A new set of World Health Organization guidelines aims to drastically reduce adolescent pregnancies and strengthen girls’ health and rights. Released in April 2025, the recommendations focus on tackling root causes such as child marriage, improving access to education, and delivering adolescent-friendly health services. Governments and communities are urged to treat these actions as top priorities to improve outcomes for young women.
Adolescent pregnancy remains a global public health challenge. Each year, more than 21 million girls in low- and middle-income countries become pregnant, with about half of these pregnancies unintended. In Thailand, the adolescent birth rate has declined but persists, especially in rural and economically disadvantaged provinces. Early pregnancy increases health risks like infections, preterm birth, and complications from unsafe abortions, often worsened by limited access to respectful, non-judgmental care. Beyond health, early pregnancy disrupts schooling, limits career prospects, and can trap families in cycles of poverty. Data from global health sources show these patterns are not unique to one country but reflect shared challenges affecting Thai communities as well.
The guideline highlights multiple drivers of early pregnancy—gender inequality, poverty, limited opportunity, and barriers to sexual and reproductive health information and services. A critical factor in Southeast Asia remains child marriage. In lower-income settings, nine out of ten adolescent births occur among girls married before 18. While Thailand has pursued legal reforms and public campaigns to delay marriage, social and economic pressures still fuel the practice in some communities.
A holistic, multi-pronged approach is recommended. The core strategy is to provide credible alternatives to early marriage by strengthening education and expanding economic opportunities for girls. The WHO estimates that universal secondary schooling could cut child marriages by up to two-thirds. For those most at risk, policies should consider incentives such as direct stipends or targeted scholarships to keep girls in school. The guidelines also call for laws prohibiting marriage under 18 and for mobilizing communities to challenge the practice at its roots.
“Early pregnancies have serious physical and psychological consequences and reflect deeper inequalities that affect girls’ ability to shape their futures,” explains a senior WHO official. “Tackling this issue means creating conditions where girls can stay in school, access respectful health services, and have real choices about their lives.” Data from WHO indicates that empowering girls through education and health rights can transform communities and reduce early pregnancies.
Transforming adolescent access to high-quality, nonjudgmental reproductive health services is another major focus. Barriers such as parental consent requirements and social stigma prevent many youths from obtaining care. The WHO urges removing age-based restrictions and implementing adolescent-friendly services that protect privacy and respect young people’s needs. A WHO scientist adds that education is essential to shifting norms and enabling both boys and girls to understand consent and take charge of their health.
Comprehensive sexuality education (CSE) is a pillar of the guidelines. Rights-based, age-appropriate sex education can delay sexual activity, reduce early pregnancies, and improve understanding of contraception and reproductive health. In Thailand and much of Asia, implementation of CSE has been uneven due to cultural sensitivities and parental concerns. Public health research shows gaps in curriculum coverage and teacher confidence, with many students receiving inconsistent information about sex and contraception.
Thai policymakers are urged to invest in teacher training, culturally appropriate curriculum adaptation, and community outreach to broaden acceptance of sexuality education. The WHO emphasizes that CSE empowers young people, promotes gender equality, and supports personal autonomy.
For pregnant adolescents, the guideline stresses access to high-quality, stigma-free care during pregnancy, childbirth, and the postpartum period. It also endorses safe abortion services where legally permitted and insists that healthcare settings treat adolescent patients without discrimination. In Thailand, ongoing reforms in reproductive health access encourage providers to adopt adolescent-friendly practices and uphold a rights-based approach to care.
Globally, adolescent birth rates have fallen: in 2021, about one in 25 girls gave birth before 20, down from one in 15 two decades earlier. Yet disparities remain, with some countries reporting close to one in ten adolescent births annually. Thailand’s rates mirror this trend of gradual decline, though rural and marginalized communities continue to bear a disproportionate burden, particularly among ethnic minorities, migrants, and those from poorer households.
Historically, religious, traditional, and economic factors have shaped Thai views on marriage and family. While early marriage was once seen as protective or necessary, it is increasingly viewed through a health and rights lens. Civil society campaigns have highlighted links between girls’ education and broader social progress, underscoring the urgency of enforcing the 18-year marriage age and closing enforcement gaps.
Looking ahead, the guideline’s success will depend on commitment across national policy, community leadership, families, schools, and health systems. Thailand’s experience shows progress is possible, but sustained investment and cross-sector dialogue are essential. Experts recommend embedding the guideline into Thailand’s adolescent health and education strategies, with support for research, data monitoring, and accountability mechanisms.
For Thai readers—parents, educators, policymakers, and young people—the message is clear. Support girls’ education by reducing barriers tied to poverty and social expectations. Advocate for comprehensive, age-appropriate sexuality education in schools and communities. Challenge norms that tolerate early marriage and pregnancy, and ensure health services meet all adolescents’ needs without discrimination. By collaborating, Thailand can build on recent progress to secure a healthier, more equitable future for its young women.