The onset of the fertility decline in Indonesia occurred as the Family Planning program was implemented in the mid 1970s (United Nation Population Fund, 2003). Contraceptive use rose rapidly with the increase in the supply of modern contraception through the family planning programme. However, despite the overall success in the reduction of the fertility rate in Indonesia, in some provinces, fertility has risen since the IDHS (Indonesian Demographic Health Survey) of 2002-2003. One of these provinces is West Sumatra which was recorded by the most recent IDHS in 2007 as having one of the relatively higher rates of fertility (3.40 children per women). This is in spite of the fact that the percentage of any contraceptive use and age at first marriage in this province was also relatively higher than other provinces with comparatively lower fertility rates. This relationship appears to be unconventional in terms of demographic outcomes, where the link between fertility and contraception, and fertility and age at marriage, is found to be inversely correlated. Another extremely interesting dimension is that West Sumatra is the only province in Indonesia with a matrilineal structure, where the women’s status is highly respected.
Thus, this study proposes to identify the factors which are behind the high fertility level in West Sumatra. Derived from the literature reviewed and the various theoretical frameworks, the analysis was conducted in order to explore the contribution to reduction of the proximate determinants and identified the relationship between the contextual determinants and the proximate determinants.
An analysis of the contribution of each proximate determinant found that the proportion of marriages has the highest fertility reduction effect compared to other proximate determinants. Meanwhile, it also showed that the effect of reduction of fertility through contraceptive prevalence in this province was lower compared to the proportion of married couples and the duration of breastfeeding.
Concerning the relationship between fertility and its indirect determinants, socio cultural norms were also found to influence fertility levels in West Sumatra. Age, place of residence, the women’s and their partners’ education level, women’s empowerment and their ideal number of children were identified as factors which have influenced the fertility level in West Sumatra through the proximate determinants (age at first marriage, use of contraceptives, and the duration of breastfeeding).
This study concludes that the main cause of the increase in total fertility rate in West Sumatra province is the slight fall in age at first marriage, as it has also the strongest association with fertility levels. Meanwhile, the impact of contraceptive prevalence on fertility reduction in this province is lower compared to the other two proximate determinants namely the proportion married and duration of breastfeeding. Hence, the increase of the Contraceptive Prevalence Rate (CPR) could not lead to fertility decline as its fertility reduction impact was offset by the fertility enhancing impact of declining age at marriage. Regarding the effects of socio cultural norms, the result of present study clearly indicates that some program is needed to be created in order to reduce the fertility rate in this district. In particular this is should be the program to increase the educational achievement as it was found to have a significant impact on age at first marriage in West Sumatra province.