Iwu Dwisetyani Utomo

Prevalence, motivations, and adverse effects of vaginal practices in Africa and Asia: Findings from a multicountry household survey

BACKGROUND Women worldwide use various vaginal practices to clean or modify their vulva and vagina. Additional population-level information is needed on prevalence and motivations for these practices, characteristics of users, and their adverse effects. METHODS This was a household survey using multistage cluster sampling in Tete, Mozambique; KwaZulu-Natal, South Africa; Yogyakarta, Indonesia; and Chonburi, Thailand. In 2006-2007, vaginal practices and their motivations were examined using structured interviews with women 18-60 years of age (n=3610). RESULTS Prevalence, frequency, and motivations varied markedly. Two thirds of women in Yogyakarta and Chonburi reported one or more practices. In Yogyakarta, nearly half ingest substances with vaginal effects, and in Chonburi, external washing and application predominate. In Tete, half reported three or four current practices, and a quarter reported five or more practices. Labial elongation was near universal, and 92% of those surveyed cleanse internally. Two thirds in KwaZulu-Natal practiced internal cleansing. Insertion of traditional solid products was rare in Chonburi and Yogyakarta, but one tenth of women in KwaZulu-Natal and nearly two thirds of women in Tete do so. Multivariate analysis of the most common practice in each site showed these were more common among less educated women in Africa and young urban women in Asia. Explicit sexual motivations were frequent in KwaZulu-Natal and Tete, intended for pleasure and maintaining partner commitment. Practices in Chonburi and Yogyakarta were largely motivated by femininity and health. Genital irritation was common at African sites. CONCLUSIONS Vaginal practices are not as rare, exotic, or benign as sometimes assumed. Limited evidence of their biomedical consequences remains a concern; further investigation of their safety and sexual health implications is warranted.

Sexual perceptions and practices of young people in Northern Thailand.

This study draws together survey and qualitative data on sexual practices among more than 1750 young Northern Thai people aged 17–20 years. The survey data indicate that sexually active young people frequently engage in, or are subjected to, risk-taking behaviours that may expose them to sexually transmitted infections and unwanted pregnancies. These include having multiple sexual partners and quite frequent partner turnover. High percentages also engage in unprotected sexual intercourse with various types of sexual partner (steady, casual and paid), and young women especially had often experienced sexual coercion. Qualitative data revealed a mixture of perceptions and practices affecting sexual intercourse among the young, such as having unplanned sex, engaging in sexual relations to display love or cement committed relationships, and having serial relationships, both monogamous and non-monogamous. We conclude that condom use should be a central focus of activities aimed at preventing adverse sexual health outcomes, but that new intervention approaches to encourage use of other contraceptives are also needed. Changes in sexual norms among young people also need to be acknowledged and accepted by older Thai generations in order for programmes and interventions to combat negative sexual and reproductive health consequences to be more effective.

MIGRATION AND TRANSITION TO ADULTHOOD: Education and employment outcomes among young migrants in Greater Jakarta

This paper examines the relative education and employment outcomes among young migrants and non-migrants in Greater Jakarta in 2009/2011. Using data from the 2010 Greater Jakarta Transition to Adulthood Survey that includes 3006 respondents aged 20 to 34 years old, the paper highlights the importance of the age at migration in influencing the patterns of schooling and employment among young people. Patterns of schooling and employment are investigated for four groups of young people: those who migrated to Greater Jakarta between ages 0 and 10, between ages 10 and 17, after age 17, and non-migrants. We found that young people who migrated to Greater Jakarta at 10–17 years of age are over-represented in the lower spectrum of occupational rankings, even though they are more likely to be employed than non-migrants and those who came to Jakarta at other ages.

