Articulo 4
Articulo 4
RESEARCH ARTICLE
to the identification of the interviewees. Data is   globalization come with high public health risks. Furthermore, although vertically integrated
stored in Ausvet’s internal cloud-based storage      players dominate the market with 60% of production coming from industrialized farms [3], the
system. Access to anonymized and de-identified
                                                     poultry sector still involves a large number of small and medium enterprises operating in low
data may be requested by contacting Ausvet
Europe (contact@ausvet.eu) and the Medical and       biosecurity settings, which creates risks for disease emergence and spread [2, 5]. High-impact
Health Research Ethics Committee of Gadjah Mada      endemic diseases such as Newcastle disease (ND) and highly pathogenic avian influenza
University, Indonesia (komisietik@ugm.ac.id).        (HPAI) continue to cause major economic losses [5, 6]. Barriers to maximizing the potential of
Funding: This study was conducted as part of the     poultry production also include farm input and output price fluctuations, limited resources,
TRANSFORM (Transformational Strategies for           lack of education on biosecurity and management, and inadequate market regulation [3, 5, 7].
Farm Output Risk Mitigation) funded by USAID            These constraints have the potential to be addressed by providing access to timely and reli-
(Cooperative Agreement No. 7200AA21CA00004).         able information on poultry production and health through technical innovations [8–11].
The funders had no role in study design, data
                                                     Although many individual actors and organizations in Indonesia currently use poultry-related
collection and analysis, decision to publish, or
preparation of the manuscript.
                                                     data to improve their business efficiency, their specific information needs, analytical capacities,
                                                     and willingness to share their own data vary greatly. In the absence of industry-level standard-
Competing interests: The authors have declared
                                                     ized mechanisms for collecting and managing data, integration and interpretation remains
that no competing interests exist.
                                                     challenging. In particular, the existing National Animal Health and Production Information
                                                     System iSIKHNAS (Sistem Informasi Kesehatan Hewan NASional) has had limited uptake in
                                                     the poultry sector [12]. Failure of new interventions or technologies to achieve the desired
                                                     impact despite effective delivery is often attributed to a lack of consideration of the partici-
                                                     pants’ needs [13–16]. Therefore, assessing the needs, capacities, and priorities of the people
                                                     whose behaviour will dictate the success or failure of management strategies is a crucial step in
                                                     the design of effective and sustainable interventions [13, 16, 17].
                                                        There is growing recognition of the value of qualitative approaches for facilitating the design
                                                     and implementation of animal health interventions or innovations. Qualitative approaches can
                                                     offer valuable insight into the views and perceptions of individuals or groups and provide an
                                                     in-depth understanding of the social, cultural, and economic factors that shape the context in
                                                     which they are situated [16, 18]. Thematic analysis (TA) is a theoretically flexible method that
                                                     can be applied to a diversity of contexts and research questions that has been widely used in
                                                     qualitative research to provide rich and detailed accounts of qualitative data [19–22]. Building
                                                     on previous analysis of the Indonesian commercial layer value chain and information networks
                                                     [12], this study uses TA to explore the challenges and priorities of actors of the commercial
                                                     layer sector regarding production and health management and assess their needs and capacities
                                                     for informed decision-making. The specific topic of antimicrobial use is the subject of a specific
                                                     study and is therefore not addressed here [23]. The research questions were formulated as fol-
                                                     lows: 1) What are the challenges faced by stakeholders of the Indonesian commercial poultry
                                                     production system and how are these challenges prioritized? 2) What are stakeholders’ current
                                                     practices, needs, and capabilities in terms of collecting and using poultry health and production
                                                     information to make health and production management decisions? and 3) What are their per-
                                                     spectives regarding potential solutions to address current gaps in the decision-making process?
                                                     The findings will help researchers and policymakers to design effective and acceptable innova-
                                                     tions to support the development of the industry in a sustainable way.
