Injectable contraception and the Arab and Islamic demographic giants: Does Indonesia offer a path for Egypt to achieve replacement-level fertility?

Indonesia is the world’s most populous Muslim-majority nation, with its highest prevalence rate for injectables (32%). Egypt has the world’s largest Arab population, but the TFR is stalling at about half a birth higher than in Indonesia, despite both countries having comparable overall and any modern contraceptive prevalence rates. Both established clinic-oriented national family planning programs in the mid-1960s with strong bureaucratic and financial support, but each has recently hit trouble. Indonesian politicians have shifted their attention and resources away from family planning. However, injectables have become increasingly offered by local midwives with strong incentives and by more private providers. Political turmoil threatens to undermine Egypt’s program, heavily dependent on the strained public sector. However, over 7% of women now use injectables, more than in other Arab states and possibly soon usurping pills as the second most common method. In both countries, government policies have led to a loss of method choice and a narrowed range of family planning providers. We examine these developments further and ask how far can Indonesia serve as a model for how injectable contraception can help accelerate Egypt’s path towards replacement-level fertility and for influencing trends in other Arab populations.