Document of

The World Bank

FOR OFFICIAL USE ONLY

Report No. 6276

PROJECT PERFORMANCE AUDIT REPORT

INDONESIA

SECOND POPULATION PROJECT

(LOAN 1472-IND)

June 23, 1986

Operations Evaluation Department

This document has a restricted distribution and may be used by recipients only in the performanceof their official duties. Its contents may not otherwise be disclosed without World Bank authorization.

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FISCAL YEAR OF BORROWER

April 1 - March 31

CURRENCY EXCHANGE RATES

Name of Currency (Abbreviation): Rupiah (Rp)

Currency Exchange Rate:Appraisal Year Average (1977) US$1 - Rp 413Intervening Years Average (1978-83) US$1 - Rp 650

Completion Year Average (1984) US$1 = Rp 1000

FOR OFICIAL USE ONLYTHE WORLD BANK

Washington, D.C. 20433U.S.A.

O1ce of Dkecttw.CealOpebain Evaluation

June 23, 1986

MEMORANDUM TO THE EXECUTIVE DIRECTORS AND THE PRESIDENT

SUBJECT: Project Performance Audit Report: Indonesia - Second

Population Project (Credit 1472-IND)

Attached, for information, is a copy of a report entitled"Project Performance Audit Report: Indonesia - Second PopulationProject (Credit 1472-IND) prepared by the Operations EvaluationDepartment.

Yves Rovani

by Otto Maiss

Attachment

This document has a restricted distribution and may be used by recipients only in the performanceof their official duties. Its contents may not otherwise be disclosed without World Bank authorization.

FOR OFFCUL U ONLY

ABBREVIATIONS AND ACRONYMS

ABRI - Armed Forces of the Republic of IndonesiaBAPPENAS - National Development Planning AgencyBKKBN - Badan Koordinasi Keluarga Berercana Nacional (National

Family Planning Coordinating Board - NFPCB)GDP - Gross Domestic ProductGNP - Gross National ProductGOI - Government of IndonesiaIDA - International Development AssociationIEC - Information, Education and CommunicationIPPA - Indonesian Planned Parenthood AssociationIPPF - International Planned Parenthood FederationIUD - Intra-uterine DeviceLKBN - National Family Planning InstituteMCR/FP - Maternal and Child Health/Family PlanningMO - Ministry of HealthMOPE - Ministry of Population and EnvironmentMRWA - Married Women of Reproductive AgeMSU - Mobile Service UnitNFPCB - National Family Planning Coordinating Board (BKKBN)NFPI - National Family Planning Institute (LKBN)NFPTC - National Family Planning Training CenterOED - Operations Evaluations DepartmentPCR - Project Completion ReportPHN - Population, Health and Nutrition DepartmentPIU - Project Implementation UnitPO - Provincial OfficePPAM - Project Performance Audit MemorandumPPAR - Project Performance Audit ReportPTC - Provincial Training CenterREPELITA - Five-Year Development PlanSAR - Staff Appraisal ReportSTC - Sub-Provincial Training CenterUN - United NationsUNESCO - UN Educational, Scientific and Cultural OrganizationUNFPA - UN Fund for Population ActivitiesUNICEF - UN Children's FundUSAID - United States Agency for International DevelopmentVCDC - Village Contraceptive Distribution CenterW%O - World Health Organization

Thir docutent has a restricted distribution and may be used by recipients only in the pedonanceof their oflicial duties. Its contents may not otherwise be disclosed without World Bank authoriation.

GLOSSARY

Crude Birth Rate (CBR): Number of live births per 1,000 populazion.

Crude Death Rate (CDR): Number of deaths per year per 1,000 population.

Rate of Natural Increase: Difference between crude birth and death rates,usually expressed as a percentage.

Population Growth Rate: Rate of natural increase adjusted for net migrationand expressed as a percentage of the totalpopulation in a given year.

Infant Mortality: Annual number of deaths of infants under one yearper 1,000 live births in that year.,

Total FertilityRate (TFR): Average number of children that would be born to a

woman if she were to live to the end of herchild-bearing years, and bear children according toa given set of age-specific fertility rates. Thetotal fertility rate serves as an estimate of theaverage number of children per family.

Life Expectancy: The average number of years childran born in thesame year can be expected to live if mortalityrates for each age and sex group remain the same.

Contraceptive Prevalence: Percentage of married women of reproductive age(15-49 years) using some method of contraception ata given time.

INDONESIA POPULATION/REALTH/NUTRITION TRENDS AND STATUS /a

1960 1984

Total Population (million) 96.3 161Crude Birth Rate (per thousand) 44 30Crude Death Rate (per thousand) 23 11Rate of "atural Increase (percentage) 2.1 1.9Population Doubling Time at CurrentRate of increase 36 years

Infant Mortality (per thousand) 150 102Total Fertility Rate 6.2 /b 4.3% Population under 14 42 39Z Population over 64 2.6 3Married women 14-44 years 24 millionZ Urban 15 22Life Expectancy Male/Female 40/52 42/55Population per physician 46,780 11,530Population per nursing staff 4,510 2,300Contraceptive Prevalence (Z) 58 /cDaily Calorie Supply per capita

Total 2,342 /das % of Requirement 110 7d

Per Capita C4P (US$) 580Literacy Rate for age over 15 years 68%Population Density (per km2 )/e 62 83

/a For definitions see Glossary.7T Average for 1960-65 UN demographic indicator for UN 1970.7W However, recent evidence has suggested that the CPR might actually be

lower./d For year 1981.7e For regional variations (Java 691/km 2 and Irian Jaya 3/km2 ) see

Table 2.

Sources: World Bank World Development Report 19E4Population Reference Bureau data sheet 1984.

PROJECT PERFORMANCE AUDIT REPORT

INDONESIA

SECOND POPULATION PROJECT(LOAN 1472-IND)

TABLE OF CONTENTSPage No.

Preface ...............................Basic Data Sheet ................................................... iiiEvaluation Summary ............... .................................. vProject Implementation Illustrations ............................... ix

PROJECT PERFORMANCE AUDIT MEMORANDUM

I. INTRODUCTION ............................................ 1

A. 3ackground and Setting ............................... 1B. The Bank's Population Activities in Indonesia ........ 3C. Demographic Profile .................. 6D. Population Policy and Program Development ............ 8

II. PROJECT IMPLEMENTATION AND SUMMARY ....................... 10

A. Project Formulation .................................. 10B. Project Implementation ...........*..*..*............. 11C. Project Administration .............................. 12D. Project Impact ....................................... 14

III. ISSUES .......... o.... .................................. 14

A. Civil Works Design ...................0.............. 15B. Project Performance and Evaluation ................ . 15C. Family Planning in the Outer Islands ................. 17D. Bank's Role o.............o.......................... 18E. Sustainability ....................................... 19

PPAM FIGURES:

1. Indonesia Population Pyramids ................................ 212. Land and Population Distribution ............................ 22

PPAM TABLES:

1. Comparative Population Data for the World and the 20 LargestDeveloping Countries - 1984 ............................... 23

2. Regional Variations in Population and Land Distribution ..... 243. Additional Current Contraceptive Users Required to Achieve

the Two Family Norms .................................... 254. New Family Planning Acceptors Within Official Program ....... 265. Family Planning Service Delivery Points ..................... 276. Staff Inputs in Preparation, Appraisal and Supervision ...... 28

TABLE OF CONTENTS (Cont'd)

Page No.

PPAM ANNEXES:

1. Highlights of First Project .................................. 292. Third Population Project ....................... .. . 313. Fourth Population Project .................................. 35

PROJECT COMPLETION REPORT

I. Introduction ...................................... 39II. Project Identification, Preparation and Appraisal ........... 41III. Project Implementation ..................................... 44IV. Program Performance and Project Support ..................... 58V. Bank Performance ............................................ 60VI. Conclusions ................................................. 63

PCR ANNEXES:

1. Project Preparation--Key Stages and Events ................... 652. Compliance with Loan Conditions .............................. 693. Schedule of Disbursements ................................. 734. Disbursements and Costs by Loan Category ..................... 755. Total Costs by Expediture Category ........................... 776. Program Performance during Repelita III ...................... 797. Target and Achievement of New Acceptors

and Current Users by Province .............................. 818. Trends in Current Users per 1,000 Eligible Couples

in Other Islands .... ....... g o.....oo..oe............ 839. Comparison of Four Bank-Assisted Population Projects'......... 85

Maps:

IBRD 12696R5 Second Population ProjectIBRD 14981 Third Population ProjectIBRD 18666R Fourth Population Project

PROJECT PERFORMANCE AUDIT REPORT

INDONESIA

SECOND POPILATION PROJECT(LOAN 147?-IND)

PREFACE

This is a performance audit of the Second Population Project inIndonesia, for which Loan 1472-IND in the amount of US$24.5 million wasapproved on June 30, 1977. The Loan Closing Date was extended from April 30,1983 to April 30, 1984. The final disbursement was made on August 29, 1984and the remaining balance of US$0.9 million cancelled. Earlier, in February1983, US$3.8 million had been cancelled because of misprocurement. In themeantime a Third Population Project (Loan 1869-IND in the amount of US$35.0million) was approved in June 1980 and a Fourth Population Project (Loan2529-IND in the amount of US$46.0 million) in May 1985. The First PopulationProject, for which Credit 300-IND in the amount US$13.2 million was approvedin March 1972, was audited in 1983 (see PPAR, Indonesia First PopulationProject, OED Report No. 5675 dated May 28, 1985).

The audit report consists of an audit memorandum prepared by theOperations Evaluation Department (OED) and a Project Completion Report (PCR)dated September 30, 1985 prepared by the Population, Health and NutritionDepartment (PRN). To a substantial extent the PCR is based on a draftProject Completion Report prepared by the National Family PlanningCoordination Board (BKKBN), copies of which are in OED files. The auditmemorandum is based on review of the Appraisal Report No. 1534b-IND dated May31, 1977, the President's Report No. P-2111-IND of May 31, 1977, the LoanAgreement dated July 6, 1977, and the PCR. In addition, correspondence withthe Borrower and internal Bank memoranda on project issues as contained inrelevant Bank files have been consulted. The Bank staff associated with theproject have been interviewed.

An OED mission visited Indonesia in July 1985. Discussions wereheld with officials of the National Family Planning Coordinating Board(BKKBN), the National Development Planning Agency (BAPPENAS), and theMinistry of Health. Field trips to visit project sites in and around Padang,Palembang, Pontianak, Denpasar, Ujung Pandang and Surabaya were alsoundertaken. The information obtained during the mission was used to verifythe conclusions of the PCR.

The audit finds that the PCR covers the project's salientfeatures. In addition to summarizing the objectives and the results of theproject, the PPAM expands upon some issues important for this and other Bank-supported population projects.

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The draft report was sent for the Borrower on March 17, 1986 forcomments. None were received. However, BKKBN did inform a Bank PHN super-vision mission that they did not have any specific disagieements with thestatements or conclusions of the report.

The valuable assistarce provided during the preparation of thisreport by officials of the Government of Indonesia (GOI), and in particularBKKBN, is gratefully acknowledged.

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PROJECT PERFORMANCE AUDIT REPORT

INDONESIA SECOND POPULATION PROJECT_(LOAN 1472-IND)

BASIC DATA SHEET

KEY PkOJECI DATAAppraisal Actual or Actual as % of

Expectation Current Estimate Appraisal Estimate

Total Project Costs (US$ milliou) 60 94.5 /a 157Loan Amount (US$ million) 24.5 19.8 7 8 LcDate Physical Components Completed 12/79 12/81

Proportion completed by that date () 100 130 130Economic Rate of Return n.a. n.a.Institutional Performance Good

STAFF INPUT /dFY75 FY76 FY77 FY78 FY79 FY80 FY81 FY82 FY83 FY84 FY85 Total

Identtfication/Preparation .5 46.9 18.5 65.9Appraisal 59.8 59.8Negotiations 8.7 8.7Supervision 1.0 25.2 32.3 17.8 21.6 16.1 5.7 6.3 7.9 133.9

TOTAL .5 46.9 88.0 25.2 .3 17.8 21.6 16.1 5.7 .3 .9 268.3

CUMULATIVE ESTIMATED AND ACTUAL DISBURSEMENTS

FY78 FY79 FY80 FY81 FY82 FY83 FY84 FY85

Appraisal Estimate (US$ million) 1.0 9.8 20.2 21.6 23.0 24.5 20.7 20.7Actual (US$ million) 0.02 1.8 4.8 8.7 10.3 13.9 14.1 19.8Actual as 2 of Estimate 2.0 18.0 24.0 40.0 45.0 67 /e 68 /e 95.6 /e

Amount Cancelled US$3.8 million (February 1983 - misprocurement)US$0.9 million (August 1984)

Date of Final Disbursement August 29, 1984

PROJECT DATES

OriginalPlan Revisions Actual

First Mention in Files 07/73 07/73Negotiations 05/77 05/77Board Approval 06/30/77 06/30/77Loan Signing 07/06/77 07/06/77Effectiveness 08/04/77 08/04/77Closing Date 04/33/83 04/30/84 04/30/84 /f

MISSION DATADate No. of Specializations Performance Types ,f

Mission (14o./Yr.) Persons kepresented / Rating /h Trend /I Problems/j

Identification 07/73 3 PPreparation CY74 2 PPreparation CY75/k 2 P,A,C,HPreparation CY767k 2 P,A,C,HAppraisal 10/76 6 -,A.C,HPost-Appraisal 04/77 1 PSupervision 1 08/77 4 - 1 1 -

Supervision 2 01/78 3 - 1 2 MSupervision 3 07/78 6 - 2 2 KSupervision 4 02/79 5 E,A,C,D 2 2 MSupervision 5 07/79 4 E,A,C,PE 1 2 0Supervision 6 02/80 5 E,A.C,PE 1 2 0Supervision 7 10/80 4 E,A,D,PH Z 2 M,TSupervision 8 06/81 3 E,A,PE 2 1 M,TSupervision 9 02/82 3 E,A,C,PE 2 1 M,TSupervision 10 05/82 4 E,P,RD 2 1 M,TSupervision 11 12/82 3 E,P,RD I1 M,TSupervision 12 08/83 2 E,P I I P,TSupervision 13 02/84 2 E 1 1 TCompletion 1

Other Project Data and footnotes on following page.

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OTHER PROJECT DATA

Borrower: Government of IndonesiaExecuting Agencies: National wamily Planning Board (8KKBN) and Ministry of Health (MON)

with the assistance of Ministry of Education (MOB) and Public WorksDepartment (PWD)

Preceding Project: Follow-On Projects:/m

Name Indonesia Population/n (i) Indonesia Population Ill/o (ii) Indonesia Population IV UCredit Number Credit 300-IND Loan 1869-IND Loan 2529-INDAmount (US$ million) US$13.2 million US$35.0 miilion US$46.0 millionApproval Date April 1972 June 1980 May 1985

/a Cost increase was largely due to increased operational costs following NFPCB's reorganizations in 1978 and 1983.Entire increase was met by 001 (PCR, pares. 3.51 and 3.52).

/b wan was reduced to US$20.7 million in February 1983, after cancellation of US$3.8 million due to misprocurement ofbicycles. Of the revised amount, US$0.9 million remained undisbursed in 1984, and we cancelled. Final loandisbursement by category to tabulated in para. 3.50.

/c Actual as % of Appraisal estimate. It was 95.6Z of revised loan amounts, see footnote /e/d Source: Planning and Budgeting Department; input as staff weeks./e As 2 of revised loan amount of US$20.7 million./f Loan was kept open for 90 days after formal closing date.TI P = Population, A * Architecture, C - Communication, H - 1ealth, E - Economics, D - Demography, PE - Population

Education, PH - Public Health, RD a Rural Development./h I - Problem-free or minor problems, 2 - Moderate problems, 3 = Major problems./i 1 - Improving, 2 - Stationary, 3 - Deteriorating.S F - Financial, M - Managerial, T - Technical, P - Political, 0 - Other.

/k An average of four preparation visits each in 1975 and 1976. Appraisal mission in 10/76 is given separately.1 Including supervision of the first project and identification of the third project./n In addition, the Bank has financed a ProvinciaL Health Project (Loan 2235-IND for US$27 million, approved in

February 1983) and a Second Health (Manpower Develoment) Project (Loan 2542-IND for US$39.0 million, approved in May1985).

/n PPAR, OED Report No. 5675 dated May 28, 1985./o SAR, Report No. 2912-IND dated May 19, 1980._/ SAR, Report No. 5404-IND dated April 10, 1985.

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PROJECT PERFORMANCE AUDIT REPORT

INDONESIA

SECOND POPULATION PROJECT(LOAN 1472-IND)

EVALUATION SUMMARY

Introduction

The Republic of Indonesia is a highly diversified country and isspread across an archipelago of more than 13,000 islands. It has asubstantial and varied resource base, a large proportion of which is locatedon the relatively sparsely populated islands of Sumatra and Kalimantan. Itspopulation at present is over 160.million. In addition to its absolute size,the fifth largest in the world, two other demographic factors have importantimplications for the country's development effort: regional extremes indensity (62% of the population is concentrated on Java which accounts foronly 7% of the land, with a population density of 690/km2 compared to IrianJaya's 3/km2 ) and urbanization (up from 15% in 1960 to 24% in 1980 andexpected to be 36% in 2000). A significant decline in the annual populationgrowth rate occurred between 1970 and 1980 (from 2.6% to 2.1%), owing tolower fertility due to rising average age at marriage and widespread andincreasing contraceptive use, especially in Java and Bali. Although theIndonesian fertility declines are impressive, total fertility is stillsomewhat higher than in neighboring counries. Assuming a reduced 1.9%annual growth rate through the rest of this century, Indonesia's populationis projected to increase to 179 million by 1990 and to about 212 million bythe year 2000. Bank projections suggest that a net reproduction rate equalto one could be achieved in 2010, leading to an ultimate stationarypopulation of 370 million. The pattern of population growth will bedetermined by fertility and mortality trends, the present age distribution,and migration. Regional differences, however, will predominate inIndonesia's future population trends and program needs (PPAM paras. 11-16).

Indonesia's population policy is defined in the broadest possibleterms and key components are: family planning services, related health andnutrition services and transmigration. The National Family Planning Coordi-nation Board (BKKBN) was established in 1970 to be responsible for familyplanning activities and services. Indonesia's population program is charac-terized by a high degree of political support and another feature is itsphased approach: geographically, technically, as well as with regard to itstargetting. The program has extensive family planning delivery pointsthroughout the country. On average there are eight service points per 1,000married women of reproductive age, but there are marked provincialdifferences. Program performance is impressive, given the present rate of

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contraceptive prevalence of 58% of women aged 15-44. Another noteworthypoint about Indonesia's population program is that its reliance on externalfunding has declined drastically over time (PPAM paras. 17-22).

To date the Bank has funded four population projects in Indonesiawith an estimated total cost of almost US$300 million. In addition, the Bankhas financed another four projects in the health and nutrition fields (PPAMparas. 6-10). Credit 300-IND in the amount of US$13.2 million was approvedin 1972 for Population I. The project consisted of a widely dispersedconstruction program in Java and Ball, but project implementation wassubstantially delayed, and the software component was of mixed effective-ness. The project was completed in 1983 and has been evaluated (PPAR, OEDReport No. 5675 05/28/85). Loan 1472-IND in the amount of US$24.5 millionwas approved in 1977 for Population II. Experience with design and imple-mentation of this project are the subject of this report. Loan 1869-IND inthe amount of US$35.0 million was approved in 1980 for Population III. Thisproject provided further support for BKKBN, expanded IEC (information,education and communication) and strengthened MCH (maternity and childhealth) services. This project has been substantially completed and BKKBN isfinalizing the PCR on this project experience. Loan 2529-IND in the amountof US$46.0 million was approved only recently in May 1985. The project willcontinue to strengthen the operational and management capacity of BKKBN inareas of field operations, staff development, IEC, population education,service delivery in transmigration areas and research. In addition, theproject would provide support for the newly created Ministry of Populationand Environment (MOPE) in developing a long-term population action plan,strengthen population studies centers, and provide support to non-governmental organizations (NGOs).

Objectives

Project formulation was started shortly after implementation of thefirst population project began and required four years to complete. Duringthat time the scope and size of the project increased substantially from theoriginal US$6 million proposal to the US$60 million project following post-appraisal. The originally proposed nutrition component was subsequentlyprepared and appraised separately (Loan 1373-IND for US$13.0 million wasapproved in 1977; see PCR, OED Report No. 5757 dated 06/20/85). The projectwas designed to support the national family planning program in Java, Baliand 10 provinces in the outer islands and to help achieve BKKBN's medium termobjective of reducing the national birth rate to 34 per thousand by 1984.Project components were designed to: (i) enhance the mobility and outreachcapacity of BKKBN staff; (ii) strengthen BKKBN's program management andadministration; and (iii) strengthen and widen the education and motivationactivities of the national program. They consisted of: vehicles and equip-ment; construction and equipping of one central and ten provincial trainingcenters; educational materials, workshops and fellowships; and support andtechnical assistance for two research studies.

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Implementation Experience

Project implementation in general was satisfactory, although therewere substantial delays, especially in construction, resulting in enormousdisbursement delays. There were serious problems, however, with bothresearch studies. Procurement generally went smoothly, but a major disagree-ment about bicycle procurement was ultimately resolved by cancellation ofUS$3.8 million because of misprocurement.

Lower unit prices and the effects of devaluation resulted in sub-stantial loan savings. Three reallocations were undertaken and additionalpurchases of equipment and services authorized. In the end, however, onlyUS$19.8 million of the loan was utilized. Total project costs at almostUS$95 million were substantially higher than estimated at appraisal (US$60million), largely due to more substantial increases in BKKBN staff andoperating costs than envisaged at appraisal.

BKKBN is a well managed organization and it implemented and admin-istered the project well. However, its effectiveness has been impaired fromtime to time by extensive reorganizations aid this continues to be a cause ofconcern.

Results

The performance of Indonesia's family planning program has beenoutstanding. The number of acceptors continued to increase substantially,and BKKBN's objective of reducing the birthrate to 34 per thousand by 1984was achieved. However, it is difficult to establish how and to what extentthe specific project activities contributed to this program success.Nevertheless, the project made a contribution to the geographical expansionof the program to the outer islands and its major impact has been tostrengthen the institutional base of BKKBN.

The community incentive scheme was innovative and also proved to bean interesting experiment with beneficial results in the villages concerned.Although the link between income generating activities and fertility declineis precarious, to say the least, the scheme has been working quite well andundoubtedly had merits. Most participants are in fact family planningacceptors and the scheme has high potential as a motivating factor forcontinued acceptance. The scheme is still fully operational, and PopulationIV is being amended to include financing of this scheme in transmigrationareas.

Sustainability

Political stability, commitment, community orientation as well asassured funding and follow-up projects all ensure the sustainability ofIndonesia's population program. Effective management and administration arekey to ensuring sustainability, but they are somewhat at risk due a constantpropensity for institutional change and reorganization. Sustainability isalso affected by how effectively the program will deal with the challenges itfaces, namely the mix of family planning methods, maintaining the high level

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of program performance as new "clients" enter their reproductive years, andreplicating program performance in other areas of Indonesia outside Java andBali where performance so far has been much juperior to other areas (PPAMparas. 48-50).

