sexual education: comparative study in indonesia and australia

8/17/2019 Sexual Education: Comparative Study in Indonesia and Australia

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Educational Continuance for Pregnant Students and Sexual Education

(A Comparative Study between Australia and Indonesia)

By Arie Pamungkas

Dept.of Sociology and Social Policy

Gadjah Mada University !ndonesia

A. Introduction

"eenagers in high schools e#perience lots of changes in $oth their psychological

and $iological conditions as %ell as their social development. At this stage in their lives

they e#perience critical life&defining events'particularly in their social relationships

e.g.( pu$erty first se#ual intercourse and adaptation to the adult %orld in terms of

independency and %ork o$ligation. Mean%hile schools are constructed as primary placesfor preparing teenagers for adult life. "he roles of schools in preparing those a$ilities is

e#plained $y Sherman Dorn )*++,- %ho says that schools function as the great socialisers

of adolescence $ecause high schools are a special type of %arehousing institution %hich

are attached to age&related e#pectations or age norms )Dorn *++, pp.-. !n this century

high schools have $ecome the dominant institution of teenagers since many are less a$le

to find %ork and secondary education has greater value in the la$or markets. At this stage

teenagers are e#pected to pursue an education until they can $ear the responsi$ilities of

$eing independent $oth personally and economically. "his vie% also refers to se#ual

activities among teenagers the results of %hich may cause to an educational pause or

even educational leave for e#ample if teenage girls are found pregnant )Sydney Morning

/erald 0une 1221-.

Because schools had $een assumed to $e institutions that provide moral learning

at least until the early t%entieth century most pu$lic schools removed pregnant students

from regular classes. "his %as supported $y the argument that says such measures %ere

aimed to protect other students 3against moral pollution4 )Dorn *+5, pp.*25-. 6or

instance in the U.S. during the ,27s as Dorn 8uoted from Goldstein )*+,+- the decision

regarding e#clusion of pregnant students %as s%inging $et%een %hether to e#clude

married students from school or e#pel unmarried pregnant students. 9et until *+:1 in the

U.S. %hen the amendments to the ;lementary and Secondary ;ducation Act $anned



se#ual discrimination in schools accepting federal aid the Department of /ealth

;ducation and <elfare ruled that e#cluding pregnant %omen from school constituted

discrimination )Dorn *+5, pp.*2+-.

A.. Australia! "eneral #rends

Mean%hile in Australia the engagements $et%een feminism and social

movements since the :27s have effectively resulted in the manifestation of applying

gender e8uity policies at schools. "his can $e inferred from several policy documents

such as( Girls school and society = >ommon%ealth Schools >ommission *+:? Se#

Discrimination Act *+5@? the national policy for the education of girls in Australian

schools = >ommon%ealth Schools >ommission *+5:? and the national action plan for the

education of girls =Australian ;ducation >ouncil *++? and Gender e8uity( A frame%ork

for Australian schools = Ministerial >ouncil *++: )Ail%ood and ingard 122*-. !n the

Se# Discrimination Act *+5@ the discussion is generally focused on discrimination on the

grounds of se# marital status pregnancy or family responsi$ilities or involving se#ual

harassment )Mc7Mahon et.al. 1222-. Cne of the aims of this act clearly states that

3to eliminate, so far as is possible, discrimination against persons on the ground

of sex, marital status or pregnancy in the areas of work, accommodation,

education, the provision of goods, facilities and services, the disposal of land, the

activities of clubs and the administration of Commonwealth laws and

program…4)i$id pp.:-.

"hus this Se# Discrimination Act has $ecome the fundamental policies regarding

any practices of se#ual discrimination. "he Gender e8uity policies are specifically

concerned %ith girl7s education $ut mostly pay attention to de$ates over the content of

education in terms of masculinity and femininity rather than identifying specific issues

concerning se#ual relationships among students that might result in the pregnancy of

female students. A specific policy related to pregnancy and the continuance of education

%as recently set out $y the Department of ;ducation and "raining. !t provides $asic

guidelines in supporting pregnant and parenting students. "he guidelines entitled

1



Procedures for Resolving Complaints and Discrimination against Students !""# %as

follo%ed $y another pu$lication $oung %others in &ducation !""'( %aterials to assist

school in their support of young pregnant women and young mothers and $oth offer

strategies and suggestions for assisting young pregnant and parenting %omen to continue

%ith their education )Milne&/ome et. al. *++,-. /o%ever different schools reflect very

different attitudes to%ard this pro$lem and %ill $e discussed later on in this article.

