Researches
Our active research in reproductive health is paving the way for innovative solutions and improved access to family planning, maternal care, and fertility treatments, ultimately enhancing the well-being of individuals and communities
I-NAMHS (Indonesia - National Adolescent Mental Health)
The Indonesia-National Adolescent Mental Survey (I-NAMHS) research is a national scale survey research for adolescent mental health which aims to increase the representation, or coverage, of data on the prevalence of mental illness in adolescents.
According to the WHO report, almost half of mental illness cases begin at the age of 14, and most are not treated properly so they persist into adulthood and some lead to more severe conditions such as psychosis, self-harm and suicide. To date, there are only a few national surveys that are representative in measuring adolescent health and there are no such national surveys in Indonesia.
The Indonesia-National Adolescent Mental Survey (I-NAMHS) research is a national scale survey research for adolescent mental health which aims to increase the representation, or coverage, of data on the prevalence of mental illness in adolescents. I-NAMHS is part of The National Adolescent Mental Survey (NAMHS), a 3-year study on adolescent health which will be carried out in three countries: Indonesia, Kenya and Vietnam. The study consisted of three separate data collection activities (national survey, pilot survey, and clinical calibration). This research began in 2018 and data collection was completed in 2021.
The I-NAMHS research is a collaboration between the UGM Center for Reproductive Health Studies (Center for Reproductive Health Studies), the University of Queensland (UQ) Australia as the main institution, and John Hopkins University Bloomberg School of Public Health in the United States as a partner.
GEAS (Global Early Adolescent Study)
GEAS research is quantitative research from the Explore 4actions (E4A) project. Explore4actions aims to understand the process of gender socialization and the factors that influence this process in adolescents.
More than a quarter of the population in Asia and the Pacific is in the youth age group (10-24 years). Sexual and reproductive health is a big challenge due to the increasing interest in sex among teenagers but the lack of information regarding premarital sexual behavior. SETARA (Adolescent World Spirit) is an adolescent sexuality and reproductive health education module aimed at junior high school teachers to be implemented in their respective schools.
GEAS research is quantitative research from the Explore 4actions (E4A) project. Explore4actions aims to understand the process of gender socialization and the factors that influence this process in adolescents. GEAS is divided into 3 waves and is currently entering the second wave. The focus of the second wave was to compare changes in perceptions of gender norms and SETARA outcomes between the intervention and control groups after 2 years of implementing the program. Data collection was carried out in 3 regions that are currently implementing the SETARA program, namely: Java (Semarang), Sumatra (Lampung), and Bali (Denpasar). Data was collected through the GEAS questionnaire, this instrument has been developed and validated since 2012 in 15 countries on 5 continents.
This research is a collaboration between the Johns Hopkins Bloomberg School of Public Health, the World Health Organization, intervention implementation partners (Rutgers, PKBI), and research institutions around the world.
Part of GEAS
GEAS-Submodul Covid-19
This research is part of the ongoing Global Early Adolescent Study (GEAS) research specifically to understand the impact of the COVID-19 pandemic.
More than a quarter of the population in Asia and the Pacific is in the youth age group (10-24 years). Sexual and reproductive health is a big challenge due to the increasing interest in sex among teenagers but the lack of information regarding premarital sexual behavior. SETARA (Adolescent World Spirit) is an adolescent sexuality and reproductive health education module aimed at junior high school teachers to be implemented in their respective schools.
GEAS research is quantitative research from the Explore 4actions (E4A) project. Explore4actions aims to understand the process of gender socialization and the factors that influence this process in adolescents. GEAS is divided into 3 waves and is currently entering the second wave. The focus of the second wave was to compare changes in perceptions of gender norms and SETARA outcomes between the intervention and control groups after 2 years of implementing the program. Data collection was carried out in 3 regions that are currently implementing the SETARA program, namely: Java (Semarang), Sumatra (Lampung), and Bali (Denpasar). Data was collected through the GEAS questionnaire, this instrument has been developed and validated since 2012 in 15 countries on 5 continents.
This research is a collaboration between the Johns Hopkins Bloomberg School of Public Health, the World Health Organization, intervention implementation partners (Rutgers, PKBI), and research institutions around the world.
Part of GEAS
GEAS Innovation
This research collects and analyzes data from three data collection activities, namely pre-testing questionnaires, cognitive interview feedback, and focus group discussions (FGD).
The expansion of technology-based technology allows us to create more interactive questionnaires so that we can increase research participants. There are several response formats, such as visual analog scale (VAS), slider, radio buttons, and others. However, each response format has an inherent degree of measurement error. The Global Early Adolescent Study (GEAS) research uses radio buttons to collect research data. Radio buttons provide closed answer options and can be adapted to any web browser. However, radio buttons are repetitive and less attractive to respondents
This sub-research focused on analyzing data collected from 3 GEAS centers to assess whether the different question formats used in the electronic survey increased youth engagement in the research process, understanding and acceptance of the different question forms. The hope is to identify question formats that increase engagement and understanding, and reduce participant fatigue.
