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Operational strategy

PPAT Strategic Plan2017 - 2022

The Planned Parenthood Association of Thailand (PPAT), under the Patronage of Her Royal Highness, the Princess Mother, is a non-profit organization and has been a pioneer in supporting the family planning programme since 1970. PPAT became a Member Association of International Planned Parenthood Federation (IPPF) in 1977.

Thailand’s economic and social situation has changed significantly as Thai society has become more multicultural. The life expectancy of Thai people is higher, and the urban areas are growing rapidly. Thailand is now faced with new challenges as a result of recent occurrences. Furthermore, the way of life of Thais has changed with economic limitations, as well as the attitude of ‘children are a burden to the family, not a joy’. This has resulted in families in Thailand getting smaller, and the number of nuclear families without children increasing accordingly.

From the analysis on the effect of population structure, the evolution of the change in society, norms and technology, the advancement to solve problems by government sector and civil society, and the achievements of the Association in advocating and serving the unmet needs in SRHR, PPAT believes that it is necessary to intensify its implementation, emphasizing quality and sustainability covering all population groups with the PPAT Strategic Plan 2017 - 2022 as follows;

A long period of declining fertility rate has put Thailand’s current total fertility rate (TFR) below the replacement level. The Office of the National Economic and Social Development Board, in forecasting Thailand’s population for the period 2010 to 2040, estimate that during the 24-year period (2016-2040), Thailand’s TFR will decrease from 1.59 in 2016 to 1.35 in 2039, with only 400,000 newborn babies per year. At present, many infants are born below their ideal weight, while some children’s early year growth is not consistent with their age. In the meantime, unplanned pregnancy has become a major problem among teenagers. Statistics from The Department of Health, Ministry of Public Health shows that in 2015, there were 104,289 women aged between 10-19 years who gave birth, an average of 286 persons per day. This was calculated to be 15% of all age groups that gave birth in that year. Moreover, there was a high rate of abortion among this population group. As Thailand is faced with low quality child bearing and a low birth rate, the cabinet of Thailand has approved the Second National Policy and Strategy on Reproductive Health (B.E. 2560-2569), which focuses on promoting quality childbirth and children’s growth according to Ministry of Public Health’s proposal to find solutions for such problems.

With Thai teenagers experiencing their first sexual encounter at an earlier age, as well as their lack of knowledge and understanding of sex education, this has resulted in unplanned pregnancy problems among teenagers. In addition, young people are inclined to be infected by sexually transmitted diseases at a higher percentage. Moreover, sex before/outside marriage has increased.

The Thai government has enacted the Act for Prevention and Solution of the Adolescent Pregnancy Problem, B.E. 2559, as proposed by the Ministry of Public Health, to solve sexual and reproductive health problems among young people. When looking at the statistics on condom usage, it was found that the use of condoms has been decreasing, particularly among sex workers. The incidence of HIV infection has increased, especially among people of working age, along with the incidence of cervical cancer in women, which is caused by the transmission of Human Papillomavirus (HPV) through unprotected sex. Furthermore, the number of cases of anal cancer among the MSM population has increased (National Condom Strategy 2015-2019).

The longstanding low fertility rate has affected the population structure of Thailand as the proportion of children will decrease from 19.8% (12.6 million people) in 2010, to 12.8% (8.2 million people) in 2040, while the proportion of people of working age will decline from 67% (42.7 million people) in 2010 to 55.1% (35.2 million people) in 2040. This will cause labour shortages in the country. At present, Thailand imports many migrant workers for its labour force. United Nations has estimated that there are 3,913,258 migrants living in Thailand. Among these migrants, 1,918,348 persons (50.6%) are from Myanmar, 969,267 persons (24.8%) are from Lao PDR, 805,272 persons (20.6%) are from Cambodia and 160,371 persons (4.1%) are from other countries. According to the statistics from the Ministry of Labour, in 2015 there were 1,414,412 migrant workers registered in the system. This means there were over 2.5 million illegal migrants in Thailand, which is a major problem for the nation. It is estimated that, without any support for family planning and reproductive health knowledge and services, there might be 16,000 to 24,000 migrant workers conceiving annually and 20,000 of them will give birth. Moreover, the incidence of HIV and STIs infection will quite possibly increase.

It is estimated that the proportion of the ageing population (over 60 years old) will also increase from 8.4 million people (13.2%) in 2010 to 20.5 million people (32.1%) in 2040. Such change will result in Thailand being a complete ageing society by 2021. Statistics on the ageing population in 2014 showed that the total income of ⅓ of this group was below the poverty line (2,647 Baht per person per month). A survey on the health of the ageing population in 2013 indicated that 1.5% are in absolute bed rest condition, while 19% are in home rest condition and 79.5% can socialize normally.