;very year in Australia as reported $y "he Association of <omen ;ducator $irth

rates to teenagers )including pregnancy rates- vary in different states as can $e seen in the

follo%ing ta$le(

9ear " "AS ED <A S< SA F!> A>" Aust

*+52 +5.+ 5.* ,.+ 2.1 15.2 1,. 1*.2 *+.+ 15.*

*++1 +2. 1+.2 1,. 1.2 11.5 *5.: *@.: *@.2 1*.+

*++@ [email protected] 1:.1 1., 1@.+ 12., *,.* *@.1 *@.2 12.:*++, :5., 1,.5 1,.2 11.5 *+.+ *5. *1.5 *@.@ 12.*

otes( Births per *222 of the estimated resident *&*+ females population *++,=

Source( the Association of <omen ;ducator( http==%%%.sev.com.au

eaving schools early is sometimes the only option for girls $ecause it is hard for

them to complete their education at the same time they have to prepare for giving $irth

and most importantly $ecoming mothers. Pregnant students e#perience often difficulties

maintaining their education due to the lack of support from schools their friends )peer

groups- the community and even their o%n parents. "his is $ecause incidents of

pregnancy among students in some schools and in a society is still stigmatied? ho%ever

there are some schools that try to channel pregnant students to%ard completing their

education. "his can $e seen in Plumpton /igh School in Sydney <estern Su$ur$s %hich

has run 3 ) $oung %other in &ducation Program4 since *++@. Plumpton /igh school

provides a very supportive environment particularly %ith a special area that functions as

a kind of childcare center. "his program has significantly helped students to cope %ith

their fears of une#pected pregnancy and their lack of skills to enter the adult %orld

particularly in caring for their $a$ies. By contrast in schools that provide little or no

support teen mothers tend to terminate their education $ecause the stigma and social

$arriers are too much to $ear

A.$. Indonesia! "eneral #rends in %eveloping Countries



!n comparison in the developing countries in this case !ndonesia the situation is

much %orse than in developed countries such as Australia. !n !ndonesia %here the

population is around 112 million )!ndonesian Bureau Statistic 1222- there is no

availa$le data a$out ho% many pregnant students %ho are e#pelled from pu$lic and

private schools. According to a report from PKBI Perkumpulan *eluarga +erencana

ndonesia or in ;nglish "he !ndonesian Planned Parenthood Association )!PPA- there

are a$out 1. million teenagers that opted for a$ortion in 1222. Most are poor and living

in remote areas of the country. "he issue of pre&marital pregnancy in a country such as

!ndonesia $ecomes very complicated $ecause at the state level there is no particular

policy that deals specifically %ith youth health and reproduction. Moreover in this

patriarchal country %omen that $ecome pregnant $ear the $lame and social stigma %hile

men are hardly held responsi$le at all. "hus it is %omen that e#perience social

disapproval and isolation. !ndeed the social stigma is so harsh that for many %omen

a$ortion $ecomes an inevita$le choice.

6urthermore young unmarried !ndonesian %omen have enormous difficulties

o$taining contraceptives $ecause $irth control is legally dispensed only to married

couples. !t is very typical in !ndonesia for those students that get pregnant to e#pect little

or no support from their schools or even their o%n families. As reported $y PHB! )!PPA-

%hich has e#perience in providing youth se#ual education and helping pregnant students

receive medical treatment it is very common among their clients that most commonly it

is parents %ho suggest a$ortion due to em$arrassment and fears of $eing persecuted $y

communities still $ound $y religious and cultural traditions %here pre&marital se# is

punished $y socially ostraciing the transgressor )PHB!&Hompas 1222-.

!n fact trends in most developing countries sho% that pre&marital se#ual activities

have increased every year as reported for instance $y 9oung Adult Ieproductive /ealth

Surveys )</C *++- in atin America average age at first intercourse ranged from *

to *, years for $oys and from *, to *5 years for girls. !n Africa among Henyan students

surveyed in the late *+52s @5J of males in primary school and ,+J of males in

secondary school %ere se#ually active compared %ith *:J and 1:J of girls in primary

and secondary schools. !ndonesia is reported to have a significant increase in se#ual

activities among adolescents from 5 J during the :27s to 12 J in the +27s )ibid -.

@



"hese descriptions reflect concern over the vulnera$ility of teenagers mostly

students in secondary schools in coping %ith their reproductive health and understanding

their rights of continuing education as a $ridge to adult life. "his case sho%s us ho%

teenage girls are the most vulnera$le victims e#periencing e#clusion from social life due

to the physical and psychological $urden of pregnancy %hile also enduring e#pulsion

from school and $eing denied their educational rights. "hese facts should $e carefully

noted $ecause preventing pregnant students from o$taining an education %orks against

any efforts to%ard alleviating poverty.

A.&. Expected 'utcomes from te Comparative Study

"here are e#pected outcomes from this comparative study. "he first is trying to

identify the de$ates over the function of schools as educational providers representing

gender e8uity and individual rights. /o% far is the idea of fighting for se# discrimination

and e8ual opportunity implemented in different social and political levels( the state

pu$lic and private schools community and family )parents-. At this point ! %ould like to

compare the different conte#ts related to this issue namely Australia a socially

progressive and modern country and !ndonesia %hich is still considered a conservative

and traditional patriarchal country.

"he second outcome is e#pected to sho% %hat constitutes the idea of reproductive

health in relation to claims over individual rights )claims over a %oman7s right to her o%n

$ody in deciding %hether to continue or terminate her pregnancy-. !n this matter ! %ould

like to criticise the educational practices that e#clude pregnant students $ased on the

moral de$ates or dra%ing from cultural or religious $elief to deny a person her individual

rights. More specifically in the !ndonesian case ! %ould like to e#amine the moral

de$ates over pre&marital se#ual activities and pregnancy among young adults and in

particular evaluate government policies on youth se#ual reproductive health )SI/-. !

also %ant to analyse the response of local communities to%ard issues of 9outh se#ual

reproductive health $y discussing the role of the !ndonesian Planned Parenthood

Association rather than simply advocating the role of schools.