                                           This study was conducted within an interpretivist (experiential) paradigm in order to priori-
                                           tize the “empathic understanding” of participants’ lived experiences and the meaning they
                                           ascribe to them [25]. Interpretivism acknowledges that different people experience and under-
                                           stand the same “social reality” in different ways, and therefore seek to extract knowledge from
                                           the subjective interpretations of the people who experience it [25, 26]. This approach was con-
                                           sistent with the study’s objectives of emphasizing poultry stakeholders’ subjective accounts of
                                           their experiences and interpretations.
                                               Sampling and study area. Sampling was purposive to maximize diversity and prioritize
                                           information-rich individuals from the Indonesian poultry sector. Initial participants were
                                           identified through consultation with local collaborators and policymakers based on their
                                           knowledge or strategic role in the poultry sector, and subsequent participants were recruited
                                           through snowball sampling until we felt we had reached a sufficient diversity of views (i.e.,
                                           actors operating at different levels of the value chains and geographic places) and that data was
                                           sufficiently rich to answer the research question. The final sample included policymakers from
                                           the Directorate of Livestock and Animal Health Services (DGLAHS), representatives from
                                           non-governmental organizations, industry associations, university professors, technical service
                                           officers (TSO) from input companies, poultry company managers, and farmers. Although the
                                           layer sector was primarily targeted upon the government’s request, several interviewees also
                                           had experience in the broiler sector. The study area covered five provinces within which most
                                           layer poultry production is concentrated: DKI Jakarta, Yogyakarta, Central Java, East Java and
                                           West Java.
                                               Data collection. Semi-structured interviews were used to collect rich, descriptive and
                                           contextually situated data for exploring the range of attitudes, experiences, perceptions, and
                                           behaviours of a diversity of poultry stakeholders. This flexible format allowed adjustment of
                                           the emphasis and order of the topics according to the interviewee’s responses and for inter-
                                           viewers to follow-up more extensively on any unexpected themes that emerged during the dis-
                                           cussion [27–30].
                                               To build a priori semi-structured interview guides, an initial literature review was con-
                                           ducted. Based on this review, the following topics were included: (1) Role and challenges of
                                           the interviewee in their field of work; (2) Practices and challenges related to the prevention
                                           and control of poultry diseases; (3) Antimicrobial use and stewardship, and (4) Practices and
                                           challenges related to the management of poultry-related information. The interview guide is
                                           provided in S1 Appendix. The questionnaire was reviewed and practiced amongst research-
                                           ers and piloted with an independent small-scale farmer to ensure understandability. Inter-
                                           views were conducted by two separate teams composed of one English-speaking researcher,
                                           two Indonesian-speaking researchers, and one professional translator with experience in ani-
                                           mal health. Interviews were conducted at the interviewee’s workplace, in public spaces such
                                           as cafes or restaurants, or online depending on logistical constraints. Representatives from
                                           associations, institutions, and government bodies were interviewed in groups of two to five
                                           people.
                                               Data analysis. Thematic analysis of interview transcripts was conducted following the
                                           framework from Braun and Clarke [22] and taking into account recommendations from Cas-
                                           tleberry and Nolen for increasing consistency in coding and ensuring transparency and thor-
                                           oughness of the analytical process [31]. Although this framework is described linearly, several
                                           cycles of coding and interpretation were performed iteratively throughout the analytical pro-
                                           cess. A codebook was developed to map the coding process [32] and ensure consistency across
                                           transcripts. It also aimed to demonstrate rigour in the methodology by providing a clear audit
                                           trail [33]. The software NVivo [34] was used to facilitate data management.
                                           1. Data familiarization. Interviews were audio recorded and transcribed verbatim in the origi-
                                              nal language (either Indonesian or English). English recordings were transcribed by
                                              English-speaking members of the research team and Indonesian recordings were tran-
                                              scribed and translated by Indonesian native speakers. All verbatim transcripts were
                                              reviewed carefully by the Indonesian-speaking members of the research team before and
                                              after translation to assess quality and become familiar with the data. Where necessary,
                                              unclear data excerpts were checked against audio recordings or field notes and annotated
                                              with contextual explanations to inform the interpretation.
