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COLLABORATIVE APPROACH
TO PREVENT THE SPREAD OF TEENAGE
PREGNANCY
By: ROMMEL LUIS C. ISRAEL III
LEARNING
Objectives
At the end of the presentation,
the participants will be able to:
• Appreciate the call for the
prevention of Teenage
Pregnancy.
• Know the causes and effects of
Teenage Pregnancy
• Apply the available
collaborative approaches in the
prevention of Teenage
Pregnancy
2
WHAT IS TEENAGE
PREGNANCY?
3
• Teenage pregnancy is a pregnancy that occurs in teen
girls between the ages of 13-19 years.
• Although precisely not a teenager, a young girl 12 or
under who is pregnant also fall into this definition of
teenage pregnancy.
• Teenage pregnancy is also widely known as adolescent
pregnancy.
Reference:
Sandesh Adhikari (2019). Teenage Pregnancy: Causes, Effects and Preventive Measures. [online] Public Health Notes.
Available at: https://www.publichealthnotes.com/teenage-pregnancy-causes-effects-and-preventive-measures/ .
4
GLOBAL FACTS
ON TEENAGE PREGNANCY
5
• In the year 2015, almost 16 million girls aged 15 to
19 years and 2.5 million girls under 16 years give
birth each year in developing regions
• Twenty-three million girls aged 15 to 19 years in
developing regions have an unmet need for modern
contraception. As a result, half of the pregnancies
among girls aged 15 to 19 years in developing
regions are estimated to be unintended (Guttmacher
institute, 2016)
Reference:
Sandesh Adhikari (2019). Teenage Pregnancy: Causes, Effects and Preventive Measures. [online] Public Health Notes. Available at: https://www.publichealthnotes.com/teenage-
pregnancy-causes-effects-and-preventive-measures/ .d a footer
6
•Every day, 20,000 girls
below age 18 give birth
in developing countries.
Reference:
Sandesh Adhikari (2019). Teenage Pregnancy: Causes, Effects and Preventive Measures. [online] Public Health Notes. Available at: https://www.publichealthnotes.com/teenage-
pregnancy-causes-effects-and-preventive-measures/ .d a footer
7
TEENAGE PREGNANCY IN THE
PHILIPPINES
8
Reference:
The Most Popular Lists. (n.d.). The Philippines has Highest Teenage Pregnancy Rate in Southeast Asia. [online] Available at:
https://www.themostpopularlists.com/2019/07/the-philippines-has-highest-teenage.html [Accessed 4 Feb. 2022].
The Philippine Statistics Authority’s Civil Registration and Vital
Statistics:
• There were about 171 live births to minors everyday in 2019.
• There were general increase in the number of births from
adolescents aged 10 to 14 in that same year, with about seven
giving birth, compared to three daily in 2011.
• In 2015, there were 5,297 repeat pregnancies, or second-time
births, among 10- to 17-year-old girls, with only a slight decrease in
2018 at 4,633
Reference:
Share, Twitter, Twitter and Twitter (n.d.). Teen mothers can be productive under new protection program. [online] www.pna.gov.ph. Available at:
https://www.pna.gov.ph/articles/1143247 [Accessed 3 Feb. 2022]. oter
9
A 2013 study on Adult Fertility and
Sexuality, showed that:
•23 percent of Filipino youth were having
sex before the age of 18.
Reference:
Ismael, J.J. (2018). Prevention of teen pregnancy bill pushed. [online] The Manila Times. Available at: https://www.manilatimes.net/2018/12/02/news/top-stories/prevention-of-
teen-pregnancy-bill-pushed/476615/ .
10
CAUSES OF TEENAGE
PREGNANCY
11
“There are a lot of factors, such as peer
pressure, broken family, lack of parental guidance,
and of course, their curiosity. At that age, they want
to explore. Without guidance, they really are prone
to give birth at an early age.”
