 |
International NGO Established in 1989 Supported by UNFPA and the Kobe City Government |
| | HOME | ABOUT US | PROGRAMS | PUBLICATIONS | DATABASE | WHAT'S NEW | ACCESS | LINKS | | |
|
Mr.Patsawadee Churbundit Director Public Health Division Khon Kaen Municipality Thailand I. Status of Progress toward Target Set at the International Conference on Population and Development (ICPD) held in Cairo in 1994, in Khon Kaen, Thailand Background For Thailand, the responsible government unit for population development is the Ministry of Public Health, and the Department of Health has to issue vital policy and strategic directions. A national conference was conducted 10/Jul 96 on World Population Day for the purpose of achieving public relations and information dissemination about reproductive health to Thais. National policy focused on "all Thai men and women of all age groups must have comprehensive and factual information and a full range of reproductive health care services." (a) Mortality Rates of Khon
Kaen Province, Thailand
Table1: Infant and Maternal Mortality Rates per 1,000 Livebirth
Table 2: Life Expectancy at
Birth by Sex, projected for 1990 - 2015
(b) Index of Education
Table 3: Numbers of Students; Primary and Secondary Schools of Khon Kaen, Muang District 1994 - 1996 (City and vicinity areas)
The percentage of children completing primary education for these three periods has reached the goal. There is no report of illiteracy rate of people over 15 years old (% by sex) but literacy findings of the people 14-50 years old (both male and female) are as followed; 199498.2 % 199598.8 % and expected for 199699 % Population numbers included every district under the local administration of Khon Kaen Province. Standard or index for quality of life may indicate to summary report on Thai quality of life standard issued by the Department of Community Development, Ministry of Interior for the year 1992-1995. Index of Reproductive Health Percentage of people with knowledge of family planning Regarding surveyed birth control data, and indications of the family planning of the Khon Kaen population, it is found that the campaign of Khon Kaen family planning reached its achievement, especially in comparison to the preceding 5 years. The rate of birth control has been increasingly improved from 69.82 percent in 1992 to 87.5 percent in 1996. It is consistent with reduction of the population growth rate, from 1.14 percent in 1992 to 1.1 percent in 1996. Table 4: Percentage of
Contraceptive Use
Numbers of births by females aged 15 - 19 (per 1,000 persons) Referring to basic surveyed data, the rate of births by mothers aged between 15-19 years old is high, reaching to 35.52 percent, or 355 persons per 1,000 persons. Thus, emphasis of contraception dissemination should focus on this female age group. As a target goal, it is expected to reduce to less than 10 percent, or 100 per 1,000 persons. II. Status of Implementation of ICPD Action Programmes in Khon Kaen Province Regarding the existing situation and trends of Khon Kaen reproductive health, there are not sufficient data to identify indications of performance and success. Implementation items of reproductive health in the preceding years were categorized into different important functions. The emphasis of government health services was on maternal and child health care and family planning. Mortality rates of mothers and children have been reduced continuously and family planning has been addressed widely among couples. Maternal and child health care services have been upgraded to meet higher standards. Family Planning Evaluation of the survey data found out that some groups of the people, e.g., migrants from other provinces, factory workers, adolescents and young people paid less attention to contraception, especially males. The rate of condom use and male sterilization is 4.46 percent and 0.07 percent respectively for contraceptive new users in 1997. Maternal and Child Health Results of data sampling found that only birth delivery by public health officers and trained midwives met standards of health care. Detection of Cervical Cancer In 1997, records of obstetric clinics show 5,826 active users, as follows: abnormal gynaecological cases, 66.23 percent; general gynaecological check up, 30.46 percent; and postnatal care. 3.31 percent. Abortion In Thailand, abortion is illegal in regard to government policy, so it is hard to track. Problems related to abortion have identified some degradation in terms of social, economic and public health investment. The collected data seemed out of date and useless for further reporting. Thus, records of abortion always come from requests for transfer admission caused by poorly managed abortions in illegal clinics by midwives. Records show that the rate