Questions/Answers

Thailand has high extremely teenage pregnancy birth rate. In the year 2010, Sisaket province has birth rate about 42.50 per thousand population. In the municipality of Sisaket has birth rate about 32.23 which caused from the rack of knowledge in sexual education and unequal access to condoms among adolescents. Thai culture, male adolescents usually use condoms, not female. To access the condom services or condom equipment were restricted to buy and condoms are expensive. Serious affects to adolescents, lead to unwanted pregnant teenagers and effected to the physical, mental, emotional and social. Sisaket Municipality has been begun the project “Unwanted pregnant teenager prevention in school” for decreasing adolescent pregnancy rate by using the sexual comprehensive education course to in-depth educate for school administrators, teachers, students, community health volunteer (VHV), and people and increasing the access to condom sales services for promote gender equality in the Municipality area by preparing condom sales dispenser for women adolescents to prevent themselves.

Unwanted pregnant teenager prevention in school Project is to promote gender equality both men and women. Increasing the procession of access to condoms for female adolescent will decrease adolescent pregnancy rate. This initiative align with category 3. In Thailand that most teenage pregnancy caused by lack of readiness for family planning or having unprotected sex. These reasons will cause pregnant teenager lack opportunity for learning in school because they are forced to drop out of school after they are pregnant. This innovation raises gender equality in public services which can be a plan for Sustainable development.

This initiative aligns with UN sustainable development goals 5: Achieve gender equality and empower all women and girls. Not only the problem of lack of readiness adolescent pregnancy occurs in the Sisaket Municipality area, but also the problem of gender inequality to access to preventive pregnancy equipment and sexually transmitted disease which is the condoms. These problems resulting in teenagers becoming pregnant and had to leave school. Teenage boys do not have any responsibility for these. Thailand has the adolescent pregnancy prevention and solution Act 2016 which aims to enable schools to provide the sexual education. The school must provide and develop teachers, including a system of care, support and protection for pregnant students to receive appropriate and continuing education. All associate partners, public and private sectors, must cooperate in organizing an environment to facilitate the use of condoms among children and young girls. All partners must prepare a memorandum of agreement between Sisaket municipality and all school in the area and support the operating budget to achieve success.

Teenage pregnancy has serious impacts on families and educational institutions, as well as creating problems to develop Thai society. Social term: This initiative lets Teenage pregnancy gain more educational opportunities, opportunity to come back to school, decreasing the adolescent pregnancy, adolescents have good sexual health, with better potential. Economic term: Teenagers get high education, good career with quality labor, more opportunity for gaining stable income, and receiving professional training to generate income. Environmental term: Providing accommodation for the affected group, develop and improve accommodation to be safe.

The original problems, we lack cooperation in integration. The school does not offer sex education courses, lack of sex education personnel and there are restrictions on access to people services and lack of supporting powerful equipment for pregnancy. To solve these problems, we have integrated all sectors and prepared a memorandum of understanding to drive solutions to the problem of adolescent pregnancy by developing comprehensive sexual education courses to educate target groups, while increasing the opportunity for access to condoms and contraception.

Thai culture, woman must be polite and to be reserved for preparing until marry and has been taught that Sexual is a shame and shouldn’t be talked in public. If the pregnancy happened, they blamed female. This initiative is designed to reduce the gender inequality by adjusting attitude and acceptance of school administrators, teachers, students, parents, public health volunteers, public health staffs and other people. We aimed to educated teens and children to learn about life and sexual health skills, protective sex, learned that they had the right to make a decision and opportunity equally.

This initiative has positive impacts. - Children and youth have been reviewed and filtered into sections, 15 children and teens vulnerable groups, 21 children and teens in some affected groups, 16 children and teens returned to the classroom, 2 children and their families forwarded. - 52 adolescent mothers have been visited after giving birth, and they have been stopped pregnancy by implanting contraceptive 20 mothers. - 40 underprivileged teenage mothers have been receive vocational training from Sisaket municipality. The results of the project implementation in all educational institutions 27 places in the municipality of Sisaket Municipality, such as 1,536 teachers taking sexual comprehensive education course, expanding results to 6,300 pilot students, passing on knowledge to 32,426 students in the classrooms. As the result, teenage pregnancy rate (2016-2019) had decreased from 13.97, 10.94, 6.69 and 0.95 respectively. Comparing the SiSaKet province, has a pregnancy rate of 26.74, while Thailand has a pregnancy rate of 39.60 in 2018.