- Vincent Ingen, Regional Coordinator of DOH-Cordillera's Adolescent Health
and Development Program
Reference:
Share, Twitter, Twitter and Twitter (n.d.). DOH-CAR launches projects to prevent teen pregnancies. [online] www.pna.gov.ph. Available at:
https://www.pna.gov.ph/articles/1053897 . footer
12
•
• “Girls who have received minimal education are 5 times
more likely to become a Mother than those with higher
levels of education. Pregnant girls often drop out
of school, limiting opportunities for future employment
and perpetuating the cycle of poverty. In many cases,
girls perceive pregnancy to be a better option than
continuing their education.”
• - According to the study by Plan International
Reference:
Teen mothers can be productive under new protection program. [online] www.pna.gov.ph. Available at: https://www.pna.gov.ph/articles/1143247 [Accessed 3
Feb. 2022] .
13
• An increase in sexual and gender-based violence may also
be a factor that can worsen teenage pregnancies in the
country.
• According to the Philippine Commission on Women (PCW),
13,923 cases of violence against women and children were
recorded from Mar. 15 to Nov. 30, 2020.
Suacillo, G. (2021). An unexpected COVID-19 side effect: More teenage pregnancies. [online] NOLISOLI. Available at: https://nolisoli.ph/94233/popcom-teen-
pregnancy-bn-asuacillo-20210211/ [Accessed 3 Feb. 2022].
14
• 2,678 cases of child rights violations from Mar. 1 to May
15, 2020, most of which involved rape, child abuse and
exploitation.
- The Philippine National Police-Crime Information Reporting and Analysis System and
Women and Children Protection Center
Reference:
Suacillo, G. (2021). An unexpected COVID-19 side effect: More teenage pregnancies. [online] NOLISOLI. Available at:
https://nolisoli.ph/94233/popcom-teen-pregnancy-bn-asuacillo-20210211/ [Accessed 3 Feb. 2022].
15
• 8 out of 10 Filipino children are in danger of falling prey to sexual
predators online.
• This is alarming especially because the Philippines has the most
number of internet users in the world at 67 million, according to
the latest data from We Are Social.
• More alarmingly, as more teenagers are finding their way to social
networking sites such as Facebook, so are predators.
- United Nations Children’s Emergency Fund (UNICEF)
Add Reference:
Jose, C.S. (2018). How to save our children from becoming victims of sexual exploitation. [online] NOLISOLI. Available at: https://nolisoli.ph/48026/how-to-
save-children-victims-of-sexual-exploitation/ [Accessed 3 Feb. 2022].a footer
16
• “An estimated 100,000 Filipino children are
brought into prostitution each year.”
• - a report by End Child Prostitution, Child Pornography and Trafficking of Children for Sexual
Purposes (ECPAT) Philippines in 2011
Reference:
Jose, C.S. (2018). How to save our children from becoming victims of sexual exploitation. [online] NOLISOLI. Available at: https://nolisoli.ph/48026/how-to-save-children-victims-of-
sexual-exploitation/ [Accessed 3 Feb. 2022].
17
EFFECTS OF TEENAGE
PREGNANCY
18
• Complications during pregnancy and childbirth are the
leading cause of death for 15 to 19- year-old girls globally
- World Health Organization, 2015
• Every year, some 3.9 million girls aged 15 to 19 years
undergo unsafe abortions
- Guttmacher institute, 2016
Reference:
Sandesh Adhikari (2019). Teenage Pregnancy: Causes, Effects and Preventive Measures. [online] Public Health Notes. Available at:
https://www.publichealthnotes.com/teenage-pregnancy-causes-effects-and-preventive-measures/ .
19
• Adolescent mothers (ages 10 to 19 years)
face higher risks of eclampsia,
puerperal endometritis, and
systemic infections than
women aged 20 to 24 years do.
Reference:
Sandesh Adhikari (2019). Teenage Pregnancy: Causes, Effects and Preventive Measures. [online] Public Health Notes. Available at:
https://www.publichealthnotes.com/teenage-pregnancy-causes-effects-and-preventive-measures/ .
20
• Eclampsia - a rare but serious condition where high blood
pressure results in seizures during pregnancy.
Reference:
Brindles Lee Macon (2018). Eclampsia. [online] Healthline. Available at: https://www.healthline.com/health/eclampsia.
