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D. K. Djan , Y. Kawaguchi , K. Tabei , S. Chanthamath , S. Yamazaki ,11
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S. Lucas , T. Kikuchi , M. Sato , A. Imoto11) Nagasaki University School of Tropical Medicine and Global Health

BACKGROUND | Current situation

OBJECTIVES

1. High and increase rate of teenage pregnancy◆ To assess actual situation of teenage pregnancy andmaternal health services for adolescents◆ To assess the gap between the expectation and theproblems which occurred in the communities◆ To examine how the programs reach to the people• Despite the rapid decrease of neonatal/infant/Under fivemortality rate, adolescent fertility rate is upward• Proportion of girls who are already mothers are increased
from 6.3% in 2002 to 13.6% in 2013.

2. Low rate of contraceptive use• Half of adolescent girls don’t use contraception however
they have knowledge
Knowledge of familyplanning methods
Regardlessof economicstatus

Contraception use
among married women of
reproductive age

METHODOLOGY | Interview
We visited different level of health facilities and health relatedorganizations to conduct in-depth interviews to health careproviders and pregnant women.

Gap
Our Interviewees

Source: European Union(2017) The Philippines Health System Review

3. Inadequate family planning services• Distribution of contraception and sex education don’t match
their situation
More than 1 in 3 (37%) of marriedadolescent haveunmet needs

Health providers

80% of first sex
among high school
students areunprotected!!

Pregnant women(aged 15-19)

Source : Field Trip Report 2017. Figure 4. Visited organization presented by level of intervention

RESULT | What we found through the interviews
1. Actual situation of teenage pregnancy and maternal health services for adolescents
Frailty of adolescent
Programmes for adolescent health• Most of the pregnant women are not married and• Facilities follow Adolescent Health Development
Program (AHDP), Healthy Young Ones (HYO), Populationcommittee “Pop-com”• Free to access to the health facilities by using PhilHealthunexpected pregnancy.
• Most of them dropped out schools due to thepregnancy.
• Injectable contraceptive method is the most preference.

2. The gap between the expectation and the problems which are occurred in the communities
Lack of human resourcesBasic knowledge on family planning method• Brain drain of medical professionals are severe• There are only a few doctors in a Barangay Health • No one have used contraception.
Station• It Teenage pregnancy is acceptable, because it is not• Sexual education in health facilities focus on how torare among family members and friends.
prevent second teenage pregnancy after first pregnancy. • My partner or the partner’s family can support
financially.
Low awareness• Teenage pregnancy is recurrent, but family of teen • Many pregnant women have attended sex education
class in secondary school: Risks of adolescentmothers are not care about the issue.
pregnancy, Menstrual Cycle and Sexual Transmitted• Teenage pregnancy is related to other problems: LowInfections.
Social Economic Status, Lack of Education, neglected byparents, rape, etc.

3. How the programs reach to the people
Low utilization of resources• Even though midwives are allocated Barangay Health
Station, all pregnant women must go to the hospitals or
Rural Health Unit (RHU) which leads over crowding

Delay and lack of contents of sex education• There is no policy for sex education

DISCUSSION

1. Sex education including risks and prevention of teenage
pregnancy should be appropriately provided at secondary
schools. Practical lesson for usage of family planning methods
as well as lectures and these education should becontinuously provided until their graduation.
2. Apart from sex education in the schools, social media can also
enlighten adolescent to be aware of their reproductive
health.
3. Sensitization of family planning for married adolescent
women and the husband need to be provided.

Low utilization of resources• No adolescent pregnant women mentioned about
existence of Youth Friendly Facility which is supposed to
be used for youth encouragement.
• adolescents cannot buy contraception without parents’permissions even if these are available anywhere.

CONCLUSION

The actual situation of the adolescents such as marital status,
educational attainments, preference of contraceptives andpregnancy was observed. We also observed that several
maternal health programs have been processed. What we
assessed as regards to the gap between the expectation and theproblems which occurred in the communities was lack of humanresources. The programs did not actually reach the people
because of low utilization of resources and delay and lack ofcontents of sex education.

ACKNOWLEDGEMENT
We would like to thank Department of Health (DOH), DOH Region VIII, Quezon City Health Department, Eastern Visayas Regional
Medical Cener, Batasan Hygiene Clinic, Payatas B Health Center, Smoky Mountain Health Center, San Vicente Barangay Health Station,Alang Alang Rural Health Unit and all organization kindly accepted our visit.
There is no conflict of interest.