The rate of early marriage in Indonesia is still quite high amid the risk of cervical cancer and stunting babies. The latest efforts are being implemented to suppress, through the cooperation of the National Family Planning Coordinating Board (BKKBN) and the Ministry of Religion.
The new strategy implemented by the BKKBN in collaboration with the Ministry of Religion was launched in Yogyakarta, Friday (11/3). Both institutions agreed to provide assistance, counseling and health checks, three months before the couple got married.
According to the Head of BKKBN Hasto Wardoyo, if so far BKKBN, PKK, and Posyandu officers have played more roles, then through this national program, religious instructors will also be included.
“The role of religious educators is important, because preventing stunting is by preventing early marriage. The marriage recommendation was from the religious court. For those who are married but do not meet the health requirements, the role of religious leaders is important. She can still be married, but it is advised not to get pregnant first, “explained Hasto.
This program requires the bride and groom to check up three months before the time of the wedding. Officers will measure hemoglobin levels, height, weight, and upper arm circumference. The data is then entered into the Electronic Ready for Marriage and Pregnancy (Elsimil) application. If the bride and groom cannot access the application, then the family companion, PKK administrator or midwife will do so.
“If the data is good, they can get married. It’s not good to be able to stay married, but what’s not good is that we can provide assistance so that the child is healthy,” said Hasto again.
Hasto also said that reproductive health education is important for teenagers. Unfortunately, there is a misunderstanding in society that places sex education, as if it were sex education.
On the other hand, Indonesia faces an alarming number of early marriages.
“During this pandemic, our early marriage rate reflects it from people who are pregnant between the ages of 15-19 years. Right now, the figure is 20 per thousand. Every thousand marriages, there are 20 people who get married early, that’s the latest data in 2021,” said Hasto.
Reproductive health education is important to discourage young people from getting married early. At least, with that education they know about the risks, such as cervical cancer and stunting. For cervical cancer, explained Hasto, Indonesia is in second place in the world. Unfortunately, until now, reproductive health education has not been provided in a structured manner in schools.
Regional Pilot Project
Bantul Regency, Special Region of Yogyakarta became a pilot project for this program. This district is considered to have sufficient commitment, because it has more than 1,200 family support team members.
Bantul is also considered successful in reducing the stunting rate, with the 14 percent currently owned. The district also budgets IDR 50 million for each hamlet to reduce stunting. The central government sees the commitment of the local government as high.
The Regent of Bantul, Abdul Halim Muslik, said that the area he leads has 933 Integrated Service Posts (Posyandu). With an injection of IDR 50 million given every year, Posyandu has a vital role
“Posyandu in the hamlet must know for sure how many pregnant people in the hamlet. How many are at high risk and coordinated with the Puskesmas. The data already exists,” said Halim.
Because there is a tendency for people in rural areas to lack information about obstetric care, the Posyandu has a role to guide it. Posyandu will also play a role in socializing the prospective bride and groom examination program, by asking those who are getting married to join the program three months in advance.
“I think we can do this Posyandu support and socialization massively,” added Halim.
In Indonesia alone there are a total of 600 thousand members of the family companion team to accompany 2 million couples who get married every year.
Ministry of Religion Committed
Minister of Religion Yaqut Cholil Qoumas ensured that efforts to prevent stunting were also part of religious orders. For this reason, more than 55,000 religious instructors in the ministry they lead will also support this program through the socialization they provide.
“Guidance for prospective brides at KUA is an important part of the Ministry of Religion’s work program. President Jokowi emphasized that family resilience is the foundation of the country’s progress,” he said.
Regarding the age of marriage, the Minister of Religion also saw that his enthusiasm was because the government was trying to provide a better life in the future.
“We will certainly do the arrangements, including early marriage, but we will continue to study what is more appropriate,” added Yaqut.
As for reproductive health education, the Minister of Religion promised to discuss it with the Minister of Education, Culture and Research and Technology, Nadiem Makarim.
Important Government Programs
BKKBN noted a number of figures that must be considered related to early marriage and its risks. The number of young women who experienced anemia or anemia before marriage reached 37, while for pregnant women the figure was 48 percent. Anemia makes the growth of the fetus in the womb infertile and causes stunting.
The government has set a target to reduce the stunting rate to 14 percent by 2024. In 2019, the figure is still 27.6 percent and in 2021 it is 24.4 percent. Indonesia is expected to be stunting-free by 2030, if a decline of around 2-3 percent is met annually.
This program is important because the stunting generation has low intellectual power, lacks memory and is difficult to reason logically. At the age of 45 years, stunting sufferers will experience obesity in the middle or center of obesity, the cause of getting sick easily, getting diabetes, stroke and high blood pressure.
This program will also measure the circumference of the upper arm with a limit of 23.5 cm as the ideal number for marriage. Women with upper arm circumferences below that number are advised to postpone marriage, or stay married but improve their nutrition so that their children will be healthy later.
Early marriage also opens up the possibility of greater death. According to Hasto, who is also an obstetrician, teenagers who married at the age of 16-17 years, their pelvis size has not yet reached 10 cm. Whereas the average baby’s head size is that big, so they will have difficulty giving birth, resulting in infant death, maternal death or both. [ns/ah]