Thailand struggles to curb high teen pregnancy rate
BANGKOK (Reuters) - When Mallika told her parents she was pregnant at 17, they pulled her out of school and ordered her to marry the baby's father. But the marriage didn't happen and the one-time aspiring singer now cares for her baby girl alone.
"I love her, but at the time I hid in shame," said Mallika, now 23 and a vendor of cheap, made-in-China clothing at a weekend market in Thailand's capital, Bangkok.
"The boy's family wanted to pay me to shut up and stay away from them. We were both children ourselves," she added, sitting in her dilapidated apartment overlooking a highway on the outskirts of Bangkok.
Mallika's situation is, sadly, far from unusual. Thailand's teenage pregnancy rate is the highest in Southeast Asia after neighboring Laos, according to the Bureau of Reproductive Health at the Thai Public Health Ministry.
In fact, even though the overall birthrate is dropping, teen births are on the rise. Out of every 1,000 live births, 54 are from teen mothers aged 15-19 - higher than in the United States and ten times higher than Singapore's teen pregnancy rate.
What's more, it's rising fast. The number of live births by Thai teenage mothers aged 15-18 increased 43 percent between 2000 and 2011, a Thai annual public health report shows.
Though there are many factors responsible, health experts put weight on cultural mores that make frank discussion of the issue difficult, whether in an official context or a personal one. This is complicated by gender issues.
"Women are told to protect their virginity but Thai men who have multiple sexual encounters are seen as cool," said Visa Benjamano, a commissioner at the Thai National Human Rights Council (NHRC).
"If men sleep around, their image is not at stake whereas a woman's image is. Women are generally more afraid to discuss their sexual health needs in public."
LACK OF DISCUSSION
Although sexual education is part of the national school curriculum, teaching is clearly insufficient. The Education Ministry limits instruction on the subject to eight hours a year despite changing attitudes towards sex among the young.
"Teachers are prudish and out of touch with Thai kids today and they approach the topic like a biology class rather than talking about the emotional issues involved," said Visa.
The consequences of unplanned pregnancy are often left out of classroom teaching too, despite a lack of legal options.
A 2011 report by the United Nations Population Fund (UNFPA) and Thailand's National and Economic and Social Development Board (NESDB) shows the number of women hospitalized in connection with abortions increased by over 16 percent between 1994 and 2009, hitting 60,000 in 2009.
Yet abortion is illegal in Thailand except in cases of rape or incest, to save a woman's life or preserve her physical or mental health, and if the woman is under 15 years of age.
Under Thai law the penalty for performing illegal abortions is up to five years in prison or a fine of up to 10,000 baht ($340). Despite this, illegal clinics and back street abortions abound.
In 2010, Thai police found 2,000 fetuses on the grounds of a Bangkok Buddhist temple. They were to have been sent there from illegal abortion clinics.
The discovery left the Thai public grappling with the reality of a highly charged religious and social issue. Abortion is recognized as a "sin" in the Theravada Buddhism practiced by up to 95 percent of the population.
Unlike the predominantly Catholic Philippines, Thailand offers easy access to contraception and birth control pills, with condoms and most other contraceptives readily available and sold over the counter.
But when it comes to teenage girls getting them, social stigma gets in the way.
Kanya Musiket was 15 when she started a physical relationship with a boy in her neighborhood. But when she ventured to a local shop to buy condoms, shopkeepers would look at her "disapprovingly," making her feel ashamed.
In a bid to find solutions, a Thai delegation visited Britain in November 2012, looking to emulate programs there.
The number of babies born to teen mothers in England dropped by 27 percent between 2000 and 2010 and overall conception by teens fell by 25 percent between 1999 and 2010. Some areas, like Hackney in East London, showed reductions of over 40 percent.
This was due largely to a 1999 government plan aiming to halve England's under 18 conception rate by 2010. The plan used local grants and guidelines, government funds to improve access to contraceptives and media campaigns to raise awareness.
By contrast, Thailand issued a population strategy plan in 2012 that focuses on reducing teen births but does not include either target reduction goals or concrete ways to do so.
There are university-led sexual health awareness programs, and the UNFPA is trying to raise awareness through both civil and private networks. Yet the most fundamental measure is the hardest to achieve: changing attitudes.
"This is about trusting the moral standards of those young people whom we have invested years of education and nurturing - our children," said Caspar Peek, UNFPA Representative for Thailand and Country Director for Malaysia.
"We need everyone ... to see this as a challenge to development and not just something bad that happens to teenagers because they do 'bad' things." ($1 = 29.8000 Thai baht)
(Editing by Elaine Lies)