Findings and Lessons

Most of the findings (project design, administrative influence, Bankperformance and supervision, and sustainability) covered in the audit of thefirst project (OED Report No. 5675 dated 05/28/85) are also of relevance forthis project. In addition, the following points are worth noting:

- even though project construction encountered various problems,building design was well adapted to the local environment andtraditions, something not often encountered in Bank-financedprojects, and buildings continue to be adequately rehabilitated andmaintained (PPAM paras. 38-39);

- population programs are difficult to evaluate as program achieve-ments cannot adequately measure project effectiveness, and it willtherefore be necessary to establish a hierarchy of objectives andtargets to make evaluation of population programs and projects moremeaningful; it is suggested that PHN develop such an evaluationmethodology soon (PPAM paras. 40-43);

- with the expansion to other provinces, the need for diversificationof methods has become more apparent and some action-orientedresearch to support this might be needed (PPAM para. 44);

- the Bank still plays an important role in the population dialoguein Indonesia, but it needs to be more sensitive to competition andpossible overlap among different programs and implementing agenciesit supports (PPAM para. 45);

- the Bank has spent considerable manpower resources on itspopulation program in Indonesia; nevertheless, its supervisionmissions could usefully have spent more time in the field (PPAMparas. 46-47);

- project savings were reallocated to other project components oractivities not originally envisaged at appraisal; this practice issomewhat different from that applied to many other projects,although seemingly fully justified if properly reported (PPAMpara. 46); and

- although not required under the Loan Agreement, BKKBN prepared anadequate PCR, but as it was not judged to be perfect, PHN decidedto produce its own PCR. However, it would have been preferable ifattempts had been made to help the Borrower improve its PCR forsubmission to OED, if necessary with a Bank overview (PPAM para.46).

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INDONESIA POPULATION 1I(LOAN L472-IND)

Family Planning Acceptor at Motivational Meeting

ip

- Transport for Field Workers

An IncomeGenerating CommunityIncentive Scheme (Small-Scale irrigatlon)

f -

mm,

Checking Records and ReviewingProgress of Community Incentive Schemes

Project Vehicles andMainten., ce of Project Buildings

BKKBN Warehouse with Supplies

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PROJECT PERFORMAN"E AUDIT MEMORANDUM

INDONESIA

SECOND POPULATION PROJECT(LOAN 1472-IND)

I. INTRODUCTION

A. Background and Setting

1. The Republic of Indonesia is a highly diversified country, spreadacross an archi lago of more than 13,000 islands, with a land area of abouttwo million km* The country has a varied resource base with plentifulprimary energy resources, significant mineral deposits, large timberpotential and a developed system of agricultural commodity production andexport. A high proportion of these primary resources are located on thesparsely populated islands of Sumatra and Kalimantan. The 1983 estimate!/of GNP per capita is US$560, which places Indonesia among middle incomecountries.

2. Until 1981, the economy had been growing at almost 82 p.a. for overa decade. This growth was associated with rapid increases in public expendi-tures, total investment and savings. The initial impetus for this occurredin the period of recovery from the turbulence of the mid-1960s. The Govern-ment of Indonesia (GOI) took effective action to restore macroeconomicstability, liberalize the economy, rehabilitate infrastructure, and provideincentives for domestic and foreign private investment. However, thedominant external influence over the past decade has been the huge expansion,and significant variability, in foreign exchange earnings from oil. During1982, the Indonesian economy was affected adversely by the protracted inter-national recession and the accompanying decline in export earnings,especially from oil. These developments led to a sharp turnaround inIndonesia's external resource position and a fall in real per capita income.In response, the Government acted promptly to ensure that the country'sbalance of payments situation remained manageable and to provide a basis forlonger-term structural transformation. Particular attention was paid toreducing Indonesia's dependence on oil for export earnings and publicrevenues. Substa tial growth of the non-oil economy by at least 5% p.a. isprobably necessary to have a significant impact on employment creation andpoverty alleviation over the remainder of this decade. To promote such agrowth rate, without generating unmanageable balance of payment pressures, isone of the major challenges facing the Government. Successful transformationof the economy will require continued action in three key policy areas:

I/ On the basis of the World Bank's system of country classification andatlas methodology for calculation of GNP.

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management of the public investment program (and improvements in theregulatory/policy environment for private Investment), rationalization of theexternal trade regime and development of the financial sector.2/

3. With a population of 161.6 million, Indonesia accounts for 3.4% ofthe world's population (see Table 1). Indonesia's population increased at ananaual average rate of 2.1% between 1965-73 and 2.3% between 1973-83.However, this increase in the average growth rate between the two decadesmarks a significantly declining trend in annual growth rates during thelatter period: from 2.6% in 1970 to 2.1% in 1980, owing to lower fertilitywhich in turn is attributable primarily to widespread and increasing contra-ceptive use, especially in Java and Bali. In addition to the population'sabsolute size, the fifth largest in the world, and still high growth rates,two other demographic factors have important implications for the country'soverall development efforts: regional extremes in density and urbanization.Nearly 62% of its population is concentrated in Java which, however,comprises only 7% of the land (average density is 690 persons per km2 ). Onthe other hand average density in Irian Jaya, which accounts for more than20% of the total land area, is only 3 persons per km2 . Increased urbaniza-tion is due both to rural-urban migration and higher birth rates in urbancompared to rural areas. In 1983, urban dwellers accounted for abcit 24% oftotal population, up from 15% in 1960.3/ Still, more than three-quarters ofthe population live in rural areas, and although agriculture accounts foronly slightly over 30% of GDP, it provides 62% of total employment.

4. Employment growth in the 1970s was more rapid than labor forcegrowth. Most of the increased e-tployment was created in non-agriculturalactivities. Nevertheless, there is no doubt that the most pressing develop-ment issue facing Indonesia is the need for employment creation. Compared tothe 1970s, when it increased at an annual rate of 2.2%, in the 1980s thelabor force is expected to grow at 2.8% primarily due to a greater rate ofgrowth of working age population and increased participation. DuringRepelita IV, at least 1.8 million people will enter the labor force eachyear. There is a genuine question as to how much increase can be absorbed inproductive employment in a period when overall economic growth is expected tobe lower. While this squeeze in the labor market is not expected to lead todramatic increases in unemployment, there is a risk of stagnant or declining

2/ For more details see: President's Report, Fourth Population Project,Report No. P-402b-IND dated April 15, 1985. In addition, this reportprovides substantial insights into human resource development inIndonesia.

3/ This proportion is expected to increase to about 36% by the year 2000.

returns to labor in both rural areas and in the urban informal sector, andthis could threaten the past progress made in poverty reduction. /

5. As detailed in the audit of the first project, 5 / the Governmentsystem is highly centralized with the role of the President being mostimportant and powerful. 6/ However, for implementation, the system is effec-tively decentralized with different administrative levels (Regency,Kabupaten, Kecamatan and kelurhan) maintaining control over administrativedecisions concerning implementation in their jurisdiction. Much of the ofsuccess of Indonesia's population program stems from its reliance on thisdecentralized inititiative as well as effective community involvement and useof peer pressure, combined with a clear set of centrally defined guidelinesand ob ectives and their effective translation through the decentralizedsystem.'/

B. The Bank's Population Activities in Indonesia

6. As of June 30, 1985, Bank lending to Indonesia covered about 150operations and amounted to almost US$9 billion (about US$8.0 billion in IBRDloans and around US$940 million in IDA credits). In the population sector,three projects have been implemented so far and a fourth population projectwas approved on May 7, 1985. All four population projects included effortsin institutional development, motivational activities and expanded familyplanning delivery system. In addition, the Bank has expanded beyond thepopulation field into health and nutrition8 / and has actively pursued itssectoral dialogue with the Indonesian authorities. A nutrition project (Loan1373-IND in the amount of US$13 million) was approved in March 1977 and has

4/ "Indonesia, Policies and Prospects for Economic Growth and Trans-formation", World Bank Report No. 5066-IND dated April 26, 1984. For afollow up see: "Indonesia, Policies for Growth and Employment", WorldBank Report No. 559-IND dated April 23, 1985.

5/ PPAR, Indonesia First Population Project (Credit 300-IND), OED ReportNo. 5675 dated May 28, 1985, further referred to as PPAR First Project.

6/ For more details, see Area Handbook, Indonesia, A Country Study, FourthEdition, 1983; and also, "Basic Information on Population and FamilyPlanning Program", BKKBN, 1982.

7/ For factors contributing to Indonesia's success with its populationprograms, see Paul, Samuel, Managing Development Programs: The Lessonsof Success, Westview Press, Boulder, Colorado, 1982 (Chapter 5), andParson, J.S., "What Makes the Indonesia Family Program Tick", PopuliVol. II No. 3, 1984 (pages 5-19).

8/ See: Indonesia, Health Sector Overview, World Bank Report No. 2379-INDdated February 20, 1979.

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been completed.9/ A (first) provincial health projectl0/ fo4using onSulawesi is under implementation; a second health (manpower development)project 11/ was approved in May 1985 and the loan became effective in January1986; and a second nutrition project, incorporating community healthelements ,2/ was approved in November 1985 and became effective in February1986.

Population, Health and Nutrition Projects in Indonesia

Loan/Credit Approval ProjectNumber Amount /a Date Cost /b

Project Name (US$ million) (UST million)

Population I Cr 300 13.2 03/28/72 32.4 /cNutrition I Ln 1373 13.0 03/01/77 22.0 7Population II Ln 1472 24.5 06/30/77 94.5 TePopulation III Ln 1869 35.0 06/10/80 72.6Provincial Health Ln 2235 27.0 02/08/83 54.8Population IV Ln 2529 46.0 03/07/85 94.4Health II Ln 2542 39.0 04/14/85 65.9Nutrition 11 La 2636 33.4 11/26/85 57.7

231 T 19T.-3

/a Amount as approved./b Appraisal estimates except where actuals are available.7 Actual; appraisal estimate was US$33.0 million.71 Actual; appraisal estimate was US$26.0 million.1 Actual; appraisal estimate was US$100.0 million.

7. At appraisal, the first population project was estimated to costUS$33.0 million, and was funded by an IDA credit of US$13.2 million and anUNFPA grant of US$13.2 million. That project was designed to strengthen and

9/ For more details see PCR, Indonesia Nutrition Development Project (Loan1373-IND), OED Report No. 5757 dated June 28, 1985.

10/ For details see: SAR, Provincial Health Project, Report No. 4131-INDdated January 12, 1983 and also President's Report P-3402-IND(01/12/1983).

11/ For details see: SAR, Second Health (Manpower Development Project,Report No. 5442-IND dated April 24, 1985 and also President's ReportR-4040-IND (04/17/85).

12/ For details see: SAR, Second Nutrition and Community Health Project,Report No. 5840-IND dated November 7, 1985 and also President's ReportNo. P-4180-IND (11/01/85).

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expand the Government's efforts towards fertility reduction. The projectconsisted of a widely dispersed construction program in East Java and Baliand a sizeable software component. Project implementation was substantiallydelayed, and the software component was of mixed effectiveness. Despitethese problems, the project contributed greatly to strengthening the deliverysystem as well as the national family planning program in Indonesia (seeAnnex 1).

8. Total cost of the second population project was estimated atUS$60.0 million at appraisal; the Bank (Loan 1472-IND) was to contributeUS$24.5 million. The project was approved on June 30, 1977, and the LoanAgreement was signed July 6, 1977 and became effective on August 4, 1977.Physical completion was substantially achieved in 1981, but the loan accountwas not closed until August 28, 1984. The general objective of the secondproject was to assist the National Family Planning Coordinating Board(BKKBN) 1 3 / to achieve its medium-term objective of reducing the nationalbirth rate to 34 per thousand by 1984. The more specific project objectiveswere to: enhance the mobility of family planning staff; strengthen andexpand the program's educational motivational activities; provide administra-tive support; and achieve national contraceptive production capability.Experience with project design and implementation are the subject of thisaudit report and detailed in Chapter II.

9. The third population project provided further support for BKKBN,expanded IEC (information, education and communication) activities andstrengthened MCH (maternity and child health) services. Its basic aim was tohelp Government achieve its Repelita III family planning program targets,mainly reducing the fertility rate from 4.8 to 3.5 (for further details seeAnnex 2). Total project cost was estimated at US$72.6 million at appraisal;the Bank would contribute US$35.0 million (Loan 1869-IND). The project wasapproved on June 10, 1980, and the Loan Agreement was signed on June 13, 1980and became effective on September 10, 1980.14/ This project has now beencompleted.15/ The major problem with the third project was the delay inimplementation caused by dispersion of the Project Implementation Unit whichwas established for the first population project, and of which one sectionwas retained for the implementation of the second project. These delayssubstantially affected disbursements (cumulative disbursements had onlyreached 67.7% by March 31, 198516/).

13/ This is the acronym used in Indonesia and will therefore be used in thePPAM rather than the NFPCB acronym used in the PCR.

14/ No disbursements took place under this Loan Agreement. The non-pooledloan was replaced by a pooled loan. The pooled Loan Agreement wassigned on March 26, 1981 and became effective May 6, 1981.

15/ A draft completion report has been prepared by BKKBN and is beingreviewed.

16/ By end 1985, however, US$24.21 million had been disbursed and theremainder (US$10.79 million) had been cancelled.

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10. The fourth project, while continuing its support to strengthen theoperational and management capacity of BKKBN in areas of field operations,staff development, IEC, population education, service delivery in transmigra-tion areas and research, provides support for the relatively new Ministry ofPopulation and Environment (MOPE) in developing a long-term population actionplan, strengthening population studies centers, and providing support tonon-governmental organizations (NGOs) (details in Annex 3). The total costof the project is estimated at US$94.4 million; the Bank would contributeUS$46.0 million (Loan 2529-IND). The project was approved on May 7, 1985,The Loan Agreement was signed June 18, 1985 and became effective on Novem-ber 7, 1985.

C. Demographic Profile

11. Although fertility in Indonesia declined in the 1970s by an averageof 19%, population nevertheless grew by 28.4 million people. The decline inmortality, which fell faster than fertility, contributed to this substantialgrowth. However, in the latter part of the 1970s fertility began to declinemore rapidly, slowing the growth rate from 2.6% in 1970 to 2.1% in 1980.Most of the reduction in fertility is due to the use of modern methods ofcontraception. 17/ Although the Indonesian fertility declines are impres-sive, total fertility, at 4.3, is still high compar(d to neighboring coun-tries such as Malaysia (3.7), Thailand (3.6) and the Philippines (4.2).

12. Assuming a reduced 1.9% average annual growth rate through the restof this century, Indonesia's population is projected to increase to 179million by 1990 and to about 212 million by the year 2000. Bank projec-tionsl8/ suggest that a net reprodi ction rate equal to one would be reachedin 2010, leading to an ultimate stationary population of 370 million.Assuming a continued gradual decline in fertility, the average annual popula-tion growth rate is projected to decrease from just over 2.0% between 1980-85to 1.8% between 1990-95 and further to 1.4% between 2000-05. Between1980-90, population growth rates are expected to decline in all provinces,except Yogjakarta and East Nusa Tenggara owing to the temporary impact of theexisting age structure on fertility in those two provinces. Java's share inthe total population is expected to decline from about 62% in 1980 to about58% by the year 2000, despite an absolute increase in netropolitan Jakarta.Sumatra is expected to experience the largest proportionate increase, risingfrom 19% of total population in 1980 to about 22% by the year 2000. Theshares of Kalimantan and Sulawesi are also projected to increase slightlyduring this period.

17/ Geoffrey McNichol and Masri Singarimbum, "Fertility Decline inIndonesia", National Academy Press, Washington, DC, 1983.

18/ See SAR, Fourth Population Project, Report No. 5404-IND dated April 10,1985 (para. 1.07) and World Development Report 1984.

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13. Mortality also declined in the 1970s. However, mortality amongchildren remains high, especially infant mortality, which, at 102 perthousand live births, is one of the highest in the region (Philippines--51,Thailand--51, Malaysia--29). Between 1971-80, the mean life expectancy atbirth increased substantially in Indonesia for males (45.0 te 50.0) andfemales (48.0 to 54.0).

14. The present age distribution presents some problems for futurefertility declines and therefore a challenge to the population program. Inthe 1970s, the program was assisted by the fact tha. the age groups between30-34, 35-39 and 40-44 were relatively smaller than in the past and thanthose now projected for the future. As Figure 1 illustrates, there will be asubstantial increase in the size of the child-bearing age groups between1985-2000, implying an upward pressure on the birth rate for years to come.It will not be until 1995 that a cohort 1 9 / will arrive at tue age of 15-19that is smaller than the one preceding it.

15. Migr& ton is a third component determining the pattern of popula-tion growth. The population of Indonesia is relatively immobile. Between1975-80 only 3.5 million people aged 5 years and over, comprising roughly2.4% of the total population, moved across provincial boundaries. The pat-tern of population movement shows two dominant trends. The first is aninflux of immigrants into metropolitan Jakarta and Lampung, two areas withvery dissimilar economies: metropolitan Jakarta dominates in Indonesia'surban-bound migration, and Lampung (South Sumatra) is the focus of resettle-ment schemes associated with .he official transmigration program. The secondmajor population movement is out of East and Central Java. As a result, insuch provinces as Jambi, Bengkulu, Lampung, Central and East Kalimantan andSulawesi, growth rates increased by at least 20-30%, whereas Central Java'sgrowth rate decreased by 35%. Compared to t,ose in Java and Bali rates ofnatural increase are also higher in other provinces and these furtherinfluence differentiation in the rates of population growth.

16. Regional differences will therefore predominate in Indonesia'sfuture population trends and program needs. 2 0! Tables 2-4 illustrate thesevariations in population density and distribution, growth rates, additionalcontraceptive users required to achieve the two-child family, family planningprogram performance, and population distribution by region.

19/ "Cohort" is a demographic term and means the group of people in aspecific 5-year age group of the population pyramid.

20/ A more detailed treatmunt of regional variations in population, migra-tion and economic and social development is available in "Indenesia:Selected Aspects of Spatial Development", World Bank Report No. 4776-INDdated November 1, 1984.

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D. Population Policy and Program Development

17. GOI defines its population policy in the broadest possiblesense. 2 1/ The key components of its policy are: family planning services,related health and nutrition services, and transmigration. Demographically,Repelita IV projects a reduction in the Crude Birth Rate (CSR), from 33.5 perthousand in 1984/85 to 31 per thousand in 1988/89.

18. By Presidential Decree No. 8 of 1970, BKKBN was made responsiblefor family planning activities and services. At the central level, BKKBN isheaded by a chairman, directly responsible to the President of the Republic,a vice chairman, and deputies in charge of different divisions.22/ Sinceits inception, BKKBN has undergone many reorganizations to meet the changingneeds of Indonesia's population program. In 1972, additional organizationalunits were created in BKKBN to strengthen its -monitoring and planningcapabilities. In 1974, it was again reorganized to make decentralization ofthe program more effective. Another reorganization followed in 1978. In1979, Village Contraceptive Distribution Centers (VCDCs) were established,and in 1983, management at provincial levels was expanded. More recently theMinistry of Population and Environment (MOPE) was created to be responsiblefor coordinating population policy and integrating population considerationsand perspectives into all aspects of national development. Under the fourthpopulation project (Loan 2529-IND), MOPE will receive further technicalassistance (PPAM paras. 10 and 45 and Annex 3).

19. Indonesia's population program is characterized by a high degree ofpolitical support. This is of great importance as it provides BKKBN, anautonomous non-line agency, with an environment conducive to effectivecoordination with other agencies, something which has proven to be difficultto achieve for other agencies. Despite concerns both in BKKBN and the Bankthat increased size would lead to more centralization, the broad-basedpolitical support has enabled BKKBN also to maintain its decentralizedmanagement, thus allowing for the necessary flexibility in program implemen-tation. Furthermore, the program is based on active .ommunity involvement,and this has enabled BKKBN to develop a strong field-level institutional net-work, especially in Java and Bali. Ultimately this network could be usefulfor the implementation of related programs as well.

21/ In Repelita I (1969/70): "The main purposes of family planning are:(a) improving the welfare and health of mothers and children; and (b)improving conditions so that populations growth will not outstripproductive capacity". In Replita IV (1980-89): "to reduce fertilityand mortality; to increase life expectancy, and to reduce the imbalancein the population distribution." For more details, see SAR, IndonesiaFourth Population Project, Report No. 5404-IND dated April 10, 1985.

22/ A detailed organigram of BKKBN was included in the SAR (Report No.5404-IND) dated April 10, 1985 of the Fourth Population Project.

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20. Another feature of Indonesia's population prograv is its phasedapproach, geographically, technically as well as with regard to itstargeting. Geographically, the program was started in Java and Bali (wherethe population problem was more serious) and subsequently in two furtherphases expanded to the other islands. Technically, the approach was ini-tially more focused on motivation and non-clinical contraceptives.Throughout the 1970s, there was great emphasis on the pill method, and thisstill accounts for nearly half of the contraceptive use within the program.However, since 1981, attempts have been made to provide a greater method mix,especially with more emphasis on IUDs and injectables (Table 4). Further, asthe program matured it adopted a more integrated approach, first with healthin the provision of nutrition and clinical family planning services. Atpresent, the program is moving towards broader integration, with ruraldevelopment efforts for the time being in selected priority areas (CentralJava) where BKKBN's institutional infrastructure, due to its experience inthose areas, is more effective than in other provinces. In terms of targetpopulations, areas are distinguished on the basis of levels of acceptance.For example, provinces are divided into areas with over 65% acceptance,between 48-65%, 26-47% and below 25%. This is done to determine and phasethe extent and type of services needed.

21. The program has extensive family planning delivery pointsthroughout the country. On average, there are eight service points per 1,000married women of reproductive age (MWRA), but there are marked provincialdifferences (Table 5). Program performance is impressive, given the presentrate of contraceptive prevalence of 58% of married women aged 15-44.23/This remains true even given the fact that there are some in'ications ofoverestimation by about 10% in BKKBN statistics. 2 4 / However, very recentlyresults of the intercensal population survey (SUPAS), undertaken in October1985, have indicated that the actual figure might in fact be even lower.Preliminary results of the SUPAS 85 intercensal survey indicate thatcontraceptive prevalence is about 38%, substantially lower than previousestimates derived from the BKKBN service statistics. Nonetheless, thecurrent CPR is more than double the 19.2% reported in the 1976 SUPAS survey.

22. Another noteworthy point about Indonesia's population program isthat its reliance on external funding has declined dramatically over time asthe table below shows. From less than half in the early 1970s, GOI is nowfinancing more than 80% of its population program. This is important as itallows for more consistency in policy formulation and program execution than

23/ BKKBN, Statistic Reports, March 1984.

24/ P. K. Streatfield, "Reliability of BKKBN Prevalence Statistics: AComparison of BKKBN and Census Figures, 1980", University of GadjahMada, Indonesia, 1984. The PCR suggests that statistics might even haveto be discounted by as much as 20% (PCR para. 4.01).

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in situations where substantial dependence on foreign funding entailsaccommodating the widely diverging views of population experts as well as thesubstantial political sensitivities of aid donors. 25/

Financing the Indonesia Family Planning Program /a(billion Rupiahs)

GOI ForeignBudget Funding Total

Repelita I 6.7 (40%) 10.0 (60%) 16.7(1969/70 - 73/74)

,epelita II 35.6 (52%) 33.0 (48%) 68.6(1974/75 - 78/79)

Repelita III 153.5 (72%) /c 59.0 (28%) 212.5(1979/80 - 82/83)/b

Grand Total 195.8 (66%) 102.0 (34%) 297.8

/a Source: PPAR, First Project (PCR Annex 7).7b Did not include last Repelita III year (1983/84).7-c Within this period the percentage increased from 60% (1970/80) to almost

80% (1982/83).

