Adolescent pregnancy prevention through local wisdom: The role of Tiga Batu Tungku in Indonesia
Main Article Content
Abstract
Adolescent pregnancy remains a pressing global concern with profound effects on maternal and infant health, as well as broader social and economic development. This study examines the role of Tiga Batu Tungku, an Indonesian concept of local wisdom that embodies three key societal pillars—the local government, religious figures, and educators—in efforts to prevent adolescent pregnancy. A case study approach was utilized to analyze the social and cultural factors influencing pregnancy prevention among adolescents. Data were collected through in-depth interviews, participant observations, and document analysis, involving key informants such as representatives from local government, the church, schools, the Health Department, and the member of Youth Integrated Health Post. The study employs the Health Belief Model (HBM) (Rosenstock, 1994) to evaluate how these pillars contribute to shaping adolescents' understanding of premarital pregnancy risks, including their perceived vulnerability, severity, benefits of preventive measures, and existing barriers. The findings reveal that Tiga Batu Tungku operates as an integrated system where religious institutions provide moral education and character-building, local governments support health initiatives such as Youth Integrated Health Post, and educational institutions integrate reproductive health education and counseling services into their curricula. This study offers valuable insights for policymakers and public health practitioners seeking to develop culturally sensitive and community-driven strategies to reduce adolescent pregnancy rates.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
This open-access article is distributed under a Creative Commons Attribution (CC-BY) 4.0 license.
You are free to: Share — copy and redistribute the material in any medium or format. Adapt — remix, transform, and build upon the material for any purpose, even commercially. The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms: Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
No additional restrictions You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
How to Cite
Share
References
Achigibah, A. D., AmdjadFar, M., Krugu, J. K., Ruiter, R. A., & Mevissen, F. E. (2024). The end point of it is abstinence: A qualitative analysis of underlying factors influencing Christian leaders’ adoption and implementation of sex and sexuality education in Bolgatanga, Ghana. Culture, Health & Sexuality, 26(10), 1301-1315. https://doi.org/10.1080/13691058.2024.2311138
Adom, D., Kportufe, G. E., Asare-Aboagye, I., & Kquofi, S. (2024). Artificial reproductive technology: Cultural considerations through an African lens. Research Journal in Advanced Humanities, 5(3). https://doi.org/10.58256/4hsp3z34
Ahinkorah, B. O. (2021). Under-5 mortality in sub-Saharan Africa: Is maternal age at first childbirth below 20 years a risk factor? BMJ Open, 11(9). https://doi.org/10.1136/BMJOPEN-2021-049337
Al Zaabi, O., Heffernan, M. E., Holroyd, E., & Jackson, M. (2021). Parent-adolescent communication about sexual and reproductive health including HIV and STIs in Oman. Sex Education, 22(5), 611-627. https://doi.org/10.1080/14681811.2021.1980719
Asare, R. O., Nukpezah, R. N., Azowine, F., Cheremeh, L. G., Ayinpoka, A. S., Asumadu, O. D. K., & Mills, E. (2022). Socio-demographic and other determinants of teen pregnancies in the Tamale Metropolis: A community-based unmatched case-control study. Health Science Journal, 16(2), 1-15. https://doi.org/10.36648/1791-809X.16.2.915
Baney, L., Greene, A., Sherwood-Laughlin, C., Beckmeyer, J. J., Crawford, B. L., Jackson, F., Greathouse, L., Sangmo, D., Ward, M., & Kavaya, S. (2022). It was just really hard to be pregnant in a smaller town …: Pregnant and parenting teenagers’ perspectives of social support in their rural communities. International Journal of Environmental Research and Public Health, 19(24), 16906. https://doi.org/10.3390/ijerph192416906
