Socio-cultural and demographic factors affecting child survival in D.I.Yogyakarta (DIY) and Nusatenggara Barat (NTB) - Indonesia

Abstract

This study is a comparative analysis of the socio-cultural determinants and correlates of child survival in two provinces in Indonesia: Daerah Istimewa Yogyakarta (DIY), and Nusatenggara Barat (NTB). In 1980, the infant mortality rate (IMR) for Daerah Istimewa Yogyakarta was the lowest in Indonesia, while the IMR for Nusatenggara Barat was the highest. The quantitative part of this study covers provinces, the qualitative part covers one kabupaten within each province: Kabupaten Gunung Kidul in Daerah Istimewa Yogyakarta and Kabupaten Sumbawa in Nusatenggara Barat. Quantitative analysis of mortality data based on the 1980 census for both provinces points to the importance of micro, in-depth studies of socio-cultural determinants and correlates of child survival. Census data are unable to explain how or why the infant mortality rate is low in areas such as Kabupaten Gunung Kidul, a poor and backward area where, until the early 'seventies' often suffered from famine, and where adult women have a lower average level of completed education. Census data are also unable to explain how or why an infant mortality rate is high in relatively affluent areas such as Sumbawa. This study identifies a number of important factors that underlie behaviour which plays an important role in determining infant and child survival in Kabupaten Gunung Kidul and Kabupaten Sumbawa. The connections between health-related intervention programmes and other aspects of social structure and behaviour seem to be important. Although Gunung Kidul emerged as poor compared to Sumbawa in terms of women education, the availability of facilities, services and food, the nutritional status of the children there was better than in Sumbawa. Community activities, particularly the women's activities organized by a few comparatively welleducated women in Gunung Kidul, have played a vital role in influencing women's attitudes towards health care and in involving of the majority of lowereducated women in health programmes.