The percentage of married couples not wanting children has increased from 5.6% in 1987 to 16.2% in 2017. At the same time, infertility rate has also increased. In recent years, family size has shrunk. In 2013, the number of young single mother families increased to 7.1%. During this time, the number of women over 60 years old who became the head of cross-generation families (families with grandparents raising grandchildren) increased to 2%. Most single mother families and cross-generation families are living in poverty and lack the knowledge to raise children, resulting in these children being under-developed. In addition to the change of the population structure that has become an important factor to the nation’s future development, Thailand is faced with social inequality, particularly among marginalised populations such as ethnic groups, refugees, migrant workers, population living in remote areas, low income population, people living with disabilities, sex workers and LGBT population. Social inequality has made these groups vulnerable as they are not able to access reproductive health information and services due to their race, religion, language, social or economic status.

Focus will be on the development of the population in all age groups and at all levels, considering the current situation of the population, and the direction of change that is beneficial to every population group. This will assist them to live in a multicultural society happily, and become a major force to advance the nation’s development to a sustainable level, particularly in reproductive health.

1 Not less than 7 political organizations, government agencies, private organizations and civil society organizations support sexual and reproductive rights, reproductive health services, family planning, STIs and HIV prevention, and quality, friendly and gender-equality counselling and reproductive health services.

1.1 Target organizations, both government and private, execute policies regarding sexual and reproductive rights, reproductive health service provision and gender equality into concrete practice.

1.1.1 Promote correct understanding among stakeholders from political/government sectors and civil society to advocate for sexual and reproductive health and rights and gender equality as priority issues for the implementation of a work plan.

1.1.2 Support and encourage the gathering and linking between networks that facilitates the target group, particularly the disadvantaged population, women and young people, for them to be able to express their thoughts to advocate for acceptance and change

1.1.3 Support information on sexual and reproductive health to mass media to advocate for acceptance on this subject ongoing. 1.2 Concerned agencies support and cooperate promoting the involvement of women, men and young people in promotion and protection of sexual and reproductive rights, access to news and information of sexual and reproductive health, and gender. Strategy

1.2.1 Coordinate with local administrative organizations to increase their roles in prioritizing sexual and reproductive rights by allocating funds to implement activities etc.

1.2.2 Improve knowledge and skills of women, men and young people as peer educators to disseminate knowledge on sexual and reproductive rights, sexual health and gender and establish as a group for sustainability.

1.2.3 Encourage male involvement in promoting and protecting sexual and reproductive rights through the integration of contents and activities into the relevant projects to create positive attitudes towards gender issues.

1.2.4 Connect sexual and reproductive rights protection networks to empower the network, especially in co-organizing activities to attract attention from society.

Outcome 2 Not less than 100,000 adolescents to have knowledge on sexuality, sexual health, and appropriate sexual relations which will substantially reduce unplanned pregnancies among teenagers. Objective

2.1 Provide adolescents knowledge on Comprehensive Sexuality Education (CSE) and create attitudes that enable appropriate sexual behaviours for their age.

Strategy

2.1.1 Promote activities to provide CSE knowledge for adolescents/young people both in and out of schools.

2.1.2 Develop CSE information, education and communication (IEC) materials, both printed media and social media, according to the needs of adolescents/young people.

2.1.3 Provide counselling, information and knowledge on reducing unplanned pregnancies for adolescents/young people, supporting strategies 2.1.1 and 2.1.2.

Objective 2.2 Enable adolescents to realize the consequences of teenage unplanned pregnancy and infection of HIV and STIs

Strategy

2.2.1 Provide correct knowledge and information on prevention and dealing with unplanned pregnancies among adolescents/young people, as well as raising awareness of the consequences of teenage unplanned pregnancy.

2.2.2 Disseminate knowledge on sexual health to raise awareness among adolescents/young people on HIV and STIs infections and their prevention.

2.2.3 Conduct counselling activities for young people, both in and out of schools, in the format of “friend helping friend”.

Objective 2.3 Cooperate with partner agencies, particularly young people organizations, to promote appropriate sexual values and attitudes, and responsible sexual relations.

Strategy

2.3.1 Support and promote activities with partner agencies, particularly young people organizations.

2.3.2 Build the capacity of staff and volunteers to implement activities that are relevant to race, religion, culture and sexuality of target group.

Outcome 3 In the target populations, particularly the disadvantaged group, not less than 500,000 persons have enough knowledge and understanding of sexual and reproductive health, STIs and HIV infection prevention, have access to quality and friendly reproductive health services, or are able to take care of their health and live happily.

Objective 3.1 Increase opportunity and channels to access news, information and knowledge on sexual and reproductive health and STIs and HIV infection prevention, particularly through social media which has a huge impact on society.

Strategy

3.1.1 Develop IEC materials on reproductive health, HIV and STIs prevention and maternal and child health that conform to ways of life, tradition and cultures of target groups.