"he third outcome is aimed to%ard searching for alternative options for pregnant

students if they chose to continue their pregnancy. "his might accomplished $y



integrating the roles of different actors( state schools )including teachers- local

communities and also family )parents-. "he 8uestion is ho% these roles could $e

distri$uted among those actors and ho% they might operate to help students in achieving

their education goals. !n this stage ! %ould like to study and use the case of Plumpton

/igh School as a model that can $e applied to solve similar pro$lems in !ndonesia.

!ndeed regarding the fact that most Schools in !ndonesia are not actively involved in the

areas of 9outh se#ual and reproductive /ealth this study tries to find an alternative

program to that proposed $y another institution )!PPA = PHB!- in dealing %ith this issue.

. #e Case of Pregnant Students in Australia! An In*uiry to te Individual +igts

and "ender E*uity

!n Australia there has $een a distinct shift in teenager7s decision to resolve their

pregnancy %hich moved from a dichotomy of marriage and motherhood or adoption to

one of motherhood )sole parent- or a$ortion );vans 122*-. !n the ,27s %hen teenage

girls %ere found to $e pregnant they %ere often sent to live %ith their relatives or friends

or at a $oarding house to deliver their children for adoption. "hus at that time the

decision %as in the family7s control %here in some cases churches actively supported

the family in dealing %ith this pro$lem. !n the *+:27s control over the decision $egan to

move a%ay from social institutions to%ard more individual decision making )i$id-.

6inancial support from the government for single parents and the option to undertake

a$ortion have induced young %omen to make their o%n decisions outside the family

structure )i$id-.

/o%ever there are other factors that influence students in deciding %hether to

continue their pregnancy or terminate it. ;vans indicates that these other factors include

%omen7s living arrangement and area of residence that is related to the source of

influence they might receive? and access to a$ortion services %here for instance %omen

%ho live in Sydney Metro are more likely to have an access for a$ortion rather than

%omen %ho live in rural or remote areas );vans 122*. pp.1-. !n a recent research report

;vans found that the decision to undertake a$ortion is likely to $e an individual decision

,



although there are reported influences from others )partners $oyfriends family or

friends-.

De$ates over %omen7s rights over their o%n $odies are marked $y the notion of

individual rights %hich is 8uintessentially li$eral since the ideology of possessive

individualism is centred on the proposition that individual is the rightful possessor of his

or her $ody capacities )C7>onnor et-al . *+++. pp.*5-. !n this notion the term 3rights4 is

usually associated %ith the capacity to %ork and the capacity to determine %hat %ould $e

suita$le for their $ody7s )reproductive- capacities ) ibid -. "herefore the argument that

says a %oman has the right to control her o%n $ody means that she has the right to

choose to e#press her free %ill regarding her o%n $ody and resultantly she has the right

to decide she %ants to continue her pregnancy or terminate it. !ndeed it suggests that

reproductive right is a form of citienship %hich entails civil political and social rights

)ibid pp.*,*-.

.. #e Scool,s +esponse on te issue of Individual +igts and "ender E*uity

!n principle schools are e#pected to $e places %here adolescents prepare for their

adult life. "his %ould $e a 3$ridge4 for adolescents to enter the adult %orld particularly

in regard to employment. !n this sense young people are more likely defined as $eing 3 at

risk 4 in achieving a successful transition to adult roles in society $ecause of the

possi$ility of leaving school early. Batten and Iussell as 8uoted from Mc!ntyre et al

)*+++- put pregnancy and motherhood as one of other potential indicators of school

leaving in Australia. Mc!ntyre7s report finds that $et%een the early *+527s and the *++27s

there %as a marked increase in the proportion of young people completing 9ear *1 from

J to 52J )i$id. pp.*2-. !t also says that completion rates for female students had

$egun to rise in the mid *+527s $ut no% it had decreased consistently )ibid -.

!n regard to this issue the S< Government circulated the e% South <ales7s

>harter for e8uity in education and training )*++:- %hich states(

&veryone is entitled to high e.uality of education and training programs that

provide recognised credentials and clear pathways to employment and lifelong

learning- /he outcomes of education and training should not depend on factors

beyond the learner0s control or influence- )ll young people are entitled as a

:



minimum, to be able to complete their school education to $ear !1 or a vocational

education e.uivalent )Mc!ntyre et.al.*+++ pp. 5-.

6rom the a$ove statement it can $e inferred that there are some people %ho do not

complete their education and %ho do not receive recognied credentials and clear

path%ays to employment and lifelong education. 6ocus on youth education therefore

plays an important role in the attempt to provide path%ays to employment and lifelong

education. !n this sense more schools that support students in coping %ith their

difficulties and disadvantages inhi$iting them to finishing their education are needed. !n

this part school functions as an educational provider that values gender e8uity and

individual rights and provides access to employment and lifelong education. "hus young

people may face disadvantages in gaining access to the la$our market due to their

outcomes from schooling. "herefore supportive schools that help students to find

path%ays to the adult %orld is very important.

!n regard to the gender e8uity issue >arol Gilligan notes that due to the

differences in the %ays that teenage girls think of themselves and resolve issues related to

other teenagers girls should $e given a different sense of priority from $oys. /ere

pregnancy is an o$vious area %here %omen rather than men are truly the su$jects.

