REDUCING TEENAGE PREGNANCY THROUGH OSTPC Sarawak … · REDUCING TEENAGE PREGNANCY THROUGH OSTPC...
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REDUCING TEENAGE PREGNANCY THROUGH OSTPC –
Sarawak Experience
Dr. Radziah Haji Mohamad
State Health Department
4th UNIMAS Public Health Seminar 2017,
25-26 October 2017
Teenage Pregnancy KKM 2014: • 16,528 pregnancy among 10-19 years.• 0.1% of total world pregnancies
Adolescent fertility rate (2014)- Malaysia;13.4 birth/1000 women age 15-19 yo- Sarawak; 22.6 birth/1000 women age 15-19 yo
Teenage Pregnancy WHO 2014: • 16 million teens age 15-19 years• 1 million teens age <15 years old
• give birth every year
Teenage Pregnancy Data Facts
The current situation
• Age of first sexual intercourse < 20
• Unmarried girls had unintended pregnancy 10-40%
• Children born yearly to young mothers 14 millions
Causes of teen pregnancy
• Customs and traditions
• Adolescent sexual behavior –alcohol and drugs
• Peer pressure
• Access to contraception
• Sexual abuse
• Poverty
• Low education ambition and goals
• Exposure to abuse. Violence and family strive at home
Life outcomes on a teen mother /child/ sibling
• Drop out of school
• No or low qualifications
• Unemployed or low-paid
• Live in poor housing conditions
• Suffer from depression which may result in suicide
• Child –live in poverty; grow up without father, become victim of neglect or abuse, do less well in school, involved in crime; risk of becoming teenage parents
• Younger siblings – accept sexual initiation early, play less importance on education and employment.
TEENAGE PREGNANCY FACTS
I am 16 yrs old, the eldest in family, I am a cheerleader in school, I love biology
I met my right man; he is so caring and he is more mature than me
Why me!!!!
I love my child, and I will take care of her
No good school had a mother in a classroom
You had shame a family name, you are good for nothing
I want to die
Continue to raise a child alone? What should I do?
NEGERI2011 2012 2013 2014 2015
Bil. % Bil. % Bil. % Bil. % Bil. %
Perlis 164 4.1 158 4 139 3.5 145 3.4 121 2.9
Kedah 688 2.2 708 2.3 666 2.0 764 2.3 574 1.7
Pulau Pinang 308 1.6 362 1.8 357 1.8 350 1.7 402 2.0
Perak 1,009 3.2 1,068 3.3 965 3.2 892 3.0 787 2.6
Selangor 1,765 2.2 1,614 1.9 1,640 1.8 1,486 1.6 1,461 0.7
N. Sembilan 310 1.9 308 1.8 255 1.5 255 1.5 325 1.8
Melaka 240 1.8 240 1.7 230 1.6 250 1.8 228 1.6
Johor 1,720 3.0 1,650 2.8 1,491 2.5 1,408 2.4 1,319 2.3
Pahang 1,085 4.1 1,061 4 1,015 3.7 1,032 3.7 940 3.5
Terengganu 479 2.0 508 2.3 436 1.9 460 1.9 438 1.8
Kelantan 546 2.1 615 2.4 792 3.0 739 3.0 775 3.0
Sarawak 3,707 9.5 4,131 9.7 4,075 9.9 3,396 8.4 2,910 7.5
Sabah 6,090 9.8 5,916 8.7 4,988 8.0 4,795 7.6 3,084 6.3
WP KL 370 2.2 359 2 380 2.0 412 1.9 350 1.6
WP PJ 2 0.0 10 0.2 8 0.2 4 0.1 7 0.2
WP Labuan 169 7.4 139 5.8 151 6.8 140 6.1 110 5.2
Malaysia 18,652 4.1 18,847 4.0 17,588 3.7 16,528 3.4 13,831 2.4
Number & Percentage of Teenage Pregnancy in Malaysia, 2011-2015
TEENAGE PREGANCY IN SARAWAK
CURRENT SITUATION
Malaysia
• Total teenage pregnancy
reported 12,492 (2016); 2.7%from total pregnancy
•33.0% decreased from total pregnancy reported in 2011 (18,652)
Sarawak
• The 2nd Highest number of teenage pregnancy after Sabah (2481 compared to 2564)
• Highest Percentage of teenage pregnancy , 2.4x compared to Malaysia (6.4 vs 2.7)
• 54.1% were unmarried; no of unmarried increasing
• 90-95% were not schooling at the time of booking; data fluctuates
• 56.7% were between the age of 10-17 yrs old. The age of pregnancy is getting younger.