                                           2. Initial coding. The entire dataset was coded systematically using a primarily inductive or
                                              “data-driven” approach [35, 36] (i.e., without committing to a pre-existing theory or frame-
                                              work) to best represent meaning as communicated by participants. Deductive coding was
                                              used to some degree to ensure meanings were relevant to the research question and provide
                                              more details on some aspects of interest. This combined approach is appropriate for studies
                                              that aim to explore specific issues but also leave scope for unexpected aspects of partici-
                                              pants’ experiences or interpretations to be brought up [37, 38]. Semantic (explicit) and
                                              latent (implicit) codes were developed to allow the data to be both described and inter-
                                              preted [22]. An initial codebook was developed, including the following components: label,
                                              definition, and ideas to include or exclude. When coding the excerpts from interview tran-
                                              scripts, the researcher retained as much contextual information as needed to ensure quotes
                                              would be understandable.
                                           3. Generating themes. Once all data had been coded, the data was reviewed to determine how
                                              codes may be grouped to form themes or sub-themes [35]. “Keyness” or meaningfulness
                                              was the central criterion for determining themes (i.e., whether it captures something impor-
                                              tant in relation to the research question) [22, 31].
                                           4. Reviewing themes. Themes were reviewed against the entire dataset to determine whether
                                              they formed a coherent pattern and were relevant to the research question [22, 38, 39].
                                              Codes or themes that shared the same underlying meaning were merged, while those that
                                              did not fit within the overall analysis were discarded and their data re-coded as appropriate
                                              to facilitate the most meaningful interpretation of the data. The first author recorded all
                                              decisions to rename, merge, discard, and sort codes into themes in NVivo to keep track of
                                              the changes and allow for going back and re-code previously coded material to ensure con-
                                              sistency in coding.
                                           5. Refining and defining themes. Themes were reviewed individually and in relation to one
                                              another. An accompanying narrative was written for each theme and sub-theme.
                                           6. Producing the report. Themes were organized together with their analytic narratives to illus-
                                              trate the overall story in response to the research question. Direct quotations were collated
                                              in a table (S2 Appendix). All quotations were referred to in the main text using identifiers
                                              and the most relevant were reproduced in full to demonstrate how themes are rooted in
                                              empirical data and allow the reader to assess the validity of the interpretation. Minor gram-
                                              matical and linguistic corrections were made by the researcher to ensure comprehension.
                                              Where necessary, contextual explanations were added in brackets.
                                           Ethics statement
                                           This study obtained ethical approval from the Medical and Health Research Ethics Committee
                                           from the Faculty of Medicine, Public Health and Nursing of Gadjah Mada University (Ref. No.
                                           KE/FK/0675/EC/2022). The interview started with a self-introduction from both the inter-
                                           viewer and interviewee, following which the interviewer explained the scope, objectives, and
                                           interview process. Verbal consent to participate in the study and record the interview was
                                           obtained from all interviewees in the presence of all research team members and documented
                                           using a recording device. Data was stored securely in restricted access folders. Transcripts
                                           were relabelled with code names before analysis and any information that could lead to the
                                           direct identification of the interviewee was removed from the quotes. At the end of the inter-
                                           view, interviewees received a non-monetary gift for their participation.
                                           Results
                                           A total of 34 individual and 7 group interviews involving 56 participants were conducted from
                                           27 June to 22 July 2022 with value chain stakeholders, experts and policymakers, of which 38
                                           were audio recorded. Table 1 presents the number of interviews according to stakeholder cate-
                                           gory. Although the layer sector was primarily targeted upon the Indonesian government’s
                                           request, many interviewees provided information or had a personal experience in the broiler
                                           sector.
                                              Five major themes were developed including 16 sub-themes which are detailed in the code-
                                           book (S3 Appendix). The accompanying narratives are described below.
