Household Expenditure and the Utilization of Family Planning and Maternal Health Services in Indonesia by Tohir Diman and Andrew Kantner. East-West Center Working Papers, Population and Health Series, No. 101. February 1998. 45 pp.

Abstract

In recent years, the Indonesian family planning program has placed increasing emphasis on the private sector for the provision of family planning and maternal health services. By 1994, the private sector served 28 percent of all family planning users. Using data from the 1994 Indonesia Demographic and Health Survey (IDHS), this paper provides information on family and household income and expenditure levels that could help the government evaluate the affordability of family planning and health services along with the feasibility of extending private-sector services to poor households.

The analysis shows a substantial variation in the level and distribution of household expenditure in Indonesia. Households with high expenditure levels are more likely to use contraception (56 percent) than are households with low expenditure levels (45 percent). Households with higher expenditure levels are also more likely to rely on the private sector for family planning, prenatal, and delivery services.

In 1994, women who obtained their last contraceptive method from a private-sector outlet paid considerably more than women who obtained services from the public sector. In general, the total costs for family planning services are far lower for households with low monthly expenditure levels than for more prosperous households. Among clients who paid for family planning services, however, the median price paid for pills does not vary by household welfare status, suggesting a rather inefficient market segmentation.

Multivariate analysis indicates that poor Indonesian households are still heavily reliant on government outlets for family planning and maternal health care. Continuing efforts are needed to ensure that poorer households are able to gain access to family planning and maternal health services, primarily through low-cost public-sector providers and better-segmented commercial distribution systems.