• 2016 data
Introducing the OSTPC
One Stop Teenage Pregnancy Committee (OSTPC)
OSTPC is a committee made up of representatives from various government and
non-governmental agencies that discuss and resolve specific issues face by
teenage mothers.
Rationale on Establishing the OSTPC
Due to the high incidence of teenage pregnancy in the
state and the complex issues faced by them, a
comprehensive approach involving various agencies was
established to address this issue.
Since the teenage mothers are in close contact with the
health department throughout their pregnancy, this
initiative was brought forward by the State Health
Department to the State Government for implementation.
OSTPC Objectives
General Objective:
To reduce the morbidity and mortality among pregnant teenagers
and newborns.
Specific Objectives:
1. To collaborate together with various agencies in efforts to prevent
teenage pregnancies.
2. To improve morale, self-esteem, and support particularly in the area
of education, skills training and spiritual support so that they can
return as productive members of the society.
3. To provide protection and accommodation to pregnant teens in need.
4. To prevent abortion and baby dumping.
5. To prevent occurrence of a second pregnancy in teenagers.
OST
PC S
TATE
ORGANISATION
• Chairman: YB Datuk Hajjah Fatimah Abdullah
• Director of Sarawak Health Department • Director of Sarawak Social Welfare Department
• Director of Sarawak Education Department
• Director of Sarawak Registration Department
• Director of Sarawak Islamic Development Department
• Director of Sarawak Police Department
• Director of Sarawak LPPKN
• Other Agency/NGO’s
STATE
• Chairman: Resident Officer • Divisional Health Officer
• Divisional Welfare Officer
• Divisional Education Officer
• Divisional Registration Officer
• Divisional LPPKN Officer
• Divisional PDRM Officer
• Other Agency/NGO’s
DIVISION
• Internal Committee of every agency regarding each issues related to teenage pregnancy before going to divisional secretariat INTERNAL
OST
PC S
TATE
S TAT E OS TPC
DI VI S I ON OS TPC
I NT E RNAL OS TPC
OST
PC S
TATE
FLOW CHART
Pregnant Teen <20 y.o
Visit doctor/Specialist Antenatal Registration
Problems Other Than
Health
Continue antenatal follow-ups
NOOSTPC Registration
Teenage Pregnancy Management Card Returned to Divisional OSTPC Secretariat
Case status reporting in Divisional OSTPC Secretariat
Case status reporting and Presentation to State OSTPC Secretariat
Teenage Pregnancy Case From Other Agency
State Education
Department
State Registration Department
Social Welfare
Department
JabatanAgama Islam
Sarawak/ Syariah Court
/MAIS
PDRM JWKS/NGO LPPKN
Referrals to respecting agencies (Teenage Pregnancy Mx Card)
NEW CASE REFERRED to OSTPC Secretariat
ISSUE/PROBLEMS
WELFARE DEPARTMENT
Financial Aid
Child/Baby/ Pregnant Teenage
Protection
Social Support
EDUCATION DEPARTMENT
Leave with reason
(Delivery)
Continuation of education
Deferment of education due to pregnancy/delive
ry
Sitting for exams
Change school
JWKS/NGOs
Counselling during
pregnancy
Counselling after pregnancy
Financial aid
Social support (Transportation, Morale support)
Survival skills
PDRM
Report of rape/statutory rape/Domestic
Abuse/Child abuse/Incest/s
exual abuse/Baby
dumping/etc. concerning
crime
LPPKN
Parenting skills for teenage
couples
Sexual Awareness
and Advocacy Programme
(with KKWKK)
Counselling aid for Teenage pregnancy
