Thailand SRMNCAH factsheet: December 2020

THAILAND | 1 Country profile Value Year of data GNI (PPP) per capita63 18 520 2019 Percentage of population below international poverty line26 0 2018 Percentage of population using safely managed sanitation services including a handwashing facility with soap and water NA NA Improved sanitation41 100 2019 Handwashing facility with soap and water41 89 2019 Percentage of population using safely managed drinking water services41 100 2019 Source: 63World Bank, World Development Indicators 2019 | 26Global Health Observatory - World Health Organization 2018 | 41Multiple Indicator Cluster Survey 2019 Demographic Value Year of data Total population65 69 800 000 2020 Total under-5 population65 3 596 000 2020 Total adolescent population (10–19 years)65 8 492 000 2020 Women in reproductive age group (15–49 years)65 17 177 000 2020 Annual number of births61 707 000 2019 Total fertility rate (births per woman)41 1.4 2019 Adolescent birth rate (per 1000 women aged 15–19 years)41 23 2019 Births registered (%)41 100 2019 Source: 65World Population Prospects 2020 | 61United Nations Population Division 2019| 41Multiple Indicator Cluster Survey 2019 • Under-5 population 5% • Total adolescent population 12% • Women in reproductive age group 25% • Total fertility rate 1.4 • Adolescent birth rate 23 per 1000 population • Births registered 100% Basic profile Source: 48Trends in maternal mortality 1990 to 2015: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division 58Trends in maternal mortality 2000 to 2017: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division 1.6% annual rate of reduction between 2010 and 2017, and the assumption that all things will remain as in 2017 considered for calculating the 2030 projection for maternal mortality ratio • 14% reduction in MMR between 2000 and 2017 Impact indicators Maternal mortality ratio (per 100 000 live births) 40 23 43 43 42 38 37 15 100 80 60 40 20 0 1990 1995 2000 2005 2010 2015 2020 2025 2030 THAILAND SRMNCAH Factsheet December 2020 2 | THAILAND • Stillbirth rate (per 1000 births) is 660 • Adolescent mortality rate (deaths per 100 000 adolescents) is 960 Source: 60UN IGME database 2019 • 75% reduction in neonatal mortality rate between 1990 and 2019 Source: UN Inter-Agency estimates: Levels and Trends in Child Mortality: Report 2020 (UN IGME 2020) 4.0% annual rate of reduction between 1990 and 2019, considered for calculating the 2030 projection for neonatal mortality rate Neonatal mortality rate (per 1000 live births) SDG target NMR: 12 SDG target achieved 1990 1995 2000 2005 2010 2015 2020 2025 2030 100 80 60 40 20 0 3 20 17 13 10 8 6 5 • 76% reduction in under-5 mortality rate between 1990 and 2019 Source: UN Inter-Agency estimates: Levels and Trends in Child Mortality: Report 2020 (UN IGME 2020) 4.9% annual rate of reduction between 1990 and 2019, considered for calculating the 2030 projection for under-5 mortality rate Under-5 mortality rate (per 1000 live births) SDG target U5MR: 25 SDG target achieved 37 28 22 17 14 11 9 5 1990 1995 2000 2005 2010 2015 2020 2025 2030 100 80 60 40 20 0 Nutrition indicators • Prevalence of LBWa increased from 9% to 11% between 2015–2016 and 2019 • Stunted under-5 children increased from 11% to 13% between 2015–2016 and 2019 Source: 39Multiple Indicator Cluster Survey 2015–2016 | 41Multiple Indicator Cluster Survey 2019 | 47The State of the World’s Children Reports 2019 For definition of the superscript please refer to page number 125 of the country fact sheet 201647 Underweight in adolescents 8%d Overweight in adolescents 20%e Stunting in under-5 childrenc 100 80 60 40 20 0 Wasting in under-5 childrenb 8%5% 11% 13% 2015–201639 201941 Prevalence of anaemia in women aged 15–49, disaggregated by age and pregnancy statusf NA THAILAND | 3 Source: 16Global Burden of Disease study 2019 Causes of maternal deaths • Proportion of direct maternal deaths