The Jakarta Post
Apart from its threat to the health system and the economy, the COVID-19 pandemic could lead to a baby boom that would slow the country’s bid for recovery. The number of pregnancies has risen during the pandemic, prompting the National Population and Family Planning Board (BKKBN) to double efforts to promote family planning and contraceptive use.
Contraceptive services have been severely disrupted as human movement restrictions – one of the measures to contain the virus – prevents health officials from offering routine family planning counseling and contraceptive services. Physical distancing has reduced patient services and operating hours of health facilities, clinics and midwife services, while fertile couples are somewhat reluctant to go out and seek family planning services for fear of virus transmission.
BKKBN data show the number of active users of contraception declined to 26 million in April from 36 million in March. One-fourth or 2.5 million of those who have stopped using contraception were fertile couples aged between 20 and 35 years.
The possibility for contraceptive users to get pregnant within the first month after quitting injections, intrauterine devices (IUDs) and pills stands at 10 percent, 15 percent and 20 percent, respectively. In the end, about 370,000 to 500,000 women may have become pregnant as of May.
The use of contraceptives also declined by 35 to 47 percent from February to March, which could contribute to a 15 percent increase in unintended pregnancies in 2021, BKKBN data also reveals. Nationwide, the percentage of unintended pregnancies stands at 17.5 percent, which means 17 in every 100 pregnancies are unintended. This is quite alarming.
“One of the leading causes of the unintended pregnancies is fertile couples’ lack of access to contraceptive supplies and services,” BKKBN head Hasto Wardoyo said during the launch of an online-based family planning application, KlikKB, in Jakarta on Aug. 17. The app launch is for World Contraception Day, which will be commemorated on Sept. 26.
According to Hasto, concerns about coronavirus transmission in health facilities, the closure of contraceptive providers and transportation disruptions due to large-scale social restrictions (PSBB) have kept users of contraception from seeking the care they need.
World Contraception Day is a global campaign to raise public awareness that every pregnancy should be a planned one. Launched in 2017, it aims to improve public knowledge about contraception and share adequate information so that women can understand and make proper decisions on their reproductive health.
If coronavirus-related lockdowns and restrictions continue, more than 47 million women worldwide could lose access to contraception over months, the United Nations Population Fund warned in June.
As the pandemic may last for years, it is now a critical time for Indonesia, the world’s fourth-most populous country, to push forward contraceptive services for fertile couples. The government should help them practice family planning, namely through the temporary delay of pregnancy, the spacing of births and permanent contraception methods.
In the 1970s, Indonesia won global praise for its successful family planning program under a popular tagline “Dua Anak Cukup” (Two Children Are Enough). Nowadays, a surge in pregnancies is expected as an unintended consequence of the curbs to contain the pandemic.
To prevent a further decline in contraceptive use, the BKKBN has taken initiatives, such as deploying family planning facilitators and counsellors to directly distribute free pills and condoms to the public. In some regions, BKKBN offices, using various media, have encouraged people to delay pregnancy and avoid unintended pregnancy during the pandemic. In fact, the human immune system tends to weaken during pregnancy, making pregnant women more prone to COVID-19.
The BKKBN also provided free family planning services across Indonesia as part of the One Million Acceptors campaign and National Family Day (Harganas) celebration, which fell on June 29. On that day, the contraceptive service reached 1.37 million people.
To boost family planning services during the crisis, the BKKBN partnered with local governments in about 500 regencies and cities and midwife associations to ensure the safe delivery of contraceptive tools, family planning services and information on family planning programs.
The online platform KlikKB is an innovative approach to bring family planning and reproductive health services closer to society. Jointly developed by telemedicine app KlikDokter and the BKKBN, KlikKB provides live chat services with providers, information on family planning service centers, as well as contraceptive alarms for both providers and users. The alarm reminds people when to take their contraceptive pills.
The alarm also aims to prevent contraceptive dropouts, which remain high especially in short-term contraception cases. In the last three months, 10 percent of 36 million fertile couples have abandoned their contraceptives, according to BKKBN data.
With KlikKB, the supply of contraceptive tools can be monitored to prevent stock-outs in health facilities. Currently, 2,000 midwives in areas across Indonesia are involved as service providers. Midwives as counsellors will be assigned to provide consultations via KlikKB.
With its primary goal to help families produce healthy children, the BKKBN has now turned to teenagers, young adults and people under 40 as its target market. As reproductive health is not a subject in school curriculum, Hasto said the BKKBN had to develop new strategies and more creative ways to disseminate information on reproductive health to teenagers.
Despite the pandemic, family planning services must continue under strict health protocols. It would not be an exaggeration to say that the government’s decision to ease restrictions could lead to a revival of family planning services.
Staff writer at The Jakarta Post