Gilligan continues as 8uoted from Milne&/ome )i$id.pp.1*- that women and girls have

been shut out of the story of human development, as can $e found from her statement(

23hen women0s studies is 4oined with the study of girl0s development, it becomes

clearer why adolescence is a critical time in girls lives, a time when girls are indanger of losing their voices and thus losing connection with others, and also a

time when girls gaining voice and knowledge, are in danger of knowing the

unseen and speaking the unspoken and thus losing connection with what is

commonly taken to be 2reality5- /his crisis of connection in girls0 lives at adolescence links the psychology of women with the most basic .uestions about

the nature of relationship and the definition of reality- 6irls0 .uestions about the

nature of relationships and about reality, however, also tug at women0s silences)i$id pp. 1*-

Disadvantages due to pregnancy range from declining opportunities for

educational continuance to limited access to employment and training and are considered

as 3forms of silences4. Stigmatiation of pregnant students continues %hen they are

5



una$le to continue their education and vie%ed as school drop outs. Milne et-al- argue

that unlike $oys girls typically refuse to separate feelings of love from their

consideration of the rightness or %rongness of se#ual intercourse. At this stage girls

move into contractual and attachment reasoning %here the primacy of relationship

typifies the attachment orientation of girls %hich includes care and justice )ibid -.

/o%ever it is very difficult to $ring the perspective of pregnant students in

academic considerations due to emphasis on pu$lic morality and private shame relegates

adolescent parenthood as a type of deviance in the theoretical frame%ork )i$id-.

"herefore educational continuance for pregnant students )adolescents- needs

perspectives that support gender difference. !n this sense $oth individual rights and

gender e8uity perspectives are e#pected to contri$ute to pointing educational directions

for girls( paid %ork domestic life and citienship. !n attempt to provide a model for

school policy %e may take a look at the case of the Plumpton /igh School under the

<estern Sydney project as an e#ample of ho% special policies for pregnant students is

integrated %ith a supportive school environment.

. $. -earning from te estern Sydney Pro/ect

According to <SIC> )<estern Sydney Iegional Crganisation of >ouncils- on

their report 3$oung %others of the 3est 4 a$out pregnant and parenting students in the

<estern Sydney region there are some findings that sho% support given $y schools %ill

effectively determine a student7s a$ility to continue his or her education. "his research

categorised 1 types of support from schools(

+asic Supporting Schools, %hich provide(

a. Support = encouragement

$. >ounselling

c. Department of >ommunity Service notification

d. !nform the student of educational choices

e. 6le#i$le %ith attendance and timeframe re8uirement

f. Some communication %ith the student7s family

Mean%hile Pro7)ctive Schools %ill provide(

a. A designated access point )a special teacher=support %orker=mentor-

+



$. inks %ith family

c. inks %ith childcare

d. A specific policy

e. Provisions of information a$out rights and options to students generally

f. ;ducational options advice to pregnant students

g. Maternity leave

h. Special facilities such as feeding= $a$y room toilets maternity sied uniform

i. A supportive environment created through those a$ove practices.

"his report indicates that schools providing a pro&active attitude to%ards pregnant

and parenting students have significantly higher retention rates )55J amongst participant

schools in <estern Sydney- compared to those schools that provide only $asic supporting

)1,J- )<SIC> report 1221-. "his clearly proves that in the attempt to achieve their

educational completion parenting students need full support from their school %hich may

ena$le them to $ear their responsi$ility to%ard completing their education as an

investment in their future and their ne% responsi$ilities as young mother. Some schools

that seem reluctant to practice pro&active support for their pregnant students often argue

that some $arriers preclude them from conducting this program.

"here are some $arriers indicated from the pro$lem( the pregnancy itself

parenting personal $eliefs and attitudes family relationship and community attitudes.

!ndeed there are some possi$le recommendations to cope %ith those $arriers

recommended $y <SIC> (

a. Pregnancy Related +arriers

"hese $arriers relate to $oth physical and psychological conditions during

pregnancy and its effects on pregnant students a$ility to continue her education.

"hese $arriers include tiredness sickness self consciousness )due to change in

appearance- and their medical conditions. As reported $y <omen7s /ealth

Eueensland <ide !nc. )the Association of <omen ;ducators 1221- these %omen

tend to e#perience higher complication rates %ith pregnancy %hich may affect

their achievement at school. >onse8uently students may need an e#tended period

for resting %hich also means educational pause or termination.

*2



!n attempt to face this pro$lem <SIC> report recommends the possi$ility of

continuing education for those students $y indicating the timing of the $irth. !f a

$irth %as due late in the year a return to school the follo%ing year might seem

more managea$le as all students %ould soon take holidays and time is availa$le

to adjust to the ne% situation. "his means that students may$e a$le to complete

their education on that year. /o%ever if the $irth %ould occur in the mid year

%hen students may miss their class taking time off and missing out on %ork

could $e such possi$le options for them.

$. Parenting Related +arriers

"his $arrier could $e the most significant difficulty for students due to the

availa$ility of accessi$le and afforda$le childcare. !n case that e#ternal child care

is needed there are some issues that %e have to consider e.g.( transport and

financial support for childcare facilities. !n some cases the cost of childcare

$ecomes the reason of %hy some students terminate their education.

