Yayasan Inisiatif Perubahan Akses menuju Sehat Indonesia

Access to safe abortion is important rights of women and girls, yet abortion stigma is prevalent and accepted as social norms across nations and various social-cultural context

I am a believer of investment in young people, especially if the investment relates to changing social norms and creating specific behaviors that respectful to women's sexual and reproductive rights as well as addressing gender and power dynamics in the society. Nowadays, young people have more liberty to explore information from various media platform, are able to analyze critically information that they receive, while at the same time they are exposed to diversity of culture and ways of living. They are more likely to be open minded and are able to exercise or to support reproductive rights of themselves and others

I will use the elevate prize funding to work on reducing abortion stigma amongst young people in Indonesia - in particular working with youth leaders in 3 Provinces in Java - Jakarta, Central Java and Jogjakarta. My organization, IPAS Indonesia have been working with these youth leaders and champions around adolescents sexual and reproductive health and rights in general. With this funding, we will focus the work on addressing abortion stigma

I’m a passionate feminist doctor and dedicated leader of Yayasan Inisiatif Perubahan Akses menuju Sehat (IPAS) Indonesia. I am motivated by our mission, which is to ensure that women and girls in my country have access to reproductive health care in particular safe abortion care, they have the power to make their own decisions, and they can enjoy the human rights to which we are all entitled.

Abortion is legally restricted and punishable under the law, and women have no choice but to turn to unsafe methods or untrained providers. I know firsthand the harm of these restrictions. I am a survivor of this low quality and discriminative care 

Now,in IPAS Indonesia I proudly work to reduce the number of  women and girls who have to go through my experience. And to make sure that when the service is there, it’s a quality service. Ipas Indonesia works with supply side and demand side of the abortion care. We're not only strengthening the health care system, but we also work in educating women and girls on their reproductive rights, and collaborate with wider civil society groups to advocate for better reproductive health care including safe abortion and prevention of unintended pregnancy 

Abortion is allowed in Indonesia only in medical emergency situations (life-threatening maternal conditions or major fetal impairments) and rape cases (limited to the first six weeks of gestation). With unmet needs for contraception is as high as 11% amongst married women aged 15 - 49, unintended pregnancy and abortion are daily facts for women in Indonesia. While Data on abortion incidence is not part of routine reporting by the government,  A study by Guttmacher Institute and University of Indonesia estimated that 1,698,230 abortions took place in Java, Indonesia’s most populous island, in 2018. 

While abortion is prevalent, it is highly stigmatized and is a social taboo in the society. People do not talk about it openly and religious narratives dominate the discourse on abortion in Indonesia. Information on safe/unsafe abortion is rarely - if not never, included in sexual and reproductive health information to community, as well as to young people in the comprehensive sexuality education. IPAS Indonesia works to ensure that safe abortion is part of SRHR information and education session, targeting women and young women in the community, as well as other important stakeholders who are gatekeepers to abortion care at local level

Ipas Indonesia work both at supply side (health care providers) and demand side (women, girls, and community) of the abortion care. We have staff with medical  and health system strengthening background to work with the health system and its stakeholders (MOH, professional organizations and academicians). We also have staff with extensive experience in community engagement to educate women and girls on their reproductive rights, and to collaborate with wider civil society groups on advocacy.

Working with the demand and supply side, can strengthen the capacity of service providers to deliver quality care while also being accountable and transparent in delivering health care; it also can increase participation of the patient groups and community to  advocate for better reproductive health care including safe abortion and prevention of unintended pregnancy. We have seen this approach works well when we developed the model of care for post-abortion care at  district level, and now it has been adopted by Indonesia Ministry of Health in January 2021 for scaling up at national level

Many civils society organizations working on safe abortion advocacy in Indonesia still focus on working with the demand side and advocacy

IPAS Indonesia adopted Sustainable Abortion Ecosystem framework as Ipas’ response to the urgent need to support and hold accountable governments for whom ensuring access to safe abortion care remains a challenge – contributing to high maternal deaths, along with other problemsUsing a human-centered approach, this framework recognizes that sustainable abortion care is dynamic and requires new thinking on how to collaborate with partners to achieve goals, and how to strike a delicate balance across many factors. A sustainable abortion ecosystem is then defined as “ a dynamic condition in which resilient local stakeholders and systems are actively accountable and committed to abortion rights and responsive to everyone’s abortion needs”. There are 8 key programming components for action and evaluation, and each of the key programming is derived from and mapped to abortion ecosystem that exists around an individual. Ipas believes that understanding and addressing the abortion ecosystem through this approach will help program designers to understand and to design interventions which can improve the enabling environment surrounding individual’s abortion decision making. This will in turn assist in more efficient and responsive program implementation for a more sustained access to person centered,    high quality abortion care.