PPAT’s Strategic Plan 2011-2015
The Planned Parenthood Association of Thailand under the Patronage of Her Royal Highness the Princess Mother is a non-profit organization that since 1970 has been a pioneer in supporting the family planning program of Thailand. Since 1977, it has been a Member Association of the International Planned Parenthood Federation (IPPF). Well known by its acronym, PPAT, the Association is now in its fifth decade of operation.
Over that period Thailand has successfully decelerated its population growth rate to a satisfactory level. However, rapid changes in the country’s economic and social situation, especially the rapid development of communications technologies, have resulted in a number of social problems. In light of those problems, PPAT developed its first five-year Strategic Plan 2005-2009 by expanding the coverage of its work to include reproductive health issues. That Strategic Plan emphasized the management of resources and the development of expertise to meet the needs of the people, and made outreach activities its top priority. PPAT has also established networks with communities nationwide and has utilized the mass media to disseminate information on and advocate for sexual and reproductive health and rights for adolescents and young people, as well as on HIV/AIDS, unplanned pregnancies and access to reproductive health information and services, among other topics. In the course of its operations, PPAT also developed an effective system of administration and management to attain the objectives of its strategic plans.
The PPAT Strategic Plan 2011-2015 is the Association’s second such plan; it has been designed in accordance with the reproductive health situation of the Thai population, including various ethnic groups. Although the Strategic Plan 2005-2009 was a five-year plan, owing to political instability and national policy during that period, PPAT decided to extend the plan to 2010. The Strategic Plan was developed in cooperation with the PPAT Council, Advisory Committees, members, volunteers and staff. In all its functions and regular work, PPAT receives good cooperation from specialists in governmental and non-governmental agencies in terms of opinions and suggestions given by trainers, researchers, implementers, and funding agencies, as well as people in target areas.
Sexual and Reproductive Health Situation in Thailand
Reproductive health is one aspect used for measuring the quality of life of the people with regard to reproduction and sexual health, physically and psychologically, which is coherent with the social norms, sexual behaviors and genders of the population in all age groups, from the moment of impregnation until death.
The promotion of sexual and reproductive health requires cooperation from all segments of society. Engaging with international organizations in networks helps reflect the image of Thailand at the international level by demonstrating that the country gives high priority to reproductive health and rights for all population groups, and that it promotes women’s reproductive health and rights, as well as gender equity.
Rapid changes in Thailand’s economic and social situation, the development of communications technologies and high awareness of family planning that exists among the people, all played a role in enabling Thailand to successfully reduce its population growth rate from a high level in 1970 to a low level now. Thailand’s annual population growth rate is currently about 0.5 per cent, and it is likely that the rate will continue to decline further over the next 10 years. However, while Thailand is no longer facing the problems caused by a high population growth rate, other population and social issues are emerging, such as the break up of families due to economic problems and the exploitation of and violence against women and children, all of which have a negative effect on reproductive health. In response, the Thai government has attempted to address such issues; it has established measures to prevent a situation where the population is smaller but of lower quality. Thus, those measures need to be sustained and made permanent, if Thailand is to realize the development of the high-quality population envisioned in its stated goal.
Maternal and child health is one aspect of population development which starts when a person is born. Researchers have found that approximately 2,500 girls under 15 years of age become mothers each year, as do 84,000 girls between 15 and 18 years old, and 20 per cent of young women 19-20 years old. Research has shown that it is inappropriate – physically and psychologically – for females between 15 and 20 years of age to get pregnant or bear children. Further, with regard to obstetric care, approximately 5 per cent of women giving birth in Thailand do not receive proper medical care, a situation which could be harmful in terms of maternal and neonatal health. A related issue is iodine deficiency during pregnancy: it causes disorders in fetal development, and can result in miscarriage, as well as physical or mental disability in infants. As for neonates, each year approximately 9 per cent of newborns are delivered underweight, which in absolute terms means that as many as 70,000 infants annually may have underlying health problems or become unwell. There are also other neonatal problems, such as disability, and infections transmitted from mothers to infants, among other kinds of disorders. Each year approximately 240 infants are infected by their mothers with the human immunodeficiency virus (HIV), which can lead to the development of the acquired immunodeficiency syndrome (AIDS). Infant mortality is approximately 10,000 annually and maternal mortality is about 400 women per year.
