes of death based on rural health surveys, hospital records, and other health data. Regression parameters for estimating the cause of death structure during infancy and early childhood are also shown and may be used independently of the all-age regression estimates.

A framework for estimating causes of death in Indonesia [causes of death in Indonesia]

A number of demographic techniques for the indirect estimation of trends in causes of death in Indonesia are proposed. These involve "the use of rates and proportions derived from other nations experiencing similar levels of mortality to that prevailing in Indonesia. Four sets of estimates were produced, the first based on a regression developed by Preston, the other three derived from national patterns of Mexico, the Philippines, and a composite group of countries. These were compared with available epidemiologic and clinical data from Indonesia to produce a final set of estimates which accord both with known Indonesian patterns and medical findings from other nations."