* Group interviews
https://doi.org/10.1371/journal.pone.0308379.t001
                                           cash flow or poor financial management. Farmers felt this was most apparent during the
                                           COVID-19 pandemic, which led to a sharp decrease in the number of independent smallhold-
                                           ers, while contract farmers’ losses were absorbed by their companies. Farmers generally
                                           expressed a pessimistic view regarding the future and stressed the psychological burden of
                                           maintaining their businesses in the face of competition and uncertainty (a1, a2, a3, a4).
                                              “Only big integrators, big companies can survive because they have a lot of money. But small
                                              farmers, many of them they close, they sell their cages [. . .]. It’s quite challenging to be a
                                              farmer in Indonesia.”
                                              (a4)
                                              “That’s why the breeders now are like a tossed ship. Like the ship in the middle of the sea doesn’t
                                              know where it’s going, its purpose is not clear. We must survive alone, we must fight alone.”
                                              (a5)
                                              Interviewees told us that the lack of price regulation and official certification schemes
                                           opened the door to uncontrolled production and fraudulent practices, allowing, for instance,
                                           farmers or traders to artificially increase prices by retaining eggs or by using false labels (e.g.,
                                           for omega eggs) (a6, a7).
                                              Difficulties in sourcing farm input. Price and availability of day-old chicks (DOCs) and
                                           poultry feed, which together account for more than 80% of farmers’ production costs, were the
                                           main concerns of most poultry producers. Indonesia’s heavy reliance on imports for the supply
                                           of DOCs and feed raw materials (e.g., meat-bone-meal, soy-bean-meal, corn, etc.) made local
                                           production highly sensitive to international commodity prices, exchange rate variations, and
                                           global shocks such as the COVID-19 pandemic or the Ukraine-Russia war (a8). We were also
                                           told that government import policies and subsidy schemes also had a strong impact on avail-
                                           ability and price stability. The Directorate General of Livestock Farming and Animal Health
                                           has established import quotas on grandparent DOC in an attempt to achieve a balance
                                           between supply and demand. However, interviewees told us that the quotas appeared to be
                                           determined with limited stakeholder consultation and based on inaccurate data, leading to an
                                           imbalance between supply and needs (a9).
                                              “The government imports this GPS [grandparent stock] as if they are doing whatever they
                                              want. This means that the need is not calculated, how much is needed for DOC [day-old
                                              chicks], how many eggs are needed, oh if I have to import that much, there won’t be any.”
                                              (a9)
                                              Farmers believed that the government’s strategy of favouring local corn production by limit-
                                           ing imports has created many difficulties for sourcing poultry feed. In their opinion, local corn
                                           production remains insufficient and sub-optimally managed (a10), with temporal and geo-
                                           graphical imbalances between corn and poultry production coupled with logistical issues in
                                           conveying feed raw materials. Farmers also reported difficulties in accessing subsidized corn
                                           and complained of its poor quality and prices being higher than unsubsidized corn. This led
                                           feed dealers and farmers to develop variable coping strategies, which negatively impacted the
                                           quality of feed (e.g., replacement with wheat, use of fake meat-bone-meal, mixing with sand).
                                              Unequal power dynamics. As Indonesian poultry production has intensified and as inte-
                                           grated companies have developed, farmers felt that integrators’ monopoly in the domestic
                                           market was being reinforced (a11). Independent farmers were becoming increasingly depen-
                                           dent on large integrated companies for the supply of production input and had to comply with
                                           their terms and conditions, such as the bundling of feed and DOCs. Many independent farm-
                                           ers expressed a fatalistic view, believing that they did not have the capacity to compete and
                                           were doomed to be overtaken by large players (a12, a13, a14).
                                              “It is impossible for us small farmers to face them. They have DOC [day old chicks], they have
                                              feed, they have medicine, they have vaccines, even the last one, they have all the final results.
                                              [. . .] My question is, will integrators replace us after we run out?”
