Speech on Health Promotion and Environmental Health Strategy:
A Stronger Tomorrow
By
Mr Kwabena ASANTE-NTIAMOAH
Country Director a.i for UNFPA Thailand
The 14th National Health Promotion and Environmental Health Conference 2021
Beyond COVID - 19 Crisis: A Decade of Health Transformation
by Department of Health, Ministry of Public Health, Thailand
Monday 9 August 2021
Good morning, Sawadee Krup
Dr. Satit Pitutacha, Deputy Minister of Public Health
Dr. Suwannachai Wattana-yingcharoen,
Director-General, Department of Health, Ministry of Public Health
My colleague
Dr. Daniel Kertesz, WHO Representative to Thailand
Dignitary guesses, ladies and gentlemen,
It is an honour for me to speak to all of you this morning. It would have been best to have this occasion as an onsite event but due to the pandemic we all have adjusted to the virtual way of working.
On behalf of UNFPA in Thailand, I would like to congratulate the Ministry of Public Health for its continuous commitment to health promotion and environmental health strategy with this 14th national conference as a climax. Thailand has made great progress in the health sector and for the past five decades a number of achievements, such as these have been made:
- 99 percent of the births on the soil of Thailand are attended by skilled health personnel.
- Maternal mortality ratio of 21.8 per 100,000 live births
- A high contraceptive prevalence at 78 percent,
- The Universal Health Coverage of 99.2 per cent; and
- The recent ‘Line Official Teen Club’ which is the official digital platform on sexual and reproductive health for young people.
All these achievements reflect hard and continuous work in health promotion by service providers and commitments by the Thai government. The success is also an advancement under the International Conference on Population and Development (the ICPD).
Friends, these past two years have been among the most difficult times for everyone--from medical personnel, senior citizens, pregnant women, people living with disability and chronic disease, to people from all walks of life. No matter how strong any public health system is, the COVID-19 pandemic of this present scale and magnitude is a reminder to all of us to plan better and take a critical review of the public health system in a holistic manner with a strong focus on the vulnerable.
As an underlying foundation for all healthy life, UNFPA applauds Thailand for its comprehensive health promotion for all segments of its population. Thailand, prior to the pandemic, has always emphasised health promotion for the population including the vulnerable groups like children, adolescents, women, older persons, people living with disabilities and ethnic, stateless and migrant people which the pandemic has demonstrated that this focus is important.
During this pandemic, UNFPA is continuously advocating for the continuous provision of quality health services for sexual and reproductive health services, addressing gender based violence, ensuring and provision of personal protective equipment especially for frontline health workers through partnerships globally. In Thailand, during this pandemic time, UNFPA focuses our advocacy on policies of three areas. They are sexual and reproductive health, response to GBV and addressing inequality.
The recent figure from the Department of Health shows that from December last year to 17 July this year, up to 856 pregnant women, both Thai and migrant, are affected of COVID-19. Among them, 15 died. The recent measure to include pregnant women of more than 12 weeks’ pregnancy in the priority list of the population to be vaccinated is definitely the right decision. Since women do not stop giving birth during pandemics or emergency situations, investing in a system that supports maternal health and safe delivery even during crises is a key strategy that saves life and births, reducing preventable maternal deaths. In this light, the Department of Health, UNFPA and Reckitt launched a public-private partnership project called ‘Save Birth for All’ to ensure safe delivery to ethnic mothers living in the rural areas in the north of Thailand since last year.
During this pandemic, the Department of Health has observed that the number of women with an unplanned pregnancy who seek counseling services have increased almost two times. Although Thailand has a high contraceptive prevalence of 78 percent among women of reproductive age, that rate is still low among the young population. Statistics show that adolescents with unplanned pregnancy as a result from not using contraceptives increased from 24.7 percent in 2018 to 27.1 percent in 2019. In the same period of time, those who have unplanned pregnancy as a result from not using contraceptives consistently or correctly increased from 26.5 percent to 33.5 percent. These figures demonstrate that whether it is an emergency situation or not, Thailand needs a strategy to ensure that young people can exercise their rights and choices in family planning with an informed decision. The Department of Health has issued the 2nd National Reproductive Health Development Policy and Strategy from 2017 to 2026 on the Promotion of Quality Birth and Growth to promote voluntary births, in which every pregnancy is planned and intended, as well as provide support for women having children. Yet, there might be a need to explore more participation of stakeholders, especially young people and vulnerable groups like ethnic youth and youth with disability, to design a policy that is friendly to them. It might be a friendly consulting service, comprehensive sexuality education and de-stigmatisation from adults including community members and service providers. The Act to Prevent and Solve the Adolescent Pregnancy is seen to be a good policy instrument for this participation.
Pandemic situations invariably affect almost all sectors of a country beyond the health sector, in areas such, the safety and security of women and girls, specifically gender based violence. Globally, one in three women experiences physical or sexual violence in her lifetime. In Thailand, the statistics show that the number of women facing violence has increased. This unfortunate phenomena of violence against women was at its highest in May 2021, with 4,461 women or 149 women per day on average. UNFPA is heartened that the One-Stop Crisis Centres in some hospitals are open during the pandemic. This ensures that survivors can access life-saving services even during the pandemic time. UNFPA looks forward to working more closely with ministries especially with the Ministry of Public Health to ensure that this life-saving service is provided equally both at the national and sub-national levels both during and after the pandemic times.
The last but not least area of our advocacy during this pandemic is addressing inequality. UNFPA in partnership with College of Population Study, Chulalongkorn University, launched a study on COVID-19 impact on older persons. It shows that they were most affected in terms of economic hardship during the big spreading last year. However, in this present round of spreading, the statistics show that up to 66 percent of deaths are among older persons. Among 1,422 deaths since April, 356 are those aged 61-70; 305 aged 71-80; and 287 aged 51-60. Spreading within families is the top reason for the death. In this light, the policy and strategy of health promotion and environment health strategy might need to include guidelines, measures or even special financial instruments to ensure that older persons and populations in fragile conditions especially in the lower economic quintile are safe even in emergency situations. With this focus, Thailand, as a soon-to- be super-aged society, will have appropriate preparedness measures in place.
Ladies and gentlemen, we cannot deny that the present pandemic is shaking our hope and plan for sustainable development that we all want. As Thailand and the rest of the world seek to build back better, three steps are urgently needed. First, we need to take immediate actions to control the COVID-19 pandemic and meet the needs of the most vulnerable. Second, we need to boost economic recovery and sustainability by shifting towards a more diversified economy and providing financial relief to the most vulnerable people. Last but not least, we need to address inequalities, especially gender inequality, and deepen the promotion and protection of human rights. COVID-19 recovery is an opportunity to address inequalities by investing in education and health coverage, including sexual and reproductive health. This is an opportunity to empower women and girls, ensure equal rights and participation in decision making — and to invest in the education, employment and leadership of young people. These investments are in line with UNFPA’s planned partnership with Thailand in the next five years. They are to create lasting benefits for all including vulnerable populations.
Distinguished guests and participants, I wish you all the best experience and discussion from meetings in this conference. UNFPA always stands firm in partnering and supporting Thailand for a stronger tomorrow for all, leaving no one behind.
Thank you, Khop Khun Krup.
