Advocacy toolkit for Family Planning issues in Indonesia Guideline for advocates 1
Production team Danielle Johanna Monique Soesman Nurul Agustina Rinaldi Ridwan Layout design activ design studio Rutgers WPF Indonesia Jl. Pejaten Barat Raya no. 17B Jakarta Selatan 12510 T. +62 21 717 937 09 E. info@rutgerswpfindo.org www.rutgerswpfindo.org 2
CHILD MARRIAGE KEY ISSUES CHILD MARRIAGE Related Facts and Figures General Population: Girl Age15-19 Applying single year age specific of incidence of marriage Unmarried 88.7% Ever Married 11.3% Access to education 55.70% No access to education 44.30% Ever married 11.3% Unmarried 88.7% No access to education 8.95% Access to education 91.05% 1
CHILD MARRIAGE Seven per cent of the girls aged 15-19 already had their first child. 1 Child brides are at greater risk of experiencing dangerous complications in pregnancy and childbirth, becoming infected with HIV/AIDS and suffering domestic violence. With little access to education and economic opportunities, they and their families are more likely to live in poverty. 2 At the Islamic State University Alauddin in Makassar, Professor Siti Aisyah Kara is also focusing on child marriage, which affects one in six girls around Indonesia. Girls who are married off at an early age are often more vulnerable to domestic violence and abuse. 3 2
CHILD MARRIAGE From the 15 categories of causes for divorce in 2014, the top were: disharmony 31% (86.423), lack of responsibility 24% (66.735) and economic factors 22% (61.687). This trend of the three main causes in 2014 was similar to that of 2013 with disharmony (29%), lack of responsibility (23%), and economic factors (18%). There is a strong linkage between child marriages and the rate of divorces caused by the factors mentioned above, especially since spouses are unprepared to build and maintain good communication and relationship with their spouses and unprepared to take economic responsibility. 3
CHILD MARRIAGE Related Laws/Policy/International Treaties and Covenants National Indonesian 1945 Constitution, Article 28B Paragraph (1), Article 28J Paragraph (1). Law No. 1, 1974 on Marriages Legal marriage age Without parent consent Men: 21 Women: 18 With parent consent Men: 19 Women: 16 Law No. 7, 1984 on the Ratification of the Convention on the Elimination of All forms of Discrimination Against Women, Article: 10. Law No. 39, 1999 on Human Rights:Article 1 point5, Article 9, Article 10, Article 11, Article 30, Article 45, Article 48, Article 52, Article 53 Paragraph (1), Article 58 Paragraph (1), and Article 66 Paragraph (6). Law No. 23, 2002 on Child Protection: Article 1, Article 4, Article 3, Article 13, Article 16 Paragraph (1) & (2), Article 17 Paragraph (1), Article 20, Article 48-49. Law No. 10, 2012 on the Optional Ratification of the Protocol for the Convention of Children s Rights: Part on the Consideration of Point (a). International Convention on the Elimination of All forms of Discrimination Against Women 1979, Article 16. Convention on the Rights of the Child 1989: Article 24, Article 34, Article 37, and Article 39. Beijing Platform for Action 1995. Key issues such as Education and Training and Human Rights. 4
CHILD MARRIAGE Key Messages Child marriage limits young girls skills, resources, knowledge, social support, mobility and autonomy. Young married girls have little power in relation to their husbands and in-laws. They are therefore extremely vulnerable to domestic violence, abuse and abandonment. Violence may include physical, sexual or psychological abuse. The State has the responsibility to advance the well-being of its citizens and should prevent child marriages with comprehensive programs. State institutions such as the National Coordination Body for Family Planning (BKKBN), Ministry of Religious Affairs, Ministry of Women Empowerment and Child Protection, Ministry of Health, and Ministry of Education and Culture and its implementing agency have to coordinate to prevent child marriages. These institutions have to cooperate to ensure that all Indonesian children have the same access to education and sexual and reproductive health. Each youth and adolescent has the right to decide on When, How, and with Whom to marry. Parents and the State have to respect these rights and ensure that youth and adolescent can exercise their right to decide for themselves what is best for them. The State has to guarantee the rights of children who for whatever reason have got married to continue their education to the highest level and ensure that they get employment commensurate with their interests and skills. Child marriage does not come from Islamic teaching. Instead, we need to empower Indonesian girls. 5
access to contraceptives and unwanted pregnancies KEY ISSUES access to contraceptives and unwanted pregnancies Related Facts and Figures 4 Unsafe Sex* Five per cent of men between 15-54 years have paid for sex and two per cent have done so in the past twelve months. The probability of married men from 15-54 who live in cities to have paid for sex is higher than those who live in the rural area. The probability of payment for sexual services increases with the increasing level of education. 6
