Adolescent Health

Priority:  Decrease incidence of teenage pregnancy and STI

The FSM teen birth rate in 2020 was 38.7 births per 1,000 females ages 15-17; an increase of 2% from 2019 MCH data reported on teen pregnancy.  High-risk sexual behaviors among adolescents are a significant public health concern in the FSM.  These behaviors account for increasing rates of premature morbidity and mortality by contributing to risk of unintended teen pregnancy, HIV/AIDS, and other sexually transmitted diseases. 

It is customary in most of the FSM States to bear children at a young age. In Pohnpei, the legal age of consent is 18 years old. In Yap, the legal age of consent is 13 years old.  Chuuk has increased the legal age of consent from 13 to 18 years old. Teen mothers are less likely to finish high school and have low school achievements, drop out of high school, and were burden to their families as well.  Cultural and socioeconomic factors may influence high-risk sexual behaviors, which may, in turn, increase risk for STDs, unintended and teen pregnancies. The rate of sexually transmitted diseases (STDs) and HIV/AIDs in the FSM is still a problem. 

The MCH Program is currently working with youth groups in each State to reach the adolescent population.  Such groups are Youth for Change in the states of Chuuk and Yap.  Chuuk Youth Council, and the Public Health PREP- Personal Responsibility Educational Program to encourage positive health behavior activity in adolescents, through comprehensive interventions at age-appropriate levels in a culturally-sensitive manner that will impact the frightening possibilities of unplanned pregnancy and teen birth, sexually transmitted diseases in the adolescent and young adult population, alcohol and drug use. Marijuana and alcohol usage were obvious in youths and older peoples with pressures that create more problems and difficulties in the families and communities.  There is lack of law enforcement on the sales of alcohol, and many businesses in the FSM sell cheap alcohol to the young adults which in turn contributed to the spread of STI’s among adolescents and increase percentage of teen pregnancies in the young girls. 

Although the behavioral risk factors in the adolescent population seems to increase during the reporting year, yet the MCH programs in the states are still reaching out to this population through information dissemination strategies and awareness activities in the schools.

Chuuk State:

In 2020, 100% of the middle schools in Chuuk was visited by the MCH and other Public health programs.  All Public Health programs were part of the campaigns in all the school in which they provided MMR vaccines, HPV vaccinations and de-worming medicines. IEC materials on (STDs including HPV, Teen pregnancy and substance abuse) were also distributed to students during the visits. The data also showed that the number of teen pregnancy (ages 15-17) reported also decreased by 26 %.  This is due to the health awareness conducted in the field by the MCH and other Public Health program partners. 

In 2020, Accident and suicide rate in Chuuk continue to be an issue, this is due to the fact that alcohol and drug (Marijuana, propane/Gas inhalation/kava, betelnuts) use were very common in the communities which influence and entertain many youngsters. Loss to follow up on our positive STD clients was also a challenge, and this was because of the migration of people within the state and abroad.

MCH Program will continue to work collaboratively with Public Health program partners, NGO partners, Dept of Education and the College of Micronesia in doing public awareness on health issues that are affecting adolescence health.

Kosrae State:

The percentage of schools that received educational awareness on teenage pregnancy, STDs, alcohol and drug abuse and healthy lifestyles remain at 100% in 2020 similar to 2019. The rate of suicide among adolescents remained 0 in 2020 and 2019.  The rate of mortality in adolescents due to motor vehicle accidents remained 0 in 2020 and 2019. In 2020, the rate of teenage pregnancy tremendously increased to 43.5/1,000 from 1.4 in 2019. All of these pregnancies were single teens. Most of them were left by their parents on island, unsupervised, while parents seeking medical help and jobs abroad.

All the 7 schools in Kosrae (public and private) received educational awareness on teen pregnancy, STI, alcohol, tobacco used and healthy lifestyles which were provided by the collaborative public health programs. Kosrae state department of education is still lacking curriculum for family life education at the secondary level.

Due to Covid 19 community awareness education workshops on this domain was not conducted.

Kosrae MCH program will strengthen programs at the public health and groups in the communities that provide all the education and counseling in the future after the fact that the pandemic is over. Continue the collaboration between programs and other agencies to do awareness and education. Working with department of education to create curriculum for family life education is in plan for the program to do in next years’ activity along with more parental education on the prevention of teenage pregnancy.

Pohnpei State:

The closing down of schools due to COVID-19 had affected schools activities causing a decline in the number of schools visited to provide awareness and services on adolescents’ health. Schools locked down had also prevented the continuity of school health awareness in the schools for the school year.

In 2020, prior to close out of the schools, collaboration of health teams along with MCH were able to provide HPV vaccinations and sexual health awareness to 28 schools in the state of Pohnpei.  Changing of Lifestyle encourages teen pregnancy and STI, which involves parents accepting their young ones to go on unsupervised courting which ended up in teen pregnancies.

The 2020 data showed a decrease of 33.8/1,000) from 40.6/1,000 birth to teenage mother ages15-17 years old.  This is probably due to the Law on Age of consent where perpetrators are punishable by law.

The MCH program will continue to collaborate with STI and School Health programs to provide awareness on STI and Age of Consent Law to increase the public knowledge and understanding on the regulations and laws on STI and Teen pregnancy. Since FSM is still COVID-19 free, outreach and awareness from the public health teams will still be going on.  All Covid-19 preventive measures will be observed during outreaches on these health awareness issues.

Yap State:

Teenage pregnancy has declines from 26.5/1000 in 2019 to 12.1/1000 in year 2020.   Schools were targeted during the pandemic for education, and MCH took the chance to get involved in the planning to ensure school health is part of this one time visit to the schools.  Multiple agencies and programs worked together to serve the adolescent population such as the Cancer program, Immunization program, FP program, PREP, and other NGO groups as CRS and Red Cross.  With every school, Cancer Program took the liberty to educate the students on HPV and other youth issues as teen pregnancy, STI and other risky behaviors.  Procurement of the MCH vehicle was a big assistance to the program’s outreaches as in school visits and other community activities.  Amid the COVID19 activities, School Health continued and this year with additional focus on proper hygiene and COVID19. 

Even with the 30% of primary schools enrolled into the PREP program, there was still a significant percentage of STI in the youth group (21.7/1000) and teen pregnancies (12.1/1000), the youngest as low as 14 years of age. HPV coverage dropped a little but it was only due to the few that refused the vaccine.  Outreach activities were only done in the schools, but it was not possible to do community outreaches during the year due to COVI19 challenges and activities. Resources for school health are limited to Primary and ECE schools currently. High schools were visited only with invitations or other health activities in the schools. Extending this school health visits to the high school levels will greatly impact education awareness to this age population.

MCH will continue to join and support all Public Health activities on Main Island and in the Outer islands, to reach out to this age population by visiting schools in the state to educate on teen pregnancy prevention, STI and drug and alcohol use awareness.  MCH will continue to work with FP for emphasis on teen pregnancy prevention; STI Programs to reduce the incidence of STI in the youth group, and with Cancer program to educate on cervical cancer and the benefits of the HPV vaccine.  MCH will continue to work closely and support PREP program to conduct their curriculum in the schools.