<hen support comes from the government for instance( >enterlink there are

some administrative pro$lems they might face as can $e found in the infle#i$le

procedures. Iecommendation for this $arrier is offering part time study for them

if those $arriers are very difficult to overcome.

c. Personal +arriers

As mentioned earlier adolescence e#perience emotional turmoil at that age and

pregnancy can result in trauma. "herefore support and encouragement should $e

practiced through ver$al encouragement and some conducive activities sho% $y

teacher7s attitudes peer groups and parents.

d. 8amily +arriers

6amily provides the $asic protection for pregnant and parenting teenagers.

Support from family including from the $a$y7s father is needed to encourage

students return to school. ack of support from family $y hiding their girl7s

pregnancy or their parenting %ould lead to undermine self esteem and motivation.

e. Relationship +arriers

**



"his may arise from social e#clusion from their peer groups and even social

isolation. Preventing young pregnant %omen from schools %ould mean to social

e#clusion and social isolation.

f. Community )ttitude +arriers

"his relate to community and school attitudes and $ehaviours %hich influence

pregnant students to stay at schools. Such traumatic e#perience caused $y

un%elcome attitudes %ould discourage them to leave school earlier. "herefore

enhancing community a%areness is very important for this task particularly $y

changing teacher personal attitudes

Based on this e#planation it is very o$vious that support from the school is

a$solutely crucial? ho%ever lack of support from parents such as %anting to hide the

pregnancy and removing decision making from their daughter sustains the $elief that

pregnant students should leave schools. !n such cases schools should at least inform

students a$out their rights and possi$le options for continuing their education. <SIC>

also suggests that %hile schools are improving their support schools can assist students

$y providing information on community service support making links %ith support

agencies %orking %ith student7s families and e#ploring innovative support strategies

such as providing mentoring.

.$. Some Policy Implications from te S+'C Pro/ect

Cnly a very fe% schools have a policy regarding pregnant and parenting students

and indeed most are una%are of the Department7s guidelines and strategies. "here are

several reasons for this. 6irstly the Department does not re8uire schools to adopt the

policy $ut only to present general guidelines %ith minimum supervision over pregnant

students )<SIC> report 1221. p.*:-. Some schools argue that the policy is unclear and

thus need a revised version that clearly determines the responsi$ilities of schools in this

area )ibid -. !n fact although the current policy contains vital information regarding the

school7s role and the realities of adolescent parenting it is neglected. "he argument that

the school7s responsi$ility to improve services for pregnant students is precluded $y the

*1



lo% level of support from the Government in releasing num$ers of reported pregnancies

cannot $e fairly accepted. "his is $ecause schools are e#pected to seek the information

actively. <SIC> suggests that it should $e the school that seeks information actively

regarding pregnant and parenting students )ibid p.*:-.

"his situation could lead to a 8uestion of %hy only some schools participate in the

pro&active program %hile some others seem to ignore it. Despite the fact that some

schools and government are very cooperative in improving their support for pregnant

students it seems that other elements %ithin society nevertheless stigmatise the pregnant

student. !n order to improve such circumstances <SIC> also suggests that school can at

least inform their students a$out options if they may leave school due to pressure from

their peers family or community. !n this regard teenagers and their families deserve

honest information a$out the availa$le options for them. "his %ould help students to

decide their continuance of education %hether they %ant to continue parenting or

rethinking other options i.e. adoption etc. "herefore roles of schools are very important

in improving the educational support of pregnant students as %ell as help them face

e#ternal $arriers. "hese should $e included as the main tasks for every school( providing

information on community service support %orking cooperatively %ith students and their

families and making a link %ith other related agencies. Schools could offer additional

help $y helping the pregnant student e#plore innovative support strategies.

C. #e Case of Pregnant Students in Indonesia! A Policy +eview on te Problematic

0out (Adolescent) 1ealt Policies of Indonesia

According to </C )*++- adolescents are people $et%een *2 and *+ years old

%ho e#perience a comple# development $oth physically and psychologically. <hen

seeking reproductive and se#ual healthcare services !ndonesian adolescents face many

o$stacles due to governmental policy la% and culture. Despite a la% that $ans premarital

se# there is a significant gro%ing num$er of se#ually active teenagers in !ndonesia )as

mentioned earlier in the introduction chapter-. >urrently there are no pu$lic healthcare

clinics designed to offer youth&friendly and non&discriminatory services for these

*



teenagers. "herefore the adolescent stage constitutes a 3$lank spot4 in the country7s

health efforts although the health pro$lems that emerge during the adolescent stage are

uni8ue and need special attention. "he lack of access to reproductive and se#ual health

services has significant implications for !ndonesian adolescents. At this point ! %ould

like to specifically look at the youth health policies in !ndonesia $y taking an e#ample

from the case in PHB! )!PPA- in the province of 9ogyakarta my hometo%n.

C.. %emograpic ac2ground (0ogya2arta)

"he estimated population in !ndonesia in 0uly 122* %as 115 million )!ndonesian

Bureau Statistic 122*-. According to U6PA )1222- the age distri$ution of !ndonesia7s

population is as follo%( 2&*@ years K 2.:J? *&1@ years K *+.5J? and ,2 years and over

K :.J. !ndonesia has varied ethnic groups consisting of 22 tri$es %here 0avanese is the

$iggest ethnic group )@J- and a$out :J of its population are Moslems )!ndonesian

Bureau Statistic 122*-.

