Estimation of the adolescent pregnancy rate in Thailand 2008-2013: an application of capture-recapture method

Community pharmacists' roles in providing contraceptive services: views and experiences of adolescents in urban Khon Kaen, Northeast Thailand

OBJECTIVES

Adolescent pregnancy is a national public health priority in Thailand. While contraceptive methods are available to prevent adolescent pregnancy, Thai adolescent contraceptive usage is low. Community pharmacists are likely the first health professionals to contact adolescents engaged in unprotected sex and needing emergency contraception. However, there is limited research on Thai pharmacists' roles in promoting sexual and reproductive health. This study examines Thai adolescents' perspectives on community pharmacists' roles in promoting contraceptives and preventing unwanted pregnancies.

METHOD

This qualitative study recruited 38 adolescents aged 15-19 from one vocational school and one secondary school in Khon Kaen, Thailand. Data were collected from focus group discussions and in-depth interviews and analysed using thematic analysis.

KEY FINDINGS

Participants felt community pharmacists had potentially critical roles in promoting adolescent contraceptive use. Community pharmacists had relevant knowledge of effective contraceptive methods, the risks and benefits of each method, and the quality of different condoms available. Community pharmacists, at times, also provided emotional support to distressed adolescents who came to their store. However, participants reported pharmacists' age, gender, and non-empathetic and judgemental attitudes could be barriers to adolescents' ease of access to contraceptive services.

CONCLUSION

This study highlights the potentially crucial role community pharmacists could play in providing contraceptive information for adolescents. It suggests the need for changes in government policies and education and training of community pharmacists to enhance their soft skills - empathetic and non-judgemental attitudes - and their roles in delivering youth-friendly sexual and reproductive health services.

Change of contraceptive preference after the free-LARC program for Thai teenagers

Background

In 2014, the Thai government launched a free-of-charge long-acting reversible contraception (LARC) program for Thai female adolescents. However, its acceptance had not been reported. Therefore, this study aimed to describe contraceptive use among women of reproductive age before and after the program was implemented.

Methods

This retrospective cross-sectional study was carried out from the medical records of 9000 women of reproductive age, who attended the Family Planning Clinic at Maharaj Nakorn Chiang Mai Hospital between 2009 and 2018. The Chi-square test was used to compare the contraceptive methods administered before and after the program was implemented, and binary logistic regression was used to find the factors associated with implant use after completion of the program.

Results

Depot medroxy progesterone acetate (DMPA) injection was the most popular contraceptive method used among 40.9% of the women. The rates of subdermal implant use were increased significantly after the program was implemented (2.3–9.3%, p < 0.001). Implant use for adolescents aged less than 20 years increased from 2.6% to 56.4%, while DMPA was the most popular method used among adult women at 36.4%. Factors associated significantly with implant use after implement of the program included age of less than 20 years (aOR = 4.17 (CI: 1.84–9.44); p = 0.001) and nulliparity (aOR = 8.55 (CI: 3.77–19.39); p < 0.001).

Conclusion

This study showed a significant increase in contraceptive implant use after the free-LARC program for adolescents had been applied.

Statement of implications

Contraceptive implant is the most effective hormonal reversible contraception. Its use rate is low among all age groups, but increased clearly after the free-of-charge program was applied for adolescents.

Developing and evaluating the Teen-Strong life skills programme in Southern Thailand

Risk sexual behaviours are known as a threat to health and wellbeing of adolescents. Although there are standard sexual education curriculums in Thai schools, most schools use traditional teaching methods rather than participatory teaching activities. This study aimed to (i) develop 'Teen-Strong' programme by combining the concept of the World Health Organization's life skills programme with Thai sexual education curriculum and (ii) investigate the association of Teen-Strong programme with knowledge and decision-making regarding risky sexual behaviours and teenage pregnancy in Thai adolescents. The Teen-Strong programme was developed by means of experts review and cognitive interviewing process and evaluated in 66 adolescents in Grades 7-9 from six schools in southern Thailand. Twenty-six students were assigned to the experimental group (attended Teen-Strong programme and standard sexual education) and 40 to the control group (attended only the standard sexual education). A pre-post-test quasi-experimental design was used and the Teen-Strong questionnaire (TSQ) was administered to measure knowledge and decision-making at three time points: before (T1), immediately after (T2) and 1 month after (T3) attending the programme. A 2 × 3 mixed-design ANOVA was used to analyse the data. TSQ scores in the experimental and control groups were higher at T2 and T3 as compared with T1. Mean increase in TSQ scores at T2 and T3 compared with T1 were significantly higher in the experiment than the control group [T2 vs. T1: t (64) = 4.07, p-values < 0.0001; T3 vs. T1: t (64) = 3.32, p-values = 0.017]. This study showed that Teen-Strong programme could increase adolescent's knowledge and decision-making skills regarding risk sexual behaviours.