II. PROJECT IMPLEMENTATION AND SUMMARY

A. Project Formulation

23. Project formulation was started (May 1973) shortly after implemen-tation of the first project began, and required four years to complete (PCRpara 2.01). During preparation, project scope and size escalated from anoriginal GO proposal in November 1974 of US$6 million, to a US$42.3 millionproposal in October 1976 (at appraisal), to the final US$60 million projectby March-April 1977, following a post-appraisal. In its original proposals,GOI, using National Development Planning Agency (BAPPENAS) cost guidelineswhich were lower than the Bank's unit cost, had planned to fund constructionentirely from its own resources; second, as identified, the project wasviewed as a simple extension of the first project, albeit with a smallnutrition component. The nutrition component was subsequently prepared andappraised separately2 6 / when GO (in 1974) decided to expand the population

25/ Such is the case, for example, in Bangladesh; see PPAR, Bangladesh(First) Population Project (Credit 553-BD), OED report underpreparation.

26/ See PCR, Indonesia Nutrition Development Project (Loan 1373-IND), OEDReport No. 5757 dated June 20, 1985.

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program to the outer islands. Given that situation, the Bank felt that itwas no longer necessary to regard the second project as an interim projectthat would only complement the first project. The Bank became much moreclosely involved in project preparation, now proceeding on the basis of anational program, despite misgivings expressed by some consultants thatBKKBN's planning capabilities were still weak (for full details see PCR Annex1).

24. A loan of US$24.5 million (total estimated project cost US$60 mil-lion) was approved by the Board on June 30, 1977. Thereafter, signing andeffectiveness were achieved rapidly: the Loan Agreement was signed onJuly 6, 1977 and the loan became effective on August 4, 1977.

25. The project was designed to support the national family planningprogram in Java, Bali and ten provinces in the outer islands and to help inachieving BKKBN's medium-term objectives of reducing the national birth rateto 34 per thousand by 1984. Project components (for full details see PCR,para. 2.08) were designed to: (i) enhance the mobility and outreach capacityof BKKBN staff; (ii) strengthen BKKBN's program management and administra-tion; and (iii) strengthen and widen the education and motivation activitiesof the national program and consisted of:

(a) provision of vehicles, motorcycles, motorboats, together with IUDand public health kits, as well as support for their maintenanceand operation;

(b) construction and equipping of a training facility in Jakarta andprovincial training centers and BKKBN offices in the ten provincesof Outer Islands 1, as well as support for their operations andmaintenance;

(c) provision of education materials, seminars, workshops, fellowshipsand technical assistance to complete the integration of populationeducation into formal and non-formal education programs initiatedunder the first population project; and

(d) support and technical assistance for two research studies:(i) a community Incentive scheme to promote family planning;

and(ii) a feasibility study of providing local botanical raw

materials for the production of oral contraceptives.

B. Project Implementation

26. Project implementation is clearly narrated in the PCR (ChapterIII). Project implementation in general can be regarded as satisfactory,although there were substantial delays, especially in construction, in turnresulting in enormous disbursement delays. There were serious problems withboth research studies. The delays in civil works construction ultimatelyamounted to 1-2 years because of the following reasons: reorganization ofBKKBN; initial difficulties in including responsibilities for site supervi-sion, as per GOI requirements, in the architects' contracts; flooding

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in some project areas; problems in obtaining the building permit for theNational Family Planning Training Center (NFPTC) in Jakarta; and subsequentdelays in obtaining additional approvals to expand the NFPTC from itsoriginal four-story design to eight stories (for full details, see PCRparas. 3.35-3.45). Due to these construction delays, some of the originaltargets related to the training component were not achieved (PCR paras.306-3.08). Even though the total number of persons trained between 1979-85in all categories is higher than the PCR states, especially in the morerecent years, the audit confirms what is implicit in these figures namelythat the training centers are not utilized to their fullest capacity.7/

27. Problems occurred with implementing the community incentive scheme(CIS), mainly related to differences over the design of the CIS scheme (PCRparas. 3.27-3.34). Originally, the scheme had been prepared quickly duringpost-appraisal without much involvement of BKKBN staff. The initialproposals were subsequently redesigned by BKKBN. These new proposals wereonly accepted by the Bank after three years of strong resistance. It is opento argument which of the designs was better, although the audit doubts thatthe original design (as detailed in Annex 9 of the appraisal report) couldhave reached all of its stated objectives. Nevertheless, it is clear thatboth during design and subsequently, the Bank did not sufficiently involvethose who would ultimately be responsible for CIS implementation. In thecase of the raw materials study, the problems were of a more technicalnature. As explained in the PCR (paras. 3.23-3.26), this related to thephasing and direction of the research. Initial field research was limitedto certain ipecies despite the fact that an earlier literature review hadalready indicated that these would not have adequate raw material content andthis was confirmed. Subsequent field work was expanded to cover otherspecies which showed some promising sources of raw materials, but without anadvanced chemical industry in Indonesia these cannot yet be processedlocally.

28. Start-up of the population education component was delayed by abouta year, and implementation was ultimately behind schedule by three years.Furthermore, although population education was integrated in the formalschool curriculum, books and materials had not been adequately distributedand teaching materials were in short supply (PCR paras. 3.09-3.17).

29. Procurement of equipment and vehicles generally went smoothly,although there were delays, vehicle licensing problems, and logisticalproblems in distributing centrally procured items to their destinations. Amajor disagreement arose between the Bank and GOI regarding the bid award fora major purchase of bicycles, and after protracted discussions, US$3.8

27/ Some training centers cater to courses given by agencies other thanBKKBN, and these do not show up in central BKKBN statistics. To theextent that this is feasible and compatible with BKKBN training needs,alternative use of training facilities should be encouraged (andrecorded).

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million was cancelled because of misprocurement (PCR paras. 3.45 and 3.48).Also, the procurement of boats was cancelled on the basis of a disappointingMOH experience with operating boats; in restrospect, this was a mistake, inthe audit's view, as (i) MOH floating clinics were not the type of boats thatwould have been needed for mobile family planning work and (ii) in many areasof South and West Kalimantan and South Sumatra, the major means ofcommunications are the rivers, and some BKKBN officers would have preferredboats for that purpose (PCR para. 3.04).

30. Because of the implementation delays, d'sbursements lagged behindschedule throughout the project implementation period, mainly because ofdelays in civil works construction, the effects of the 1978 reorganization ofBKKBN and delays in starting some of the other components. This, combinedwith the effects of devaluation, lower unit prices, lower constructionprices, etc., resulted in substantial loan savings. Three reallocations wereundertaken and additional purchases of equipment and services authorized toutilize the loan savings (PCR paras. 3.47-3.51). The loan Closing Date wasextended by one year to March 30, 1984, but the loan account was kept opensix more months to allow full disbursement of commitments already enteredinto. Ultimately, a balance of US$0.9 million was cancelled, in addition tothe US$3.8 million which had been cancelled earlier because of misprocurement(PPAM para. 29).

31. In the end, only US$19.8 million of the US$24.5 million loan wereutilized. Total project cost of the complete4 project (US$94.4 million) wassubstantially higher than the appraisal estimate (US$60*0 million). This waslargely due to substantially larger increases in BKKBN staff and incrementaloperating costs than foreseen at appraisal (PCR paras. 3.51-3.53).

C. Project Administration

32. BKKBN was responsible for the administration and coordination ofthe project. The Project .mplementation Unit (PIU) established for imple-menting t.s first project was not retained. However, one section of theformer PIU, the civil works staff, remained to implement the constructionactivities.28/ Al1 other aspects of the project were the responsibility ofthe appropriate BKKBN bureaus, and a project officer was nominated fromwithin BKKBN to be the overall coordinator of project activities.

33. Overall, BKKBN was a well managed organization, and in general itimplemented the project well. However, its effectiveness has, in the audit'sview, been impaired from time to time by extensive reorganizations, and thiscontinues to be a cause of concern (PPAM paras. 18 and 49). Secondly, as itgrew the organization tended to become more centralized and procedures morestandardized, changing what was perceived as a smaller and more flexibleorganization.

28/ The section was abolished and no longer utilized to superviseconstruction under subsequent projects.

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D. Project Impact

34. The performance of Indonesia's family planning program has beenoutstanding (for more details see PCR Chapter IV). The number of acceptorscontinued to increase substantially, and BKKBN's objective of reducing thebirth rate to 34 per thousand by 1984 was also achieved. However, it isdifficult to establish how and to what extent the specific project activitiescontributed to this program success. It is undoubtedly true that the facili-ties provided under the project supported the extension of the program to theouter islands. At the same time it is also true that the related substantialstaff and operating expenditure increases were fully funded by GOI.

35. The major impact of the project has been to strengthen the institu-tional base of BKKBN. At present, BKKBN has a well established institutionalinfrastructure with an effective rural network upon which other projectsinside and outside the program can "piggy back" for training and expansion offield services. The audit strongly recommends that this existing base couldbe effectively utilized by other projects and programs in the sector. At thesame time it should also be noted that the tendency for regular reorgan-izations could, in the audit's view, seriously interrupt and subsequentlyimpair the effectiveness of this institutional network (see also PPAM paras.18 and 33).

36. The community incentive scheme proved to be an interestingexperiment (see PPAM para. 27 and for full details PCR paras. 3.27-3.34).The original concept to establish a link between community projects and/orincome-generating activities and fertility decline was probably unrealistic,certainly within such a short time frame. The present scheme is basically avillage-based revolving fund to finance small income generating or communityactivities. Villagers pay back to the local fund, which can then use themoney again for other small projects in the village. Ultimately, theprincipal will have to be repaid to BKKBN but the accumulated interest willremain in the village fund. The link with the family planning program isbased on certain selection criteria: villages had to meet certain acceptancenorms before they could be eligible. Most data show that scheme participantswere in fact acceptors. The scheme has been working quite well and has beenfavorably commented upon, also by some Bank staff. Furthermore, it has greatpotential as a motivating factor to accept and continue use of familyplanning. The scheme is still fully operational. While the Bank is nolonger involved in the original scheme, it has agreed to amend Population IVto fund such income-generating activities in the transmigration areas coveredunder that project.

III. ISSUES

37. The audit of the first population project (OED Report No. 5675dated May 28, 1985) covered issues related to project design, administrativeinfluence, Bank performance and supervision and sustainability. The reportalso privided more background on the administrative and organizationalframework within which Indonesia's family planning program is operating.

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Most of this has not been repeated in this audit, although obviously theissues and lessons from the first project are also extremely relevant for thesecond project.

A. Civil Works Design

38. The project's construction component was substantial and encoun-tered various problems. Nevertheless, two points are worth mentioningbriefly, especially since their absence in other projects have invariablygiven rise to comments and problems:

(a) buildings have been and continue to be rehabilitated and main-tained; and

(b) building design is adapted to the local environments.

39. The PCR narrates how problems occurred with many buildings (fordetails see PCR paras. 3.40-3.42) such as leaking pipes, sinking floors andtotal destruction by fire of one of the provincial buildings, namely in NorthSulawesi.29 / However, in all cases measures have been taken to rectifythese problems and a new building was constructed in North Sulawesi. BKKBNcontinues to make budgetary provisions for up-keep and maintenance. Moreinteresting is that despite identical space requirements, building design hasnot been uniform--as in so many other projects--but has been adapted tofit the local customs, traditions and environment. As a result, some finearchitecture has been applied, a particularly good example of which isBKKBN's provincial office in Bali.

B. Project Performance and Evaluation

40. The audit agrees with the PCR (para. 1.03) that it is difficult toquantify the precise project contribution towards program achievements. Thereasons given in the PCR are valid only if program achievements are to beused as yardsticks to assess project effectiveness. However, as argued inearlier audits,2 0 / this canaot be done, and a more precise assessment ofproject (component) impact should be made. It should be possible to makesome assessment of project performance independent of program goals.Nevertheless, making assessments of population projects remains difficultbecause:

29/ Not everyone believes that the fire was caused by malfunctioning ofelectrical equipment; some are convinced it was deliberately set.

30/ See, for example, PPAR, Jamaica Second Population Project (Loan1284-JM), OED Report No. 5589 dated April 19, 1975; PPAR, MalaysiaPopulation Project (Loan 880-MA), OED Report No. 5641 dated May 10,1985; PPAR, Indonesia First Population Project (Credit 300-IND), OEDReport No. 5675 dated May 28, 1985; and PPAR, Philippines FirstPopulation Project (Loan 1035-PH), OED Report No. 5544 dated March 19,1985.

- 16 -

(a) Population programs often have multiple objectives. In addition,they have a multitude of components, each with a different set ofobjectives. Logically, sub-objectives established for and achievedat different component levels should add up to the program goals.Furthermore, each component consists of many activities with theirown targets, and meeting all these should logically result inachieving the component objectives. A hierarchy of goals, objec-tives and te-gets therefore exists in nearly all population pro-grams. 3 1/ The problem has been that the Bank's population proj-ects in general have failed to conceptualize this hierarchy ofobjectives within a program and to identify those which the Bankproject would attempt to impact.

(b) Population projects tend to spread themselves across many compo-nents of the program, thus making it difficult to evaluate theproject as a whole. Furthermore, project investments might onlypartly cover certain activities. For example, construction oftraining centers is oftAn supported by Bank, but the actual train-ing might be provided for under other arrangements. In otherinstances, it could be providing staff salaries whereas suppliesfor staff to use for outreach work is not within the Bank project,or the other way around.

(c) Appraisal reports generally lack adequate indicators as to whattargets project components should meet. Supervision reports do notinclude such indicators either. In the absence of such targets orcriteria, performance judgments become rather subjective.

41. For the above reasons, assessing the effectiveness of theIndonesian second population project remains difficult as can be illustratedwith a few examples. No specific target was mentioned in the appraisalreport (SAR, Annexes 6 & 7) for the family planning and population trainingcenters. However, it is obvious that the fact that they have been con-structed is insufficient justification by itself. Some indication as to thetype of training to be provided as well as output would have enabled a moreobjective assessment. The objective for mobile family planning services was"to carry family planning and basic health services to areas and peoplebeyond the reach of static service centers. The secondary objective is thatit will result in increasing the number of new acceptors and continuing usersof contraception. It will also support the national program in its plan tospread family planning information to the community level." As a generalstatement, all this is true, but again it does not specify what services,which area, to whom and what amount of increase is expected, etc. And thatis the type of information needed to guide data collection or develop

31/ David Solkevon and Ismail Sirigeldir, "Cost-Benefit and Cost-Effectiveness Analysis in Population Programs", Evaluating PopulationPrograms, Proceedings of International Workshop, 1981, (ed) Sirigeldiret. al., Martime Press, 1984.

- 17 -

criteria for assessment. In the absence of baseline information or utiliza-tion data, the PCR could only comment that "the availability of projectvehicles is reported to have greatly improved the provision of services inoutlying rural areas" (PCR para. 3.05). It is impossible to objectivelyevaluate such an assessment.

42. The bottom line is that unless specific targets are set during pre-paration, population projects will remain difficult to evaluate. This pro-blem can also be illustrated, simplistically, as follows. In the case of afictive population project, two outcomes could be imagined. The objectivesof the projects are stated to be a reduction in the population growth rate(or fertility rate), while the project components largely cover the construc-tion of clinics and training centers. The first outcome could be that thereduttion in the growth rate actually took place but that the clinics werehardiy used, understaffed and not well maintained. The second outcome wouldbe the opposite (high utilization of facilities, no discernable effect onfertility). Which should be evaluated as the more successful outcome?

43. The audit, therefore, suggests that PHN develops as soon aspossible an adequate methodology to evaluate population projects and activi-ties. This should start by setting project objectives realistically, defin-ing the relation between the program and the project, and between proje-tcomponents and activities and project objectives. Furthermore, a matr"xframework couid be established listing for each component or activity:planned inputs, expected outputs, and outcome. 3 2 / This should be includedin the appraisal report, monitored through Bank supervision and finalized inthe PCR. Such a framework would at least provide the details for a moreobjective assessment of project impact.

C. Family Planning in the Outer Islands

44. The Indonesia population program has now expanded to Outer IslandsI and II, in fact now covering the whole nation. There are marked differ-ences in contraceptive prevalence in these areas as well as in the levels ofawareness and knowledge about family planning and use of contraceptives.There are enormous regional differences (PPAM para.' 16 and Tables 2-4), notonly in these fields but also political, religious and cultural. It may wellbe that the factors which explain why the program was so successful in Javaand Bali33 / do not operate to the same extent in the Outer Islands. Thepopulation in these areas is more widely dispersed, the social cohesivenessmay not exist to the same extent, and there may be less acceptance of tradi-tional authority. The program, therefore, should face up to the fact that itmust diversify its IEC and delivery systems to build upon the cultural,psychological and structural norms of these differing societic.. It did so

32/ Evaluation of Family Planning in Health Services, WHO, 1975. Also seeJack Reynolds, K. Celeste Gospoie, "Cost-Effectiveness Analysis",Operations Research Methods, Pricore Monograph No. 2, May 1985.

33/ See Parson, "What Makes the Indonesia Family Progrm Tick", op. cit.

- 18 -

successfully in Java and Bali; it now should adapt to the requirements ofother regions also. Some action-oriented research in these regions in orderto identify types of IEC methodologies and types of effective deliverysystems may be useful.

D. Bank's Role

45. In the population sector, the Bank has had an ongoing dialoguesince the early 1970s. As its contribution has been s.All (and decreasing)compared to GOI's contribution to the program, the Bank's leverage ininfluencing policy may not have been as strong as in some other cases.Nevertheless, the Bank still plays an important role through its closecontact with BKKBN and potentially through its planned involvement in thedevelopment of a plan of action by the Ministry of Population and Environment(substantial technical assistance is provided under the fourth populationproject for this purpose). The Bank, with its increasing involvement in thewhole sector including health and nutrition (see PPAM paras. 6-10), needs tobe more sensitive, in the audit's view, to competition and possible overlapamong the different programs and implementing agencies it supports. Someconcero has been expressed by certain donor agencies that the Bank isexpanding into areas such as research and evaluation in Indonesia, whereother agencies have already spent considerable resources and in which theyare better equipped to monitor, given their representation in the field.Given resource constraints, countries may be better off obtaining resourcesfor certain software elements from elsewhere, especially when these can befinanced from grants and/or when these software components require closesupervision which the Bank is not equipped to provide.

46. A few other points are worth mentioning in the context of Bankperformance:

(a) Supervision. The audit mission, in this case as well as during theaudit of the Thailand Population Project, visited more projectsites than supervision normally covers during a series ofmissions. While administrative preoccupations undoubtedly requirelonger discussions at project headquarters, it should normally bepossible for the multi-person PHN mission to spend more time in thefield, where the impact of the program ultimately will have to beassessed.

(b) PCR. While not required under the Loan Agreement, BKKBN neverthe-less prepared a PCR, the second version of which was not perfect,but rather adequate. However, the Bank decided to produce its ownPCR. In the audit's view it would have been preferable if sometime had been spent with BKKBN officials attempting to furtherrefine the PCR, in which case Bank staff could have limited theirfurther involvement to possibly writing a short overview. Ifdissemination of lessons learned is a major objective of the PCR,then it is important that Borrower officials be involved as closelyas possible. The same applies to Bank staff as well, and it would

- 19 -

therefore be most effective (also cost and timewise) if they,rather than consultants, unfamiliar or only partly familiar withthe project, would handle the PCR rrocess.

(c) Cancellation. In this project, as well as many other PHN projects,it is usual to reallocate savings to other project components orrelated population activities not originally envisaged at apprais-al. While the audit does not have any negative assessment to makeregarding these reallocations, it nevertheless would like to cross-refer these to other experiences in the Bank. It is normalpractice that substantial changes in project content (reallocatingabout one-third of the loan appears to be substantial) be reportedto the Executive Directors, either in a separate memo (as recentlyhappened for the Kenya Population II project) or at least in theReport on Bank and IDA Operations. Also, it is normal practiceunder many other Bank projects that savings, due to devaluations,be cancelled.

47. The Bank has spent considerable resources on its population programin Indonesia. Since 1972, an estimated 40 staffyears have been utilized forthe preparation, appraisal and supervision of the four population projectsalone (see Table 6).

E. Sustainability

48. The PCR has detailed a number of factors that contributed toproject success (political stability, commitment, community orientation,etc.--see PCR para. 4.06) and stated that the sustainability of the projectis assured (PCR paras. 1.04 and 6.06). The audit generally shares thisopinion, but a few points are worth highlighting.

49. Effective management and administration are key to projectsustainability. The Bank's response to ensure project sustainability in thepopulation sector has varied with the specific country circumstances. In thecase of Indonesia, the Bank's major focus has been in developing the institu-tional base of BKKBN by providing administrative support, technical assis-tance and resources for staff development. Although BKKBN has an effectiveinfrastructure and capacity to maintain and sustain the present effort (PPARparas. 32-33 and also paras. 18 and 35), its institutional capacity isnevertheless endangered, in the audit's view, by the constant propensity forchange. Each project has expanded in range to new departments and agencies,introduced additional technologies, expanded rapidly to new geographical andprogram areas, and identified new research and policy issues, often requiringsetting up of additional institutions, therefore requiring changes withinBRKBN. There is, therefore, some concern as to how much more expansion andchanges BKKBN can effectively accommodate.

50. Sustainability is also affected by how effectively the challengesfacing the program can be dealt with (for more details, see also PCR para.4.07). First, it is GOI's intention to emphasize more effective methods, andthis would require a change in the mix of family planning methods, but also

- 20 -

alter the motivation processes. Second, there is the question as to how tomaintain the level of program performance as new married couples in theirreproductive years enter the "market". At present, most acceptors are amongfamilies already with children, which is a different target group than newlywed couples. Third, there is the challenge to extend the program to otherareas in Indonesia. So far, BKKBN has encountered more problems in attempt-ing to achieve elsewhere the performance levels of Bali and Java.

- 21 - u

INDONESIASECOND POPULATION PROJECT (Loan 1472-IND)

Indonesia Population Pyramids(based on populaton census, 1961,1971,1980)

1961

MALE AQ0 FEMALE750

70 - 7465-6960-6455 -5950 -- 5445 - 4940-4435- 3930-3425 - 2920- 2415 - -1910 -145-90-4

1971

MALE Age FEMALE75.

70.- 7465- 6960 - 645 - 5950-54

40 -4435 - 39

l 25 - 291 20 -24

r1 -b 19110 -145 -90 4

1980

MALE FEMALE75

70 - 7465 -6960- 6455 -5950 -5445 4940 ·· 443b 3930 - 3

25 ~9 .