                                              (a12)
                                              “Our association [of small poultry farmers] still needs to improve our relationship with the
                                              government because government policies often do not suit our needs. Of course, the govern-
                                              ment must consider the interests of prominent business people, but this policy is ultimately not
                                              in the interests of our farmers.”
                                              (b2)
                                               Being more advanced in terms of knowledge and technology, large-scale farms or compa-
                                           nies failed to see the benefits of interacting with the government and often displayed a distrust-
                                           ful attitude towards them (b3, b4, b5). Interactions were generally limited to the NKV (Nomor
                                           Kontrol Veteriner, veterinary control number) certification or compartmentalization program
                                           for Avian Influenza (AI) (b6).
                                               Information gaps lead to inadequate management of poultry diseases. Private actors
                                           were generally reticent about sharing their internal data and rarely reported diseases to author-
                                           ities for fear of penalties (b7). The official animal information system iSIKHNAS, which has
                                           been successful in cattle, was perceived by interviewees as ineffective in poultry (b8). There-
                                           fore, data held by the government was considered incomplete or inaccurate, leading to inade-
                                           quate policy-making and response to industry needs, and in particular late or no response to
                                           disease outbreaks (b9, b10, b11).
                                              “After all, the government is often not ready, especially when facing poultry disease outbreaks.
                                              [. . .] If we weren’t prepared, we would have collapsed a long time ago for various reasons.”
                                              (b10)
                                              Many mentioned the first AI crisis in 2003, telling us that the government failed to recog-
                                           nize the threat, forcing farmers to manage the issue themselves by sourcing vaccines from
                                           China outside any legal framework (b11, b12).
                                              “the government at that time [during the first AI outbreak in 2003], they were unwilling to
                                              declare that we had been infected by avian influenza. [. . .] The ability of our government to
                                              address this issue was very weak.”
                                              (b11)
                                               Industry actors perceive academic education and research as disconnected from real-
                                           life. Actors from the private sector felt that the academic world was disconnected from the
                                           reality in the field. A farming businessman suggested that poultry sciences should be taught by
                                           private industry experts to ensure knowledge is rooted in real life and to better prepare future
                                           practitioners (b13). However, he deplored academia’s closed attitude towards external lectur-
                                           ers (b14).
                                              “Academics are usually born in a community where a system has been formed. [. . .] They feel
                                              confident and do not need advice from others. [. . .] That’s their weakness. They have a good
                                              brain but can’t accommodate outside advice”
                                              (b14)
                                              “It is different from 10 years ago [. . .] In terms of disease, nowadays cases of disease are
                                              increasingly complex, they do not stand alone, so the symptoms are not clear and this does
                                              require a lab approach”
                                              (c3)
                                             Interviewees also pointed out the role of environmental risk factors in disease introduction
                                           and spread, including high poultry population and farm densities, low feed and water quality,
                                           and exposure to extreme weather events.
                                              “The problem is that for animal health, if you look at the budget here in the Ministry, the bud-
                                              get has been going down year after year, livestock production is much more important than
                                              animal health, so it’s partly the problem of the government itself”
                                              (c9)
                                               Control and support from health authorities to farmers appeared to be lacking due to insuf-
                                           ficient financial and human resources, but also due to the unstable political and administrative
                                           environment which farmers told us frequently disrupted the funding and implementation of
                                           national health programs (c9, c10). This was even more critical at the time of the study, as the
                                           government had reallocated most of its resources to the management of a nationwide FMD
                                           outbreak.
                                               Resistance to behavioural changes. Several farmers and technical service officers
                                           described a generational gap regarding farming practices. They mentioned it was difficult to
                                           educate the old generation of farmers and update their knowledge about poultry farming
                                           because of their unwillingness to change practices that have been passed down through genera-
                                           tions (c11, c12).
