Tuesday, December 3, 2013

Reproductive Health Education on Disadvantaged Adolescents in Thailand and India (case Study in Northern)


NEED AND CONTEXT
It has been observed that the recent economic growth in the Asian cities indicate that there has been a breakdown of traditional support systems such as the family because of rapid urbanization and modernization. Moreover, a large number of people are living below the poverty line in impoverished environment in urban and rural communities. Their acute needs for housing, food, health, education, and incomes are the very forces that push adolescents to look for a means of livelihood on the streets, engage in prostitution, be hooked up with crime/drug syndicates, or become victims of sexual and physical abuse. It is a battle of bare struggle for daily survival and contributes in every ways they can. Any measure to penalize parents of such children will only result in further abuse and oppression of people who are already disadvantaged. Such children struggle hard in getting the most essential requirements to meet the basic needs of life and such children need special attentio n and educational intervention. These disadvantaged adolescents are generally malnourished and often anemic; many of them physically stunted, suffer psychologically from undue family pressures and abuses and are neglected at home. They tend to develop low self-esteem from broken families, single-headed households because of the death, separation, or labor migration of one of their parents. Moreover, they live in slums and squatter communities, sub-human conditions and are susceptible to crime syndicates and gang conflicts, substance/drug abuse, and gambling.

In the developing and under developed countries like India and Thailand a large percentage of population live below the poverty line and adolescents from such environment face difficulties in getting access to good education. It is therefore felt that in both the surround adolescents are of in the process of development and failure to meet their developmental need have lend to safe and serial destructions behaviors. Adolescents lack necessary life skills for cape up in to the realities and challenges of life. Adolescents accords for the largest portion of the worlds population and have been on an increasing trend and there are 230 million Indian adolescent in the age of group of 4 to 19 that (Population and Health IndoShare, 2006). Moreover, it is expected that this age group will continue to grow reaching over 214 million by 2020 (United Nations (UN) 2000) due to has traditionally been a male dominated society and has a strong son preference in most part of but Indian girls tend to be discriminated against by their families and also demographic trends indicate deep-rooted gender discrimination. In India, the condition of disadvantaged adolescents resembled that of their centers pail Thailand. Indian Young adolescents are facings serious problem of lack of access to reliable knowledge on the process of growing up reproductive health practices and value system. There has been a need to provide education on the developmental changes and needs during teenagers. This may reduce the risk of future.

Today, almost every Indian and Thai whether rich or poor, young or old, is exposed to much that is foreign, largely because in the last two decades India and Thailand has become one of the regions most popular tourists destinations. At times, the growing economy and favorable investment opportunities have also attracted many foreign multinationals, which continue to add to the already fair large expatriate community. However, despite the intensity of their exposure to foreign influences, particularly western cultures and lifestyles, Indian and Thai culture remains a solid influence within family life and early childhood. From birth, Indian and Thai adolescents are still much more deeply immersed in culture than they are exposed to foreign influences despite the fast-paced changes that have been affecting Indian and Thai adolescents. The adolescents of deferred families are emotionally disturbed and driven adrift as wanderers, delinquent children with im-permissive behaviors such as loitering, gambling, drug addiction, crime, truancy, prostitution, and begging, illegal dealings. As the consequence of these adverse behaviors, cases of illegal pregnancy, baby abandonment, and HIV/AIDS infection are becoming more and more severe.

There also reported, Thai Children are spending more time in talking and chatting on the phone and the trendiest models of mobile phones, love hanging out with their friends at night, the drugs problem and the loss of Thai identity and shopping for brand name products. The latest fashion among the hobbies of many of todays Thai children is they are becoming increasingly violent and blaming society and their own families for their behavior and involve in premature sex, drugs and aggressiveness. The study found that despite the well-to-do family backgrounds of the teens surveyed, most of them shared a common problem of loneliness, depressive tendencies and a need for love. The gap between parents and children is greater than ever before, arising from broken families or from families which faille to inculcate morals in their children because they havenless time for their children and had left them to the peril of sick and violent society in Thailand (Aphaluck Bhatiasevi, Thong bai Thongpao 2002), (Tong Thum Struggles, 2006)

