Strategic Communication in Sexual and Reproductive Health and Rights Advocacy: A Case Study of a Local Organisation in Indonesia

Abstract

Sexual and reproductive health and rights (SRHRs) remain a sensitive issue in Indonesia due to entrenched structural, cultural, and social barriers, particularly affecting adolescents, women, and minority groups. In response, the Indonesian Planned Parenthood Association of Yogyakarta Special Region (PKBI DIY) actively promotes SRHR access through value-based, community-centred communication strategies. This study explores how PKBI DIY applies strategic communication to strengthen SRHR advocacy by employing collaborative and participatory methods. Using a qualitative case study approach, researchers conducted in-depth interviews with 11 key informants. Thematic analysis identified three core strategies. First, PKBI DIY fosters inclusive and non-discriminatory communication through educational outreach that challenges stigma and engages diverse audiences. Second, it adopts value-driven, community-focused communication practices that reflect its organisational ethos and build public trust. Third, it practices reflective and collaborative communication with government bodies, civil society, and the media to reinforce advocacy and ensure sustainable outcomes. PKBI DIY illustrates that NGO communication transcends message delivery by embodying advocacy values, affirming organisational identity, and supporting long-term impact. The findings contribute to the broader discourse on value-based strategic communication in human rights work and provide practical guidance for NGOs aiming to implement ethical and socially impactful communication models in SRHR.

1. Introduction

Over the past two decades, the role of non-governmental organisations (NGOs) in advocating for social issues, including sexual and reproductive health and rights (SRHRs), has undergone a significant transformation through the adoption of value-based strategic communication approaches and the strengthening of cross-sectoral partnerships and collaborative knowledge platforms (Meijers et al. 2022). Global policy shifts emphasising the importance of human rights and gender inclusivity have become central to SRHR frameworks (Johnson 2023), while the integration of SRHR into universal health coverage agendas has been promoted globally (El Kak 2020). These shifts have prompted NGOs to reinforce their strategic communication efforts in advocating for access and awareness of SRHR (Matos 2020). In Indonesia, the role of NGOs such as the Indonesian Planned Parenthood Association of Yogyakarta Special Region (Perkumpulan Keluarga Berencana Indonesia Daerah Istimewa Yogyakarta-PKBI DIY) has become increasingly vital, especially in response to the growing demand for SRHR services that are inclusive, community-based, and culturally sensitive.

NGOs have responded to their expanding role in SRHR advocacy by directly addressing the structural and social pressures that affect vulnerable groups such as adolescents, women, survivors of sexual violence, and gender and sexual minorities (Khanna et al. 2022; Schindele et al. 2022). Advocacy efforts have also focused on increasing public awareness of inclusive values while actively involving parents and communities in creating supportive environments (Eastman et al. 2023; Senghor et al. 2024). In many conservative cultural contexts, communities continue to resist open discussions on sexuality, gender, and reproductive rights. This resistance creates significant barriers for NGOs in delivering inclusive services and disseminating accurate information (Ferguson and Narasimhan 2022). In the Yogyakarta context, resistance to SRHR advocacy typically arises from a combination of religious conservatism, patriarchal cultural norms, and deeply rooted stigma around open discussions of sexuality. Local values that emphasise family honour, female modesty, and social expectations can intensify community opposition to SRHR programmes, especially those targeting adolescents and unmarried individuals. Community leaders and religious authorities often regard SRHR initiatives as threats to moral order or as promoting promiscuity, making them hesitant to allow access to public spaces, schools, or youth groups. These social dynamics compel NGOs to navigate expectations carefully, build trust gradually, and frame their messages in ways that respect community values while advancing rights-based goals.

To overcome these obstacles, NGOs design and implement communication strategies that do more than provide factual content; they aim to transform public perceptions and foster empathetic, culturally sensitive engagement (Mosley et al. 2022). By applying these approaches, NGOs build trust, honour local values, and empower marginalised communities. Studies show that many NGOs have successfully used transformative and empathetic communication to reach groups often facing multiple layers of exclusion, including people with disabilities (Rugoho et al. 2024). Moreover, NGOs strengthen their organisational legitimacy, enhance stakeholder trust, and shape more inclusive public discourse on SRHR through effective communication practices (Sorce 2021).

PKBI DIY actively aligns its work with the spirit of the Sustainable Development Goals (SDGs), particularly Goal 3 (Good Health and Well-being) and Goal 5 (Gender Equality), by implementing participatory, cross-sectoral, and value-based communication strategies grounded in non-discriminatory principles. PKBI DIY expands access to SRHR services, education, counselling, policy advocacy, and legal and psychosocial support through these strategies, especially for vulnerable communities. This approach exemplifies how NGOs increasingly position themselves as strategic communication actors, influencing public policy and driving social transformation, consistent with broader participatory and community-based advocacy trends supporting SDG implementation in Indonesia (Margiono et al. 2022; Ramadhani et al. 2020).