15 -- 1910 -145 .... -0-4

10 5 0 0 10

Milhons Mdhons

Sourc Con~o. J8. "Socio Economic and Demographic Latu ~elevant to anAssessment of the Indoneson Populatton ond Famly Planning ProgarnPopultion Council New York. September 29 1982

World Bon- 302311

- 22 -

INDONuASECOND POPULATION PROJECT (Loan A24ND)

Land / Population Ddbuon

44 b

0 0zS o

* 0

z z

- 23 -Table I

PROJECT PERFORMANCE AUDIT HEMORANDUM

INDONESIA SECOND POPULATION PROJECT(LOAN 1472-IND)

COMPARATIVE POPULATION DATA FOR THE WORLD ANDTHE 20 LARGEST DEVELOPING COUNTRIES-1984

1983 Percent ofBirth Death Rate of per population ofrate rate natural capita all develop- the

Geographic areas Population per 1,000 per 1,000 increase GNP ing countries World(million) population population (M) (US$) (M) (M)

World 4,762 28 11 1.7 2,800 - -

More Developed 1,166 16 9 0.6 9,190 - 244Less Developed 3,596 32 11 2.1 750 - 75.6

Countries

1. China 1,034.5 21 8 1.3 310 28.7 21,72. India 746.4 34 14 2.0 260 20.7 15.63. INDONESIA 161.6 34 13 2.1 580 4.5 3.4

4. Brazil 134.4 31 8 2.3 2,240 2.85. Bangladesh 99.6 49 18 3.1 140 2.7 2.16. Pakistan 97.3 43 15 2.8 380 2.7 2.07. Nigeria 88.1 49 17 3.2 860 2.4 1.88. Mexico 77.7 32 6 2.6 2,270 2.1 1.69. Vietnam 58.3 34 10 2.3 NA 1.6 1.210. Philippines 54.5 32 7 2.6 820 1.5 1.111. Thailand 51.7 26 6 2.0 790 1.4 1.012. Turkey 50.2 31 10 2.1 1,370 1.4 1.013. Egypt 47.0 38 11 2.7 690 1.3 0.914. Iran 43.8 44 12 3.2 NA 1.2 0.915. Rep. of Korea 42.A 23 7 1.6 1,910 1.2 0.916. Burma 38.9 38 14 2.4 190 1.1 0.817. Zaire 32.2 46 17 2.9 190 0.9 0.718. Ethiopia 32.0 47 23 2.4 140 0.9 0.719. Argentina 29.1 24 9 1.5 2,520 0.8 0.620. Colombia 28.2 28 7 2.1 1,460 0.8 0.6

Source: Population Reference Bureau, 1984 Wor:d Population Data Sheet.

Note: Figures for Indonesia may vary from those found elsewhere. PopulationReference Bureau estimates have been used for consistency with estimatesfor other countries.

Figures may not add up due to rounding.

- 24 -

Table 2PROJECT PERFORMANCE AUDIT NEORANDUM

INDONESIA SECOND POPULATION PROJECT(LOAN 1472-IND)

REGIONAL VARIATIONS IN POPULATION AND LAND DISTRIBUTION

Percentage Population Fercentagedistribution density 1980 distribution

Province/Region of population (persons per of land Growth Growth1980 sq.ka.) area Rate Rate(2) (%) 1961-71 1971-80

Daerah Istimeva Aceb 1.77 47 2.88 2.14 2.93North Sumatra 5.67 118 3.69 2.96 2.60West Sumatra 2.31 68 2.59 1.82 2.21Riau 1.47 23 4.93 2.99 3.11Jambi 0.98 32 2.34 3.25 4.07South Sumatra 3.14 45 5.40 2.21 3.32Bengkulu 0.52 36 1.10 2.55 4.39Lampung 3.14 139 1.74 5.82 5.77

Sumatra 19.00 59 24.67 2.96 3.55

DRI Jakarta 4.41 11,028 0.03 5.09 3.93West Java 18.61 594 2.41 2.05 2.66Central Java 17.20 742 1.78 1.70 1.64D.I. Yogyakarta 1.87 868 0.17 1.02 1.10East Java 19.79 609 2.50 1.55 1.49

Java 61.88 691 6.89 2.28 2.16

West Kalimantan 1.68 17 7.65 2.07 2.31Central Kalimantan 1.85 6 7.05 3.60 3.43South Kalimantan 1.40 55 1.96 1.44 2.16East Kalimantan 0.83 6 10.55 2.92 5.73

Kalimantan 4.56 12 28.11 2.41 3,41

North Sulavesi 1.43 111 0.99 2.79 2.31Central Sulavesi 0.87 18 3.63 2.82 3.86South Sulavesi 4.11 83 3.79 1.37 1.74Southeast Sulavesi 0.64 34 1.44 2.47 3.09

Sulavesi 7.05 55 9.85 2.36 2.75

Bali 1.67 444 0.29 1.74 1.69West Nusa Tenggara 1.85 135 1.05 2.00 2.36East Nusa Tenggara 1.86 57 2.49 1.55 1.95

Maluku 0.96 19 3.88 3.24 2.88Irian Jaya 0.79 3 21.99 2.04 2.67

Indonesia 100.0 77 100.0s/ 2.10 2.32

Source: Central Bureau of Statistics

a/ Totals may not add due to rounding

- 25 -

Table 3

PROJECT PERFORMANCE AUDIT MEMORANDUM

INDONESIA SECOND POPULATION PROJECT(LOAN 1472-IND)

ADDITIONAL CURRENT CONTRACEPTIVE USERS REQUIRED TO ACH1EVE THE TWO FAMILY NORh(80% Of MARRIED WOMEN OF REPRODUCTIVE AGE)* RANKED BY PROVINCE AND TARGET NUMBER

( o00

Province Married Women Current 80 Current(Target group of Reproductive Contraceptive of Target Users as

ranking) Age (MWRA) Users MWRA Group 2 of NWRA(1) (2) (3) (4)*(3)-(2) (5)

1. West Java 4974 3073 3957 885 622. Central Java 4174 2888 3339 451 693. East Java 5107 3641 4086 438 714. North Sumatra 1260 658 1008 350 52S. Jakarta 1120 581 896 315 52

6. Lampang 822 380 658 278 467. South Sumatra 731 353 584 231 488. East Nusa Tenggara 372 71 298 226 199. Riau 345 70 276 206 2010. South Sulawesi 895 521 716 195 5811. st Sumatra 502 234 402 168 46

12. Aceh 416 170 333 163 4113. Irian Jaya 199 17 159 142 814. Msluku 206 29 165 136 1415. Jambi 252 72 202 130 2816. West Kalimantan 408 199 326 125 4917. East Kalimantan 201 53 161 108 2618. West Nusa Tenggara 420 231 336 105 5519. Central Sulavesi 197 57 158 101 2920. South Kalimantan 347 184 278 94 5321. Central KalirAntan 154 40 123 83 2622. South East Sulawesi 134 34 107 73 2523. East Timor 77 4 62 58 624. North Sulavesi 321 206 257 51 6425. bengkulu 127 64 102 40 4826. Balit 395 288 316 28 7327. Yogyakarta 398 298 318 20 75

TOTAL 24,532 14,422 19,626 5,204 59 a

/a See also para. 21 for further observations on this figure.

Source: BKKBN Monthly Service Statistics Report, March 1984.

Note: figures may not add to totals due to rounding.

- 26 -

Table 4PROJECT PERFORMANCE AUDIT MEMORANDUM

INDONESIA SECOND POPULATION PROJECT(LOAN 1472-IND)

NEW FAMILY PLANNING ACCEPTORS WITHIN OFFICIAL PROGRAM-1984

New New Acceptors perYear Acceptors Percent Using Each Contraceptive Method 1,000 Married Women

Total Pill IUD Condom Injection Other Surgical Aged 15-44

A. Java-Bali

1970 53,103 27 55 18 - - - 51971 181,059 44 42 14 - - - 151972 159,330 54 41 3 - 2 - 401973 1,078,899 56 35 7 - 2 - 811974 1,369,077 63 21 15 - 1 - 1011975 1,475,016 69 11 19 - I - 1031976 1,785,908 68 13 18 - I - 1261977 1,979,445 67 18 13 - 2 - 1371978 1,934,806 71 17 9 - 2 - 138

1979 1,797,565 68 20 8 - 4 - 1321980 1,772,174 68 20 8 - 4 - 1311981 2,145,402 68 19 8 - 5 - 1551982 2,075,029 62 23 6 - 9 - 1451983 2,825,938 56 30 5 6 - 3 192

B. Outer Islands I

1975 117,875 66 17 14 - 3 - 241976 180,677 69 16 11 - 4 - 361977 233,345 69 16 11 - 4 - 451978 313,662 73 14 7 - 6 - 621979 418,228 75 11 8 - 6 - 821980 400,912 75 11 8 - 6 - 72

1981 768,992 73 9 12 - 6 - 1351982 717,090 72 13 5 - 10 - 1191983 851,598 72 13 8 4 - 3 1351984 1,009,852 67 16 7 7 - 3 165

C. Outer Islands II

1980 56,705 68 15 7 - 10 - 281981 136,850 63 21 7 - 9 - 661982 174,778 59 21 7 - 13 - 821983 207,940 59 23 5 10 - 3 911984 341,212 53 22 4 18 - 3 150

Source: BKKBN Reporting and Recording Statistical Summaries.Note: All data are presented by Indonesia Fiscal Year (April 1 through March 31). For example,

April 1, 1983, through March 31, 1984, is reported as 1984.

- 27 -

Table 5PROJECT PERFORMANCE AUDIT MEMORANDUM

INDONESIA SECOND POPULATION PROJECT(LOAN 1472-IND)

FAMILY PLANNING SERVICE DELIVERY POINTS(March 1984)

Hospitals and Village Sub-village Total /a Total Points /bHealth Clinics Depots Depots Service Points per 1,000 MWRA

Total for Country 7,538 61,623 113,857 202,978 8

A. JAVA-BALI 3,970 31,069 99,352 134,391 8

1. East Java 1,503 8,384 35,119 45,006 92. Yogyakarta 150 845 5,853 6,848 173. Bali 177 3,578 3,726 7,481 194. Central Java 852 9,733 33,230 43,815 105. West Java 899 6,179 19,809 26,827 56. Jakarta 389 2,350 1,615 4,354 4

B. OUTER ISLANDS I

1. North Sulavesi 154 1,271 6,355 7,780 242. Lampung 164 1,709 7,987 9,860 123. South Kalimantan 162 1,684 1,304 3,150 94. West Nusa Tenggara 150 665 3,513 4,328 105. South Sulawesi 309 1,200 3,812 5,321 66. West Sumatra 265 3,493 3,332 7,090 147. Aceh 188 3,377 1,462 5,027 128. South Sumatra 299 2,348 2,237 4,884 79. West Kalimantan 164 3,000 1,600 4,764 1210. North Sumatra 464 5,515 1,816 7,795 6

C. OUTER ISLANDS II

1. Bengkulu 107 985 931 2,023 162. East Kalimantan 149 642 41 832 43. Jambi 122 557 -- 679 34. Riau 141 574 -- 715 35. Central Sulawesi 118 799 21 938 56. Central Kalimantan 140 324 -- 464 37. Southeast Sulavesi 69 613 -- 682 58. East Nusa Tenggara 155 1,111 54 1,320 49. Maluku 112 331 -- 443 210. Vest Irian 97 219 -- 316 211. East Timor 39 137 -- 176

Source: BKKBN, Bureau of Reporting and Recording.

/a Hospitals are located in major cities at the provincial and regency level. Services IncludeIUD, pill, condom, injection, plus sterilization in selected hospitals.Health Center Clinics are located country-wide at the district (kecamatan) level and providecounseling, IUD, pill, condom, injection, and sterilization referral.

Field Workers and Supervisors on Java-Bali and Outer Islands I provinces recruit new acceptors,link depot to clinic, provide contraceptive supplies door-to-door.

Mobile Clinic Teams work out of district health centers to recruit new acceptors.

Village Depots serve as the village resupply point for pills and condoms. Accurate data presentlyare unavailable.

Sub-village Depots and Family Planning Groups insure contraceptive resupply at the sub-village(hamlet) level; motivate new acceptors; and provide peer support to acceptors.Accurate data on number of sub-village depots presently are also unavailable, figures are inestimation.

/b NWRA a Married Women of Reproductive Age.

PROJECT PERFORMANCE AUDIT MEMORANDUM

INDONESIA SECOND POPULATION PROJECT(LOAN 1472-IND)

STAFF INPUTS IN PREPARATION, APPRAISAL AND SUPERVISION(Staff-weeks)

1972 73 74 75 76 77 78 79 80 81 82 83 84 85 TOTAL

Population IIdentification/Preparation 1.3 0.1 1.4Appraisal 57.7 0.2 57.9Negotiations 4.7 4.7Supervision 4.5 19.5 29.0 51.4 64.8 11.0 37.0 39.4 21.1 17.7 13.7 8.0 11.8 0.4 329.3

Subtotal 68. . 2 T T 6 1. TY7 r W1T 477g 0 70 W 11.8

Population IIIdentification/Preparation 0.5 46.9 18.5 65.9Appraisal 59.8 59.8Negotiations 8.7 8.7Supervision 1.0 25.2 32.3 17.8 21.6 16.1 5.7 6.3 7.9 133.9

Subtotal M T r-g V.-o = 72 If = T6.1 -6.T 7W 268.3

Population IIIIdentification/Preparation 5.8 36.7 25.3 67.8Appraisal 0.5 1.9 100.4 102.8Negotiations 16.2 16a2Supervision .8 18.6 20.4 23.6 16.2 5.3 84.9

Subtotal 63 38. 142.7 18.6 20 . 3 4 T6-2 3. 1271.7

Population IVIdentification/Preparation 1.5 38.0 2.1 41.6Appraisal 60.1 60.1Negotiations 18.9 18.9Supervision 2.7 2.7

Subtotal 1.5 38.0 83.8 123.3

Total

Identification/Preparation 1.3 0.1 0.5 46.9 18.5 5.8 36.7 25.3 1.5 38.0 2.1 176.7Appraisal 57.7 0.2 59.8 0.5 1.9 100.4 60.1 280.6Negotiations 4.7 8.7 16.2 18.9 48.5Supervision 4.5 19.5 29.0 51.4 64.8 12.0 62.2 71.7 39.7 57.9 50.2 37.3 34.3 16.3 550.8GRAND TOTAL 68.2 1 29.0 51.9 TI f7 990 68.5 i 7 11.6 3I 0.2 3.8 72.3 9T 056.6

Source: Planning and Budgeting Department, World Bank.

- 29 - ANNEX 1Page 1

PROJECT PERFORMANCE AUDIT MEMORANDUM

INDONESIA SECOND POPULATION PROJECT(LOAN 1472-IND)

HiLhlights of First Project 1/

1. The relationship between population and development has long beenrecognized as important by the Government of Indonesia (GOI), and under thefirst Five-Year Development Plan (Repelita 1, 1969/70 - 1973/74) reduction ofpopulation growth was considered important for health and other developmentreasons. GOI adopted a national family planning program in 1968 andestablished the National Family Planning Coordination Board (NFPCB) in 1970.NFPCB reports directly to the President of Indonesia, who continues to givepersonal attention to this problem. The Bank has supported this programti.rough three population projects (Credit 300-IND for US$13.2 million; Loan1472-IND for US$24.5 million; and Loan 1869-IND for US$35.0 million). Afourth population project has recently been approved.

2. The main objectives of the First Population Project were to greatlyincrease the scale of the Government's family planning program and to broadenthe range of its activities. The project consisted of a widely dispersedconstruction program involving over 300 structures mainly locat d in EastJava and Bali and a sizeable set of software components deemed necessary toincrease the effectiveness of the national program. The project was to beimplemented over a five-year period at a cost of US$33.0 million.

3. Project implementation was substantially delayed, by about fouryears, but costs remained close tto original estimates. Moreover, roughly 55%of the clinics were deleted from the project, but construction wassubsequently funded by Government under a separate program. Ineffectivenessof the management consultants, inappropriate budgetary planning and complexsite approval procedures all contributed to the delay in the hardwarecomponent of the project. In addition, coordination problems betweenGovernment departments, and between the donors, as well as the fact thatNFPCB was only relatively recently established, contributed to difficultiesduring implementation of this sizeable project. Implementation of thesoftware component encountered mixed results.

4. Despite these problems, the project contributed greatly tostrengthening the delivery system as well as the national family planningprogram in Indonesia, The project also provided a strong institutional basefor strengthening NFPCB capabilities, but the full impact of this was notevident until later when the second and third population projects were alsobeing implemented.

I/ Verbatim from Project Performance Audit Report, Indonesia FirstPopulation Project (Credit 300-IND), OED Report No. 5675 dated May 28,1985.

- 30 - ANNEX 1Page 2

Important leasons were learned from the Indonesian project design:

(i) A longer time frame beyond the project period is neededfor institution building, especially when a program isrelatively new;

(ii) The role of technical assistance should vary with thedegree of institutional development already achieved.There is a particular need to differentiate betweenconsultant-advisors and consultants with "line"operational responsibility within the project. Thefailure to make such distinctions clearly may have beenthe reason, in the audit's view, for consultants'services not being fully utilized;

(iii) Hatching management capacity and project diversity isneeded. In the audit's view, this sizable project offersa good example of over-extention of management capacity.In 12 of the 13 supervision reports, management was list-ed as an implementation problem. An alternative, in theaudit's view, would have been a phased approach underwhich smaller projects would be implemented initially,with succeeding projects building on institutionaldevelopment achieved under preceding projects; and

(iv) The priorities and interests of cofinancing agencies aswell as their relevant administrative rules and regula-tions should be clearly understood at an early stage.

- 31 - ANNEX 2Page 1

PROJECT PERFORMANCE AUDIT MEMORANDUM

INDONESIA SECOND POPULATION PROJECT(LOAN 1472-IND)

Third Population Projecti/

Objectives

1. The GOI has set for itself the goal of reducing the 1971 fertilityrate by 50% by 1990. This goal can best be achieved through a comprehensiveprogram which will have an impact on all factors affecting fertility, andthrough an intensified effort to reach all of the population of Indonesia.

2. The proposed project will assist GOI to achieve this goal in thefollowing ways:

(a) Helping NFPCB to decentralize the management of the family planningprogram by providing office training and storage accommodation;

(b) Expanding the information, education, and communication activitiesbegun under the first two projects; and

(c) Strengthening maternal and child health services.

Project Composition

3. The proposed project will provide for:

(a) Infrastructure development: Construction of, furnishing andequipping:

(i) Eleven provincial population and family planning centers inthe Provincial Capitals of Riau, Jambi, Bengkulu, CentralKalimantan, East Kalimentan, Central Sulawesi, SoutheastSulawesi, East Nusatenggara, Timor Timur, Maluku and IrianJaya; each such center to include an administrativeheadquarters, a training center, and a warehouse for storingcontraceptives and information, education and communicationmaterials;

(ii) Warehouses for storing contraceptives and information,education and communication materials in the following tenprovinces: Aceh, North Sumatra, West Sumatra, South Sumatra,Lampung, West Kalimantan, South kalimantan, South Sulawesi,North Sulawesi and West Nusatenggara; and

1/ Verbatim from SAR Third Population Project, Report No. 2912-IND datedMay 19, 1980 (paras. 5.01-5.03).

- 32 - ANNEX 2Page 2

(ii) A district population and family planning multipurpose centerin each of the 107 districts in the ten Provinces set out in(ii) above.

(b) Support for National Family Planning Program:

(i) Information, education and communication activities.Strengthening the information, education and communicationprogram by providing 50 specially equipped mobile informationunits (29 replacement units for Provinces in Java and Bali and21 units, one each for Provinces outside Java and Bali),equipment, consultant's services, fellowships, and operatingcosts for the provincial media production centers, filmproduction and training;

(ii) Population education. In-service training in populationeducation of teachers (about 50,000), school supervisors atdistrict and sub-district levels (about 4,200), sub-districtlevel supervisors for non-formal education (about 1,600) andvillage workers for non-formal education (about 16,000), andprovision of teaching equipment, instructional materials,fellowships and operating costs.

(iii) Strengthening of supervisory capacity. Provision of about1,500 motorcycles to supervisors and field coordinators in theProvinces outside Java and Bali.

(c) Maternal and Child Health and Family Planning Support Services:

(i) Training of traditional birth attendants. Assisting in, andimproving, the capabilities of TBAs by (a) providing operatingcosts for the training of about 20,000 and the retraining ofabout 47,000 TBAs, and (b) providing support for trainingmaterials and operating costs for about 3,100 trainers.

(ii) Retraining of nurses and midwives. Assisting in the retrain-ing of about 1,080 nurses and midwives to become primaryhealth nurses at nine existing nursing schools in the follow-ing locations: Banda Aceh, Medan, Padang, Palembang,Pontianak, Banjarmasin, Samarinda, Ujung pandang and Ambon, byproviding vehicles, special equipment, fellowships and supportfor tre.ining expenses.

(iii) Training of teachers in nursing schools in community health.Assisting in training in community health 960 teachers innursing schools at four existing nurse training schools byproviding vehicles, special equipment, fellowships and supportfor training expenses.

33 - ANNEX 2Page 3

(iv) Maternal and child health and referral services. Construc-tion, furnishing and equipping of 10-bed in-patient annexes at50 existing health centers in the Provinces of North Sumatra,West Sumatra, South Sumatra, West Java, Central Java, andSouth Sulavesi.

(v) Training of health center doctors. Assisting in, and improv-ing, the training of 50 staff doctors to be assigned to thehealth centers referred to in (c)(iv) above by providingsupport for fellovships.

(vi) Training of health center medical and paramedical personnel,local administrators and community leaders. Assisting in thetraining of health center medical and paramedical personnel,local administrators and community leaders, by support ofstudy tours and training sessions.

一 97 一

才飾 ＇,C 才 妒編 斤

35 - ANNEX 3Page I

PROJECT PERFORMANCE AUDIT MEMORANDUM

INDONESIA SECOND POPULATION PROJECT(LOAN 1472-IND)

Fourth Population Prgject I/

A. EUo ect OMectives

1. Taking into account the GOI's population policy and overallfertility reduction goals during Repelita IV and beyond, the main objectiveof the Project is to help strengthen further the NFPCB* In addition, thisProject would assist MOPE, a policy coordinating ministry, to carry out itsoverall population policy development and planning mandate. In thecircumstances, the six NFPCB components and three MOPE components included Inthe Project described below were selected on the basis of NFPCB and MOPEpriorities during Repelits IV$ their potential contribution to theachievement of the national demographic goals and to the Institution-buildingobjectives noted above.

2. In summary, the Project's operational objectives and contentconsists of two main parts, as follows:

Part A: Strengthening NFPCB

(a) field Operations Development: completing NFPCB1s decentralizedfield infrastructure in the districts of Outer Islands II and InJakarta and improving field communications and mobility throughoutthe country through the construction of 84 NFPCB district officesand the provision of communication equipment, 6,480 motorcycles and47,600 bicycles, and 2 manyears of technical assistance;

(b) Staff DeveloLment: expanding and improving NFPCB19 staff educationind training capacity through construction of a new headquarterstraining center in Jakarta and the provision of equipment,vehicles, technical assistance (16.5 manyears), 153.5 manyeare offellowships, and teaching materials-

(c) Information, Education, and Communication (IEC): strengtheningNFPCB's IEC activities in producing and disseminating audiovisualand printed materials through provision of equipment, vehicles,training, technical assistance (5 manyears), and materials for 87mobile units and for the headquarters and the 27 province-level IECunits;

I/ Verbatim from SAR, Fourth Population Project, Report No. 5404-IND datedApril 10, 1985.

- 36 - ANNEX 3Page 2

(d) Population Education: expanding population education through thetraining of 15,800 school principal*, supervisors and teachereducators and 85,000 out-of-school tutors, supervisors andfacilitators and the provision of equipment, training materials,and funds for monitoring and evaluation;

(e) Service Delivery in Transmigration Areas: developing integratedfamily planning, health and nutrition services in transmigrationsettlement units in the provinces of Riau, Jambi, Bengkulu, SouthSumatra, and West Kalimantan through provision of equipment, 90motorcycles for NFPCB subdistrict-level supervisors and 600bicycles for NFPCB family planning fieldworkers, materials,technical assistance (5.8 manyears), and funds for training costsand baseline survey; and

(f) Research: strengthening NFPCB's cpacity to coordinate, manage andundertake operational research through provision of additinaloffice space (in the new training center), funds for researchactivities, technical assistance (6 manyears), and 15 manyears offellowships for overseas graduate-level traning of about 9professional staff and local short-term training of about 6professional staff.

