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Breaking the Morality Taboo, To Spread Sexuality Awareness in Indonesia

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Complicated, convoluted, and cluttered, these are the words that came to mind when we talk about implementation of government programs in Indonesia, and it’s no exception when it comes to Sexuality and Reproductive Health Education or Comprehensive Sexuality Education (CSE). In the previous decade, it was even worse. At the time, there was no guidelines regarding CSE, either at the policy level or at the education unit level. To put it simply, CSE at that period was lifeless. The program was there, and the budget was provided – albeit perfunctorily, but it was lacking real goals, and seemed like a waste of time. But the story changed when Rutgers came into the picture and brought in SETARA. SETARA, which means equal in English, is an acronym of Semangat Dunia Remaja (The Ardor of Adolescence), was the seed of growth for positive CSE without morality taboo. It also triggered movements for legal protection and prevention of child marriages in several regions in Indonesia. It came in the form of a reproductive health education module which acted as a guide post for a clueless CSE at the time.
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“We had integrated health service (posyandu) program for teenagers, but it was ineffective because it was conducted in the morning, when kids are in school. It was a cursory service but we didn’t achieve any real target,” said Erni Suryana, Secretary of Office for Women Empowerment, Children Protection and Family Planning in West Lombok Regency.

Rutgers Indonesia – an organization working in Sexuality and Reproductive Health Rights (SRHR) and prevention of Sexual and Gender Based Violence (SGBV) – used SETARA CSE modules in schools and Rutgers’ assisted villages during implementation of previous CSE programs, among them are UFBR (United for Body Rights), GUSO (Get Up Speak Out) and Yes I Do. SETARA modules were produced by adopting from Rutgers Netherlands’ reproductive health education which complies to International Technical Guidelines on Sexuality Education (ITGSE). ITGSE is an international guideline standardized by UNESCO. Erni explained further that in Lombok Barat regency, knowledge about CSE among teenagers is considered minimal. This condition resulted in high level of early marriages and unwanted pregnancies. Actually, several first health facilities such as community health centers (puskesmas) have CSE programs. However, only some of the public health staff had good understanding of CSE. Another challenge that they were facing was mutation of CSE competent public health officers. In their new place, they might have titles and roles that are different from the previous ones, preventing them from continuing the CSE for teenagers.
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“Another thing, CSE was conducted in community health centers, and people have stigmas, that this place is only for those who are sick, or for troubled teenagers, so teenagers seldom used the counseling and reproductive health services provided,” Erni continued.

Aside from that, at the school level, CSE was conducted as a brief socialization activity. Capacity building for educators and family was non-existent. The learning materials were outdated. Most regions faced the same problem when they wanted to include CSE in the curriculum.

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The Head of Public Health Division in the Office of Health for Denpasar Municipality, Tri Indarti, added that there is another problem at the stakeholders’ level: un-integration. Each stakeholder had their own CSE program and they are all working separately.

“We have to admit that this Office is highly compartmentalized. It’s exhausting because today we must have coordination with the Office of Health, and the next day we do the same thing with Agency of Civil and Family Planning, as well as Office of Education and Sports. While SETARA has an integrated material.”, said Erni.

Triggering Regulatory Changes

When SETARA came to West Lombok by means of Yes I Do program, a lot of significant changes were made in terms of how stake holders view CSE. Previously the programs were there for formality, now they come alive. Rutgers have assisted four villages and now they have fully functional integrated service center for youths, managed directly by teenagers and conducted in the afternoons. Erni sent news that they’re now working more actively to create games and youth empowerment program. Public health officers only need to facilitate and monitor their activities. “The youth reproductive health program seems fun, and it should be.” Furthermore, at the regulatory level, West Lombok has succeeded in establishing several restrictions concerning child marriages from provincial to village levels. Starting from West Lombok Regency Regulation No. 30 of 2018 concerning Prevention of Child Marriages. Followed by West Lombok Regency Regulation No. 9 of 2019 concerning Postponement of Marriage Age. Lastly, West Nusa Tenggara Provincial Regulation No. 5 of 2021 concerning Prevention of Child Marriages. In the smaller authority regions, some villages in West Lombok have also implemented Village Regulation concerning prevention of child marriages. They set aside a village budget specifically designated to fund youth activity related to reproductive health. “Rutgers assisted us to drive regulation by referring to SETARA implementation results. Research in schools has proven that there are reduced numbers of juvenile delinquency, there are even schools with zero number of child marriages,” described Erni to prove that SETARA implementation at the various levels produced concrete results. Other than that, in Bali, the local government has signed an agreement with Rutgers to continue implementing SETARA at middle school level. They also plan to provide more reproductive health trainings for teachers to enhance their competencies.
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“SETARA program has been implemented in 14 public schools in Denpasar. We want to expand it to the existing 76 private schools as well,” A.A Gede Agung Wiratama, the Head of Office for Youth Education and Sports in Denpasar Municipality added.