There are other serious reproductive health issues too. Although it is estimated that approximately 1 million women get pregnant in Thailand each year, only 800,000 infants are delivered. This situation implies that as many as 200,000-300,000 women terminate their pregnancies annually. Moreover, about 20,000 women receive medical care annually for complications resulting from miscarriage. These figures show that Thailand still faces problems regarding unplanned pregnancies and unsafe abortion.
Unplanned pregnancy – which usually becomes an unwanted pregnancy – is often caused, in part, by domestic and sexual gender-based violence. The many frequent news reports and the number of lawsuits filed annually attest to the fact that such incidents of sexual violence toward young people and women have become commonplace. It may be presumed that the number of such incidents is actually much higher than what is reported. Globalization, changes in social structures and weak family bonds often lead young people to engage in premature sex, which puts them at risk of unplanned pregnancies and infection with HIV and other sexually transmitted diseases. Evidence in support of this observation is that the overall number of persons newly infected with HIV has declined, but the proportion thus infected among young people and married women has increased.
Developments in the area of medical care and health technologies are enabling people to live longer; however, that desirable situation combined with low birth rates has created a new issue: rapidly increasing numbers of older people (60 years and older) in the population. According to a national survey of elderly people undertaken by the National Statistical Office in 2007, the population of older persons in Thailand accounts for 10.7 per cent of the total population, a situation which has implications for dependency and health care, among other things, as that proportion will increase in the future. Research on mental health conducted in 2008 by the National Statistical Office found that the population of older persons had poorer mental health compared with other population groups; the mental health of this segment of the population was found to be 20 per cent lower than the average for the overall population. The causes were chronic diseases, physical regression, and depression due to the loss of self-esteem as a result of the declining economic and social roles played by the elderly. Older persons were found to be suffering from anxiety, stress, mental disorders, depression, or dependence on drugs. Older persons deserve better: during their lifetime this population group contributed significantly to the nation, society, their communities and their families. Many of them have the capacity to contribute even more, but their capability, knowledge and experience are not as well utilized as they should be.
These are some of the dimensions of the population issues that Thailand has dealt with in the past and which it faces now and into the future. Such issues have been the baseline for PPAT’s Strategic Plan 2011-2015.
To prevent and resolve problems occurring among young people, it is necessary to build immunity among them by disseminating knowledge and understanding about sexual rights, reproductive health services and rights, including the dangers posed by illicit drugs, and by carrying out initiatives to prevent their misuse.
The measures to reduce infection with HIV and sexually transmitted diseases should be continued, as well as the care of and treatment for HIV-infected persons, the protection of the rights of people living with HIV, and the improvement of the quality of life of people infected and affected by HIV/AIDS, without any discrimination.
In order to prevent and tackle problems of unplanned pregnancy and unsafe abortion, PPAT will provide counseling services, targeting young people and women, with the aim of empowering them to make informed decisions and receive appropriate and good quality services.
Accessibility to reproductive health information and services
The efforts to improve the quality of life of the population thoroughly and equally, particularly among women, disadvantaged groups, and difficult-to-reach groups, whether because of location or social condition, and the population with unstable status, have to utilize a strategic approach which is aimed at being effective in increasing the access of the population, without regard to gender or age, to reproductive health information and services.
Thai society currently is still at the turning point with regard to change. Reproductive health is still one of the most contentious issues in the country; therefore, it is necessary to continue advocating for reproductive health, especially reproductive rights.
The aging population still has the potential to take part in developing Thai society and the country, particularly in serving as a pillar for the family and in promoting reproductive health which conforms to the country’s traditions and culture. Additionally, continued capacity-building for the aging population is important since older people have significant potential for supporting the development of this age group and increasing its importance.
Economic instability in the country and globally has adversely affected PPAT in terms of funding for its programs. Therefore, it is necessary to support the development of the Association’s management system in order to strengthen the capacity of the organization to working toward sustainable self-sufficiency.