Few researchers have systematically examined how organisations such as PKBI DIY design, implement, and communicate their SRHR strategies within Indonesia’s socio-cultural complexities, despite their consistent engagement in diverse communication initiatives. Studies have shown that women’s organisations and NGOs in Indonesia face persistent challenges in integrating SRHR into broader health policies due to cultural resistance and gender norms (Sciortino 2023). Additionally, sexual health education efforts in Indonesia continue to be limited by intergenerational taboos and societal pressures, often marginalising adolescent voices in programme development (Sikoki et al. 2024). Moreover, rapid knowledge translation strategies across Indonesia, including those targeting youth SRHR, reveal that participatory and contextualised approaches are essential but underutilised in local NGO work, particularly when these approaches involve tailoring messages to local cultural norms, language use, religious sensitivities, and community power dynamics (Meijers et al. 2022). Evidence from evaluations of structural SRHR interventions shows that programmes addressing upstream social norms and youth empowerment are more effective, yet local NGOs seldom incorporate these methods in implementation (Burchett et al. 2022).

While international literature offers valuable insight into SRHR communication strategies, Indonesia also has a unique trajectory of rights-based advocacy. Since the 1970s, national initiatives led by organisations like PKBI have focused on population control and family planning, often with limited attention to rights-based or participatory approaches. Over time, shifts in political openness and decentralisation allowed NGOs like PKBI DIY to adopt more community-driven models. In Yogyakarta, PKBI DIY has gradually expanded its work from clinical services to advocacy, education, and cross-sector engagement. However, entrenched cultural taboos, moral policing, and fragmented local policies continue to challenge these efforts. Although some partnerships with local governments and schools exist, coordinated multi-stakeholder frameworks remain limited and inconsistent. This study seeks to fill that gap by exploring how PKBI DIY operationalises strategic communication in such a complex historical and cultural landscape. A recent survey by (Arindita and Naura 2023) on the Eduka5eks reproductive health education programme reveals the importance of media-based, participatory strategies explicitly tailored to youth audiences. This finding aligns with broader research on meaningful youth involvement in SRHR programming across Southeast Asia, emphasising that sustained youth engagement strengthens programme relevance and effectiveness (Van Reeuwijk 2018). However, analyses focusing on how local NGOs operationalise these strategies remain scarce and warrant further investigation.

The article examines how PKBI DIY applies strategic communication to advance SRHR advocacy in Indonesia. It analyses how the organisation crafts inclusive and non-discriminatory messages, applies value-based and community-driven approaches, and builds collaborative networks for advocacy. Through these strategies, the study shows how NGOs actively shape public discourse, increase access to services, and promote structural change through policy reform, including regulations on access to adolescent reproductive health services, comprehensive sexuality education, and protections against discrimination for gender and sexual minorities, alongside cross-sectoral collaboration, and the development of inclusive social norms in pursuit of fulfilling sexual and reproductive health and rights.

2. Literature Review

In the discourse on NGOs’ strategic communication, recent studies have underscored the vital role of communication in shaping public opinion, mobilising community support, and influencing policy on sensitive social issues, including sexual and reproductive health and rights (SRHR). Feminist and health NGOs across different regions use advocacy communication to reshape public attitudes and drive policy reform, emphasising the need to deconstruct dominant discourses and engage diverse stakeholders through inclusive strategies (Matos 2020). Research from (Dimitrova and Ozdora-Aksak 2023) found that NGOs adapt their communication strategies to local political and cultural contexts, using tailored public engagement and media campaigns to foster trust and policy influence.

Within the Indonesian context, civil society organisations such as PKBI have become key actors in raising awareness, reducing stigma, and broadening access to SRHR services. Recent studies have confirmed that socio-cultural barriers, such as stigma and lack of community engagement, significantly hinder adolescent access to reproductive health services. For instance, (Hunersen et al. 2023) show that gender-transformative interventions in Indonesia improve SRHR knowledge and communication when implemented in culturally sensitive ways and with strong community involvement. Research findings from (Wahyuningsih et al. 2024) emphasise the need for inclusive education and destigmatising efforts to address reproductive health challenges among adolescents in rural Indonesia. These findings reinforce the importance of NGOs in providing education and framing SRHR narratives in culturally acceptable and non-threatening ways to conservative communities.

