Abstract
The Government of Indonesia has established a set of program interventions to enhance the quality of family planning services. The program gives preferences to the acceptance of family planning services and the readiness of the supply side. This study is intended to better understand the extent to which the public and private sectors deliver quality family planning services in 4 selected provinces within Indonesia. The six elements of quality of care (Bruce, 1990) were utilized as the study framework. The study confirmed that the mean of all six elements of quality of care are significant (alpha =0,05) in two out of the four study sites. From the clients’ point of view, information on contraceptive choices was the most neglected aspect in the public health facilities, while ‘follow up and a continuity mechanism’ was most neglected in the private health facilities. The equity index showed a substantial difference in the overall quality of care between the two types of health facilities (public= 4.53 versus private= 5.34). As far as health providers are concerned, quality of care is still below the optimum standard. Emphasis should be given to formally shape the desired health provider behavior and find a way to create an ‘after-sales-service’ scheme. The concept of quality goals need to be mindful of program maturity across regions. Periodic monitoring and evaluation is required to ensure more client satisfaction which leading to more sustained use of modern contraceptives.
Highlights
The law of the Republic of Indonesia number 17/2007 on the 2005-2025 National Long-Term Development Plan (Rencana Pembangunan Jangka Panjang Nasional/RPJPN) states that the ultimate goal of human resources development could be manifested, among others, within population management (Ministry of National Development Planning/National Development Planning Agency, 2005)
In-depth interviews were conducted to gain insight on programs implementation relevant to the 34 respondents from the Provincial Family Planning Office (PFPO), Provincial Health Office (PHO), District Family Planning Office (DFPO) and District Health Office (DHO), health care providers are those working in the public and private health facilities which were purposively selected
In order to increase modern Contraceptive Prevalence Rate (mCPR) to 61.1 percent and at the same time reduce unmet need by 10.14 per cent in 2018, the Government of Indonesia had set a target of 965,000 additional contraceptive users and to expand the family planning program coverage by 48 percent in 122 remote areas (BKKBN, 2017)
Summary
The law of the Republic of Indonesia number 17/2007 on the 2005-2025 National Long-Term Development Plan (Rencana Pembangunan Jangka Panjang Nasional/RPJPN) states that the ultimate goal of human resources development could be manifested, among others, within population management (Ministry of National Development Planning/National Development Planning Agency, 2005). In an attempt to offset Indonesia’s capacity to improve its human resources, national population growth is expected to reach a replacement level (Total Fertility Rate/TFR= 2.1) by 2025. This value represents the average number of children a woman would need to have for the population to replace itself and the children who are born survive to childbearing age. Between 1971 and 1997 Indonesia successfully reduced its total fertility rate by almost half from on average of 5.61 to 2.78 births per Indonesian woman (Central Bureau of Statistics – BPS et al, 1992; BPS et al, 1995; BPS et al, 1998). During the period of 1997-2003 the pace of TFR reduction significantly decreased, resulting in a TFR that has remained stagnant for the last one and a half decades (Figure 1)
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