Future Challenges

SETARA program has left an impressive mark. The reproductive health modules have proven to produce positive results, driving changes in the perspectives of youths, teachers, parents and shareholders, regarding the urgency of CSE at all levels. Some regions have initiated expansion of SETARA implementation on their own as they are so impressed by the results produced. For example, in Semarang, SETARA modules have been included in the Office of Education programs. They targeted to implement the modules in 30 different schools within this year.
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“SETARA implementation is a key performance indicator for child friendly schools. We can say that CSE implementation in Semarang has exceeded our target by more than 70%,” disclosed Fajriah, Head of Curriculum and Evaluation Section for First Middle School Level at Office of Education for Semarang Municipality.

Semarang has targeted to implement CSE in all schools in the municipality, although they are facing a crucial challenge common to any local governments: budget issues. Especially when the Covid-19 pandemic hit, the budget to fund the program was diverted for the pandemic instead.

“We really support CSE with SETARA, we’re willing to collaborate and we’re committed to provide a designated funding taken from the Semarang Municipality’s development budget.” Budget restriction is a crucial problem in any program implementation. Office of Youth Education in Denpasar complained about similar problem, Agung commented that this issue has halted CSE empowerment program among teachers from achieving its’ targets. “Initially, we want to add more teachers to be included in the CSE training, but alas, the budget was reduced due to Covid,” said Agung. United Nation Population Fund (UNFPA), a UN organization focused on sexuality and reproductive health also said the same thing. They mentioned three main issues in UNFPA program implementation in Indonesia, budget issue was on the top.
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“Previously, the challenge was ignorance, and the taboo. Now, everyone agrees that CSE is important, the problem is that the government lacks financial commitment as CSE is not a priority,” said Sandeep Nanwani, UNFPA Program Officer for Youth Sexuality and Reproductive Health in Indonesia.

According to Sandeep, the other two challenges are systemic capacity and curriculum. What he meant by systemic capacity is educators’ capability. He saw that CSE implementation in Indonesia is mostly fear based. More often, teachers threaten students, rather than providing critical pedagogy. CSE is supposed to be delivered by experience-based teaching. The teachers should explore values from learners to empower them to make healthy decision in terms of sexuality and reproductive health. It’s made even more complicated by lack of curriculum.
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“There is no room for development of reproductive health, so what we did was hitching them to other materials. Ideally, CSE should be integrated to the national evaluation.” As UN representation, so far UNFPA has power to influence government at certain countries, to drive them to produce policies related to sexuality and reproductive health. UNFPA is one of ITSGE’s compilers. In Indonesia, UNFPA with Rutgers have collaborated with the following related ministries: Ministry of Health (MOH), Ministry of Education, Culture, Research and Technology (MOEC) and Ministry of Religious Affairs (MORA), to produce a national CSE standardized module – adopted from SETARA modules. They also encouraged CSE program to be included to the School Health Unit.
In addition, East Javanese people with strong religious values often misinterpret the norm of child marriage. They normalize early marriage to avoid adultery. Similar to East Java, in Lombok, the Sasak tribe still allows the merariq kodeq tradition, which allows a man to take away a woman to marry. However, there is a misperception in understanding this tradition. Due to ignorance or even intentionality, merariq is used as a customary excuse to marry underage women. In fact, this method actually violates the custom because merariq kodek actually requires agreement between the male and female parties, and is also closely monitored by traditional elders.
Tradisi Merariq
In the merariq tradition, there is a procession of memaling or selarian. Instead of “kidnapping” or “eloping”, memaling means hiding on the basis of an agreement between the girl’s parents and her child who is old enough. In this procession the prospective groom is obliged to bring his female family to accompany the prospective bride. In terms of age, the man must already have 25 buffaloes or cows, while the woman is able to spin cotton into yarn, woven into 144 pieces of songket, and then sell them. If calculated based on the age of adulthood, merariq can only be done by women aged 22 years and over.
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Slowly but Sure:
The Changes that
Empower Youth

The adolescent phase is a crucial transitional period from childhood to adulthood. In this stage adolescents experience many changes, including physical, mental-emotional, social, and cognitive maturity. The process of self-discovery and sexuality information begins at this point.