Moreover, recent research confirms the importance of value-based communication in campaigns surrounding sensitive issues such as reproductive health. For example, (Hall et al. 2018) developed and validated an adolescent SRH stigma scale in Ghana and demonstrated that higher stigma scores were significantly associated with lower contraceptive use, emphasising the value of culturally sensitive messaging that aligns with community values. Implemented a school-based stigma-reduction intervention in Kenya, which significantly decreased stigmatising attitudes toward abortion and contraceptive use by over 25% in both boys and girls, reinforcing the effectiveness of structured, value-driven educational messaging in adolescent populations (Makenzius et al. 2023). Cultural stigma led teenage girls in Kenya to fear pregnancy more than HIV, yet avoid using contraception due to similar stigma, thereby emphasising the need for community-informed communication strategies to address these deeply rooted attitudes (Miller et al. 2021). These findings reinforce the role of culturally grounded communication in shaping public perception and advancing SRHR goals.

However, while international literature has extensively examined strategic communication approaches in reproductive health, researchers have seldom explored how local NGOs, particularly PKBI DIY, design and implement their communication strategies in culturally and politically resistant environments. Most existing studies focus on evaluating program outcomes or service delivery, rather than analysing how NGOs choose, adapt, and negotiate communication strategies in everyday practice (Blaak 2023). Practitioners confront deep cultural tensions that necessitate adaptive and reflective messaging to sustain SRHR advocacy within complex local contexts (Govender 2025). Many SRHR programs falter when they overlook cultural taboos and language barriers that hinder message reception in conservative communities, as (Da Silva 2020) finds. Therefore, this study argues for a deeper, context-sensitive investigation into how NGOs employ communication strategies to support SRHR advocacy at the local level. In the Indonesian context, various institutional actors, such as the religious court, religious organisations, local health departments, and civil registry offices, play an influential role in shaping public understanding and regulation of sexuality, marriage, and reproductive rights. These institutions not only interpret but also enforce prevailing social norms, particularly around issues such as early marriage, gender roles, and access to SRHR services. As such, they become both gatekeepers and potential allies in advancing inclusive and rights-based approaches to reproductive health. Despite their influence, existing literature rarely explores how NGOs engage with these institutions to shift public discourse or policy, highlighting the need for closer examination of these cross-sectoral dynamics.

This study seeks to fill that gap by analysing how PKBI DIY has developed and applied communication strategies to promote sexual and reproductive health rights in the Yogyakarta region. By examining narrative framing, communication channels, collaborative partners, and the packaging of messages, this research aims to deepen our understanding of how strategic communication drives progressive social change within complex social, political, and religious contexts.

Strategic Communication: Design and Implementation in SRHR Advocacy

Strategic communication in the NGO context consists of intentionally crafted messages designed to overcome policy barriers and influence public opinion to support social change. They propose a typology of strategic advocacy that integrates message content, communication methods, and credible messengers in a coordinated manner. NGOs deliberately choose credible messengers to reinforce message acceptance and drive public support for policy change (Dominic et al. 2025). Moreover, (Abiddin et al. 2022) highlight that NGOs develop coordinated communication strategies by aligning message content with effective communication methods and engaging credible actors to build public trust and foster sustainable policy engagement. NGOs such as PKBI DIY implement communication strategies centred on public relations and social marketing to promote critical awareness, improve sexual health literacy, and expand the reach of rights-based services. This practice aligns with findings by (Duong 2017), who shows that fourth-generation NGOs adopt value-based and adaptive communication approaches to foster public engagement and support impactful social campaigns. These approaches underscore the importance of tailoring advocacy messages to local cultural values and social contexts to enhance communication effectiveness, especially when addressing sensitive issues such as sexual and reproductive health and rights.

Building on this foundation, recent studies highlight how NGOs strategically integrate social marketing and public relations to deepen their influence in culturally sensitive environments. Rather than merely promoting services, social marketing emphasises behaviour change that benefits society by requiring careful audience segmentation, culturally resonant messaging, and empathetic, non-judgmental framing. NGOs in Myanmar have effectively applied participatory and value-based communication strategies, such as interactive workshops and community dialogues, to address stigma, enhance SRHR knowledge, and foster positive behavioural shifts in underserved and conservative communities, as shown by (Win et al. 2024). Similarly, (Fu and Wang 2024) argue that NGOs enhance visibility, build organisational legitimacy, and strengthen stakeholder relationships by combining visible communications, attentive listening to stakeholder concerns, and cross-sector partnerships, thereby effectively managing external resistance and securing their mission. Within the PKBI DIY context, such integration allows the organisation to develop advocacy that resonates with local communities while promoting broader structural changes in public discourse and policy regarding SRHR.

Sociopolitical environments where reproductive rights are contested and NGO legitimacy is constantly negotiated further elevate the importance of communication strategies. Research by (Awobamise and Jarrar 2018) on post-conflict Libya shows that strategic public relations, particularly through social media, is vital in strengthening NGO visibility, attracting donor support, and fostering public trust amidst adversity. This finding reinforces the importance of message design, communication infrastructure, and stakeholder engagement in advancing sensitive causes such as SRHR. In PKBI DIY’s context, integrating public relations with participatory media and localised narratives can amplify advocacy efforts and sustain momentum toward reproductive justice despite institutional and cultural resistance. For PKBI DIY, strategic communication goes beyond simple information delivery; it serves as a vehicle for negotiating public discourse. Consequently, communication emerges as a central instrument in advocating for SRHR as a fundamental human right and reinforcing the NGO’s role as a transformative force in society.

