Reproductive Health Services Must Target the Youth

Monday, 23 November 2015 - 10:51:59 WIB
By : Haryani Dannisa | Category: Gender & Sexuality - 2818 hits - 2 shares
“Why is finding a job so hard?”

Since my graduation two months ago this question has been rolling around my head. When I meet my friends, we don’t have anything more interesting to talk about than the excitement – or the horror – of finally entering the working world. We talk about how the recruitment process is going, how A suffers at company B, or how C has decided to change her career path to D.

But one friend is the exception in this conversation. She has not applied for any jobs and has not attended any interviews, not because she’s chosen to go straight for a master’s degree after graduation, but because she has to take care of her kids.

My friend got married when she was 18, right after she found out that she was pregnant with her boyfriend. Don’t worry, she and her family are doing great right now, but what I would like to talk about is how five years ago she had no options – and nobody, including me, knew that she should have.

Five years ago, when we were 18, it didn’t occur to us that there were these things called sexual and reproductive health and rights (what is now known by the abbreviation SRHR), which, had my friend been able to access, would have given her more choices in life. My friend and all of us who were still teenagers back then should have had access to SRHR services, which include comprehensive sex education and counseling. These rights should be recognized and the services should be provided by the government indiscriminately – but they weren’t there for us back then, and they are hardly available now.

Don’t Ask, Don’t Tell

How do young people like me access information about sexual and reproductive health? Out of curiosity, I asked around. The answer is, of course, the Internet – because it’s silly to ask someone something you can Google, right?

“My mom… a.k.a. Mrs. Google,” one friend said, before laughing at the improbable thought of asking older people, especially her mom, about reproductive health information. Another friend, a male, said he got his information from Reddit.

We’re afraid to ask, and even if we do, they won’t tell us. From 15 people that made up my small group of respondents, only one person admitted to having gone to a clinic. This friend, who’s not married yet, went to a gynecologist in a clinic to ask about a problem she was having, only to be labeled promiscuous and have people assume that she had had sexual intercourse before marriage. She went on searching for other clinics, and finally found an ideal one, which she described as being “non-judgmental“.

“Being judged” is how young people describe the reason they neither go for consultations at public health services, or talk to their parents about sexual and reproductive health. A lot of my friends also thought that since they were not going to be sexually active until they got married, they wouldn’t need the information now. Maybe in a few years time.

This is the root of many reproductive health problems in Indonesia: the misconception that one has to be sexually active to require access to sexual and reproductive health services. Because of this misconception, and, since religion and culture here do not recognize sexual activity before marriage, SRHR services are largely only catered to married couples. And that is not right.

The question is, if such barriers still exist even in urban life, what do young people in Indonesia’s poor rural areas and marginalized communities have to deal with when they need access to sexual and reproductive health services (sometimes without access to the Internet)? People in marginalized communities face even greater barriers in gender stereotyping and certain cultural beliefs. They are subjected to a greater risk of child marriage, unwanted pregnancy and sexually transmitted infections.

Sex education and preventive health services, when provided to youth, only reach those who are in school, when, according to the Ministry of National Development Planning (Bappenas), only 43 percent of children aged 16 to 18 in the poorest quintile are in school. This is why 60 percent of reproductive health problems come from adolescents who are not in school, according to Indonesia Planned Parenthood Association (IPPA).

It is funny that our country’s health services are missing their main target, while young people are the ones who should be kept productive at work. If you’re an Indonesian youth aged 16 to 25 like me, you are part of what the World Bank calls the “demographic bonus”. We are currently 65 million in number – the largest generation of young people our country has ever seen – and we’re vital for Indonesia’s economic growth for the next 15 years.

Furthermore, the rate of Indonesian mothers dying in childbirth has increased from 228 deaths per 100,000 births in 2007, to 359 in 2012, with a large number of these unfortunate mothers being young women, teenagers in fact. According to the National Population and Family Planning Agency (BKKBN), abortions increased by 15 percent last year, to 2.4 million, with about 800,000 of those women being teenagers.

To fully remove existing barriers in reproductive health services for adolescents, a holistic approach is needed. This must start with the government repealing all laws and regulations at both central and regional levels that restrict access to sexual and reproductive health services for the youth, as well as the education of health workers at the frontline, such as midwives.

Religious and cultural barriers may limit someone’s sexual activity, but they should not be limiting someone’s access to sexual and reproductive health or the upholding of their rights. Every youth in Indonesia – married or not – deserves a friendly health service, where they can comfortably access information and consultation about their sexual and reproductive health, without being judged.

