LEARN Lao PDR - consultation workshop to find solutions for the high rate of teenage pregnancy in Lao PDR

On December 10 2019, with the support of SPHIP, a consultation workshop was conducted to engage stakeholders and implementers in producing policy recommendations for policymakers/implementers. LEARN/MCNV is partnering with the University of Health Science and Lao Tropical and Public Health Institute and researchers to formulate the outcomes of the consultation workshop in a policy recommendation brief. Furthermore, it was suggested in the consultation workshop to establish a committee including stakeholders and implementers to bring the policy recommendation letter to the Ministries of Health and Education and school boards in order for the government to find long lasting solutions to prevent teenage pregnancy and give young adolescents the chance to continue their education after childbirth.

The Lao Equity through policy Analysis and Research Networks (LEARN) project aims to use evidence based research to engage in policy dialogue with policy makers to influence policy development in the areas of Sexual Reproductive Health,  Nutrition and Antenatal Care. Participants were invited from the Ministry of Health, Ministry of Education, ANC staff from hospitals, Maternal and Child Health Centers and Secondary schools, International NGOs, as well as the Lao Youth Union and Lao Women’s Union with the goal to of generating discussion around practice and possible policy recommendations regarding teenage pregnancy.

The LEARN researchers presented findings, gaps and policy suggestions. Small group discussions followed to find additional gaps and suggestions for policymakers and implementers to meet those gaps. Lively discussions took place which focused around more emphasis on SRH education for adolescents in and outside the schools and better telephone hotline services for counselling. In addition discussions concentrated on the need for more youth friendly services from the local to the national level, based on the key outcome that youth do not seek family planning information or services at facilities that are open to all. Beyond setting up more youth friendly services, there must be education on changing the attitudes of the service providers so they understand how to meet the needs of youth. These suggestions should be assigned throughout the health sector to guide the implementation, monitoring and evaluation. Clearly, these changes must also be accompanied by changes in mind-set and budget allocation.

The teenage pregnancy rate is very high in Laos (17% LSIS II). Nearly one in five women between the age of fifteen and nineteen already have one child and roughly one in twenty began childbearing before this age. Two in ten boys and three in ten girls aged fifteen to nineteen are sexually active.

Most pregnancies occur in young women who are in rural areas and or women with low education levels; in both situations, teenage pregnancies (TP) are twice as high. Pregnancy at an early age is associated with an increased risk for health, or even death, of both mother and child. Problems during pregnancy or child birth are the leading cause of death and disability among girls aged fifteen to nineteen. Children born to adolescents suffer poorer health outcomes than those born to adult women. Most teenage pregnant girls are expelled from school, which further increases their likelihood to grow up poor.

Girls whose pregnancies are unplanned and unwanted often find a solution in abortion. Nearly one in ten girls undergoes an abortion in Lao PDR. These illegal abortions are often performed by untrained practitioners, which puts these girls at serious health risks and even death.

Only 14% of adolescents between the ages of fifteen to nineteen use contraceptives. The key reason for the lack of contraception use is that mainly married women access public family planning services, not adolescents. Although the services are open to everyone irrespective of gender, sex and age etc., unmarried adolescents feel they cannot access these services and there is only one Youth Friendly Service in the country. In addition, more than half of adolescents have adequate health literacy, and thus face difficulties in understanding information, communicating about health and making decisions about their own reproductive and sexual life.

Adolescents often have difficulties understanding their own needs, and are not able to find services that are geared towards their specific needs. This high teenage pregnancy rate will continue to exist unless appropriate measures are taken at policy and implementation levels.