Male stereotype as 'Leader' and Female Double Burden

Brief Report Male stereotype as 'Leader' and Female Double Burden Gap between Normative and Factual Perspectives, and Challenges to Develop a New Masculinity Concept for Gender Justice QUALITATIVE BASELINE STUDY RUTGERS-WPF INDONESIA MEN-CARE PROGRAM

Prepared by: E. Kristi Poerwandari Shelly Adelina Iklilah Muzayyanah DF

September 17, 2013 GENDER RESEARCH CENTER UNIVERSITY OF INDONESIA GRADUATE PROGRAM

TABLE OF CONTENT CHAPTER ONE. INTRODUCTION AND OVERVIEW OF THE STUDY AREAS BACKGROUND AND GOAL METHODOLOGY Study Locations Data Collection Method Data collectors/ Field researchers Field implementation Table 1.1. Data collection and informants in three study areas

OVERVIEW OF STUDY AREAS Lampung East Java DI Yogyakarta

CHAPTER TWO. NORMATIVE AND FACTUAL DIVISION OF GENDER ROLE AND RESPONSIBILTY NORMATIVE PERSPECTIVE "A Man is Responsible to Provide for the Family and Leads the Households, a Woman Has the Duty to Please the Man” Normative Perspective of "Man Is a Leader, a Good Woman Is the One Who Takes Care of Her Family and Obedient" Normative Perspective: "Man Is the Head of the Family, but the Wife Deserves Respect; Both Work, Earn a Living and Take Care of Their House Together" Polygamy

FACTUAL CONDITION ON FOR DIVIDING WORK BETWEEN HUSBAND AND WIFE IN THE FAMILY Lampung DI Yogyakarta East Java Husbands Are Reluctant to Do Household Chores Women’s Double Burden

How a Wife Acts Men’s 'Domination Game' Dilemma on the Normative Perspective that 'Man Is the Leader of the Household and Breadwinner'

Special Cases Changes toward Equal Husband and Wife Partnership

CHAPTER THREE. REPRODUCTIVE HEALTH AND FAMILY PLANNING STATISTICAL DATA Table 3.1. Active FP Users in two study areas and in Lampung province, 2013 Table 3.2. Percentage of Active FP Users by Method in Bondowoso and Jombang in 2011 Table 3.3. The percentage of active FP users in DIY by District / City, 2011

COMMUNITY FAMILY PLANNING PRACTICES

Responsibility on FP Male FP Worried to Get Pregnant, FP and Side Effects on Women Special Groups that Reject FP

PREGNANCY, LABOR AND DELIVERY, AND HUSBAND’S ROLE Antenatal Care Financing Myths and prohibitions Husband Involvement in Household Chores during His Wife’s Pregnancy When wife gives birth The Importance of Providing Comfortable Situation for Women during Childbirth Postpartum period

CHAPTER FOUR. SEXUAL RELATIONSHIP REALITY OF SEXUAL RELATIONSHIP BETWEEN HUSBAND AND WIFE Characteristics of female sexuality The need to have more open discussion

BIO-PSYCHO-SOCIAL REVIEW OF MALE AND FEMALE SEXUALITY INFIDELITY, TEEN PREGNANCY AND PREGNANCY OUT OF WEDLOCK

CHAPTER FIVE. CONFLICT RESOLUTION AND PHENOMENON OF VIOLENCE CONFLICT AMONG MEN IN SOCIETY GENDER-BASED CONFLICT Domestic Violence, Restrictions and Forms of Violence Community Explanation on the Causes of Domestic Violence Bias Understanding about Domestic Violence The Domestic Violence in the Form of Reciprocity

VIOLENCE AGAINST CHILDREN Discipline through Physical Punishment Rejection on Violence against Children

PREVENTION AND MANAGEMENT OF DOMESTIC VIOLENCE

CHAPTER SIX. BECOME A FATHER AND A CAREGIVER Experience as a Father Woman’s Perception of an Ideal Father Figure A Man’s Perception of an Ideal Father Figure

CHAPTER SEVEN. RECOMMENDATIONS FOR PROGRAM DEVELOPMENT PROCESSING 'PSYCHOLOGICAL' ASPECTS AND MEN AWARENESS What Can Complicate Attitude and Behaviour Change Empathy and Guilt Lie low, "Time Out" Sanctions and Social Control Education to Change Perspective

STRATEGIES RELATED TO PROGRAM APPROACH

Program Name Strategy

UNDERSTANDING THE MACRO CONTEXT Facilitate positive activities for adolescents Streamline the existing mechanism "Triggering"

LESSON LEARNED FROM THE HEAD OF PUSKESMAS

CHAPTER ONE INTRODUCTION AND OVERVIEW OF THE STUDY AREAS BACKGROUND AND GOAL Since 2007 RutgersWPF Indonesia works with partner organizations in Indonesia to develop a counseling program for men in the context of intimate relationship. The goal is to help men who commit violence change their behaviors so they can have intimate relationship with respect. Men should be involved and actively involve in prevention and intervention of various women's issues and gender relationships.

Various issues on female sexual and reproductive health often occur due to patriarchy-biased perspective and masculinity concept sees women and marginalized groups as inferior groups. Narrow interpretation of religion makes the situation worse considering that some complex socio-cultural, economic and political issues are denoted and justified by religious teachings. Women and marginalized groups suffer due to poor fulfillment of their sexual, reproductive health rights and gender-based violence, or at least, suppressed by a very hard and double burden to do productive work (to earn a living), reproductive work (both biological and social reproduction), and social work.

RutgersWPF initiated Men Care program and will implement the program in Indonesia by involving partners from Lampung, Jakarta, Yogyakarta and East Java. The goal is to address gender inequality that affect the rate of violence against women and children, poor quality of women's health, the many issues on women's reproductive health, to the high number of maternal deaths. We will involve men as the spouse who care and are actively involved in parenting and family life. For the purpose of Men Care program above, we will reconstruct the concept of masculinity and 'be a father', which in turn will change the life practices in partnering with women, families, and parenting, to be more concerned and actively involved.

In connection with the above, the Gender Research Centre, Graduate Program University of Indonesia (PPs Research Center-UI) was engaged to carry out a preliminary study using qualitative approach. The goal is to provide baseline for program development in:  Baseline data to illustrate men’s understanding, appreciation of and practices in social and family life, particularly with respect to their relation with women and children.  Information about the implications of the understanding, appreciation, patterns of male behaviors on the relation of men with women and children, and on the quality of life of women and children.

Included in them are issues on gender-based violence, general health, sexual and reproductive health, as well as women's workload.  And information on contemporary habit of young people in the study areas, various formal and informal activities, current strategies for media advocacy and efforts to change the concept of masculinity, as well as lessons learned to inform strategies for dissemination, training, advocacy, detail materials and approach.

METHODOLOGY The study seeks to obtain robust information from (a) young men who will be the main target of the program, (b) young women who live with men, to confirm or dis-confirm, and describe gender relations

and men’s attitudes / behaviors; (c) some other supporting resource persons can give context of the real situation, and outline strategies to change men’s attitudes / behaviors to be more gender sensitive. The main resource person will be men, especially young men, given that the target of the program is men.

Data from other groups complement understanding and context for the purpose of triangulation Study Locations The study was conducted in three areas: Lampung, East Java and Yogyakarta Special Region, and two locations were selected in each area: • Lampung: Bandar Lampung and West Lampung, particularly Liwa • East Java: Bondowoso and Jombang • DI Yogyakarta: Gunung Kidul and Kulon Progo Data Collection Method This study used two data collection methods: FGDs and focused interviews. The groups were: • FGD for male group • FGD for female group • Interviews with several male clients of Rifka Annisa‘s 'Men's Program' • Interviews with health providers who were well-informed about reproductive health issues in study areas • Interviews with religious leaders who know beliefs and religious practices in study areas • Interviews with people who understand the characteristics of local culture. It is considered necessary to invite informants with these characteristics to provide information about the contemporary culture and popular information media in study areas. Thus, the data will inform a number of appropriate strategic approaches for the program. Focused interviews were finally undertaken with several media workers.

Data collectors/ Field researchers Given the sensitive issue and needs to protect confidentiality of the most robust data, the main facilitators for FGD to probe data from men were also men. Researchers who led FGD and interviews with women were from PRG PPs -UI who are generally women.

Field implementation The study team worked together with local partner agencies for field preparation and data collection: • Lampung: Lampung IPPA chapter (PKBI Lampung) • East Java : East Java IPPA chapter (PKBI Jawa Timur) • DI Yogyakarta: Rifka Annisa Women's Crisis Center Local partner agencies also appointed male staff as the main facilitator for FGD with male.

Table 1.1. Data collection and informants in three study areas

LAMPUNG

BANDAR LAMPUNG

WEST LAMPUNG

Time : Monday, May 6 to Saturday May 11, 2013

- 1 FGD with 9 unmarried young men - 1 FGD with 10 married young men with children - - 1 FGD with 10 women, combined between unmarried and married with children

- 1 FGD with 9 young men (combined between unmarried and married with children) - 1 FGD with 9 women (combined between unmarried and married with children)

Number of informants: : 56 people:

( 31 men and 25 women )

Focused interview with: - 1 male religious leader - 3 female reproductive health service providers (midwives) - 1 male media and culture observer

Focused interview with : - 1 male religious leader - 3 female reproductive health service providers (midwives)

EAST JAVA

BONDOWOSO

JOMBANG

Time : Monday, May 6 to Saturday May 11, 2013

- 1 FGD with 11 young men combined - 1 FGD with 7 young men combined between unmarried and married with between unmarried and married children with children - - 1 FGD with 9 young women, - - 1 FGD with 11 young women, combined between unmarried and combined between unmarried and married with children married with children Focused interview with: Focused interview with: - 1 male religious leader - 2 male religious leaders - 1 female reproductive health service - 2 female health providers, head of providers, senior midwife Puskesmas Focused interview with 1 female media personnel who can provide information on media, and or characteristics of contemporary culture of East Java communities

Total number of informants: 45 people (21 men and 24 women )

D.I.YOGYAKARTA

KULON PROGO

Time: Tuesday, May 14 to Saturday, May 18, 2013

DI Yogyakarta: - Focused interview with 3 men who committed violence / had counseling from Rifka Annisa - Focused interview 1 female media personnel who have a good understanding on media, and or culture of DI Yogyakarta communities - 1 FGD with 7 young men (combined - 1 FGD with 9 young men (combined between unmarried and married with between unmarried and married children) with children) - 1 FGD with 8 young women - 1 FGD with 8 young women (combined between unmarried and (combined between unmarried and married with children) married with children) Focused interview with: Focused interview with: - 1 male religious leader - 1 male religious leader - 1 female community leader - 1 male community leader/elders - 3 reproductive health service - 2 health providers, 1 man and 1 providers woman who are the head of They are 2 men (head of Puskesmas), Puskesmas and 1 woman, head of midwives

Total number of informants: 45 people (25 men and 20 women )

GUNUNG KIDUL

Data from the field managed to collect stories and sharing from a total of 146 informants who were 77 men and 69 women. This number includes 112 community members who are the main focus of the program or men and women in the society; and informants incorporating health providers, religious leaders, community leaders and media workers with a total of 24 people.

OVERVIEW OF STUDY AREAS This sub section briefly discusses local characteristics and communities in the study areas in Lampung, East Java and DI Yogyakarta provinces.

Lampung Lampung province constitues of 12 districts and 2 cities with Bandar Lampung as the capital. In the coastal area of Lampung, the community is mostly fishermen, while those who settled in the inland grow crops like pepper, coffee, clove, cinnamon, and bananas. In addition to that, the community develops large scale palm, rice, cassava, cocoa, black pepper, corn, and sugar cane plantation and shrimp farms.

Population density is uneven between regions and generally very high in urban areas. The highest density is in the city of Bandar Lampung, and the lowest is in the West Lampung district. Both are study areas and will be the Men Care program development sites.

For a long time, Lampung used too be famous for its pepper plantation. The Sultanate of Banten, interested in pepper production, colonized Lampung in the early 16th century and and introduced Islam.

Pepper plants also attracted the foreign migrants from Europe such as the trading company from the Netherlands. The colonial Netherlands government introduced transmigration program to Java residents who lived in densely populated areas and tried to move to Lampung. The presence of migrants from other regions created a multicultural Lampung.

The local Lampung residents have a tradition of "piil", which was originally used to mean a noble act, the ability to do good, honest, and commendable act. The arrival of Islam changed piil to "piil pesenggiri".

The word "pesenggiri" means positive competition for virtue.

Somehow during the process, the tradition was then interpreted more narrowly; that is to put men’s interest above family which caused bias and detrimental to women. In general the conclusion is that those new Lampung people, particularly those who migrated from Java, demonstrates a pattern of relationship and role of men and women that is more balanced and mutual support, compared to the local Lampung, or those who are married to a local Lampung man.

East Java East Java is divided into 38 administrative areas: 29 districts and 9 cities. These studies took place in two areas: Jombang district in the highland and Bondowoso district in the lowland (http://jatim.bps.go.id/index.php/ pelayananstatistik /subyek-statistik-jatim/statistik-jatim-geografi, accessed June 29, 2013).

In Bondowoso there is no mall, movie theaters, or plazas, but quite a lot of Islamic boarding schools and small mosques for Koran recital. Some schools provide boarding for students and some do not.

