CHANGING DEMOGRAPHICS UNICEF Indonesia - Resources - Publications

THE SITUATION OF CHILDREN AND WOMEN IN INDONESIA 2000-2010 47 SECTION 3: ANALYSIS OF NATIONAL INDICATORS ON THE SITUATION OF WOMEN AND CHILDREN THE SITUATION OF CHILDREN AND WOMEN IN INDONESIA 2000-2010 48 THE SITUATION OF CHILDREN AND WOMEN IN INDONESIA 2000-2010 49 INTRODUCTION This section provides a general overview about key aspects of the situation of children and women in Indonesia. There are five broad clusters of analysis: health and nutrition focusing on trends in outcomes relating to mortality rates and nutrition; water and sanitation; HIV and AIDS and adolescent health practices relating to sexually transmitted infections STIs; education focusing on attendance, early leaving rates, access and quality; and finally, child protection including citizenship and birth registration, protection from violence, abuse, and exploitation, alternative care systems, and child freedom and participation. The first subsection on health and nutrition, and the second on water and sanitation, relate to Millennium Development Goals MDGs numbers 1, 4, 5, 6 and 7. 1 The third subsection, on HIV and AIDS, relates to Goal 6. The fourth part, on education, relates to Goals 2 and 3. Due attention is given to MDGs in that the analysis presented here is centred on children and women, but we also consider inter-related analysis of the situation of child protection. In addition, while presenting a large number of indicators that correspond to data aggregated at the national level, whenever possible the discussion also focuses on evidence of the profound and wide- ranging disparities and inequalities which characterize Indonesia today. The fifth subsection, on child protection - or ‘special protection’ as it is known in Indonesia - is distinct in that it relies less on indicators and aggregate quantitative data for the whole country due to data insufficiencies and more on in-depth case studies some of which include quantitative data, as well as qualitative data. The approach in the analysis is intended to capture and illustrate the challenges and contradictions that accompany the incipient construction of child protection in Indonesia. Whilst this section is divided into five distinct subsections, it is important to underline that these five areas of analysis are deeply interrelated, such that outcomes in one may affect changes in others. Each section of analysis also identifies the major changes in policies and initiatives that have been undertaken in relation to the themes of the section, although the discussion is not exhaustive given the rapidly changing policy and regulatory environment in Indonesia. Some mention is made of these changes in relation to decentralisation, although further discussion takes place in the sub-national analysis in Section 4. The following analysis highlights that, in terms of almost all the indicators and available data, considerable progress has been made towards improving the situation of women and children over the past decade, both in terms of the regulatory framework and national aggregate figures in health, nutrition, water and sanitation, and education, although much work remains to be undertaken in the area of HIV and AIDS prevention and child special protection. However, across these indicators, there are consistent inequalities and inequity between the provinces, such that in many cases a few more successful provinces serve to raise the national average. Furthermore, the poorest quintiles and people in rural areas tend to be left behind in terms of the gains for women and children in recent years. Moreover, on some indicators gender inequities remain. These results underline the importance of policy initiatives that aim to achieve the MDGs with equity and to ensure that growth in Indonesia is pro-poor and seeks to remedy regional, socio-economic and gender inequities. The National Medium-Term Development Plan RPJMN 2010-2014 of the Government of Indonesia GoI and the corresponding sectoral Strategic Plans Renstra, Rencana Strategis and government actions also place importance on reducing inequalities and inequities and focussing on improving the situation of the poor. As such, the policy space exists to continue to strive for progress with equity in the coming decade. 1 These MDGs are as follows: Goal 1: Eradicate extreme poverty and hunger; Goal 2: Achieve universal primary education; Goal 3: Pro- mote gender equality and empower women; Goal 4: Reduce child mortality rate; Goal 5: Improve maternal health; Goal 6: Combat HIV AIDS, malaria, and other diseases; Goal 7: Ensure environmental sustainability.

3.1 HEALTH AND NUTRITION

Appropriate health and nutrition, as well as access to clean water and adequate sanitation are vital for the welfare and wellbeing of children and women. Three of the eight MDGs Goal 1: Eradicate extreme poverty and hunger; Goal 4: Reduce child mortality, and Goal 5: Improve maternal health have been specifically targeted at improving outcomes in the welfare of women and children through reducing malnutrition rates, infant and child mortality rates, and maternal mortality rates. Other interrelated MDGs and sub-targets pertaining to assisted births, the use of birth control, reductions in malaria and tuberculosis rates, HIV prevention, improved water and sanitation etc., contribute to improving health and nutrition outcomes overall, as well as to child survival and development. The examination in this report of health and nutrition in relation to children and women in Indonesia comprises three subsections: mortality, nutrition, and some related determinants including, access to water and sanitation. These various aspects of health are deeply interconnected, as shown by the conceptual framework on determinants of malnutrition and mortality in Figure 3.1.1. 2 The diagram shows that malnutrition, for example, is not just attributed to a lack of available food or income to buy food, but also to caring practices such as breastfeeding or hygiene practices and living in unhealthy environments for example, with poor access to clean water and sanitation. Good hygiene practices and nutrition can also help to prevent the spread of common diseases and resilience to other illnesses such as diarrhoea, which can all in turn increase the risk of child and infant death. The provision and access of services are essential for improving health and the likelihood of child and mother survival during childbirth. Information and education that promote healthy hygiene and sexual practices are vital too, to prevent illness and the transmission of diseases. However, as Figure 3.1.1 demonstrates, improving nutrition and decreasing child and infant mortality rates also relates to the policy and institutional environment, as discussed further in the case studies in later sections of this report. 2 UNICEF 1998 State of the world’s children 1998, Oxford University Press: Oxford © UNICEF2004Rachel Donnan