This research collects and analyzes data from three data collection activities, namely pre-testing questionnaires, cognitive interview feedback, and focus group discussions (FGD). Participants in this research were several selected junior high school students from state schools where GEAS was studied in Yogyakarta City.
YVR (Youth Voice Research)
This study aims to understand how young people aged 18 to 24 years experience and respond to various messages, norms and expectations related to gender and sexuality, and how this manifests in romantic and sexual behavior online.
According to the Central Statistics Agency, in 2020 the young population (10-24 years) is predicted to reach 67.8 million or around 25% of the total population. So the issue of health and welfare in the young age group is important to study considering its significant effect on the population.
The young age group faces many challenges during their growth and transition to adulthood. This challenge is increasingly complex with the factors of social media, urbanization, unhealthy diets, climate change and migration. Gender and sexual socialization are important processes that influence sexual behavior and (risks to) health and well-being. Unfortunately, this topic is rarely studied from the perspective of young people. Additionally, in Indonesia (as in many other places), research and interventions related to the sexual and reproductive health of young people often take a health- or risk-based approach, with an explicit or implicit focus on preventing premarital sex. This approach often omits a broader focus on the context surrounding young people and its influence on their sexual and reproductive values and behavior. There is little research on how contemporary young people in Indonesia respond to forces that often conflict with traditional Indonesian values, media and globalization, social norms, personal and relational interests, and the power of solid conservative Islam. So research is needed to answer reproductive health problems faced by teenagers.
Youth Voice Research (YVR) research seeks to address this gap. This study aims to understand how young people aged 18 to 24 years experience and respond to various messages, norms and expectations related to gender and sexuality, and how this manifests in romantic and sexual behavior online. YVR is qualitative research that is part of the Explore4action (E4A) program.
Explore4action (E4A) itself is an international program designed by Johns Hopkins University, Karolinska Institute, Gadjah Mada University Yogyakarta (UGM) Center for Reproductive Health, and PBKI (Indonesian Family Planning Association) to look for factors that can influence teenagers to have a smooth transition period. experienced by healthy and positive teenagers. There are 3 data collection locations, namely Bandar Lampung (Sumatra), Semarang (Java), and Denpasar (Bali). These three sites represent different backgrounds and cultures so they are considered to represent Indonesia. Data collection was carried out using focus group discussions (FGD) with groups of students and groups of parents at schools that received the SETARA (Semangat Dunia Pemuda) intervention.
The findings in this research will be used to support improving adolescent reproductive health interventions in Indonesia, especially the implementation of Reproductive Health Education.
Adolescent Mental Health Focus Group Discussions
This study aims to understand how young people aged 18 to 24 years experience and respond to various messages, norms and expectations related to gender and sexuality, and how this manifests in romantic and sexual behavior online.
Adolescent Mental Health Focus Group Discussions is a study related to the mental health of adolescents aged 12 to 19 years. This research is a multinational study involving several countries, namely the Republic of Chile, People’s Republic of China, Democratic Republic of Congo, Indonesia, Egypt, Jamaica, Jordan, Kenya, Malawi and Sweden. Yogyakarta was chosen as the region representing Indonesia in this research.
For this research, Gadjah Mada University (UGM) collaborated with the United Nations Children’s Fund (UNICEF), The Johns Hopkins Coordinating Center of the Global Early Adolescent Study, Johns Hopkins Bloomberg School of Public Health, United States.
The aim of the research is to provide an opportunity for teenagers in Yogyakarta to contribute their opinions to global data related to adolescent mental health to be compiled by UNICEF, to then be presented in the 2021 State of the World’s Children (SWC) report.
BEING
Being is a global mental health initiative committed to fostering a world where youth experience well-being and flourish.
Being is a global mental health initiative committed to fostering a world where youth experience well-being and flourish. Our mission involves collaborating with young individuals to enhance their mental health through research, innovation, and the development of supportive ecosystems. Prioritizing prevention and promotion, we concentrate our efforts in 13 key countries, with the Center for Reproductive Health UGM leading our endeavors in Indonesia. Building on the groundwork of our 2023 landscape analysis and stakeholder consultations, we are embarking on a longitudinal research initiative. This programmatic study aims to deepen our understanding of the learning and support communities, fostering the sharing of best practices, lessons, and our collective impact on global mental health. Through this, we aspire to contribute to the ongoing improvement of mental health and well-being for young people worldwide.”
Being promotes rights-based, culturally appropriate care that creates supportive communities where young people are the agents and drivers of their own mental health, and where proactivity is prioritized over reactivity. By focusing on prevention and promotion as the drivers of mental health and wellbeing, with an approach rooted in community-based, locally driven innovation, impact, and sustainability, Being will build on the learnings of other funded initiatives and contribute as a global mental health ecosystem leader, helping to drive the field forward and ensure scaling and uptake of funded solutions.
AWaRe (Access–Watch–Reserve)
This study is committed to improve the surveillance of antimicrobial resistance and reduce inappropriate antibiotic consumption.