21
• PUERPERAL ENDOMETRITIS – Synonym: Postpartum Endometritis
- it is a uterine infection, typically caused by bacteria
ascending from the lower genital or gastrointestinal tract.
- Symptoms are uterine tenderness, abdominal or pelvic pain,
fever, malaise, and sometimes discharge.
Reference:
Merck Manuals Professional Edition. (n.d.). Postpartum Endometritis - Gynecology and Obstetrics. [online] Available at: https://www.merckmanuals.com/en-ca/professional/gynecology-and-
obstetrics/postpartum-care-and-associated-disorders/postpartum-endometritis?redirectid=4068?ruleredirectid=30 [Accessed 4 Feb. 2022].
22
• SYSTEMIC INFECTION -
An infection in which the infecting agent or organisms
circulate throughout the body.
- It can be life-threatening
Reference:
TheFreeDictionary.com. (n.d.). systemic infection. [online] Available at: https://medical-dictionary.thefreedictionary.com/systemic+infection.
23
• Adolescent pregnancy remains a major
contributor to maternal and child mortality.
Reference:
Sandesh Adhikari (2019). Teenage Pregnancy: Causes, Effects and Preventive Measures. [online] Public Health Notes. Available at:
https://www.publichealthnotes.com/teenage-pregnancy-causes-effects-and-preventive-measures/ .
24
• “Women who get pregnant during their adolescence may
experience health problems, such as high blood pressure or
increased blood sugar, which can cause organ damage. There is
also a high probability for the babies to be born premature or
even die. If they survive, children born to young mothers may also
be prone to infection and diseases"
- Amelita Pangilinan, Regional Director, DOH-CAR
Reference:
DOH-CAR launches projects to prevent teen pregnancies. [online] www.pna.gov.ph. Available at: https://www.pna.gov.ph/articles/1053897 .
25
• High risk of Low Birth Weight (LBW) child
• High chances of premature infants
• Anemia
• High risk of Infant mortality
• Drop out of school
• Lower school accomplishment
• Unemployment as a young adult
• Lack of proper emotional support and cognitive stimulation by the children who are
born to teen mothers.
• Behavioral problems and chronic medical conditions of the children
• Higher chances of foster care settlement of the children.
Reference:
Sandesh Adhikari (2019). Teenage Pregnancy: Causes, Effects and Preventive Measures. [online] Public Health Notes. Available at: https://www.publichealthnotes.com/teenage-pregnancy-causes-
effects-and-preventive-measures/ .
26
Teen mom goes through various mental stress due to unplanned
pregnancy such as:
• Sleepless nights
• Insomnia
• High chances of postpartum depression
• Baby blues: Woman experiences symptoms like mood swings, anxiety,
sadness, overwhelm, difficulty concentrating, trouble eating, and difficulty
sleeping for one to two weeks after giving birth which collectively known as
‘Baby Blues’.
Reference:
Sandesh Adhikari (2019). Teenage Pregnancy: Causes, Effects and Preventive Measures. [online] Public Health Notes. Available at: https://www.publichealthnotes.com/teenage-pregnancy-causes-
effects-and-preventive-measures/ .
27
More chances to experience post-traumatic stress disorder (PTSD) that includes more severe and significant
symptoms than baby blues.
Likewise, the teen mom can have additional symptoms of postpartum depression like-
• Difficulty bonding with baby
• Overwhelming fatigue
• Feeling of worthless
• Anxiety
• Panic attacks
• Thinking of harming own self or the baby
• Difficulty in enjoying activities
Reference:
Sandesh Adhikari (2019). Teenage Pregnancy: Causes, Effects and Preventive Measures. [online] Public Health Notes. Available at: https://www.publichealthnotes.com/teenage-pregnancy-
causes-effects-and-preventive-measures/ . 28
• Adolescent pregnancy, according to Plan International, remains a
major contributor to maternal and child mortality.
• Some 3.9 million unsafe abortions occur each year to girls aged 15
to 19 in developing regions.