With the best intention and efforts of the education as a social instrument, it is possible to promote the complete welfare of disadvantaged population. Among the several types of disadvantaged adolescents, Adolescents forced to enter the labour market, adolescents affected by HIV/AIDS and adolescents affected by narcotic drugs need special attention. They have trouble in getting proper guidance to overcome personal problems and require proper guidance and counseling to become aware of the ill effects narcotic drugs, labour market and HIV/AIDS. It may not be possible to develop awareness in the expected manner through normal school curriculums. Hence, a separate educational intervention, which is nothing but a planned programme of educational guidance, organized to meet the scientific and psychological needs of disadvantaged adolescents in the age group of 13-16. Hence, in this study, an attempt will be made to study the educational adjustment of disadvantaged adolescents an d to find out the impact of a structured educational intervention programme in developing proper awareness and attitude towards reproductive health, drugs, sexuality and values.

The present study examined the impact of an educational intervention programme on the knowledge and attitude on disadvantaged adolescents in Northern India and Thailand. The study intends to assess and compare the knowledge about the process of growing up, HIV/AIDS awareness, values and attitude of teen-age students staying in the schools. Reproductive health education is a key strategy for promoting preventive measures among teenagers.
METHOS
The sample for the study consisted of 225 disadvantaged adolescents who included 125 adolescents from India (Chennai Himmat Slum area, Jammu region) and Thailand (Yong People Develop Chiang Mai and Teresa Anusorn Foundation (Ban Teresa) Chiang Rai, Province). The sample populations of disadvantaged adolescents are residents of orphanages and slum area and studying in high school classes in the age of groups from 13 to 16 years. Data was collected by administering knowledge test consisted of items on process of growing up HIV/AIDS, reproductive organs and their functions family planning and parenting and attitude scale to measure beliefs and practices about sexuality and abstinence. An experimental design consisted of experimental and control group was formed. Questionnaires were translated from English to Hindi and Thai, (mother tongue of the respondent), then back in to English to ensure that no meaning was lost in translation. There were use two groups of learner: both the groups were given Pre-Test as well as Post-Test, where experimental group were given intervention programme and control group was not be given any intervention programme.
Control group: - there were in two states: ten administrators conducted face-to-face interviews and Focus groups with disadvantaged adolescent in India and Thailand.
First state, in India country; 10 Indian administrators were called the Indian disadvantaged adolescents from there house at Slum area (Jammu), meeting for data collected were an adjustment questionnaire in each of person and groups by Hindi (mother tongue of the respondent).
Second state, in Thailand country: 125 questionnaires in Thai (mother tongue of the respondent) were administered to the Thai disadvantaged adolescent of two orphanages, I collected later the questionnaires.
Intervention / Treatment Programme
Experts: Facilitators who were willing to participate in the study were invited for receiving community sensitization, booklet distribution, and CD training;
Experimental group: 200 students (and also inmates) belonging to Channai Himmat, Slum area (Jammu, India), Teresa Anusorn Foundation (Ban Teresa), and Yong People Develop (Thailand) who had got least scores namely, were given one day training programme on intervention or treatment as;
In the morning: the orientation and participants programme concentrated on basic issues such as general framework of adolescent growth, and consisted of discussions and demonstrations. The training programme practiced the activities to develop the knowledge level and the attitude about HIV/AIDS, drug abuse and reproductive health education
In the afternoon until evening: the revised questionnaires were administered to the experimental group in 3 sessions as: (a) the personal details. (b) The knowledge level and attitude were administered to find out themselves and whenever they had doubt in understanding the items, the administrators made them easy by giving supplementary examples. In addition, (c) group discussed for preparation of suggestive measures to improve and policies. Design of the study
An educational intervention programme consisting of awareness activities presented through media presentation, discussion and interaction was presented to the experimental group. Universals and multivariate analysis of the data were used to assess the impact of interventions and to identify the predictors of change in knowledge and attitude. Significant changes in terms of gain between pre-test and post-test was observed.
Analysis
The completed questionnaires were collated and entered into the computer. The data was entered and analyzed using SPSS. After verification and reduction of data, descriptive frequencies were completed. This was followed by uni-variate and multi-variety procedures to assess the impact of the interventions and to identify other predictors of change in knowledge and attitude. Analysis was stratified by sex shown how responses to the variables of knowledge and attitude, differ boys, girls, age, and education. Descriptive statistics was used to profile the study population. Knowledge and attitude was then used to explore the demographic variables associated with HIV/AIDS, drug abused and reproductive Health Education. The following statistical techniques were applied in the present project: Paired Samples T-test and F-test.
FINDINGS
The demographic profile of the 250 Indian and Thai respondent questionnaires is shown the relationships between demographic characteristics of Indian and Thai were founds Indian boys (54.40%) less than Thai boys (56%), and Indian girls (45.60%) more than Thai girls (44%). In the same age group of Indian and Thai 15 years old, and the same of the secondary school of Indian: (Standard: 9) and Thai: (Grades 3), had significant .05 is shown in Table 1.
Answers were grouped in comparing scores from Indian and Thai disadvantage adolescent after received a treatment on knowledge and attitude about HIV/AIDS, drug abuse and reproductive health education, all participating (N= 200) were group interviewed and after the intervention had significant difference is (0.05), are shown in Table 2-16.
The findings also revealed significant differences between boys and girls in knowledge and attitude towards reproductive health education. Implications of the study for the awareness programmes were suggested.
DISCUSSION
In many Northern states of India and Thailand, the HIV/AIDS, drug abuse and reproductive health needs of Indian and Thai disadvantaged adolescents are either poorly understood or not fully appreciated. Evidence is growing that this neglect can seriously jeopardize the HIV/AIDS, drug abuse and reproductive health education needs and future well-being of them.
The policies addressed the effectiveness of the programmed to highlights what there needs to be done to promote and protect to the disadvantaged adolescent in India and Thailand in the future as: all schools should develop textbooks making learning interesting by following extensive community sensitization in support of adolescent reproductive health education appropriate in Indian and Thai cultural and tradition. Because of Indian and Thai culture and tradition, adolescents kept learning by them long time ago that, made them grow up in the wrong life and have been against morality.
Indian and Thai adolescent problems erupt from families and by themselves after they have been sexually abused or because their families could not understand adolescent behavior and teach them about reproductive health education and sexual health education. Such as should improve in knowledge and attitude among school-going adolescents with the media modern of families. In addition, it was found that sexually abused violated in Indian and Thai adolescents should learn and practice self-protection and should gather knowledge of the Child Rights and much more.
India disadvantaged adolescents
1. Indian disadvantaged adolescents are neglected from home, school and there country of the knowledge. They tend to undeveloped of the confidents and very poorly of the knowledge, attitude about Reproductive Health, drug and HIV/AIDS. Thus as, should to improve and increase and learn the knowledge attitude and understanding of disadvantaged adolescents
2. In India, the responsible organizations both governmental and non-governmental of India have to develop policies for adolescent and should to include HIV/AIDS education and health programme in schools curriculums. In addition, those reproductive health educational services for adolescent girls are especially needed in schools and families.
3. Parents, families, teachers and administrators in orphanages or schools should be encouraged to discuss or give guidance and approval about reproductive health education, drug and HIV/AIDS with their disadvantaged adolescent.

