Development of Preventive and Solving Strategies for Teenage Pregnancy by Participation of Family, Community and Local Organizations in Kumpawapi Sub-District, Udonthani Province

Abstract

This study aimed to assess adolescent pregnancy situation, the perception and sexual health behavior of adolescents, and the parents’ attitudes towards care for teenage children; and to developguidelines for prevention and solution of adolescent pregnancy problems by family members and communities. It was conducted as a participation action research (PAR) between 2014 to 2016; and the participants were 60 stakeholders in Kumpawapi Sub-district, Kumpawapi District, Udornthani Province. It was found that teenage pregnancy situation was at an increasing trend. The adolescents had low awareness of self-protection, and many of them had unsafe sex. Some of the teens started to have sexual intercourse at the age of 12; and most of those who had the first sex did not know how to use contraception. In addtiton, many of them had over use of emergency contraceptives. They had negative value such as the sexual competition among girls. Based on the assessment at the beginning of the study, the pregnancy prevention knowledge in adolescents was at moderate level (71.0%), condom use rate was at 53.5%, teenage families had a lacke of knowledge and skills to communicate with the teens. The schools had limited competency on comprehensive sexuality education. The hospitals provided services that did not meet teenage needs, and the available services were difficult to access. The community and local people considered the teens as the origin of the problems. There were lack of policy and plans to solve the problem. With the efforts of this research, a local teanage pregnancy strategic plan was developed to included various activities covering all problems, including the establishment of a camp of youth models, youth volunteers for peer education, kind parents and adult volunteers to support the programs, mobilevoluntary counseling and testing, youth friendly health clinic in hospitals/communities/schools, school sex education, capacity building for health workers, and social welfare support for affected teens. There were efforts to gather budget from various sectors and establishment of ordinances for the local administration organizations to implement the strategic plan. Assessment at the end of the project revealed positive attitudes of families and communities toward the adolescents. Knowledge, attitude and sexual behavior of the youth was improved to reach a very good level (89.6%), and the rate of condom use increased to 85.1%. The adolescent pregnancy rate gradually declined, from 52.2 per 1,000 adolescents in 2014, to 48.2 in 2015 and 22.6 in 2016. The repeated pregnancy rate in adolescents reduced from 30.4% in 2014 to 18.1% in 2015 and 0.0% in 2016. The coverage of post-natal long-term birth control implant increased from 23.0% in 2014 to 100.0% in 2015 and 2016.