Reference:
Teen mothers can be productive under new protection program. [online] www.pna.gov.ph. Available at: https://www.pna.gov.ph/articles/1143247 [Accessed 3 Feb. 2022].
29
• Complications relating to pregnancy and childbirth
are the leading cause of death for girls aged 15 to 19
globally as they suffer from complications due to
their immature bodies.
Reference:
Teen mothers can be productive under new protection program. [online] www.pna.gov.ph. Available at: https://www.pna.gov.ph/articles/1143247 [Accessed 3 Feb.
2022].
30
•
“Adolescent pregnancy can also have negative social and
economic effects on girls, their families, and communities.
Unmarried pregnant adolescents may face stigma or
rejection by parents and peers as well as threats of
violence. Girls who become pregnant before age 18 are
also more likely to experience violence within a marriage
or partnership.”
- A study by Plan International
Reference:
Teen mothers can be productive under new protection program. [online] www.pna.gov.ph. Available at: https://www.pna.gov.ph/articles/1143247 [Accessed 3 Feb. 2022]. 31
A CALL TO ADDRESS
THE PROBLEM OF
TEENAGEPREGNANCY
32
• “We want our children to be children and to actually have a
childhood. It is our duty, not only as legislators, but also as
parents, to equip them with the knowledge they need to navigate
the new and seemingly vast terrain of puberty and reproductive
health and to guide them as they grow into adulthood that is not
jarred by expectations of parenthood,”
- Senator Risa Hontiveros, Sponsor of Senate Bill 1888
Reference:
Ismael, J.J. (2018). Prevention of teen pregnancy bill pushed. [online] The Manila Times. Available at: https://www.manilatimes.net/2018/12/02/news/top-
stories/prevention-of-teen-pregnancy-bill-pushed/476615/ .
33
• “This requires more than a whole-of-government
approach. Thus, we are calling on the private sector, LGUs,
development partners and relevant government agencies
to collaborate closely with us in arresting this social
menace grappling our youth,”
- Juan Antonio Perez III
Health Undersecretary and POPCOM Chairman
Reference:
Suacillo, G. (2021). An unexpected COVID-19 side effect: More teenage pregnancies. [online] NOLISOLI. Available at: https://nolisoli.ph/94233/popcom-teen-pregnancy-bn-
asuacillo-20210211/ [Accessed 3 Feb. 2022].
34
PUT A STOP TO THE
GROWING PROBLEM
OF TEENAGEPREGNANCY
35
•
Reference:
Reference:
Jose, C.S. (2018). How to save our children from becoming victims of sexual exploitation. [online] NOLISOLI. Available at: https://nolisoli.ph/48026/how-to-save-children-
victims-of-sexual-exploitation/ .
36
IT STARTS AT HOME
"It helps to re-evaluate our view that exploitation only happens in brothels and in the streets.
In reality, it can happen inside the house, in your child’s bedroom, when they open Facebook,
and even at school. As such, she suggests that intervention and prevention begin at home.
Sometimes when I give advice to parents I feel like I am scaring them. But then again it may be
good to scare them enough to do something,”
- Dr. Protacio-De Castro
•
Reference:
Reference:
Jose, C.S. (2018). How to save our children from becoming victims of sexual exploitation. [online] NOLISOLI. Available at: https://nolisoli.ph/48026/how-to-save-children-
victims-of-sexual-exploitation/ .
37
SEX EDUCATION AS A FOUNDATION
• WHEN?: “As soon as they ask no matter what age.”
• Answers that are deemed age-appropriate so your child can understand them
given their level of comprehension.
• If parents avoid discussing the topic of sex with their children, they might
consult with peers who often have a lot of misconceptions about sex.
•
Reference:
Reference:
Jose, C.S. (2018). How to save our children from becoming victims of sexual exploitation. [online] NOLISOLI. Available at: https://nolisoli.ph/48026/how-to-save-children-
victims-of-sexual-exploitation/ .
38
TEACH THEM ABOUT CONSENT
We have the lowest age of consent (the age at which a person's, typically a girl's, consent to sexual
intercourse is valid in law) at 12 in Asia, according to UNICEF, which means that sexual intercourse with
children of this age is not considered statutory rape.
