Every year, approximately five percent of girls in this age group become pregnant. Additionally, 30 percent of girls in the age group experience poor nutrition. The high pregnancy rate and poor nutrition trends lead to increased maternal and infant mortality risk, low birthweight, and childhood stunting. Unsurprisingly, Sukabumi ranks sixth worst in maternal and child mortality and has the second-highest number of stunting among the 27 districts in West Java.
To address these issues, the local government has established integrated healthcare centers for teenagers, called Posyandu Remaja, throughout the districts. However, this initiative has fallen short of the initial expectations, mainly due to poor awareness and a lack of involvement among the target age group.
Recognizing the need for a targeted intervention, USAID MADANI has worked with the local civil society organization Saba Desa and the multi-stakeholder forum SIMPONI to reduce the prevalence of teenage marriage, which is associated with high maternal and newborn mortality and undernutrition.
Together with SIMPONI, Saba Desa advocates for increasing awareness of reproductive health issues among teenagers and the importance of nutrients for pregnant teenagers and young mothers by educating youth groups, communities, village administrators, and community health centers (Puskesmas).
The district welcomed the effort and signed a partnership agreement with Saba Desa to start revitalizing selected healthcare centers for teenagers in the three villages with the highest maternal and child mortality prevalence. This revitalization entails improving access to health services by reopening the Posyandu Remaja facilities and services to the target population, as well as reducing stunting and maternal and infant mortality rates through better education on child marriage, health, and nutrition.
The government also recommended that Saba Desa and the District Village and Community Empowerment Agency (DPMD) create a working group for improved coordination. The Deputy Head of Sukabumi District appreciated Saba Desa and SIMPONI’s efforts, stating: “By reviving the healthcare centers for teenagers, we can tap the full potential of many of the facilities that were left underutilized for years.”
On 23 February 2022, Saba Desa engaged the Sukabumi Islamic Institute to provide counseling services at the healthcare centers. As part of their volunteer program to serve the community, the counselors will help patients to address the complex thoughts and feelings that often arise during teenage pregnancies or in the younger parent population.
The program’s success in reopening the Posyandu Remaja, educating the public, and mobilizing youth groups and government support in the three villages has helped Saba Desa to advocate for revitalizing all the healthcare centers for teenagers across the district. Their advocacy work eventually won further support from the government. On 31 March 2022, the head of the Sukabumi District Government issued a circular letter stating its intention to improve the healthcare centers for teenagers in all 386 villages throughout the 27 sub-districts in the region, using the model initiated by Sabadesa.
The district government has appointed Saba Desa and SIMPONI to a team that will design, implement, monitor, and evaluate the healthcare centers. Representatives from various government agencies, state-owned enterprises, and the local university will be part of the team.
This significant milestone illustrates the local government’s buy-in to replicate and scale-up Saba Desa’s local innovation with full funding support from the district. The Regional Planning and Development Agency (Bappeda) is aiming for a gradual rollout in 2022, prioritizing villages in the 13 sub-districts with the highest maternal mortality and stunting rates.