Questions/Answers

1.1 To prevent and solve the problem of pregnancy in rural teenagers in Thailand, that is the second highest in the world, by coordinating with the relevant network partners. The development of model schools is initiated in order to assist adolescent to have a deep understanding of sex, gender equality, and shared responsibility. They have self-help skills and adolescent friends when experiencing sexual problems. They would be strongly grow to be the quality citizen of the world. 1.2 To give children and teenagers access to services of sex information and providing universal reproductive health education.

Thai rural society still has the culture and belief that Thai women have to maintain celibacy. If a woman has sex before time should be considered bad, spoiled to leave school to lack of educational opportunities. Teen pregnancy must be concealed. Some find a way out with illegal abortions and suicide. In the Thai society, sex talk is embarrassing, and teenagers do not dare to access information about sexuality. Changes in culture and beliefs must be adjusted to the attitudes of all people in Thai society to understand human nature and gender equality. This helps preventing and resolving sexual problems.

It is important for all parties to have a positive attitude about sex. All genders are aware of their involvement in prevention and resolution of both pregnancy and sexually transmitted diseases based on the Ottawa Charter. It is the goal of sustainable development, education, and rights in family planning. This will reduce the maternal mortality rate. Teenage girls who are having sexual problems are entitled to equal quality education. Also they are treated equally so that they do not get stigmatized and forced marriage to claim dowry from pregnancy.

From 2012 until now, adolescents aged 10-19 have unborn childbirth rates of up to 130,000 people per year, ranked first in Asia and the second in the world. Childbirth rates in adolescence have affected many aspects, such as death, mother and baby lack of parenting, abandoned child, delay development, unsafe abortion, school drop-out, and loss of educational opportunities. Parents and teachers do not talk about sex and do not teach sex. They have negative attitude about sex because of the culture and beliefs of people in rural society. Adolescence lack knowledge and self-help skills when problems arise. Roi-Et Hospital has been developed the teachers in schools and initiated integration with the network targeting teenagers in school, which is the most problem group base on the Ottawa Charter. It developed, monitored, supported, and evaluate the performance by honoring mention. All networks define this as a policy for continuous and sustainable development.

Since lack of knowledge and self-help skills of adolescents, many agencies have created curriculum and instructional guidelines for sex education to support adolescents. Teachers and parents have negative sex attitude. Prototype schools in the successful operation as the guide and source of learning are needed. Innovation is the collaboration with the school networks as the model in preventing teen pregnancy problems based on the Ottawa Charter. Innovations are included the standards and indicators of the school, student screening, and learning centers. All the schools have innovative teaching methods of sex education based on the way of sufficient rural life.

The model school in prevention and correction pregnancy is conducted with the target group of the rural schools. Development of leading personnel involved with administrators, teachers, parents and students to be the core of the operation. There are standards and indicators in the operation. There is a method for screening students to provide appropriate knowledge and assistance. Performance appraisal conducted by the cooperation of relevant network. The model schools will be supported by local government organizations to create a network with neighboring schools. There is a period of learning between the schools and set as policies for continuity and sustainability.

Domestic transferability: 1. Reproductive Health Department selected the best practices guidelines for the rural people across the country. 2. Regional Health Promotion Center Area 7 visualized the lessons to be used as a guideline for operation. 3. Development and implementation of guidelines for health promotion in Roi-Et province. 4. Transfer guidelines for teachers-students support in 1,587 schools. 5. Department of Children and Youth took the lessons learned from the implementation in 2018 to publish. International transferability: Neighboring countries such as Laos and Cambodia established the focus group discussion is to evaluate the application for future network.

Roi-Et Hospital initiated budget in developing teachers on sex education during 2013-2015. In 2016, the first model network was established. Then the MOU was signed with the relevant authorities to set policies for the prevention and correction of teen pregnancy problems. Roi-Et Provincial Office of Education funded to support with Roi-Et Hospital for schools extension in 2017. Model schools were supported by Local Administration Organizations and Thai Health Promotion Foundation to develop a policy to monitor and supervise the implementation. It is the cooperation of provincial agencies to make the operation sustainable.

In the past, all sectors recognize that pregnancy in adolescence is a serious problem. Yet there is no knowledge to solve the problem based on traditional culture and beliefs. This project promotes networking among teachers, parents, students both male and female to know the problem together and to have a positive attitude from participating in prevention and resolution. This will result in sustainable development in rural society, families love, understanding, and have a better life. When this group of teenagers grow up, they educate and adjust sexual attitudes. This will result in a social equality without problem of pregnancy among teenagers. As a result, the environment in society is happily sustained.

Yes

8.1 The results of the operation appear in the Health Data Center of the Ministry of Public Health clearly stated that maternal birth rate in Roi Et decreased. As a result, the rate in the Health Promotion Zone 7 and Thailand decreased. 8.2. Department of Children's Affairs Ministry of Social Development and Human Security which is an external agency follow-up and evaluate to implement in the 2018 annual report as a guideline for operations in other areas of Thailand.

Thailand establishes strategic indicators within the year 2026 that the birth rates in women aged 10-14 years are no more than 0.5 per thousand while the 15-19 years age group does not exceed 25 per thousand population. Birth rates in 10-14 years women decreased from 0.9. to 0.21 in 2018 and the 15-19 age group decreased from 41 in 2004 to 10.92 per thousand in 2018. This is lowest in the 4 provinces of health promotion zone 7.

The integration of the work is to as a result, the effective reduction of adolescent pregnancy rates between 2016 and 2018 showed that there were no pregnant women in 23 model schools and expanded the whole province. There is no problem dropping out of pregnancy. This is an opportunity for education to rate of birth delivery among women aged 10-14 years decreased from 0.9 to 0.21 per thousand in 2018 and the 15-19 age group decreased from 41 in 2004 to 10.92 per thousand in 2018. The lowest in the four provinces of health zone 7.

Roi-Et Hospital has begun to drive the prevention and correction of pregnancy problems in adolescents in cooperation with Roi Et Provincial Office of Education. Then return the information about the problem with the relevant agency. Then make a memorandum of agreement (MOU) with all agencies. As a result, the province has a policy of operation. There are committees from all agencies. They set goals for the schools where most teenagers are in the education system. Developing the model school, there are courses, standards and indicators for supervision, support, proactive and evaluation support. The development of a network of student support systems. Teachers can screen, counsel, and refer students who are experiencing sexual problems. Leaders have been involved in the implementation and extension of the community. It develops student can communicate sexuality, reproductive health. The Children's Council produces online media to communicate and empower teenagers. All local and child protection funds have local provisions to support the budget. District Quality Development Committee, District Health Commission, Public Health Volunteers, and Community Leaders seek gender communication in communities. This is a participatory process that ensures that it complies with the sustainable development agenda.

This operation teaches teens to have understanding, promote equality of appropriate sex. Success factors are 1) Network partners must have knowledge, understanding and positive sexual attitude. 2) Systematic operation with the networking partners by the proactive support, morale, and 3) Policy formulation of the agency. School level 1) Teachers and parents have a positive attitude. 2) Teachers need to build trust and keep secret. Leadership development because the adolescents are close and accessible and can provide counseling. Creating a mentoring system on the LINE encourages adolescents to access the service conveniently and confidently.