Transcript Document

NEEDS ASSESSMENT ON SEXUALITY AND
REPRODUCTIVE HEALTH EDUCATION
OF SECONDARY SCHOOL STUDENTS IN
YALA, THAILAND
Awirut Singkun
Master of Public Health
College of Public Health Sciences
Chulalongkorn University
Background & Rationale

Abortion Situation
More than 2000 illegally aborted fetuses at the
Wat Phai Ngern temple in Bangkok.
(Mong, 2010)

Young people are engaging in sexual activity at a
younger age and have had sex without protection
(Deepasert, 2006)
Background & Rationale

parents are failing to discuss sex with their child
(Creel and Perry, 2002)

Sexual and reproductive health requires
knowledge of normal physiology and development
as well as communication skills
(Shaw, 2009)
Background & Rationale

Yala is a province in the Southern part of Thailand
with a Muslim majority populations (75.5%)
(Abuza, 2011)
Background & Rationale

Southern unrest in Yala efforts to kill and
intimidate teachers and burn schools.
(Abuza, 2011)
Background & Rationale

At least 30 school students were killed and 92
injured due to violence between January 2004 and
December 2007 and 140 teachers have been killed
between December 2008 and June 2011, causing
many schools shut down. This situation undermine
the secular educational system.
(Abuza, 2011)
Background & Rationale

Sexual education in schools and societies is still
largely ignored
(Chao and et al., 2008)

Need assessment of adolescents is crucial for
improve adolescents’ knowledge and skills
appropriate to enabling them to have healthy
development and prevent health problems, and to
increase access to health services to meet their
needs
(Aree Prohmmo, 2004)
Research questions
Do adolescents need on sexuality and reproductive
health education?
What factors associated to adolescents need on
sexuality and reproductive health education?
Objectives
1.
2.
3.
4.
To study Socio-demographic factors
To study social behaviors’ acceptance
To study attitudes toward premarital sex
To study factors related to adolescents’ needs on
sexuality and reproductive health education
of secondary school adolescents in Yala.
Conceptual Framework
Independent variables
Socio-demographic
- Sex
- Religion
- School level
Social behaviors’ acceptance
Attitudes toward pre marital
sex
Independent variables
Needs on
- Reproductive
health education
- Sexuality health
education
Research Methodology
Research Design
Cross-sectional
Study Area
Yala province, Thailand
Study Population
3,307 students (Grade 10 – 12) form
11 secondary schools under the regulation
of the office of the basic education commission
area 12
Sample & Sample size
 Sample estimation calculated by the Formula of
Taro Yamane (Yamane,1967)
n



=
N
1 + Ne2
n is the sample size
N is the population size
e is the significant level (0.05)