access to contraceptives and unwanted pregnancies Sexually Transmitted Infections* Twelve (12) per cent of women between 15-49 and 1 per cent of married men between 15-54 years of age who have had active sexual relations were reported to have a sexually transmitted infection or its symptoms in the 12 months before the survey was done. The highest prevalence of sexually transmitted infections was with unmarried women (24 per cent) and women between 15-19 years of age (19 per cent). Among the women between 15-49 years, the prevalence of sexually transmitted infections was the highest with women who had not finished secondary high school and on the lowest position on the wealth index (14 per cent respectively). There was a slight difference between sexually transmitted infections and their symptoms between married men aged 15-54 and women aged 15-49 years old. 7
access to contraceptives and unwanted pregnancies Related Laws/Policy/International Treaties and Covenants National: Indonesian 1945 Constitution. Law No. 7, 1984 on the Ratification of the Convention on the Elimination of All forms of Discrimination Against Women (CEDAW). Law no. 36/2009 Article 4 and 5 which state that each person has the same rights to access to health irrespective of marital status. International: Convention on the Elimination of All forms of Discrimination Against Women, 1979. International Conference on Population and Development (ICPD) 1994, in Cairo, Egypt: Right to sexual and reproductive health comprising of four (4) different but interrelated components, including Reproductive Rights and Sexual Health. Beijing Platform for Action 1995. Key issues such as Health and Violence Against Women. 8
access to contraceptives and unwanted pregnancies Key Messages Unsafe sex remains a reproductive health problem among youths and people in the reproductive age group. To decrease the prevalence of sexually transmitted infection including HIV, the Government has to open access to contraceptives, especially condoms, to youths and people in the reproductive age group. The Government has to pay special attention to access to contraceptives for young women since the available data (for instance SDKI 2012) indicates that the highest prevalence of sexually transmitted infections is found among unmarried women (24%) and young women (19%). Apart from contraceptives, Comprehensive Sexuality Education is extremely needed to enable young people to say NO to risky behavior, including unsafe sex, unwanted pregnancies, drugs abuse and alcohol. The Government has to increase the budget for the development of maternal and reproductive health services to three per cent of the total budget for the health sector in the National Budget in order to meet the SDGs maternal mortality rate target of 102 deaths per 100.000 live births. The Government has to revitalize its Population and Family Planning program in Indonesia by improving the Family Planning design, institutional coordination and governance among national and provincial.. Each province and regency/city should have a Regional Family Planning Coordinating Agency that should spearhead the Family Planning Program. Unmet Family Planning needs are the most important causes of maternal deaths. 9
SAFE ABORTIONS KEY ISSUES SAFE ABORTIONS Related Facts and Figures 50.7% women and 40.3% men knew someone who had had an abortion. In Indonesia, about 11 to 14 percent of maternal mortality (392 in 100,000 live births) is caused by unsafe abortions. It means there are 43 to 55 women who die due to unsafe abortions per 100,000 live births, while there are about 4.5 million births per year in Indonesia. Other studies estimate 37 abortions in 1,000 women aged 15-49 years. The real number may be higher, as most unsafe abortions are illegal and unrecorded. 10 Abortion is allowed for the following circumstances to save women s life and rape 10
SAFE ABORTIONS Related Laws/Policy/International Treaties and Covenants National: Indonesian 1945 Constitution Law No. 7, 1984 on the Ratification of the Convention on the Elimination of All forms of Discrimination Against Women (CEDAW). Law No. 36, 2009 on Health. Regulation of the Minister of Health of Indonesia No. 97, 2014 on Pre-pregnancy, Pregnancy, Natal and Post-natal Health Services, Provision of Contraceptive Services, and Sexual Health Services. International: Convention on the Elimination of All forms of Discrimination Against Women 1979 (CEDAW). Law No. 36, 2014 on Health Provider (Especially the articles on Health Services Facilities and Health Officers Competence Requirements). Regulation No. 61/2014 is based on the 2009 Health Law. In terms of content, the new regulation on abortion contains no new policy. Abortion in Indonesia remains prohibited in most cases, unless the mother s life is in danger or in the case of rape.restrictions on abortion in Indonesia mean that institutional safe abortions are impossible to access. If the safe way is restricted, the only choice is unsafe abortions. Presidential Regulation No. 61, 2014 on Reproductive Health. International Conference on Population and Development (ICPD) 1994, in Cairo, Egypt: Right to sexual and reproductive health comprising of four (4) different but interrelated components including Reproductive Rights and Sexual Health. Beijing Platform for Action 1995. Key issues such as Health and Violence Against Women. 11
