Understanding Sexual Reproductive Health from the perspective of Older Adolescents in Northern Thailand: A Phenomenological study

Abstract

Background: Worldwide, Sexual Reproductive Health (SRH) issues comprise a third of health problems for women aged 15-44. SRH education equips people with knowledge of concepts around sexuality and reproduction, and the attitudes and skills help to make informed decisions to prevent sexual and reproductive ill-health problems, including unplanned pregnancy and HIV/AIDS, and other sexually transmitted infections (STIs). The aim of this study is to explore the experiences of older adolescents relating to SRH, examining their attitudes toward sex and contraception, and to identify the gaps in decision-making to prevent risk-taking behaviour.Methods: A qualitative phenomenological study was undertaken with 30 adolescents aged 18-19, purposively and snowball sampled from a university in Northern Thailand from July 2020 to January 2021. In-depth individual interviews were conducted until data saturation was reached. Data were recorded, transcribed, and analysed in ATLAS.ti version 9, using Modified Interpretative Phenomenological Analysis to identify related themes.Results: Participants revealed five key experiences of SRH related to sex and contraception: Keeping a secret; Seeking Freedom and Love; Having SRH education; Self-protection; Parental acceptance. All findings reflected the value and impact of SRH on the experiences of older adolescents.Conclusions: This study provides detailed knowledge about adolescents’ perspectives of SRH and rights in terms of accessing sexual and reproductive health care and information as well as autonomy in sexual and reproductive decision-making. Gaining SRH education can assist decision-making concerning contraceptive methods for family planning and STI prevention. The study recommends that SRH and rights should be designed responsively and appropriately for female and male adolescents, their families, and society. The inclusion of SRH issues should be informed and advocated healthcare providers, educators, policy makers, and systems to empower adolescents in order to achieve effective SRH education.

Narratives on Sex and Contraception From Pregnant Adolescent Women in a Northern Province in Thailand: A Phenomenological Study

“…nausea, headache and migraine, weight gain, breast tenderness or mood swings) were barriers to use and this supports findings from previous studies. 26,45,46 This study also revealed that the reasons for discontinuation or non-use of family planning were lack of sex education and contraceptive methods as well as fear and concern about contraception. Meanwhile, other studies illustrated a similar barrier to contraceptive use in terms of fear of side effects by users.…”

“…The effect of education on attitudes towards contraceptive use have been established. 26 A study in Thailand 53 found that adolescent women who achieve well in school and do not exhibit risk behaviours are more likely to become pregnant when they do not have sufficient knowledge and skills to protect themselves from risky sexual behaviours, and that adolescent men did not understand how contraceptive methods worked.…”

“…This reflects changing Thai family patterns. 25,26 Adolescents are more likely to engage in risk-taking behaviour, including in sexual activity, and parental acceptance of such behaviour was manifest in some participants' accounts (e.g. overt approval of cohabiting with sexual partners).…”

“…overt approval of cohabiting with sexual partners). 26 A constructive parental role regarding adolescent sexual and reproductive health is associated with reduced levels of risk-taking behaviour in their children. Parental monitoring, discipline and communication with fathers, for female adolescents, can predict transition to first sexual intercourse and has been shown to delay having premarital sex and increase contraceptive use.…”

Understanding sexual and reproductive health from the perspective of late adolescents in Northern Thailand: a phenomenological study

“…Previous studies have explored the experiences of pregnant adolescents and revealed that contraceptive decision-making is influenced by the quality and type of sexual health education, especially knowledge about contraception and adolescents’ perceptions regarding hormonal contraception as well as gender-based power imbalances in intimate relationships [ 29 – 31 ]. Gender roles and imbalances of power can influence the outcomes of adolescent sexual activity including pregnancy when girls lack the negotiation power to insist on contraception use [ 1 , 19 , 30 , 32 ]. The influence of gender roles on sexual and reproductive health may be presented in terms of existing gender power imbalance and the assumption that males have higher social status than females [ 30 , 33 ].…”