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Thailand and Family Planning: An Overview
Background Figure 1: Population Pyramid Thailand
The Thai government established its first 75-79
Population Policy in 1970. As a result of
participation in the 1994 International
Conference on Population and Development 60-64 Male Female
(ICPD), reproductive health policies were
reviewed by the National Family Planning
Committee. In 1997, the Minister of Public 45-49
Health set forth the National Reproductive
Health Policy, which includes family planning and Age
maternal and child health. 30-34
As of July 2003, Thailand’s population was 63.2
million. As Figure 1 shows, 25% of the population 15-19
is under the age of 15. About 66% of the
population lives in rural areas and the majority
are farmers reliant on subsistence agriculture. 0-4
The urban population is, however, increasing. Percent
Sweeping social changes have had an impact
Source: UNAIDS, 2002
on sexual lifestyles; there has been an increase
in pre-marital sex, unwanted pregnancies,
unsafe abortions, and the transmission of HIV Almost all of the contraceptive methods
and STIs. used in Thailand are modern methods. Oral
contraception is the most popular method.
Situation Analysis According to users, it is easy, convenient,
inexpensive, and accessible at drug stores.
Examples of progress made: As shown in Figure 3, female sterilization is
When Thailand started its National Family the second most popular method followed by
Planning Programme in 1967, the total injectables, which are increasing in popularity.
fertility rate (TFR) was 6.3. By 2003 TFR Methods for men are not widely used.
was reduced to below replacement level, at
1.7. Of the women using contraception, 68.6% said
Over the last 30 years, Thailand’s annual they did so because they did not want more
population growth rate decreased by more children, 30.5% said they wanted to space
than half; in 1970 it was 3.3% their births, and 1% said they had
and by 2003 it was 0.8%. health problems.
The transformation
In 1970, the contraceptive
prevalence rate (CPR) was in attitudes and Elements that have contributed
14.4%. Since then, CPR behaviour, and the to the success of Thailand’s family
has continuously increased, rapid decline in planning programme include:
reaching 79.2% in 2000. fertility over the Family planning has been a
past several decades government priority, in policy
Figure 2 shows the trend in have been described and implementation. It has been
specific contraceptive methods as a “reproductive integrated with other public
used. health services in existence,
revolution”.
especially MCH.
Figure 2: Trends in Contraceptive Method Use sector have facilitated work that the
government alone would not have been able
78.9
79.2
90 to provide. Government support of this work
72.2
1987
69.8
80 1997 comes in the form of technology, funds,
61.8
contraceptives, and medical equipment.
60.1
2000
70
% of Married Women
60
University-based research has facilitated
50
acquisition of data.
40
Integration with other development
programmes, including agriculture, education,
26.8
22.6
23.1
22.3
30
and community development, has increased
22
22
17.7
17.3
the demand for family planning.
20
7.8
6.4
5.3
10
3.2
3.1
2.4
1.8
1.7
1.7
1.5
1.2
0.3
2
1
0
0
0
Pill Injectables Implants IUD Female Male Condom Any Any Other Any
sterilization sterilization modem traditional methods method
method method
Method Used Rapid change and urban migration
have had a disruptive effect on
Source: Thailand DHS, 1987;1997; Thailand Reproductive Health
Profile, 2003, Unpublished social structures.
Family planning services are extensive. Although a period of fast economic and social
Methods of contraception have been provided transformation improved the quality of life, there
conveniently, largely free of charge, without is now evidence that the income disparities both
incentives, and with controls for quality and within and between regions and populations are
safety. widening.
A range of health care providers have been
involved in implementing family planning Current Family Planning Efforts
programming, from physicians to midwives.
This enables the government to expand The Thai Government, led by the Prime
services from the district to the community Minister’s Thai Rak Thai party, won the last
level, providing convenience to clients and national election on a pro-poor, pro-rural, and
more choices in contraception. pro-Thailand platform. Since its installation, the
Partnerships with NGOs and the private government has focused on five programmes,
Figure 3: Contraceptive Method Use by Married Women in Thailand, 2000
Other methods: 0.3% Not using any
Condom: 1.7% method: 20.8%
Male sterilization: Pill: 26.8%
1.2%
Female
sterilization :
22.6%
Injectables: 22%
IUD: 3.1% Implants: 1.5%
Source: Thailand Reproductive Health Profile, 2003, Unpublished
including providing universal health care to Key Indicators:
the population at 30 baht per visit. The
Total Population, 2003 (in millions) 63.2
government is in the process of implementing
its medium-term strategies through the Ninth Population Growth Rate, 2003 0.8%
National Economic and Social Development Plan Population Density, 2003 (people per
122
(2002-2006). square km)
Urban Population, 2003 34%
The present National Plan clearly recognizes Population <15 years of age, 2003 25%
reproductive health. Strategies identified Total Fertility Rate (TFR), 2000-2005 1.7
include:
Contraceptive Prevalence Rate (CPR),
Maintain fertility at replacement level by 79.2%
2000
fostering knowledge and understanding,
providing health education and information, - Pills 26.8
and integrating reproductive health and - Injectables 22.0
family planning; - Implants 1.5
Disseminate population knowledge into - IUD 3.1
education curriculum at every level; and - Female Sterilization 22.6
Promote life skills learning, sex education,
- Male Sterilization 1.2
family education, and equitable gender roles.
