Questions/Answers

Currently, teenage pregnancy is a critical problem in the world. Now Thailand is ranked the second in ASEAN. Roi-Et had reported that women of 15-19 years of age have a repeated pregnancy rate at over estimated by 13.86% while national rate does not exceed 10%. In Roi-Et Municipality during the year 2015-2016, there were 0.7% and 1.0% pregnant women aged 15-19 years old respectively. From this situation, Roi-Et Municipality had studied the problems of premature pregnancy using a unique child-center approach. The objectives were explored the promotion of sexual values and organizing environment in the community for proper sexual expression. The focus was to minimize the societal inequality of adolescents experienced pregnancy problems and to prevent issues with the unborn baby. This innovative approach in protecting teen pregnancy is an extension to the holistic sex education program. Operations focus on creating collaboration between schools, communities and local health workers by building trust via offline-online approach, such as, teachers’ home visit and ICT tool implementation. A novel communication channel was introduced by using the LINE@ group instant messaging mobile application called "Teenage Friends". The professional nurses take personal counseling and education program were introduces to members by this channel. LINE@ is also used to help the youth to solve the problems. Multidisciplinary team of counseling is based in "Sisterhood," to create values and the proper environment. The result in 2017, found that 15-19-year-olds adolescents had lower pregnancy rates from 2016 (from 1.0% to 0.6%). The 6 pregnant adolescents were able to return to education and be accepted by family and lived in society with dignity. The working group also learned the problem solving process and realized that giving love and understanding teen's sexual changes in the family is needed. Finally, the innovative helps to prevent premature pregnancy effectively.

An innovative approach in premature pregnancy prevention puts importance of prevention of inappropriate sexual act by educating and refusing skills to protect oneself and establish more self-esteem. This focuses to all the youth, both male and female. Even when problems arise, if there is no access to help solving the problem, it may be viewed as the girl's fault. Stigmatization of woman is placed, even if she has really been the victim. Innovation on pregnancy prevention helps society and families to play a role in problem solving; both protection and remedies, to empathize with the pregnant girl. She should receive educational opportunities and return to society with dignity.

The work complies with three goals of the 2030 Sustainable Development Agenda, as follows. The innovation aims to end premature pregnancy problems and discrimination against women and girls. When the problem were occur, if teachers or parents do not understand and punish them by forcing them to leave the school, the girls do not receive an equal education and opportunity to work, while the boy may not seem to be affected. So that innovation of premature pregnancy prevention can promote gender equality (SDGs 5). Also, this innovation aims to educate young people about sexuality, guided to proper contraception and knowing the law on women's rights. Innovation has a clear purpose in helping teens, which can maintain in education system equally, even if they are facing problem of premature pregnancy (SDGs 4). Finally innovation can prevent pregnancy in adolescents at an age when her body is not ready to have baby. There is a risk for survival of premature baby. Many health problems will be followed. So we believe in educating of self-protection. This will reduce the risk of both the mother and the baby. Its result is on a better quality of life. (SDGs 3)

Innovation is the process of educating, management mechanism, and protection to reduce the unwanted pregnancy rates. It helps the youth to know what will happen. It includes the process of participation of all sectors. We need to work together to solve the problem together by using the child center. The girls deserve help in order to get back to normal life in society. Typically, public services may not be accessible to at-risk youth. This causes many social problems to follow. So this innovation can be modified to fill the gap and increase the outreach of youth groups.

Innovation of preventive premature pregnancy makes a great contribution to the youth, family, and community in preventing problems for the families of the young women. The baby is born in a family where living conditions are unprepared. The innovation encourages youth to learn about sexuality to prevent premature pregnancies from being a problem of society. Children are not abandoned as orphans. Parent and families understand the problem. Mental remedies for children and families are supported. They do not need to face the problem alone.

