Family Planning – a Challenge to Decentralization

fasli_jalal_bkkbnFebruary 5, 2014 At today’s Family Planning 2020 stakeholder meeting, Prof. Fasli Jalal, head of the National Population and Family Planning Board, Indonesia, addressed his country’s strategy for addressing family planning in the context of a highly decentralized political system.

Indonesia took the “big bang” approach to decentralization in 2000, devolving resources and decision-making authority to provinces and districts – creating “516 little kingdoms” (district-level governments) across the 17,000 islands and 360 ethnic groups that make up the nation.

Before decentralization, Indonesia had made rapid progress in family planning – increasing contraception utilization from 10% to 57% during the 1990s. But the issue was not a top priority for district governments, and so progress has stalled for the past decade and the number of family-planning field workers has declined from 40,000 to 15,000. Formerly strong local family planning offices have been closed. Maternal mortality has recently increased.

Indonesia’s president has made turning this situation around a high priority – but obviously he cannot do so simply by command – he must incentivize it. Prof. Jalal described a series of measures being taken to “decentralize” the commitment to family planning.

  • Strong support by the president and the cabinet.
  • A 2009 law to establish new institutions at every level of government.
  • Launching a “Family Resilience Program” in the medium-term development plan.
  • Capacity development for local governments.
  • Increasing budget allocations, with special allocations to districts to strengthen facilities.
  • Integration into the growing national health insurance system which is on track to be universal by 2019.
  • Maximizing the role of village midwives as family planning field workers.
  • Educating candidates to local elections about

Prof. Jalal spoke via teleconference to 700 participants around the world attending a stakeholder meeting that follows-up the 2012 Family Planning Summit in London that launched the Family Planning 2020 Initiative. More information is available at

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