Dr. Protacio-De Castro said that for children to have the capacity to have consent they must be
psychologically and developmentally prepared, and this is not happening at 12 years old.
In the meantime, given the faulty laws and the freedoms afforded to the youth, what she suggests is early
intervention. “As elders, we, parents, and members of the family have a responsibility to teach and inform
children about the consequences of their action, especially the case of sexual consent.”
•
Reference:
pcw.gov.ph. (n.d.). Amending the Anti-Rape Law | Philippine Commission on Women. [online] Available at: https://pcw.gov.ph/amending-the-anti-rape-law/.
39
AMMENDING THE ANTI-RAPE LAW: Raising the Age of Sexual Consent
Article 266-A 1(d) of the Republic of the Philippine Congress as amended by R.A. No. 8353:
- Age for determining statutory rape at “below 12 years old”.
- Any sexual intercourse with a minor who has not reached the age of 12 is automatically
regarded as rape, even if the minor consented or appeared to have voluntarily
engaged in the sexual act.
- Once a child reaches the exact age of 12, he or she is legally deemed mature enough to
give sexual consent to another person.
Are we really protecting the children here?
- the law leaves them vulnerable to sexual predators especially those who are
significantly older than them and who may take advantage of their impressionability.
•
Reference:
pcw.gov.ph. (n.d.). Amending the Anti-Rape Law | Philippine Commission on Women. [online] Available at: https://pcw.gov.ph/amending-the-anti-rape-law/.
40
The Philippines has the lowest age of sexual consent in Southeast Asia (12 years old).
Other countries like Brunei, East Timor, Indonesia, Malaysia, Singapore, and Taiwan peg the
age of consent at 16.
Japan and Vietnam set it at 13 years old.
PROPOSAL:
That the legal age of sexual consent in the country which is set too low at 12 years old, be
raised to at least 16 years old.
•
Reference:
Jose, C.S. (2018). How to save our children from becoming victims of sexual exploitation. [online] NOLISOLI. Available at: https://nolisoli.ph/48026/how-to-save-children-
victims-of-sexual-exploitation/ .
41
TEACH THEM ABOUT CONSENT
Given the faulty laws and the freedoms afforded to the youth, an
early intervention is suggested:
“As elders, we, parents, and members of the family have a
responsibility to teach and inform children about the consequences
of their action, especially the case of sexual consent.”
•
Reference:
Jose, C.S. (2018). How to save our children from becoming victims of sexual exploitation. [online] NOLISOLI. Available at: https://nolisoli.ph/48026/how-to-save-children-
victims-of-sexual-exploitation/ .
42
STRENGTHEN THEIR LIFE SKILLS
“By life skills, I mean, in terms of self-assertion, the art of saying no; attitude
towards relationships and partners, as well as with others. We have to equip
them with abilities to surmount these problems on their own because, at
the end of the day when we are not there, they will have to help
themselves.”
- Dr. Protacio de Castro
Self-Assertion- the confident and forceful expression or promotion of oneself, one's views, or one's
desires.
•
Reference:
Jose, C.S. (2018). How to save our children from becoming victims of sexual exploitation. [online] NOLISOLI. Available at: https://nolisoli.ph/48026/how-to-save-children-
victims-of-sexual-exploitation/ .
43
FAMILY VALUES ARE CRUCIAL
"The formation of the personality and characteristics of a child are highly dependent on
what kind of family they have and how they are raised."
- Dr. Protacio-De Castro
- How you are as parents make a huge difference for your kids
- the least parents can do is to find a middle ground, which psychologists call as “positive
parenting.”
- training those who play an integral part in raising the family: caregivers, and helpers as
“psychological first-aid.”
•
Reference:
Jose, C.S. (2018). How to save our children from becoming victims of sexual exploitation. [online] NOLISOLI. Available at: https://nolisoli.ph/48026/how-to-save-children-
victims-of-sexual-exploitation/ .