3. Research Methods

This study adopts a qualitative case study approach and uses in-depth interviews as the primary data collection method. The researchers selected this design to obtain a contextual and comprehensive understanding of the experiences, perspectives, and strategic communication practices implemented by the Indonesian Planned Parenthood Association of Yogyakarta Special Region (PKBI DIY) in advocating for sexual and reproductive health and rights (SRHR). They conducted face-to-face interviews with 11 informants, including the Executive Director of PKBI DIY (Informant 1), branch directors from five districts, the Director of PKBI Yogyakarta (Informant 2), the Director of PKBI Sleman (Informant 3), the Director of PKBI Bantul (Informant 4), the Director of PKBI Gunungkidul (Informant 5), the Director of PKBI Kulon Progo (Informant 6), the clinic director (Informant 7), clinic counsellors (Informant 8), doctor (Informant 9), program staff (Informant 10), and community volunteers (Informant 11). Participants in the interviews provided in-depth and reflective insights into how PKBI DIY formulates and implements strategic communication within complex socio-cultural contexts. This approach reflects the view of (Nathan et al. 2018), who emphasise that qualitative interviews are essential for exploring complex social processes through participants’ lived experiences in health and community contexts. Their work underscores the importance of context-sensitive inquiry in capturing nuanced and subjective insights, critical for case studies aiming to understand real-world communication strategies within organisational and socio-cultural settings.

The researchers interviewed 11 informants from PKBI DIY’s internal structure and professional partners. These included the Executive Director of PKBI DIY, Directors of PKBI branches in the five districts/cities of Yogyakarta Special Region, the clinic director, clinic counsellors, doctor, program staff, and community volunteers. The researchers selected informants purposively, prioritising those who held strategic roles and actively participated in implementing SRHR advocacy communication. They also used snowball sampling to identify additional participants based on recommendations from initial key informants considered credible and relevant to the research focus (Miles and Huberman 1994). The final sample size was determined based on thematic saturation, the point at which additional interviews no longer yielded new insights. Saturation was observed after approximately nine interviews, with two additional participants included to confirm the consistency of emerging themes. This approach prioritises depth and relevance over representativeness, as is standard in qualitative research.

This study aimed to explore how PKBI DIY conceptualises, executes, and evaluates its communication strategies in promoting SRHR within the socio-cultural context of Yogyakarta. In a setting shaped by conservative norms and structural limitations, such as fragmented policy implementation, limited government support for comprehensive sexuality education, and bureaucratic barriers to youth-friendly SRHR services, strategic communication is key in fostering trust, encouraging participation, and enabling cross-sector engagement. Over three months, the researchers used a semi-structured interview guide to elicit in-depth reflections on communication practices, campaign planning, inter-organisational collaboration, value-based messaging, and community responses. Each interview session lasted 45 to 90 min. The researchers designed the questions to uncover how these strategies operate in practice. Questions focused on communication experiences, campaign strategies, cross-sectoral collaboration, value-based approaches, and SRHR issues. Examples of the interview questions included: “How does your organisation approach communication when discussing sensitive SRHR topics with communities?”, “Can you describe a recent campaign and how the messages were developed and delivered?”, “What challenges do you face when collaborating with government institutions?”, “How do you ensure that your communication strategies reflect the values of inclusivity and non-discrimination?”.

The researchers analysed the data using reflexive thematic analysis (Roseveare 2023). After transcribing all interviews verbatim, the first author conducted initial open coding, followed by the development of thematic categories. To ensure rigour and consistency, a second researcher independently double-coded a subset of transcripts. Any differences in coding were discussed and resolved through collaborative reflection. The team used NVivo software to manage the data, organise codes, and identify patterns across participants’ narratives (Seals 2024).

The researchers undertook two validation steps to ensure data validity and reliability. Internally, the researcher conducted data triangulation and repeated the analysis process at different intervals to test the consistency of findings. Externally, member checking was conducted by inviting informants to review the main findings and confirm the accuracy of the researcher’s interpretations, ensuring alignment with the meanings and contexts conveyed during the interviews. This method aims to capture the depth of PKBI DIY’s communication strategies in addressing SRHR advocacy challenges and to contribute to developing value-based strategic communication practices in NGOs’ work within the reproductive health field.

