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Accelerating Indonesia’s ambitions towards the promise of three zeros

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19 September 2022 Tags: family planning, gender-based violence, Indonesia, maternal mortality, sexual health and rights of young people, SRHR

Over the three days in late August 2022, Yogyakarta was the hub to figure out how Indonesia could reach an ambitious future for sexual health and reproductive rights (SRHR). The big question is? How can Indonesia become a country with:

  • Zero preventable maternal death,
  • Zero unmet need for family planning and,
  • Zero gender-based violence & harmful practices against women and girls?

Young people, researchers, public health professionals, civil society actors, policymakers, donors and INGOs came together to address the conundrum during the 2nd International Conference on Indonesia Family Planning and Reproductive Health (ICIFPRH 2022).

Participants poured over the wealth of data presented in 120 articles, 286 papers, five plenaries and numerous sessions to understand the SRHR situation in Indonesia on these three axes.

The numbers are not good.

The consensus is that the numbers are not promising.

The maternal mortality rate (MMR) in Indonesia is still high, at 305 per 100,000 live births (SUPAS, 2015). This is far from the target set in the National Medium-Term Development Plan (RPJMN), which is 183 per 100,000 live births in 2024.

It is suspected that the restrictions introduced because of the COVID-19 pandemic hampered access to services and commodities, contributing to higher dropouts from family planning.

And there are other social factors involved. In Yogyakarta, for example, the Maternal Mortality Rate (MMR) has not decreased even though the number of health workers is sufficient.

Public health officials say women face a lot of familial and social pressure to have multiple children. For this reason, many pregnancies are with women at risk of maternal mortality due to four factors: “too young, too old, too many or too close”. In turn, these profiles reduce the effectiveness of the health system in addressing health risks to women once they are pregnant.

Sexual violence Pandemic

The Women’s Life Experience survey (SPHPN, 2021) revealed that 1 in 4 women aged 15-64 years in Indonesia had experienced violence during their lifetime.

According to research by Komnas Perempuan’s 2020 Annual Records (CATAHU), sexual violence increased with around 340,000 cases of gender-based violence reported in 2021, a 50% increase from 2020, according to Indonesia’s National Commission on Violence Against Women (Komnas Perempuan).

In the study, 70% of the respondents agreed that women were raped or sexually harassed because their clothes were revealing or inviting. This statistic also demonstrates the pervasive, harmful gender norms that underpin some challenges related to achieving the three zeros.

Another effect of the Covid-19 pandemic was an uptick in child marriages. The Ministry of Women’s Empowerment and Child Protection reported a significant increase, especially among lower-income communities with low education levels. The main factor behind such marriages is pregnancy, as families do not want a daughter to become an unwed mother. When girls must drop out of school because of an unplanned pregnancy, they are more likely to remain trapped in a cycle of poverty.

The desire for change

The conference confirmed the powerful desire for change on these three axes. With multi-sectoral efforts, it is possible to turn things around. Strategies, such as the quality delivery of sexual health education, can make a difference. Ensuring that the education uses a gender transformative approach can help challenge the norms which underpin harmful practices. Ideally, school-based sexuality education should take a more positive perspective and help young people in Indonesia develop necessary social, emotional and cognitive skills so that they can achieve a sense of well-being about their bodies, their relationships, and their sexuality.

For policymakers, the focus on SRHR, especially for young people, is precise and targeted. Their main concern is ensuring Indonesia can capitalise on its demographic dividend to fuel economic growth. The 2020 population census from Statistics Indonesia (Badan Pusat Statistik) showed that 70% of the estimated 270 million people in the country are in the prime working age group [between 15 and 65 years old].

Policymakers highlighted that the effects of child marriage, unplanned pregnancies, maternal mortality, and gender-based violence seriously threaten their economic future. Indonesia will soon have one of the largest, most highly educated and youthful workforces. There are moves to protect this workforce.

In April 2022, Indonesia passed the sexual violence law, which increased the forms of sexual violence to nine: non-physical and physical sexual harassment, forced contraception, forced sterilisation, forced marriage, sexual abuse, sexual slavery, and electronic-based sexual violence—which includes recording or transmitting sexual material without consent.

The new law also extends the definition of rape to cover marital rape and recognises men and boys as victims of sexual violence. The work underway by the government, with vital input from civil society actors, is focused on how to operationalise this law.

Meanwhile, the three zeros are tabled for further research in a background study for developing a new National long-term development plan for Indonesia [RPJPN 2025-2045].

If the promise of the three zeros is fulfilled, Indonesia benefits socio-economically and will make significant progress toward achieving Sustainable Development Goals (SDGs).

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