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The Discussion of Sexuality, Reproductive Health and Rights Among the Young: Issues of Disability, Unwanted Pregnancy, Policy and Youth-Friendly Services

Saturday 21 March 2015, 1130 – 1300, Lecture Theatre 5

Desintha D Asriani
Universitas Gadjah Mada

Ario Wicaksono
Universitas Gadjah Mada

This panel paper is mainly focused on the issue of reproductive health and rights among adolescent or young group. The panel, consisting of four papers will give many alternative perspectives in describing the dynamic of youth in the discourse of reproductive health and right.
Two papers are the study based on the explanation of cases, such as young woman with disability and the experience of teenager with unwanted pregnancy. In the disability issue, the discussion goes to the elaboration of social changes of psychological, social and physical affected by their (young-woman) impaired bodies. Another case of this panel is about unwanted pregnancy of teenager group and the experience of stigma. The research intentionally discusses about what will teenager construct about stigma and how they can deal with it. The important thing of both cases above is that juvenile, whatever the constraint must be faces are recognized as the subject and the source of knowledge itself. It may be different with the mainstream that often mention young people as the object of source of problem.
The cases above then are framed with the perspective of policy and services in Indonesia. The writing of policy study and the achievement of youth-friendly services, has been implemented in Indonesia will try to give the argument about how far those have already adopted youth-friendly principle. Here, several lesson learned of each achievement shall become the important point to be discussed. Hence, in the last, it is proper to be used to list the alternative or possibility as reference for youth problem related to the sexuality issue.

Paper 1: The Transition to Adulthood of Newly Young Women with Physical Disabilities in Yogyakarta Post Earthquake Disaster

Fina Itriyati
Australian National University

The 2006 earthquake disaster in Yogyakarta has changed the lives of the victims. Research on the experiences of people with disabilities in post earthquake have flourished. However, there is no yet research on the experiences of newly young women with disabilities who have become paraplegia since the disaster. My paper focuses on the transition to adulthood of newly young women with disabilities in 2006 post earthquake in Yogyakarta. I use the life history method to understand the experiences of disabled teenagers or young adult aged 15-24 during emergency, recovery and post recovery of disaster response phases.
In this paper, I elaborate how their impaired bodies affected their life and have changed their psychological, social and physical development of adolescents. What I want to see from this research is how these newly young women with disabilities have adapted to changes and coped with their problems. In this research, I also disclose how is the relationship of these young disabled adolescents with their parents, peers and larger communities in their surroundings. More specifically, I want to see how they negotiate their transition of their female identity from teen to adult women.
The discourse of autonomy, sexuality and identity are useful to understand their experiences. Furthermore, their meaning of being young women paraplegia would also become my primary concern to understand how they shape their lives in the present and in the future. To complete my paper, I also analyse how significant is the construction of disability in Yogyakarta shapes newly young disabled women’s understanding of disability.

Paper 2: Unwanted pregnancy and The Experience of Stigma

Desintha D Asriani
Universitas Gadjah Mada

This study mainly discusses about the girl’s experience story in facing the unexpected pregnancy. Pregnancy here becomes the critical issue due to its complex effect, particularly for those who are still in teenage age. It, though surely involves role of both boy and girl, often brings more difficult obstacles for girls. The girl must face several rules coming from the structural side like school institution and the culture like social norm would be the constraint with unexpected pregnancy. Beside the threat of drop out, they could not avoid the social judging or what it calls as stigma. However, according to the study of Yardley (2008), this kind of stigma may give the self-mechanism of coping as adaptation effort in the different social life. Hence, this research sociologically wants to deeply elaborate girl negotiation ability to deal with the stigma itself. By using the concept of structure and agency, this research analysis goes to the explanation of how the girls living in the constraining society obtain their solution. This concept then will place the girls as the subject and source of knowledge rather than as the object or victim. Moreover, the method of observation and in depth-interview enable this research to briefly provide the result that agency owned by each girl has influence to the divers performance in facing the stigma. It means that some are likely trapped in the stigma, but the others also can realize the strategy to survive and continue their life happily. To sum up, this research depicts that stigmatized girls are possible to move on from the negative label as long as their agency increasingly works in daily life.

Paper 3: Tracing Back Adolescent Reproductive Health Policies in Indonesia: Are Youth Friendly Enough?

Ario Wicaksono
Universitas Gadjah Mada

Young people are less willing and able to seek reproductive health services for many reasons, mainly related to poor knowledge of reproductive health, and the absence of specific reproductive health services. Given that young people tend not to use existing reproductive health services, specialized approaches must be established to attract, serve, and retain young clients, that what is called youth-friendly service. But in the other hands, providers still indicated unresponsive to fulfill adolescent special needs with distinct treatment from other reproductive health services which usually set for adult. From policy perspectives, policy barriers in serving adolescents and youth in Indonesia are mainly also include lack of sustainability, limited scope, short timeframes, and funding shortages, complementing major problems related with sensitivity over adolescent and youth reproductive health issue. Here, the lack of policy commitment will have implication on the quality of youth reproductive health status. Moreover, Indonesia with almost 230 million people is the world’s fourth most populous country with young people represent 30 percent of the population, making it as the country with significant demographic dividend until 2025. This writing tries to deliver contribution to policy maker regarding how far policies has already adopted youth-friendly principle in its content and delivery, based on regulation as well as related research findings document-analysis procedures. policy, adolescent, reproductive health and right

Paper 4: Strengths and Challenges of Youth Friendly Health Services In Indonesia

Laily Hanifah
Mitra Inti Foundation

In Indonesia, there are more than 65 million young people between 10 and 24 years of age, representing about 28% of the population. For the next 15 years these young people will constitute the main driver of economic growth and social change in Indonesia, yet they will face many challenges, including in the area of sexuality and reproductive health.

Every year, 1.7 million people under the age of 24 give birth; while it is estimated that up to 30 per cent of Indonesia’s maternal mortality ratio may be due to unsafe abortion attempts by unmarried young people. Actually, the government of Indonesia has introduced Youth Friendly Health Services (YFHS) in community health centers throughout Indonesia. On the other hand, many non-governmental organizations (NGOs) have been delivering such services to young people across Indonesia since long time ago. However, each of those programs has its own strengths and challenges.

The YFHS provided by both government and NGOs actually could be accessed easily, while in the service provided by government — even though sometimes it is underutilized — they could link it to the health education in their school and has been implemented in 70% districts in Indonesia. However, the commitment and resources from the stakeholders varies widely, from supportive to unsupportive. At the same time, the services provided by NGOs’ usually over utilized because they involving youth and have strong partnership with adults. However, sometimes they did not use the data or report to develop and strengthen their program. Those facts showed us that the partnership between government and NGOs are highly needed to improve the young people’s quality of life.