Thailand disadvantaged adolescents
1. Should to improve and increase the knowledge attitude and understanding of disadvantaged adolescents in Northern about reproductive health education and sexual health education.
2. Especially, in Northern, Thailand having spread of higher Drug and HIV/AIDS, thus as should to teach or train to get about the knowledge attitude and understanding of reproductive health to adolescents and parents more then other.
3. The reproductive and sexual health education should be included in the curriculum for the second level primary education (Grades 4-6), Third level secondary education (Grades 1-3) and Fourth level secondary education (Grades 4-6). It is too late to start from Third level secondary education (Grades 1-3) in Thailand thus; the Ministry of Education has to prepare a new policy to put this subject at the Basic Education Curriculum Standard as soon as possible.
4. It appears that in Thailand media has caused a change in sex related values among adolescents. With the misuse of Internet in getting information on sex related issue supplemented by the use of Cell phone, TV, VCD, DVD and booklets is increasing Crime problems of sexually abused. Thus, the qualities of the textbooks or booklets to be distributed to the adolescents.
TABLE

ACKNOWLEDGEMENTS
I thank to Dr. Y. N. Sridhar, Guide of Research for me. I would like too many helpful and thank the following students, Mr. Kasame Sakonllapap, Mr. Santi Jongkongka, Mr. Prasarn Ruansang and people for their supported. I thankfulness to Father Carlo Luzzi, Mother Elisa Cavana, Father Niphot Thiengwiharn and my family, for contributing to this study by providing funding.

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