                                              Because they feel right, it is difficult to change the mindset of farmers. [. . .] And sometimes
                                              that’s wrong, because they have the principle of "I’ve been there for decades, what are you new
                                              kids doing?", it’s sometimes difficult for us to go there for education”
                                              (c11)
                                              In contrast, the younger generation was thought to be more aware of the importance of bio-
                                           security and more willing to use IT tools for farm management.
                                           on an individual farm or customer basis, thereby limiting their analytical capacity (d3, d4).
                                           Management of data by the government itself was also thought to be suboptimal by some par-
                                           ticipants, as highlighted by an industry association that criticized what they described as bur-
                                           densome submission procedures and underutilization of data (d5).
                                              “Even with the government, we feel that they might not be able to provide valid data. [. . .]
                                              The government needs to be encouraged the importance of actually compiling this data so it
                                              can actually be used for something. It’s not just asking for data and then stop there, because
                                              they don’t have any system to compile them.”
                                              (d5)
                                              “Information spreads through suppliers. [. . .] If there’s a big problem, the supplier usually has
                                              a stake. For example, if there is a virus, later, the vaccine supplier will announce to Blitar
                                              farmers through a seminar, "So we got information that this virus has started to enter Blitar."
                                              [. . .] However, between farmers, no one wants to tell each other.”
                                              (d9)
                                              “it is not easy to get the data [from sector 3 farmers], they don’t want to share any informa-
                                              tion, especially if there is no benefit for them. [. . .] the key is I think, how to show and to prove
                                              they get the benefit, and how to prove this really secure and confidential.”
                                              (d15)
                                              Poultry health and production data was therefore managed through multiple systems with
                                           different standards and procedures, which resulted in high variability and discrepancies
                                           between private and official data, further impairing its usability.
                                              “If farms really think the government is corrupt, then they also feel the government is not inde-
                                              pendent [. . .] if you want to use the Public Private Partnership approach, the main problem is
                                              information confidentiality and good governance.”
                                              (e5)
                                              “It would be better if the government could support us. [. . .] If they collaborated with us, they
                                              could work faster because we have the laboratories so we could help them. But I think they
                                              don’t trust us yet.”
                                              (e6)
                                           provided through seminars led by experts from companies or universities, onsite training, or
                                           newsletters. However, those providing the education felt that important knowledge gaps
                                           remained, especially in smallholders. Farmers generally relied on their practical experience
                                           and a diversity of informal information sources including technical service officers, university
                                           professors, the internet, fellow farmers, and veterinarians who may sometimes lack scientific
                                           updates (e10). A local entrepreneur thought training should be tailored to the specific needs of
                                           small-scale farmers (e11):
                                              “These past few years, I have tried to educate middle to lower-level farmers whose animal
                                              health awareness still needs to improve. [. . .] However, my efforts are still very far away. [. . .]
                                              The seminars they need are about disease management and production management in a lan-
                                              guage they can easily digest”
                                              (e11)
                                              There is also a strong need for research and innovation in poultry nutrition and health,
                                           especially for alternatives to antimicrobials and raw feed materials that can be locally produced
                                           (e12). However, according to academics, research in poultry is not yet sufficiently developed to
                                           support the rapid growth of the industry (e13).
                                              “Even though we are number four in Asia [. . .] it is not easy to find funding for research in
                                              poultry. [. . .] And indeed, that is our weakness, even though the poultry industry in Indonesia
                                              is quite large, the research is not yet developed.”
                                              (e13)
                                              “Now we only know when the disease is here. But the disease is not just there all of a sudden,
                                              there is this process, and we need to know this process [. . .] We don’t want to fight fires, once
                                              we have fires and we fight it, we don’t want to do this. We want to know the pattern so that
                                              we can be better prepared.”