decreased from 86% to 84% between 2015 and 2019 Source: 25Global Health Observatory - World Health Organization 2017 More than 6700 under-5 children died, mainly due to: • newborn causes • pneumonia and diarrhoea • infections Causes of under-5 deaths Source: 25Global Health Observatory - World Health Organization 2017 More than 3600 newborns died in the first month of life mainly due to: • prematurity • congenital anomalies • birth asphyxia Causes of newborn deaths Other direct maternal disorders Maternal haemorrhage Maternal hypertensive disorders Indirect maternal deaths Maternal abortion and miscarriage Late maternal deaths Maternal sepsis and other maternal infections Ectopic pregnancy Maternal obstructed labour and uterine rupture Maternal deaths aggravated by HIV/AIDS Prematurity Congenital anomalies Birth asphyxia and birth trauma Other communicable, perinatal and nutritional conditions Sepsis and other infectious conditions of the newborn Acute lower respiratory infections Injuries Tetanus Other noncommunicable diseases Meningitis/encephalitis HIV/AIDS Diarrhoeal diseases Malaria Measles Congenital anomalies Prematurity Other noncommunicable diseases Acute lower respiratory infections Birth asphyxia and birth trauma Other communicable, perinatal and nutritional conditions Injuries Sepsis and other infectious conditions of the newborn Diarrhoeal diseases Meningitis/encephalitis HIV/AIDS Tetanus Measles Malaria 3.7% 2.5% 0.5% 0.5%3.7% 37.9% 18.5% 12.4% 11.6% 8.7% 0%1.0% 1.0% 0.3% 0.1% 0% 0.01% 0% 26.1% 12.8% 10.6% 6.4% 3.5% 38.2% 3.5% 2.6% 0.9% 0.8% 0.5% 0.2% 0.03% 26.7% 22.6% 10.8% 8.8% 7.8% 7.7% 7.1% 4 | THAILAND SRMNCAH policy survey Presence of key national policy/guidelines on SRMNCAH at the national level (Y/N) On family planning/contraception45  On sexually transmitted infections diagnosis, treatment and counselling45  On comprehensive national cervical cancer prevention and control45  On antenatal care45  On childbirth45  On postnatal care for mothers and newborns45  On management of low birth weight and preterm newborns45  On child health and development of children45  On early childhood development45  On integrated management of childhood illness45  On management of childhood pneumonia45  On management of childhood diarrhoea45  On management of malaria with appropriate recommendations for children45  On management of acute malnutrition in children45  On adolescent (10–19 years) health issues45  Multisectoral plan of action for violence against women45  On CAC/post-abortion care15   Yes  No Source: 45Reproductive, Maternal, Newborn, Child and Adolescent Health Policy Survey, 2019 | 15Global Abortion Policies Database, 2017 Causes of adolescent deaths Top 5 causes of adolescent deaths Source: 24Global Health Observatory - World Health Organization 2016 2 Drowning 3 Self-harm 4 Interpersonal violence 5 LeukaemiaRoad injury 1 THAILAND | 5 Source: 39Multiple Indicator Cluster Survey 2015–2016 | 41Multiple Indicator Cluster Survey 2019 | 66Global Health Observatory - World Health Organization 2019 Coverage indicators Sexual, reproductive and maternal health • 90% received 4+ ANC visits during last pregnancy • 99% institutional deliveries • 99% deliveries attended by skilled health personnel • 5% increase in C-section between 2015–2016 and 2019 • More than 50% but less than 70% women aged 30–49 were screened for cervical cancer66 Source: 41Multiple Indicator Cluster Survey 2019 Equity in coverage 100 80 60 40 20 0 Pe rc en ta ge o f w om en o f re pr od uc tiv e ag e (1 5– 49 ) w ho h av e th ei r n ee d fo r fa m ily p la nn in g s a tis fie d w ith m od er n m et ho d s U nm et n ee d fo r f am ily pl an ni ng (t ot al ) Pr op or tio n of w om en ag ed 1 5– 49 w ho re ce iv ed fo ur o r m or e an te na ta l c ar e vi sit s Pr op or tio n of w om en ag ed 1 5– 49 w ho re ce iv ed tw o d os es o f t et an us In st itu tio na l d el iv er y Pr op