4. Results

This study, grounded in a qualitative case study approach, explored the strategic communication practices of the Indonesian Planned Parenthood Association of Yogyakarta Special Region (PKBI DIY) in advocating for sexual and reproductive health and rights (SRHR) in a culturally sensitive Indonesian context. The researchers conducted a thematic analysis of in-depth interviews with eleven key informants, including the Director of PKBI DIY, branch directors at the district/city level, community volunteers, clinic counsellors, and a doctor. They identified three interrelated themes that illustrate how the organisation develops, implements, and perceives strategic communication in its day-to-day advocacy work.

The first theme highlights PKBI DIY’s commitment to inclusive, non-discriminatory communication aimed at public education and raising awareness. The organisation fosters open dialogue by creating safe, formal, and informal spaces where sensitive SRHR issues can be discussed, rather than simply delivering information. This approach is vital in dismantling stigma and increasing community literacy, particularly among youth and marginalised groups.

The second theme reflects the organisation’s value-based and community-oriented communication approach. PKBI DIY emphasises empathy, confidentiality, and respect for diversity in every communicative interaction. These core values are embedded in service delivery and manifested in grassroots engagement, where community members actively shape discourse around reproductive rights.

The third theme underscores the organisation’s reflective and collaborative communication across multi-stakeholder networks. Through partnerships with schools, local governments, healthcare providers, religious organisations, and media, PKBI DIY positions itself as a service provider and a strategic actor in public discourse and policy advocacy. The organisation intentionally crafts communication strategies to influence public opinion and policy frameworks, making them vital to long-term institutional sustainability.

Together, these three themes illuminate the case of PKBI DIY as a model for how community-based NGOs can utilise strategic communication to advance SRHR in a socio-cultural environment often resistant to such discourse. Rather than viewing communication as a linear process of message dissemination, this case reveals a dynamic, participatory, and ethically grounded model of advocacy communication.

4.1. Inclusive and Non-Discriminatory Communication Through Education and Public Awareness

The findings of this study indicate that PKBI DIY places inclusive and non-discriminatory educational communication at the core of its strategy to promote sexual and reproductive health and rights (SRHR). This theme focuses on how PKBI DIY uses inclusive educational outreach to challenge stigma, disseminate accurate information, and build awareness among diverse groups, especially youth and marginalised communities. It presents communication as a tool for public engagement and knowledge transformation. The organisation implements this strategy by emphasising equal access to information and sensitivity to individuals’ experiences, identities, and vulnerabilities, particularly among youth and marginalised communities. Education is regarded not merely as a means of disseminating knowledge, but as a transformative instrument to deconstruct deeply rooted social stigmas surrounding SRHR.

Through a wide range of initiatives delivered across both formal and informal platforms, such as seminars, trainings, community discussions, film screenings, and arts-based cultural activities, PKBI DIY aims to engage diverse audiences in culturally appropriate and contextually relevant ways. These activities create safe spaces where individuals feel empowered to express their experiences and questions without fear of judgment. Communication, therefore, is not seen as a unidirectional process of message delivery but as a reciprocal mechanism that builds trust and empowers individuals as active agents of social change.

PKBI DIY concretely manifests this approach through the strategic use of digital media. The organisation uses social platforms such as Instagram, podcasts, and YouTube to reach adolescents, a demographic with the highest need for SRHR information but often hindered by social barriers. PKBI DIY creates content that is both engaging and relatable, while preserving its educational integrity. In doing so, the organisation disseminates information and fosters emotional and cognitive proximity with its intended audience.

The voices of various informants reinforced the importance of this approach. As stated by the Director of PKBI DIY, education serves as an entry point for dismantling stigma and raising collective awareness:

“Through the education it delivers, the organisation gradually dismantles negative stigma and builds awareness.”

(Informant 1)

A program staff member explained that informal approaches, such as film screenings with an angkringan-style (traditional street food) setting followed by discussions, can foster meaningful communication by creating a relaxed and safe atmosphere that encourages participants to open up about sexual and reproductive health issues:

“When PKBI organised film screenings with an angkringan-style (street food stalls) setting, followed by discussions, they finally began to open up about their experiences related to sexual and reproductive health. It’s not about data, it’s about creating a safe space.”

(Informant 10)

In addition, the Director of PKBI Bantul also reiterated the strategic use of digital media:

“…because nowadays that’s where the youth are.”

(Informant 4)

Information obtained from interviews with informants underscores the importance of adopting an inclusive and non-discriminatory educational approach. The Director of PKBI Sleman emphasised that public communication must remain sensitive to the diversity of identities and community backgrounds. He stated:

“In Sleman, we often collaborate with local communities to ensure that reproductive health messages are not only informative but also respectful of their cultural and social contexts.”

(Informant 3)

Meanwhile, the Director of PKBI Kulon Progo highlighted the importance of reaching marginalised groups through approaches that are closely connected to people’s daily lives and readily accepted by the community:

“We try to reach marginalised groups using approaches close to their daily lives so that the messages can resonate more easily.”