of abortion in married women is higher than that of single women. The age group of the two groups of women is between 20 - 24 years old. The mortality rate before re-treatment is 0.1 percent and 0.6 percent while receiving re-treatment. Mortality Condition of AIDS To follow the Action Plan of National Policy on AIDS Prevention and Control (1997-2001), many Khon Kaen local government offices have collaborated and cooperated broadly and openly in a campaign of public relations to bring AIDS information to the public. However, knowledge of AIDS is by principle a fundamental basis for self-awareness. The spread of AIDS is still having an impact. The record of AIDS patients in Khon Kaen province through 30 December 1997: Male1,525 cases Female 315 cases Total1,804 cases Sexual transmission91.09 % HIV transmission from mothers 5.11 % The age group between 20-44 years old represents 87.94 percent of total AIDS patients, and are in agricultural farming and general wages/labour. Table 5: Index of Khon Kaen
Maternal and Child Health
Table 6: Service Percentage of
Maternal and Child Health 1992 - 1996
Table 7: Detection Results of
Cervix Cancer in 1997
Other Illness related to Reproductive Health At the provincial level, there is no report or papers related to other illness but there is a reference source from a regional report in 1997, brief description as follows; Diseases related to infection of pelvis and disorders.......68.06 per 100,000 persons Diseases of male genito-urinary system.....................24.45 per 100,000 persons Diseases of the genito-urinary system......................126.45 per 100,000 persons Malignant neoplasm of breast.................................13.87 per 100,000 persons Malignant neoplasm of uterus..................................7.57 per 100,000 persons The trend of the above mentioned-diseases is to increase and is described in the following table. Table 8: Causes of Genital
Organs Diseases and Labour, from
Hospital by Region, Number and Rate per 100,000 Population
III. Current Situation and Problem of "Family Planning, Reproductive Health and Maternal and Child Health" Policy in Khon Kaen, Thailand Problems of Reproductive Health 1. Inadequacy and low accessibility of public health services and family planning for labour migrants, adolescents and young people 2. Low standard of postnatal care 3. Low rate of detection of cervix and breast cancers 4. Quantities and unsafe abortions 5. Reduction of sexually transmitted diseases for three preceding years, but constant high rate of AIDS 6. Indirect obstetric diseases Development of Reproductive Health 1. Disseminate public relation of reproductive health via all possible mass media from time to time continuously in order to decrease social sensitivities 2. Increase skills and personnel potential and efficiency of all level public health officers including technical promotion e.g. principles of sexual health, right of reproduction, responsibilities of male and female on reproductive health 3. Improve existing reproductive health care for examples of family planning, prevention and control of sexual transmitted diseases, etc. in order to address needs of users 4. procure equipment and tools and medical materials to promote adequacy and efficiency of the services 5. Implement behavioral research related to reproductive health in various aspects for extension of the services and appropriate change of the behavior 6. Construct coordinate mechanism with government and private sectors 7. Promote and support people for self-reliance Summary Tasks of family planning have been reached its satisfactory goals; to reduce population growth rate. Total fertility rate is equal to replacement level. Thus, other further mission is to develop quality of life of the people. It is needed to clarify and be stated in the National Economic and Social Development Plan in order to be in line with Action Plan of the ICPD. Development of reproductive health needs continuous varieties and changes to push up for better status of the people and their self-reliance. Innovative programmes must be developed to make information, counseling and services for reproductive health accessible to adolescents and adult as well as promotion of all age woman groups in participating reproductive health for quality child care. This is also included with planning management of inequality of human sexuality, discriminatory of social practice and negative attitudes toward women, girls and families. Government should promote much greater community participation in reproductive health care services by decentralizing the management of public health programmes and by forming partnerships in cooperation with local public and private organizations. |
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||