Mean%hile 9ogyakarta is located in >entral 0ava under the province of Special

Iegion of 9ogyakarta. !t has population around .* million in 1222 %ith total area is

*5*5 ha %hich is considered as one of the most densely populated areas of !ndonesia

%ith +*+ persons per s8. km )!ndonesian Bureau Statistic 122*-. 9ogyakarta is a famous

tourist destination after Bali %ith a strong 0avanese culture. Iegarding the custom in

9ogyakarta )0ava- in almost all parts of this country the relationship $et%een males and

females is very patriarchal. <ithin 0avanese culture males are perceived as superior to

females therefore males are allo%ed to dominate and control females. "his can $e

o$viously found in a very %ell&kno%n aphorism( 2to heaven will go along with you and

to hell will also follow5 %hich means that %oman only join and depend on her

hus$and=partner even if she has to follo% him to the hell )Hhis$ijah et. al *++: pp.,1-.

!n addition the influence of religion in !ndonesia is very strong in gender and

se#uality matters. !t strengthens the patriarchal culture and inhi$its the developing of

se#uality and reproductive health issues )ibid -. 9ogyakarta is also kno%n as a 3 student

city4 %hich constitutes of @ state universities ,, private colleges *2 high schools and

122 elementary schools )!ndonesian Bureau Statistic 122*-. 6rom this data it can $e

seen that the youth in 9ogyakarta comprises a large part of the population %here many

*@



adolescents come from several parts of !ndonesia )including other provinces=islands- and

live in $oarding houses or private accommodations to pursue their education %ithout the

direct supervision of their parents or relatives.

C.$. 1ealt Care System in Indonesia! "eneral %escription

"he Department of /ealth in !ndonesia is part of the People7s <elfare Sector

along %ith Department of ;ducation Department of /ousing and Iegional Development

Department of Ieligious Affairs and Department of <orkforce all under the Ministry of

People7s <elfare and Poverty Alleviation )/idayati 1221-. Iegarding health the infant

mortality rate is 5 per *222 live $irths the total fertility rate is 1. %hile adolescent

fertility rate is :.5 per %oman aged *&*+ and the contraceptive prevalence is J

)U!>;6 1222-. "he leading cause of hospital mor$idity in !ndonesia in *+5+ for

instance %as intestinal infection follo%ed $y complications of pregnancy and a$ortion

)U6PA 1222-.

"he family planning program in !ndonesia generally has generally successful %ith

$irth rates dropping from ., children per %oman in the :27s to 1.+ children per %oman

in the +27s )!ndonesian Bureau Statistic 122*-. 6ertility declined mostly in the 527s %hen

the ational 6amily Planning Program e#tended to cover the entire country. !n addition

the population is still concentrated in the younger age groups %ith the current gro%ing

rate at *.,J annually )U!>;6 1222-.

C.&. Some Critics against te -egal 3ramewor2 and Policy of Sexual +eproductive

1ealt in Indonesia

Utomo )*+++- descri$ed the significant periods %hich can $e identified as a

turning point for !ndonesian government in emphasising concern and focus on issues

relating to se#uality and reproductive health issue. Cne of those is the esta$lishment of

3 Population Development and the Development of 9appy and Prosperous 8amily :aw4

of *++1 %here only married couples can access to se#ual and reproductive services.

Additional policy that regulates family and marriage arrangement is the !ndonesian

Marriage a% in *+:@ concerning the age at marriage %hich allo%s *+ years old for

males and *, years old for females.

*



Since the 527s the !ndonesian government has implementing a reproductive

health program for young people called 3 Population &ducation.4 "his program aims to

increase the a%areness and attitudes of young people to%ard reproductive health in

attempt to institutionalise the concept of the 3Small /appy and Prosperous 6amily.4

!ndonesian youth reproductive policies comprise advocacy se#ual and reproductive

health counselling and supportive activities. /o%ever most schools in !ndonesia are not

actively involved in this program. "he program is currently run mainly $y GC7s like

!PPA )PHB!-. 6or its part !PPA )PHB!- has encouraged schools to actively participate in

socialising youth se#ual reproductive health education program.

Iegarding a$ortion a health la% %as enacted in Septem$er *++1 that states that

a$ortion is accepta$le under specific circumstances as mentioned earlier %hich affect the

%omen7s health conditions )Djohan et.al. *++1-. /o%ever the e#act notion of a$ortion

is not clearly e#plained in the la%7s article. "he term of 3a$ortion4 is su$stituted %ith

3tindakan medis tertentu4 )in ;nglish( certain medical procedure-. 9et even this vague

la% is limited in the %ay it allo%s for legal a$ortion( %hen %oman %ants to undertake an

a$ortion she has to provide %ritten approval from her hus$and. Surprisingly most

adolescents %ho undertake a$ortion are Moslems )52J- rather than other adolescents

from non&Moslem religious groups for instance >atholic )J- )Hhis$ijah et.al. *++:.

pp.1,&15-. According to Hhis$iyah there is an argument %hy Moslems agree to

undertake a$ortion %hich is due to the Sharia7a )!slamic- la% allo%ing %omen to

undertake an a$ortion $efore the fetus reaches months. By contrast >atholic $ishop

$anned the practice of a$ortion entirely and put it as a type of sin of killing innocent

people %ho deserve to live. /o%ever in general $oth !slamic and >atholic groups in

!ndonesia agree that a$ortion is a violation of individual rights of un$orn children %ho

deserve to live.