Basu, J. K., Stewart, A., Feucht, U., Wing, J., & Basu, D. (2024). Adolescent maternal mortality at a district health services over a five year period in South Africa: A retrospective study. International Journal of Gynecology & Obstetrics, 167(3), 1084-1089. https://doi.org/10.1002/ijgo.15763
Bodunde, E., Buckley, D., O’Neill, E., Al Khalaf, S., Maher, G. M., O’Connor, K., McCarthy, F. P., Kublickiene, K., Matvienko‐Sikar, K., & Khashan, A. S. (2024). Pregnancy and birth complications and long‐term maternal mental health outcomes: A systematic review and meta‐analysis. BJOG: An International Journal of Obstetrics & Gynaecology, 132(2), 131-142. https://doi.org/10.1111/1471-0528.17889
Brown, J. L., Marais, L., Sharp, C., Cloete, J., Lenka, M., Rani, K., Marime, P., Ditlhare, I., Moqolo, R., Peterson, D., & Sales, J. M. (2020). Cultural consensus modeling to understand South African adolescent girls’ attitudes, awareness, and uptake of dual protection strategies. Journal of Adolescent Health, 67(6), 793–803. https://doi.org/10.1016/J.JADOHEALTH.2020.07.003
Cherotich, A., Olayo, R., & Odero, E. A. (2024). Cultural factors as determinant of teen pregnancy prevalence in Kakamega County, Kenya. African Journal of Empirical Research, 5(3), 474–486. https://doi.org/10.51867/ajernet.5.3.41
Cintra, L. C. G., Araújo, A. S., Santos, M. J., Carneiro, S. A. M., Campos, G. R., & Cozac, E. E. (2020). Panorama do perfil sociodemográfico e cultural da adolescente grávida. Brazilian Journal of Development, 6(11), 92464-92474. https://doi.org/10.34117/bjdv6n11-597
Deswinda, D., Machmud, R., Yusrawati, Y., Indrapriyatna, A. S., & Bayhakki, B. (2020). Adolescent pregnancy prevention behavior in Indonesia: Internal and external factors influencing. Open Access Macedonian Journal of Medical Sciences, 8, 516–520. https://doi.org/10.3889/OAMJMS.2020.4946
Degge, H. M., Olorunsaiye, C. Z., Achema, T. A., Ubanyi, T. O., & Yada, F. N. (2022). Adolescent pregnancy outcomes in Jos, North Central Nigeria: The roles of disclosure and social support systems. Global Public Health, 18(1), 2129724. https://doi.org/10.1080/17441692.2022.2129724
Ely, D. M., & Driscoll, A. K. (2024). Infant mortality by selected maternal characteristics and race and Hispanic origin in the United States, 2019-2021. National Vital Statistics Reports: From the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System, 73(3), 1-9. https://doi.org/10.15620/cdc:145589
Gbetoglo, D. K., & Noussoukpoe, S. K. (2024). Traditional socio-cultural practices and early pregnancies in Togo. African Journal of Reproductive Health/La Revue Africaine de la Santé Reproductive, 28, 122-129. https://doi.org/10.29063/ajrh2024/v28i8s.14
Grønvik, T., & Sandøy, I. F. (2018). Complications associated with adolescent childbearing in Sub-Saharan Africa: A systematic literature review and meta-analysis. PLOS ONE, 13(9). https://doi.org/10.1371/JOURNAL.PONE.0204327
Haberland, N., & Rogow, D. (2015). Sexuality education: Emerging trends in evidence and practice. Journal of Adolescent Health, 56(1), S15-S21. https://doi.org/10.1016/j.jadohealth.2014.08.013
Harrington, E. K., Casmir, E., Kithao, P., Kinuthia, J., Kinuthia, J., John-Stewart, G., Drake, A. L., Unger, J. A., Ngure, K., & Ngure, K. (2021). “Spoiled” girls: Understanding social influences on adolescent contraceptive decision-making in Kenya. PLoS One, 16(8), e0255954. https://doi.org/10.1371/journal.pone.0255954
Henriksen, L., Kisa, S., Lukasse, M., Flaathen, E. M., Mortensen, B., Karlsen, E., & Garnweidner-Holme, L. (2021). Cultural sensitivity in interventions aiming to reduce or prevent intimate partner violence during pregnancy: A scoping review. Trauma, Violence, & Abuse, 24(1), 97-109. https://doi.org/10.1177/15248380211021788
Humaizi, H., Tarigan Sibero, B. M., Kusmanto, H., & Ridho, H. (2024). Impact of global crisis on social and economic inequality in Medan City: A strategic approach to community empowerment and multisector collaboration. Research Journal in Advanced Humanities, 5(4). https://doi.org/10.58256/ezhqb222