Effects of mobile health education on sexual and reproductive health information among female school-going adolescents of rural Thailand

Background: Adolescent pregnancy is one of the major public health issues globally, as well as in Thailand. Sexual health literacy (SHL) has been a proved effective intervention for preventing teenage pregnancy.

The objective of this study was to evaluate the effects of mobile messages to improve sexual and reproductive health literacy among secondary school female students.

Methods: A comparative cross-sectional study with pre–post design was conducted in two secondary schools of rural Thailand. 128 respondents were selected through a simple random sampling method; equal number of female secondary school students were selected from each school. Health education through mobile messages on sexual and reproductive health literacy were delivered in one group while the other group was observed through routine care for 24 weeks. Baseline (pre) and endline (post) measurement was taken to compare the effects of mobile messages. Study was ethically approved by the institutional review board of Chulalongkorn University, Thailand.

Results: Both groups were same at baseline and found statistically non-significant (p>0.05). After the 24-week health education program, the mean scores of health education groups was found statistically significant (p<0.05), while the mean score in observed group did not show any statistical change (p>0.05) . Level of sexual health literacy scores among female students in the health education group was found statistically significant (p<0.05) in all four domains. While, the observation group was remained same at both measurements pre and post (p=0.521).

Conclusion: The study concluded that the mobile messages have proved an effective information method for sexual and reproductive health information among female secondary students of rural Thailand.

Gross motor development of Thai healthy full-term infants aged from birth to 14 months using the Alberta Infant Motor Scale: Inter individual variability

BACKGROUND

The gross motor percentiles of the Alberta Infants Motor Scale (AIMS) have been commonly referenced in research. Cross-cultural assessment of gross motor development during the first year of life is suggested as diverse child-rearing practices can cause inter-variability. The main aim of this study was to develop an AIMS percentile curve for typically developing home-raised infants in the northeastern part of Thailand. The AIMS scores of these infants were also compared with the standard Canadian norms.

METHODS

The gross motor development of 574 full-term infants aged 15 days to 14 months was assessed using the Thai version of the AIMS. Percentile curves of their gross motor ability were developed. The Thai infants' mean AIMS scores were compared with the Canadian norm using the one-sample t-test.

RESULTS

The percentile curve of gross motor development of healthy Thai infants showed that mean AIMS scores increased with age. Large inter-variability was present from the 7th to 10th months. The mean AIMS scores of Thai infants were significantly lower than the standard Canadian means during the first three months (P < 0.05), but significantly higher in three age groups: 7-<8 months, 11-<12 months, and 13-14 months.

CONCLUSION

The developed percentile curve of gross motor development is applicable for infants from the same demographic and environmental context. According to the study, infants from diverse cultures display a natural inter-variability in gross motor development between the 7th and 10th months.

Estimating the number of farms experienced foot and mouth disease outbreaks using capture-recapture methods

Foot and mouth disease (FMD) is recognized as an endemic disease in Thailand and throughout other countries in Southeast Asia. The underreporting of FMD outbreaks has affected the true status of the disease. This study aimed to determine the number of dairy farms in Chiang Mai that had experienced FMD outbreaks (FMD outbreak farm) during 2015-2016 using capture-recapture (CR) methods. Two independent FMD outbreak data sources including data from the livestock authorities and survey questionnaires were analyzed using Chapman estimator and Chao estimator. Results showed that the estimated number of FMD outbreak farms was 264 (95% CI = 250, 277) and 273 (95% CI = 259, 292) farms based on the Chapman estimator and Chao estimator, respectively. The estimated prevalence of FMD corresponding to the Chapman estimator was lower than the Chao estimator. The active approach of the survey method offered a higher degree of sensitivity compared to the passive method used by the livestock authorities. Estimations from the CR method provided an upper bound for the true number of outbreak farms. This study demonstrated the use of the CR method to estimate the true status of FMD outbreaks. Our proposed approach can potentially be used as a tool to enhance the accuracy and sensitivity of established monitoring and surveillance systems.