This initiative is the policy of Sisaket Municipality and is the provincial agenda. The development of the comprehensive sexual education courses, which is applied from the curriculum of the PATH organization to be in accordance with the local circumstance, by changing the process of teachers in schools to be a center for passing on knowledge about sexuality education, moved forward educated to 1,536 teachers, 500 pilot teachers, 10,300 children, and youth pilots have been created. We call "Joo Jim Yim Sod Sai”, which meaning of healthy penis and vagina. We have to create a risk group surveillance system in the school, train 580 parents to expand the knowledge of all-round sexuality education for families, expand the community by training 150 volunteers and informal youth to bring knowledge to counseling teens in the community. Increasing the opportunity to access free condom corner services, from 5 community health centers and in the community areas, we have been supported the free condom in all 27 schools and educational institutions through sex teachers, student pilots and youth, parents, a total of 22,860 pieces. The private sector organizes cheap condoms in all gas stations in the municipality areas which we have only men toilets in the past but now we have both men and women toilets, including the promotion of condom use in female adolescents for safe sexual health, including adjusting the family's attitude Communities and service providers in community health center staff, providing friendly services for teens. There are 50 sex education curriculum courses have been taken. Performance evaluation from supervision of the Health Security Fund Committee, shows that adolescents Birth rate in the Sisaket Town Municipality has been continuously decreased.

Obstacles: Regarding attitudes of school administrators, and some parents do not agree with the importance of teaching about sex education in schools. They think that it is unsuitable for their age and Government education programs cannot be solve the problems. Solution: Creating the comprehensive sexual education courses for the school administrators (executive session), which making the agreement of administrators and All 27 schools in the Sisaket municipality have been participated in the projects. Especially at the elementary school level, teachers have been changed attitudes and understanded the curriculum that can be adapted appropriately according to age.

The initiative is innovation about the condom vending machines which is cheapest for female adolescents. In the past, we had the condom vending machines only in the male toilets. They had never setting up in the female toilets because Thai society value focus the use of condom with male. Female should not have sex before getting marry. If female go to the convenience stores, they will be insulted from sellers and condom will be expensive too.

This initiative has been developed the comprehensive sexual education courses which making children and youth have the knowledge of safe sexual health. They can use the equipment to protect the adolescent pregnant. If we do not have the equipment to prevent the pregnant because inequality that female adolescents can not reach, the knowledge of comprehensive sexual education could not lead to practicality. These will cause unwilling pregnant and sexually transmitted infection.

The comprehensive sexual education and life skills have published on YouTube. We have embraced the results of the initiative of sexual education and sexual educated short films from schools and educational institutions are published on the website and Sisaket municipality’s web pages for children, youth and partners. We also have advised about sexual education by line and Facebook for adolescents who do not want to expose themselves.

The initiative has been passed on knowledge. 1. Selected as a Model Local Government Year 2018, and convey the lessons to 400 Local Administrative Organizations in the 10th Health Service Area. 2. Join the network seminar with the Department of Disease Control, develop a disease prevention and control system in the city, as a source of study visiting to manage the health care system of the city on the model of health promotion of the learning exchange community in 2018. 3. is a study site on health service provision in the community and in the educational institution of students Master of Arts Program and Doctor of Philosophy Program International Health Social Sciences Mahidol University 2018 4. Sharing knowledge with the Department of Health, Ministry of Public Health. Drive the prevention and resolution of pregnant adolescents, and become a convoy lesson speaker for 600 local government organizations nationwide, the Public Health Office Health centers nationwide 2019 5. Became a member of the Committee on Prevention and Problem Solving of Teenage Pregnancy in Sisaket Province, and have convey lessons in working for the relevant committees to be used in the operations of Sisaket Province.

Convey lesson of this initiative for local government organizations in Sisaket Province; Committee to Prevent and Solve Teenage Pregnancy in Sisaket Province, all 3 related committees to be used in the operations of Sisaket Province. In the strategy 1 Development of an educational system that promotes sexuality education and life skills with the provincial education chief as the president. Funding method: use the budget from the health insurance fund of Sisaket Municipality and arrange the course, organize the sexual learning plan to use in the lesson period. Teach them in the reduce the study time, increase the learning time period, in elective course and homeroom hours. From the beginning, only 1 model school in each district would be operated. Now we providing a new training program comprehensive sexual education. We aim that in the year 2021: 60 percent of the schools at each level have trained teachers, and reach 100 percent in the years 2026.

-This initiative is an educational innovation that is improved comprehensive sexual education course to suit the local cultural context. -Course tools: comprehensive sexual education and media. -Condom equipment and Condom selling machines -26 staffs responsible for the project, including Experts, psychologists from the youth shelter Community Health Center Officer, Clinic staff, and social worker. -Funding: For the processing of publicize comprehensive sexual education course, teacher training meeting for target groups, producing teaching and learning materials, organize a meeting, follow-up, evaluation, take lessons cost totaling 1,520,000 baht from the Local Health Security Fund or the Sisaket Municipality.

