Improving Sexual and Reproductive Health Service that is friendly for all
Rutgers WPF Indonesia has launched the Unite for Body Rights (UFBR) program whose objective is to advance the health status of Indonesian people through the fulfillment of their sexual and reproductive health and rights (SRHR). One of the program’s core activities is the development of youth-friendly sexual and reproductive health (SRH) services at community health centers (Puskesmas) or clinics. The availability and the quality of services, as well as client satisfaction are the success criteria of the program. There is an additional criteria, i.e. the optimization of services at the health facilities or, in other word, the number of youth who have access to sexual and reproductive health services.
The availability of the required sexual and reproductive health services is also called Integrated Package Essential Services (IPES), which include the following services:
- Counseling: sex, sexuality and reproductive health.
- Contraception: counseling, oral contraceptive, condoms, injection, middle and long-term and emergency contraceptives
- For unplanned pregnancy: pre and post counseling, medical and surgical services, and post-abortion care.
- Reproductive Tract Infection (RTI) and Sexually Transmitted Infections (STIs): at least one of the services, a lab for at least one of the infections, condom distribution
- HIV: pre and post counseling, an HIV test lab, staging and monitoring test lab, condom distribution
- Gynecology: manual pelvic examination, manual breast examination, papsmear and other method of cervical cancer services
- Pre and post natal care : pregnancy test, essential pre-natal care, essential post-natal care
- Sexual and Gender based Violence – SGBV : SGBV exam or diagnose, referral mechanisms for clinical, psychological and protection services
This IPES-based SRH services is not yet available in health centers at all levels. Rutgers WPF Indonesia and its partners are encouraging the public clinics to provide these services.
The availability of such service facilities will also maximize Rutgers WPF and our partners’ efforts to empower youth at schools and their communities for their SRHR. The sustainability of the program is shown by teachers and peer educators that continue to provide SRHR information at schools and in community, and by the availability of integrated SRH services at the health centers (Puskesmas and clinics)
Sustainability of SRHR service is crucial as statistics shows that the following cases occur in Indonesia everyday:
- 4,3 children suffer from violence
- 8 women and 2.5 children suffer from sexual violence
- 89 people contracted HIV
- 2.191 abortion
Data in 2013 showed that maternal mortality rate (MMR) remained high at 359 per 100,000 live births, meaning that every 15 minutes a woman died of complication during childbirth!
This means that the optimization of access to and the availability of SRH services, particularly youth-friendly SRH services, allows Rutgers WPF and our partners to hope that the figures above can be reduced or even eliminated.
The remaining work that needs to be done is how to empower youth to eliminate their fear, concerns or embarrassment to visit health centers to obtain SRH information or services. For youth: Do you want to have accurate and reliable information? Go and visit Puskesmas or clinic, rather than seeking information from unreliable sources.
Below are testimonies of healthcare providers and young people regarding SRHR services at Puskesmas and our partners; clinics:
“I am satisfied and comfortable with the service provided by the clinic. The staffs are friendly and treat me as family. I highly recommend this clinic to my friends who have concerns about STIs.” (Client of PKBI ProCare Clinic)
“Training on youth-friendly SRHR services helped me to understand how to provide youth-friendly services. I used to be judgmental and discriminative to my clients who had STIs, but the training has changed my perspective for the clients. Even though I still have my own reservation, now I understand that I can be more supportive and professional in doing my job” (Bie, doctor at Satelit Clinic)
“People of diverse sexuality is facing complicated situation since we have very limited access to SRHR services. Now we know that we are not alone because the PKBI clinic can help us by providing access to their services and there is legal aid for us when we have legal issue. (Michelle, Gaylam, Lampung).