Part B: Assisting MOPE

(a) Indonesian Population Plan of Action: assisting the MOPU todevelop a long-term Population Plan of Action for Indonesia to beused in the preparation of five-year development plans for theperiods 1989-94 and 1994-99 through the provision of technicalassistance (27 manyears);

(b) Population Studies Centers: strengthening vopulation studiescenters in 10 universities through provision of 120 manyears ofoverseas graduate-level training and funds for population researchstudies; and

(c) Support to Non-Governmental Organizations (NGOs): strengtheningthe capability of NGOs to carry out population activities byproviding training and materials in population-related subjects formembers of NGOs.

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INDONESIA

SECOND POPULATION PROJECT

La 1472-ID

PROJECT COMPLETION REPORT

Population, Health and Nutrition DepartmentSeptember 30, 1985

g-

6 4<rr & /s» A'

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REMI

1.01 This project completion report reviews the experience of the secondpopulation project (La. 1472-IND for US$24.5 million), which was prepared in1973-77 and implemented in 1977-84. The project followed Cr. 300-ID (for$13.2 million, signed in April 1972), and preceded La. 1869-IND (for $35.0 million,_igned in June 1980). Except for an innovative research component which faceddifficulties during preparation and implementation, project components wererelatively simple in design, and were satisfactorily implemented. However,loan closing was delayed by two years, mainly due to difficulties encounteredby the two research studies.

1.02 Project targets for the years 1977-84 have largely been achieved.The project's objectives (para 2.07) of enhancing the mobilitylof field staff,and extending decentralized program activities in 10 provinces / in Other IslandsI have been met. Population education activities in Indonesia have been expandedand strengthened, though at a slower pace than anticipated at appraisal.

1.03 Indonesia's family planning program is widely recognized for its successfulservice delivery and demand mobilization strategies, and has consistently achievedits targets throughout the past fifteen years (para 4.04). The precise contributionof the second project towards this overall success is, however, not easily quanti-fied, for two reasons: (i) it is methodologically difficult to measure thedirect program contributions of activities such as training, mobile servicedelivery, population education etc., and to disaggregate them from the collectiveimpact of a variety of other influences such as the contribution of governmentand other external agencies; and (ii) in this particular case, project inputsoverlapped considerably with the first and third projects; and also with substantialnon-Bank inputs (both GO and from other donors).

1.04 The sustainability of program activities started under the secondproject is assured (para 6.04). Most project components were reinforced underthe third project (which has recently been completed, in March 1985); and willbe continued under the fourth project (approved by the Bank's Executive Directorsin May 1985). More importantly, the Government continues to support the program,both politically and financially; and there is no reason to suppose that itscommitment to the family planning program will slacken in the near future.

1/ These 10 provinces were Aceh; North, West and South Sumatra; Lampung;West and South Kalimantan; North and South Sulawesi; and WestNusateuggara.

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1.05 Sector Backaround. The National Family Planning Coordinating Board(NFPCB) was established in 1970 as a government organization and is responsiblefor the "coordination, integration and synchronisation of efforts" in familyplanning. It also generates policy, implements service delivery and IEC activitieswith Ministry of Realth (NOR) support, coordinates all foreign aid for the program,and provides technical guidance to the implementing units-primarily the MORand the Armed Forces (ABRI). The NFPCB Chairman reports directly to the President,who has ultimate responsibility for the program.

1.06 In the provinces, Governors are responsible to the President for alldevelopment programs, including family planning; and the NFPCB's provincialchairmen are required to obtain the Governor's directives on operational matters.Much of the motivational work for family planning is undertaken with the cooperationof the Indonesian civil service hierarchy, from provincial to village level.In the two islands of Java and Bali (where, according to the 1980 census, 632of the 147 million population lived on 71 of tb land area), the IYPCB has developedand directly organized a cadre of lay field workers for providing motivationaland informational services. Close collaboration with village level volunteers,operators of village contraceptive distribution centers (VCDC), the villageheadman (Lurah), and community acceptor groups is also maintained. The nationalprogram was extended to the 10 provinces of Other Islands I in 1974. Until1977, the appraisal date for the second project, service delivery to these areasrelied primarily on static facilities of the MOR and ABRI.

1.07 The national program had recruited 8.97 million new acceptors duringthe period 1968-77, and had achieved its target in each year since 1972-73.Estimated program expenditure had risen from U8$2.1 million in 1968-69 to uS$25.5million in 1975-76. However, in Java and Bali expenditure per new acceptorhad dropped from $81 to $15 during 1968-76, partly due to the larger numberof clients served, but also due to a major shift in preference from IUDs tooral contraceptives. (Use of Ms had fallen from 55% to 18%, while use ofpills had increased from 281 to 671 during the period 1968-77). By March 1977,24.11 of the married women of reproductive age in Java and Bali were practicingcontraception, compared with 6.21 in the other islands.

1.08 The rate of population growth in 1976 was estimated at 2.21 per annum,with a total fertility rate of 5.1, and a crude birth rate of 40 per 1000 pop-ulation. The NFPCB's long-term program goal was to reduce fertility over theperiod 1971/2000 by 501. An intermediate target war to reduce the birth rateto 34 per 1000 population by 1983-84, the end of the third national five-yearplan.

1.09 In support of this objective, the first population project had beenstarted in 1972, jointly funded by IDA and UNFPA. The project, with an estimatedtotal cost of U8$33.0 million, was broad in scope, covering activities suchas: (i) constructing and equipping one NFPCB central office, ten paramedicaltraining schools, six provincial training centers (PTCs) and offices (P0s),ten sub-provincial training centers (STCs), and 320 maternal and child health/familyplanning (MCIPP) centers in East Java, Bali and Jakarta; (ii) salary and transportfor 7000 family planning field workers; (iii) 115 mobile information units;(iv) a population education program; (v) a hospital post-partum program; (vi)a demonstration field post-partum program; and (vii) technical assistance (advisers,

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fellowships, studies, seminars etc.) for program management, population education,training, IBC and project implementation.

1.10 As of April 1977, when the second project loan was negotiated, US$13.3million (50% of the funds from IDA and UNFPA) had been disbursed. Most majorbuildings had been constructed or were nearly complete, vehicles and mobileinformation units had been procured and were in use, field workers had beenhired and trained, population education and IEC activities were ongoing, andother components were being implemented as planned. Start-up problems had beenfaced earlier, largely due to NFPCB's inexperience with a project of this size,and problems of establishing a Project Implementation Unit (PTU) and using foreignmanagement consultants. These problems had been overcome by 1977. The NFPCB'sbureaus had benefited from the technical assistance provided under the firstproject, and were considered capable of managing the existing and proposed programactivities on their own. Also, the GOI had shown itself capable of learningfrom experience and willing to make changes, especially in the way it util edindigeneous administrative resources to expand family planning activities. /

1.11 In order to continue these efforts, OI had developed a program strategyfor the years up to 1983/84. During the next seven years, new contraceptiveacceptors were expected to increase by 15.15 million in Java and Bali, and by4.45 million in the 10 provinces of Other Islands I. Current users, as a percentageof eligible couples, were expected to go up from 24.1% to 35% in Java and Bali,and from 6.2% to 25% in Other Islands I. For achieving these targets, the NFPCBplanned to follow the program strategy initiated in 1974, relying more on community-oriented distribution and motivation activities than on static service centers.It also intended to bring about a wider acceptance of family planning nationwide,consistent with the cultural and administrative traditions of small rural communi-ties.

II. P2OJ=C IDWTIFCAINE, MWDARMNC MI APPRIAL

2.01 Identification and Preparation. Identification of a possible secondproject was initiated in May 1973, just six months after implementation of thefirst project began (Annex 1, para 1). The project was initially viewed bythe NFPCB as an extension (Phase II) of the first credit, but in 1974 the Governmentdecided to extend the national program to the other islands, as part of theSecond Five Year Plan, and a more substantive project was considered necessary.This resulted in a major reworking of proposals prepared thus far, and tookanother two years. Responaibility for project preparation shifted from a Governmentinteragency task force to NFPCB's senior staff, assisted by expatriate consultantsand Bank staff-both headquarters and the population specialist assigned tothe bank's Resident Mission in Indonesia (RSI). Frequent Bank missions wereundertaken, involving about 50 man-weeks in the field.

2/ For details of the first project (Cr. 300-IND) see project completionreport dated February 28, 1984.

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2.02 A chronological account of key events in project preparation is givenin Annex 1. Attention is drawn to changes in project scope, content, and cost,and to the nature of preparation undertaken.

Averaisal and A29roval

2.03 By Fall 1976 all project components were reported to be well prepared,except the community incentive scheme (CIS), and the oral contraceptive rawmaterial feasibility study. Background work for the Third Five-Year Plan was

also completed. Appraisal was conducted in October 1976 (except for the CISwhich was not ready. Total project cost was estimated at US$42.3 million; with

a possible Bank loan of 8$20.6 million. Component costs were estimated as:US$9.9 million for civil works; US$7.8 million ror vehicles, equipment, training

aids, technical assistance etc; US$13.8 million for incremental operating expenses;and US$10.7 million for contingencies.

2.04 Soon after Appraisal, Government sought help from the R1I's population

specialist for preparing the CIS. Preparation activities for the contraceptiveraw materials study were also expedited. Meanwhile in Washington, the DecisionMeeting bad been held in November 1976; and had suggested no changes in AppraisalMission recommendations.

2.05 A post-appraisal mission in February 1977 finalized the various compo-nents. The proposed community incentive scheme was still not ready, but was

expected to be finalized by March-April 1977. Final details of the two researchstudies were incorporated into Appraisal documents just a few days before Negoti-ations with Government representatives in May 1977. Total project cost was

estimated at US$60.0 million; with a Bank loan of US$24.5 million.

2.06 The Bank's Executive Directors approved the US$24.5 million loan on

June 30, 1977, without discussion. The loan was declared effective on August4, 1977, less than one month after loan signing.

Proiect Descriation

2.07 The project's specific objectives were to:

a. enhance the mobility of family planning staff to enable them to provideservices to population groups who could not now easily avail themselvesof services provided by static outlets;

b. assist the national program to widen and strengthen its educationand motivation activities aimed at providing widespread acceptanceof the small family norm and contraceptive practice; and

c. support the administration of the national program by providing officefacilities and assistance for its plan to achieve a national contraceptivecapability.

2.08 Project components were described as under:

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a. provision of 274 equipped, four-wheel drive vehicles, 1,661 motorcyclesand 8 small equipped motor boats, together with IUD and public healthnurse kits for the 1,661 motorcycles provided under this project and1,405 motorcycles now in use without kits, as well as support fortheir maintenance and operation (US$13.5 million).

b. construction and equipping of facilities for the NFPCB's Bureau ofEducation and Training in Jakarta and PTCs in each of the 10 provincesof Other Islands I, with support for staffing, maintenance, provisionof special equipment, transport, fellowships and technical assistance,together with the construction of 10 NFPCB offices, as well as supportfor their maintenance, and operation, which were to be built in conjunctionwith the PTCs on the same sites (US$21.5 million);

c. provision of education materials, seminars, workshops, fellowshipsand technical assistance to complete the integration of populationeducation into formal school curricula and non-formal education program.(US$4.0 million);

d. two research studies providing:

(i) technical assistance, monitoring and evaluation studies, andincentives for the introduction of a pilot community incentivescheme in Java, Bali, North Sumatra and South Sulawesi designedto promote family planning in 14 of the most economically under-developed kecamatans (US$2.9 million); and

(ii) technical assistance, fellowships, and special equipment fora study of the feasibility of providing raw materials for localoral contraceptive production from botanical material availablein Indonesia (US$2.4 million).

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2.09 Loan allocation was as follows:Amount

Cate&nr (US $ million)

I. Civil Works 7.7II. Furniture and Special Equipment 3.9

III. Vehicles 3.5

IV. Consultants, Experts Services,and Fellowships 1.7

V. Operational Coste of Studies,Workshops, Seminars 3.3

VI. Training Aide 1.1

VII. Unallocated 3.3

TOTAL 24.5

2.10 The component-wise allocation of the estimated US$60.0 million totalproject cost was: civil works 8$10.8 million (18%); vehicles and equipmentUS$5.5 million (9.22); technical assistance, fellowships, training aide etc. US$5.2million (8.72); incremental operating costs US$22.8 million (381); and contingenciesUS$15.7 million (26.2%).

Ill. PRO SNNONAM1U

3.01 The project was implemented through the NFPCB's own organization,i.e., its bureaus and implementing units. Because NFPCB's program managementcapabilities had improved considerably by 1977, a special project implementationunit was not considered necessary. RFPCB had gained sufficient experiencewith the implementation of the first project that it could implement the secondproject without a Project Implementation Unit. For civil vorks, however, staffalready working on the first project was transferred to the NFPCB Secretariat,and was to be assisted by local architectural consultants responsible for preparingdesigns and supervising construction contracts. Project monitoring and evaluation,procurement, and administration were done by the regular bureaus, under theoverall direction of a Project Officer within the NFPCB.

3.02 Project implementation is discussed below under four headings: (a)major activities; (b) research; (c) construction and procurement; and (d) disburse-ments and costs. Most loan conditions were met satisfactorily (Annex 2).

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A. MAJOR aTIVITIS

3.03 Mhile Famil ZlaMMA SeKiae. Procurement of mini-buses, jeepsand motorcycles (equipped with special equipment such as IUD kits, MCR kitsand physician's kits) started off well. Within one month of loan effectiveness,the NFPCB had prepared draft specifications for all vehicles and equipment,had got them approved by MOR (except for boats), and had prepared vehicle distri-bution lists, an operational manual, and procedures for reporting vehicle utili-zation. However, tendering was delayed by more than one year, partly due touncertainties caused by NPPCB's reorganization in 1978. Bids for vehicles andspecial equipment were invited in aid-1979; and procurement was completed inJune 1980. Some initial problems were encountered in getting licenses for vehiclesand in delivering equipment, but by the end of 1980 all units, except the 8boats, were operational.

3.04 The procurement of boats, intended for use in riverine and coastalareas where road transportation was not feasible, was cancelled in aid-1980.The November 1980 Bank supervision report explained that the N01 had experienceddifficulties in the past operating floating clinics, and had decided not toprocure any more. The difficulties cited were that staff was unwilling to serve,because of long absences from home, operrtional costs were extremely high, andthe NO01 did not receive sufficient budgetary funds to cover costs. The Governments'draft PCR of March 1985 states that the boats were cancelled because "the MORwas already operating in these areas." However, some NFPCB provincial officeswould have preferred boats for general transportation purposes (not just forclinics), because in parts of South and West Kalimantan and South Sumatra, whererivers are the major means of comunication, vehicles such as jeeps and motorcyclesare inappropriate and "are already beginning to show signs of rust."

3.05 In addition, the Government draft PCR states that the capacity ofmotorcycles is too small for some mountainous areas (in Sumatra and Sulawesi),and that the availability of spare parts for jeeps and minibuses is a problemin all provinces, (possibly due to logistical problems within the NFPCB). Despitethese limitations, the availability of project vehicles is reported to havegreatly improved the provision of family planning services in outlying ruralareas.

3.06 Training. This component was estimated to cost US$21.5 million forthe construction and equipping of a National Family Planning Training Center(NFPTC) in Jakarta and 10 Provincial Training Centers (PTCs), and the provisionof vehicles, teaching materials, audio-visual equipment, films, overseas fellowships,technical and professional training, study tours, and incremental operatingcosts. Delays of 1-2 years were experienced in civil works: the PTCs wereconstructed and equipped by mid-1980, and the RNPTC by end 1981 (para 3.37).The delay in constructing the NFPTC resulted in a corresponding delay in purchasinglibrary equipment and materials. As of March 1980, only 15% of the US$1.1 millionearmarked for training aids had been spent.

3.07 Recruitment of qualified staff for the PTCs and NFPCB's Educationand Training Bureau uncountered problems due to delays in obtaining atprovalsof instructors' posts for the PTCs, and also due to a general shortage of competent

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trainers. Opportunifies for fellowship training could not be fully utilizedbecause of staff shortages in NPPCB, and the difficulty of releasing candidateswho could satisfy the language and academic requirements of foreign universities.The latter problem has now been tackled with USAID assistance, by providingan English language-training laboratory and assistance in liaison with foreignuniversities. Study tours were more widely used, but these too were curtailedafter 1981 when BAPPERAS began closer scrutiny of all projects' overseas seminarsand study tours, with a view to eliminating expenditure of loan funds on trainingof little value.

3.08 By February 1982, however, provincial training centers had a fullcomplement of staff, except physicians who were engaged on an ad hoc basis.Library materials for the NFPTC were procured, and plans were made to relatetraining loads to manpower requirements of NFPCB. Preparation of instructionalmaterials, development of curricula and courses, and utilization of the remainingoverseas fellowships were undertaken in 1982; and by September 1983, the 10PTCs were reported to have trained 42,600 persons, roughly 551 of the appraisalestimate of 77,000. The shortfall was due to three main reasons: first, thedifficulty of recruiting qualified trainers for provincial training centers;second, the delay in completing the construction of the National Family PlanningTraining Center; and third. the reorganization of NFPCB. The comparable figuresfor the NFPTC were 8,409 (14%) trained; and for Java and Bali 70,210 (581) trained.A number of overseas fellowships and training courses had also been availedof, mostly in April-December 1982. Courses were attended in the United States,Philippines, and Japan; study tours covered relevant institutions in the UnitedStates, England and other ASEAN countries. A comprehensive evaluation of thetraining component has not been conducted but is included in the fourth populationproject.

3.09 Poalation Bducation. This component was to be implemented nationwide,and sought to strengthen and expand the activities started under the first project.Its objective was to integrate population education into both the formal andthe informal educational systems. The following activities were to be undertakenby the Ministry of Education and Culture (MORC): teacher training, productionand distribution of teaching materials (books and audio-visual aids), technicalassistance for curriculum development, and fellowships. Implementation responsi-bility was given to MOEC's National Population Education Project (PNP). TheNFPCB's Bureau of Logistics was expected to handle procurement and distribution.

3.10 By 1979 population education was to be integrated into curricula coveringall school grades (some 30 million students), community education courses (about50,000 people), and Government-supported teacher training institutes (340).Implementation was initially slower than expected, for several unforeseeablereasons, including: (i) the Government decision in September 1977 not to hirean expatriate adviser for preparing and editing textbooks, developing teachingkits, and formulating evaluation procedures. (It took more than one year forthe 001 and the Bank to reach agreement on the change, because Bank staff feared(para 3.18) that the proposed local experts were too eminent and busy to devoteadequate time to the work); (ii) a 4-month delay in releasing the 1978 NFPCBand NORC budgets; (iii) a 3978 reorganization of the MOEC and NFPCB, resultingin several key vacancies due to promotions and transfers, and a shortage ofsuitable senior level replacements; and (iv) extension by Ministerial Decree

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of the 1979 school year by six months, and suspension of all school activities,except teaching.

3.11 Despite these problems, nearly all provinces had incorporated populationeducation into formal school curricula by September 1979. As of June 1980,a population education curriculum for vocational schools had been developed,and that for learning centers was being prepared. The printing and productionof instructional materials for the in-school program had also been completed,except for teaching kits, while tendering for production of books for the out-of-school program, and training of program instructors was in progress. The November1980 supervision mission reported that the component was making satisfactoryprogress: curricula had been prepared, instructional materials produced, audio-visual equipment procured and distributed, and teachers and instructors trained.

3.12 However, the June 1981 mission reported that although population educationbooks had reached NFPCB provincial offices, they had not been subsequentlydistributed to schools in some provinces of the other islands, partly due tologistical problems, reportedly caused by a lack of funds for transport. Theproject had provided only US$25,000 for distribution expenses, out of a US$2.0million budget for population education, even though the Appraisal Report hadacknowledged that the distribution of materials such as textbooks and teachingkits presented a great problem. Communications were difficult and expensive;and materials would need to be delivered to thousands of schools, non-formaleducation centers and training institutions. Concurrent with this shortageof funds for material distribution, the NFPCB estimated a likely savings ofUS$660,000 from the population education budget. Workshops for this componentalone had been allocated US$1.4 million, of which only us$0.13 million had beenused by January 1982.

3.13 Two evaluations of the population education component have been conducted.The Teachers Training Institute in Bandung evaluated the formal school programactivities in 1979, and concluded that although teachers and secondary schoolstudents were responsive to population education, primary school students encountereddifficulties in comprehending the concepts. In addition, although the trainingof teachers had been effective, the available textbooks and teaching materialswere insufficient.

3.14 A second evaluation was conducted by the Population Studies Centerof Gajah Mada University in 1982. This study found that teachers trained inpopulation education had incorporated the relevant concepts in subjects thatthey taught. The study also administered tests to some 11,000 students in selectedprimary and secondary schools in 9 provinces, and found that, on average, thestudents were able to correctly answer 50% of the questions asked. However,teaching materials were still in short supply: some 25% of the formal-schoolteachers, and an even larger proportion of those teaching in the out-of-schoolprogram had not received any population education textbooks or teachers' manuals.Also, the cost-effectiveness and utilization of training, and the criteria forselection of trainees could be improved substantially.

3.15 Based on these findings, Government adopted a new policy of2 integratingpopulation education concepts into existing social studies curricula in primaryand secondary schools (rather than as a separate subject), thereby partially

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solving the problem of sbortage of teaching materials. In September 19828 Bankstaff from the PUN and Education departments reported satisfactory completionof all activities, except the distribution of teaching kits for non-formal education,and the production and distribution of teaching kite for the in-school program.They also identified some additional areas in which improvements were needed.These were: () commanication between implementing units at the national, provincialand district levels; (i) testing of alternatives for reducing the cost of trainingteachers; and (iii) better utilization of master trainers who had received intensivetraining under the first and second projects. This last aspect was especiallyimportant since in 1982-83 more than 3,000 teachers from different school stageswere to be trained in intensive courses, each of four days duration.

3.16 Additional steps for further institutionalization of population education,both programatically and administratively, were also recommended. AlthoughPNPK had already been transferred from the Office of Director General of Primaryand Secondary Education to the more strategically placed Office of Educationand Cultural Research (termed BP31), it still did not have a suitable permanentlocation, and remained weak. It therefore faced difficulty in attracting experiencedstaff from the MOBC, who feared losing promotional opportunities. A similarstaff shortage existed in the population education section of the NFPCB.

3.17 By late 1982, all population education activities in the originalproject description had been completed, though three years behind schedule.However, the production of additional instructional materials (inclu0td duringreallocation of savings, paras 3.48 and 3.49) and the various activities ofthe third project were ongoing. Implementation was slow, primarily becauseBAPPENAS and the Ministry of Finance had withheld counterpart funds for 1982-83,pending the results of the evaluation of the overall population education program.Progress remained slow throughout FY82-83, partly due to reorganization withinNFPCB and MORC, some of which got resolved only after a major reorganizationin March 1983. Population education activities were expanded under the thirdproject and the recently approved fourth population project.

3.18 Technical Assistance. GO accepted expatriate technical assistanceonly for the contraceptives raw material study (para 3.22). For the rest ofthe components--population education, training, and the community incentivescheme--local consultants were used. Bank staff were regularly consulted, andgave useful guidance on terms of reference, duration of appointment etc. Ina few instances, the NFPCB first hired the consultants with BAPPERAS approval,and subsequently obtained Bank concurrence.