Sample estimation
n =
3,307
1 + 3,307(0.05)2
= 356.74
A purposive sampling was used to select one school
that was the biggest proportion of students and
has many students entered from all district. A
random sampling by draw lots by class was made
to get the sample size of 393 students.
Measurement Tools
Validity
Socio-demographic factors use the index of item
objective congruence (IOC) to analyze by 3 experts.
Content validity by IOC equal 1 of each item.
Reliability
The  coefficient was used to test for reliability
- Social behaviors’ acceptance was 0.86
- Attitudes toward premarital sex was 0.77
- Need on sexuality and reproductive health education
was 0.91.
Data Collection
Ethical consent from the ethical review committee
for research involving human research subjects,
health science group, Chulalongkorn university proved
and made consideration.
Asked school director for permission to collect
the data among students by self-administered
questionnaires.
Data Collection
All subjects were informed background and rationale,
objectives of the study, the operation definitions,
reason to choose for study, and contents of the
questionnaires. Students could ask any question until
they were no doubt and signed in the informed consents
form before answering the questionnaires.
Data Collection
This study waived assent signed from their parents
in order for students feel free to answers.
In any case of subjects who were absent, refused to
participate in the study and non completed response
are excluded from this study. Then, an accidental
sampling for each level to get the amount of total
subjects was made.
Results
Socio-demographic
Sex
Female
Male
Age
15 years old
16 years old
17 years old
18 years old
19 years old
Mean 17.3 S.D. 0.95
Range 15 – 19
Frequency
Percentage
239
154
60.8
39.2
6
92
105
162
28
1.5
23.4
26.7
41.3
7.1
Results
Socio-demographic
factors
Frequency
Percentage
Religion
Buddhism
Islam
Christianity
254
117
22
64.6
29.8
5.6
School level
Grade 10
Grade 11
Grade 12
136
113
144
34.6
28.8
36.6
Results
Socio-demographic factors
Current resident
Home
Apartment
Relative’s house
Private dormitory
Students live with
Father/Mother
No one
Relatives
Friends
Lover
Frequency
Percentage
293
57
35
8
74.6
14.5
8.9
2.0
272
42
42
36
1
69.2
10.7
10.7
9.2
0.3
Results
Socio-demographic factors
Students discuss sexuality
and reproductive health
with (Choose more than
one)
Friends
Lover
Mother
Father
Elder brother/sister
Boyfriend/Girlfriend
Frequency
Percentage
322
227
152
111
54
50
81.90
57.80
38.70
28.20
13.70
12.70
Results
Social behaviors
High acceptance (> 41.2)
Moderate (25.8 – 41.2)
Low acceptance (< 25.8)
Frequency
80
252
61
Percentage
20.4
64.1
15.5
Total score 60, Min 20, Max 52, Mean 33.5, S.D. 7.8
Results
Attitudes toward premarital Frequency
sex
Positive (> 31.3)
43
Neutral (18.6 – 31.3)
280
Negative(< 18.6)
70
Percentage
11.0
71.2
17.8
Total score 45, Min 9, Max 40, Mean 25.0, S.D. 6.4
Results
Needs on reproductive
health education
High (> 22.8)
Moderate (14.7 – 22.8)
Low (< 14.7)
Frequency
Percentage
70
261
62
17.8
66.4
15.8
Total score 30, Min 10, Max 30, Mean 18.8, S.D. 4.0
Results
Needs on sexuality
health education
Frequency
Percentage
High (> 18.1)
Moderate (12.1 – 18.1)
Low (< 12.1)
52
253
88
13.2
64.4
22.4
Total score 25, Min 7, Max 25, Mean 15.1, S.D. 3.0
Results
Sex
Male
Female
Total
Reproductive health
Sexuality health
Low
Neutral High Low Neutral High
no
no
no
no
no
no
(%)
(%)
(%)
(%)
(%)
(%)
20
109
2
34
100
2
(13.0)
(70.8) (16.2) (22.1) (64.9) (13.0)
42
152
4
54
153
3
(17.6)
(63.6) (18.8) (22.6) (64.0) (13.4)
62
261
70
88
253
52
Reproductive 2 = 2.330 Sig. = 0.312 Sexuality 2 = 0.035 Sig. = 0.983
Results
School level
Grade 10
Grade 11
Grade 12
Total
Reproductive health
Low
Neutral
High
Sexuality health
Low Neutral High
no
(%)
21
(15.4)
no
(%)
98
(72.1)
no
(%)
1
(12.5)
no
(%)
31
(22.8)
no
(%)
91
(66.9)
no
(%)
1
(10.3)
18
(15.9)
23
(16.0)
72
(63.7)
91