SAFE ABORTIONS Key Messages Safe and legal abortions may save the lives of millions of women including young women. The Government has to ensure that safe and legal abortions are available to all women who need them irrespective of their marital status. The Government has to give protection to clients and health provider to prevent criminalization toward abortion from happening. The State s failure to protect its citizens, let alone its criminalization of those who need a way out of their problems is a form of violence that should be ended. The Government has to prevent the unsafe abortion practices conducted by unreliable service providers by offering training and courses to health while safeguarding the privacy of the clients. 12
HIV KEY ISSUES HIV Related Facts and Figures 11 Estimated numbers of people living with HIV&AIDS, 2015 Men 458.878 Women 300.813 New HIV infections, 2015 Men 56.753 Women 34.088 New infections according to infection routes in 31 provinces, 2011-2015 Sex among trans woman 9% Sex among menn who have sex with men 32% Sharing needles 2% Sex with sex workers 25% Unpaid sex 2% Wife - Husband 4% Husband - Wife 26% New infections according to infection routes in 31 provinces, 2011-2015, Papua Sex with sex workers 30% Unpaid sex 31% Wife - Husband 20% Husband - Wife 19% 13
HIV Related Laws/Policy/International Treaties and Covenants National: Indonesian 1945 Constitution. Law No. 7, 1984 on the Ratification of the Convention on the Elimination of All forms of Discrimination Against Women (CEDAW). Law No. 36, 2009 on Health. Law No. 36, 2014 on Health providers (Especially the articles on Health Services Facilities and Health Officers Competence Requirements). Decision of the President of Republic IndonesiaNo. 36, 1994 on the Formation of AIDS Eradication Commission AIDS (KPA). Presidential Decree, 2006 on the National AIDS Eradication Commission. Regulation of the Minister of Women Empowerment and Child Protection of Indonesia No. 1, 2015 on the Strategic Planning of the Ministry of Women Empowerment and Child Protection of Indonesia. Anti-trafficking Law no 21/2007. Regulation No 2/2007 on Harm Reduction among Injecting Drug Users issued by the Coordinating Minister for People s Welfare. Chief of National Police Regulation No 8/2009 on Human Rights Approach in Carrying out National Police Tasks. Article no. 20 in this regulation particularly emphasizes the special approach to women. Government Regulation no.9/1999 on Gender Mainstreaming. Regulation No. 35/2009 about Narcotics Supreme Court Decree No.7/2009 about Harm Reduction (Potentially the harm reduction program will be more acceptable in programs for so-called medical and social rehabilitation). International: Convention on the Elimination of All forms of Discrimination Against Women 1979 (CEDAW). International Conference on Population and Development (ICPD) 1994, in Cairo, Egypt: Right to sexual and reproductive health comprising of four (4) different but interrelated components, including Reproductive Rights and Sexual Health. Beijing Platform for Action 1995. Key issues such as Health and Violence Against Women. Convention on the Rights of the Child 1989. ILO Recommendation No. 200, 2010 14
HIV Key Messages Young people need to have access to information on how to use condoms including ways to communicate about condoms with partners. The Government has to ensure that young key affected population pose this knowledge. Since having the right knowledge is the key to the desired change in conduct, the Government has to offer access to early Comprehensive Sexuality Education accessible to all young people. Apart from offering condoms and Comprehensive Sexuality Education, the Government has to ensure that each person who has contracted HIV has access to ARV therapy as soon as possible in accordance with the World Health Organization protocol of 2015. Young People living with HIV and AIDS also have sexual and reproductive rights that need to be respected. It is imperative for young people to get access to education, knowledge, and access to contraceptives and ARV and to be free from stigma, discrimination and criminalization due to their HIV status. 15
ENDNOTES & REFERENCE endnotes 1 SDKI 2012 2 http://www.girlsnotbrides.org/what-is-the-impact/ 3 http://unicefindonesia.blogspot.nl/2015/09/breaking-cycle-of-violence.html 4 SDKI 2012 5 Trends in Maternal Mortality: 1990 to 2013 Estimates by WHO, UNICEF, UNFPA, The World Bank and the United Nations Population Division http://www.who.int/reproductivehealth/publications/monitoring/maternal-mortality-2013/en/ 6 Modern Contraceptives include pill, injections, condoms, implants MOP and MOW. 7 Traditional Contraceptives include periodic abstinence and coitus interruptus. 8 UNESCO, International Technical Guidance on Sexuality Education, 2009. 9 http://sexualrightsinitiative.com/wp-content/uploads/indonesia-upr-13-ippa.pdf 10 http://www.thejakartapost.com/news/2014/08/24/why-indonesia-should-legalize-abortion.html#sthash.pumuty8e.dpuf 11 Estimation and Projection of HIV/AIDS in Indonesia 2011-2016, National Aids Eradication Commission, Ministry of Health. reference Convention on the Elimination of All forms of Discrimination Against Women (CEDAW) 1979 http://www.un.org/womenwatch/daw/cedaw/ International Conference on Population and Development (ICPD) 1994 http://www.iisd.ca/cairo.html Beijing Platform for Action 1995 http://www.un.org/womenwatch/daw/beijing/platform/ Convention on the Rights of the Child 1989. http://www.ohchr.org/en/professionalinterest/pages/crc.aspx 16
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