Adolescent contraceptive self-care in Indonesia

In Indonesia, and across Asia and the Pacific, adolescents’ lack of access to contraception is a major driver of unintended pregnancy. This brings severe health and social risks. Using the World Health Organization's new model of self-care, we’ve developed a transdisciplinary approach to address these challenges in Indonesia.

Asia accounts for 40% of adolescent pregnancies globally (8.3 million). Of these, 43% are unintended.

Unintended pregnancies create a triple burden among adolescents:

• increased risk of poor maternal health outcomes and maternal mortality
• severe health outcomes for future generations due to poor perinatal outcomes
• socioeconomic outcomes that perpetuate gender inequality and poverty in the life course and across generations.

In Indonesia, adolescents tend to access modern contraception only after marriage and the birth of their first child, mostly from formal health services. This approach fails to address the high, unmet need for modern contraception among adolescents. It also fails to alleviate associated health and social outcomes.

The World Health Organization (WHO) has conceptualised a new model of ‘self-care’ for sexual and reproductive health (SRH). The model enables people to promote health and prevent disease with or without health service support.

The project will use SRH self-care to revolutionise adolescent contraceptive care in Indonesia. This moves the process away from the traditional provision of family planning to married adolescents by formal health services. Instead, adolescents with the highest levels of unmet need will be able to access contraceptive self-care in safe digital settings and community settings close to where they live.

Our transdisciplinary approach combines knowledge from science, the public sector, the private sector and citizens. In this way, we’re helping to identify new solutions to this complex societal challenge.

Co-designed contraceptive self-care for young people

We aim to co-design evidence-based, acceptable, cost-effective and scalable contraceptive self-care solutions for young people aged 15 to 19 years.

We’ll do this through 4 key activities:

1. determining and mapping patterns of adolescent contraceptive use and demand
2. supporting models of adolescent-responsive SRH self-care by identifying:
   • adolescents’ SRH self-care strategies
   • health and community systems requirements that support self-care
3. co-designing new models of adolescent-responsive contraceptive self-care
4. maximising uptake and impact by estimating how resources can be best invested across a mix of contraception self-care solutions among different sub-population groups.

The study is co-led by a Youth Lab established by Burnet and Gadjah Mada University, Indonesia. It comprises 6 young researchers aged 18 to 24 years. They’ll be supported and trained to co-lead research activities, co-produce study outputs, lead research translation and explore long-term research careers.