Kim, J., Park, H., & Lee S. (2022). The impact of integrating reproductive health education into school curricula: A systematic review of school-based interventions. Journal of Adolescent Health, 70(3), 412–420. https://doi.org/10.1016/j.jadohealth.2022.01.005
Koronya, C. K., Olungah, C. O., & Odipo, G. (2022). Attitudes and practices on induced abortion among Igembe Women in Meru County, Kenya. Research Journal in Advanced Humanities, 3(4). https://doi.org/10.58256/rjah.v3i4.930
Kurniawati, K. D., Kusumawati, A., & Prabamurti, P. N. (2020). Hubungan pengetahuan, persepsi keseriusan, persepsi hambatan dan efikasi diri dengan partisipasi remaja dalam mengikuti posyandu remaja. Jurnal Kesehatan Masyarakat, 8(3), 406-409. https://doi.org/10.14710/jkm.v8i3.26411
Kusumawati, I., Murti, B., & Pamungkasari, E. P. (2024). Meta-analysis of associations between maternal age, low hemoglobin level during pregnancy, low birth weight, and preterm birth. Journal of Maternal and Child Health, 8(6), 762-775. https://doi.org/10.26911/thejmch.2023.08.06.10
Kyu, H. A., Chotipanvithayakul, R., McNeil, E. B., & Thu, N. L. (2024). Cultural taboos and low sexual and reproductive health literacy among university students in Magway city, Myanmar. Culture, Health & Sexuality, 1-15. https://doi.org/10.1080/13691058.2024.2420704
Leung, J. T. Y., Shek, D. T. L., To, S., & Ngai, S. W. (2023). Maternal distress and adolescent mental health in poor Chinese single-mother families: Filial responsibilities—risks or buffers? International Journal of Environmental Research and Public Health, 20(7), 5363. https://doi.org/10.3390/ijerph20075363
Maness, S. B., Bhochhibhoya, S., & Cheney, M. (2023). Adolescent pregnancy prevention: How cultural components play a role in programs tailored for minority youth. Journal of Health Disparities Research and Practice, 16(1), 6. https://digitalscholarship.unlv.edu/jhdrp/vol16/iss1/6/
McDermott, E. R., Jahromi, L. B., Umaña‐Taylor, A. J., Martinez‐Fuentes, S., Jones, S. M., & Updegraff, K. A. (2021). Mexican‐origin adolescent mothers’ economic contexts, educational re‐engagement, and their children’s school readiness. Child development, 92(4), e513-e530. https://doi.org/10.1111/cdev.13514
Mullis, M. D., Kastrinos, A., Wollney, E., Taylor, G., & Bylund, C. L. (2021). International barriers to parent-child communication about sexual and reproductive health topics: A qualitative systematic review. Sex Education, 21(4), 387-403. https://doi.org/10.1080/14681811.2020.1807316
Nketia, R. (2022). Parent-adolescent communication on sexual and reproductive health: Perceptions and experiences of out-of-school adolescent mothers in the East Gonja Municipality, Ghana. International Journal of Multidisciplinary Studies and Innovative Research, 10(3), 1589-1601. https://doi.org/10.53075/ijmsirq/746464353242
Noori, N., Proctor, J. L., Efevbera, Y., & Oron, A. P. (2022). The effect of adolescent pregnancy on child mortality in 46 low-and middle-income countries. BMJ Global Health, 7(5). https://doi.org/10.1136/bmjgh-2021-007681
Padhani, Z. A., Rahim, K. A., Tessema, G. A., Avery, J. C., Damabi, N. M., Castleton, P. E., Salam, R. A., Meherali, S., & Lassi, Z. S. (2024). Exploring preconception health in adolescents and young adults: Identifying risk factors and interventions to prevent adverse maternal, perinatal, and child health outcomes–A scoping review. PLOS ONE, 19. https://doi.org/10.1371/journal.pone.0300177
Rahmawati, I., & Setiawan, H. (2021). Community and parental engagement in adolescent reproductive health: A case study of rural Indonesia. BMC Public Health, 21(1), 1548. https://doi.org/10.1186/s12889-021-11540-3
Raymond, T., Johnson, J., & Hogans-Mathews, S. (2024). Evaluating the prevalence of maternal health indicators on infant mortality rates in Florida. Cureus, 16(6). https://doi.org/10.7759/cureus.63539
Rosenstock, I. M., Strecher, V. J., & Becker, M. H. (1994). The health belief model and HIV risk behavior change. In Preventing AIDS: Theories and methods of behavioral interventions (pp. 5-24). Springer US.