The global rise in inappropriate antibiotic use is a threat to population health. Over 90% of human use is in primary care (PC), with rapidly increasing use of broad-spectrum oral Watch antibiotics seen in low- and middle-income countries (LMICs). A core component of antibiotic stewardship is improvement in clinical treatment decision-making by frontline health workers. The overall aim of this proposal is to develop and test a framework for future surveillance, benchmarking and population-based interventional trials of optimal antibiotic use in LMIC PC settings. We will pilot new methods of estimating patterns of antibiotic use (WS1), develop a new AMS intervention (WS2) and evaluate it in a paradigmatic clinical trial (WS3). Novel methods of measuring antibiotic use will be designed to facilitate national surveillance, benchmarking and improved outcome capture in LMIC PC clinical trials. The educational and organisational intervention will be based on the 2022 WHO Essential Medicines List (EML) AWaRe (Access–Watch–Reserve) Book. The pragmatic global cluster randomised trial will be performed in countries across Asia and Africa to determine the effectiveness and safety of an AWaRe system-based intervention on appropriately reducing total and oral Watch antibiotic prescribing and will be designed as a blueprint for future population-based PC trials.
NIMH-GEAS
This study aims to develop, refine, and validate a novel cross-cultural assessment tool of gender normative perceptions regarding mental health in adolescence. It is a sequential explanatory mixed method study that consists of 3 phases.
Built upon the findings from I-NAMHS and GEAS Indonesia, the CRH together with the National Institute of Mental Health, United States are developing a study known as NIMH-GEAS R21 study. This study aims to develop, refine, and validate a novel cross-cultural assessment tool of gender normative perceptions regarding mental health in adolescence. It is a sequential explanatory mixed method study that consists of 3 phases. Phase 1 is a formative research focusing on identifying central themes with broad cross-cultural relevance; phase 2 focuses on instrument development; and phase 3 focuses on instrument evaluation.
The result of this study is hoped to lay a strong methodological foundation for future longitudinal efforts to uncover specific mechanisms through which gender norms influence mental health among adolescent boys and girls, thus, inform the development and implementation of gender-transformative interventions targeting mental health and well-being among vulnerable adolescents around the world. Apart from Indonesia, this study will also be carried out in Chile and Democratic Republic of Congo.
Mapping of HPV Vaccination and Cervical Cancer Screening in Indonesia
This study aims to map the implementation of primary prevention efforts for cervical cancer with HPV vaccination and secondary prevention with screening using IVA and Pap smears as well as follow-up on positive screening results.
Globally, cervical cancer is the fourth female cancer with an estimated number of 604,000 new cases and 342,000 deaths in 2020. The incidence and mortality rates for this disease vary greatly between countries, and even within a country. This variation is thought to be due to various factors, including socio-economic and behavioral factors in preventing cervical cancer. Around 90% of cases and deaths due to cervical cancer occur in low and middle income countries, including Indonesia.
The World Health Assembly in 2020 recommended a comprehensive global strategy for dealing with cervical cancer (The Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem). This comprehensive approach targets primary and secondary prevention, namely:
1) 90% of adolescent girls receive a complete human papilloma virus (HPV) vaccine before the age of 15 years;
2) 70% of women aged 35-45 years have been screened for cervical cancer;
3) 90% of women identified as having pre-cancer are treated and women diagnosed with cervical cancer receive treatment and care appropriate to their stage.
The global cervical cancer elimination target is known as the 90-70-90 target which needs to be realized by 2030. Indonesia has followed this global policy and strategy, including the target to be achieved 90-70-90.
Apart from HPV vaccination for school children, cervical cancer screening is a secondary prevention policy that applies throughout Indonesia. However, it is suspected that cervical cancer screening is not evenly distributed throughout Indonesia. This is because it is hampered by various things, including: lack of health workers who are capable of implementing the program; inadequate training; the availability of screening equipment and facilities in primary care is inadequate; insufficient regional financing sources; and the low priority of cervical cancer prevention at the regional level.
This study aims to map the implementation of primary prevention efforts for cervical cancer with HPV vaccination and secondary prevention with screening using VIA and Pap smears as well as follow-up on positive screening results.
Cognitive Testing of A Survey Instrument To Assess Sexual Practices, Behaviours, and Health-Related Outcomes
The aim of this research is to refine a ‘standard instrument’ (in English and other language versions) by testing it in a variety of demographic cross-sections of the general population, worldwide.
The aim of this research is to refine a ‘standard instrument’ (in English and other language versions) by testing it in a variety of demographic cross-sections of the general population (e.g. older
persons, persons in rural areas), worldwide. The ‘global applicability’ of this instrument will be determined by this research. Specific outputs include:
• A standard set of sexual practice-related measures that have been tested in different languages across a variety of geographic and cultural environments.
• A process for adapting the survey to a new setting (including translation), which can be replicated in the future by researchers wishing to incorporate the instrument into their sites.
• Recommended implementation ranges (for example, allowing HRP to indicate that the tool can be implemented in the general population among persons age XX-XX).
Cognitive interviewing, subsequently described, will be used to determine whether target audiences (cross sections of the general population) are willing and able to answer the instrument’s questions.
It will also determine whether questions are interpreted (understood) by the target population in the way intended.