REGISTRATION DEPARTMENT
Registration of birth
Identification for pregnant
teen and partner
Certification of Adoption
Processing of Nationality
request
JAIS/SYARIAH COURT
Pre-Marital course
Registration
Marriage with non-muslim
partner
Underage marriage request
Pregnancy due to Co-habitation
cases
Polygamy involving Teen
pregnancy
RESIDENT/DISTRICT OFFICE/ MAJLIS ADAT ISTIADAT
Registration of Customary Marriage
Adoption of child
PROBLEM BASED MANAGEMENT
OST
PC
TEENAGE PREGNANCY MANAGEMENT CARD
OST
PC
TEENAGE PREGNANCY MANAGEMENT CARD
OST
PCKEY PERFORMANCE INDEX
KPI: 10 % DECREASE OF TEENAGE PREGNANCY FROM THE PREVIOUS YEAR
NO INDICATOR STANDARD NUMERATOR DENOMINATOR
1 Percentage of High Risk Clients to be pregnant within 2 years after current pregnancy
20% Number of High Risk Client (OSTPC Registry) with recurrent pregnant within 2 years
Total High Risk Client registered under OSTPC Registry
2 Percentage of referred Teenage Pregnancy given help by Education Office
100% Number of teenage pregnancy mothers aided
Total teenage pregnancy mother referred to District Education Office
3 Percentage of referred Teenage Pregnancy given help to obtain marriage certificate (If both parents and teenager consented)
100% Number of teenage pregnancy mothers with obtain marriage certificate by Adat
Total teenage pregnancy mother with issues regarding Adat Marriage Certificate
4 Percentage of teenage pregnancy with “statutory rape” brought to court
80% Number of “statutory rape” teenage pregnancy case brought to court
Total teenage pregnancy mother with issues regarding “statutory rape” referred to PDRM
5 Total Case of Teenage Pregnancy referred given social aid
N/A Number of teenage pregnancy case given social aid
Total teenage pregnancy mother with social issues referred to social welfare dept
6 Total Case of Teenage Pregnancy referred given child protection
N/A Number of teenage pregnancy case given child protection
Total teenage pregnancy mother with protection issues referred to social welfare dept
2017 ACHIEVEMENT’S
SARAWAK’S OSTPC MANAGEMENT OF TEENAGE PREGNANCY BOOK
GRAND LAUNCHING 10 AUGUST 2017
OSTPC MEETING ACCORDING TO DIVISION
DIVISION MEETINGS NUMBER CHAIRMAN
2016 2017
Kuching 12 3 DHO
Samarahan 3 3 Residen(6)
Serian 1 2 Residen (3)
Sri Aman 2 2 DHO
Betong 1 1 DHO
Sarikei 2 1 Residen
Sibu 0 1 Residen
Mukah 2 2 Timbalan Residen(4)
Kapit 1 0 Residen(1)
Bintulu 2 3 Residen (2), DHO (3)
Miri 11 7 DHO (14)
Limbang 2 Nil
NEGERI 2 2 YB Datuk Hajjah Fatimah Abdullah
279 Cases discussed at
Divisional OSTPC meetings
2015 - 2016
EDUCATION ISSUES; 21 CASE
WELFARE ISSUES; 141 CASE
REGISTRASTION ISSUES; 24 CASE
RELIGION ISSUES; 22 CASE
LAW ISSUES; 32 CASE
234 Cases discussed at Internal
OSTPC meetings 2017 (Jan-Jun)
79 Cases were discussed at
Divisional OSTPC meetings 2017
(Jan-Jun)
ACHI EVEMENTS
JAN JUN 2017
OST
PC S
TATE
TEENAGE PREGNANCY 2011 -2016
Sumber : SPKK, Jabatan Kesihatan Negeri Sarawak, 2016
3698 3866 4078 3401 2909 2481
18652 18847 1758816528
1383112492
9.5 9.1 9.98.4 7.5
6.4
0
5
10
15
20
2011 2012 2013 2014 2015 2016
0
5000
10000
15000
20000
25000
Sarawak Malaysia %
Reduction of Teenage Pregnancy 2011-2016.-Sarawak 33.0%: Decreased by 27.1% (2014-2016)
compared to 8.1% (2011 -2014)
RE DUC I NG T E E N PRE GNANCY AND B I RT H I S ONE OF T HE MOS T E F F E C T I VE WAYS T O RE DUC I NG CHI L D POVE RT Y I N T HE COUNT RY
- J O R D A N B R OWN
THANK YOU