Students in the latter school usually come from the surrounding community and they are called “nyolok� students. In Bondowoso, the tradition to have an early marriage still exists at the time of the study. It is common for school children to have an arranged marriage, and many of them between relatives. This arrangement, among others, is based on economic considerations.

Jombang city is known as the city of Islamic students because there are many great Islamic schools with hundreds or even thousands of students. However, most students who go to Jombang Islamic boarding

schools come from outside the city so that the values of Islam are not absorbed by the local, but by the outside community. Rate of pregnancy out of wedlock is pretty high in rural and urban areas.

DI Yogyakarta Yogyakarta Special Region (DIY) administratively consists of 4 districts and 1 city. The city has several names: the city of battles, the city of culture, a university town, and a heritage city. As a university town, there are many educational institutions providing basic to higher education in Yogyakarta; students not only come from the local areas, but also from various cities across Indonesia. The conclusion is that although Javanese culture is the dominant color of life, the community is open to other cultures of the migrants.

Gunung Kidul was formerly known as an arid and poor region despite its natural potentials. There is a tradition that brings joy to the local communities; it is a cleaning activity or well know as “Rasulan”.

Rasulan is usually celebrated after the second harvest season or after the dry season passed. Almost every year every village presents shadow puppets, “ketoprak”, other artistic activities, and sports.

The uniqueness of Gunung Kidul is, since quite a long time, this area is also famous for the high rate of suicides among its residents. Most people believe in the myth of pulung gantung. When there is a red light moving over the hill and then comes down into one of the houses in the evening, many locals believe that pulung gantung falls over a person who lives in the house; this person’s destiny is to die by hanging himself. Early marriage in Gunung Kidul increases from year to year. It shows in the increasing number of files for dispensation to get married in the Wonosari Religious Court for very young couples due to out-of-wedlock pregnancy.

Kulon Progo district is located in the West of Yogyakarta; it is a flat land surrounded by mountains in the northern region. Early marriage in Kulon Progo increases significantly from year to year. Quite a lot of these early marriages were caused by out-of-wedlock pregnancy.

CHAPTER TWO NORMATIVE AND FACTUAL DIVISION OF GENDER ROLE AND RESPONSIBILTY The general norms in the society; either in Lampung, East Java and DI Yogyakarta is that a man earns a living outside the house; while a woman is responsible for taking care of the children and household and in the house. Man may help do the house chores when his wife is overwhelmed; but only to help out, not to become his main responsibility. A woman can go to work to earn money to help her husband, but she must have permission or at least consent from the husband. This is also not the main resonsibility of the woman. She who works outside her house should not neglect her primary responsibilities (taking care of the children, husband and house). This perspective is often considered as religion-based.

NORMATIVE PERSPECTIVE Above is actually one of several normative perspectives. Below are some perspectives on the normative division of labor by gender in the community.

"A Man is Responsible to Provide for the Family and Leads the Household Households, a Woman Has the Duty to Please the Man " Moslem ulemmas strongly believe this perspective in East Java. One religious leader in Gunung Kidul who received his education in Kediri also believes this. Some male informants from East Java and Kulon Progo, Yogyakarta also believed in this teaching. In the perspective of this group, based on religious teachings, the task of a husband is actually a lot, he has to fully provide for his family. He must ensure that he fulfills the needs of his wife, from 'nothing to luxury things,’ he has to ‘take care,’ protect, pamper her at home. His wife can work /go out of the house with the husband’s permission. The group is aware of the fact that now many women work outside the house and the husband is waiting at home.

It is considered to be 'very un-Islamic'- husband who is bigger and stronger than his wife, lets her work hard outside, while he actually has to protect the wife and satisfy her needs.

According to this teaching, the wife must meet her 'religious obligations' which is to please and meet the biological needs of her husband. "Whenever her husband needs her, she is always ready, always please her husband, if there is still a little wrinkle on her face, then the husband no longer has the obligation to provide for her."(N, religious leader, Bondowoso) Similar to the perspective that man is responsible for everything, either to earn a living or lead a household; there is the perspective that still places a great responsibility on the man, but he shares the task with his wife for childcare. The only difference is on his obligation to educate the children which falls on the wife. In this perspective, a man must provide for his family, he also works in the household such as cooking, cleaning and washing. At the same time a woman is obliged to educate her children, serve her husband, and reminds him when he makes mistakes. Household chores are not a woman’s duty as a wife.

Some fundamental issues to question under the perspective are the great responsibilities of a man, while in reality the man is not perfect. He is an ordinary person with a lot of weaknesses. There are lot of restrictions for a woman, she is only allowed to live within the family, and seen as a 'vulnerable', 'weak' being who needs protection that ultimately leads to discrimination. Woman seems to be 'very

pampered' and cherished, but positioned as an 'object of entertainment', and in the end she cannot become a complete human being. This perspective highly dichotomize woman and man, and highly idealistic, almost impossible to realize.

Normative perspective of "Man Is a Leader, A Good Woman Is One Who Takes Care of Her Family and Obedient" This group confirms men’s leadership in his position in the realm of production and women are obliged to take care of reproduction. Religious leaders in East Java who were interviewed think that this perspective does not reflect Islamic family law because it is not based on a qualified understanding of Islam. This perspective enables practices that do not comply with the principles of Islamic family law.

However, it is quite common among religious and community leaders, even more prominent in some areas, for example in Lampung.

The previous perspective stresses the big resposibility of men as leader; this one emphasizes the privilege of men as leaders, and women's obligation to obey. Religious teaching is also used to justify this perspective. The first one looks at men as the one with the heavy workload, even household chores are also men’s work; the second perspective emphasizes the privilege of men and the duty of women to perform all household chores.

The implications of the above perspectives are considered common and normal to require a man as the breadwinner and a woman to take care of the house and children. But when a man is unable to perform his obligation to fully provide for his family, the wife has to adjust to what her husband can provide.

When necessary she has to be ready to earn a living as well without neglecting her main responsibility to take care of the house. This perspective imposes the obligations of the wife with the implication to increase wife’s double burden. This perspective reinforces male dominance and condescending perspective and lack of empathy to the difficulties that women are facing.

Normative Perspective: "Man Is the Head of the Family, But the Wife Deserves Respect; Both Work, Earn a Living and Take Care of Their House Together" This perspective is quite common, many informants both men and women in three provinces (or 6 locations) where the study was conducted agreed to this. This perspective is based on the religious belief that the husband is the head of the family, and wife leads the household, but both work hand in hand and respect each other. The main responsibility of the husband is to make a living, while the wife takes care of the household and children. But it need not be held too rigid, so that husband and wife can help each other.

For example, the wife helps make a living; husband helps wife to resolve household chores and childcare. Mutual respect is also reflected in the perspective that family planning is a joint responsibility.

Sirri (marriage without permission from first wife or blessing from parents) marriage and polygamy is not a good marriage because they have many negative impacts on the family.

Polygamy Many communities still practice polygamy. People in Bondowoso and Jombang, East Java, in particular, have a lax perspective on polygamy. Ulemmas are likely to approve polygamy, which somehow influence public perception.

Polygamy is mostly performed in secret by the village chief; it is a common topic for discussion. That polygamy is openly among ulemma or Moslem leaders, and the marriage is not always listed in the KUA

(office of religious affairs). Marriage is generally performed by permission from the first wife, and is considered to have good purpose, that is to have more children.

In general, the act of polygamy is still considered as part of religious teaching; men often use this as an excuse to legitimize polygamy, and the wife had to accept her husband to get married again. Verse that is used to legitimize polygamous marriages is generally the surah An Nisa verse 3.

Sometimes the justification given is the argument that it is to follow what the Prophet did; what happened is that the similarity lies only on the practice of polygamy, while the values and reasons behind the marriages are not understood. Another argument is related to the population of women which is considered higher then population of men. This argument is not based on statistics, and often uses incorrect data, but is often used to justify polygamy and why religion allows it. "My job is to read out verses that promote polygamy. When we are reading Qoran, we believe that the book is holy; it is an absolute value, absolute in the sense of haliyah. OK then, about the connection with polygamy, the BPS data show a proportion of almost 60-40; there are 60 women for every 40 men. For Jombang, it is 45 men for every 55 women. Well, if all women are selfish and refuse polygamy, how about the rest of them? Do you want the rest of them go to Surabaya? (Where?) Dolly. "(C, religious leader, Jombang).

This informant clearly used incorrect data and misinformed the community.

The third argument relates to put foward compassion. Polygamy is recognized as part of Islam, but it must apply the principle of compassion, not lust. In this perspective, polygamy is only allowed to help women and or orphans who are in unfavorable conditions. There are prerequisites for polygamy and that is to get permission from the first wife and it is not to impose what men want.

FACTUAL CONDITION ON FOR DIVIDING WORK BETWEEN HUSBAND AND WIFE IN THE FAMILY In reality, in all study areas, quite a lot of women has to work to earn a living because of husband’s limited income. In addition to earning a living, generally the women continue to bear the main responsibility to take care of the household chores and child care.

Lampung In Lampung, especially among locals, women’s double burden is a prominent issue because of the very strong perspective that the tasks (traditionally considered as the tasks of) women. It is inappropriate if men have to do it. In this society a man very often uses the excuse of 'embarassing' and 'worried that others will talk about it' and let the wife bear the big burden of taking care of the household and children. On the other hand, migrants, division of labor among husband-wife seems to be more flexible although later on some migrants also adopted the cultural practice that despise men who do 'women's tasks'.

DI Yogyakarta Men in the Gunung Kidul area are more open to the concept of equivalent work between husband and wife. In general, informants stated that there was no rigid division of labor; a man can do house chores and it is perspectiveed as Okay, it is normal for the community. Women are active and work outside the house to earn a living, and some of them are more active then men, bringing routine income for their family. The most common is men’s involvement in childcare, although the time is more limited, such as play with the children, or bathe and feed them.

In Kulon Progo, although the concept of gender equality is accepted, the perspective is not as open as in Gunung Kidul. People’s acceptance still varied. Some people see and apply the rigid practices to divide the role and others accept equivalent division of labor among husband and wife. Normative perspective in Gunung Kidul and Kulon Progo sees the husband as the main breadwinner, and wife is more responsible for household chores. However, in many young families, both husband and wife work; and even in some cases, the wife is the main breadwinner of the family. In this situation, the wife generally continues to be more dominant in doing household chores with the help of her husband. So the double burden still falls on the wife.

East Java Here, the common normative perspective is that actually men’s task is considered very hard, he has to earn a living as well as take care of the household. At the same time, there is also a strong perspective that (in ideal condition) a wife does not have to work outside the house. Religion actually commissions husband to earn a living and the wife actually should not have employment. "The bottom line, miss .... so it is not the arrogance of a man ... Nope, wife should only work to complement family economy. If the economy of the family is all good, I am sure; she does not have to have a job. Because actually religion does not allow it... it is not allowed ... "(FGD with men, Bondowoso). Though such practices are still praticed, community members in reality place the burden of household chores on the wife.

Complexity of gender construction is reflected on the answer. On one hand there is a normative perspective that the task of a man or a husband is very hard: responsible for providing all the family needs and even do everything. Here we see women’s job to do household chores (as is the case in other areas) can be lifted.

But on the other hand a woman is in the position to 'please her husband'; this can be interpreted as a priority to women’s role as 'sexual object', and negate the integrity of a woman as a human being with all her interests, potentials, and complex needs. With this way of thinking, three ulemmas in East Java who were interviewed approved polygamy. One of them said that religion allowed polygamy, but he personally chooses not to do it to respect his wife.

Husbands are reluctant to do household chores Although reasons varied, but some of these that prevent a husband to do household chores is mainly embarrassment and that others will talk about him. Some men said their wife would be a topic of discussion if she has the heart to let the husband do household chores. People will also talk about the husband because he is considered to be 'afraid of his wife'. "In my neighborhood .... neighbors talk when a husband cooks, relatives think that husband is not capable ... "(FGD with men, Bondowoso).

The following dialogue may explain husband’s reluctance to equally share the household work, even though his wife works outside the house. This adds more burden on the part of the wife: (Whose responsibility is washing and cooking?) "Well, it is a wife’s duty. A husband has to go to work." (But the wife also has a job) "Well, the wife only works to complement income." (What time does the wife go to work?) "She departs at 6 a.m." (What time do you go?)" The husband leaves at 8. "(but the wife washes and cooks?) "Yes." (Suppose she should leave at 6, whether she goes teaching, whether she works in a factory, it means that she has to get up at 4 the latest, right.) "Yes, at 4. If the wife gets up and makes coffee and gives a little snack, it is not difficult for a husband to earn a living outside the house. Probably like that. Suppose the husband gets up, no coffee, no breakfast. It will probably be hard for the husband." (FGD with men, Kulon Progo).

Embarassment and reason 'afraid to reflect bad on the wife' also justify man to stay put when he sees that his wife is burdened by the household chores. A celebration can illustrate a situation when trivial issue can be considered an insult and embarrass the husband. "In this area, when there is a celebration, we will be busy tidying up plates after meal. For example our child is cranky, we ask for help from our husband. And let’s say he is talking to his friends, it becomes a problem. Actually our hands are full, we certainly ask for help. Husband, please take care of our child. It is considered an insult. The child may then become a victim. Finally the child cries, well, then the mother brings the child home. It embarrasses the husband. Then we quarrel at home ... "(FGD with women, West Lampung).

Y, a community leader in Gunung Kidul concluded, "Sometimes I look at my neighbor, the husband helps wash clothes, the wife cooks, cleaning up and so on. I guess only 40 percent of husbands in average will do something like that. The other 60 percent only want their wife to serve them though they are unemployed."