(Informant 6)

The clinic counsellor explained that they also incorporate education through a clinical approach grounded in empathy and humanism:

“When clients come to the clinic, we make sure they feel accepted and not judged. We integrate educational messages into the consultation so they can understand and feel safe to ask questions.”

(Informant 8)

Inclusive and non-discriminatory communication is a foundational principle and a concrete practice in PKBI DIY’s broader strategy to improve SRHR literacy and foster a more open, equitable, and supportive social environment. Education is positioned as a tool for long-term social transformation, addressing not only cognitive dimensions but also emotional and cultural aspects, with the ultimate goal of cultivating a more aware, participatory, and empowered society in the realm of reproductive health.

4.2. Value-Based and Community-Oriented Communication Practices

The second key theme emerging from the data highlights that PKBI DIY’s communication strategy is firmly rooted in the organisation’s core values, including non-discrimination, solidarity with vulnerable groups, and a strong commitment to privacy and individual autonomy. In contrast to outreach-focused communication, this theme highlights a relational and ethical approach, where messages are shaped by empathy, mutual respect, and alignment with local values. Here, communication is not only about content delivery but also about fostering trust and social connection. Rather than focusing solely on delivering information, PKBI DIY adopts a communication approach grounded in relational ethics, prioritising safety, mutual respect, and equality between service providers and their communities. This value-driven strategy has proven effective in cultivating public trust and positioning PKBI DIY as a stigma-free and non-judgmental service provider.

Informants reflected this ethical stance by welcoming each individual at service points without judgment or assumptions based on sexual orientation, religion, marital status, or other personal identifiers. As explained by the doctor, the primary concern is the individual’s needs, not their background:

“We don’t ask about sexual orientation, religious background, or marital status when someone comes in for services. What we ask is: what do you need help with today?”

(Informant 9)

PKBI DIY embeds these values in its broader communication practices at the community level, extending beyond clinical interactions. The organisation facilitates communication through participatory engagement, active listening, and respect for local knowledge systems, rather than imposing it top-down. PKBI DIY co-creates educational and advocacy efforts with communities to ensure that individuals actively produce knowledge and shape the discourse on SRHR, rather than being treated as passive recipients of information.

The Director of PKBI DIY articulated this approach by emphasising the importance of grassroots and culturally attuned communication:

“We listen to their stories, this is about equality… fostering a healthier way of thinking about sexuality.”

(Informant 1)

Another informant highlighted the central role of values in shaping communication practices across all activities carried out by PKBI DIY actors. The Director of PKBI Yogyakarta emphasised that respectful communication requires empathy, which is a key part of PKBI DIY’s values of pioneering spirit and volunteerism:

“Empathy is part of our values of pioneering and volunteerism. So communication is about trying to understand and listen.”

(Informant 2)

A volunteer explained that ethical communication is a crucial foundation in their work, especially when interacting with marginalised or stigmatised groups. They highlighted the importance of being communicative, empathetic, and capable of “ngemong”, a Javanese concept that means to nurture and guide with patience and deep understanding. Although the volunteer has personal boundaries or dislikes, such as smoking, they continue to respect the choices made by the marginalised individuals they engage with. For this volunteer, maintaining a gentle attitude, withholding judgment, and avoiding harshness are essential to building safe and trusting relationships:

“What’s important is that we stay communicative. We need to be able to “ngemong” marginalised groups. I don’t like smokers, but if someone from a marginalised group wants to smoke, that’s their right. When engaging with marginalised groups, I need to be kind, able to “ngemong”, and not harsh.”

(Informant 11)

This culturally embedded concept of “ngemong” reflects the relational and context-sensitive nature of PKBI DIY’s communication approach. By adopting “ngemong”, communicators foster emotional proximity and trust, which are essential for delivering SRHR messages in a way that is both respectful and effective.

The Director of PKBI Gunungkidul reflected that efforts to align communication with the organisation’s core values, such as inclusivity, respect for individual rights, and collaboration, have played a vital role in maintaining long-term community engagement. She emphasised that when communication is built without judgment or discrimination, and roles are distributed fairly and respectfully, people feel more comfortable and valued:

“What’s most important is how we share roles, and then ensure we don’t pass judgment or discriminate.”

(Informant 5)

Value-based communication is a core ethical feature of PKBI DIY and a strategic instrument for building organisational legitimacy and expanding the reach of SRHR messaging. By positioning communities as partners in advocacy and dialogue, PKBI DIY promotes a socially just and sustainable model of communication that aligns with the lived realities and aspirations of those it serves.

