| 2.1. Economic trends
There has been a relatively constant annual growth rate in
the gross national product (GNP), of almost 7.25 percent, between 1992 and
1995. The GNP per capita has increased from US $ 661 to $ 978 during the same
period but later on it decreased to US$710 in the year 2002 (WHO CORE
Indicators 2005). The percentage of poor, both total and rural, has shown
marginal declines to 11.7 percent and 12.6 percent respectively. Oil and
natural resources remain the predominant contributors to growth. However,
several other sectors, particularly agriculture, home industries and tourism,
have grown quite significantly. Poverty still remains a substantial problem.
Regional inequities in healthcare are important considerations, particularly
maternal health, which is still a major problem in rural areas.
According to Human Development Report 2006, the national
Human Development Index (HDI) was estimated at 0.711, ranking Indonesia 181
among 177 countries. However, it has improved from the HDI value of 0.623 in
1990. Similarly, Indonesia’s
Gender Development Index is 0.704, ranking it at 81 among 177 countries
(UNDP, Human Development Report, 2006).
Applying the international criteria of $ 1 per day, the
proportion of poor population in Indonesia in 1990 was 20.6 per
cent and 7 in 2004. The proportion of poor population – those living below
the national poverty line is 17 in 2004. In 1998, the Indonesian Government
adopted new thresholds for the national poverty line that reflected a higher
standard of living. Subsequently, 1996 poverty levels were adjusted to
incorporate the 1998 criteria. During
the economic crisis, the proportion of poor population increased to 23.4 per
cent in 1999, and then declined to 18.2 per cent in 2002 and 17 per cent in
2004.
Related Links World Bank HDI - UNDP UNESCAP
2.2. Demographic trends
According to final results of population census 2000, the
population was 205.8 million (2000). Population of Indonesia in 2006 was estimated
to be 222 million (according to Selected Indicators of Indonesia, Pusat Statistik June 2006). The
annual growth rate of population decreased sharply from 1.97 in 1980-90 to
1.34 during 2000- 2005; but it has slightly increased to 1.5 during 2000-03.
The crude birth rate (CBR) and crude death rate (CDR) per 1000 population
were 19.5 and 6.6, respectively in 2005. The total fertility rate (TFR) in
2005 was estimated at 2.2.
The urban population in Indonesia in 1990 was 31 percent,
which increased to 42 percent in 2000 and 48 percent in 2005 (according to
Selected Indicators. Social-Economic of Indonesia, July 2006).
According to Selected Indicators. Social-Economic of Indonesia,
July 2006, the population under 15 years of age is 20 percent, population
aged 15-59 years is 62.5 percent, and population of 60 years and above is 7.5
percent. There is an increasing trend in the number of older persons (over 60
years), which will demand more personalized healthcare services. The needs of
an increasing older population will add to the existing burden of disease, with
prevailing communicable diseases on the one hand and the rising prevalence of
non-communicable diseases on the other.
The Life Expectancy at birth for males has increased from
57.9 years in 1990 to 69 years in 2005. Since 1960, the IMR in Indonesia has
decreased from 128 per 1,000 live births in 1960, to 68 between 1986 and
1991, and to 32 per 1,000 live births in 2005
Related Links Health Profile WHR –
WHO/HQ
2.3. Social trends
Literacy: The adult literacy rate
>15 years in 2004 was 91 percent overall literacy rate in 2003 was 91
percent (Welfare Statistics 2004). Literacy and numeracy
are being addressed through non-formal group education, the main constraint
being the ability to reach out to the poor and those in remote areas.
Primary Net Enrolment ratios: Data
from the National Socio-Economic Surveys (Susenas)
show that Indonesia
has achieved high levels of access to primary education for children aged 7
to 12 years. The Net Enrolment Ratio (NER) has increased from 88.7 percent in
1992 to between 92 and 93 percent in recent years (Figure 2.1). Data from the
Ministry of National Education (MoNE) show slightly
higher NERs over the years (94 percent in 2002).
Figure 2.1. Net
enrollment ratios, primary and junior secondary education
Primary Gross Enrolment ratios: The
NERs are significantly different from the Gross
Enrolment Ratio (GERs). For example, MoNE data shows the primary GER in 2002 at 112 percent,
which is significantly higher than the NER of 94 percent. This indicates a
high number of under-aged (under seven years of age) and over-aged pupils
(over 12 years of age). According to MoNE data,
10.3 and 4.9 percent of primary school students are under-aged and over-aged,
respectively. Under-aged children can enrol in
primary schools, a trend that has increased, especially in urban areas.
Over-aged students may be a result of late enrolment – for example, 42.2
percent of newly enrolled primary-school students were aged eight years and
more in the 2000-01 school year. Also, by repeating grades, students complete
primary school, when they are older than 12 years.
Disparities in primary education:
Further analysis, based on 2002 Susenas data, shows
consistently high NERs and GERs
in primary schools in all population groups, with no significant disparities
between rural and urban areas, between girls and boys, and among poverty
quintiles. However, inter-province
variation is considerable, with the NER of some provinces below 90 percent.