Women’s double burden As mentioned before, women seem to bear the double burden; she has to take care of the household chores and childcare, but also to earn a living. Some women become the backbone of the family and even the main breadwinner in the household. Stories about this appear in all of the study areas. "Our work is hard, complete farming steps, including planting chili. I do everything myself. I used hoe. I am always on my own. Well, my husband, after he finishes taking care of other people, well, he is a village official. The work, I do it on my own. It is a different job as a Lurah, the salary is different from a village official. I also have to do all the household chores, cleaning the house. But for financial issue, our earnings complement each other’s. "(FGD with women, West Lampung)

"In this area, mostly the wife is a housewife, but some work in cigarette factory. The husband only takes her to and from the office. The husband stays at home, care for their children. As far as I know, the wife cooks and takes care of the house. "This is not something that does not impact family life. A woman from Kulon Progo added that a wife was stressed, and it caused her to be grumpy, easily irritated. "Her husband does not have an income, probably she is tired, because she has to do all the work, so she is easily emotional. "(FGD with women, Kulon Progo).

How a wife acts There are varied attitudes how women react to the division of household chores. Some women showed resignation, and voluntarily do the household chores by herself. When she was asked whether her husband helped, or she did not want her husband's help, the answer is: "well, I feel sorry for my husband. Taking care of other people is already a complicated job. Poor husband. I will feel embarrassed if my husband helps me. People will say, the husband is afraid of his wife."

Other women felt pressured by the situation, but found it difficult to speak openly, for fear that she was demanding to her husband. "Yes. Everything is amiss. I feel guilty if people perspective me as demanding, and also because it is considered a woman's job ... ".

Other women cannot accept it and try to make their husbands willing to share the household chores.

The wife expects her husband to give attention and help. An unmarried young woman informant realized that it cannot be ignored. Division of labor and other agreements should be discussed before marriage. "It is a must. For examples my sister is married, automatically I see an example. I cannot be

like her. I should discuss it when I go out on a date with the man, what if we get married, such as the division of labor."(FGD with women, West Lampung).

Women understand that tension and conflict and the heavy burden borne by women depress them and it can lead to bigger problems, including domestic violence. "a lot of factors lead to domestic violence, economy is one of these. So we look for a job, and when we get married, can we split the time? Let alone if we have to go to work in the morning, automatically we have to split our time. When one of us washes clothes, the other can sweep the floor. "(FGD with women, Kulon Progo).

Male 'domination game' Though it is not the attitude of majority of men, several male informants recognized the convenience of life as a man because their wife takes care of everything. Even the wife also works to earn a living. They then argued that women did not want 'their husband to pamper them', not willing to live like wives in other countries (let’s say Saudi Arabia) who only have to take a shower, sit down, “dress up” "Oh it is like this, mam ... sometimes being a husband is so much fun .... A husband’s role is actually convenient. Early in the morning a husband wants coffee .... coffee, cigarettes, my wife laid them out, wife serves... coffee, wife ... cooks, wife ... sweep, wife ... washes clothes, iron, let’s say it like that ... the husband works until 10 at the latest... sometimes the wife also works, her burden doubles. Sometimes she just does not want to have a pampered life... . I once said to my wife ... do you want to be the wife of an Indonesian or an Arabian ... I said so to her. An Arabian .. in Saudi Arabia, a wife only has to “dress up”, just to take a shower, just..., just sit down, just serve the husband, that is how it is in Saudi Arabia ... she does not want it, she prefers to be the wife of an Indonesian." It is understandable that his wife is not willing to accept the offer, because he continued, "Every work is my effort, my work is my effort, cooking is my effort, our child is my business, but one thing that a wife must not comment is when I want to have two wives.”(FGD with men, Bondowoso).

In one case a husband in Kulon Progo demonstrated inconsistent attitude and at the same time showed that he took advantage. On one hand he admitted that actually based on religious teaching, men have great responsibility to provide for the family and lead a household. On the other hand he let his wife do all the household chores without his help, also on the grounds of religious teaching. "Well although I know that taking care of and educating children is a husband’s job, thanks but no thanks, I almost never wash clothes, I almost never cook. "(Why is that so?)

"Thank God, my wife is a shalehah (obedient). She knows that God promises so much reward so my wife does not want to have a job or else I will take away all the sunnah (rewards) opportunities."(FGD with men, Kulon Progo).

Dilemma on the normative perspective that 'man is the leader of the household and breadwinner' With the norm that places a man as a leader of the household and breadwinner, some men feel that they has done enough for their share of responsibility when they work outside the house. They demand their wife to 'make do with whatever they earn, and. When a wife says that the money is not sufficient, it shows disrespect to the husband.

In fact, it is not easy for a wife to make do with the income because she must deal directly with the various needs such as the money to buy foodstuff, the cost of feeding children (e.g., milk for their little child), child's education, and so forth. It is thus difficult for a wife to accept a normative answer: "it shows how smart a wife when she knows how to spending the income”. On the other hand, the husband can feel very offended when a wife requests or says that the money for the household is not enough.

When asked if a husband has ever felt offended because of financial issue, the answer that came up is "Yes definitely!! I personally will definitely feel offended if it ... as if I were a man who never understands what a man has got to do ... "(FGD with men, Bondowoso, Kulon Progo) Quite a lot of men felt 'higher' because they are the head of the family, so they are very guarded in case their wife 'humiliates' them. As a result, there are works that they will avoid, and they tended to be easily offended if their wife asked them to do certain things. The answer was revealed during an FGD with men in all study areas. "I am willing to take her to the market, but if I have to do the shopping on my own, I will avoid it. Because I am afraid that she will make it a habit. A wife tells her husband as she wishes. "(FGD with men, Jombang). FGDs in Bandar Lampung and West Lampung: the question is whether a man is willing to buy something that his wife or girlfriend needs when she is sick, some replied: "If I am told to do something, I do not want to! if she can still walk, let her buy it herself. Unless we are husband and wife, if we have a child, send the child. We avoid peope’s impression, oooh why is the husband willing to be told to do things? People think badly of it... "(FGD with unmarried men, Bandar Lampung).

If any man fails or unsatisfactorily plays his role as a breadwinner and leader of the family, he still expects his wife to respect him and be polite to him. "It is a man’s dignity, yes, as mentioned before; a wife should remain 'Tawwaddu' of the husband. That is the important point, there are rules, when a husband makes a mistake, for example, in any religion do not follow a husband who violates a rule, it is the same when a wife makes a mistake, the husband also has the right to remind her. "Furthermore, he said," Sometimes when a wife has got a little bit of income, automatically she will say something that is not good to hear ... " (Can you give an example?)" For example, “when we got married, what did you bring,”. It can be offensive. To be compared with others, A already has this and that, how come we don’t ... "(FGD with men, Jombang).

Special cases Some cases are special, ranging from a very dominating wife who does not do household chores. Though the husband had a full time job to earn a living and the wife just stays at home; to a husband who completely does nothing at home and lets his wife bear the burden to earn a living and take care of the house. Such stories are common in all study areas, including Lampung where the residents often admits to “position men as leaders and kings.”

Changes toward equal husband and wife partnership Despite the above problems, the study also found new facts about openness among some men to lead a more equal life with women, shoulder to shoulder to help each other. These men realize how heavy household chores can be. Such men exist in all study areas, both in Lampung, East Java and DI Yogyakarta. "This is in my house. My wife and I work in the farm. Sometimes I work in construction as a mason. The division, I earn a living. My wife takes care of the house. That is the main thing. Sometimes we switch roles. Sometimes my wife joins me in the farm, helps me. My role to the child, care for him/her, watch her/him, the burden is more on my wife. Because she is closer to the child, she is at home. But that is not only her burden. My wife is a little overwhelmed to take care of everything. Then we split it. I will take a responsibility in it. For household chores, I chip in. For example, washing the dishes after meal. "(FGD with married men, Bandar Lampung).

CHAPTER THREE REPRODUCTIVE HEALTH AND FAMILY PLANNING This chapter explains the related issues on reproductive health and family planning. Started with available statistics, followed by a more subjective information on real life practices based on FGD data from male and female informants and interviews with health providers in six study areas.

STATISTICAL DATA All study areas show that very few men used FP. Data from Lampung Province shows that FP devices include injection, then pills, and implants. A lot of women use IUDs as well, and in Bandar Lampung IUD is the third choice for FP.

Table 3.1. Active FP Users in Lampung province and in two study areas, 2013

No

Type of contraception

West Lampung

Bandar Lampung

Lampung Province

Quantity

%

Quantity

Quantity

1

IUD

11,826

16.26 16,193

14.32 160,379

13.38

2

Tubectomy

546

0.75

2,275

2.01

16,381

1.37

3

Vasectomy

198

0.27

1,440

1.27

14,414

1.20

4

Condom

2,316

3.18

3,059

2.70

33,389

2.79

5

Implant

16,500

22.69 9,163

8.10

181,229

15.13

6

Injection

23,574

32.41 41,073

36.33 413,674

34.52

7

Pill

17,770

24.38 39,857

35.25 378,819

31.61

TOTAL

72,730

100

100

100

113,060

%

1,198,285

%

Source: Head of Advocacy and Information (ADPIN) division, Lampung Provincial Population and Family Planning Board (BKKBN), Drs. Parada Koerniadi, note on July 31, 2013 For East Java, particularly in two study areas, 2011 data showed that the two preferred contraceptie devices were syringe and pills, the third was IUD. Meanwhile other types of contraceptive devices had fewer users, the ranks were implant, condom, vasectomy (male operation method) and the last was female operation method, or tubectomy (http://jatim.bps.go.id/tables/2012/kesehatan / tabel_5.2.6.pdf, accessed on June 29, 2013).

The percentage of active FP users compared to total fertile couples was 76.14% for Bondowoso district and 80.25% for Jombang district.

Table 3.2. Percentage of Active FP Users by Method in Bondowoso and Jombang in 2011

No

Type of contraception

Bondowoso district

Jombang district

Quantity

%

Quantity

%

1

Injection

53,255

38.00

115,112

55.73

2

Pill

36,833

26.27 43,573

21.09

3

IUD

35,146

25.07 15,165

7.34

4

Implant

9,250

6.59

14,952

7.24

5

Condom

1,403

1.00

2,680

1.3

6

Vasectomy

2,630

1.90

1,219

0.6

7

Tubectomy

1,640

1.17

13,833

6.7

TOTAL

140,157

100

206,534

100

Note: Data were extracted from the East Java National Population and Family Planning Board, http://jatim.bps.go.id/tables/2012/kesehatan/tabel_5.2.6.pdf, accessed on June 29, 2013 For D.I. Yogyakarta, the percentage of contraceptive users varied among districts / cities. The highest number of users for injection was in Gunung Kidul district (60.55 percent), the highest percentage for IUDs was in Yogyakarta City (35.60 percent), the highest percentage for pills was in Bantul district (16.49 percent).

Table 3.3. The percentage of active FP users in DIY by District / City, 2011 Married = <15 years

Women (15-49) FP users

Tubectomy

Vasectomy

IUD

Injection

Implant

Pill

Condom

Traditional

Kulon Progo

3.41

58.55

4.69

0

21.16

48.54

9.34

10.30

1.29

4.68

Bantul

1.48

60.13

4.00

1.34

16.79

42.23

5.04

16.49

4.89

9.22

Gunung Kidul

3.53

67.53

3.55

0

13.50

60.55

9.49

11.95

0.85

0.11

Sleman

3.21

59.72

4.70

1.08

22.42

44.25

1.75

13.63

6.63

5.55

Yogyakarta

3.13

53.50

4.65

0

35.60

32.75

0.75

11.16

9.21

5.87

DIY

2.84

60.90

4.22

0.66

19.61

47.40

5.36

13.37

4.31

5.07

Extracted from 2011 Public Welfare Statistics, D.I. Yogyakarta Province

COMMUNITY FAMILY PLANNING PRACTICES The following outlines various family planning perspectives, practices and relevant issues as stated by male and female informants.

Responsibility on Family Planning The question is about the person responsible for family planning. Most FGD male and female informants in the six study areas, everyone replied "Both. Responsibility of husband and wife. "However, it does not mean that men are fully open to actively use contraceptives. The above answer just means that men realize the importance of contraception, to space births and limit number of children given the huge financial demand in running a household. The number of families who used family planning for men is very little compared to those using contraceptives for women.

Men’s awareness to use contraceptives is indicated by their acceptance of the women’s preferrence of contraceptives method. The general answer from the husbands is to let the woman choose, following advice from a health provider. But there are husbands who decided the contraceptive method. The concerns that their wife will get pregnant again - and it means additional high costs for the life of another child - caused some men to feel that family planning is also their responsibility, at least to remind their wife.

The concern that their wife will pregnant again also caused some men to resist the urge to have sex when contraception is not available. "My wife wants to use pills. She used to have injections, but her bleeding was irregular. Now she uses pills. It takes a lot of discipline. She rarely delays taking it, never forget to take it. So birth spacing is good. 6 years and 5 years between one child to the next. Our agreement, if we do not have time to buy it, we refrain from having sex. "(FGD with married men, Bandar Lampung).

Male Contraceptives Only a few men use contraceptions. Men and women still think that vasectomy violates religious teaching, or has negative impacts on men's health. As an example, one male informant answered: "It had better be the woman. Vasectomy in terms of family planning is good, but in terms of health, it is not good. When sperm pocket is full, the sperms push to come out, where can they go? Sperms never stop reproducing. It is better if the woman uses FP. "(FGD with unmarried man, Bandar Lampung).