-This initiative is sustained because it has been a municipal policy since 2016, in accordance with the national strategy being the agenda in Sisaket Province, being the course to teach in every educational institution. -The dimension of the organization has made a memorandum of understanding between the provincial governor and the provincial administrators from five main ministries including Ministry of the Interior, Ministry of Education, Ministry of Labour, Ministry of Social Development and Human Security, and the Ministry of Public Health, integrating cooperation in the implementation of such matters with all schools and academy In order to receive a funding.

Yes

The Office of the Permanent Secretary, the Office of the Prime Minister, Thailand, has organized an annual award competition to select outstanding administrative organizations which exemplify high quality of public services, initiate local innovation, and demonstrate effective professional management. The first section is the Local Performance Assessment: LPA. Which must pass about 80% of all categories. All categories consist of 5 parts such administration, personnel management, fiscal management, public administration and good governance all about 235 indicators. The second section is the evaluation of advisory University by using T-Score from 5 categories. The third section is the evaluation of the committee by using the point of the innovation of local organizations.

The first section is the Local Performance Assessment: LPA. Which must pass about 80% of all categories. All categories consist of 5 parts such administration, personnel management, fiscal management, public administration and good governance all about 235 indicators. The second section is the evaluation of advisory University by using T-Score from 5 categories. The third section is the evaluation of the committee by using the point of the innovation of local organizations, 5 categories as follows: Sisaket Municipality has been assessed using 5 categories as follows: No. Assessment Categories Results 1 Responding to local public problems Good 2 Impact on beneficiary groups Good 3 Project innovativeness Excellent 4 Quality of public participation Good 5 Project sustainability Fair Overall Very Good

The main findings of the evaluation have been Selected from the local government organizations with good management of the Office of the Decentralization Commission to local government organizations Prime Minister's office, getting the second prize about 4,000,000 baht. The main findings of the evaluation have been Selected from the Department of Health Ministry of Public Health with certification of the local government organizations Model in the prevention and treatment of adolescent pregnancy problems. Sisaket municipality have been adjusted the attitude of sexuality education by 27 schools in the area. We strengthen the sustainability of teachers transfer knowledge to next generation. We get the budget support from the health Security fund. We have the memorandum of the understanding in the prevention and treatment of adolescent pregnancy problems from all partners base on country’s strategies, which have caused cooperation in all sector, state, private, and civil society. The surveillance systems are strengthened in school which preparing for adolescent at risk of pregnancy, including access to condom services for female adolescents which is a new concept in providing strong sexual health care.

This initiative has been combined with the National Health Security Office Region 10, Ubon Ratchathani, which have supported the budget for health promotion and protection for Sisaket Municipality. It is also used as a model organization for prevention and correction of pregnant teenagers. In the 10th Health Service Area, which is regarded as a part of the public policy movement, which aims to meet the health needs of local people. To be aware Play a role in coping with community health problems, with Health promotion, which is essential and focus on reducing health risks, as social determinant of health.

Sisaket Municipality, main host and coordinator for all schools and institutions, all related network partner schools and educational institutions in the municipality. School administrators attending the brainstorming session to improve and train the all-sex sexual education curriculum in schools and institutions to adjust the viewpoint and perception of sex leading the sexual education curriculum into action by having the teacher attend the training And pass on knowledge about sex to students and parents public health service unit. Provincial Health Office Srisaket, Muang District Bureau Responsible for overseeing policies and indicators Operations in adolescents- Sisaket Hospital, an expert on sex education. The gynecologist has an obligation to end the pregnancy. Community Health Center 1-5 Clinic for young mothers providing friendly services to support Condoms and contraceptive services. Reliance Centers (OSCC) and Children and Family Shelter take care of children and adolescents who encounter problems. Private Thongchai Petroleum Support a condom cabinet at a cheap price of 20 baht in a gas station. Evaluation by the Health Security Fund Committee.

1. Schools and institutions have a broader perspective on gender perceptions, and use the sex education curriculum, increasing the access the condom in the school and institutions, among with driving Act. 2016 to prevent and solving teenage pregnancy into action. 2. Sisaket Municipality, the main host, has been managed sexual knowledge, network partners strong working together, focusing on problem prevention rather than solving at the end causes. 3. Starting from problems at the local level, data from research is managed as a base for prevention and correction, together with the policy of the management team, strong network partners in the government, civil society, private, budget support And supervised by a Memorandum of Understanding (MOU) for sustainability. The way to improve. • Increasing objectives and goals for reducing pregnancy in adolescents From 2014-2018, found that 4.54, 17.24, 8.33, 17.64 and 36.36 percent of repeated pregnancies are still higher than the target set for not more than 10 percent. Network partners should analyze the data and find solutions to reduce the repeated pregnancy. Development of sex education curriculum in families and communities In order to cultivate rights Gender equality of men and women.