This innovation is an integrated concept of public health and compulsory education. It’s focuses on the knowledge, school involvement, communities and families. Modern communication technology such as LINE@ group is an accessible communication channel to reach youth. They find it the place to consult. Young people have the courage to communicate their problems with their roommates. They can help oversee and supervise the problems of premature pregnancies to occur. The teachers will monitor the risk behaviors for the children in the school system and the community. In the case of unwanted pregnancy, the teacher will coordinate with the Municipal Health Center 1, the center will coordinate with the departments of the Ministry of Public Health at Roi-Et Hospital (Teen Clinic) to get proper counseling and care. At the same time, the Mental Health Center 1, will provide physical and mental support. All youth, family, and school are involved to help young people get back into education. Family and society welcome normal youth without social problems.

Innovation in prevention of premature pregnancy is a development of holistic sex education. There are active sex education activities for the youth group separate from the regular courses in the school. The group instant messaging application (LINE@) called "Teenage Friends” has been developed for the youth to access more easily. It provides young people with instant access to information and services. The communication information of the client and the counselor is confidential. It ensures the trust in counseling and good relationships with the youth. Sisterhood has been main focus on relationship.

The innovation include many resources, that verify how important and completely of it, the resources as follow; Money: The innovation is funded by the Roi-Et Municipality Health Insurance Fund. The educational program is funded with a budget of 45 baht per capital by the Health Insurance Fund and 27 baht per capital by Roi-Et Municipality (total 72 baht). Personnel: The multidisciplinary team consists of physicians, pharmacists, professional nurses, social workers, community committee, parents, teachers, and student friends. Materials: Informational materials such as pamphlets, demonstration equipment (both permanent and temporary contraceptives) and pregnancy test kits. Technology: Communication technology by using group instant messaging application (LINE@) to answer questions and express opinions individually. The information is kept confidential by trained nurses. It takes a five minute questioning session. Sex education session is provided once a week. These are good ways to communicate with the youth.

Yes

The operation of innovation has been transferred to the participating schools. They are 4 secondary schools in the municipality. A Stop Teen Mom Roi-Et Municipality Model (STM Roi-Et Model) is introducing prevention of premature pregnancy. This is a good way to protect them from unwanted pregnancies. There is a plan of lesson learned in preventing premature pregnancy in youth to be presented in other schools in other agencies and other municipal in the municipality league meetings.

The aim of the innovation is to prevent premature pregnancy in youth at school age to have the correct sex education and to provide families and teachers with attention to the young who are curious. It attempts to understand and solve problems rather than to punish them when problems are found. It is a reflection of the problem to society. It builds a society for safe environment from sexual intimidation, both intentional and unintentional. It also encourages group of friends to help friends to strengthen youth relationship. It provides appropriate guidance to solve the problem in the right way. They have convenient access to the information needed to protect themselves. It also promotes correct sexual values and beliefs. If the youth can graduate compulsory education, they will have a chance to get a good job and earn more family income. Innovation also promotes problem solving through the use of Child Center to be more comprehensive and sustainable.

Innovation of prevention in premature pregnancy (Stop Teen Mom Roi-Et Municipality Model: STM Roi-Et Model) is a continuation of the holistic sex education program continuing from 2012 and expanding into schools and communities. The schools have brought the project to a network of school prototype in sex education. Currently, there are 4 participating schools, which are secondary schools in Roi-Et municipality. The innovation will be extended to outside schools.

Yes

Innovation in preventive premature pregnancy (Stop Teen Mom Roi-Et Municipality Model: STM Roi-Et Model) is part of the 5-ring local innovation network (under the Health Promotion Department), which has been evaluated by the Decentralization Commission of the Local Administration Organization. It won the first place among large local government group, with outstanding management where featured innovation of 5-ring local administration organization (under health promotion) in 2017.