                                              (e17)
                                           Discussion
                                           Our study offers insight into how the Indonesian poultry system operates, describes the main
                                           issues faced by the stakeholders, and identifies opportunities to address them. Focusing pri-
                                           marily on the layer sector allowed us to fill an important research gap, as most past studies
                                           have been conducted in the broiler sector. Our findings also highlight the highly interconnec-
                                           ted nature of the Indonesian poultry system and may therefore be of interest to those who seek
                                           to understand global poultry production and trade dynamics, especially in the wider SEA
                                           region. Finally, our study demonstrates the value of qualitative approaches for exploring com-
                                           plex systems, moving beyond the technical or biological aspects to encompass the broader
                                           social, cultural, and economic determinants of health.
                                           [47–49]. Nonetheless, important educational gaps remain, especially for independent small-
                                           holders who lack formal training on biosecurity, and farm and financial management. At pres-
                                           ent, it appears that research and education in poultry sciences are insufficiently developed to
                                           fulfil the industry’s needs for innovation and skilled graduates. To address part of this issue, a
                                           study suggested creating a research data bank that could be used as a reference for farmers and
                                           their advisors [46].
                                           understanding of the way the private sector functions, including the traditional sector, with
                                           particular attention to the trade of strategic elements such as feed and DOCs. The issues and
                                           recommendations identified in this study are well aligned with those formulated by Task
                                           Force 6 –Global Health Security and COVID-19 regarding One Health implementation dur-
                                           ing the 2022 T20 summit in Indonesia [57].
                                           relevant for understanding similar issues in other contexts. The implications of these findings
                                           may be used to inform strategies to improve animal health management and guide the design
                                           of further quantitative and quantitative studies [61].
                                           Conclusion
                                           Our qualitative approach allowed us to gain an in-depth understanding of stakeholders’ needs
                                           and capabilities for managing poultry production and health in Indonesia and highlighted
                                           gaps in the decision-making process, as well as potential opportunities for improvement. Mar-
                                           ket and political instability, ineffective management of poultry data, and limited inter-sectoral
                                           collaboration appear to be the main barriers to the development of the sector. Addressing
                                           these challenges would require increased cooperation from all sides to develop and implement
                                           industry standards for data collection and sharing, provide education and practical training
                                           based on real-life situations, and accelerate research and innovation to respond to the evolving
                                           market and regulatory requirements.
                                           Supporting information
                                           S1 Appendix. Interview protocol (generic).
                                           (DOCX)
                                           S2 Appendix. Quotation table.
                                           (DOCX)
                                           S3 Appendix. Codebook.
                                           (DOCX)
                                           Acknowledgments
                                           The authors thank all the participants who took part in this study and the translators for their
                                           valuable support.
                                           Author Contributions
                                           Conceptualization: Lorraine Chapot, Rebecca Hibbard, Kurnia Bagus Ariyanto, Kusnul Yuli
                                             Maulana, Havan Yusuf, Widya Febriyani, Angus Cameron, Mathilde Paul, Timothée
                                             Vergne, Céline Faverjon.
                                           Data curation: Lorraine Chapot, Rebecca Hibbard, Kurnia Bagus Ariyanto, Kusnul Yuli Mau-
                                             lana, Havan Yusuf, Widya Febriyani.
                                           Formal analysis: Lorraine Chapot.
                                           Investigation: Lorraine Chapot, Rebecca Hibbard, Kurnia Bagus Ariyanto, Kusnul Yuli Mau-
                                              lana, Havan Yusuf, Widya Febriyani, Angus Cameron.
                                           Methodology: Lorraine Chapot, Rebecca Hibbard, Kurnia Bagus Ariyanto, Kusnul Yuli Mau-
                                             lana, Havan Yusuf, Widya Febriyani, Angus Cameron, Mathilde Paul, Timothée Vergne,
                                             Céline Faverjon.
                                           Supervision: Timothée Vergne, Céline Faverjon.
                                           Writing – original draft: Lorraine Chapot.
                                           Writing – review & editing: Lorraine Chapot, Rebecca Hibbard, Kurnia Bagus Ariyanto, Kus-
                                             nul Yuli Maulana, Havan Yusuf, Widya Febriyani, Angus Cameron, Mathilde Paul,
                                             Timothée Vergne, Céline Faverjon.
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