Apart from the unclear policy on 9outh Se#ual Ieproductive /ealth )SI/-

various youth SI/ activities have $een done in some provinces including 9ogyakarta

sponsored $y international funding agencies e.g.( U6PA <orld Bank 6ord 6oundation

AusAid etc. "hese programs are run $y GC7s and government institutions such as

ational 6amily Planning >o&ordinating Board )6P>B-. "here are several e#isting rules

and regulations including regulations that prohi$it youth from access to contraceptives

*,



policies that $an unmarried pregnant students from attending schools $ureaucratic

regulations that prevent youth SI/ education in schools and la%s and regulations that

prohi$it se#ually e#plicit materials from $eing distri$uted through the mass media

)/idayati 1221. pp. 1@-.

C.4. 'ter 'bstacles! 1ealt Providers and Community Attitudes

/o%ever there are still o$stacles in developing a youth SI/ program in

!ndonesia. "here are ta$oos in the SI/ issues stigmatisation of youth using the services

as se#ually active persons and negative attitudes of the health %orkers. Usually this

service is integrated into 3maternal and child care4 or 6amily Planning services %hich

only target married couples. "hus such homogenous services cause an uncomforta$le or

inconvenient feelings among adolescents %hich may lead to illegal and unhealthy

a$ortions.

Cften the program encounters pro$lems in gaining community acceptance %ith

reasons that it may encourage youth7s se#ual activities. /ence e#isting advocacy is

particularly directed to%ard politicians community and religious leaders to counter

negative perceptions on youth SI/ programs )/idayati 1221 p. -. Services for youth

%ith special pro$lems such as un%anted pregnancy related complication of unsafe

a$ortion and S"D7s are mostly conducted $y GCs and certain cooperative hospitals.

C.5. 0out Sexual +eproductive 1ealt Care Provision in Indonesia

"here are t%o models of implemented programs? the first is clinical $ased and

outreach programs and the second is a community or a group empo%erment and other

referral system %hen pro$lems are unsolvea$le %ithin those groups. <ithin the first

model PHB! )!PPA- $ecame the first model in !ndonesia that deals %ith youth health

issues e.g. counselling and hot&line information centre dissemination $asic and medical

treatment for adolescent pregnancy and adolescent a$ortion and some other related

trainings for its %orkers and volunteers )/idayati 1221. p,-

*:



C.6. Searcing an Alternative 7odel! #e IPPA (P8I) Adolescent Clinic Pro/ect

Some health related pro$lems particularly in reproductive and se#ual health

emerge during the adolescent period as can $e seen from this story(

2 am an !; year7old teenager and have a fairly serious problem- 3henever

e4aculate feel very sick- feel tortured and wrong because have beenmasturbating often since was in the 4unior high school- 3hat kind of illness is

this and where can get medicine<

)"aken from one letter in the 3Dear entera Sahaja4 ne%s column in the local

daily ne%spaper Bernas Ccto$er 122*-

"hat story a$ove is only one e#ample of a distraught adolescent %ho is facing a

reproductive and se#ual health pro$lem. /e is ignorant of $asic se#ual $ody functions

and confused a$out %here he can get reproductive and se#ual health services. Another teenager admits in the ne%spaper that she feels like there are no reproductive and se#ual

health clinics for adolescents although she realises that many of her friends are in need of

such services. Also feelings among her peers are $ecoming more and more intense. She

said( 2f we don0t have accurate information about reproductive and sexual health then

we will most likely get lost5 )Bernas !$id-. Many of these teenagers are indeed getting

lost. Data collected in !PPA )PHB!- 9ogyakarta in Decem$er 122* reveals :11 reported

cases of un%anted pregnancy among teenage girls )*@&*+ years old-. "here are also

several reports concerning on the S"D )se#ual transmitted deceases- cases among

9ogyakarta7s adolescents )PHB!&Hompas 122*-. >onsidering the difficulties in accessing

healthcare for this specific age group %e can assume that the num$er of un%anted

pregnancies and S"Ds surely outnum$ers the data mentioned.

"he reproductive and se#ual health services that e#ist in !ndonesia are not

specifically designed for adolescents. Ieproductive and se#ual health services are more

inclined to serve adults or married couples. !n addition %hen a married adolescent

receives reproductive and se#ual healthcare services the healthcare they receive is

designed for married adults. !f adolescents use these services they are discriminated

against $y people %ithin the clinic and also from those %ho administer the services. Due

to these circumstances most adolescents have yet to make use of reproductive and se#ual

*5



health services. So %here are the services for adolescentsL "his treatment can $e

considered unfair to some teenagers.

"he health services currently availa$le most often perceived adolescents

)teenagers- as children not capa$le of making a good decision. "his narro% thinking fails

to see that adolescents are entering adulthood and should receive the support that they

need and deserve. ack of reproductive and healthcare services for adolescents is due to

the hypocritical attitudes among mem$ers of society %ho assert that teenagers should not

e#press their se#ual desires during their school period complemented $y the other

argument that allo%ing teenagers to have access to reproductive services including the

use of contraceptive means accepting pre&marital se# %hich is considered as a source of

moral pollution.