- Condom 1.7
With regard to family planning, the Thai - Other Methods 0.3
government aims to: Unmet Need 5.9%
Accelerate family planning efforts in areas Average age at first marriage, 2003 23.5
where TFR is still high and CPR is low; Average age at first birth N/A
Provide services for married and unmarried
Crude Birth Rate (CBR) (per 1,000
male and female youth, specifically aiming to 19.6
population), 1995-2000
reduce adolescent pregnancy;
Promote a three-year birth space interval;
Maternal Mortality Ratio (MMR), 2000 36.46
Monitor quality of services; Infant Mortality Rate (IMR), 2000-2005 20
Promote male involvement in family planning; HIV adult prevalence, 2002 1.8%
and
Better meet the needs of specific populations,
Figure 4: Population Projection: Thailand including ethnic minorities, such as Muslims,
4.9
migrant workers, slum dwellers, and the
5
TFR
72.8
80
under-served.
Total Population 72.1
70
63.1
4
57.8
60 The government has an integrated
50.6
development policy of population,
50
3 environment and maternal and
Population in Millions
child health.
TFR
41.3 40
2.3
2 1.9
30
1.7
The Ministry of Health is the main provider of
1
20
family planning services in the country.
10
Challenges and Opportunities
0 0
1976 1987 1994 2004 2025 2050
1. Inadequate number of health personnel.
Source: World Population Policies, 2003 The number of health personnel in Thailand
is inadequate, especially for deployment at access to services. The Southern region
the health centre level (tambon/sub-district of Thailand still has: low CPR and high TFR;
level). According to staffing patterns (1995- limited reproductive health information and
1997), each health centre should have five services for unmarried youth and weak male
staff members yet the average is only three. involvement.
There are wide regional disparities, with
the lowest numbers of health personnel 3. Decreasing use of male contraceptive
in the Northeast, followed by the North. methods. Use of male contraceptive methods
Shortages of health personnel are also due is low and decreasing. Generally, Thai women
to ill-distribution of staff, designators and take the responsibility of limiting or spacing
transfers. births. Myths regarding condoms and
vasectomies abound, and that Thai men do
2. Low access to family planning services in not like to use condoms for family planning as
Southern region. While Thailand has been they associate them with preventing sexually
overall successful with its family planning transmitted diseases and HIV.
programming, there are still disparities in
Sources
1. Epidemiological Fact Sheet on HIV/AIDS and Sexually 6. “Thailand Reproductive Health Profile” by Reproductive Health
Transmitted Infections: Thailand, 2002. UNAIDS, UNICEF & Division, Department of Health, Ministry of Public Health,
WHO. Thailand. With support from WHO. Unpublished, 2003
2. Thailand Country Profile, 2003. International Planned 7. Thailand, USAID Country Profile, 2003: http://www.usaid.gov/
Parenthood Federation: http://ippfnet.ippf.org/pub/IPPF_ pubs/cbj2003/ane/th/
Regions/IPPF_CountryProfile.asp?ISOCode=TH 8. World Contraceptive Use, 2003, United Nations, Population
3. Thailand Demographic and Health Survey, 1987; 1997. Division, Department of Economic and Social Affairs.
4. Thailand Country Health Profile, WHO/SEARO, 2003: http:// 9. World Population Data Sheet, 2003. Population Reference
intranet/cntryhealth/thailand/index.htm Bureau. www.prb.org
5. Thailand Health and Population, World Bank. http://www. 10. World Population Policies, 2003. United Nations, Population
worldbank.or.th/ Division, Department of Economic and Social Affairs.
For Further Information please contact:
The Department of Family and Community Health
World Health Organization
Regional Office for South-East Asia
World Health House
Indraprastha Estate
Mahatma Gandhi Marg
New Delhi - 110002 India
Email: fch@whosea.org
www.whosea.org
http://w3.whosea.org/fch