The innovation’s results in the year 2017, proactive sex education is now provided in all Roi-Et Municipal schools, which are included in the curriculum. The total number of 1,573 upper and lower secondary students participated in the workshops. This encourages them to participate in the discussion on sexuality through demonstration and teaching correct methods of contraception. There are brainstorming activities to solve the problem. Evaluation is conducted before and after the training. Post-training knowledge was higher than before training at 68% and 85% respectively. Qualitative results found that 15-19-year-olds had lower pregnancy rates from 1.0% (in 2016) to 0.6% (in the year 2017). They are accepted by their family and live in society without problems. The working group also learned the problem of solving process by involving young people, teachers, counselors and families. They realized to give enough love and understanding in the family is necessary. They understand the sexual changes of youth from consultation to a professional team in "Sisterhood" concept. It enhances creation of sexual values and right environment to prevent premature pregnancies. This model can be transferred to other communities where they have similar problems.

Innovative prevention of premature pregnancies complies Sustainable Development Goals (SDGs) 3 SDGs as follows: This innovation will help at-risk youth to know how to protect themselves from premature sexual intercourse and maintain a healthy body. Because of the body of the teenager is not ready for physical demands of motherhood, if she gets pregnant, it may cause harm to both mother and baby (SDG3). It’s educates youth in Roi-Et Municipality about the right method of contraception, the rate were 44.12% between 2015 and 2016 (the SDG 3 Objective (Section 3.7.1). The innovation can reduce the pregnancy rate among adolescents (10-14 years and 15-19 years) from 1.0% to 0.6% in 2017 (SDG 3 (Article 3.7.2). Six adolescents were remained in compulsory education at secondary school level at 100%. (SDG 4: Section 4.1.1) Also, this innovation can help prevent marriage or stay together before age 18, down from 1.0% to 0.6% (SDG 5: Section 5.3.1). In finally, this innovation allows young people aged 15-19 to make the right decision to plan their own contraception. The rate of contraception in the age group 15-19 was 44.12%. (SDG 5: Section 5.6.1)

This innovative prevention of premature pregnancy of Roi-Et Municipal explores the problem, knowledge, attitudes, and behaviors related to premature pregnancy among the students under the Roi-Et Municipality in 4 schools. There is a brainstorming platform in the group of stakeholders to recognize the problem and impact which will occur as well as to find solutions together. Each party plays a role as followings: 1) Family of Youth and Community. They play a role in awareness raising, co-decision making in problem solving. They encourage families to have proper sexual behavior. 2) Community health volunteers. They jointly search for at-risk youth or inappropriate sexual behavior as well as the correct knowledge about sexual behavior, contraception, persuasion to join the project, and monitor the behavior of the risk group. 3) Roi-Et Municipal Team. They support and plan the projects and activities to coordinate cooperatively with all sectors. They create communication channels to provide youth with access to essential knowledge about appropriate sexual behaviors through the LINE@ group. It accepts the questions from the youth who are interested in getting the right information to have more appropriate behavior. 4) School's youth team. It consists of class teachers, health education teachers, school administrators, and schoolmates. They play a role in educating right understanding, monitor risk behaviors, and create the right environment in sexual expression. 5) Professional team. It consists of physicians, pharmacists, nursing professionals, psychologists, Thai traditional medicine, and social workers. They play a role in assessing the problem and being an intermediary to coordinate understanding between youth, families, and schools to provide appropriate problem-management.

1.Families are aware of the importance of caring, counseling, forgiveness are more preferred than censoring. Opportunities are needed when the youth makes mistakes. Nevertheless, premature pregnancy not accepted by Thai society. Therefore, the parents should understand when pregnancies occur, they should give the opportunity to make corrections and provide solutions to the problems. They should not judge by having them leave school or married. Adolescents should have the rights to choose which way they wish to take. 2. Community is aware of the cooperation in creating appropriate environment to express values of sexual expression. 3. School have learned attitude and behavior of the youth they responsible for. They learn how to solve premature pregnancy problems in youth and bring knowledge to transfer to other schools in similar context of urban community. Promote teaching of refusal skills about sex to prevent premature pregnancy problems. 4. The professional team also learned the problem from solving process with the participation of youth, teachers, counselors and families. They realize to provide loving attention and understanding from the family. Consultation of a professional team is based on "Sisterhood". It ensures the creation of values and right environment to prevent premature pregnancy.