a face shield as a protective measure amid the COVID-19 coronavirus
pandemic at a clinic in Bireuen, Aceh province on April 15, 2020.
AMANDA JUFRIAN / AFP
This article originally appeared on VICE US.
Indonesia is anticipating a spike in births in the coming months due to the disruption of family planning services during the COVID-19 pandemic, a development that jeopardizes the country’s precarious efforts towards fighting childhood stunting, and infant and maternal mortality.
Rather than wait for the demographic wave to crash, however, the country’s National Population and Family Planning Body (BKKBN) has launched efforts to secure and promote contraception for citizens under lockdown, including officials on the ground urging locals to hold off on having kids—via loudspeaker.
“To all women, now is not the time to get pregnant. You will become more vulnerable to COVID-19,” a BKKBN official shouted through a megaphone from his car on Bangka island. “To the men, please hold off. You can get married, but use contraceptives.”
Conversations about condoms, and contraception in general, are still taboo in Indonesia, the world’s fourth-most populous nation, and BKKBN officials’ decision to go village to village with their message rubbed some netizens the wrong way. Some left comments that the act “violated religious law.”
But in addition to the unusual campaign, some regional BKKBN officials have begun offering door to door services, passing out condoms and oral contraceptives along with staple foods to get locals on board.
According to BKKBN statistics, the number of individuals using intrauterine devices (IUDs) fell from by over 35 percent between February and March, while the number of Indonesians using contraceptive injections plummeted by a similar amount in the same time period. Meanwhile, the number of individuals using oral contraceptives and seeking vasectomies or tubectomies each fell by more than 40 percent.
“Providing family planning services is heavily reliant on human to human contact,” BKKBN head Hasto Wardoyo told CNN Indonesia. “With physical and social distancing, the availability of family planning services will certainly be affected.”
Wardoyo also told VICE News that sexual activity will continue whether or not citizens can access contraceptives, hence BKKBN’s plan to conduct a census of fertile couples in rural areas and provide them with contraceptives.
Wardoyo said he hoped Indonesians would overcome their resistance to contraceptives during the pandemic, citing a statistic that roughly 17.5 percent of Indonesian babies suffer neglect in the first 1,000 days of their lives.
Yasmin Dermawan, owner of the Cahaya Bunda Women and Children’s Hospital in Cirebon city, told local media she’d personally witnessed a spike in pregnancies between March and May.
“Over 80 percent of my 1,000 patients are expecting. That’s a 10 percent increase from the previous month,” before the pandemic started, Dermawan said.
An April 2020 report by the United Nations Population Fund (UNFPA) estimated that the pandemic-related limits on birth control distribution could result in up to 7 million unplanned pregnancies worldwide. This, in turn, could lead to an increase in unsafe abortions, female genital mutilation, and child marriages.
“This new data shows the catastrophic impact that COVID-19 could soon have on women and girls globally. The pandemic is deepening inequalities, and millions more women and girls now risk losing the ability to plan their families and protect their bodies and their health,” UNFPA Executive Director Dr. Natalia Kanem said in a written statement. “Women’s reproductive health and rights must be safeguarded at all costs. The services must continue; the supplies must be delivered; and the vulnerable must be protected and supported."
Closer to home, the predicted baby boom threatens to upend Indonesia’s efforts to combat childhood stunting, a key facet of which was the government’s promotion of smaller families.
The World Bank estimates that more than a third of Indonesian children are affected by stunting, placing them at risk of adverse health effects that continue well into adulthood.
But the health risks are also more immediate. According to a recent Reuters report, Indonesia has experienced an abnormally high incidence of child mortality from COVID-19 as compared to other countries.
One of the culprits, according to a senior health official, is child malnutrition.