Age at Menarche in Indonesia

Age at Menarche in Indonesia

Folia Medica Indonesiana Vol. 39 No. 1 January – March 2003 18

AGE AT MENARCHE IN INDONESIA

LD Hendrawati and Josef Glinka SVD

ABSTRACT

Since 1937 data on age at menarche are gathered in Indonesia. An overview of the whole literature and unpublished thesis until 1996 is

presented in this paper. The data originate from Java, some other also from Sulawesi, Sumatra and, recently, from Flores. The general

mean values in a diachronic sequence demonstrate a trend of decrease in menarcheal age of 0.145 year per decade. This means that in

general the wealth and health conditions in Indonesia improved in the last six decades. Statistically significant differences in menarcheal

age between girls from different socio-economic class’ and the father's occupation, like traders (14.13), teachers (14.48) and farmers

(14.63); rich (13.90), medium situated (14.60) and poor (14.88); between girls from different environmental conditions like urban

(12.27), fisherman village (12.85), farmer village (13.19). The role of animal protein intake as the most influential factor where the

differences in menarcheal age between girls who eat meat e.g. 13 times (11.64) and those eating only 1-4 times a week (13.46). The

mother's education constitutes an indirect influencing factor because better-educated mothers have knowledge required to give their

children more suitable food. The menarcheal age is: 12.19 from mothers with university, 12.88 with highschool and 12.93 with low

education. These data confirm the assertion that age at menarche constitutes a sensitive indicator of the wealth and health of a

population (Bielicki & Welon 1982; Brasel 1978).

Keywords:

Age at menarche, Indonesia, environment

Growth and age at menarche are considered as indicators of wealth and good health of a population [Bielicki & Welon 1982; Brasel 1978]. As a physiological process age at menarche is even more sensitive on environmental changes than growth despite its high (HR = 0.89) genetical determination [Bergman & Orczykowska-Swiatkowska[1988]

MATERIAL

Here under a literature review of the research results on age at menarche in Indonesia. The first known research had been done in 1937 by a Dutch scholar and is continued till the present by Indonesians. Most date come from Java (Semarang, Jakarta, Klaten, Yogyakarta, Surabaya, Malang, Tengger) but there are also some data from Madura (Pamekasan), Sumatra (Palembang, Kayu Agung), Sulawesi (Ujung Pandang)

and West-Flores (Tab. 1). Table 2 presents the influence of socio-economic conditions on the age at menarche in different places. Environmental conditions given in Table

__________________

Department of Anthropology

Airlangga University School of Social and PoliticalSciences Presented at the Annual Conference of the Australasian Society for Human Biology, Perth 7 December 1999 3 reflect in substance also socio-economic differences, which are caused by the local economic and occupational situation of the people. A very important factor, i.e. the weekly animal protein intake, is given in Table 4. How far mother’s education influences age at menarche reflects

ANALYSIS AND DISCUSSION

Looking on Table 1, ordered diachronically, one can observe a zigzaggy line which slowly diminish. If we draw a regression line to get the common trend then the bcoefficient achieves a value of 0.0145 per year for all records and 0.01626 per year only for Java. It means that in the last six decades the expected values of the age at menarche dropped from 14.08 in 1937 to 13.22 in 1996 for all records and from 13.79 to 12.83 in the two respective years only for Java. According to other publications it could be said that generally health and nutritional conditions improvement in Indonesia is caused by better health service in rural areas and by continued informative actions on healthy food among mothers. – But there is a big worsening leap between 1938 (12.67) and 1948 (14.63), i.e. at the end of the Dutch colonial occupation and after the war and the independence.

Two factors could be responsible for this deterioration:

(1) wartime and Japanese occupation was a time of famine in most areas of Indonesia, and the general the increase in age at menarche reflects this situation;

(2) because the data were collected in schools and, during this Dutch colonial time, only children from well-to-do parents could

Age at Menarche in Indonesia

Folia Medica Indonesiana Vol. 39 No. 1 January – March 2003 19

go to school, whereas after the independence every

children get the opportunity to go to school, children from

rich as well as from poor families. These data reflect both

factors.

Table 1. Age at Menarche by Years

Place Age Author/year

Semarang 13.07 Bree-Maeuleman, 19371

Jakarta 12.67 Bree-Maeuleman, 19381

Klaten 14.63 Radioputro, 1948

Yogyakarta 14.48 Doerjadibroto, 1952-58 (1970)

Surabaya 13.96 The Tik Lien, 19592

Palembang 13.90 Noer, 1975

Kayu Agung 15.52 Noer, 1975

Surabaya 13.20 Ferdinandus, 1976

Ujung Pandang 14.29 Luhulima, 1979

Malang 13.27 Sjamsuar 1983

Yogyakarta 13.09 Aswin, 1985

Surabaya 12.81 Yoeliana, 1990

Pamekasan 12.62 Hendrawati, 1993

Surabaya 12.00 Kurniasari, 1994

Surabaya 12.03 Kurniasari, 1994

West-Flores 13.22 Sukadana, 1995

Tengger 13.27 Putri, 1996

Note: 1 cited after Doerjadibroto, 1970;

2 cited after Sjamsuar 1983

Table 2. Age at Menarche by Socio-Economic Condition Place Occupation/profession Age Author, year Yogyakarta traders 14.13 Doerjadibroto, 1970

teachers 14.48

farmers 14.63

Palembang rich 13.90 Noer, 1973

medium 14.60

poor 14.88

Surabaya upper class 12.39 Ferdinandus, 1980

middle class 13.78

lower class 13.98

Malang upper class 12.98 Sjamsuar, 1983

lower class 13.38

Pamekasan upper class 12.12 Hendrawati, 1993

middle class 12.70

lower class 13.03

Table 2 reflects well how the economic status influences process of sexual maturation. Generally traders are the rich or upper class whereas farmers build the poor or lower class. In most of the cases the differences are statistically significant.

Age at Menarche in Indonesia

Folia Medica Indonesiana Vol. 39 No. 1 January – March 2003 20

Table 3. Age at Menarche by Environment

Place Environment Age Author, year

Palembang urban 13.90 Noer, 1975

suburban 15.52

Madura urban 12.27 Hendrawati, 1993

rural (fishermen) 12.85

rural (farmers) 13.19

The same factor is on work when environmental factor is considered (Tab. 3) where urban means an economically better-situated population whereas rural means uncertain economic conditions. It is not only the problem of food intake but also the burden of work which children have to do in villages [Jasicki et al. 1962]. An exception are fisherman villages. Economically they are generally seen as the poorest population but they consume systematically more animal protein than the farmers who, referring to a joke, eat meat only when either the farmer or the chicken is sick.

Table 4. Age at Menarche by Animal Protein Intake Animal protein intake per week Age Author, year 13 times or more/week 11.64 Hendrawati, 1993

9-12 times/week 12.22

5-8 times/week 13.03

1-4 times/week 13.46

The importance of the animal protein intake is nicely documented in Table 4. In the growth and maturation process wealth means not much without a rational food intake by children. It is clear that generally bettereducated mothers give their children better nutrition according to age than less educated mothers do. This seems to be proofed in Table 5. The correlation between mother’s education and the menarcheal age of their daughters is highly significant whereas no correlation was found between the father’s education and age at menarche of their daughters.

Age at Menarche by Mother’s Formal Education Place Mother’s education Age Author, year Madura Higher 12.19 Hendrawati, 1993

Medium 12.88

Lower 12.93

As conclusion it could be said that age at menarche constitutes a sensitive indicator of wealth and health of a population (Bielicki & Welon 1982; Brasel 1978).