44
COMMUNICATE AND LISTEN IN NEW WAYS
Example:
“Listen to them, look at the way they communicate, read between the lines
when they post something (such as on Facebook). Di ba minsan alam mo na,
meron ka nang nabasa, meron nang warning. Why didn’t anyone call, pick up
the phone or message the person? It’s not that they are not communicating
but they do, just in new ways.”
- Anthony Pangilinan, OIC-“Called to Rescue” (a worldwide organization helping
prevent human trafficking through education and training)
•
Reference:
Sandesh Adhikari (2019). Teenage Pregnancy: Causes, Effects and Preventive Measures. [online] Public Health Notes. Available at:
https://www.publichealthnotes.com/teenage-pregnancy-causes-effects-and-preventive-measures/ .
45
Abstinence
Self-restraint from sexual activity at early age is the best way to prevent teenage pregnancy.
Contraceptives
Using contraceptive devices or emergency pills during a sexual intercourse helps in preventing
teenage pregnancy and early parenthood.
Communication
Active and positive interaction between child-parent regarding sex education or difficulties may
prove beneficial to step down the barriers of early pregnancy.
•
Reference:
Sandesh Adhikari (2019). Teenage Pregnancy: Causes, Effects and Preventive Measures. [online] Public Health Notes. Available at:
https://www.publichealthnotes.com/teenage-pregnancy-causes-effects-and-preventive-measures/ .
46
Provision of sex education in higher secondary schools along with the
consequences.
Targeting messages at teen boys, not just at the girls.
Increasing the availability of condoms to teens.
Encourage mentoring by older teens to younger teens regarding teenage
pregnancy and consequences.
•
Reference:
Sandesh Adhikari (2019). Teenage Pregnancy: Causes, Effects and Preventive Measures. [online] Public Health Notes. Available at:
https://www.publichealthnotes.com/teenage-pregnancy-causes-effects-and-preventive-measures/ .
47
• Organizing community-based programs on teenage pregnancy
and adverse effects.
• Schools should provide adolescent-friendly health services
along with counseling.
THENEW
PROTECTION
PROGRAMFOR
TEENAGEMOTHERS
•
Reference :
Teen mothers can be productive under new protection program. [online] www.pna.gov.ph. Available at: https://www.pna.gov.ph/articles/1143247 [Accessed 3 Feb. 2022].
49
Social Protection Program for Teenaged Mothers and their
Children (SPPTMC)
- an information system to identify young mothers
- a collaboration of the Department of Social Welfare and
Development (DSWD) and the Commission on Population and
Development (PopCom) that will address the needs of Teenaged
mothers, especially those of minor age,
•
Reference :
Teen mothers can be productive under new protection program. [online] www.pna.gov.ph. Available at: https://www.pna.gov.ph/articles/1143247 [Accessed 3 Feb. 2022].
50
Social Protection Program for Teenaged Mothers and their
Children (SPPTMC)
- provides beneficiaries access to health services like nutrition and
mental health support, opportunity to return to school, and a social
amelioration program for those belonging to the lowest
socioeconomic bracket until they are able to find gainful work or
livelihood.
PREVENTIONOFTEEN
PREGNANCYPUSHED
•
Reference:
Ismael, J.J. (2018). Prevention of teen pregnancy bill pushed. [online] The Manila Times. Available at: https://www.manilatimes.net/2018/12/02/news/top-
stories/prevention-of-teen-pregnancy-bill-pushed/476615/ .
52
Senate Bill (SB) 1888 or the “Prevention of Adolescent
Pregnancy Act,”
- seeks to ensure that young mothers would get the necessary
healthcare they need throughout their pregnancy.
-it reiterates the importance of education in the prevention of
teenage pregnancy and reminds educational institutions that
suspension, expulsion, dismissal and denial of admission to pregnant
girls are prohibited.
•
Reference:
Ismael, J.J. (2018). Prevention of teen pregnancy bill pushed. [online] The Manila Times. Available at: https://www.manilatimes.net/2018/12/02/news/top-
stories/prevention-of-teen-pregnancy-bill-pushed/476615/ .