Haryani Dannisa is a 20-something who loves to read and write in order to keep the faculty of wonder in her soul ever alert. She's a recent Journalism graduate from Universitas Indonesia.

Got an opinion on this issue? Let’s talk about it in the comments section below.

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COMMENTS
Kartika | 23 November 2015 | 12:14:12 WIB
Finally! It's about time someone write about this.
Feby | 23 November 2015 | 12:39:47 WIB
This is indeed an important issue to be addressed in Indonesia.

This type of "sexual ignorance" is one of the leading reasons why it's so easy for children/teen are incapable of identifying potentially dangerous situations (such as having early sex without knowing the risks, or even worse, raped) because they don't even have a good understanding of sexuality, doesn't even have anyone to talk to, or even mentor them on the topic.

Somebody needs to push the button and emphasize that sex is only dangerous when not done properly, and that is the purpose of education -- not supressing education because of religious reasons! I mean, while it's perfectly fine for people to believe sex is "immoral for religious reasons", these folks should NOT be forcing those beliefs on others by making it illegal to be sexually permissive/open with children and limit them to get the right information.
Baskara | 23 November 2015 | 12:50:07 WIB
This article is spot on--especially on how our society shun down the idea of sexuality every now and then.
Resha | 23 November 2015 | 13:03:06 WIB
To be honest I much prefer to have sex education in the hands of parents rather than the government. However, it's obvious that many, many parents in Indonesia (including mine) prefer to defy human nature by keeping us ignorant on the subject.

MAYBE what's more important than sex-ed to youth is an education to parents on how to teach sex-ed to their children.
Andra Dwita Putri | 23 November 2015 | 14:08:59 WIB
The irony is even better when a lot of young girls' main source on sexuality is 50 Shades of Grey. Lol.
Fadil | 23 November 2015 | 14:14:56 WIB
I agree with this! Its scary to find out many topics in this country that is still considered taboo. Things like this should be publicized more and talked about rather then just try to swept it under the rug for the parents & the government. Teenagers & young adults need to know about sex-related stuff & parents should be the first teachers!
Diva | 23 November 2015 | 14:20:45 WIB
Very great insight. Hope more people in this country aware about this issue. We need to spread it more and continuously to raise public awareness about this issue. Thanks for sharing Dannisa, very glad someone did it :)
Ilman Dzikri | 23 November 2015 | 14:48:58 WIB
I like the way the writer share her thought..

The article managed to touch my heart and (of course) my mind with its portrayal about the reproductive health service problem in Indonesia. I agree that it is not only about government providing a reproductive healt services, but also about changing the perception of the society toward sex education.
Ilman Dzikri | 23 November 2015 | 14:48:59 WIB
I like the way the writer share her thought..

The article managed to touch my heart and (of course) my mind with its portrayal about the reproductive health service problem in Indonesia. I agree that it is not only about government providing a reproductive healt services, but also about changing the perception of the society toward sex education.
Mayang | 23 November 2015 | 15:12:36 WIB
Great article! Besides, what's more dangerous than keeping the sexual curiosity amongst the youth high. Better educate them rather than let them looking for informations from some random internet sites with unknown accuracy, which can lead them somewhere we don't want them to be.
Kintan | 23 November 2015 | 15:25:33 WIB
Couldn't agree more. I personally think, this sex-ed in Indonesia will be success if the government also targeting the parents as the secondary target. I know to achieve this, it's going to be a long journey due to its cultural thing but it doesn't mean that it can't be done. It's about time to really talk about sex in the right way for the sake of the individual health. Forget about taboo stuff, and of course it will be awkward, but there are more things that can be save by start talking about this rather choosing not talking about this just because it's awkward.
Patty | 23 November 2015 | 16:17:36 WIB
Great read, this bravely points out an issue that's rarely been talked about in our society.

As much as I agree with the big picture here regarding the importance of sexual health and education, I believe solely lifting up the barriers through Gov programmes wouldn't really make a huge betterment. The thing about anything sex-related in our society, is that it's still widely a taboo to be brought up in public sphere. My concern is whether, assuming such access and facility to sexual health exists to fulfill their SRHR, everyone will necessarily be up and brave enough to exercise their rights?