3.1.2 Cooperate with government/private sectors and service providers to provide up to date information on STIs and HIV infection prevention and treatment on an ongoing basis.

Objective 3.2 Develop quality and friendly sexual and reproductive health service provision, according to basic rights which conform to the need, way of life, tradition and culture, in order to reach out to various target groups.

Strategy

3.2.1 Improve services of PPAT and network providers to be quality, friendly, diverse sexual and reproductive health services according to the needs, ways of life, tradition and basic rights of clients.

3.2.2 Provide quality, friendly family planning services and counselling to promote planned pregnancy at the appropriate age with the appropriate numbers of children, as well as to assist in the infertility treatment according to PPAT’s capacity and develop a quality referral system.

3.2.3 Build the capacity of service providers to provide quality services efficiently according to the needs, ways of life, tradition and basic rights of target groups

Objective 3.3 Expand opportunities to disadvantaged groups, including migrant workers, to access quality and friendly sexual and reproductive health services and counselling.

Strategy

3.3.1 Establish network agencies as a channel to increase access to safe and friendly sexual and reproductive health services and counselling among target group by strengthening the volunteer system.

3.3.2 Cooperate with government/private sectors, and service providers to expand service networks and develop efficient referral systems.

3.3.3 Campaign among disadvantaged population communities to raise awareness on prevention and reduction of risks of STIs which affects the quality of life of the target group.

3.3.4 Strengthen the capacity of PPAT’s service provision units in order to be able to provide quality sexual and reproductive health services to the disadvantaged population, including migrant workers in the workplace and residential areas.

Objective 3.4 Encourage people who are entering their elderly stage, and elders in urban and rural areas, to live with values that are well-suited for their age and physical and mental changes, particularly concerning reproductive health.

Strategy

3.4.1 Encourage people who are entering the elderly stage, and elders, to access information on general health and reproductive health through mass media continuously in order to reduce problems which occur commonly among the elderly, as well as economic and social problems that have become major issues among this group through a lack of preparedness.

3.4.2 Promote and strengthen capacity in self-care on health, health related behaviours and development in preparation to enter the elderly stage with quality through lifelong learning methodology.

3.4.3 Endorse co-organization of activities among groups of people who are entering the elderly stage and elders as a platform to share information, assist each other and as leaders to implement activities for other elderly and people in their communities.

3.4.4 Promote the establishment of health care mechanisms among people who are entering the elderly stage and elders in communities to facilitate access to quality services and able to link with government service providers efficiently.

3.4.5 Create understanding and raise awareness of families and communities on the impact of reproductive health towards the physical and mental health and capacities of people who are entering the elderly stage and elders.

3.4.6 Campaign for increased awareness regarding the environment and facilities that are friendly to the elderly in families and communities.

Outcome 4 PPAT’s organizational structure, management system and personnel are effective and efficient as a volunteerism learning organization.

Objective 4.1 Strengthen the capacity of personnel on expertise and work happiness in order to perform as NGOs with dignity.

Strategy

4.1.1 Strengthen the knowledge and skills of staff and community volunteers needed for implementation

4.1.2 Support the capacity building of staff to be able to implement efficiently.

4.1.3 Reinforce learning mechanisms by organizing experience and knowledge sharing activities regularly.

4.1.4 Create a positive work environment and increase the involvement of all staff to reinforce implementation by everyone.

Objective 4.2 Advance the capacity of the organization in order to become a quality, self-reliant, learning organization Strategy

4.2.1 Encourage personnel to increase their knowledge, be innovative and improve work quality continuously, as well as turning organization into a family planning information centre that people can visit for a study tour.

4.2.2 Establish an information technology system and two-way communication system for organizational management which are up-to-date and readily available.

4.2.3 Organize lesson learning and experience sharing activities on implementation among staff and stakeholders

4.2.4 Develop resource mobilization activities/projects continually to improve capacity for self-reliance.

Objective 4.3 Regularly update organizational structures and management systems appropriately.

Strategy

4.3.1 Review/restructure PPAT’s organizational chart to conform to current context and the organization’s mission.

4.3.2 Strengthen the efficiency of the organization’s implementation supporting system.

4.3.3 Apply up-to-date technology to keep the management efficient and effective.

Objective 4.4 Encourage participation from all stakeholders in PPAT activities with a volunteer spirit. Strategy

4.4.1 Strengthen PPAT’s volunteer network.

4.4.2 Extend volunteer base to cover people of all genders, age and occupation.

4.4.3 Support the establishment of women/youth’s reproductive health volunteer groups at regional and national level.

4.4.4 Encourage PPAT volunteers to join PPAT’s membership.

4.4.5 Build the communication capacity/skills of volunteers for knowledge dissemination and provide academic support and IEC materials to assist in organizing activities promoting sexual and reproductive health, rights and services to target groups and mass media.