The World Health Organization (WHO) has unveiled a comprehensive new guideline aimed at significantly reducing adolescent pregnancies and improving the overall health and well-being of girls worldwide—a move that holds substantial relevance for Thailand and the broader region. The updated recommendations, announced in April 2025, target several root causes of early pregnancies, with a strong emphasis on preventing child marriage, extending girls’ access to education, and strengthening adolescent-friendly health services. These actions, according to the WHO, must be top priorities for governments and civil society striving to improve outcomes for young women.
Adolescent pregnancy remains a critical public health concern globally, with over 21 million adolescent girls becoming pregnant each year in low- and middle-income countries—approximately half of which are unintended. In Thailand, while the adolescent birth rate has fallen in recent years, the issue persists, especially in rural and economically disadvantaged provinces. Early pregnancy can result in serious health risks—including higher rates of infection, preterm births, and complications from unsafe abortions—exacerbated by restricted access to appropriate, stigma-free healthcare. Beyond the immediate health impacts, adolescent pregnancy disrupts girls’ education, limits their employment opportunities, and can entrench cycles of poverty that last across generations (WHO).
The WHO’s latest guideline reflects on the multiple and interrelated drivers of early pregnancy, such as gender inequities, poverty, lack of opportunity, and significant barriers to obtaining sexual and reproductive health information and services. A critical factor—acutely relevant in Southeast Asia—is child marriage. In low- and middle-income countries, nine out of ten adolescent births occur among girls married before age 18. For Thailand, while various legal reforms and public campaigns have aimed to delay the age of marriage, social and economic pressures continue to fuel the practice in specific communities.
The guideline recommends a holistic, multi-pronged approach. Central to the recommendations is the urgent need to provide viable alternatives to early marriage, primarily through strengthened education and economic prospects for girls. Notably, the WHO estimates that universal secondary school completion could reduce child marriages by up to two-thirds. For girls at greatest risk, the guideline suggests policymakers and educators consider incentives—like direct financial stipends or targeted scholarships—to support them through secondary school. There is also a call to enact and enforce laws prohibiting marriage below 18, consistent with international human rights frameworks, and to mobilize community-level engagement to challenge the practice at its roots.
Dr. Pascale Allotey, Director of Sexual and Reproductive Health and Research at WHO, explains: “Early pregnancies can have serious physical and psychological consequences for girls and young women, and often reflect fundamental inequalities that affect their ability to shape their relationships and their lives… Tackling this issue therefore means creating conditions where girls and young women can thrive—by ensuring they can stay in school, be protected from violence and coercion, access sexual and reproductive health services that uphold their rights, and have real choices about their futures” (WHO).
Another major focus of the guideline is on transforming adolescent access to high-quality, nonjudgmental sexual and reproductive health services—including a broad range of contraceptive options. The report highlights persistent barriers, such as legal requirements for parental consent and social stigma, which prevent many young people from getting the care they need. The WHO calls for the removal of age-based restrictions and the adoption of adolescent-responsive health services, ensuring that care is confidential, respectful, and tailored to young people’s needs.
Dr. Sheri Bastien, Scientist for Adolescent Sexual and Reproductive Health at WHO, underscores the role of education: “Education is critical to change the future for young girls, while empowering adolescents—both boys and girls—to understand consent, take charge of their health, and challenge the major gender inequalities that continue to drive high rates of child marriage and early pregnancy in many parts of the world.”
Comprehensive sexuality education (CSE) is another pillar of the WHO’s recommendations. Evidence indicates that age-appropriate, rights-based sex education can delay the onset of sexual activity, reduce rates of early pregnancy, and increase adolescents’ understanding of contraception and reproductive health. However, CSE implementation across Thailand and much of Asia remains inconsistent, often limited by cultural sensitivities and parental opposition. Recent studies from the Thai Public Health Ministry and educators reveal gaps in both curriculum coverage and teacher confidence, with many adolescents reporting incomplete or conflicting information about sex and contraception (UNESCO).
Thai policymakers are thus urged to invest in teacher training, culturally sensitive curriculum adaptation, and community outreach to foster broader acceptance of sexuality education. This aligns with the WHO’s guidance that CSE is critical for empowering young people, not just for preventing pregnancy but also for promoting gender equality and personal autonomy.
For girls who do become pregnant, the guideline emphasizes access to high-quality, stigma-free healthcare during pregnancy, childbirth, and the postnatal period. The recommendations go further to recognize the importance of providing safe abortion services where permitted by law, and to ensure that adolescent girls are not excluded or discriminated against in healthcare settings. In Thailand, amid reform efforts on abortion rights and broader reproductive health access, healthcare providers are being encouraged to adopt adolescent-friendly practices and reinforce a rights-based approach (Thai Medical Council).
Globally, adolescent birth rates have fallen: in 2021, one in 25 girls gave birth before the age of 20, compared to one in 15 two decades ago. Despite this, major disparities remain; in some countries, close to one in ten adolescent girls gives birth each year. Thailand’s adolescent pregnancy rates reflect this trend of gradual decline, but rural and marginalized communities are still disproportionately affected, and outcomes for ethnic minorities, migrant girls, and those from poorer families remain a concern (UNFPA Thailand).
Historically, the interplay of religion, tradition, and economic realities has shaped perceptions of marriage and family in Thai society. Early marriage, previously framed as a protective or necessary step, is now viewed increasingly through a health and rights lens. Recent civil society campaigns have spotlighted the link between girls’ education and broader social progress, highlighting the urgency of full implementation of laws setting the marriage age at 18 and the importance of closing enforcement gaps.
Looking forward, the success of WHO’s new guideline will depend on strong commitment at all levels: national policy, community leadership, family engagement, and the ability of schools and health systems to respond to diverse adolescent needs. Thailand’s experience shows that progress is possible, but that sustained investment and inclusive dialogue across sectors are vital. Experts recommend integrating the guideline into Thailand’s existing adolescent health and education strategies, with support for research, data monitoring, and mechanisms to ensure accountability.
For Thai readers—parents, educators, policymakers, and young people—the call to action is clear. Encourage girls to complete their education by supporting school attendance and reducing barriers stemming from poverty or social expectation. Advocate for comprehensive, age-appropriate sexuality education in schools and communities. Challenge social norms that excuse or promote early marriage and pregnancy, and demand that health services meet the needs of all adolescents, without discrimination. By working collectively, Thailand can build on recent progress and help secure a brighter, healthier, and more equitable future for its young women.
For more details, see the WHO guideline.