"o deal %ith these circumstances efforts have $een made $y a fe% organisations

in 9ogyakarta. "he !ndonesian /ealth Department for instance has tried to create a kind

of adolescent health consultation group at $oth the political district and inter&school

organiational level. !PPA )PHB!- 9ogyakarta for e#ample initiated a pilot project %ith

the offering of 3youth&friendly4 reproductive and se#ual health services for adolescents.

"his clinic strives to create an atmosphere %hich is peaceful and comforta$le and in

%hich adolescents can receive services %ithout judgement discrimination or stigma

)PHB!&Hompas 122*-. "his development seems to $e a right direction for the future of

youth health services in !ndonesia. /o%ever difficulties to conceptualie the construction

of an adolescent clinic still inhi$its this effort $ecause of conflicts of moral and religious

values and culture.

*+



%. Conclusion

6rom this comparative study it can $e seen that there are some similarities %hich

$oth occur in Australia and !ndonesia. "his includes the social $arriers for pregnant

students to cope %ith their decision of continuing education pregnancy and parenting in

the same time. /o%ever dra%ing from the pregnant student case here it is o$vious that

Australia has esta$lished pre&conditions that support pregnant students as can $e seen

from the legislation and related policies despite other pro$lems in encouraging active

school participation. !n terms of individual rights and gender e8uity it can $e said that in

Australia decision over se#ual reproductive health is an individual7s o%n.

!n !ndonesia the pro$lems are much more difficult and comple# not only due to

the local social $arriers $ut $roader cultural $arriers as %ell. "he dominant patriarchal

culture has influenced every policy released $y the government as can $e seen from the

un%illingness of most schools to cooperate %ith the issue of student pregnancy. Despite

such difficulties efforts made $y some GCs like !PPA )PHB!- have resulted in

alternative solutions for pregnant students in particular and 9outh Se#ual Ieproductive

/ealth in general.

E. +eferences!

Ail%ood 0o and Bo$ ingard. 122*. "he endgame for national girls schooling policies in

AustraliaL in the )ustralian =ournal of &ducation, )pril 1>>! volume ?#,Australian >ouncil 6or ;ducational Iesearch. Availa$le at( !6C"IA>"(

http==%%%.usyd.edu.au )accessed *1 Septem$er 1221-

;vans Ann. 122*. "he influence of significant others on Australian teenagers7 decisionsa$out pregnancy resolution in 8amily Planning Perspective @ol-AA Bo-# = Sept&

Cct 122* e% 9ork.

Djohan ;. *++. "he attitudes of /ealth Providers to%ard a$ortion in Reproductive

9ealth %atters !""A @ol-1 Bo-!! pp.+.

Dorn Sherman. *++,. Drop outs as social Problem, Praeger<estpoint USA. !n the

>hapter >reating the Dropout( An !nstitutional and /istory of School 6ailure.

12



/a%kes Gail. *++,. ) sociology of Sex and Sexuality. Cpen Univ.Press Buckingham.

>ph.1( Se# and Modernity

/idayati oor. 1221. nwanted Pregnancy in $ogyakarta H!" )Ioyal "ropical !nstitue-

/ealth Department Amsterdam "he etherlands. )Iesearch report

unpu$lished-

/uman Iights and ;8ual Cpportunity >ommission- )nnual Report !"""71>>>( Sex

Discrimination avalai$le at(http== %%%.hreoc.gov.au )accessed *1 Septem$er 1221-

!ndonesian Bureau Statistic 122*. Changing on Demographic data. Availa$le

at(http==%%%.$ps.go.id )accessed *@ Ccto$er 1221-

0ohn Mc!ntyre 0ohn 6reeland Bernice Melville >ristina Sch%enke *+++. &arly School

:eavers at Risk . >F;I South Australia.

Hhis$iyah Murdiyana D and <idjayanto. *++:. nwanted Pregnancy among

)dolescents >enter for Demographic Iesearch Gadjah Mada University9ogyakarta !ndonesia.

ancaster and /am$urg. *+5,. School )ge Pregnancy and Parenthood Social ScienceIesearch >ouncil e% 9ork.

e%is Gail Sharon Ge%irt and 0ohn >larke.1222. Rethinking Social Policy Sage

ondon. )pp.1@&1,-.

Mc7Mahon A. "homson 0 and <illiams >. 1222. nderstanding the )ustralian 3elfare

State Macmilan Mel$ourne.

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Project & Australian Government Pu$lishing Service >an$erra

C7>onnor 0ulia Crloff and Shaver *+++. Body Iights Social Iights and Ieproductive>hoice in State, %arkets, 8amily( 6ender, :iberalism and Social Policy

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1*

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"he Association of <omen ;ducators 1221. Present, Pregnant and Proud, keeping

pregnant students and young mums in education( Availa$le at( http==

%%%.sev.gov.au )accessed *1 Septem$er 1221-

</C Ieport *++. Gro%ing num$ers diverse needs )discussion of reproductive health

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U6PA 1222. nited Bations Population 8und Proposed Pro4ects and Programmes

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sexual education: comparative study in indonesia and australia

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