3.19 Two local consultants were used for training. Both received favorableassessments from the NFPCB's Center for Education and Training, which felt thatthe consultants had helped communicate with training institutions abroad, finalizefellowships and study tours, and expedite the disbursement of funds for technicalassistance. For population education, four highly respected senior facultymembers of the Teachers Training Institutes in Jakarta and Bandung were hiredon a part-time basis, each for 6 months. Their input was considered useful,but somewhat academic. The consultants apparently did not spend enough timeat the NFPCB, thus limiting the transferability of knowledge to regular staff.

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3.20 For the Commuity Incentive Scheme, a number of institutions wereassigned different tasks. In general, LAPI-ITB's technical assistance for physicalinfrastructure, and YSTM/Bina Svaday's training of acceptor groups were consideredparticularly useful. Detailed assessments of these and other consultants have,however, not been undertaken.

3.21 Two studies were included in the project: (i) a study of indigenousplants to assess their suitability as sources of raw material for the localproduction of oral contraceptives; and (ii) a pilot commnity incentive schemein selected subdistricts of Java, Bali, North Sumatra, South Sulawesi and WestNusa Tenggara. Both studies faced substantial difficulties, and got delayedby several years.

3.22 Oral Contracetive Raw Material Feasibility Study. The objectiveof this study was to determine whether it was possible to produce the F-ecursorsfor the production of steroid hormones and eventually steroid oral contraceptivesin Indonesia, using existing national resources. Funds were provided for technicalassistance, fellowships, and special equipment. Implementation responsibilitywas given to the NFPCB, which was expected to involve a number of other institutions,primarily the Bogor Agricultural University and the Pharmaceutical ResearchCenter of the Ministry of Health. The feasibility study for local manufactureof oral contraceptives had been undertaken earlier (in 1976), with the helpof an expatriate bio-chemist familiar with problems of contraceptive manufacturein developing countries. Production was expected to start in December 1977.The raw material feasibility study was started in January 1978, a few monthsafter the second project loan became effective. Since the consu!tant on contra-ceptive manufacture had helped prepare the stud7 proposal, he was appointedas technical adviser for the raw material feasibility study as well.

3.23 Two species of plants-slanace and dioscorea were to be explored,adapted, and analyzed for raw material content. The preliminary library researchwas completed in October 1978, and indicated (incorrectly, pars 3.24) that indigenoussolaacesl did not exist in Indonesia, and that the six reported species ofdiasorea were not among the 12 species known to be rich in digtAnn, the requiredraw material. Field exploration was started in August 1979, and by March 1980,7,100 samples of 9 species of diogcores had been collected, staff had undertakenoverseas fellowships/study tours, and equipment for phytochemical analysis hadbeen ordered.

3.24 Analytical results of various specimens confirmed the findings ofthe library research: none of the species of digs-sora contained sufficientlevels of diosgenin to justify commercial production of oral contraceptives.These results were presented in June 1981 at an international seminar held inJakarta, after which it was decided that subsequent exploration activities shouldfocus on species of Cogsas (which can also yield diosgenin) and on species oflama (which are potential sources of solasodine, a precursor of steroid hor-mones). The second and third phases of exploration were then conducted in 1982,after delays (as in Phase 1) due to unpredictable storms and floods, and problemsof transportation to the remote exploration sites. Fortunately, however, analysis

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of some species of solana and Cjstu shoved promising preliminary results.Adaptation trials for these species were then conducted, and the results presentedat a national seminar in August 1984.

3.25 The solasodine content of some solanum species is considered promising,potentially reducing the raw material cost from US$50 per kg (imported) to $16per kg (local). However, since Indonesia does not have a fine chemical industry,it appears that crude solasodine might have to be exported to companies abroadfor processing, possibly including contraceptive man-afacture. The governmentis presently examining various options for importing the needed technology,and is concurrently adapting solanum khasianum (a type of eggplant grown inIndia) on a pilot basis, for potential conversion to the raw materials neededfor manufacturing oral contraceptives.

3.26 Thus, although research on local raw materials has been useful, ithas taken 7 years instead of the 3 years anticipated at appraisal. Some ofthis delay was perhaps inevitable, considering the rather optimistic appraisalschedule, and the uncertainties inherent in any innovative field research.However, in retrospect it appears that exploration of both gslamm and dioscoreashould have been started simultaneously (as recommended in the Appraisal Report),particularly in view of the library research findings as early as 1978 thatthe diogorea species in Indonesia were not likely to yield promising results.Although technical specialists were available at the Bogor Agricultural University,the hiring of expatriate consultants trained in agronomy or other botanicalsciences (as was suggested in the Apprairal Report), instead of the industrialbio-chemist (whose services were retained even after the contraceptive manufacturingstudy was completed), might also have helped.

3.27 Community Incentive Scheme (CIS). This pilot scheme had two objectives:(i) to test whether the promotion and acceptance of the small family norm couldbe encouraged by applying incentives for predefined community achievements infamily planning; and (ii) to test alternative institutional arrangements fordirect government intervention in fertility behavior. Study designers expectedthat the community incentive funds would produce basic changes in the socio-economicstructure of the participating communities, which would contribute, independently,to an overall reduction of fertility. An Appendix to the Appraisal Report describedthe US$2.9 million scheme, its conceptual justification and expected/potentialbenefits. Although the scheme was to extend for the full 5 years' project imple-mentation period, it was expected that by June 1978 (less than 1 year afterloan effectiveness), its basic elements would have been determined, and preparatoryactivities completed.

3.28 Implementation did not proceed smoothly. The scheme had been preparedjointly by BAPPENAS and the Bank's RSI just a few months before Board Approval(para 2.04), and apparently did not have the support of key NFPCB staff responsiblefor its implementation. The latter questioned the basic design of the scheme,including the concept of incentives and whether the development funds shouldbe given before or after performance was achieved. They proposed a redesignedscheme which, according to some Bank staff, had characteristics of typical ruralcommunity welfare programs. Bank and BAPPEWAS staff resisted strenuously foralmost three years, but finally accepted the change. As a result, the schemewas never implemented in its original form.

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3.29 In a significant departure from the original proposal, the revisedscheme granted funds to a community in advance to enable it to start its income-generating activities (rather than as a reward for community achievements inrecruiting contraceptive acceptors). The Bank approved this change in early1981, although concerns regarding the timing, basis, and size of incentives,suitability of the implementation machinery, cost-effectiveness of the proposedscheme, and funding implications for replicability nationwide, were expressedby various Bank staff.

3.30 Under the revised scheme, short-term loans were to be given to eligiblecommunity groups (those with a minimum of 35% of eligible couples practicingfamily planning), for use by the community or by individual contraceptive acceptors,for two kinds of activities: (i) building simple infrastructure (roads, communitybuildings, water supply facilities, mosques, wells, bridges, schools, etc.),and (ii) income-generating activities, which were to be decided at the locallevel through an informal process of needs assessment involving the acceptorgroups and various community leaders. Construction management was to be theresponsibility of the local village leader, supported by technical specialistsand contractors provided by the project. Management of the loan funds was tobe done by the village acceptor group, supervised and monitored by the villageleadership and the NFPCB field worker.

3.31 Pre-implementation activities started in February 1981, with nationaland provincial-level workshops to discuss the scheme, site selection criteria,and conduct of a feasibility study of pilot areas. As a result, 64 villagesin 32 subdistricts in 9 provinces were selected. Baseline surveys were conductedduring the period July 1981-March 1982 by a private research organization.An academic institution (LAPI-ITB) and a private firm (Dian Desa) were assignedthe task of designing the physical facilities, supervising construction, andtraining the local people in their maintenance. Another non-governmental institution(YSTM) was appointed to give 3-day training to leaders of acceptor groups insimple administrative and bookkeeping skills, so that they could better managethe loan capital, the distribution of which was begun in April-May 1982.

3.32 The income-generating activities undertaken by acceptor groups includedsmall-scale production of soybeans, cattle raising, handicrafts, food and grocerystalls, pig raising, and transport services. However, because of their loweducational levels, the leaders had difficulty utilizing their training in book-keeping, and in some cases the loan amounts had to be reduced in order to preventpotential problems. The scheme proved to be an effective government-sponsoredscheme for extending micro credits to the poorest income groups.

3.33 An evaluation conducted in 1984 by the School of Public Health ofthe University of Indonesia concluded, inter alia, that: (i) project inputshad been sufficient to support the scheme, 224 physical facilities of varioustypes had been constructed, but additional assistance from local consultantswas needed; (ii) the content of training for acceptor groups had been relevantto their needs, but the 2-3 day training was too short, and better needs-assessmentwould have helped; (iii) the local village government had played an importantrole in mobilizing the participation of various sectors in implementing thescheme; (iv) some acceptor groups felt that the amount of money they received

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as a loan was insufficient to have any meaningful effect on their income, andthat for certain economic activities (such as cattle-raising) a one-year loanperiod was too short (funds were to be used on a rotational basis); (v) themonitoring and reporting system bad been too complicated and of limited usefulness;(vi) the number of contraceptive acceptors had increased significantly in thepilot areas, partly due to the CIS, and some acceptors had converted from lesseffective to more effective methods; and (vii) the intensity of service deliveryand the involvement of women in economic activities had increased.

3.34 Rowever the study did not evaluate the results of the pilot schemeagainst its original or revised objectives, using criteria such as cost-effective-ness, potential for replicability, actual or potential effect on fertility rates,effect on incomes and standards of living, suitability of institutional arrangements,and impact on socio-economic relationships. Thus, although selected villagecommunities seem to have benefited directly, there is little data for makingbroader generalizations based on the design, implementation and evaluation ofthe scheme. At the national program management level, the pilot scheme hasbeen unable to provide clear guidance on how the links between contraceptiveacceptance and socio--economic development could be strengthened in Indonesia.Nonetheless, the GOI considers the scheme to have yielded substantial benefitsfor individual communities and is expanding the program to cover other partsof the country, including transmigration areas.

C. CONSTRUCTION AND PROCUREMENT

3.35 yivil Works. The project's construction component, its largest loancategory (87.7 million), got off to a slow start, despite the fact that anexperienced works organization--the staff who had worked in the Project Imple-mentation Unit of the first project-- was already in place in the NFPCB. Siteidentification and acquisition had been completed soon after loan effectiveness,but the finalization of architect's contracts and tender documents was delayedby about one year. Part of this delay was due to the NFPCB's reorganizationin 1978, but an additional reason was that GOI procedures required approvalof on-site supervision costs on an annual basis, after building costs for thatyear had been determined. As a result, there was initial difficulty in includingresponsibilities for on-site supervision in the Architect's agreement, as originallyintended. Instead, arrangements had to be made for the staff of the PublicWorks Department to undertake this work, in their capacity as advisers to ProvincialChairmen of the NFPCB, and as members of the building implementation committeesat the provincial level.

3.36 Subsequent delays in construction were caused by flooding in someproject areas, and by the devaluation of the rupiah by 502 in November 1978.In anticipation of higher prices following devaluation, building materials werein short supply, and contractors slowed the pace of work until BAPPENAS issuedguidelines on increases in contract amounts. In addition, finalization of thecontract for the National Family Planning Training Center (NFPTC) was delayedby difficulties encountered by the NFPCB in obtaining a building permit fromthe Jakarta Provincial Government. Issuance of this permit was held up becausecity regulations required a minimum of an eight-story building whereas the originalplan was for a four-story building.

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3.37 A further complication arose soon thereafter. The reorganizationof the NFPCB in 1978 resulted in a major increase in staff and an acute shortageof office space. Thus, the NFPCB now wanted to build an eight-story buildingwith the top four floors financed by the Government. However, the issue waswhether to tender again for these additional floors, as required by a PresidentialDecree (No. 14A dated April 1980). The State Secretariat took several monthsto grant exemption from this regulation, and to allow the new contract to begiven to the builder of the first four floors. It also took several monthsto obtain the Bank's approval for reimbursing the cost (US$305,000) of air-condi-tioning, fire protection, elevators, and sunshades for the entire building.

3.38 Construction of the entire eight-floor building was completed by endof 1981, two years behind schedule. The 10 provincial training centers and10 provincial offices had been completed a year earlier. The revised estimateof total construction and furniture cost showed a saving of US$3.5 million fromthe loan amount, primarily due to the effect of devaluation.

3.39 The first four floors of the NFPTC building were originally meantfor training activities and offices for staff. Since July 1984, however, theNFPTC occupied barely two floors, and the other two floors were used for officesby NFPCB staff. This is largely attributable to the NPPCB's reorganizationin 1983, which created new bureaus and new staff. Of the two floors presentlyallotted for training purposes, one is used as offices for training staff, leavingonly one floir for educational and training activities and as dormitory space.The space for training offices is also congested: each room has 7-8 staff members,instead of the 3-4 originally intended. A new NFPTC building is now plannedto be constructed under the fourth project.

3.40 The 10 PTCs and P0s have now been in use for 4-5 years, and most ofthe buildings are in satisfactory condition. Classrooms and offices in thePTC in North Sulawesi were, however, destroyed by a fire in 1982, apparentlycaused by an electrical short circuit. The building has been rehabilitatedby the GOI. The PTC in Aceh suffered damages due to a severe earthquake in1983, but has also been completely rehabilitated.

3.41 The buildings in West and South Kalimantan also encountered problems:some of the floors were slowly sinking. The sites were previously swampy areas,as is the rest of the land in these two provinces. Buildings in these provincesare usually built on foundations made from a special type of water-resistantwood. Floors of buildings are also usually wooden, supported by stilts a fewmeters above the ground. As would be expected in these circumstances, concretefoundations and cemented floors, such as those used for the PTCs, have a naturaltendency to sink. The NFPCB is reported to be continuously monitoring thisproblem, and has made provisions in its annual budget fir rehabilitation ifit should become necessary; but the problem should obviously have been avoidedat the building design stage.

3.42 A different problem is faced in regard to two-story dormitory buildings:water pipes leak from the bathrooms on the second floor, with water accumulatingin the rooms below. The problem is probably caused by low quality, domesticallyproduced pipes: at the time these buildings were constructed, the PWD had apparently

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not established quality standards for such items. Nere again, the NPPCB hasprovided in its budget for repairs; but the problem should have been detectedearlier by the consultant architects who were responsible for supervising con-struction.

3.43 An additional problem is space constraints in the 10 Provincial Offices:space originally intended for 42 persons is now used by 70-80 people; and 2more divisions (with 27 additional staff) have already been sanctioned, followingthe 1983 reorganization of the NFPCB. These positions are not yet filled, butthe NFPCB provincial chairmen are understandably concerned about their potentialimpact on space availability. In addition, NPPCB staff strength could increasefrom 27,900 in 1984 to 67,500 by 1989. The space problem could become worse;but, of course, such large increases in staff requirements could not have beenforeseen in 1973-77, when the second project was being designed.

3.44 Procurement. The purchase of most items originally included in theproject proceeded smoothly, but new items included after 1981 faced problems.All furniture for the various project buildings (NFPTC, PTCs and P0s) was procuredcentrally in Jakarta, and was available for use in provincial buildings withinone month of their completion. As of July 1984, this furniture was still inuse in the provinces, and was in fair condition. Vehicle procurement was doneby international competitive bidding (ICB). There are problems of spare partsavailability, possibly due to logistical difficulties within the NFPCB. Procurementof boats was cancelled (para 3.03). Special equipment was procured by localcompetitive bidding, generally without problems.

45 In 1981, Government suggested that US$3.8 million out of loan savings?para 3.48) be used for prrchase of 63,000 bicycles (10,000 for NFPCB fieldworkers, and 53,000 for family planning volunteers, one in each village). Afterobtaining Bank approval, prccurement by ICB was initiated in March 1982, anda list of three lowest bidders was informally announced. Subsequently, however,citing State Secretariat policy, the bid evaluation committee, supported bythe NFPCB, wanted to award an exclusive contract to the firm submitting thesecond lowest evaluated bid, on grounds that this firm would manufacture bicyclesusing only domestic products, and also offered the "lowest" price, excludinglocal distribution costs. The Bank objected to this decision, stating thatboth reasons given by Government were unacceptable because: (i) domestic manu-facturers already had a 15% price preference, as per the Bank's procurementguidelines, and any additional preferences were not permissible; and (ii) thebidding documents had specifically asked that quotations include local distributioncosts, and therefore bid evaluation could not exclude this item. After protracteddiscussions and lengthy correspondence between the NFPCB and the Bank, the lattercancelled (in February 1983) a sum of US$3.8 million from the loan amount, onthe grounds of misprocurement. The Government procured only 9,500 bicyclesfor its field service program.

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3.46 Problems were also faced in procuring teaching kits and slides, andpublic address units, all out of loan aavings. In each case the GOI's initialdecisions conflicted with the Bank's procurement guidelines; and after extendedcorrespondence, the GOI agreed to abide by the Bank's requirements.

D. DISBURSEMENTS AND CQSTS

3.47 Disbursnts. Annex 3 shows that actual disbursements lagged behindappraisal estimates by large amounts throughout the implementation period.In September 1979, two years after effectiveness, only VS$2.7 million had beendisbursed against an estimated US$15.0 million. The Bank supervision missionidentified the following major reasons: (i) the slowdown in construction; (ii)lingering effects of the November 1978 reorganization of the NFPCI; (iii) delayin starting the community incentive scheme; and (iv) change of plans for theNFPTC, from a 4-story to an 8-story building. The following additional reasonswere identified in 1980-81: (1) reduced loan requirements (from US$24.5 millionto U8$18.6 million) due to devaluation by 51% in November 1978, and the speedwith which the NFPCB awarded contracts, thereby saving on price and physicalcontingencies; (ii) the use of lower standards approved by BAPPENAS than thoseused in the appraisal estimates (for studies, workshops and seminars), and lowerbid prices for vehicles and training aide; (iii) delays in submitting reimbursementapplications for construction work already completed; and (iv) delays in initiatingtht contraceptive raw material feasibility study, and population education activi-ties.

3.48 By January 1982 only US$10.1 million had been disbursed, leaving abalance of US$14.4 million to be disbursed by the loan closing date of April30, 1983. Meanwhile, the savings, estimated as US$7.1 million (US$3.3 millionof which was due to the unutilized "unallocated" category) had been reallocatedfor the purchase of additional special equipment. A second reallocation wasdone in February 1983 when the US$3.8 million for bicycles was cancelled (para3.45). The balance was to be spent for purchasing more medical equipment, publicaddress units, reprinting of films and books for population education, and forhiring financial management consultants, thereby supplementing the ongoing activitiesof the First and Third Bank-funded projects. The loan closing date was alsoextended to April 30, 1984.

3.49 A third reallocation was done in October 1983 to utilize the estimatedsavings of US$2.4 million for audio-visual equipment and staff training (seeAnnex 4). As of that date, US$14.1 million (68%) of the revised US$20.7 millionloan amount had been disbursed. Meanwhile, to speed up disbursements, the Bankhad agreed to reimburse against certified statements of expenditure (insteadof receipts), in respect of activities undertaken in widely dispersed areasof the country.

3.50 By March 1984, just one month before the revised loan closing date,the entire US$20.7 million loan was fully committed, but US$6.5 million hadyet to be disbursed. The loan account was kept open up to September 1984 to

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permit full disbursement of the loan proceeds. The final disbursement positionas of August 29, 1984, when the undisbursed balance of US$0.86 million was cancelled,was as given below.

Final Disbgrsement Position-US $.Million

original Final FinalLoan Reallocation Disbursement

Cateitory Asieemnt (Oct. 1983) (Ana 12A)

I. Civil Works 7.7 4.5 4.5

11. Furniture and specialequipment 3.9 5.8 6.2

III. Vehicles 3.5 3.1 3.0

MV. Consultants, Services andFellowships 1.7 1.5 1.1

V. Operational Costs ofStudies/Workshops 3.3 1.6 1.7

VI. Production and Cost ofTraining Aids 1.1 4.2 3.3

VII. Unallocated 3.3 - -

TOTAL LOAN ANOUNT 24.

A/ US$ 3.8 million was cancelled due to misprocurement.b/ US$ 0.9 was cancelled.

3.51 Csts. In March 1985, the 001 estimated the total cost of the completedproject as US$94.4 million, compared with the appraisal estimate of US$60.0million. The itemized breakdown was as follows:

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Appraisal Actual CostUn Coat Istima (US$Million)

1. Civil Works 10.8 9.0

2. Vehicles 3.2 4.0

3. Special Equipment and Materials 2.3 8.4

4. Seminars and Workshops 0.9 0.4

5. Surveys and Evaluation 2.5 2.7

6. Preparation and Productionof Training Aids 1.1 0.9

7. Fellowships and Advisers 0.7 1.1

8. Audio-Visual Aids/Reprinting of Films - 2.0

9. Incremental Operating Costs 22.8 65.9

10. Contingencies 15.7 -

TOTAL 60.0 94.4

3.52 Of the US$94.4 million, a sum of US$19.8 million was disbursed underthe Bank loan. The activities originally included in the loan were estimatedin February 1983 to have cost only US$14.1 million; the rest was used for newitems added as a result of reallocation of savings (parse 3.48 and 3.49). TheGovernment's share of project costs mainly covered incremental recurrent expendituresfor salaries, maintenance, and operating costs, as well as site developmentcosts for land purchase, building fees, taxes and surveys. Of the estimatedUS$75 million provided by the GOT, roughly US$68 million (more than triple theamount estimated at Appraisal) was used for incremental operating costs. Thissubstantial increase is attributed to the unforeseen increase in NFPCB personnelby about 4002 since loan signing in 1977 (with proportional increases in staffassociated with project activities, such as the NFPTC, PTCs, POs, PopulationBducation, etc.). Operational costs for salaries, incentives and supervisioncosts have also risen, but exact figures are not available. The Governmentfinanced these additional operational costs from its own resources.

3.53 Government has submitted audited annual accounts regularly, but withminor delays.

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IV. PROGRAM PERFORMANCE AND PROJECT SUPPORT

4.01 By the end of REPELITA III in 1983-84, the program had achieved thefollowing results: new acceptors, 5.2 million in 1983-84; current users, 14.4million; couple years of protection, 12.4 million; years of effective protection10.3 million, or 42 percent of the 24.5 million eligible couples. The crudebirth rate (CBR) was estimated to have declined to 32 per thousand, and totalfertility rate (TR) to 4 (see Annex 6 for details of program achievements duringREPELITA III). Although some of these figures might not be completely accurate--andsome observers have suggested that the figures be discounted by 202, (the fourthproject includes components that will help NFPCB improve the precision and re-liability of its service statistics) -the overall program performance is nonethelessimpressive.

4.02 In Other Islands I, as per NFPCB's service statistics, the numberof new acceptors increased from 350,000 in 1979-80 to 730,000 in 1983-84 (86.6%of the target). About 3.1 million persons were estimated to be current users(as of May 1984)-roughly 51.7% of the eligible couples-compared with 75.7%in Java and Bali. (Appraisal targets were 25% and 35% respectively, for theother islands and Java and Bali, para 1.11). Although there are considerablevariations among the 10 provinces of Other Islands I, the trends in contraceptiveacceptance and total fertility rate are favorable for all the provinces coveredby the second project. As indicated in Annex 7 the targets of new acceptorsfor 1983/84 in all the provinces on which the second project was focused, wereall exceeded, with the exception of the target for West Nusa Tenggara. Trendsin current users also show sharp increases during the period 1977/78 to 1981/82(Annex 8). An examination of the profile of new acceptors in these provincesreveals that their average age had declined from 30 years to 27 years by 1982/83.This drop in the median age has also contributed to the fall in the total fertilityrate in the ten provinces. The number of children born to new acceptors alsoshowed a downward trend-from 4.2 in 1974/75 to 3.1 in 1983/84.