In addition to constraint from religious perspective, it is not uncommon for informants to have wrong understanding. Some are worried that the condom may be left inside the womb, and vasectomy makes a husband lose his sexual desire, even shorten the penis. Man’s reluctance to use contraception sometimes is caused by husband’s discomfort; eventhough the wife had a lot of side effects from particular contraceptive. "First we use pills, after that (my wife) lost weight, she got skinnier ... eventually we switched to injection. I do not want other methods. Condoms, I do not want it... " (Why, sir?) "I do not want to. It is not comfortable. Let’s take cooking as an example, it is less savory. "(FGD with men, Jombang)

After the wife changed contraceptions several times and still it was not good, some husbands were willing to use male FP. Some men explained the traditional method, interrupted intercourse. "My wife used to have injection. It was bad for the spouse. Because her menstruation became irregular. It was too much. Her body became fatter. Then she had pills, they were unsuitable for her body. She had pain all over. She had no desire. She could not be stimulated. So, now we just take care of ourselves. Natural. By ‘azl method. Using condom is complicated. So just use azl. "(FGD with married men, Bandar Lampung).

A man who had a vasectomy said that the reluctance to have male FP is a reflection of male egoism.

"Male ego. In our village only 8 men had vasectomy. Men are selfish. "(FGD with men, Gunung Kidul). He continued that the limited FP devices for men affected the small number of men who use male FP. In addition to that the women are worried that their husbands will easily have an affair when the men use FP.

Worried to Get Pregnant, Contraceptives and Side Effects on Women Husband and wife are generally very concerned when the number of children continues to add. A husband’s concern is related to the cost of family life. A wife sees more worries. In addition, both are worried that cost will soar; the women are also worried about being unable to care for and take care of their children well. The women realized how life will be more hectic if there are more children.

Concern to get pregnant again and very low participation of husbands to use contraceptions cause women to continue use of contraceptives although they had side effects. The effects ranged from fever, obesity, loss of desire and discomfort during intercourse.

There were quite a lot of complaints related to use of injection, although it has the most use. Complaints include irregular bleeding, pain in many parts of the body, especially in the joints. And the body was not fit such as fever ('Greges-Greges') and became obese. Injection also led to wife’s loss of sexual desire.

Some even feel pain during intercourse.

Special Groups that Reject Family Planning In DI Yogyakarta, both in Gunung Kidul and Kulon Progo, a small group prohibits family planning and immunization. Informant explained that the group call themselves LDII, Indonesian Islamic Propagation Institute. Besides the belief that religion forbids contraceptions, informants explained that members of this group also have the goal to increase number of members who do not use contraceptions.

Search through the internet yielded other information on LDII. From LDII official site, many pictures display them as an official Islamic organization established since 1972, initially under the name of Islamic Employees Foundation (Yakari). In 1981 it was renamed to be the Institute of Islamic Employees (Lemkari). Then in their conference in 1990 it changed its name again to become the Indonesian Islamic Propagation Institute (LDII) (see LDII official website: http://www.ldii.or.id/, downloaded July 20, 2013).

Outsiders consider LDII a cult, or used to be once. It is a reincarnation of Islam Jama’ah that we should be weary. The most fundamental thing that makes it a concern is the perspective to see Moslems outside LDII as kafir – hypocrite (see, for example, 'The perspective of Muhammadiyah about LDII', http://www.muhammadiyah.or.id/13-content-188-det-tanya-jawab-alislam.html, downloaded on July 20, 2013). LDII themselves claimed to have nothing to do with Islam Jama'ah and / or other misteaching, but it is legal, it refers to Pancasila (the Indonesian Five Principles), loyal and compliant to the Government of Indonesia. It has a public program that is transparent and open to public (LDII official website, http://www.ldii.or.id/, downloaded July 20 2013).

With a description based on online search as specified above, researchers are unable to confirm whether the small groups in the community who rejected FP is affiliated with LDII or another group.

PREGNANCY, LABOR AND DELIVERY, AND HUSBAND’S ROLE This section describes the stories from the wives during pregnancy, labor and delivery and post-delivery, and how the husband is involved in providing support or not providing support to improve the quality of his wife’s reproductive health

Antenatal Care Most antenatal care is provided regularly, and each month pregnant women go to posyandu (integrated health post) for free care. For delivery, some prefer to have midwife’s attedance or go to hospital. It was very rare for women to go to a traditional birth attendant. Those who asked for TBA services are usually only to bathe the baby.

Many husbands stated that they accompanied their wife to have antenatal care. Though so, health providers in Lampung thought that there are more wives who come without their husband. Different study areas show different data. When a woman had company, it is usually the mother, female relative, female neighbor or a rented motorcycle rider. When the husbands take the wife, some of them felt embarrassed. So, some husbands waited in the street so that they did not obtain first-hand information (from the midwife or physician) regarding the pregnancy and the wife’s condition.

Recognizing the importance of husband’s engagement and understanding to create support for his pregnant wife, some doctors and midwives asked the husbands to play a more active role; as much as possible the husband should come along when his wife check her pregnancy (e.g. West Lampung).

Meanwhile, in DI Yogyakarta, Puskesmas and health providers took a variety of steps and activities to ensure that more and more husbands are aware of the importance of providing support to their wife during pregnancy and postpartum.

The Desa Siaga - Alert Village - concept developed the mechanism for each hamlet to be ready for immediate move if a pregnant woman needs transport immediately. "If the husband cannot take his wife because he does not have a motorcycle, then a rented motorcycle rider will pick her up. The Alert Village requires each hamlet to have people who are willing to loan their vehicle as “standby ambulance" (FGD with men, Gunung Kidul).

Financing Cost of maternal care and more specifically cost of labor and delivery is one of the main things that people think of. Quite often costs hinder a woman to obtain the best care during pregnancy and childbirth. Among people with limited economic conditions, antenatal care and delivery costs are addressed by Jamkesta, Jamkesman, and Jampersal, government policies for insurance. However, there are still complaints related to the offer. Jamkesnas, Jamkesda and Jampersal cannot cover health care for infants with problem.

Myths and prohibitions Myths and prohibition have very little influence. The community realizes that pregnant women often need prohibited foods because of their nutrient. Husbands though, adhere to a number of taboos such as not to kill or badly treat animals, because it can have negative impacts on the child to be born. For

example, "We, the husbands, must not kill chicken. Some parents did it, and the child was born with cleft palate. "(FGD with men, Jombang).

Husband’s Involvement in Doing Household Chores during His Wife’s Pregnancy During pregnancy, a wife still does household chores as usual, except when she has problem with her pregnancy, such as feeling weak or vomiting. In such circumstances a lot of husbands take over their wife’s job to take care of household chores. In general, it was revealed that a husband shows care and concern when his wife is pregnant. "(When she is pregnant) my wife was lazy to move. In the early months I took over the role. For example, to cook ..., yes because my wife was nauseated by the smell of rice cooking, she continuously felt weak.

That was when she had our second child, up to 4 months, early pregnancy. "(FGD with men, Jombang).

There are also husbands who entirely took over their wife’s duty.

It happened in West Lampung when a woman stayed with her in-laws. "I was sick from the second to the fifth month of pregnancy. I was really ill. Anything that went into my mouth would come out. So from staying with my in-laws, then I moved into my parents’ house. My husband also joined me in my parents' house. My husband loves me, although we stayed in his father and mother’s house, he washed my clothes when I was sick. For four months of pregnancy, I stayed in my room and could not do anything."Another informant said that her husband would massage her feet when she had cramps during pregnancy (FGD with women, West Lampung).

Some handed over household chores to a paid helper. This is because of the social norms that a woman should serve her husband. She felt uncomfortable when her husband had to wash her clothes. "When my first pregnancy was difficult because I could not eat, rice would not go in at all. My blood pressure was just eighty, ninety. Sometimes I feel sorry for my husband. I am embarrassed when my husband washes my clothes. If he washes his own clothes and the children's clothes, it is not a problem for me. So, sometimes without my husband knowing, I asked someone to wash my clothes. I feel that my husband loves me more when I am pregnant. "(FGD with women, Bondowoso).

When wife gives birth Husband’s attention when his wife is giving birth is important for the wife and she needs it. On this subject, some women gave birth without her husband by her side, but some husbands did. Some midwives motivated the husband to accompany his wife in the delivery room. A husband's presence created different experiences. Some women felt happy that their husband accompanied them; some were actually nervous because they were concerned how much their husband were able to stay calm looking at the process of giving birth. "My husband was inside the room. The baby did not come out for many hours. In the end the midwife called my mother; uh my baby came straight out. If my mother had been summoned earlier, the baby would probably have come out earlier. Maybe it did not want its father to wait. My husband was also silent standing up, 'I do not know what to do ', he said. I was in pain and he was stress in the room. "(FGD with women, Bandar Lampung).

Some husbands cannot stand to see their wife struggle during labor and they even fainted. Others said that the husband could not wait near her, but it was not a problem because for these women, they felt more comfortable with their mother present. Mother can accompany and help them when they had contractions, bowel movements, and so forth, those are not things that they felt comfortable to ask for their husband’s help. "My husband could not wait for me because he had to work. So I stayed with my

mother. I'm more comfortable with my mother. Because of her attention, she knows how I feel. It felt like I wanted to defecate, my mother would take me, my mom would hold me." (FGD with women Bandar Lampung).

The Importance of Providing Comfortable Situation for Women during Childbirth Women sometimes do not get comfortable situation due to family’s insensitivity; it will impact difficulties during childbirth process. From cases in Lampung, pregnancy and childbirth are often seen as a big family event and the big families want to attend or participate in decision making.

The hectic presence of the big family 'to see the baby' makes it difficult to treat the woman. "Sometimes I just knew who the husband is at childbirth, when he accompanied her. There are parents, in-laws. If I do not tell them no, all of them go to labor room. So I try to hand a cloth, close it out. Because the father-inlaw will go in. Instead, her husband stays outside. "(interview with a midwife, West Lampung). The family is insensitive when a woman is struggling between life and death to give birth. Sometimes midwives and health providers are so confused that they do not dare to scold her family, only to 'tell' the pregnant woman who is tired because of her pregnancy. "Sometimes I tell the woman, ma’am, why is it not your husband who comes inside. Are you not embarassed?"

Other health providers tried to be more assertive: "Indeed, I am rather assertive in that situation, I say, excuse me, sir, maybe just one or two can accompany her, others please go out." Health providers have difficulty to find a space to stand for optimum attendance because everywhere there is someone who wants to see the labor and delivery process. Midwives observed that very few pregnant women were assertive to ask her family members to get out of the room: "Probably one among ten women who was giving birth dare to say. 'Go out I cannot push! All of you go out! 'Well, one dared say so. Dare to shoo everyone away. But most of them are resigned."

Researchers also found that there are husbands who do not learn from experience, although the first child was born at home. The second and third children were also born at home without adequate preparation for the childbirth process that their wife had to go through. Instead, these husbands were proud that they accompanied his wife to give birth at home three times, though they did nothing (FGD with married men, Bandar Lampung).

Postpartum period In general, informants said that post partum period lasted until 40 days, and wife or woman usually is released from daily household chores. On the other hand, many people say that, in practice, after a few days or one week, and the woman’s health is good, the postpartum woman will resume her activities.

Those who help the woman during childbirth are the biological mothers, mothers-in-law (if they live with in-laws, as revealed by informants from Lampung and Gunung Kidul), and sometimes neighbors.

Some husbands admitted that they helped to do their wives’ duties such as boiling water or cooking rice and sweeping the floor. Others said that the duties were taken over by other women in the family, or settled by paying someone else. During postpartum care, some people still use TBA services.

Some informants said that husbands help mix formula for infants and wash diapers. "In my village, after chilbirth, our wives are weak, right, husbands wash diapers, in the village it is common. It is the obligation of a husband. Later when our wives are healthier, well, pass the chores again to her. They (husbands) wash clothes in the river is OK." (FGD with unmarried men, Bandar Lampung).

A few days after delivery some women resumed their activities. "In my area many people do not have bathrooms. So we have go to the water source or river, so although we just gave birth two days before, we had to go to the river, sometimes when we are healthier, we wash clothes. Because we do not want to burden others. As poor people, parents advised us to have big hearts, something like that, ma’am. We should accept our condition, be strong.“ She continued, "Husband goes to work, and at home it is unusual for man to wash, it is like that, ma’am." (FGD with women, Bondowoso). There was once a woman who just gave birth, hoisted a bucket to fetch water, and then she had serious hemorrhage. FGD informant uses the term, 'her womb descended'. " (FGD with woman, West Lampung).

CHAPTER FOUR SEXUAL RELATIONSHIP. This chapter discusses the reality of sexual relationship between husband and wife, various complex biological, psychological, social, cultural and economic issues around it, as well as information about sexual relationship out of wedlock and also teenage pregnancies that have become quite a serious problem in the study areas.

REALITY OF SEXUAL RELATIONSHIP BETWEEN HUSBAND AND WIFE The reproductive system and sexuality is more complex in women, the stories from FGD with men and women explained that most men (always) want sex, but women are not ready to do that quite often.

However, husbands and wives both stated that sexual intercourse is comfortable when the intercourse occurs when they both want it. Most husbands also said that their wife sexual satisfaction is important to them, and that they are not going to impose their will on their wife.