or tio n of b irt hs at te nd ed b y sk ille d he al th p er so nn el C -s ec tio n Pr op or tio n of w om en w ho ha ve p os tp ar tu m c on ta ct w ith a h ea lth p ro vi d er w ith in tw o d ay s o f d el iv er y 89 % 88 % 6% 8 % 91 % 90 % 52 % 51 % 99 % 99 % 99 % 99 % 33 % 35 % N A N A 2015–201639 201941 By wealth Poorest Richest By geography Rural Urban By maternal education No education (Pre-primary or none) Secondary education FP satisfied with modern methods (%) FP unmet need (%) ANC 4+ visits (%) Two doses of tetanus (%) Contact with a health provider within two days of delivery (%) SBA (%) Institutional delivery (%) 89 85 92 53 99 99 98 98 8 9 83 52 NA NA Contact with a health provider within two days of delivery (%) FP satisfied with modern methods (%) FP unmet need (%) ANC 4+ visits (%) Two doses of tetanus (%) SBA (%) Institutional delivery (%) 89 87 9 8 89 99 51 51 99 919999 NA NA Contact with a health provider within two days of delivery (%) FP satisfied with modern methods (%) FP unmet need (%) ANC 4+ visits (%) Two doses of tetanus (%) SBA (%) Institutional delivery (%) 85 90 8 12 62 93 62 100 99 49 100 98 NA NA 6 | THAILAND Newborn health • 8% newborns got skin-to-skin contact in the first hour of life Source: 39Multiple Indicator Cluster Survey 2015–2016 | 41Multiple Indicator Cluster Survey 2019 Proportion of infants who were breastfed within the first hour of birth Proportion of newborns who have postnatal contact with a health provider within two days of delivery Skin-to-skin contact in the first hour of life Hospital discharge at least after 24 hours after birth Proportion of newborns who have home visits in the first week of life NA NA NA NA NA NA NA 100 80 60 40 20 0 40% 34% 8% 2015–201639 201941 Child health and development • 15% increase in children getting full immunization between 2015–2016 and 2019 • 94% got measles vaccination • 92% introduced semisolid or soft foods at 6–8 months Source: 39Multiple Indicator Cluster Survey 2015–2016 | 41Multiple Indicator Cluster Survey 2019 Pe rc en ta ge o f i nf an ts <6 m on th s w ho a re fe d ex cl us iv el y w ith b re as t m ilk In tro d uc tio n to se m iso lid o r s of t fo od s 6 –8 m on th s Pe rc en ta ge o f c hi ld re n fu lly im m un ize d M ea sle s/ M R va cc in at io n at 9 m on th s V ita m in A su pp le m en ta tio n 6– 59 m on th s Pe rc en ta ge o f c hi ld re n w ith d ia rrh oe a re ce iv in g or al re hy d ra tio n sa lts (O RS ) Pe rc en ta ge o f c hi ld re n w ith d ia rrh oe a w ho re ce iv ed O RS a nd z in c Pr op or tio n of c hi ld re n w ith su sp ec te d p ne um on ia ta ke n to an a pp ro pr ia te h ea lth p ro vi d er A nt ib io tic tr ea tm en t f or c hi ld re n w ith a cu te re sp ira to ry in fe ct io n (A RI ) s ym pt om s C hi ld re n ha ve p la y th in gs a t h om eg C hi ld re n w ith in ad eq ua te su pe rv isi on h 100 80 60 40 20 0 72 % 8 2% 94 % 89 % 14 %2 3% 92 % 85 % 80 % 76 % 6% 5% N A N A N A N A N A 70 % N A 73 % N A 80 % 2015–201639 201941 Adolescent health and development Source: 29Global School-based Student Health Survey 2015 | 41Multiple Indicator Cluster Survey 2019 For definition of the superscript please refer to page number 125 of the country fact sheet 100806020 400 Physical activity (>1 hour/day) or prevalence of insufficient physical activity among adolescentsi Current tobacco use (any form)j Attempted suicidek Percentage of students who were in a physical fight one or more times during the 12 months before the surveyl Percentage of women aged 20–24 who were married or in a union before age 18 12% 14% 13% 26% 20% 201529 201941 THAILAND | 7 • Out-of-pocket health expenditure is decreasing General government expenditure on health as % of total government expenditure Out-of-pocket health expenditure as % of total expenditure on health 100 80 60 40 20 0 15% 15% 13% 11% Source: 17Global Health Expenditure database 2015 | 18Global Health