4.3. Reflective and Collaborative Communication Within Multi-Stakeholder Networks for Advocacy Purposes

The third key theme reveals that PKBI DIY’s communication strategy extends beyond educational functions, encompassing a reflective and collaborative approach that strengthens its advocacy efforts. PKBI DIY implements this strategy through cross-sectoral partnerships involving schools, primary healthcare centres, local health departments, religious institutions, and civil society organisations. The organisation builds these strategic alliances to create an interconnected communication network that enhances its influence and broadens outreach across multiple layers of society and governance.

A core aspect of this strategy lies in developing policy narratives rooted in marginalised groups’ lived experiences and needs. PKBI DIY ensures these voices are heard at the grassroots level and represented in policymaking forums. As stated by the Director of PKBI Bantul, the organisation actively participates in local government forums to channel the perspectives of youth and vulnerable communities into policymaking processes:

“Regarding reproductive health, the existing data and plans include a fact sheet compilation program at the end of each year. The factsheet compiles data on cases such as violence, maternal mortality, infant mortality, and so on. This compilation involves inviting relevant agencies, including the religious court, the health department, and the civil registry office. It will also be incorporated when they have data, such as on marriage dispensations. In December, we have an event called ‘Bantul Update,’ where these data sets are presented, showing, for instance, that there are cases in Bantul involving unwanted pregnancies, child marriages, and similar issues.”

(Informant 4)

Other informants underscored the importance of maintaining open and sustained dialogue with various institutional partners as a strategic tool for long-term change. The Director of PKBI Kulon Progo highlighted the collaborative relationship with primary health centres (Pusat Kesehatan Masyarakat-Puskesmas) and religious organisations to amplify advocacy efforts at the grassroots level:

“There is also collaboration with Puskesmas and religious organisations, as they play an important role. When they join in voicing issues related to Sexual and Reproductive Health and Rights (SRHR), the message becomes even more impactful.”

(Informant 6)

The Clinic Director explained the cross-sectoral collaboration involved in the HIV/AIDS handling scheme through a referral mechanism:

“If further counselling is needed, we refer them; that’s the system here. Our referral is in collaboration with RSUP Dr Sardjito’s Edelwise Clinic, because once someone tests positive for HIV, they need to take ARV medication for life. We don’t provide that service yet, so we refer them to access ARVs, and we also refer them to institutions that can address their psychological concerns.”

(Informant 7)

PKBI DIY adopts a collaborative communication approach to disseminate information and integrate it into a reflective advocacy strategy. Through cross-sectoral partnerships, PKBI DIY builds an interconnected communication network with broad outreach capacity. This approach enables the organisation to strengthen its social legitimacy, expand the influence of its advocacy, and promote policy changes responsive to vulnerable groups’ needs. In this context, social legitimacy refers to the trust, recognition, and acceptance PKBI DIY gains from communities and stakeholders, particularly by involving them in dialogue, co-producing advocacy materials, and demonstrating cultural and political sensitivity. The advocacy communication model implemented is data-driven, non-confrontational, and oriented toward constructive dialogue with key stakeholders.

5. Discussion

This discussion explores three key themes from the study on PKBI DIY strategic communication practices in advocating for sexual and reproductive health and rights (SRHR). The themes of inclusive and non-discriminatory communication through education, value-based and community-oriented communication, and reflective and collaborative communication within multi-stakeholder networks collectively offer a comprehensive understanding. This understanding shows how strategic communication can be effectively designed and implemented in a culturally complex context like the Yogyakarta Special Region.

These findings reinforce the understanding that practitioners of public health advocacy must integrate strategic communication with prevailing social contexts and local value systems. Strategic communication helps organisations achieve specific goals and missions (Abidin et al. 2024). In this regard, PKBI DIY does not merely transmit information; it creates safe and equitable dialogic spaces, offline and digital, that enable communities, especially youth and vulnerable groups, to participate actively. His strategy reflects the core principles of Social and Behaviour Change Communication (SBCC), by fostering two-way, empathetic, and community-based engagement that empowers individuals and reshapes social norms, a process that is central to effective SBCC and well-documented in community-driven communication initiatives (McKee et al. 2014).

In addition, while PKBI DIY employs digital platforms such as Instagram and YouTube to expand its outreach, these platforms are not neutral tools. Each carries distinct communicative logics, such as algorithmic amplification, aesthetic curation, and short-form temporality, that shape how messages are seen, shared, and interpreted. These structural affordances may favour specific types of content, potentially limiting the nuance and complexity required to address sensitive SRHR topics. As such, digital SRHR communication is not merely about content delivery but involves strategic negotiation with platform constraints and visibility regimes. This recognition underscores the need to analyse not only the instrumental role of media but also their performative power in shaping the discursive field of advocacy. This approach also aligns with broader calls for NGOs to improve strategic communication capacities to influence policy, build coalitions, and foster social change, particularly in sensitive fields such as SRHR (Matos 2020). Matos emphasises that effective advocacy requires NGOs to deconstruct harmful narratives and design communication strategies that reflect local identities and global rights-based frameworks.