Male informants said some reasons for not enforcing their desires, among others, is that it was not pleasing to have intercourse with a wife who does not want it. Others explained that they understand when a wife does not want to do it; certainly it is not comfortable to have sex.

Characteristics of female sexuality It is important to understand specific female sexual characteristics to know when a woman can have intercourse comfortably and enjoyably; when her psychological condition is ready. "Rarely feel the joy.

Because I have a lot of thoughts."Or"Feel satisfied. But if I have something in mind, tired, I cannot. I feel tired now. When I am tired, I don’t feel anything. I just provide service."(FGD with women in different locations). 'Psychological condition' means being prepared - although one woman thinks it differently from others - generally it shows through her happy feelings, does not feel it as a burden, no physical strain due to fatigue, and feeling comfortable in everyday relationship with her husband. Household issues, disharmonious relationship with the husband, tension due to insufficient income, fatigue and lack of support from husband make it cause difficult to arouse women.

Although many husbands said they would not impose their desire, stories from the wives posed a different picture, that some husbands still imposed their desire. "I want it to be consensual, when the atmosphere is calm. But my husband does not think so, mam. My husband does not think that his wife is tired, it is important that he is happy. Especially when he just returned from outside, heeehh ... my husband does not accept rejection. "(FGD with women, in several different locations). The society generally requires women to 'serve' husband’s sexual needs. In some communities, the demand is coupled with frightening threats that bring guilts on the women. "The teaching says that when the husband asks, and the woman refuses, she commit a sin. Just to be angry to her husband for one night, for example, he wants to do it with us, the angel, takes our virtue away from us. We studied religion in high school; there was a lesson about marriage life. "(FGD with women, Kulon Progo).

Quite a lot of husbands immediately replied that a wife’s rejection that offends them is "the tired excuse". Some men are suspicious when his wife rejects them, meaning that she has another man. A husband said that if he suspected his wife had another man, he would also look for another woman.

"The important thing is, there should be no other men. Unless there is another man. If my wife gets it from somewhere else (from another man), we can go to others, too .... "(FGD with men, Jombang).

FGD with men in Jombang revealed that problems related to disharmonious sexual relationship brought the conversation to polygamy. When the question was asked, quite a lot of men stated that polygamy crossed their mind or imagination. They justified the thought with the excuse that men who never think about it means that the man is not 'normal'. "well, to be honest, bro [ha .. ha .. ha participants crowd laughed], but we can anticipate not to make it happen. I am a man, a normal man will certainly think it, if not, then he is not normal. " It was not explored further what the informants meant by the statement. Referring to the religious characteristics of the informant, researches suspect that informants think polygamy is a way to legitimize having sex from religious perspective, with a woman other than his wife (current). "We know the rules, but we just have it in our minds. We will not let it happen. The effect is bad." They claimed that men who committed polygamy generally do it quietly. (FGD with men, Jombang).

It is good that some men understand women's burden. "I'm sorry for my wife. There is a belief that a wife should not refuse her husband under any circumstances, but it is not as rigid as that, we have to understand the condition of our wife. If she does not want, what is the use for us to have our pleasure.

But somebody used that argument. Only few people think that way. I think the majority of husbands know the condition of their wife." (FGD with men, Gunung Kidul).

Some other informants were quite aware that rejection form their wives were based on certain issues, that actually they should talk more openly. "Sometimes my wife (said) she had menstruation as an excuse to refuse, it may mean something else. Usually we should talk about this more." (FGD with men, Jombang).

The need to have more open discussion Many men want to be able to talk about sex more openly. "We actually want openness. Wives do not have to be ashamed, it means wives should talk what is not sufficient" (FGD from different locations).

Then some informants said that they would find time and the right circumstances to a chat with their wife. "When we are relaxed. Just the two of us, for example when we are going to sleep, when we watch TV and the children are playing outside. When we are watching TV, the two of us are sitting around. â&#x20AC;&#x153;(FGD with men, Jombang) There was a wife, although it was not the picture of the majority, told that her husband would do steps to increase her desire. "For example, it is something like this, when husband stimulates me, it increased my lust. I get my pleasure. It succeeds." She told that her husband would turn on erotic video, then other FGD participants said it was a 'sin'. But she replied: "Not a sin. Because we do not watch it with other people." (FGD with women, West Lampung).

To improve quality of sexual relationship, a wife, although not a picture of the majority, dared to speak openly to her husband when she was ready or not to have sex, and what she wanted. "Talk. I talk. If I do not dare I am the one who loses. Because once I did not say, I had pain." (FGD with women, West Lampung and Gunung Kidul). Others tried to relax and communicate with their husband.

BIO-PSYCHO-SOCIAL REVIEW OF MALE AND FEMALE SEXUALITY Reflecting the data above, one important thing to note is that men control their body, men do not have any problem with their bodies, and tend to be 'always ready' for sex. The problem they have is that they

have to manage their sexual urges, because their wife does not always fulfill their sexual needs. Some groups consider this a bad thing (e.g., sperms should go out, otherwise they will harm men’s health and men cannot concentrate in work), so some particular groups demand that a wife should be ready to 'serve' husband whenever the need arises. If it does not happen, find a way out for the men, for example religious perspective that allows men to perform polygamy.

Women have very different situation. Women have reproductive and sexual characteristics to get pregnant and deliver babies, and the task to breastfeed. They do not always go through their pregnancy comfortably, their body often feels uncomfortable due to hormonal changes; and there is another human being attach to their body for more than nine months. In addition they struggle for their life during childbirth, and they have a role in child care and to nurture their child which is a traditional task for them.

Although the majority believes that FP is the responsibility of husband and wife, more husbands leave the decision of FP use to their wife for many reasons. Considering that female contraceptive is hormonal, quite a lot of women suffer from side effects.

In addition to health, physical appearance changes and problem arises because physical appearance is important for women. Some women have spots on their face, thinner body, or vice versa, more gain weight. The very important issue is that hormonal contraceptives can decrease or eliminate a woman's sexual desire. Some women reported that they felt pain during intercouse.

Although men want to discuss sexuality more openly, they tend to have narrow understanding about sex. Sometimes they define rejection and reluctance from their wife in a narrow sense (e.g., my wife is ashamed to reveal her preferred way), men do not link rejection to broader issues, including inequality or equality in husband and wife relationship.

From their answers, apparently men still need to understand the uniqueness of female sexuality, a lot of things can affect female sexual desire. Sexual desire decreases or goes away not only because of hormonal FP method, but often woman feels tired and has too much work to do. How far her partner shows care and understanding, willingness to help in household chores, takes care of child growth and development, and treats her politely and gently, all can affect woman mood.

Thus, a woman needs understanding and care from her husband, and the answer below is expected from men in the future. "I need the agreement from both of us. So no coercion and the frequency should be agreed as well. So when I am in a good mood, it is OK. Wife satisfaction is a must for a husband. I cannot neglect my wife’s needs. I can know whether my wife reaches her climax or not from her body language. I discovered it from my own experience with my wife." (FGD with men, Gunung Kidul)

INFIDELITY, TEEN PREGNANCY AND PREGNANCY OUT OF WEDLOCK Like domestic violence, infidelity is considered bad and the talk of the society. The difference is that people are generally more assertive against infidelity than domestic violence. One woman talked about a case in her neighborhood "The woman seemed to go to Koran reading. She went from her house, actually she went to one of the early childhood education places, then at that place she met a man.

Apparently someone knew and followed them. Well, in village the culture is strong, ma’am, yesterday they, the woman and the man, were fined 15 million. The money was used to repair the road." (FGD with women, Gunung Kidul).

Male and female informants knew about pregnancy at a young age, means among teenagers, and a lot were found in their areas. In Bandar Lampung and West Lampung a lot of women got married very young. Meanwhile in East Java, at least in Jombang and Bondowoso, as well as in Yogyakarta, at least in two study sites in Gunung Kidul and Kulon Progo, there were a lot of teenage pregnancies out of wedlock.

Someone explained that teen pregnancy was considered common, even a community group was proud about it "it is common in our tradition here when a man impregnate a woman. Her mother would proudly tell others. 'My daughter is smart, she is unmarried, but she is pregnant, and I will soon have a grandchild.’ Something like that is common, getting pregnant before marriage is a pride ." (Y, community leader, Gunung Kidul). Unlike Y’s story, some other informants explained that a lot of teenage pregnancies out of wedlock happened, but it was not to be proud of. It was still considered negative.

One male FGD participants admitted that he got married at a very young age because his girlfriend was pregnant. "Honestly I myself experienced it. Previously I was in college, I had sex out of wedlock, so I had to get married when I was still studying and had a child. It was my fault because I mingled with my college friends who were too carefree. At that time I lacked parental attention. They think I've grown up, and let me be free. It was a lesson for me and I did not want today’s generation to be like me. In terms of mentality, I feel it as a burden. When I wanted to go out, I felt ashamed because of my fault." (FGD with men, Gunung Kidul). He worried about today’s teenage courtship style that is like 'husband and wife', with a lot of cases involving students. The environment is too permissive, while the teenagers are in vulnerable condition because they are still searching for self identity.

Male and female informants explained that the community looks down on a girl who gets pregnant out of wedlock. "Very negative. The teenage girl will be considered 'willing to do it with anyone', 'slut'. The teenage boys will be jugded 'naughty'. But the negative perspective is more on the teenage girls.

Because girls should be stay more at home, so when something like that happens it means the girls like going out. It is considered uncommon. "(FGD with men, Gunung Kidul).

In addition to sexual relationship out of wedlock, it happens because the couple likes each other and become pregnant, young women are vulnerable to violence, including sexual violence. Incidentally, when researchers collected data in Kulon Progo and Gunung Kidul, there was a headline in DIY newspaper, a UGM (Gajah Mada University) student killed his baby whom his girlfriend just delivered.

Sexual violence and murder happened in the FGD informants’ circle of friends. "My senior at school, two years older than I am, was forced to have sex, and then she was murdered. She knew him via facebook, then exchanged phone numbers, she was asked to meet at the beach. They were two men, the girl was only herself and was taken to the bush, at first she was tortured. In the end she died. Then it happened to my juniors too, two of them were pregnant last month." (FGD with women, Kulon Progo).

The informant explained that her junior was forced to marry a man who coerced her for sex. She explained further that generally when a schoolgirl gets pregnant, she will be expelled from school. When the community can identify the man who made her pregnant, and he is student, he will be expelled from school as well. Then they are forced to get married.

CHAPTER FIVE CONFLICT RESOLUTION AND PHENOMENON OF VIOLENCE This chapter explains the various issues that can lead to a conflict, in general at community level and in particular in relationship between men and women and family. It also discusses community’s perspective on child disciplinary action and abuse.

CONFLICT AMONG MEN IN SOCIETY Male FGD participants in all study areas said that in their neighborhood, in general, conflict will be resolved hospitably, or when it is in a family, settled amicably. If the conflict cannot be resolved, it will be brought to RT, RW, or village, and the solution involves others outside the family, village officials or community leaders, as mediator.

If the conflict is not resolved, sometimes it continues to a fight. FGD informants from all study areas talked about it, but fights are more prominent in Lampung and East Java. "When it is not, well, when it is unsuccessful, yes, a fight. It is shortcut. When there should be a fight, usually it is a mob or mass fight, not one on one duel. When it happens between differrent villages, it will be a brawl between villages.

When it happens in one village, well, the fight is between groups. Woman becomes the trigger between villages. A lot of problems are because of women in this area.”

Most FGD participants experienced and were directly involved in such a fight. "Actually, my student was once involved. I also applaud him in a way, he's fighting for principle, he did not accept the insult. At that time he was ridiculed 'ugly, ugly', he felt offended. Finally he defended himself. He hit his friend, eventually a brawl started, his friend brought in his other friends from outside, even brought a sword, too. I was also confused at the time, I did not know because at that time I was already on my way. This happened in the school yard. " (FGD with men, Jombang).

Informant explained further that when it is related to a woman, it is a sensitive issue. "If you are here, the most sensitive (issue) is especially a woman. Case by case, but a problem that cannot be avoided is one that involves a girl ... woman, when I see ... " (FGD with men, Jombang). "last time my girl friend texted me, she poured her heart out. Then the hitting started (who hit who?) Yes ma'am I was hit, her boyfriend hit me!! I was having coffee in front of the campus at that time, I was with my friend. Abruptly 'Gub' .... he immediately hit me. Well, I fought him back. "(FGD with men, Bondowoso). The stories about the fights that started by jealousy or fight over women also emerged in the focus group discussion with women.

GENDER-BASED CONFLICT FGDs with male and female informants found that some things are offensive to men’s self-esteem and feelings. Husband will be offended when his wife talks about unfulfilled family's finance. In a man’s perspective, these things reflect the attitude of the wife who does not understand the condition of the husband. Wife confided in, talked about the problem with someone else, while the husband was not consulted or husband heard from others about the problem in his own family; this can also offend men.

A man's self-esteem will be greatly disturbed when he finds his dominance in the family is disturbed. For example, his wife bosses him around, or the husband is not regarded as a leader in the family. The wife does not ask for his permission to go out of the house, it can make men feel neglected. Jealousy easily causes arguments. For example, when a wife or a girlfriend texts another man that the husband/boyfriend does not know or the husband/boyfriend suspects her to have an affair with the other guy. A man feels offended when he is not served and taken care of. For example, during meal time, there are men who want company and to be served. Rejection to an invitation for intercourse offends men, especially if the husband had asked a few times, but his wife rejects it. It is the same when the child is fussy. The more rigid a man holds the norm or ideology that he is a leader and must be respected; there is higher possibility that he is easily offended by all those things.