(63.2)
2
(20.4)
3
(20.8)
22
(19.5)
35
(24.3)
73
(64.6)
89
(61.8)
1
(15.9)
2
(13.9)
62
261
70
88
253
52
Reproductive 2 = 4.318 Sig. = 0.365 Sexuality 2 = 0.516 Sig. = 0.642
Results
Social
behaviors’
acceptance
High
Moderate
Low
Total
Reproductive health
Sexuality health
Low Neutral High Low Neutral High
no
no
no
no
no
no
(%)
(%)
(%)
(%)
(%)
(%)
18
56
6
36
40
4
(22.5)
(70.0)
(7.5) (45.0) (50.0)
(5.0)
42
161
4
48
167
3
(16.7)
(63.9) (19.4) (19.0) (66.3) (14.7)
2
44
1
4
46
1
(3.3)
(72.1) (24.6) (6.6) (75.4) (18.0)
62
261
70
88
253
52
Reproductive 2 = 15.882 Sig. = 0.003 Sexuality 2 = 35.773 Sig. = 0.000
Results
Attitudes
toward
premarital
sex
Positive
Neutral
Negative
Total
Reproductive health
Low
Neutral High
Sexuality health
Low
Neutral High
no
(%)
8
(18.6)
no
(%)
29
(67.4)
no
(%)
6
(14.0)
no
(%)
13
(30.2)
no
(%)
25
(58.1)
no
(%)
5
(11.6)
44
(15.7)
10
(14.3)
193
(68.9)
39
(55.7)
4
(15.4)
2
(30.0)
67
(23.9)
8
(11.4)
180
(64.3)
48
(68.6)
3
(11.8)
1
(20.0)
62
261
70
88
253
52
Reproductive 2 = 8.942 Sig. = 0.063 Sexuality 2 = 8.634 Sig. = 0.071
Results
Current need
met on
reproductive
health
education
High
Moderate
Low
Total
Reproductive health
Low Neutral High
no
no
no
(%)
(%)
(%)
Sexuality health
Low
Neutral High
no
no
no
(%)
(%)
(%)
3
(3.8)
40
(15.9)
41
(51.3)
182
(72.2)
3
(45.0)
3
(11.9)
7
(8.8)
56
(22.2)
47
(58.8)
173
(68.7)
2
(32.5)
2
(9.1)
19
(31.1)
38
(62.3)
4
(6.6)
25
(41.0)
33
(54.1)
3
(4.9)
62
261
88
253
52
70
Reproductive 2 = 63.152 Sig. =0.000 Sexuality 2 = 47.021 Sig. =0.000
Results
Current need
met on
sexuality health
education
High
Moderate
Low
Total
Reproductive health
Low Neutral High
no
no
no
(%)
(%)
(%)
3 (5.2)
27
2
(46.6) (48.3)
26 (9.8)
33
(47.1)
198
(74.7)
36
(51.4)
62
261
Sexuality health
Low Neutral High
no no (%)
no
(%)
(%)
2
33
2
(3.4)
(56.9) (39.7)
4
47
(15.5) (17.7)
1 (1.4)
39
(55.7)
70
88
193
(72.8)
27
(38.6)
2 (9.4)
253
52
4 (5.7)
Reproductive 2 = 103.912 Sig. =0.000 Sexuality 2 = 93.743 Sig. =0.000
Discussion
69.2% of adolescents lived with their father/mother.
However, 81.9% of them discuss sexual and reproductive
health with their friends similar study was done by
Creel, L.C. and Perry, R.J. (2002) found that young
people learn about sex from their friends (57.8%) and
discuss with their lover (38.7%). This finding was
comparable to a study in young people that parents are
failing to discuss sex with their child
(Creel and Perry, 2002)
Discussion
Attitudes toward premarital sex of adolescents
found that they strongly agree on the statement of
“It is normal in boys to have premarital sex” (12.7%)
the mean score was 3.19.
This attitude was similar compared to a survey
study in Thailand found that Thai youth having sexual
experience, 98% of male and 70% of female ever had
premarital sex
(Chai Podhisita and Xenos, 2009)
Discussion
A study in Song Khla, Thailand reported
that 9.3% of the sample had an initial sexual
relationship between 12-19 years of age
(Ingkathawornwong et al, 2007)
A survey study in secondary school students
and vocational schools across Thailand found that
attitudes towards premarital sex in adolescents were
that it was acceptable especially among males [10],
sexually active adolescents place themselves at risk of
a sexual transmitted infection (STIs) when they
engage in unprotected sex
(World Health Organization, 2004)
Recommendation
Students accepted social behaviors at
moderate level (64.1%), and high level (20.4%).
This finding should conduct learning program to
enhance suitable behaviors and make them be
aware of behaviors associated with STIs/HIV.
Recommendation
The highest weight mean score of adolescents’
attitudes toward premarital sex was “It is normal in
boys to have premarital sex”. For this attitude, boys
trend to have premarital sex. So that the life skill is
necessary for them to have safe sex, prevent them
from STIs/HIV and unwanted pregnancy, abortion
and related complication of their sexual partnership.