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Application of a multivariate analytical technique to the World Fertility Survey data for Java and Bali indicates that demographic variables, particularly the length of the preceding birth interval, are more important in explaining infant and child mortality differentials than are such social variables as education of parents or urban–rural residence. These findings are weakened to some extent by the lack of satisfactory data on household economic status which might have provided a better base for indirectly discerning the effects of nutrition and sanitation on mortality at young ages. [ABSTRACT FROM PUBLISHER]

Background: Women worldwide use various vaginal practices to clean or modify their vulva and vagina. Additional population-level information is needed on prevalence and motivations for these practices, characteristics of users, and their adverse effects., Methods: This was a household survey using multistage cluster sampling in Tete, Mozambique; KwaZulu-Natal, South Africa; Yogyakarta, Indonesia; and Chonburi, Thailand. In 2006-2007, vaginal practices and their motivations were examined using structured interviews with women 18-60 years of age (n=3610)., Results: Prevalence, frequency, and motivations varied markedly. Two thirds of women in Yogyakarta and Chonburi reported one or more practices. In Yogyakarta, nearly half ingest substances with vaginal effects, and in Chonburi, external washing and application predominate. In Tete, half reported three or four current practices, and a quarter reported five or more practices. Labial elongation was near universal, and 92% of those surveyed cleanse internally. Two third's in KwaZulu-Natal practiced internal cleansing. Insertion of traditional solid products was rare in Chonburi and Yogyakarta, but one tenth of women in KwaZulu-Natal and nearly two thirds of women in Tete do so. Multivariate analysis of the most common practice in each site showed these were more common among less educated women in Africa and young urban women in Asia. Explicit sexual motivations were frequent in KwaZulu-Natal and Tete, intended for pleasure and maintaining partner commitment. Practices in Chonburi and Yogyakarta were largely motivated by femininity and health. Genital irritation was common at African sites., Conclusions: Vaginal practices are not as rare, exotic, or benign as sometimes assumed. Limited evidence of their biomedical consequences remains a concern; further investigation of their safety and sexual health implications is warranted.

The promotion of social sciences capabilities in public health research in universities frequently encounters unexpected barriers. This paper argues that, in Indonesia, historic factors and institutional structures of public health research have created constraints to success in public health research and international technical assistance. Donors are often frustrated by apparent inconsistencies between agreed intentions and the subsequent behaviour of recipient colleagues, thus resulting in poor relations and failure of collaborative links. For social sciences to be integrated into public health research, assistance is needed in graduate education, library development, computerisation, and research methodology. Contributions in these areas may be ineffectual if they are not preceded or accompanied by efforts by recipients to reform or circumvent existing institutional weaknesses. Some important barriers to the development of research capabilities in Indonesia are beyond the control of individual faculties of public health, or even universities, and are affected by regulations and budgeting procedures of the National Department of Education and Culture, or the civil service administration. There are, however, changes that can be made at faculty or university level to encourage a more productive 'research culture' and promote linkages between the social and health sciences.

Induced abortion is one of the most difficult sociomedical problems facing the Indonesian government. While well-known in traditional society, the practice was discouraged by all Indonesian religious groups, and forbidden by the Dutch colonial authorities. Although abortion was technically illegal under the criminal code, a judicial interpretation in the early 1970s permitted medical professionals to offer the procedure so long as they were discreet and careful. The numbers of medical abortions carried out in Indonesia rose dramatically, and there was evidence of matching declines in the incidence of morbidity and mortality caused by dangerous illegal procedures. Medical and community groups campaigned for a more liberal abortion law to protect legal practitioners and stamp out illegal traditional practices. Their efforts appeared to bear fruit in the draft Health Law, but when the law was passed by the legislature in late 1992, the issue was again clouded by contradictions and inconsistencies.

A method of estimating current fertility from information on last live births is presented. The technique is developed from one proposed by Hull for estimating fertility rates for Indonesia using 1976 intercensal survey data and does not depend on conditions of stable fertility or on assumptions about past mortality. "The estimates of [the] total fertility rate for Indonesia 1980 are 4.40, 3.87 and 4.28 for the rural, urban and the total areas respectively, and compare well with the estimates derived by the 'Own Children' method." A comment by Aris Ananta (pp. 49-53) is included. (summary in IND), (excerpt)

A number of demographic techniques for the indirect estimation of trends in causes of death in Indonesia are proposed. These involve "the use of rates and proportions derived from other nations experiencing similar levels of mortality to that prevailing in Indonesia. Four sets of estimates were produced, the first based on a regression developed by Preston, the other three derived from national patterns of Mexico, the Philippines, and a composite group of countries. These were compared with available epidemiologic and clinical data from Indonesia to produce a final set of estimates which accord both with known Indonesian patterns and medical findings from other nations.", (excerpt)

Fertility trends in Indonesia for the period 1967-1985 are analyzed. Data are from the Indonesian censuses of 1971 and 1980 and from the 1985 Intercensal Survey (SUPAS 85); they concern fertility rates by province, marital status, and for the general population. An overview of the sociocultural factors that affect data reliability and a discussion of the effectiveness of the date of last birth method are included. The authors conclude that the evidence "has confirmed the existence of a major fertility decline throughout Indonesia. The pace of the decline has been faster in 1980-85 than during the 70s. On present trends, it should be possible to reach the ambitious target of halving fertility between 1979 and 1990.", (excerpt)