The model development of participatory education on adolescent reproductive life (Pearl) programme to prevent unintended pregnancy among Myanmar migrant adolescent and youth in Samut Sakhon province, Thailand

Abstract

Pregnancy among young adolescents is a significant problem in the world. Migrant workers from Myanmar come from a variety of geographical locations and ethnic groups. According to Samut Sakorn Provincial Health Office data, there were 1,507 antenatal care cases, 1,517 delivery cases and 113 abortion cases among 7,000 Myanmar migrant women in 2009. Abortion rate was three times more than 2008 in same population. The objective of the study was to develop a participatory education on adolescent reproductive life (PEARL) programme to prevent unintended pregnancy among Myanmar migrant adolescent and youth in Samut Sakorn Province, Thailand. Population for this study was Myanmar migrants both female and male, 15-24 years of age, both registered and unregistered living in Samut Sakorn Province. The study design was a research and development (Action Research), after development of the model PEARL, implementation was done between the two intervention groups “PEARL”, “Teaching only” group comparing with “Control group” there had no intervention. The effectiveness of this program was assessed by pretest and posttest 1 month, 3 months and 6 months after intervention during the period from 17 July 2010 to 22 January 2011. During the study period, there were 33 participants enrolled in each group. The study results found that all general characteristics and pretest mean scores of most of the measured variables were not significant difference among the three groups (p-value >.05). Comparison of the mean scores before and after 6 months intervention, all of the knowledge variables (Knowledge on puberty KOP, Knowledge on adolescent and youth pregnancy KOAYP, knowledge on pregnancy prevention KOPP, and knowledge on induced abortion KOIA) were significantly improved in “PEARL” group, whereas, KOP, KOAYP, and KOPP were also improved in “Teaching only” group (p-value <.001) but no change in “Control” group (p-value > .05). On the other hand, significant improvement of attitude towards unintended pregnancy prevention and induced abortion were only found in “PEARL” group (p-value <.001). Regarding intension to refuse sex and to use condom in the next 6 months, there had a significant improvement in “PEARL” group and “Teaching only” group (p-value <.001). Pairwise comparison among groups for post 6 months assessment was found that “PEARL” group had significant higher mean scores in 3 out of 4 knowledge variables (KOP, KOPP, and KOIA) (p-value < .05), attitude towards unintended pregnancy prevention and induced abortion (p-value < .05), and intension to refuse sex and to use condom in next 6 months (p-value < .001) than “Teaching only” group, whereas, all of the knowledge, attitude, norm for safe sex and induced abortion, intension to refuse and to use condom in next 6 months were significantly higher than “Control” group (p-value < .001). Only one unintended pregnancy was noted at post 6 months assessment in “Control” group. This revealed that participatory education on unintended pregnancy prevention plus facilitation by peer volunteers (PEARL) had the best outcome improvement in knowledge, attitude, and intension to prevent unintended pregnancy among Myanmar migrants in Samut Sakorn Province, Thailand. There should be continuous action plan for sustainable achievement to prevent unintended pregnancy among Myanmar migrants.