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Adolescent engagement key to reducing disease burden in Indonesia

  • 29 Aug 2023

Young people need to be involved in policy making to address the growing rate of disease burden in Indonesia, according to a study led by Burnet Institute in partnership with UNICEF.

Non-communicable diseases (NCDs) such as cancer, diabetes, heart disease, mental disorder and chronic lung conditions are the leading cause of death and disability in Indonesia.

Many of the risks for these diseases emerge in adolescence, yet actions and policy interventions to address these risks rarely target this age group, let alone involve young people in prevention.

Conducted in partnership with UNICEF and Hasanuddin University in Indonesia, the study, published in The Lancet, involved qualitative interviews with key stakeholders to explore how young people are currently engaged in policy and decision making regarding NCDs in Indonesia, and how engagement could be improved.

Study participants were selected from a diverse cross-section of professional backgrounds related to adolescent health and NCD prevention, including advocacy, policy, programming, and implementation.

The study found strong support amongst stakeholders to engage young people in policy development and decision making to reduce the burden of NCDs.

Burnet research officer in the Global Adolescent Health group and lead author of the study, Karly Cini said while there was a focus on how to prevent NCDs in Indonesia, adolescents often weren’t included in these discussions.

“We found that while young people are very involved at the grassroots level of prevention and control for NCDs, they aren’t involved enough when it comes to priority setting and policy development,” she said.

“Our participants told us programs that engaged young people as co-facilitators from the beginning were the most successful.”  

Ms Cini said adolescence was a time when risk factors for NCDs increased, largely due to a steep uptake of smoking, as well as a shift in eating habits and a decline in physical activity, which could lead to obesity.

“Adolescence is when risks for NCDs emerge and it is also an important life stage for intervention, yet young people are often at the margins of NCD policy and actions,” she said.

“It is a time of life when young people have more independence, and also when social and commercial factors have a greater influence on their health.”

Participants in the study said many of the existing prevention and screening activities were focused on adults and were insufficient to address NCDs and their risk factors in adolescents. Meanwhile, adolescent health programming had little focus on prevention of NCDs.

In relation to current engagement activities, young participants said not enough action was taken on issues raised and there was a lack of transparency about how their engagement was used, leaving many with the perception that their involvement was tokenistic.

They also gave examples of how to improve youth engagement.

Recommendations for increasing youth engagement to promote action on NCDs included involving young people as equal partners, identifying areas where young people could take the lead, bringing diverse groups together to inform policy and decision-making, and using quality data to inform evidence-based actions to reduce NCDs. 

Ms Cini said intervention aimed at adolescents was crucial to curbing the incidence of NCDs.

“By intervening during adolescence, we have the opportunity to prevent many health problems before they become long-term, chronic conditions, and also to improve the quality of life for young people today,” she said. 

Burnet Institute honorary fellow and senior author of the study, Professor Peter Azzopardi said he hoped the research would highlight to governments and non-government organisations the importance of engaging adolescents in policy development.

“We were able to showcase programs that have strong youth engagement in Indonesia, there is some incredible work happening in partnership with young people,” Professor Azzopardi said.  

“I hope this study will give people in government and policy settings a clear example of how to engage with young people and involve them in the policy making process.”