53
Senate Bill (SB) 1888 or the “Prevention of Adolescent
Pregnancy Act,”
- Strategies and programs aimed at preventing incidence of teenage
pregnancies shall also be integrated in the Sangguniang Kabataan
(Youth Council) programs at the local and community level using 10
percent of SK funds.
•
Reference:
Ismael, J.J. (2018). Prevention of teen pregnancy bill pushed. [online] The Manila Times. Available at: https://www.manilatimes.net/2018/12/02/news/top-
stories/prevention-of-teen-pregnancy-bill-pushed/476615/ .
54
Senate Bill (SB) 1888 or the “Prevention of Adolescent
Pregnancy Act,”
- The Department of Education, with assistance from the council and
in collaboration with other relevant agencies, shall be required to
develop and promote educational standards, modules and materials
for Comprehensive Sexuality Education (CSE) in schools, communities
and other youth institutions.
•
Reference:
Ismael, J.J. (2018). Prevention of teen pregnancy bill pushed. [online] The Manila Times. Available at: https://www.manilatimes.net/2018/12/02/news/top-
stories/prevention-of-teen-pregnancy-bill-pushed/476615/ .
55
Senate Bill (SB) 1888 or the “Prevention of Adolescent
Pregnancy Act,”
Legislative status :
Pending in the Committee (10/14/2020)
56
Proverbs 22:6 “Train up a child in the way he should
go; even when he is old he will not depart from it.”
Titus 2:6 “Likewise, urge the younger men to be
self-controlled.”
57
1 Thessalonians 4:3-5 ” For this is the will of God,
your sanctification: that you abstain from sexual
immorality; that each one of you know how to
control his own body in holiness and honor, not in
the passion of lust like the Gentiles who do not
know God;”
THANKYOU
ROMMEL LUIS C. ISRAEL III
My presentations (slideshare.net)
58

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TEENAGE PREGNANCY PREVENTION: A COLLABORATIVE APPROACH

  • 1. COLLABORATIVE APPROACH TO PREVENT THE SPREAD OF TEENAGE PREGNANCY By: ROMMEL LUIS C. ISRAEL III
  • 2. LEARNING Objectives At the end of the presentation, the participants will be able to: • Appreciate the call for the prevention of Teenage Pregnancy. • Know the causes and effects of Teenage Pregnancy • Apply the available collaborative approaches in the prevention of Teenage Pregnancy 2
  • 4. • Teenage pregnancy is a pregnancy that occurs in teen girls between the ages of 13-19 years. • Although precisely not a teenager, a young girl 12 or under who is pregnant also fall into this definition of teenage pregnancy. • Teenage pregnancy is also widely known as adolescent pregnancy. Reference: Sandesh Adhikari (2019). Teenage Pregnancy: Causes, Effects and Preventive Measures. [online] Public Health Notes. Available at: https://www.publichealthnotes.com/teenage-pregnancy-causes-effects-and-preventive-measures/ . 4
  • 6. • In the year 2015, almost 16 million girls aged 15 to 19 years and 2.5 million girls under 16 years give birth each year in developing regions • Twenty-three million girls aged 15 to 19 years in developing regions have an unmet need for modern contraception. As a result, half of the pregnancies among girls aged 15 to 19 years in developing regions are estimated to be unintended (Guttmacher institute, 2016) Reference: Sandesh Adhikari (2019). Teenage Pregnancy: Causes, Effects and Preventive Measures. [online] Public Health Notes. Available at: https://www.publichealthnotes.com/teenage- pregnancy-causes-effects-and-preventive-measures/ .d a footer 6
  • 7. •Every day, 20,000 girls below age 18 give birth in developing countries. Reference: Sandesh Adhikari (2019). Teenage Pregnancy: Causes, Effects and Preventive Measures. [online] Public Health Notes. Available at: https://www.publichealthnotes.com/teenage- pregnancy-causes-effects-and-preventive-measures/ .d a footer 7
  • 8. TEENAGE PREGNANCY IN THE PHILIPPINES 8 Reference: The Most Popular Lists. (n.d.). The Philippines has Highest Teenage Pregnancy Rate in Southeast Asia. [online] Available at: https://www.themostpopularlists.com/2019/07/the-philippines-has-highest-teenage.html [Accessed 4 Feb. 2022].