Our society is very polarized in terms of their openness towards this issue. Some people can liberally talk about it and others won't even bother (even in their first and closest environment such as family).
Patty | 23 November 2015 | 16:26:14 WIB
Say, if Gov really do make all the sex education program & facilities, will everyone adhere & make use of it, or will it only be the ones who are already liberal enough in viewing sexuality to begin with? Mere existence of said facilities won't automatically take the "shy" ones out of their conservative shell, which most likely would render these programs ineffective.

My lecturerer who's openly gay once shared an interesting story. He wasn't exactly sexually active, he's just conscious of reproductive health. (Contd.)
Patty | 23 November 2015 | 16:26:58 WIB
(Contd.)He went to a doctor for an HIV test. The 1st question the doctor asked was, whether he's ever had sex with guys/girls/both. When he honestly answered, the doc went on lecturing him abt how dangerous it is being a gay & judged him devious. Conclusively, the possibility of such social prejudices is a major problem that makes people less eager to pursue their SRHR. Putting aside the "he's gay" concern, a doc is not supposed to judge his/her patient about their sexual preferences, or any other personal lifestyle for that matter.
Arie Rukmantara | 23 November 2015 | 17:09:43 WIB
Bravo!

The promise of a better tomorrow for Indonesia--a young girl who cares about the world voice out her thought in a very intelligent way.

The writer rocks!
Victoria | 23 November 2015 | 21:00:41 WIB
It's very interesting that you decide to write this. I, for one, had known sex education in high school. As do students in most private schools funding this. The reality is, no one really understood the consequence of being 'sexually active' at an early age until it hits them, a close friend or a family member. I do though take your point on the subject being a taboo. Growing up in a more liberal, modern family my mother did occasionally take my sister and I to an OB/Gyn for regular check ups and it was daunting to have sat there in the waiting room surrounded by pregnant/older women staring at you thinking, "she's so young, I wonder if she's pregnant". I knew they were judging but I realized early on that my reproductive organs were more important now and in the long haul than strangers who barely knew my name. So kuddos to the writer for bringing this up! There should be more women knowing their rights and live to speak about it.
Sarah | 23 November 2015 | 21:02:30 WIB
Great piece of writing! The writer points out the urgency of reproductive health education in such captivating manner. However, in my perspective, the measures taken should start by raising awareness about necessity of sex-education followed by the access to information.
Ditto | 23 November 2015 | 21:15:21 WIB
In Indonesia, perhaps this peculiar phenomenon has something to do with the rooting domination of Muslim teachings. Such belief has been accustomed to the society, regardless of the religious views, and somehow concluded that sex talks are being considered as taboo. As a matter of fact, it is the responsibility of our generation, the "20-something Faculty of Wonder" devotees, to educate the following cohort and open up their mind about the variety of love actions.

Thank you for this inspiring piece, Dannisa!

p.s. for those who are clueless about Muslim women and their faiths, this article might enlighten you http://www.telegraph.co.uk/women/sex/10031095/Sex-What-Mus lim-women-really-want-in-the-bedroom.html
Cazadira Fediva Tamzil | 23 November 2015 | 21:43:27 WIB
Information is power. I believe information empowers us to make better decisions in life as we would know all the good, the bad, and risks associated with various types of human behaviors.

To add to your argument, information is nothing without effective delivery. I suggest we also think of how this issue can be communicated to different segments of the Indonesian society with different capabilities to discern information. Poorly crafted Public Service Announcements on this issue is the last thing we want!

Thank you for bringing this to light, dear writer! Hoping your article inspires reform on this area :)
putri widi | 24 November 2015 | 17:54:05 WIB
Dear Dannisa, may I ask for your permission to translate this piece into Indonesian and reblog it, with an attached hyperlink to the original source? I am a 20-something general practitioner and I really feel like I have to share it to my community, but many of them are not fluent in English. Or is there any translated version of it? Thank you :)
Haryani Dannisa | 25 November 2015 | 00:07:35 WIB
Hi Putri! Thank you ever so much for your interest in sharing this piece. Magdalene has asked me to translate the article - it will be up on their Edisi Indonesia next week!
I would really love to hear about your community's response towards it. :)
(I can be reached through haryanidannisa@gmail.com or Twitter @haryanidannisa)
Nadia | 28 November 2015 | 09:57:06 WIB
Great points you have there! I'm actually so upset when I read news about an elementary school student who spread his intercourse vid with his peers. This is so ironic and pathetic. It's government's issue to encourage and educate parents about how to tell kids about sex education. This may seems simple but in a long term it is very effective.















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