4.03 The First Project had succeeded in getting the support and commitmentof GOI and international aid agencies to the family planning program, and enablingthe program to make the transition from a clinic-centered approach to one basedon an outreach network. The Second Project was designed to support and expandthe national family planning efforts beyond Java and Bali. This was accomplishedthrough the improvement of motivational and contraceptive delivery services,as well as improvement of program management, supervision and professional skillsat the central and field levels.

4.04 The Second Project set out to achieve a number of objectives, oneof which was to extend the mobility of family planning field staff to enablethem to extend services to remote areas. Project inputs, in particular physicalfacilities such as training centers and vehicles, have played a major role inmeeting this objective. Without these facilities, extension of the family planning

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program in the Other Islands would have not been possible. The number of nevacceptors as well as current users have been increasing substantially, not onlythroughout the co-utry but also in Other Islands I.

4.05 The provincial training centers in Other Islands I, built with projectfunds, have trained over 42,000 participants since 1979. The training of familyplanning staff as well as community leaders was essential to enable extensionof service delivery beyond Java and Bali.

4.06 A number of factors contributed to project achievements. The amountof 001 counterpart funding, which accounted for over three times the amountestimated in the appraisal, is indicative of the continuous political commitmentand support of the family planning which have contributed to program success.The impressive increase in family planning personnel in the last five yearsalso reflects the importance that the GO accorded to institution building.Other factors contributing to the success of the Indonesian program are thefollowing: (i) a relatively long, unbroken period of national political stabilitysince 1966 when President Subarto established the new Goverament; (ii) a strongpolitical commitment to family planning; (iii) the Javanese acceptance of authority,and an astute adaptation of institutional mechanisms of the national programto use it to advantage; (iv) an emphasis on community as compared to individualacceptance of family plenning; and (v) the strategy of creating a social movementthrough family planning. /

4.07 However, there are future concerns that need careful attention. Amongthese are: (W) the present socially-imposed motivation of couples to continueusing contraception. There is a possibility that the number of contraceptiveusers will decline if community pressures are reduced, thus making the use ofalternative mechanisms (such as beyond family planning incentives and income-generating activities) necessary; (ii) the need to devise, especially for OtherIslands, alternatives to the current motivation strategies, in keeping withthe tendency of non-Javanese to be less amenable to central authority figures;(iii) the need to fulfill the program's economic claim that fewer children meanan overall improvement in the quality of life for the individual and the community;and (iv) the need to improve institutional mechanisms lor demand creation, especiallyin the region inhabited by non-Javanese ethnic groups. / These concerns areof a long term nature, and the NFPCB has already begun devising strategies totackle them.

4.08 Some of these concerns are, however, already being addressed. TheMarch 1983 reorganization of the NFPCB and MON, and the creation of a separateMinistry of Population and Environment (MOPE) are expected to have a positive

3/ For details see Jay Parsons, "What Makes the Indonesian Family PlanningProgram Tick," POPIUL Vol. 11, No. 3, 1984, pp. 11-16.

/ For details, see Jay Parsons, jhL., pp. 16-19.

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impact on future population-related activities, by separating the broader population-sector policy concerns of the MOPE from the complementary, but more specialized,family-planning oriented activities of the NFPCB. According to the Bank missionin July 1983, some improvements were already noticeable. Other unmet needsare expected to be addressed by the fourth population project, which emphasizesthe following: (i) intensifying population education activities nationwide;(ii) adopting different information, education and communication (IEC) strategiesfor different areas, depending on levels of contraceptive acceptance; (iii)improving contraceptive services through research and training; (iv) strengtheningprogram management through manpower development and training; and (v) decentralizingprogram administration further to lower levels.

V. MN PERPORMANCE

5.01 The Bank helped the Government of Indonesia, particularly the NFPCB,strengthen and expand its national family planning program. The overall strategyof this program was reviewed in 1973-74, at the very early stages of projectpreparation, and the Bank fully supported GOI's decision to: (i) rely moreon mobile service-delivery and community-oriented motivational activities thanon static clinics, and (ii) to expand the national program to the Other Islands(pars 1.11). The Government also wished to strengthen its decentralizationefforts, and to improve the effectiveness of its population education and trainingactivities at headquarters and field levels. Both these activities were receivingsupport from the ongoing first project (pars 1.10). In addition, developmentalactivities, such as the community incentive scheme, were included.

5.02 The project was conceived in May 1973 merely as Phase II of the firstproject, with project components essentially providing more of the activitiesincluded in the first project. Soon thereafter, NFPCB sug6--sted an entirelynew package addressing the broader population issues, but the Government taskforce continued to regard the proposed project as an interim credit. In response,Bank staff proposed that the Go adopt an integrated view of each component,considering all relevant aspects, not merely items for which funding was sought.

5.03 During the next two years, Bank involvement was intensified; and amajor project was developed with assistance from Bank staff and consultants.Background data for a national program covering the next 10 years was also preparedby 001 to provide the context for justifying various project components. Inaddition, the scope of the project was expanded to cover construction activities,and the estimated project cost increased from US$6.3 million to US$35.6 million(Annex 1, para 11).

5.04 Thus, the Bank's primary contribution during project preparation wasto focus Government attention on the broader policy framework, help developmedium-term plans, and assist in finalizing an overall program within whichthe project could play an essential role. This policy dialogue was necessarilyslow and arduous, and project preparation took 4 years instead of the usual

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2 years. The benefits were, however, substantial. The policy dialogue continuedthroughout the project implementation period, and served both the 001 and Bankwell, especially during the preparation of the third and fourth projects.

5.05 Despite the long preparation period, and the close collaboration ofGO and Bank officials, all aspects of the project were not prepared equallywell. As discussed earlier, the Community Incentive Scheme could not be launchedwithout substantial redesign (para 3.28). The merits of the original designaside, its preparation can, in retrospect, be considered inadequate, at leastin the sense that genuine differences of opinion on its concept and feasibilitywere not sufficiently reconciled praor to approval. These differences in pro-fessional judgment continued well into the fourth year of project implementation,when the redesigned scheme was approved by Bank staff, partly to avoid furtherdisbursement delays. In addition, although project vehicles were generallyuseful, in a few provinces they are considered inappropriate or too small foreffective use (paras 3.03 and 3.04). It would obviously have helped if GOrand Bank staff had spotted these potential problems during preparation, possiblythrough more intensive field investigations.

5.06 Implementation schedules set at appraisal also proved unrealistic.The expectation that research would be completed in three years, constructionin two years, and software (fellowships, workshops, seminars, etc.) would beutilized effectively within a few years were not met. For civil works, costand architectural design standards set at Appraisal were considered too highby BAPPENAS, which later insisted that its own guidelines take precedence overappraisal estimates. A similar cost savings was achieved by BAPPENAS for itemssuch as seminars, workshops, consultancies, and fellowships, etc. (para 3.46),for which a substantial sum (US$5.0 million) had been allocated under the loan(para 2.09). Despite these changes, there is no evidence to suggest that thequality of construction suffered more from lack of money than due to th reasonscited earlier (in paras 3.40 and 3.41). A separate evaluation of effectivenessof the software delivered under the project has not be undertaken.

5.07 During project implementation, major changes were introduced by theGovernment; for example: the currency devaluation in 1978, NFPCB's reorganizationin 1978 and 1983, the Ministerial Decree to extend the 1979 school year, andthe decisions to build an eight-story NFPTC, completely redesign the communityincentive scheme, and enforce stricter control over fellowships, study toursand other costs. These policy decisions caused delays in project implementation.

5.08 Delays were also caused by differences of opinion between 001 andBank staff on matters such as design of the CIS, procurement of bicycles andspecial equipment, hiring of local consultants for population education etc.;these were resolved only after lengthy discussions within and between the concernedagencies. However, on matters such as reallocation of savings, documentationneeded in support of reimbursement applications, and extension of the loan closingdate, both sides were able to proceed much faster. As a result, savings couldbe utilized soon after they were identified, and performance improved considerably.

- 62 -

5.09 The two areas in which project performance might have improved withmore timely and appropriate action by Bank staff were the oral contraceptivesraw material feasibility study (paras 3.21-3.25), and construction supervisionof PTCs (paras 3.40 and 3.41). The diversion of NFPTC space for office usemight have created some shortfalls in training quality and quantity, but Bankstaff probably could not have done much about internal staffing changes followingthe two reorganisations of the NFPCB. This problem is, however, being addressedthrough the construction of a new training building under the fourth project(para 3.38).

5.10 The Bank was willing to compromise with and adhere to the NFPCB'sdecision against setting up a Project Implementing Unit to manage the project.As noted in paras. 1.10 and 3.01, the NFPCB had encountered a number of problemswith the PIU structure during the First Project. Raving unlargone five yearsof experience in implementing the project, during which time program managementwas improved and strengthened, the NFPCB felt itself sufficiently competentto implement the Second Project through its existing administrative structure.The Bank has shown willingness to be flexible and to adjust to the borrower'sconditions. Similarly, the NFPCB was willing to compromise by retaining onesection of the former PIU to handle the civil works component because therewere no units within the current NFPCB organizational structure which can superviseand implement construction activities.

5.11 NFPCB would like to see some delegation of authority given to Bankresident staff in Indonesia (RSI). NFPCB feels that existing procedure ofsending all project matters for decision to Washington is often too time-consuming,and affects decision-making internally. This problem was minimized in the pastwhen the Bank had a population specialist in RSI.

5.12 Overall, therefore, Bank performance can be considered satisfactory.After a somewhat limited role during the first two years of project preparation,Bank staff and consultants suggested useful changes in project scope and design,and helped the Government finalize medium-term plans and programs that paidrich dividends in later years. Although for some activities more intensivefield supervision might have helped, most project components have been completedsatisfactorily.

- 63 -

6.01 The experience of the NFPCB in implementing the Second PopulationProject provides implications which should be taken into account in the planningand programming of future projects. It is important to note, for example, thedegree of complexity of internal administrative management had a significantbearing on project implementation. Implementation of the civil works and procurementof vehicles and equipment vent more smoothly than the software activities ofthe project. This is due to the fact that management of hardware activitieswas heavily centralized. Decision-making, control of funds and procurementwere carried out by central-level staff. The decision-uaking process for ahardware component is more clear-cut and straightforward and involved relativelyfew people, in that contractors were directly accountable to the Project Officerand his staff at the central level. There was only one level in the hierarchyto deal with in terms of decision-making, which facilitated and acceleratedimplementation. In addition, the assignment of full-time staff solely to concentrateon supervising the hardware components of the project was a positive factorwhich helped to accelerate the timely completion of civil works and procurement.

6.02 Decision-making for software activities seemed to be more elabortate,as illustrated by some of the more qualitative components of the project. Imple-mentation of the Population Education component, for example, while technicallydirected by the Center for Education and Training of the NFPCB, has been underthe coordination of the Ministry of Education and Culture.

6.03 The extension of program activities to Other Islands I was an importantstep in the evolution of the national program, and the project contributed signifi-cantly to this expansion. Although the implementation of population educationand training components was slow, their long-term impact on program performancewill be considerable. The research components encountered some problems, butwere eventually fully implemented.

6.04 Experience with the implementation of the second population projecthas shown that large-scale programmatic improvements, such as the institutional-ization of population education and execution of a broad-gauge strategy, includingbeyond family planning programs, such as income-generating activities, are extremelytime-consuming and effort-intensive, and their results can only be realizedin the long-term -- well beyond a five-year project period. The evolution ofthe broader concept of population, as opposed to the narrower one of familyplanning, started in 1973 and culminated in the creation of the Ministry ofPopulation and Environment in 1983. An important lesson from the experienceof this project is that a lot of background preparation is needed to createthe right circumstances for initiating major changes in program strategy andapproach; and the adoption of a gradual evolutionary process is the most feasibleway of doing this.

- 64 -

6.05 Another important lesson is that unforeseen contextual forces beyondthe control of both project managers and Bank staff often determine projectprogress, and the adoption of a flexible, adaptive approach to implementationis essential. An effective ongoing dialogue between Government policymakersand Bank staff has a significant influence on project outcomes. Follow-on projectsalso provide a medium for continuing a policy dialogue, as demonstrated by thefour Indonesian population projects. The perception of mutual gain can be cultivatedand sustained at all stages of the project, as was done in the case of the secondproject. A prerequisite for this is that the various agencies remain responsiveto changes in each other's thinking, and be willing to redesign the entire project(paras. 3.27 to 3.29, and 3.47 to 3.48). Procedural flexibility can also helpaccelerate disbursements (paras. 3.48 and 3.49). The need for a separate projectimplementation unit diminishes as the implementing agency gains experience inmanaging Bank-assisted projects (para. 5.10).

6.06 Although it is too early to assess the longer term durability of theproject's success-it was completed just one year ago-there is reason to beoptimistic. The project appears to satisf most of the generally accepted pre-conditions for sustainability of benefits. / For example: (i) civil worksbuilt under the project are in use, and funds are provided for regular maintenance(paras 3.39 and 3.40); (ii) institutional arrangements in the NPPCB and MONCare continuously being strengthened; (iii) a favorable policy environment remainsin place, and continues to adapt to changing environmental conditions (pars4.08); (iv) the Government remains fully committed, financially and politically,to long-term project and program goals (v) recurrent and incremental costs arebeing fully met from Government budgets (pars 3.51); (vi) the major implementingagencies (NFPCB, MOIC, NO) are well established, and retain their considerableautonomy over program matters (especially the NFPCB, whose Chairman reportsdirectly to the President, pars 1.05); (vii) a larger development process extendingbeyond family planning has been activated to support initiatives taken underthe project, and community involvement has been deliberately encouraged; (viii)socio-economic and cultural realities and traditions have been taken into accountduring program design and implementation; (ix) program objectives are ambitiousbut realistic, are consistent with implmentation capacity, and have generallybeen met; and (x) program managers are conscious of future needs and potentialproblems, and are taking anticipatory action to deal with them (pars 4.08).

6.07 A detailed quantitative assessment of the project's present and potentialimpact is, however, not feasible, partly due to methodological limitations butalso because the project overlapped with other Bank-funded projects. The imple-mentation of the second project overlapped with the first project during theperiod in 1977-80, with both the fa.'t and titird projects during the period1980-82, and with the third project in 1982-84. Other non-Bank funded activiti'swere also substantial during the period 1977-84. Reace, though it is difficultto isolate the project's contribution to program achievements, the project clearlyhelped strengthen the family planning program through infrastructural development,manpower development, service delivery, and information, education and motivationefforts in Indonesia.

5/ For details see Operations Evaluation Department's Tenth Anawal Reviewof roject Performance Audit Results. Vol I. (Report No. 5248, datedAngust 30, 1984), Chapter III, pp. 34-45 on "Sustainability of ProjectBenefits."

ANNEX 1- 65 - Page 1 of 3

PROJECT_BRUABTIDH--EY STAGES AnD EVENTS

1. In Nay 1973, a four-week Bank mission visited Indonesia to helpthe UPCB identify a project for IDA financing. It found the NFPCB, BAPPENASand NO staff very keen to have a second credit for Phase II of the ongoingFirst Population Project. Bank staff agreed that the inter-agency task forcefor family planning working on the Second Five-Year Plan should also be responsiblefor detailed project preparation, assisted by local and foreign consultants.Project components were identified tentatively as follows: construction ofMCR/PP clinics (8$5.0 million); construction of a national training center($3.0 million); management study of NFPC3 ($1.0 million); additional field workers($3.8 million); mobile service units ($0.2 million); INC ($1.0 million); populationeducation ($2.0 million); and technical assistance ($1.0 million). Total costof these population components was estimated at $17.0 million. In addition,a US$4.0 million nutrition component was identified.

2. Drafting of the Second Five-Year Population Plan was to be completedby November 1973. Project preparation was to start in January 1974, after Bankstaff had briefed the Government task force on the former's data requirementsfor detailed preparation and appraisal.

3. In December 1973, an expatriate adviser attached to NFPCB suggesteda re-examination of the assumption that Phase II should simply meet the shortfallsof the first project. Ne suggested that the second credit be an entirely newpackage (which might include extensions of Cr. 300 if needed), addressing Indonesia spopulation sector (not just family planning), perhaps through the establishmentof a new Population Planning Unit either in BAPPERAS or attached to the Officeof the President. Ne also thought NPCB staff was too busy or limited to doa really good job on the second credit planning; and suggested that Bank staffplay a mnch more active role in project preparation, in order to use its influenceand position to push 001 policy frontiers in the population field.

4. By early 1974, the Government task force had begun reviewingand appraising Phase I, and hoped to develop the second project in the followingsix months. Two separate teams had been formed for the population and nutritioncomponents since these were expected to be administered separately in the country.The Bank had agreed with 001 that the second project would be confined to Javaand Bali, would be implemented in 1976-79, and would be regarded as an interimcredit, prior to a general review of extended program assistance for a possiblethird project.

5. The three subcommittees of the task force (on training, mobilehealth facilities, and a population center, respectively) submitted their reportsin aid 1974, but these had not been considered by the population task forceuntil October. Meambile, a EWPA mission was expected in the next two mouths,to appraise a proposed project estimated to cost US$100 million. The Govern-,tat

-66- ANNEX 1Page 2 of 3

preferred grant assistance, and also hoped that UNFPA's project preparationand supervision requirements would be less stringent than the Bank's.

6. The population task force met in November 1974, and decided torequest Bank assistance for US$2.4 million. The 001 proposed that the Bankfinance items such as fellowships, experts, transport, equipment, etc. Constructionactivities were to be specifically excluded since the Government planned toexecute these entirely from its own resources, using BAPPENAS' cost guidelines,which were much lover than the Bank's. A US$6.3 million project was tentativelyagreed upon in April 1975. It included $1.5 million for mobile service units,$0.5 million for tectaical assistance, $3.0 million for equipment and vehicles,$1.0 million for training, and $0.3 million for a feasibility study of contraceptiveproduction in Indonesia.

7. However, since more detailed justification for each componentwas considered necessary by Bank staff, appraisal was postponed to Fall 1975.Bank staff suggested that GO proposals take an integrated view of each component,to cover all relevant aspects, not merely the items for which funding was tobe sought. It was suggested, as an example, that since the project visualizedthe appointment of nearly 50 additional staff in the National Training Center,the project proposal should identify how the Government planned to finance thebuildings, fellowships etc. that would be needed.

8. Soon thereafter, the Government decided that only the nutritionproject should be appraised at this time; and that the population componentsshould be enlarged to cater to the needs of the 10 provinces in the other islandsto which the population program had been extended the previous year. Meanwhile,the Government task force had been abolished and NFPCB staff was given the responsi-bility for project preparation.

PREPARATION--PHASE II

9. With the split of the nutrition components from the populationcomponents, Bank staff felt it was no longer necessary to consider the secondproject as a limited, bridging project. A new approach was considered desirable.The October preparation mission was asked to help prepare a major project thatcould expand and strengthen the overall population program during the next 4-6years. By a fortunate coincidence, NFPCB was conducting a review of progressunder the current Five Year Plan; and was asked to extend its review to coverthe third Five-Year Plan period as well.

10. In addition, a Population Council specialist posted in Taiwanwas sent to Indonesia, at Bank expense, to help prepare the project. His termsof reference described the Government's earlier proposal as "a few, unconnectedpopulation components with no apparent justification, and not fully preparedfor appraisal." Bank staff felt that the work done thus far was not wasted,but hoped to go beyond a collection of components.

11. A preparation mission visited Indonesia in March 1976, with twoprimary objectives: to assist NFPCB prepare background data for a nationalprogram covering the next 10 years, and to help prepare individual componentsfor Bank appraisal. Its primary concern was that policy and program objectivesshould be translated into specific program activities to which the proposedproject could contribute--thereby providing the context for justifying each

ANNEX 1- 67- -~TT Page 3 of 3

component. The following four components were identified: () Training: nationaland provincial training centers, and provincial offices in 10 provinces of theother islands ($26.2 million); (ii) population education ($1.2 vmillion); (ii)a mobile services program ($8.2 million); and (iv) a contraceptive productionfeasibility study. Istimated total project cost was now 8S$35.6 million. Con-struction of the PTCs and POs was included, since it was considered essentialfor strengthening decentralized administration, thereby asking program evaluationand supervision more effective.

12. Appraisal was scheduled for 2 months later, despite misgivingsexpressed by various Bank consultants regarding NFPCB's wek planning capabilities,its lack of attention to medium-term issues, and the lack of detailed justi-fication for some of the components. No work had yet been done on the beyondfamily planning component, incorporating a pilot commanity incentive schemewhich was to have been prepared by BAPPERAS' Population and Kanpower Bureau.(Other components were being prepared by NFPCB's bureau chiefs). Despite this,Bank staff felt that an important aspect of its preparation support had beenthe development of the planning function in NFPCB. They felt that NFPCB's currentproblems were mainly due to its Planning Bureau's lack of experience and qualifiedmapow- , but also due to personality clashes among senior NFPCB staff.

一 C ぎ 一

メら丁 メ汐分 ごA》ん

- 69 - ARM 2Page I of 4

AINOn ZOPULCION PROJECT (LN 1472 -M)

counims vism wu mixigas

CovegAnt status

laction 3,02:The Borrower shall employ experts and arcbitec- Architectural consultants weretural consultants whose qualificationst employed to prepare plans andexperience and terms and conditions of employment tender documents and to super-shall be satisfactory to the Bank. vise civil vorks.

82etion 3.01:The Borrower shall make arraugments Arrangements satisfactory tosatisfactory to the Bank to monitor from time the Bank were made.to time the maintenance and operation of the Monitoring of operation andvehicles provided under the Project during the maintenance was carried outproject implementation period. by N FPC B.

Section 3,04:The Borrower shall, not later than four months Implementation of the schemeafter tbt end of each fiscal year of the started in Feb. 1981 and progressBorrower until thn completion of the Project, reports were submitted to thesubmit to the Bank for review a detailed Bank for review in June 1961,report on the progress of the community incen- Jan. 1982, Jose 1982 andtive scheme and consult the Bank on the July 1983.adequacy of the scope and form of such study.

Section 3,05:The Borrower shall, (a) within twenty months Progress reports were submittedafter the commencement, and (b) within three to the Bank in Sept. 1980,months after the completion of the feasibility June 1981, Jan. 1982, June 1982.study on oral contraceptive production using and July 1983. The scope andlocal raw materials, (i) submit to the Bank form of the study were adequate.for review detailed reports on (a) theprogress of the study, and (b) the oral contra-ceptive needs and sources of supply for theBorrower's family planning program. and(ii) consult the Bank on the technical andeconomic desirability of continuing thestudy.

Section 3,06(a):Insurance by the Borrower of the imported Met.goods financed out of the proceeds of theloan against hazards.

- 70 -MI.APage 2 of 4

ComeAnt Sau

Section 3.06(b):The Borrower shall cause all goods and services Met.financed out of the proceeds of the loan to beused exclusively for the Project until itscovt?letion.

Section 3.07:(a) The Borrower shall furnish to the Bank, Not.promptly upon their preparation. the plans,specifications, reports, contract documentsand work and procurement schedules for theProject. (b) The Borrower snall () maintainrecords adequate to record the progress of theProject, and (ii) shall enable the Bank'saccredited representatives to visit the faci-lities and the construction sites...and toexamine the goods financed out of the proceedsof the loan.

