Formative years of family planning in Indonesia

While the histories of national family planning programs around the world differ, they also have common threads that provide complementary lessons. Whether one considers the debates about incentives in Bangladesh, the one-child policy in China, or the attempt by an authoritarian ruler to push population control in India, explanations for behavioral change must be looked at in a cultural or historical framework, yet the themes that emerge can often be generalized to quite different settings. A family planning program is an outcome of deliberate actions by key individuals and this results in the formation of institutions, in logistics systems, and in various health and social resources. At the same time, the population must experience a radical transformation of beliefs that leads them from a preference for large families to a preference for small families. This is the experience of Indonesia, where actions by some remarkable individuals, combined with dramatic social changes, shifted a highfertility nation to replacement-level fertility over the course of four decades. The Indonesian state was born in 1945–49 (box 15.1). Relations with Western countries were normalized over the ensuing years, leading to some international involvement in family planning in Indonesia and the establishment of a private family planning association following President Sukarno’s announced opposition to government assistance. Then in 1965 the government changed, opening the door to what would become one of the most prominent family planning programs in the world.