Domestic Violence, Restrictions and Forms of Violence Domestic violence cases in the participants’ neighborhood - in different study areas – always happened and male and female participants. Quite a lot of domestic violence cases occurred, but it was considered a disgrace or taboo if the community finds out, so it was often not reported. This type of violence was sometimes severe and a cause for concern, but the community does nothing, even avoids it. "It happened twice in my place, ma’am. All her clothes were thrown away, the woman, the wife, was totally naked. Her husband beat her. The neighbors were embarrassed, everyone hid. Well, it looked like she was being punished. "(FGD with women, West Lampung).

Although violence is generally defined as physical violence, some informants had different understanding, violence is not always physical, there are other forms of violence. "Ma’am, I want to ask you, it is about my aunt. Is it a domestic violence? Over the last 4 years they did not talk to each other, at home they were separate. Now the wife is very thin. The second child, a high school student, had an accident yesterday, her/his father was just silent, did not ask or say a word at all. The man did not want his wife anymore, and his wife continues to live in the same house, she did not know where to go." (FGD with women, Gunung Kidul).

In layman perspective, or those who do not deal with gender-based violence issue, those who are not close with religion are the ones who commit domestic violence, or those whose appearance was 'fierce' or like 'thugs'. In reality, even civilized and religious people can commit severe violence. "Ma’am, there was a case. The wife is quiet, religious and her husband is religious as well. The husband is the wife's relative, he is an “ustadz”, a religious leader in the community. The wife’s parents have 2 daughters, the first one inherited rice field. The quiet wife did not get any rice field. The husband was offended, 'why do I not get rice field '. The husband was upset and committed domestic violence; he beat his wife and his mother-in law." (FGD with men, Bondowoso).

Community explanation on the Causes of Domestic Violence The community explained that the cause of domestic violence is generally husband’s disapproval of his wife’s behavior; and then the wife is viewed as “talking too much”, does not respect her husband, for example, when a wife questions insufficient income, she does not serve her husband well, or the wife is nice to others and is suspected to have an affair. In Lampung the term of 'wife committed sin and disobeyed her husband' is used quite often. A girl in West Lampung explained that her boyfriend slapped her because he was jealous to see a short message from another man.

Financial problems, money limitation, combined with frustration can be the source of serious problem.

A group of women talked about a neighbor’s wife who became hysterical because she was so annoyed,

confused and felt heavy burden. "Usually it was because of economic factors. The husband did not have a job, his wife had one. When the wife came home late, he got angry. He said that she did not take care of their children. Then he slapped his wife." (FGD with women, Bandar Lampung). Others from the same area said, "I was once told to make coffee, but there was no coffee. He threw the thermos, sir. Well, we had visitors, he asked me to make cofee. He did not ask first, whether we had any sugar, coffee or not.

When there was none, well, I just served water. There were 4, 5 guests. All of sudden, coffee should be available. My husband does not want to know whether there is money or none. " Quite a lot of women complained that they were depressed because they were frequently blamed. "In most households wives get the blame. When I do not apply make up, my husband say that I do not have passion, when I put on a lot of make up, he says: you have a boyfriend, right? Everything is wrong, right?” Also about a husband’s jealousy, "For example, I am holding a cellular phone. I send short message to someone else, my husband will be jealous. He will ask: who is it, from whom. Then when I want to go somewhere, I have to tell him. He is too strict. I do not like it when my husband opens my cellular phone, because I never open his." (FGD with women, West Lampung).

Bias Understanding about domestic violence When a husband has an affair, wife often does not blame her husband, but the woman with whom her husband has an affair with. It was difficult to separate stories about domestic violence from participant’s bias; it actually reflects their perspective of life and gender and family relations.

The community’s view which is not always true, nagging will cause a husband to hit his wife. Although it is not a good behavior, it is considered normal for a husband to hit his wife, it is even considered a 'tradition'. They compare it with a wife who dares hit her husband. "I, thanks God, will not use violence against my wife, except if my wife hits me first. How can a woman hit a man,and we don’t do anything?"

(FGD with men, Gunung Kidul). Or similar answer, "It is dangerous, ma’am!! How can a woman hit a man ... bad woman. " (When a man hit a woman, is it not serious?) "Not serious ... it is common .."

(FGD with men, Bondowoso).

A female FGD informant in Gunung Kidul said she advised a woman who was abused by her husband to help her. But she did it with a bias perspective that cornered the victim. "I knew that her husband likes to make up stories. So I usually gave her inputs, 'well, indeed we have to be patient, like a rock, no matter how hard but if every day we splash water over it, God willing, the water will clean it, I told her that."

Although not a majority, one or two answers seem to justify domestic violence: "It is a privacy of husband and wife anyway. It may mean that the violence made the wife compliant, we do not know.

What I mean is, does the wife accept it, we do not know." (Your opinion, what if a husband does such a thing?) "Back to what I said, only both of them know about it." (FGD with men, Kulon Progo).

The Domestic Violence in the form of reciprocity Some cases have complicated picture. Prolonged conflict occured which was not properly settled, with reciprocity: blame each other, corner each other, revenge. Such couples have many injuries, disappointment, anger, and resentment that continue to haunt the relationship.

A male client of Rifka Annisa explained "I was caught red handed having an affair with another woman. I apologized to my wife. My family goes back together, but I do not think that my wife kept a very deep

hatred. Well, my wife had an affair, with her best friend’s husband. Well, I was very disappointed, I was really hurt. Why should she be with him, if she wants to take a revenge on me, why doesn’t she pick someone else. It was embarrassing, sis, her friendship was ruined. People talked bad about her, her friend’s child was in the same class with my child, it started a gossip. I got angry at that time, I hit her.

Because I was not strong. When I found out, I beat her. I slapped her." (P, male client of Rifka Annisa).

VIOLENCE AGAINST CHILDREN Domestic violence is often understood to happen only between husband and wife. Actually, domestic violence may happen to a child, or other person in the household, including to the domestic worker.

In this report, domestic violence is defined in a broad sense, i.e. in the sense of 'violence at home', can occur during dating, after divorce, or to a child.

Discipline through physical punishment View about how to discipline a child greatly varies among informants; some of them agreed with physical actions from parents to their child, some did not agree at all. In general the conclusion is that discipline through violence is considered normal. People understand when parents are rough because a child is naughty and difficult to listen, or because parents are already tired because they have difficult job.

Male FGD participants from Jombang, in particular, indicated that they are highly acceptance to physical disciplinary action by hitting, even to cause bleeding wound. "Yes, because you have to discipline your child. Firmly discipline them. If we give tolerance, it will spoil the child, and I know it. I was able to read Koran when my ustadz often hit me. Example, well, this bled [pointing his nose] because I did not read AlFatiha long enough. The ustadz punched me."

Some participants blamed the Law on Child Protection; they considered it misleading and actually made parents and teachers unable to instill discipline to a child. "That is why our laws, including the Law on Child Protection is misleading, it is a violation of human rights when teachers instill the discipline. Look at the main issue first, do not justify that it is a violation, why do they make it a problem? When parents send their children to school e.g. school A, automatically they hand over their entire authority to the school, it is up to the school to what they do to the child as long as the child does not violate any law. “(FGD with men, Jombang). They admitted that the extremely harsh discipline imposed in Islamic schools or in religious education is permissible, and quite a lot of participants allow this. (as for a girl, how is it?) "A girl is beaten as well, but by female ustadzah... ." (FGD with men, Bondowoso).

Rejection on violence against children Although quite many participants were tolerant to hard attitude towards children, one FGD informant said firmly that soft words hit the nail on the head and effective. He talked about his own experience, his parents were often violent to him; and it hurt him and he ran away from home. "For me, it was more effective with soft words than violence. I personally experienced it. I get to Jombang because of that. My family used violence to educate me. Finally I had enough. For almost 5 years I went to college and my parents did not know until I almost graduated. I had my revenge to my parents (researcher’s note: by not telling his parents). "He explains further, the more violence the parents, the higher possibility the children will imitate the example of their parents. It happens because it is in the back of their mind; it is already embedded in their mind. If someone does something wrong or unacceptable thing, that person should be beaten. "The impact of violence, it is not immediate after parents committed violence to the

child, the children learned that when someone makes a mistake, he should be beaten the same way.

That established the mindset of the child. "(FGD with men, Jombang).

PREVENTION AND MANAGEMENT OF DOMESTIC VIOLENCE Conflict is preventable before it progresses to domestic violence. When one party is patient, calm, or stay away for a while. Either the wife or the husband can be silence and stay away. "It was my mother’s experience. When my father is angry, better leave him for a while. If my father was angry, my mother went away, for example to grandma's place. "(FGD with women, Gunung Kidul). A male informant told the story. The point is to be silent, patient, wait for the situation to be calmer. "When conflict occurs, I have the knowledge that I should not demonstrate it in front of my child. But discuss it in bed. It depends on the problem. If solution is not urgent, we do not have to be too insistent. We have to wait until the children are asleep. But if it should be resolved at that time, then immediately communicate it"(FGD with men, Gunung Kidul).

When domestic violence happened to neighbor or community member, majority of informants said they would not say anything, would not intervene. They said they were sorry for the victims, but also confused what to do, afraid that people think of them to interfere in someone else’s family affair.

"Actually, I feel sorry for the victim, but if I interfere, I feel uncomfortable. Yesterday I attended dissemination. They say if there is domestic violence, report it to the police station. But if I report it to the police station, I feel bad, the victim herself did not report it, but the neighbor report it instead." (FGD with women, Gunung Kidul). People fear that they would be blamed, and partly also worried about ending up as the target of the person who committed the domestic violence who cannot control himself. At the most, they can only approach and help the victim when the incidence of violence already passes, and the husband or the perpetrator is no longer near. Some people had the courage to report when the case is considered severe. "I am just like my friends here, as a neighbor I dare not meddle in someone else’s affairs. I will just report to the head of the neighborhood or RW who has the authority. " (FGD with unmarried men, Bandar Lampung) A female FGD participant in the previous section, accompanied a woman who suffered from severe domestic violence committed by her husband, but the conclusion is that she did not really corroborate the victim. She tended to ask the victim to be patient, silent, adjust to her husband’s situation. When she was asked that in case of domestic violence, which one should change, the victim or the perpetrator, she replied that the man often got advices and it was difficult for him to change. So the only way is for his wife to change. "Since I have heard a lot of stories from my cousin, his ex-wife, and my sister was tortured until she was admitted to a hospital. I heard the story continued, if the man was given advises, later he would hit his wife again. So the only way is that I asked the wife to be patient. Because if the man knows that somebody else knows their problem, he would destroy his wife. " When the researchers insisted whether the lesson was only for the victim, while the perpetrator does not learn anything and no deterrence, the informant replied, "There is none."

When most respondents said they preferred not to interfere, only two informant for the interviews, Mrs. Y who is a community leader in Gunung Kidul, and Mr. A, an ulemma from Kulon Progo said they would, and interfered with it. Mrs. Y explained, "I did not stay silent, even yesterday a village chief candidate, I criticized him so that he would not be elected, because he likes to hit his wife. His wife was often bruised. The community stayed silent because the woman was silent, as if nothing happened." (Y, cummunity leader, Gunung Kidul).

It seems that the community rarely thinks about legal process as a way out. However, some people had

already done so. "There was a bizarre case in T, the wife of the village chief herself drafted the regulation on domestic violence and child Protection. She was a member of the local house of representative. It turned out that she suffered from severe domestic violence, and she chose to get a divorce and her husband went to jail ?" (Y, community leader, Gunung Kidul).

In Jombang some participants explained that WCC Jombang had made a difference. Participants thought that the number of domestic violence decreased, because people who could potentially become perpetrators were now more cautious. Some domestic violence cases were reported to the legal enforcer and action was taken.

Some female FGD participants suggested that Men Care program also included information on domestic violence, or there should be actions to eliminate or prevent it from happening. Because people did not know what the law says, what the sanctions are, how the law manages it, they hesitated to take action when domestic violence happened in their neighborhood. Dissemination at the neighborhood level, for example during social gathering, or provide explanation in other events, for men and women.

CHAPTER SIX BECOME A FATHER AND A CAREGIVER This chapter discusses the information from FGD informants, men and women, about their experiences with a father figure, and their perception on an ideal father figure.

Experience as a Father When informants were asked about how they feel as a father, they were happy and proud. They could prove that they were perfect male who could have children. For some informants, the happiness was greater when they had sons. The first son is expected to be able to 'take care' and 'lead' his brothers/sisters. In general the second child is greeted with joy as well, especially when s/he is the opposite sex of the first child. Husbands often prefer to have a son as their first child, although some wives expect to have a daughter for their first child. However, this preference is not prominent.

The first experience whe informants realized that they have become a father and felt affection was when they carried their child, or when they whispered adzan to their child's ear. Someone described the time when his wife gave birth: "The midwife told me to stand near my wife’s feet. So the childbirth would be smooth. Thank God, thank the midwife, I understand. It was when I had my first child." (FGD with married man, Bandar Lampung) Quite a lot of male informants had no idea what kind of father figure they would be. "I never imagine it.

I imagined I would not take care of a child. Because previously I thought it was beautiful and easy, behind a successful husband there is a superb wife." Perhaps they imagined that a husband earned a living, and the wife took care of all other responsibilities.

