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. 2023 Aug 16:18:100260.
doi: 10.1016/j.lansea.2023.100260. eCollection 2023 Nov.

Towards responsive policy and actions to address non-communicable disease risks amongst adolescents in Indonesia: insights from key stakeholders

Karly I Cini  1   2   3 , Nisaa R Wulan  1 , Dorothea Dumuid  4 , Alifah Nurjannah Triputri  5 , Iffat Abbsar  2   6 , Luo Li  2   3 , Diandra A Priambodo  2   7 , Grace E Sameve  8 , Artha Camellia  8 , Kate L Francis  2   3 , Susan M Sawyer  2   3 , George C Patton  2   3 , Ansariadi Ansariadi  5 , Peter S Azzopardi  1   2   3   9
Affiliations

Towards responsive policy and actions to address non-communicable disease risks amongst adolescents in Indonesia: insights from key stakeholders

Karly I Cini et al. Lancet Reg Health Southeast Asia. .

Abstract

Background: 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. 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. This study aimed to understand how policies and actions should address NCD risks (tobacco smoking, inadequate physical activity, and diet) for adolescents in Indonesia, and how young people can be meaningfully involved.

Methods: Qualitative in-depth interviews over videoconference (n = 21) were conducted in English or Bahasa with stakeholders in Indonesia. Participants included policymakers, implementation partners, and advocates who were focused on adolescent health or NCDs. Interviews were recorded, transcribed, translated, and thematically analysed using NVivo12. Findings were disseminated to participants for validation and feedback. Youth participants (n = 7) attended an additional workshop and considered recommendations and actions arising from this research.

Findings: Participants identified that government and non-government organisations are acting on NCDs in Indonesia, but few of the existing initiatives target adolescents, and adolescent services rarely addressed NCD risks. Participants also felt that policies to protect adolescents from NCD risks (i.e., smoke-free areas in public) were not always enforced. For programs or initiatives focused on adolescent health, those that had engaged adolescents as co-creators and leaders were perceived to be more successful. As such, participants recommended more meaningful engagement of young people, including young people's leadership of initiatives. Additional recommendations included the need for intersectoral engagement and a 'whole-of-government' approach to prevention given the complex determinants of NCD risks, and the need for evidence-based actions that are underpinned by quality data to enable monitoring of progress.

Interpretation: There is a recognised need to strengthen policies and actions to address NCD risks amongst adolescents in Indonesia. Meaningful youth engagement that allows young people to take the lead, intersectoral actions, and evidence-based data driven responses were key strategies identified.

Funding: UNICEF East Asia and Pacific Regional Office.

Keywords: Adolescents; Indonesia; Non-communicable disease; Qualitative; Risk factors.

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Conflict of interest statement

Researchers from Murdoch Children's Research Institute are supported by the Victorian Government's Operational Infrastructure Support Program. KC is supported by a postgraduate scholarship from Australia's National Health and Medical Research Council (NHMRC) GNT1190911. KC & DD are supported by The Centre of Research Excellence in Driving Global Investment in Adolescent Health funded by NHMRC GNT1171981. DD is supported by an NHMRC Early Career Fellowship GNT1162166 (2019-2022), and by an ARC Discovery Early Career Award DE230101174 (2023-2025). PSA is supported by a NHMRC Investigator grant GNT 2008574. The authors declare no conflict of interests.

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