Birth control, pregnancy and abortion among adolescents in Chiang Mai, Thailand

The authors studied more than 1750 young urban Chiang Mai residents regarding pre-marital sex, contraception and reproductive health outcomes. Almost two-thirds of the males had had sexual intercourse, compared to one-third of the females. Withdrawal was the most popular method of birth control followed by condom use. There were more females (30.5 per cent) reporting that they had been pregnant than males (17.5 per cent) reporting that they had caused pregnancies. Two-thirds of the respondents who had experienced or caused pregnancy reported that it ended in abortion. Almost half of those who had experienced abortion had induced it themselves, usually using illegal abortifacients. One-third went to a private clinic or hospital illegally. Self-induced abortions were sometimes associated with complications that were treated with pharmacy medications or severe complications requiring hospital treatment. Adolescents in northern Thailand need improved sexual health services and programmes. To be effective though, attention should also be given to underlying cultural attitudes toward sexuality and young people, especially women.

Female Migrants and the Transition to Adulthood in Greater Jakarta

This article examines the impact of internal migration, and its timing, on young women’s transition to adulthood. Using the 2010 Greater Jakarta Transition to Adulthood Survey, we identify five key groups of women living in Greater Jakarta: those who were born there, those who migrated before the age of 10, those who migrated between ages 10 to 17, those who migrated after age 17, and circular migrants. Using retrospective quantitative data, we examine the timing of five key adulthood markers for each of these groups: leaving the parental home, leaving the education system, entering the workforce, marrying, and having children. We then explore the extent to which variation in education, marriage, and fertility patterns explain the women’s current employment outcomes. Qualitative findings are also discussed to provide insights on migration motivation and the life strategies that these women adopt to navigate their transition to adulthood.

Self-rated health of older persons in Indonesia: Sex and ethnic differences

This study contributes to expanding the knowledge of the health of older persons living in Indonesia, a country with limited welfare benefits. The research employs a variable, ‘self-rated health’ (SRH), to investigate socio-cultural factors linked to the health of older Indonesians. The data presented in this study are based on fieldwork collected using a mixed-method approach. Sex-difference in SRH in older age is shown to be predominantly a result of enduring inequalities across the life course, manifested in cultural practices, education, employment and programs for health. An older persons status within the family is a significant determinant of SRH, but the direction of the relationship depends on the sex and ethnicity of the person. Other variables related to SRH are age, lifestyle, education, residential area and intergenerational transfers.

Transition into marriage in Greater Jakarta: Courtship, parental influence, and self-choice marriage

This article addresses the question of whether a shift to a self-chosen marriage partner means that traditional cultural norms stressing family influence on spouse selection have been weakened by inroads of modern norms of greater individual autonomy in the marriage process. Using a representative sample of 1552 married young adults (aged 20–34) in Greater Jakarta, we explore the courtship processes and the degree of parental role involved in spouse selection. Although only 4% of the respondents cited that their marriage was arranged by others, over half of the respondents reported their parents or in-laws played a major role in their marriage decision. Our multivariate analysis suggests that tertiary educated respondents are those most likely to report their parents playing a major role. We reflect on the prevailing cultural norms to discuss the centrality of family in studying the interactions between marriage, education, and social mobility in modern Indonesia.

School-to-work transition of young people in Greater Jakarta: the determinants of success

ABSTRACTThis study aims to analyse the determinants of successful school-to-work transition of young adults in Greater Jakarta. The study argues that the most consistent and significant influences on successful transition among young adults are micro predictors rather than mezzo predictors. Education has a strong positive relationship to successful school to work transition particularly in attaining stable job category. This study also found that traditional culture is likely to have negative influences on the successful transition of young women, while a positive transition is experienced by young men. Education is a key strategy in reducing the negative impacts of traditional cultural values and promoting successful school-to-work transition particularly if both young men and women are to attain stable employment.ABSTRACT This study aims to analyse the determinants of successful school-to-work transition of young adults in Greater Jakarta. The study argues that the most consistent and significant influences on successful transition among young adults are micro predictors rather than mezzo predictors. Education has a strong positive relationship to successful school to work transition particularly in attaining stable job category. This study also found that traditional culture is likely to have negative influences on the successful transition of young women, while a positive transition is experienced by young men. Education is a key strategy in reducing the negative impacts of traditional cultural values and promoting successful school-to-work transition particularly if both young men and women are to attain stable employment.