Babatunde Osotimehin: Family planning is not A health issue

TEMPO.CO, Jakarta - With a 1.49 percent annual growth rate, Indonesia's current population of more than 250 million is expected to surpass that of the United States by 2043, possibly becoming the third most populous country after China and India. Despite a national family planning program in place since 1967, Indonesia continues to struggle with various socio-cultural constraints that prevent it from becoming more effective and efficient. Such issues emerged during the recent International Conference on Family Planning in Nusa Dua, Bali. 

On the sidelines of the biennial conference, Tempo English contributing editor Cory Rogers spoke to Dr. Babatunde Osotimehin, the current executive director of the United Nations Fund for Population (UNFPA). Dr. Osotimehin, a Nigerian national who is serving his second term as head of UNFPA, shared his views on how empowering women through sexual and reproductive health rights is a key to unlocking Indonesia's development potential. Excerpts of the interview: 

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You just came from the World Economic Forum in Davos, Switzerland. What role do you see for the private sector in terms of family planning and reproductive health?

It's big. I want to start by saying there are many dimensions to it. The first is that we need to see family planning as central to development, and if you start from the perspective, like I do, that women and girls are absolutely central to human development, then everything flows from that. So the ability for countries and the private sector to contribute to development and the capacity of girls and women to participate in the workforce is key.

But you cannot have that if you don't have good health and good education, and one of the most important pieces is the ability for women to control their fertility. That also extends to all the issues about sexual and reproductive health services, so that when they have children, they have healthy children. So investment in women and girls is critical. The private sector has a role to play in that by providing resources to assist governments. For example, when we are looking at how to make money 'go far' in family planning, we're looking at how we can drop the price of family planning commodities. The private sector agreed to do so if we could give them a guarantee. So we gave them a volume guarantee and they dropped the price from about US$28 to US$8 per person. So that's the sort of thing we are talking about.

But is the private sector's involvement sufficient?

It's not enough: we need to scale it up. In the past, we had this thing called corporate social responsibility. We have to get away from that; to have the private sector actually see itself as a part of development. So in Indonesia for example, (they must recognize) they are a part of Indonesia's DNA. They must put their resources out, which should include job training, internships, making sure children have access to science and math and technology. That's where it has to change.

How important is directing that kind of investment to young people? 

Today in the world, there are 2 billion young people, most of them in the developing countries, and when you look at Indonesia's demography, there is a large population of young people. If you look at the fourth industrial revolution artificial intelligence, robotics, driverless cars those are the things that will be the next contributors to development. If Indonesia and the rest of the developing world is going to participate in that revolution, they are not going to go the path of Europe or North America. They will have to leapfrog in order to be part of it. That implies that we have to skill the young people today to do that. That implies that Indonesia will have to invest in a different kind of education. That's the message that has to go out.

UNFPA's eight-year program in Indonesia just ended. What will be different about the new program?

When you look at country profiles, Indonesia is not a poor country. Indonesia is advancing in terms of its own indicators of development. So we expect Indonesia to do something by itself. But you know, sometimes government policy does not achieve the objectives it sets. For example, Indonesia has decided to adopt universal health coverage. That's a good thing. But how is it going to work? What kind of money will be dedicated (to it)? How will it be divided up? How will there be assurances that resources meant for family planning actually go to family planning? How do you monitor it? How do you ensure quality care? Those are the things that exist in the policy framework and require programmatic guidance to achieve. So that's where we go, so that at the end of the day, we will help them direct resources and programming and data and foreign investments.

Are the drivers of rising maternal mortality in Indonesia still unknown?

We know some of the reasons. Early marriage is an issue; we need to address that. Equality of service is not the best; some of the points of service are not the best. And when we look at the geographies where this is happening we also need to invest in some areas that are disadvantaged.

According to the World Health Organization, Southeast Asia has one of the highest rates of unsafe abortions. How can the UNFPA help the Indonesian government address this issue?

The issue of unsafe abortions is a national thing. So we don't prescribe as to whether abortions should be available or not. But we do say this: In countries where it is legal, it has to be safe. In countries where it isn't legal, countries need to provide post-abortion care. Those are the two things. So how do you prevent unsafe abortions? I'll say two things: first is comprehensive sexual education, so they know who they are, they know their vulnerabilities. The second, of course, is access to services, access to contraception. That's something we have to think about in Indonesia. And if you look at maternal mortality here, it's not just about girls who are unmarried who are dying. Some of them are married, so it's about access to contraception. (*)

Read the full interiew in this week's edition of Tempo English Magazine