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Research shows ripple effect of sexual and reproductive health education on adolescents

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4 June 2024 Tags: Indonesia, Setara, Sexuality education

Research by Karolinska Institutet, Universitas Gadjah Mada and Johns Hopkins University into the sexual and reproductive health (SRH) education curriculum SETARA in Indonesia shows that knowledge and skills of students become more noticeable over time. Adolescents persist in developing their ability to discuss SRH topics even after being exposed to the curriculum. These results confirm that sexual and reproductive health education plays a crucial role in preparing adolescents for the future, emphasising the importance of investing in the cultivation of these skills from an early stage. 

The findings from this impact evaluation show that adolescents exposed to SETARA were significantly more likely to understand and communicate sensitive SRH issues, such as contraception and sexual relationships, compared to their counterparts. Adding to its significance, this effect persisted for two years after students received SETARA. 

“This research stands out because it follows students over a longer period after receiving sexual and reproductive health education. Most studies that look at the effectiveness only focus on short-term effects. SETARA students were monitored over an extended period, revealing sustained or even improved positive outcomes in knowledge, gender attitudes, and communication about sexuality,” responded Miranda van Reeuwijk, senior researcher at Rutgers, to the findings. 

This research stands out because it follows students over a longer period after receiving sexual and reproductive health education. Most studies that look at the effectiveness only focus on short-term effects

One explanation for this enduring impact is the increasing relevance of SETARA’s information and skills over time. The theory suggests that practicing skills, such as communication about SRH topics, accumulates and strengthens over the years. Additionally, despite knowledge gaps about pregnancy prevention and HIV among 12-year-olds at the start of the study, the study reveals a positive trend of increased knowledge over time for both genders, indicating a lasting impact on SRH knowledge.

The findings not only highlight SETARA’s potential to improve healthy sexuality competencies in early adolescence but also demonstrate sustained effects, persisting even two years after the last classroom session. Interestingly, access to accurate information through SETARA materials has exhibited positive effects, even when teachers deviate from the intended approach or when classrooms lack safe learning environments. The role of teachers in breaking taboos is crucial, especially around puberty, although challenges persist in addressing issues related to sexuality. “The positive impact of SETARA was also closely related to support it received from local governments and how well it was integrated into the existing school curriculum.” said Amala Rahmah, Deputy Country Representative at the Asia Foundation and former Director at Rutgers Indonesia. 

SETARA’s evaluation further underscores its role in promoting more equal gender attitudes, facilitating critical reflections on gender and power even among young adolescents. However, it also sheds light on disparities in impact between boys and girls, and challenges teachers face in implementing these sessions effectively. “We must improve the relevancy of SETARA for boys. This is still a challenge in Indonesia where reproductive health is regarded as an issue for girls and women,” said Amala.

SETARA’s overall success underscores the transformative potential of sexuality and reproductive health education in Indonesia, leaving a lasting impact on adolescent health and well-being. “These findings underscore the importance of starting early with sexual and reproductive health education, with no observed negative effects. Knowledge and skills acquired from SETARA become more relevant over time and support adolescents to navigate love, sexuality, and relationships, both online and offline,” concludes Miranda. 

“These findings underscore the importance of starting early with sexual and reproductive health education.”
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The SETARA programme (Semangat dunia remaja/Teen’s aspirations), is a 2-year, rights based, teacher-led reproductive health, and sexuality curriculum for grade 7 and 8 in junior high school in Indonesia (students are 12-14 years old). It consists of chapters that cover the topics of puberty, gender, decision-making, relationships, violence, mental health, and sexual and reproductive health, in an age- and developmentally appropriate way.

About the research

The research – conducted from 2018 to 2022 – included 3 measurements: the first one was held amongst students entering grade 7 (at age 12), the second one was held after SETARA lessons (at age 14) and a third measurement was carried out 2 years after the last SETARA classroom sessions, at age 16. The research was conducted in three urban areas in 3 different provinces in Indonesia (Denpasar in Bali, Lampung in Sumatra and Semarang in central Java). To measure the effects of SETARA, the Global Early Adolescent Study (GEAS) followed adolescents who received SETARA and adolescents who did not receive SETARA, at their junior high schools. The study looked at their competencies on gender equality, interpersonal skills, personal sexual wellbeing, relationships and mental health. Further research was also conducted to understand how SETARA was implemented in these different contexts and how adolescents perceived the impacts of SETARA.

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