Situation Analysis of Implementation of Repeated Adolescent Pregnancy Prevention in a Community Hospital, northern Thailand

Abstract

Repeated adolescent pregnancy prevention is an important policy for reducing adverse health consequences among adolescent mothers and their children. This study aimed to study the situation of repeated adolescent pregnancy policy implemented in Chiang Dao Hospital, Chiang Mai Province using Donabedian's approach assessing three components: structure, process and outcomes. The data were collected by using qualitative and quantitative methods. Structure and process components were collected by qualitative methods through interviewing 4 executive officers and 6 health care service providers. Satisfaction outcomes were quantitatively collected through a questionnaire administered to 10 adolescent pregnant women receiving service at Chiang Dao Hospital. Satisfactory questionnaire was validated for content validity and reliability prior to administration. Qualitative data were analyzed using content analysis and quantitative data were analyzed by descriptive statistical analysis.

            The results of the study revealed that the hospital adopted and followed the repeated adolescent pregnancy prevention according to Ministry of Public Health's policy. A service team structure was formed as the group of committees which consisted of inner and outer multi-disciplinary staff. Specific outcome indicators were identified, however there were no formal respondents for evaluation and monitoring system. There was no specific action plan for repeated adolescent pregnancy prevention program although the budget for this program was supported by the National Health Security Office (NHSO) and even medical facilities, equipment and infrastructure were sufficient. Service process of  the hospital included 1) repeated adolescent pregnancy prevention education program for adolescent mothers at any stage of pregnancy, 2) one-stop teenage -friendly service with privacy protection and 3) using technology and innovation for developing online interventions and social media. The satisfactory outcome showed that service receivers had a satisfactory score at a high level.

            The findings of this study provide the information which is beneficial for improving the strategies of repeated adolescent pregnancy prevention, especially a suitable service for the teenage group which enhances the effectiveness of repeated adolescent pregnancy prevention in the hospital.