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“Life in the past and now has different cultures and challenges. Children nowadays, if they are not told the right basics, will be dangerous because they are bombarded with information, while parents cannot catch up with the information,” said Siswanto Agus Wilopo, professor of Faculty of Medicine, Public Health, and Nursing (FKKMK) Universitas Gadjah Mada (UGM).

According to Siswanto, of all the unofficial information that teenagers receive about sexuality, as much as 75 percent of the truth cannot be accounted for. Adolescents need comprehensive education to guide them in making decisions about their sexuality.

Ideally, PKRS should be given since the child is in elementary school – of course adjusting the curriculum at that age level – because problems with reproductive health begin to appear in the early adolescent period. In boys, there is a change in body shape, while women are added with the menstrual cycle.

Without sufficient provision of CSE, adolescents – children who have just been positioned as adults – can be confused and fall into misleading information. The implementation of SETARA as a CSE module at the early and upper secondary education levels has proven to be able to prevent this kind of thing.

This condition is illustrated in a survey that was deliberately created to measure changes in adolescents’ perspectives after the implementation of SETARA, namely the Global Early Adolescent Study (GEAS). The first GEAS was launched in 2018 and was re-evaluated in 2021.

The GEAS study data was collected from three regions, Denpasar, Semarang, and Bandar Lampung-areas that were also sampled for the story of change. The three research locations were taken as examples because they have different cultural-religious backgrounds.

The more conservative Islam is represented by Bandar Lampung in Sumatra, while the more open Hindu culture is found in Denpasar, Bali. Both are compared to Semarang, Java, which is more generalized, including in terms of globalization of print and electronic media, social media, as well as tourism and contact with non-native cultures.

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“The most visible change in GEAS is that adolescents’ perspective becomes more positive in SRHR literacy and communication. They are more courageous and open to talk about pregnancy or discuss HIV,” said Anggriyani Wahyu Pinandari, GEAS study coordinator and researcher from UGM Center for Reproductive Health.

In addition, the adolescents also had increased scores in viewing body changes and puberty, sexual and romantic behavior, and suppressing bullying. In short, the implementation of the SETARA module has succeeded in breaking the taboo of sexuality in adolescents.

If I may quote Eka’s statement, in Bali, a concrete example of a story of change is reflected in adolescents’ awareness of Youth Care Health Counseling (PKPR) services. The PKPR program at Puskesmas aims to provide counseling on various health problems to adolescents.

Before SETARA was implemented, there were no teenagers who came to PKPR on their own initiative. Recording at several health centers in Denpasar revealed zero access to services. PKPR is only accessed when there are adolescents who come to the health center with the aim of treatment, then offered the service.

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“After we promote (SETARA). Yes, you could say the increase is 100 percent,” Eka said.

Now teenagers are not only familiar with biological aspects, such as information on how HIV is transmitted or the process of pregnancy. But they also understand a broader spectrum of sexuality, for example about sexual diversity, healthy relationships, recognizing emotions, and mental health.

Along with SETARA, programs at the community level such as the Power to You(th) program – although it does not have a specific study that measures change like SETARA with GEAS – also contribute to the story of change.

Rey said, adolescent girls have been transformed into the vanguard of change when for example they find child marriage in their neighborhood.

Then the stakeholders above them also oppose these practices.

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“They become more aware when their friends stop school because they are married off. They realize that this must be prevented, so they report to SETARA teachers or peer educators,” Rey continued.

After that, the simulation continued with negotiations between the Women and Children Service Unit (PPA) of the police, hamlet heads, and traditional leaders with parents of child marriage victims. At the school level, teachers in West Lombok also took the initiative to provide sanitary napkins as a fulfillment of adolescent girls’ reproductive rights.

Then what about the story of change at the policy level?

It is true that not all adolescents in Indonesia can feel the story of change, because the SETARA program has not been adopted in all regions of Indonesia. Plus it is not included in the fixed curriculum, so teachers have to steal time to provide SETARA material.
We then asked Siswanto about broader opportunities for change at the national level. He said that the results of the GEAS study have become the basis of advocacy for five ministries, specifically the Ministry of Health and the Ministry of Education, Culture, Research, and Technology to develop a national PKRS module.

It is planned that this national PKRS module will be oriented to SETARA and distributed in more than 200 districts/cities. The government will also provide CSE training to 5000 teachers gradually until 2025.

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“So the GEAS results have influenced policy makers, we just need to be patient and evaluate. In the future, there will be more students and schools that receive comprehensive SRHE,” Siswanto said hopefully.

Until then, we can start the story of change from the smallest point: schools and families. And Rutgers has started with SETARA. Because the reluctance to talk about sexuality only allows teenagers to walk down a dark alley.

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4 July 2022
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