Sectioll 3.08:(a) The Borrower shall take necessary actions to Land was acquired in time,acquire not later than October 31, 1977 land proposals for location ofrequired for construction and operation of provincial training centersProject facilities. (b) the Borrower shall were submitted to the Banksubmit to the Bank for approval its proposals for and approved.the locations of the Provincial Family PlanningTraining Centers and the NFPCB provincial offices.

Section 3.09:The Borrower shall provide to the boundary of Net.each site connecting roads, sewerage, power,water and other supporting facilities.

Section 3.10:The Borrower shall cause NFPCB to appoint, on a All these staff were appointedfull-time basis, not later than October 31, 1977 in time.qualified and experienced officers in adequatenumbers, including at least I constructioncoordinator, 2 engineers, 4 job captains,2 draftsmen and the necessary supporting cleri-cal staff to carry out the Project's civilworks.

- 71 - ANNU 2Page 3 of 4

CVeant Statul

Sectign 4.02:(a) The Borrower shall maintain records adequate Net.to reflect the operations, resources and expendi-tures of the departments or agencies responsiblefor execution of the Project.(b) The Borrower shall cause NFPCB to have Project Delays experienced in someaccounts audited for each fiscal year of the years, but covenant met.Borrower and submitted to the Bank together withthe auditors' report and any other relevant infor-mation.

Schedule 4 A:Contracts for the purchase of vehicles shall be Met.procured in accordance with procedures consis-tent with the guidelines for Procurement underWorld Bank Loans and IDA Credits.

Schedule 4 B:Contracts for furniture, equipment and materials Met.procured in packages and contracts for civil worksshall be let on the basis of competitive biddingadvertised locally, under procedures acceptableto the Bank.

Schedule 4 B.2:The Borrover may procure items of furniture, All furniture wasequipment and materials in packages esti- procured in accordancemated to cost less than the equivalent of with this provision. The$10,000 without resort to competitive GOI complied with thebidding advertised locally, provided that: covenant with respect to the(i) such items are procured on a basis of procurement of materials andreasonable and competitive procurement equipment.procedures; and (ii) the total cost of suchitems procured pursuant to this paragraphdoes not exceed a maximum amount of $200,000.

Schedule 4__C.1ror purposes of evaluation and comparison of All vehicles werebids for the supply of vehicles: (i) bidders procured by importationshall be required to state in their bid the in accordance with thisc.i.f. (port of entry) price for imported covenant.goods, or the ex-factory price for domesticallymanufactured goods; (ii) customs duties and otherimport taxes on imported goods, and sales andsimilar taxes on domestically-supplied goods,shall be excluded; and (iii) the cost to theBorrower of inland freight and other expendi-tures incidental to the delivery of goods tothe place of their use or installation shallbe included.

- 72 - AM 2

Page 4 of 4

Covenant Status

Schedgle 4 C.2:Goods manufactured in the Republic of Indonesia Met.may be granted a margin of preference.

Schedule 4 D.1(a):The Borrower shall furnish to the Bank for Net.comments the text of invitations to bid forfurniture, equipment and materials in packagesestimated to cost the equivalent of $50,000 ormore and all civil works contracts and the speci-fications and other bidding documents, and shallmake such modifications in the documents orprocedures as the Bank shall reasonably request.

Schedule 4 D.1(b):After bids have been received and evaluated, the met.Borrower shall, before a final decision on theaward is made, inform the Bank of the name of thebidder to whom it intends to award the contract andshall furnish to the Bank, in sufficient time forits review, a detailed report on the evaluation andcomparison of the bids received, and such otherinformation as the Bank shall reasonably request.

Schedule 4 D.1(c):The terms and conditions of the contract shall Met.not, without the Bank's concurrence, materiallydiffer from those on which bids were asked.

Schedule 4 D.1(d):Two conformed copies of the contract shall be met.furnished to the Bank promptly after itsexecution and prior to the submission to theBank of the first application for withdrawal offunds from the loan amount in respect of suchcontract.

Schedule 4 D.2:The Borrower shall furnish to the Bank, promptly met.after its execution and prior to the submissionto the Bank of the first application for with-draval of funds from the loan account in respectof such contract, two conformed copies of suchcontract, together with the analysis of therespective bids, recommendations for award andsuch other information as the Bank shallreasonably request.

- 73 Page 1 of 1

amp=IJL gj RISBUSMMS

Cumulative Digbarsements (0US$ Million)Actual or Latest

Fiscal Year Estimated Disbursementsand Actual Appraisal as 2 of

.0arter Radin Total Bstimate Aneraisal atimate

June 30, 1978 0.02 1.0 2

September 30, 1978 0.5 2.1 23December 31, 1978 0.5 3.3 15March 31, 1979 1.2 7.2 17June 30, 1979 1.8 9.8 18

September 30, 1979 2.7 15.0 18December 31, 1979 3.1 17.4 18March 31, 1980 3.4 19.6 17June 30, 1980 4.8 20.2 24

I=September 30, 1980 6.8 20.8 33December 31, 1980 7.9 21.0 38March 31, 1981 8.4 21.4 39June 30, 1981 8.7 21.6 40

SEpSeptember 30, 1981 9.7 22.0 44December 31, 1981 9.8 22.3 44March 31, 1982 10.3 22.7 45June 30, 1982 10.3 23.0 45

September 30, 1982 11.7 23.4 50December 31, 1982 12.5 23.9 52March 31, 1983 13.6 24.3 66 JJJune 30, 19PI 13.9 24.5 67 J

ESeptember 30, 1983 14.1 20.7 1/ 68 jDecember 31, 1983 14.2 - 69JJWarch 31, 1984 14.7 - 71JJJose 30, 1984 16.5 - 80JJ

September 31, 1985 19.8 - 96 j

Closing Date 4/30/84 4/30/83

I/ Actual or latest estimated disbursements expressed as a percentage of thereduced loan ameount of $20.7 million (after US$3.8 million vae cancelledin February 1983).

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DISBURSEMENTS ANY) COSTS BY LOAN CATEGORY

(US Dollars)

REVISED Rzy BED REVISED ACTUAL ACTUALORIGINAL ALLOCATION ALLOCATION ALLOCATION DISSURSHENT DISSURSHENT

MOS. CRTAGORY L40AN JAN 28, 1982 rZB 25, 1983 OCT 11, 1903 HrPC8'S RECORD WORLD BANK'S XMX*M(1) (2) (3) (4) M (6) (7) (a)

1. CIVIL WORKS 7.700.000 4.S73.000 4.S73.000 4.S73.000 4.S36.036,93 4.S17.SO3,41

2. mWITU . EQUIPMENT, 3.900.000 7.085.000 5.908.000 S.800.000 6.640.126*% 6.216.364,31

MATERIALS

3. VEHICLES 3.500.000 7.132.000 3.3S2.000 3.020.000 3.005.158,67 3.OOS.IS8,67

4. CONSULTANTS, EXP 1.700.000 1.821.M' 1.821.000 1.SOO.000 1.274.204,15 2.086.156.96

SERVICES & FELLOWSHIP

S. OPERATIONAL COM OF 3.300.000 2.883.000 2.983.000 1.620.000 1.478.756,94 1.697.2",63

STUDIES, W0RXSH0PS#SEMINARS

6. PREPARATION, PRODUCTION 1.100.000 899.000 2.163.000 4.220.000 2.902.180,S8 3.311.977.25

AND COST OF TRAINING

AIDS

7. UNALLOCATED 3.300.000 107.COO - -

8. CANCELLATION - - 3.800.000 3.800.000

T 0 T A L 24.500.000 24.500.000 24.SOO.OOO 24.SOO.000 19.936.464,43 19.636.464*43

Source: NFPCB, June 1985.

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TOTAL COSTS BY EXPENDITURE CATEGORY

(US S Million)

I T E M APPRAISAL ES77MTE ACTUAL COST

LOCAL FOREIGN TOTAL LIDCAL FOREIGN TOTAL REMARKS

CIVIL WOWS 9.3 1.5 10.8 4.44 4.54 8.98

VEHICLES 0.2 3.0 3.2 2.0 3.0 4.0 US $ 0,863 million was undis-

SPECIAL EQUIPMENT 0.1 2.2 2.3 1.76 6.64 6.4 bursed balance, due to can-

MATERIAL cellation of purchaginq pgqinq

SE14INAR & WORKSHOP 0.8 0.1 0.9 0.33 0.1 0.43 sYstem and tender results was

SURVEYS & EVALUATION 2.1 0.4 2.5 1.31 2.38 2.69 under budqet allocated.

PREPARATION & PRODuCTIom or

TRAINING AIDS 0.9 0.2 1.1 - 0.9 0.9

FELLOASHIP & ADVISORS - 0.7 0.7 1.1 1.2

AVA, REPRINTING OF FILMS - - - - 1.96 1.96(NEW PLAN)

INCREMENTAL OPERATING COSTS 22.8 - 22.8 65.94 - 6S.94

CONTINGENCIES 13.2 2.5 IS.7 - -

70TAL 49.4 10.6 60.0 74.78 19.62 94.4

Source: NFPCB, June 19850"II.J

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M~ VW~ -DUIMW REMITA 111

T~ and Adbkwa~ d dø b nøie in P~ M19"/l~ - 196311~

Od~ T~ Aemb~ T~ -6-6 MW Åa~ Ad*h~ CU Adde¥ýt

New cu cu N~ a~ % ~ % k~hw cu %ora on an t~ ~ tuvt dem~

Jakarta 9^000 545.OW n3.661 540,OW 1.048.723 116,5 133,8 591,125 1^4 101,6

~ 1~ 3,100,000 I^ WD 2~,221 2.450.000 4~,319 139,3 145.7 3.073.311 184,3 125.4

c~trå lava 3.0W.WO 1.568.WO 3.050.695 2.5^0W 3.938.Z" 131.3 129,1 2~ 67 184.2 115,5

Jogyakatta 300.OM 154.WO 338.738 2%,000 283.951 94.7 83.6 298.327 193,7 IMS

Eut Ti~ 2,5W.000 3.M.000 2.664.503 3.352.OW 2.921.031 116,8 109.6 3.647.336 94.6 losj

8 A L l 2WAW 228.000 216.874 290,000 233,385 116,7 107,ý6 M~ 126.4 99.4

WEST SAU 10.000,000 8.000.000 9~.692 9.428,000 12.713.633 127.1 127.2 10,,776.234 134.7 114,3

oew 1~ l 2.9W,000 1,2W.000 3,?",W2 2~.000 3,748.4« 129,3 10" 3,137,226 261,4 111,8

Outer ~ds 11 600,OW 300~ 95619" 485,000 917.485 15" 95,9 SM.091 169,7 105.0

D~N~ 13.500.000 9,5W.000 14,659.660 12,719.000 17.379.592 128,>7 118,5 14,422.551 ISIA 113,4

Note: r~M~

source: Sahala *Pandjaitang t*The IndOneSian FafflUY Pla=ing PrOgram T=Plffl~tat'<m R~te 'nThree Five Year Development Pertods"j, IMCB Techuical Býort Seriest Nmo_a2_ 190.

«~: Jakartal, september 1984).

20

s à r & A-4'

-81- ANNEX 7Page 1 of 1

TARGET AND ACHIEVEMENT OF NEW ACCEPTORS AND CURRENT USERSBY PROVINCE, 1983/84

New Acceptors Current Uskrsprovince

TARGET Achievement % Achievement % against CUD. Acoh 38,562 57,408 148.8 169,693 40.8North Sumaters 169,048 227,869 134.7 658,261 52.2West Sumatera 68,268 86,158 126.2 234,449 46.6South Sumatera 88,484 133,183 150.5 353,433 48.3Lampung 76,500 142,762 186.6 380,150 46.2West Nusa Tenggara 125,349 60,304 48.1 231,538 55.1West Kalimantan 56,947 67,261 118.1 198,674 48.7South Kalimantan 29,701 49,685 167.2 183,636 52.9North Sulawd 39,964 69,339 173.5 206,195 64.3South Sulawest 146,683 115,883 79.0 521,197 58.2Other Islands I 839,506 1,009,852 120.2 3,137.226 51.2

Source: Sahala Pandjaitan: The Indonesian National Family Planning ProProgram Implementation Results in Three Five-Year DevelopmentPeriods, September 1984, Technical Report Series, MonographNo. 42, National Family Planning Coordinating Board.

一 汗 ，夕 一

戶舟 ．＇滲介一＇為 斤

- 83 - Annex 8Page 1 of 1

TRENDS IN CURRENT USERS PER 1,000 ELIGIBLECOUPLES IN OTHER ISLANDS 1, 1977/78 - 1981/82

Year Current Users

1977/78 95.7

1978/79 106.4

1979/80 137.5

1980/81 196.6

1981/82 269.7

Source: National Family Planning CoordinatingBoard, Basic Information on Populationand Family Planning Progr&r, 1982, p. 104.

É

A

- 85 - ANNEX 9Page 1 of 1

COMPARISON OF THE FOUR BANK-ASSISTED POPULATION PROJECTS

First Project eCd teject Third Project Furth Presect

1. IIChIFP Service Delivery

Construction of 95 IICHIFP Provision of sbtie service units Construction of in-patient For developing integrated me services

Centers in East Java and equipped with 1UD and public annem at 50 essting health tn transsigration areas. Provision41 and support for health nurse tits. centers io West nd Central of equipmt, 90 motorcycles for NFPCD

hospital and field post- Java- North, Vast and South sub-district-level supervisors and 600

partue progras. Sumatral and South Sulawesi. bicycles for NFPC9 fostly planningfieldworkly's, materIaSS, technical

Provision of transport for Construction, furishing and assistance, and funds for training

WtCHIFP staff. equipping of 21 provincial costs and baseli survey.wirthouses in the Other Islands

Salary support for 7,000 and 107 district warehouses io

fasilv planning firldworkers Other Islands I for storage andand sopervisory staff. distribution of contraceptives

Ono other supplies.

2. o eanages nSt

Construction, furnishing and Construction, furnishing and Construction, furnishing and Construction of 84 KFPCD district

equipping IFFPS headquarters equipping of I) NFPCD provincial eo.pping of I NPCI provincial offices in Other Islands 11

in Jakarta in6 6 provincial offices in Other Islands I. offices in Other Islands 11 ai d

offices in Java and Bali. 107 district offices in Other Cons,ructnon of 84 drFPCc districtIslands 1. offI616 in other Islands

Technical assistance and

Fellowship vapport for Provision of solorcgiles for Provision of 6,40 sotorcycles and

program sanagitAt and field coordinators and supervisors $7u bicycles, cosuni oation

implesentation, to isprove Itsupervision of the equiplent, and technical assistanceylc F planlyr.g prograp.

3. Training

Construction, furnishing and Construction, furnishing and Construction, varnishing and tinstruction of 1fili "abnang Center

equipping of 6 KFPCD provincial equipp,ag of FPC9 National Faily Oq6tpplng of It %fPCb proncial in Jakarta

training centers and 10 sub- Plap ling Training Center nd IV ilin (tnte?$, Other Islands I.

provincial training centers. provincial training centers ;n Fro,ision of 14019at"t, Vehifles,

Other Islands T. ehaintc of health center eoctors, tethnical Assistante, fellowships

Construction, furnishing and rsrn96 And midgiVind. and teachin oattfi Ps t

equipping of 9 auFilPryn0r7etidwife training schools, training of traditional birth

Attifdiots.

Pnoision of sitiruses and

littitlilts nor nurse tmwfnil

4. Information, odurton &Ad Cpsruv0ction

Provision f 115 aopile fi: t supervsf ootile Provision o equnret, a ehsile$,

Information onits, technical Iferreatimn VnIts. ttakil; 11thq1tal AssistdA(ii, are

assistance, fellowships ave latepials fit 07 mcll# 6nItI. tod

studies for I(C activities. _ppct fir ;Foviticn tf #F ts hete ppln1gporif atorials. 1e.01 IM ;,ts.

S. POPAon uction u h d ot

support for pilot pulotinci epport tfr Int nta F411tyt oc 01pasion aio C0 e

QdJCAtiDn cGIMpOntS. pDouletten foucati., tt'l,;h ;Itt4tation~ 00 pt;.1sivt~ IS'Laticnt all tetifl d2ut.s 'd 6E.k

propiatmotl on te.1trik WkAu mt ot i tirs, Iditaticosi ite, c t k.;vvi 4 ..k.d;b.

for cn e rnTrii ee.;r. a. i'lvuiro on-'leal V.,t6ti,n, 4t 6 ire $ illi f

tprdrmpq of t cr te "'s 11nCA, toe trainin f 04 t;41F1rl' traln' ealf s too

of the i tl 1:v. . teWers ,a 4_" 04'as t riit"4tv a. v0#'ta&tC-

did Prc*j.5.*' co toolic'el

6. Research and Eraliatin

Technical aissitince, 41"~Ital assista'.P, 40l!Cw1104s 41 114-1ical 661104s':1. 1v'I'5~15Ls

fellowship s stdies i'n giu rt for a st'd, of ttu sei$.ty tfairtr4. a'i V:111-16 016..

seminars fir nteruch tod litn n Vea1tr1 Art I0 r twe"a 3 O.f U14in.

evalgattqp. local poffcticnP of Cro! ccntcdlwAJkftroai toot;eert Irhc lanids

Posifo fr equipseW .. * a* e

fou.rttSv Actd. W,9460.

THAJLAND 106' 112' 118*

BRUNEI13 fl MALAYSIA

) f MALAYSIA12 )

SINGAPORE 17

9

~ *~ 1411 .--- --..... 1)

1015

I. DMI JAKARTA

4. Dl YOGYAKARTA 65 JA TIMLIR

6, UAMPUN«,7. ENTU'u \8 SUMATRA SEAIAN9. RIAU

10 4AMBI1i sumAIRA BARAT

12. sUMAiT (A UIARA 2 i j( -13 Dl AC 4114 I<jMTAN ØARAis AEAN N16. UMANTAN SEtATAN 2217. AUMANTAN TIMUR 4 r. ? 318. SULAWIEi I[NGAH19 S~JAWESI UTARA20. SULAWt.51 SELAW4 N21. SLAWFT5 1ENOGCRA22 Dti ,~23 NUSA TENGGAIIA 9A0AT24. NUSA TENGGARA TIMU. .25 ~11x1) ø

28 MAN JAYA27 T1kOR TIMuR

100* 106* 112* 118*

1BRD 12696R6

124° 130p

PHIUPPINES INDONESIA

SECOND POPULATION PROJECTPopulation In Millions, 1980 CensusPopulation Densty Per Square .Imeter:

1000 or More6WA 100.999

50.9910.49Less than 10

19 ------ Province Boundarles-- International Boundaries 00.

Ij~18i

25

Ø 2821

27 0_400

r 0 500Km

1246 1 0 136'

SEPTEMBER 1985

THAILAND.- 5'Banda Aceh

M YSouth China Sea BRUNEIMALAYSIA

Kuala Lumpur

MALAYSIA

SINGAPOREp 7lbnjung Pinang 23

K A l M N T A N,4 Pontianak

Padang

amGKA 25 2Ef, R A Q~ lg1

7 ~ ndonPembong 4on kara 24

PROVINCES:1o. Act 60.12 suMATaA UTAA Bengkuilu

3 s~MTERA OAPAT4 RIAU5 'A

7 J Tvuk eSn e a Ujunpa

9.K... JAKARTA JAKARTATJAWA BART JNi AWA

i~W TENOMH2,-Y06y~RATA

3MA 4A9rn MADUA14~ 1015 NUSATENGGARA DARAT Band x g16 NUSAIENGGARA TIMUR Y3kr Su

17 1IÅI JAYA t suMW

IsUtAWES UTAAs20s~=es TENGAN21sIUAffså TeNGARtA22$vu~A"U'LÅTAN / n d i a n 0 c e a n Dnaa

23"A~AN TIMUR24 KALIMANTAN ULATAN25KALJMANA T ~NGA26KALIAN SAAT27TIMM" TMUR

~ I no- n,s.~

IB2D 14981(PPA)

IN DONES1A

PHILIPPINES THIRD POPULATION PROJECTOTHER ISLANDS iOTHER 13.AOS:11POPULATION IN MII.LIONS 1976 ESTIMATED

- POVINCE BOUNDARIES

- INTERNATIONAL BOUNDARIES

THIS PPA MAP IS BSED ONIBRD 14981, APRIL, 1980.

me SOME NAMES ANC MAPDISCLAIMER HAV.r BEEN UPDATED.

HALMAHERA P c i ic O c e a n 0' -

Gorontalo

tYVMlAUAN SU5A~

A,0 08/ popura

SLILAWES1

p

oNabire 7/R/AN JAY A

KenurAbon Enorotal-KaI -~CRMKokconou -I

Ban da Sea

o j sMerauke

Maumer Merouk16(9 0 100 200 300 400 500 l0'm

WongGpuMILESKupong. /Mk

14, 27 19 29 30 4100 St 600 790 80KILOMETERS

FEBRUARY 1986

THAILAND oi r 6

BRUNEICMALAYSIA

* ,MALAYSIA 9),2,3,

SINGAPORE

2 KAL MANfAþ('

454el dar AS~

j01 A23 n , 2,3,4, 5,4 456<6,7,8,9,104 5 6 6

BANGKA 0 Renta uuu

PROVINCES* 3 BEÙONG0.I. ACEN n-lU S U M A re 4

SUMATGRA fART RA.RIAU

S JAMBSUMATERA ULATAN

8 OENSKULU8 PN PTa*.guan 0L 2, 3,

.x.L, JAARTA 4,5JAWA BARAT QJAWA TeNGAN RANM lON COMPONENT JAATA ,

D.1. YOGYAKARTA ~NWSIY POP~UUON wJ.WA TIMUR S~tø CEN0IDO

1 AU V YH MAACI 0.1mmng5NSATENGGAA ART 2 m U NW OF

;~ NATENGGARA TIMUR 3 A WAS W. 9St~ATERA7 IRIAN JAYA 4SRMIAA . SAMA1ERA Y 0SUL~I UTARA

2 0 sULAWsi TENGAN 6 m ~M . Mo em -

2 SUL~UESI TENGARA M ~cA CAiD22 SU~ESI SLATAN 8 DAYN &ALU~WA

73 XAMTAN TIMUR Q 1P URA MALU~UKAL~MANTAN SLATAN ^0CæwAASI N ,lAYA

25 KAUMANTAN TENGAN25 KAUMANTAN AAT M PCB ~GIC 0C27 TIMOR TIMUR RWER TO ANNEX

100* 10. 112 lir

IBRD 18666R(PPA)lim 136*

PHILIPPINES INDONESIAFOURTH POPULATION PROJECT

) PRWVINCE 80UNOAUiUS

--- N1WINA?TWNAL B0UNDARIS

'HIS PPA MAP IS BASED ONiBRD 18666R. APRIL 1985.SOME NAMES AND BOUNDARIES

Tomo HAVE BEEN UPDATED.- HAMAHERA

11

1.:e

D 1,42203, 4

<*,2,3, ,1.,2 3,4, 5 4,56, 6. A

rA wf.N 7,8,9,

\SE*AM4,

IRIAN JAYA

3,4

V 12, 4 3 46RA $,6,7,8 fMO MILtS

:2 a '' a air s 10 20 30 40050ftuw ud(an Duuan.uemierasaai. fln e an#enÉ iOTR

124* 1 •FEBRUARY 1986