3c4teen :  platform to call together the key stakeholders, to harmonize strategies and actions, and to bring in voices of young people

Background & Rationale:

Unsafe sex among adolescents has been identified as a persistent challenge in Thailand.  Evidence shows that delivery rates among 15 – 19 years adolescents increased from 49.3 in 2005 to 53.6 per 1,000 population aged 15 – 19 years in 2011[1].  Sexually Transmitted Infection (STI) rates among youth aged 15 – 24 increased from 41.5 per 100,000 in 2005 to 59.5 in 2008 and 89.5 in 2011[2].  Behavioral surveillance data collected from secondary school and vocational school students showed a decreasing trend of age at first sex across cohorts among school students and vocational school students[3].  It is also observed that the younger generations are entering puberty earlier.

In response to these findings, adolescent pregnancy has been identified as a priority in the National Reproductive Health Strategy (2010 – 2014).  In a meeting in 2012, the National Reproductive Health Development Committee had endorsed the national goal of reducing adolescent (15 – 19) delivery rate from 53.6 to 50.0 per 1,000 by 2017.  Several interventions have been intensified, including the new initiatives according to the six strategies of the National RH Strategy for (i) strengthened capacity of new generations, (ii) Promoting sexual and reproductive health, (iii) strengthened SRH services, (iv) developing integrated SRH management, (v) applying legislation on reproductive health and reproductive rights and (vi) promoting RH knowledge management.  Seven subcommittees have been appointed by the National RH Development Committee, six to look after these six strategies while one to intensify public relations on reproductive health issues.

Subsequently in 2013, the RH Development Committee decided to continue with three subcommittees on (a) promoting sexual and reproductive health, (b) applying legislation on reproductive health and reproductive rights and (c) provincial and Bangkok metropolitan implementation.  In this connection, Department of Health has formulated a National Plan for Prevention and Alleviation of Teenage Pregnancy for 2014 – 2018, with three strategies of:

  • Public Communications
  • Access to services by adolescent
  • Referral for support and alleviation

So far, much has been undertaken and more is emerging.  While Ministry of Public Health applies ASRH – Adolescent Sexual and Reproductive Health approach in health system, Ministry of Education and PATH – Programme for Appropriate Technology in Health implement sexuality education in education systems,  WHAF – Women’s Health Advocacy Foundation and THPF – Thailand Health Promotion Foundation support provincial implementation in communities, MSDHS – Ministry of Social Development Human Security provides alleviation support through the OSCC – One Stop Crisis Centers and Senate Subcommittee on Population Development is promoting youth-led interventions in schools.  Every team is highly productive.  It is, therefore, required to bring products of each team together to generate additive or multiplicative effects.

A quick assessment by UNFPA revealed three key challenges as follow:

  • Limited use of evidence to inform intervention: Linkages between current interventions and the endpoints of safer (protected) sexual behaviors among adolescents are not clearly demonstrated. Data used to track progress are around delivery, not pregnancy because abortion is illegal and stigmatized.  Attribution of interventions, alone and in synergy has not been quantified.
  • Insufficient ownership by young people: Voices of adolescents have not been well heard. Traditionally, programmes have been designed by adults without taking into account young people’s needs and likes.  Evidence shows that the most influential persons in the lives of young people are other young people.
  • Limited coordination of interventions: While national strategy and national plans are systematically formulated, translation into strategic interventions depends on organizational work plans and expertise.

To meet these challenges, UNFPA Thailand proposes to convene a Platform for Positive Sexuality of Young People in Thailand (PS-YP) using the Three C’s Strategy of Connect, Convince and Create.   In other words, UNFPA Thailand aims to call together the key stakeholders working related to young people’s sexuality and reproductive health and rights, harmonize strategies and actions, bring in voices of young people, and the Platform will enable translation of strategies into actions for responsible sexuality of young people, of which a main effect is reduction of Adolescent Pregnancy in Thailand.

 

The Three C’s Strategy

Connect Strategy – Make it possible for everyone to share evidence, ideas and initiatives, and act together in harmony

UNFPA Thailand will add value to existing interventions by bringing together both “people” and “content”.  Experiences from other networks show that once people who work in the same issues have regular contacts, team work is naturally strengthened and hence interventions harmonized.  Given growing numbers of stakeholders and activities, the “Connect” strategy is required immediately

  • Promote collaboration among key stakeholders and increase active engagement of young people and their enablers through effective communications with young people, stakeholders, and general public via mass media, social media, electronic and other relevant channels
  • Increase capacity and visibility of young people organizations such as the National Child and Youth Council, Youth Clubs, Youth Groups, Youth Networks, by reaching out to these organizations, equipping them with knowledge about their sexual and reproductive rights and communication skills to voice their own demands, and increase their meaningful engagement in the Platform and other youth policy process

Convince StrategyUse authentic voices and concerns to convince key actors of the need for pragmatic solutions

To address the issue of lack of ownership, non-participating authorities and young people will be informed of situation, trends, determinants, solutions and their roles.  Stakeholders who are connected will likely to have the same and authentic voices with good evidences to convince more stakeholders including adolescents, parents, teachers, service providers and social enablers to work together on pragmatic solutions.

  • Collect and distribute evidence on magnitude, trends and determinants of Adolescent Pregnancy in Thailand
  • Review local and international good practices then analyze what works in Thailand and elsewhere, in order to guide strategic investment.
  • Map current interventions and analyze coverage to guide targeted interventions to protect and empower vulnerable young people and those most at risk for Adolescent Pregnancy
  • Provide information and links to other sources of information for young people to lead positive and responsible sexual lives.

Create Strategy – Create an enabling environment for promotion of positive sexuality, including safe and responsible sex, among young people

A larger mass of stakeholders will enable young people to create and maintain safer behaviours, at the same time, will shift negative societal norm towards sexuality to positive and healthy social norms.

  • Support education of parents, educators, and the public at large on the causes and consequences of unsafe sex in young people, and how to help prevent it, to create positive changes in attitudes to the issue of responsible sexuality among young people.
  • Advocate for changes in laws, regulations, and curricula, in order to create an enabling environment for promoting positive and responsible sexuality of young people in Thailand.
  • Work with potential private-sector partners and the media to create long term societal support for maintaining empowerment of young people in Thailand.

The platform will be neutral and open-source.  It will endeavor to work with all interested parties and the products will be made available to all.

 

[1] Bureau of Reproductive Health

[2] Bureau of Epidemiology 2011

[3] Bureau of Epidemiology (YEAR).  Behavioral Surveillance among students in Thailand 2007 – 2011