Junior secondary education: The
access to junior secondary education has increased significantly since 1994,
following the implementation of the Nine-Year Compulsory Basic Education
Programme. The NER at junior secondary level has increased from 41.9 percent
in 1992 to 61.7 percent in 2002, while the GER has increased from 65.7
percent in 1995 to 79.8 percent in 2002.
Disparities in junior secondary education:
Unlike in primary education, junior secondary education enrolment numbers
show considerable disparities between rural and urban areas, and among
poverty quintiles, but not, however, between girls and boys. For 2002, the
NER in rural areas (54.1%) is significantly lower than in urban areas (71.9%)
and the NER of the poorest quintile (49.9%) contrasts starkly with that of
the richest quintile (72.3%). The junior secondary GERs
also vary widely between rural (69.7%) and urban (93.5%) areas, and between
poor (64.8%) and rich (94.6%) population. Among provinces, wide disparities
exist in junior secondary NERs. The NERs of several provinces are still below 60 percent
(Central Kalimantan, Central Sulawesi, East Nusa Tenggara, Gorontalo, Papua, South Kalimantan, South Sulawesi, South Sumatra, Southeast Sulawesi,
West Kalimantan and West Nusa
Tenggara). According to 2001 Susenas
data, Papua has a much lower NER (40.5%).
Labour Force: In Indonesia,
Labour Force Participation Rate (LFPR) in 2003 was
65.72 percent. It went down compared to LFPR in 2002. However, the female job
seekers were fewer than male job seekers, though the female job vacancies
were higher than male job vacancies.
Around 90.5 percent out of 100.3 million labour forces was working in 2003. The majority (76.78%)
of workers were poorly educated (under senior high school), and the high
educated workers (senior high school and above) were only 23.22 percent.
Human Resource Capacity: According
to Statistical Yearbook of Indonesia 2003, there were 146,052 Primary
Schools, 20,918 Junior High Schools, 8,036 General
Senior High Schools, 4,943 Vocational Senior High Schools, and 1,924
Universities (78 State and 1,846 private) in the year 2002-03, under the
Ministry of National Education.
Related Links UNESCO World
Bank
2.4. Food supply and nutritional status
The proportion of children under five years of age, who
are underweight, decreased from 37.5 percent in 1989 to 28 percent in 2003.
Severe malnutrition has increased slightly, from 6.3 percent in 1989 to 8
percent in 2002. There were overall improvements in nutritional indicators
between 1986 and 1997. In 1997, the incidence of low birth weight was 7.7
percent, which has decreased to 6 percent in 2002, according to IDHS 2002-03.
The proportion of children under five years, whose
weight-for-age was below 80 percent of the median, was 20.3 percent. The proportion of school children with
iodine deficiency disorders (IDDs) was 27.2 percent
(1992), with disparities in prevalence among provinces. The proportion of
pregnant women with anaemia was 51.0 percent, and
children under five years with anaemia were 40.5
percent (1995). The reduction in the prevalence of vitamin A deficiency has
been substantial. The national xerophthalmia survey
(1992) revealed a national prevalence of 0.33 percent, which is less than the
accepted cut-off point. However, three provinces still have a problem of
vitamin A deficiency. The main constraints are inadequate coverage by
supplementation programmes (iron, vitamin A and
iodine) due to geographical and socio-cultural factors, inadequate funding,
and supplementation being restricted to endemic areas. Other general factors
include low community awareness, lack of community participation in nutrition
activities, and indifferent support from other sectors in the implementation
of integrated nutrition programmes.
According to IDHS 2002-03, 25.7 percent of women in urban
areas and 28.2 percent in rural areas started breastfeeding the baby within
24 hours of birth. There was hardly any difference in initiation of
breastfeeding to male and female babies. However, 16 percent of mothers in
urban areas and 19 percent in rural areas also gave pre-lacteal feeds to
babies.
Related Links Nutrition Promotion Nutrition Nutrition
- WHO/SEARO Nutrition
– WHO/HQ
2.5. Lifestyle and Risk Factors
Health problems related to changes in lifestyle have been
associated with changing food habits. For example, adolescents and fast-food;
smoking, particularly the increase in young smokers; has led to an increase
in lifestyle related health problems The proportion of the population aged 15
and above, who are regular smokers, was estimated to be 23 percent in 1995.
In 2001, 31.5 percent of Indonesian adults smoked; the vast majority of them
men. About 62.2 percent of male adults smoke regularly, with higher rates in
rural areas (67%). At the provincial level, the highest male smoking rates
are in Gorontalo (69%) and the lowest in Bali (45.7%).
Substance abuse, sedentary lifestyles, lack of exercise, and violence
also contribute to health problems. The main constraint is lack of social
support and national commitment, particularly with regards to smoking.
Related Links Substance Abuse - WHO/SEARO Tobacco - WHO/SEARO Tobacco
- WHO/HQ Alcohol – WHO/HQ 
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