Indonesia Takes One Step Forward On The Women’s Reproductive Health Front

In April, Indonesian Health Minister Budi Gunadi Sadikin announced a promising step toward combating cervical cancer, the third-leading cause of cancer deaths for Indonesian women: The HPV vaccine will be added to the list of routine free immunizations given to girls in secondary school.

“Vaccination is a much cheaper and more effective medical intervention compared to intervention that happens when someone is already being treated at the hospital,” Sadikin said during a press conference in Jakarta.

Indonesian women and the medical community hailed this development as an “impressive step” toward cervical cancer control. At least 50 Indonesian women are estimated to die each day from cervical cancer, representing more than half of all Indonesian women diagnosed.

“This represents a huge leap forward for Indonesia’s commitment to cancer control and the sexual and reproductive health of women and girls,” academics at the University of Melbourne, Linda Rae Bennett and Setiyani Marta Dewi, wrote in an article.

Bennett and Dewi also highlighted the remaining lack of access to high-quality and free cervical cancer screening for older women, indicating that the government would need to continue advocating and investing on this front to ensure progress for women’s reproductive health.

Health experts worldwide concur, saying that the fight against cervical cancer requires scaling up HPV vaccination as a preventative measure and expanding screening and treatment for at-risk women.

A complicating factor in the fight to prevent cervical cancer is that women’s reproductive health remains a taboo topic in Indonesia. A 2019 study conducted by the Indonesian think tank SMERU Institute showed that patriarchal values and cultures are among the barriers women face to access reproductive health services.

“Husbands have such a role in helping prevent cervical cancer in Indonesia,” Dyan Widyaningsih, a researcher at SMERU, told the FBomb, adding that research found many women who did not undergo cervical cancer screening because “they did not get permission from their husbands.”

SMERU’s study also found that patriarchal values and local cultures may hamper poor women’s access to services for pregnancy screening, safe birth, contraception, and exclusive breastfeeding,” Widyaningsih said.

When single women can seek medical treatment for their reproductive health in Indonesia, they face scrutiny and unsolicited advice. Indonesian women are far too familiar with probing questions from health workers that have absolutely no relevance to the health services they are seeking, such as: “Why are you committing a sinful act?” One single Indonesian woman described getting professional medical help as “traumatic” in a BBC Indonesia article published just last year.

On the other hand, some women in the archipelago nation don’t have access or financial means to go for routine check-ups.

Misinformation about reproductive health and HPV complicates these efforts, too. Shortly after Sadikin’s announcement last month, some Indonesian social media users called for Indonesians to reject the HPV vaccine for children, apparently due to a misunderstanding of how HPV is transmitted and how the vaccines work. At least one viral tweet ignorantly highlighted that the vaccine should not be administered to children as HPV is mainly transmitted through sexual relations.

The SMERU Institute has been among those saying that the government needs to work more on raising awareness among the general public, targeting women and men, as such efforts are essential to overcome prevailing societal values that hinder progress in women’s reproductive health.

But there is a long road ahead in the struggle.

As an Indonesian woman myself, I don’t think there’s enough discussion about women’s health in general, much less our reproductive health. As long as sex remains taboo and patriarchal values go unchallenged, women will always be at risk — even when the disease is preventable and curable. While the government’s decision represents a new commitment to protecting women and girls, Indonesian women know we’ve still got ways to go.