Expenditure database 2018 Health system indicators Health financing Health workforce Source: 23Global Health Observatory - World Health Organization 2015 | 64World Health Statistics 2020 • 28 per 10 000 population availability of doctors, nurses, midwives versus 44.5 per 10 000 recommended in Global Strategy23 • 28 per 10 000 population availability of midwives and nurses versus 18 per 10 000 population in the South-East Asia Region64 Service delivery Source: 44Provisional calculation (2021) based on available data in DHS/MICS 2012–2019; Step surveys & Nationally reported data RMNCH service coverage index 89% UHC service coverage index 82% 100 80 60 40 20 0 Total expenditure on health, per capita (USD) 1000 800 600 400 200 0 598 723 201517 201818 202144 8 | THAILAND Break-up of UHC coverage index of essential health services with RMNCH sub-index RMNCH Care-seeking behaviour of suspected pneumonia Child immunization coverage (DPT3) Pregnancy care Family planning coverage – satisfied needs Infectious disease control Noncommunicable diseases Prevalence of normal blood pressure level in population age standardized Tobacco non-use Prevalence of normal fasting blood sugar level in population Service capacity and access Health worker density (Physician, pyc., surg.) (%) Density of hospital beds, expressed as % of global threshold, 18/10 000 (proxy for basic hospital access) Health security IHR compliance (%) Source: 44Provisional calculation (2021) based on available data in DHS/MICS 2012–2019; Step surveys & Nationally reported data 80% 97% 94% 88% 70% 100% 97% 100% 70% 55% Tuberculosis (effective) treatment coverage HIV antiretroviral therapy coverage Access to basic sanitation 99% 71% 75% 89% 81% 73% 88% aLow birth weight (LBW): Percentage of births with a reported birth weight <2.5 kilograms regardless of gestational age bWasting in under-5 children: Children whose Z-score is below minus two standard deviations (-2 SD) from the median of the reference population are considered thin (wasted), or acutely undernourished cStunting in under-5 children: Children whose height-for-age Z-score is below minus two standard deviations (-2 SD) from the median of the reference population are considered short for their age (stunted), or chronically undernourished dUnderweight in adolescents: Percentage of adolescents aged 10–19 years with BMI <−2 SD of the median according to the WHO growth reference for school-age children and adolescents eOverweight in adolescents: Percentage of adolescents aged 10–19 years with BMI > 1 SD of the median according to the WHO growth reference for school-age children and adolescents fHaemoglobin levels are shown in grams per decilitre (g/dl) (For non-pregnant women <12.0 g/dl and for pregnant women <11.0 g/dl) gChildren have play things at home: Percentage of children under age 5 who play with two or more types of playthings hChildren with inadequate supervision: Percentage of children under age 5 left alone or under the supervision of another child younger than 10 years of age for more than one hour at least once during the past week iPhysical activity (>1 hour/day) or prevalence of insufficient physical activity among adolescents: Percentage of students aged 13–17 years had physical activity (>1 hour/day) or prevalence of insufficient physical activity among adolescents jCurrent tobacco use (any form): Percentage of students aged 13–17 years who currently used any tobacco products (used any tobacco products on at least 1 day during the last 30 days before the survey) kAttempted suicide: Percentage of students aged 13–17 years who seriously considered attempting suicide during the 12 months before the survey lPercentage of students who were in a physical fight one or more times during the 12 months before the survey: Percentage of students aged 13–17 years who were in a physical fight one or more times during the 12 months before the survey