Furthermore, NGOs integrating value-driven communication and collaborative engagement into their strategic models are better positioned to build public trust and navigate structural constraints in reproductive health advocacy (Taufiq et al. 2024). These practices demonstrate that the success of strategic communication is not solely determined by the clarity of the message, but also by the relational and cultural dynamics in which communication occurs. This emphasis on relational and cultural dynamics aligns with the findings of (Sabri and Adiprabowo 2023), who emphasise that cultural relevance, emotional tone, and visual narrative shape audience trust and perception in public health messages, especially in contexts with strong local values and social norms. While this study illustrates how strategic communication may mediate between universal SRHR values and local cultural norms, these interactions are rarely frictionless. In reality, translating rights-based language into culturally acceptable narratives involves symbolic negotiation, reinterpretation, and sometimes resistance. These tensions are not mere obstacles, but essential aspects of the communicative process itself, sites of instability and contestation where meaning is negotiated. Acknowledging this complexity enriches our understanding of how NGOs like PKBI DIY navigate and reframe value-laden discourses in everyday advocacy work.

Moreover, PKBI DIY adopts a value-based communication approach, emphasising non-discrimination, confidentiality, and respect for diverse identities. The organisation reflects these principles in how it welcomes individuals without judgment, regardless of their religious background, sexual orientation, or social status. Beyond clinical services, PKBI DIY enacts these values in community activities by actively involving residents in co-creating narratives. This approach aligns with co-creation principles in public health programming, emphasising the importance of meaningful community engagement throughout all stages of initiative design and implementation to foster ownership and sustainability (Vargas et al. 2022).

PKBI DIY also demonstrates a strong capacity for reflective and collaborative communication in policy advocacy. Its outreach extends not only to the broader public but also to legislative and bureaucratic stakeholders. The organisation engages in evidence-based dialogue rather than confrontation by grounding advocacy narratives in field data. This model reflects the principles of collaborative governance, where public policy success is contingent upon open, deliberative partnerships between civil society, government actors, and other stakeholders. For example, (Dove et al. 2024) emphasised that collaborative governance in health partnerships, like those in Papua New Guinea, requires mutual trust, leadership, adaptive strategies, and inclusive engagement to navigate complex settings effectively. Thus, PKBI DIY functions not only as a service provider but also as a strategic actor in shaping public discourse and policies that protect the rights of vulnerable groups.

Theoretically, these findings contribute to the strategic communication literature by illustrating how SBCC principles, cross-sectoral collaboration, and participatory approaches can be integrated into an ethical and practical advocacy framework (Juwita et al. 2025; Khanam and Uzair 2024; McGreavy et al. 2022). These insights support the argument that strategic communication requires alignment between message content, delivery methods, intended outcomes, and coherence across organisational culture and structure (Dike 2025; Holtzhausen et al. 2021). This study provides a model that other civil society organisations can replicate, particularly in regions facing similar challenges in advocating for sensitive issues. The success of this model hinges on a strong commitment to ethical values, investment in building public trust, and the capacity to form inclusive, data-informed cross-sector coalitions. As PKBI DIY practices, strategic communication is not merely a message dissemination tool but a transformative medium enabling social change, norm shifts, and sustainable policy reform. While this study offers valuable insights into the strategic communication practices of PKBI DIY, it is not without limitations. The sample size was relatively small and focused on a single organisation within a specific cultural context, which may limit the generalisability of findings. Moreover, the study relied on self-reported data, which may be influenced by informants’ positionality or social desirability bias. Future research should expand the scope to include multiple organisations across regions and employ longitudinal methods to assess the sustained impact of advocacy communication on behavioural and policy outcomes. This insight aligns with (Gupta et al. 2021), who emphasise that bottom-up, participatory strategic communication integrated with behavioural and social change goals is critical for effective advocacy in complex health and development contexts.

6. Conclusions

This study demonstrates how PKBI DIY meaningfully employs strategic communication to promote SRHR in a culturally sensitive context. Three key strategies, inclusive education, value-based community engagement, and collaborative advocacy, enable the organisation to build trust, dismantle stigma, and influence policy. By integrating SBCC principles with participatory and ethical practices, PKBI DIY models a transformative communication framework suited for NGOs in similar settings.

The findings contribute theoretically by linking strategic communication with behavioural change and collaborative governance, and methodologically by illustrating the value of qualitative inquiry in understanding advocacy dynamics. Future research should examine the adaptability of this model across regions and its long-term impact on SRHR outcomes. As practised by PKBI DIY, strategic communication is not merely informational but a participatory, relational, and policy-shaping tool vital for advancing reproductive rights in complex socio-cultural environments.