Smith, R., Johnson, M., & Williams, K. (2019). The role of religious and community leaders in adolescent pregnancy prevention: A qualitative study in rural communities. Global Health Action, 12(1), 1679754. https://doi.org/10.1080/16549716.2019.1679754
Susanti, D., Hardisman, H., Yusrawati, Y., Mudjiran, M., Machmud, R., Nursal, D. G. A., ... & Hasnita, E. (2023). Exploring adolescent pregnancy expectations in continuity of midwifery care: A qualitative study in Indonesia. Jurnal Bidan Cerdas, 5(4), 156-165. https://doi.org/10.33860/jbc.v5i4.2339
Sylla, C., Traore, K., Kone, B. S., Coulibaly, M., Keita, S., Dao, S. Z., Sanogo, S. A., Fane, S., Bocoum, A., & Dembélé, S. (2024). Adolescent childbirth at Gao Hospital in Mali. Greenfort International Journal of Applied Medical Science, 2(5), 173–181. https://doi.org/10.62046/gijams.2024.v02i05.003
Tituaña, A., Herrán, K., Galárraga, O., & Palacios, I. (2024). How to decrease teenage pregnancy: Rural perspectives in Ecuador. Frontiers in Public Health, 12, 1370507. https://doi.org/10.3389/fpubh.2024.1370507
Trost, S. L., Beauregard, J. L., Smoots, A. N., Ko, J. Y., Haight, S. C., Moore Simas, T. A., Byatt, N., Madni, S. A., & Goodman, D. (2021). Preventing pregnancy-related mental health deaths: Insights from 14 US maternal mortality review committees, 2008–17: Study examines maternal mortality and mental health. Health Affairs, 40(10), 1551-1559. https://doi.org/10.1377/hlthaff.2021.00615
Tung, I., Keenan, K., & Hipwell, A. E. (2021). Adolescent mothers’ psychological wellbeing during pregnancy and infant emotional health. Journal of Clinical Child & Adolescent Psychology, 52(5), 616-632. https://doi.org/10.1080/15374416.2021.1981339
Twitty, T. D., Hitch, A. E., Marais, L., Sales, J. M., Sharp, C., Cloete, J., ... & Brown, J. L. (2023). Pregnancy and STI/HIV prevention intervention preferences of South African adolescent girls: Findings from a cultural consensus modelling qualitative study. Culture, Health & Sexuality, 26(2), 191-207. https://doi.org/10.1080/13691058.2023.2194357
United Nations Population Fund. (2020). State of World Population 2020: Against My Will-Defying the Practices that Harm Women and Girls and Undermine Equality. UN.
Wahyudi, S. P. E., Amalia, R. B., & Frety, E. E. (2023). Correlation between adolescent pregnancy with labor complication in Puskesmas Galis Bangkalan Regency. Journal of Midwifery, 8(1), 131-137. https://doi.org/10.25077/jom.8.1.131-137.2023
Xie, Y., Wang, X., Mu, Y., Liu, Z., Wang, Y., Li, X., Dai, L., Li, Q., Li, M., Chen, P., Zhu, J., & Liang, J. (2021). Characteristics and adverse outcomes of Chinese adolescent pregnancies between 2012 and 2019. Scientific Reports, 11(1), 12508. https://doi.org/10.1038/S41598-021-92037-X