Quite a lot admitted that they did not know how to direct their children in real life. "When my child was still little I was confused. For example s/he fights with her/his friend. I should help my child understand that it is not good? But what is the most appropriate way? ". The ways to make children understand highly varies. The common answers that they mentioned were "Ask the children to pray, read Koran, set a good example to carry out religious duties properly." Some men gave advises while talking to their children. Other men punished the children by having them stand up, locked them in a close room. Some pinched and hit them.

A father confessed that he hit and administer physical punishment to discipline his child. "I’ve done it, when he was little; when he was in junior high I kicked him. Because he had a cigarette. I reminded him not to smoke when he had not had a job yet, later when you already have a job he can." The man who did this was a father who said that his current relationship with his child was like an older to a younger brother. In his opinion the disciplinary actions he took did not have a negative impact, because his child was now close to him. "Now he is grown up, when he misses me he asked..’Dad, sleep with me', something like that. So when it is the time to sleep, directly boom ... he is suddenly by my side." (FGD with men, Jombang)

Woman’s Perception of an Ideal Father Figure Women’s perception about an ideal father figure is influenced by their real experience in their relationhip with their father. In contrast to the common perception that generally, children, particularly girls, will be close to their mother, female informants from different study sites talked about a different

experiences. Some were more close to their mother; others felt closer and more comfortable with their father. "I am closer to my father than to my mother. My mother took care of household chores, she rarely played with her children. I slept, bought something, all with my father." (FGD with women, Gunung Kidul).

The key is that parents spend time with their children. "I am closer to my father than to my mother. My father, when I am sick, he often calls, asks me how I am. But my mother rarely does it. Until now. My mom is busy; she has a lot of catering orders. Dad is already retired, when I want to ask for something, well, I ask him, when I have a problem I talk to him." (FGD with women, Kulon Progo). Her father is the ideal figure for her. Someone remembered the old days and talked about her wonderful memories, when her father was still alive. Her father suddenly passed away when she was 15 years old, probably of heart attack. Her "wonderful memory" was when her father delivered and picked her up from school.

Perhaps an 'ideal father' figure in a childâ&#x20AC;&#x2122;s perspective may differ from an 'ideal husband' figure in a wife's perspective. Some informants described how much time their father devoted for them, something that they did not receive from their mother. That is why they feel closer to their father. A wife's perspective was unclear on this issue from the way the story was told, a mother figure was someone who (should) work hard for a living. Someone said that she was closer to her father because she often met her father. "My mother is working, she works outside the city, in Yogyakarta, in Ngajuk market. But my father works from home, as a construction worker. I rarely see my mother, she leaves early, at 5, she comes home at night." (FGD with women, Kulon Progo).

Some informants admitted that they were closer to their father, others said they were closer to their mother and afraid of their father. "When my father is angry, he is like a tiger. His facial expression, for me, looks like burning." Others said that their father did not give enough attention and hard, forced his opinion without even listening to his children. "What he wants done, should be done, for example, I wanted to go to a medical faculty, but my father wanted me to become a police. He said parents would not send their children into bad things. But I was depressed, actually. My father did not understand my position." (FGD with women, Kulon Progo).

About the ideal father figure, a woman explained, "Yes, like my new father (my step father). He takes care of his family, loves his children." Others explained that an ideal father is a caring one, who cares, understand his obligation as a husband and a father, and set a good example for his family. "I think it is not good to be angry in front of the children, when there is a problem, he blames his family." Other informants said, "an ideal father is someone who does not make a decision when othersâ&#x20AC;&#x2122; opinion is needed. So he involves his family, wife or children. For example, to buy something, for example to buy a motorcycle, first he will ask his wife and children, he does not suddenly decide it by himself."

The ideal father figure is a man who can control himself. "My dad is a good dad. At night he never visits the neighbors, always at home. He has a history of high blood pressure, when he is going to be angry, I am told to go away. So when my father is upset, he will keep it to himsef and not to commit violence, I am told to go away, he will not hurt his children. He is not violent to my mother." The brief summary is that the participants said that an ideal father is a man "who gives love to family, and provides for them, those are the two essential needs" A father who easily gets angry and hits or commits violence is not an ideal father and husband.

A Manâ&#x20AC;&#x2122;s Perception of an Ideal Father Figure Some participants remembered when they were children, how eager they wanted their father to ask and approach them. But they did not get it. "I wanted to be as close as possible to my child because I am not too close to my father. I feel like I long for it. My father sometimes has many problems outside, and we do not know, he is not as expressive as my mother, she told me everything." He felt his father made a distance, and when he became a father he would not be like that, but to be very close to his children, girl or boy.

One informant explained that he wanted to be seen as a good person, not someone who follows his own whimp; he wanted his children and wife to see him as a good person. "I want to be good in the eyes of my wife and children, not good only because I think I am. I should be responsible, also to the extended family. Not to choose work over family. Be able to lead my wife and children." For him, a father should communicate well with his wife and children. A wife is usually closer to the children, and he wanted to balance it, so his children would be closer to their parents. He said he should work with his wife to deal with their children, and ensure, that although their relationship is close, their children should still respect their parents.

Regarding the expectations of a father figure, two informants talked about their feelings when they were still a child. "My parents beat me, but my parents approached me, then I realized oh what I did was wrong." Other informants responded to this with a different view. "I have a different view. When the children are still young, perhaps it works. But when s/he grows up, if parents use violence, for example at the age of 17... the child will hit back. Resentment to parents will start. I experienced it. When this resentment continues, when the child is wrong and parents hit her/him right away, the resentment will appear." (FGD with men, Jombang).

A good father is a man who can be friendly with his children. "I want to be friends. It has a lot of functions. First it prevents negative things, such as drug use, or early sexual relationship. When we use emotional approach, we will know everything that is related to our childrenâ&#x20AC;&#x2122;s privacy, because s/he will indirectly confide to her/his parents." Then this informant talked about two cases that happened to her/his neighbors. The first one had no parent-child emotional closeness, and parents only provided goods for the child. The second one, it was a very humble family, but children and parents were emotionally close. In this second one, parents were very close to their children, and parents can influence their children positively. The family that was more affluent was not emotionally close, their children had problems, they were involved in drugs and early sex.

Some informants explained that a father's role is to accompany his children, and when they were asked to give an example of what is the support like in real life, the answer was to ask how the child spend his/her day, make sure that the children can talk to them. When children turn into teenagers, parents can ask them about their relationship with the opposite sex, about who they like, whether they have a girl/boyfriend and who is the girl/boyfriend. The point is to approach the children and build good communication with them.

Related to more sensitive issues, such as sex, informants said that they need more appropriate approach to match the characteristics of the children. For example, boys had a discussion with the father, the mother approached the girls. It will be better when parents and children discuss sexuality, rather than children received the information from friends or internet. Friends or Internet might simply present the interesting and exciting sides, but it did not provide information about consequences, how to manage sexual urges, and others, those are important issues for children to understand.

Unmarried men - including in Lampung - seemed to be more open, saying that they were ready to share their earning and household chores with their wife. "Well, share the task who will earn the income and who does household chores, but not strict. We are the same, help each other. Man can sweep the floor, does not have to be wife. Childcare, it does not need to be shared. Both, well, should take the role flexibly." Some informant said they were willing, even happy to participate in childcare actively, such as feeding and bathing their child.

Most male informants thought that they were not ideal fathers. For them, an ideal father is a man who is able to bring his children up to success, while their children are now still little (the average was younger than elementary school). Some informants admitted that it was difficult to educate children, boys or girls, because both are challenging, and the public will look at how they do it. "When a boy is bad, he will attract public attention, definitely people will ask who his parents are. As for a girl, as if she is the family honor! So I am still not an ideal father, to be a parent is hard. "

CHAPTER SEVEN RECOMMENDATIONS FOR PROGRAM DEVELOPMENT This chapter summarizes lessons learned from the previous chapters and proposes program development.

PROCESSING 'PSYCHOLOGICAL' ASPECTS AND MEN AWARENESS All discussions in the previous chapters conclude very complex gender relationship and structure. Men with their gender role, places them as 'leaders', they face a lot of problems to be able to accept the reality that life is not as pretty as in their imagination of their role or position as a leader. As they are accustomed to be a leader, quite a lot of men are surprised and cannot accept the fact that they are left behind in work competition and they cannot get a job as they had expected and their wives contribute more in providing for their family.

What Can Complicate Attitude and Behaviour Change In their position as a leader, men are accustomed to receive services, or sit in a high position. They have difficulties to empathize and place themselves in a position with double burden as women is facing.

They may be embarrassed and offended when they have to do the tasks that are considered to lower them as men, and some still demand special treatment although they cannot perform their role as a leader and the main breadwinner of the families well.

It is also related to sexual relationship with women; social view that men receives, makes it difficult for them to understand a woman's rejection to have sex. Rejection is perceived as a form of noncompliance or lack of respect from women. They tend to look at it in a narrow minded way, and cannot understand that for women, sex links to more complex issues, such as how far women feels understood, supported, treated, even linked to hormonal problems and side effects of the FP method that they use.

Looking at the above description, "Men Care” program should take steps to develop new 'masculinity' concept and real-life practices to respect each other and gender equality.

Empathy and Guilt An informant, a male partner of Rifka Annisa, acted improperly to his female friend. (At first) he considered it as 'consensual '. He had a fiancee, he said he loved his wife-to-be, and did not have a special feeling for his friend. He groped her female friend’s body because a chance was present. After the incident his friend demanded him to be her boyfriend and take responsibility for his action.

The man was haunted by great guilt, moreover that was the second times he did improper 'act' to women. "Until now I feel guilty, well, that I touched women. I really feel guilty. Because I am afraid of karma. Maybe I do not get it, but my offspring will bear the consequences. The fear always haunts me. If I do not repent or do not stop, perhaps my offspring will be victims or do the same thing. I mean they followed my step. It occurred to me to stop, if not, perhaps my offspring will become victims or perpetrators. "(A, male client of Rifka Annisa) This man had empathy and caring that made him feel guilty. The program to develop men’s care should tackle this, considering that men as perpetrators of domestic violence and sexual assault repeatedly

perform their actions, self-defense mechanism kills their guilt and concern, rationalize the action and attitudes for justification. So self-control will decrease, and he easily repeats his physical and sexual violent behaviors.

Lie low, "Time Out" How to prevent a conflict from getting bigger and out of control? Quite a lot of men explained they would keep 'quiet', 'try to be calm', and if needed 'to come out from a conflict situation', for example, they went away for a while to calm their mind. It is one of the very important techniques often called 'Time Out' technique, to go out from a conflict situation to compose themselves, to prevent their emotion from escalating. Based on researcher’s experience with domestic violence perpetrators, doing 'Time Out' is not always easy, especially people who are accustomed to be bossy, those who want to be the last person to give the final word in a debate. It takes a big heart to be quiet, calm, even go for a while to leave the conflict arena is necessary. It was interesting and good that in fact a lot of men practiced those.

Sanctions and Social Control Sometimes good intention is not enough. Social sanctions or supervision are often required, so people will do good things, change their behaviors and be more responsible. Similarly to change a man’s perception and behaviors so that they care, should be considered in the program. The story of a domestic violent perpertrator who became more cautious and changed his behaviors as a result of social supervision is a good illustration. In psychology there are some social learning approaches, through strengthening and sanctions – one does not have to experience it oneself- but to see by oneself what others have experienced, other men. "Indeed sometimes people do not have that knowledge, well, someone that WCC managed before. Now people feel more cautious. Even someone’s husband was arrested. There have been changes; even we had a village meeting in the village office. WCC invited community members, told the perpetrator to write a statement, 'if you do not change your attitude, you'll be detained, reported and arrested '. These incidents decreased. " (FGD with men, Jombang).

Education to Change Perspective Actually a lot of men do not have good knowledge and understanding, and as a result their behaviors are reckless. They need to understand about women’s double burden, the positive side from a mutual cooperation, mutual respect and strengthen each other between husband and wife, unique female sexuality that is different from men, the side effects of FP and the impact on women's health and sexual behaviors, male FP methods, and many more.

Public education proved to change people's behavior, including increase of men’s participation in FP and their willingness to use male FP, such as condoms, vasectomy, or at least, use natural FP through good cooperation with wife. "Husbands are still afraid their losses when they have sterilization. For example to become impotent. Health providers should straighten out the wrong perception. FP providers always hold discussion. Male users are asked to testify. Meaning about vasectomy, yes. "(D, Puskesmas Semin, Gunung Kidul).

Sexuality education and reproductive health are not only for those who are married, but also for adolescents and even teenagers. It becomes very important because the many adverse sexual relationships among adolescents cause teen pregnancies, abortion, sexually transmitted infections, and gender-based violence. Education and training for youths will be better when facilities for sustainable mentoring are available after the activity. "Now there is PKBI Youth Forum, visit to schools, counseling on

sex and other issues. We have the cellular phone number, right, then make an appointment during free time through short messages, well, sis, come here, let’s talk about how we feel. So s/he provides time to come when anyone wants to talk about one’s feelings." (FGD with women, Kulon Progo).

STRATEGIES RELATED TO PROGRAM APPROACH Program Name The program name 'Men care' is well regarded, although some informants criticized it, 'do you think all this time we do not care?' It seems that quite a lot of men do not yet or do not care, perhaps some informants are not aware of their ignorance. We could not come up with any appropriate local term.

Some informants say Indonesian language is quite good, and perhaps it is more appropriate to use.

Strategy Informants from different study sites proposed some strategies. Generally the message is similar; it is about the importance of dissemination to raise men awareness. Specifically, the dissemination methods are: One, use a male voice or figure. Dissemination in any form will hit the target when it uses male voice, not female’s. When female voice is used, male egoism can easily come up. When a woman is involved as a resource person, there should be men to support her, and she should have specific expertise in a particular field, for example about maternal and child health.

Two, present a local figure, usually religious leader who is respected by communities. "Well, it depends which leader lives in the area. Some villages had no community figure, drinking, drunk, stealing are considered normal. Then we actively assign Moslem scholars into the villages with the hope that young generation will change for the better. Indeed, there is effect. The child of the village figure diligently goes to the mosque, pray; other kids were embarrassed, the fund followed. So it depends on the leader or figure whom they admire. "(Y, community leader, Gunung Kidul).

Three, Uswatun Hasanah or to set a good example. This method is considered highly effective in all study sites. Especially when it is a religious or community leader who set the good example, the success will be easier to reach. "In this area, sis, it is important, do not lecture people. In the community here, first is to respect my family, every day he (points to her husband) dries clothes, cooks rice. It was not like this before, sis, no husband helped his wife. Many of them said something like this, ustadz was doing laundry, sometimes people came here to visit, ustadz was cooking rice, e .. My husband cooks, so finally a lot people followed suit." (Wife of N, religious leader, Bondowoso).

Four, have a popular local entertainment figure. It was proposed in Gunung Kidul and Kulon Progo.

"Now Campur Sari is popular. It is some kind of music entertainment. Everywhere, old and young like Campur Sari. Especially in Gunung Kidul, the popular ones are Zarimah and Tejo. Formerly s/he used to sing duet with Soimah, before Soimah became popular. So this Tejo, when someone had a party, if one is affluent, one would invite Tejo or Soimah. Tejo did not only sing, ma’am, he could tell jokes as well, so he is an MC plus a singer. He will give the message. I think he connects with (his fans), many people wanted to take a picture with Tejo. "(D, Puskesmas Semin, Gunung Kidul) Five, present testimony from a married couple or witness who successfully practiced good cooperation.

Six, involve more male than female participants. This proposal was also a criticism to gender equality approach that was delivered by NGOs and government all this time. Most programs invite women, or seldom involve men. As a result, women’s knowledge is higher, but men’s is not and their behaviors do not change.

Seven, tap into a local and (still) popular cultural event in the society. In the society, usually quite a lot of events routinely take place, a lot of men gathered during this time. It includes social work, Koran reading, or for example rasulan. During the meeting, program manager could include slogan or important messages related to gender equality. "For example, in early June there will be people’s party.

They are willing to look for sponsor, etc. Every year there is this Rasulan ceremony, a procession, each village presents a parade, Rasulan from Ngalang is usually the most well-known in Gunung Kidul. " (Y, community leader, Gunung Kidul) Eight, tap into group activities that men prefer, particularly sports. Program manager can hold sports competition and / or a friendly game, and use the event to educate people. Present message on gender equality and new masculinity concept in short messages. Men and quite a lot of women like sports, particularly football. So it is worth considering to use sports especially football, or other type of sports as a media to pass the message.

Nine, different perspective on effectiveness of electronic media such as TV or radio. Some thought that TV was quite effective, particularly in the form of soap opera or opera, such as Opera van Java. Some thought that TV was not effective because men often times only watched news and sports. In general, radio was considered ineffective to use as a media to educate people in urban areas; people seldom listened to the radio. However, to reach out rural communities, radio was quite effective. In the perspective of media workers, radio was considered quite effective, especially using popular radio programs, insert important message and the main slogan of the program.

Ten, use of cellular phone and internet, for example, via short message center or social media. "In the cities, newspapers and social media are effective. Today people read issues, opinions or facts through updates in social media, rarely meet people. We do not meet our friends when we visit their house, but we can find them online on facebook, “Hi, earlier I visited your house, where are you?” Internet and social media are effective, and it is not only in the city, because in the village, Junior High School students search the internet to complete school work.

Eleven, avoiding dissemination through the media using intense text materials. It is important to consider, especially in an area where many people are still illiterate. It is better to use images or if there is text, it should be quite short and brief.

Twelve, avoid dissemination in the form of a lecture. Dialogue is considered more effective than a oneway lecture. In a dialogue men and women express their feelings and concerns more openly. In practice, men and women can be together or separated in the dialogue, depending on the themes that are presented and discussed. In such a situation, the suggestion is to have face-to-face meeting with relatively small number of people.

Thirteen, informal method. Adolescents do not like formal method. Young people prefer informal approach particularly through activities and figures that were close to them. These community figures can ask adolescents to participate in the activity. "Perhaps I prefer not to be formal, because now adolescents are more appreciative of informal activities. For example motorcycle community. We use

one to reach out to adolescents. Then football club for example, through the head of the club. Later his friends will trust us and participate." (FGD with men, Kulon Progo).

UNDERSTANDING THE MACRO CONTEXT Program managers also need to understand the macro context complexity from program preparation and implementation. Individual behaviors are influenced by surrounding community behaviors, and these are closely related to some more macro aspects.

Facilitate positive activities for adolescents quite a lot of informants suggest to facilitate positive activities to address issues such as free sex, teen pregnancy, drug use, unemployment, fights and brawls, or gender-based violence. Several practices or negative behaviors are related to absence of public facilities for positive activities. Some joint activities, such as revitalizing Karang Taruna (youth organization), sport activities, study groups, will at least decrease youth involvement in unproductive and harmful activities.

Quite often, those who do not have activities, use their time unproductively, for example playing games or accessing pornography on internet. Hence, facilitating positive activities is very important and fundamental.

Streamline the existing mechanism Many informants submitted one suggestion that is to streamline the existing mechanism. It is considered better than creating a new group every time, the latter has no function when the program does not continue. Developing a new community is ineffective and it starts from nothing. Coverage is also very limited. There were a lot of existing institutions and mechanisms: school, youth organization, PKK (Family empowerment), 'Kifayah' (e.g., in Bondowoso). Kifayah is male gathering, participants recite yasin letter, but also collect money for revolving fund.

Other institutions to invite to work together are local NGOs and organizations that were established by health institutions, such as Karang Taruna, Desa Siaga (alert village) with Suami Siaga (alert husband).

Using the existing institutions and mechanism will revitalize them through new programs, and whenever possible, new funding. "Well, Desa Siaga organization exists here. But to run it, well, it has very little fund. Although we can say that there are many financial sources, from PNPM (National Program for Community Empowerment), ADD, village budget; but they are small and most PNPMs still focus on infrastructure issues. Actually, I think nobody will refuse. For example, public service announcement on TV. Suami Siaga. The problem is that the ad is not powerful enough, too short, unoptimal. "(Dr. B and midwives, Puskesmas Gedangsari, Gunung Kidul) Related to teenagers, use the many youth organizations that were established before the new program starts. "In this area, there is Langit Biru community, youth organization voices youth issue through the media, and develop activities such as shirt painting, drawing, writing. Skateboard community. Musical fans club, bicycle groups. All of those are for young people. "(N, media worker, Bondowoso).

"Triggering" Some health professionals in the interview proposed to develop pilot program or in health language: a 'triggering' program, to build on the success of previous program, such as development of non-smoking or sanitation area. In the triggering, one sample area was selected and would undergo specific interventions that reflected local problems and characteristics. For example, to develop non-smoking

areas, agreements and regulations were developed and community members should comply. For example, smoking is prohibited in meeting, RT meeting or something. The same thing can be used to address men’s concern to improve the quality of his wife’s and family health. Program is piloted in one village, sets a good example, then people hear, see and follow it.

For example we choose one village for triggering; this village has a lot of reproductive health problems.

For example, thre are quite a lot of high-risk pregnant women. Program manager will collect various important data, relevant issues, risks and potential sources as well. To address risks during pregnancy and childbirth, women’s health problems are recorded in detail, and husbands are invited to be actively involved to prevent problems. There should be practical approach, not just theories or one-way education. For example role play and practice. Simulate a case as if it happens, what a husband should do.

LESSON LEARNED FROM THE HEAD OF PUSKESMAS Learn from Dr. S, Head of Puskesmas Pengasih II, Kulon Progo to know about the importance of understanding macro context and how to take appropriate strategies. Previously Dr. S worked as the head of Puskesmas Kali Bawang, 2000-2008. The sub district won Sayang Ibu award. Then he was transferred to Puskesmas Pengasih II in 2008.

Triggering Dr. S emphasized the effectiveness of "triggering" compared to large scale program which is considered too difficult. There will be priority areas, and assurance to realize the Plan of Action (POA). POA should state timeline to review progress. For example, I focused on only one hamlet in the village, set up the system, provided training to increase understanding, and concluded it with a POA. There would be monitoring and evaluation later. After it was successful, I performed triggering in other areas.

Education for men Dr. S emphasized the importance of educating men. Because actually women are quite exposed to education and knowledge, but husbands make the decision. Unfortunately husbands are difficult to embrace. Dr. S believes that people change when they have knowledge, so he keeps on thinking how to find the most appropriate media to improve people’s knowledge, particularly husbands’. Husbands often do not know the basic issues, including gender. In his mind, there is a huge gap in knowledge; and ignorance is the cause why men reject FP, an attitude that shows neglect on pregnant woman’s health and other health issues.

Start to prevent maternal deaths Maternal mortality ratio (MMR) is a major problem in Indonesia, due to its very high number. "Sweeping ... So, we have data on pregnant women, for example, this month there are 100 pregnant women, we meet all pregnant women in the posyandu. If they do not come to posyandu, the midwife will go to their houses. " Pregnant women is assigned with different indicators, red, green, and yellow based on their health examination. Red indicates high risk, and it is directly recorded via short message notification.

Again, the problem depends quite a lot on men. Husbands often do not understand that giving birth is a very risky situation.

In the catchment are of the puskesmas under his responsibilty, midwife plays a role to support husbands who do not understand the issues and whose attitude do not support wife's health, policy maker is involved. "Such situation is preventable because midwife provides support, and replace husband’s

position. Midwives have a role to insist on the husband; this is a must, sir, sign here ... They were scared and forced to sign. Formerly in emergency we called the head of sub district, he immediately came, so he and his wife immeidately turned up. When they came, the husband was afraid... Then he started to take action."

Embrace policy makers and work with other sector As stated above, Dr. S took strategically made a breakthrough to ensure improvement of public health quality, particularly women’s by 'forcing' fathers’ active involvement. He embraced policy makers who have the authority to draft regulations. To encourage public officials to help, he emphasized the importance of public officials role for improving quality of life and asked them to cooperate, "Not bad, if I had to work by myself, it would be impossible, because I could not write regulations. Then I went to the district, to the head of the sub district, they were the one to push, insist. Well after that, it was easy. I lobbied them with the excuse that I provide service to their people. Aren’t you willing to help, I help your people ... ". So, one important thing is to ask parties that the community accepts, policy makers, and work with other sectors.

"Reward" and "Punishment" System Dr. S imposed a reward and punishment system, gently 'coerced' action using reward. When the husband did not come along, Dr. S would not provide services. According to him, opportunities should be created to motivate, educate, and promote health. "The key is innovation. I met the head of sub district, I asked for help in the form of regulation, I did not want a program that gives out milk, sir, no supplementary feeding program. I do not want to help pregnant woman WITHOUT her husband’s presence." 'Coercion' worked, considering that health services tend to attract attention and desirable.

Because the head of Kulon Progo district is an obstetrician and gynecologist, s/he gave a lot of support.

"The invitation was to the husband first, then to the wife. I initiated something like that. Since 2012; I came here in 2008, I saw, I mapped the situation. I did the mapping in 2009, I saw the problem in 2010, worked with other sector in 2011, I tried it out in 2012. "

Make priority on understanding substances Although dr. S applied the reward and punishment system, he stated that the most important was to change the understanding. Therefore, do not make a policy carelessly or uncautiously. When reward is provided, but the understanding does not change; people only pursue the prize. Something like that could be dangerous. When knowledge is put forward, and when reward no longer exists, people still understand the benefits of life practices or methods that the government recommends for them.

Preventing teen pregnancy Dr. S found that unwanted pregnancies constituted the most teenage pregnancies. The woman was not ready to get pregnant. Unwanted pregnancies cause mental and moral burden, and family who does not show concern and appreciation. "After I knew that, I made an evaluation. I wanted to know, I invited the KUA (Office of Religious Affairs) official. I asked data from the KUA. The number of pregnancies out of wedlock was high. “So pregnancy out of wedlock and teenage pregnancies could be the contributors for increased morbidity. After that, think of a way out to prevent teen pregnancy.

He tried his approach in a village with high teenage pregnancy rate, he gathered all teenagers.

"The teenagers gathered, it was a youth reproductive health education. Education with no sanction makes no effect. So an agreement was drawn among teenagers. If they got pregnant out of wedlock, boys and girls, will be expelled, humiliated; the agreement was in writing. Well,

Talangsari is the largest contributor, after the program the KTD (Unwanted pregnancy) rate was down to zero. Thank God, it has been zero in these three years. I tried to do the same in another village, it is still ongoing."

Approach to specific religious groups Dr. S believes that specific belief community rejected the health policy because they have â&#x20AC;&#x153;poor knowledgeâ&#x20AC;?. He also has the same conclusion for a specific religious group that often rejects FP and immunization. To change their attitude, dr. S approached their religious leader, the ustadz, and developed an intensive dialogue.

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