  • 9. The Philippine Statistics Authority’s Civil Registration and Vital Statistics: • There were about 171 live births to minors everyday in 2019. • There were general increase in the number of births from adolescents aged 10 to 14 in that same year, with about seven giving birth, compared to three daily in 2011. • In 2015, there were 5,297 repeat pregnancies, or second-time births, among 10- to 17-year-old girls, with only a slight decrease in 2018 at 4,633 Reference: Share, Twitter, Twitter and Twitter (n.d.). Teen mothers can be productive under new protection program. [online] www.pna.gov.ph. Available at: https://www.pna.gov.ph/articles/1143247 [Accessed 3 Feb. 2022]. oter 9
  • 10. A 2013 study on Adult Fertility and Sexuality, showed that: •23 percent of Filipino youth were having sex before the age of 18. Reference: Ismael, J.J. (2018). Prevention of teen pregnancy bill pushed. [online] The Manila Times. Available at: https://www.manilatimes.net/2018/12/02/news/top-stories/prevention-of- teen-pregnancy-bill-pushed/476615/ . 10
  • 12. “There are a lot of factors, such as peer pressure, broken family, lack of parental guidance, and of course, their curiosity. At that age, they want to explore. Without guidance, they really are prone to give birth at an early age.” - Vincent Ingen, Regional Coordinator of DOH-Cordillera's Adolescent Health and Development Program Reference: Share, Twitter, Twitter and Twitter (n.d.). DOH-CAR launches projects to prevent teen pregnancies. [online] www.pna.gov.ph. Available at: https://www.pna.gov.ph/articles/1053897 . footer 12
  • 13. • • “Girls who have received minimal education are 5 times more likely to become a Mother than those with higher levels of education. Pregnant girls often drop out of school, limiting opportunities for future employment and perpetuating the cycle of poverty. In many cases, girls perceive pregnancy to be a better option than continuing their education.” • - According to the study by Plan International Reference: Teen mothers can be productive under new protection program. [online] www.pna.gov.ph. Available at: https://www.pna.gov.ph/articles/1143247 [Accessed 3 Feb. 2022] . 13
  • 14. • An increase in sexual and gender-based violence may also be a factor that can worsen teenage pregnancies in the country. • According to the Philippine Commission on Women (PCW), 13,923 cases of violence against women and children were recorded from Mar. 15 to Nov. 30, 2020. Suacillo, G. (2021). An unexpected COVID-19 side effect: More teenage pregnancies. [online] NOLISOLI. Available at: https://nolisoli.ph/94233/popcom-teen- pregnancy-bn-asuacillo-20210211/ [Accessed 3 Feb. 2022]. 14
  • 15. • 2,678 cases of child rights violations from Mar. 1 to May 15, 2020, most of which involved rape, child abuse and exploitation. - The Philippine National Police-Crime Information Reporting and Analysis System and Women and Children Protection Center Reference: Suacillo, G. (2021). An unexpected COVID-19 side effect: More teenage pregnancies. [online] NOLISOLI. Available at: https://nolisoli.ph/94233/popcom-teen-pregnancy-bn-asuacillo-20210211/ [Accessed 3 Feb. 2022]. 15
  • 16. • 8 out of 10 Filipino children are in danger of falling prey to sexual predators online. • This is alarming especially because the Philippines has the most number of internet users in the world at 67 million, according to the latest data from We Are Social. • More alarmingly, as more teenagers are finding their way to social networking sites such as Facebook, so are predators. - United Nations Children’s Emergency Fund (UNICEF) Add Reference: Jose, C.S. (2018). How to save our children from becoming victims of sexual exploitation. [online] NOLISOLI. Available at: https://nolisoli.ph/48026/how-to- save-children-victims-of-sexual-exploitation/ [Accessed 3 Feb. 2022].a footer 16
  • 17. • “An estimated 100,000 Filipino children are brought into prostitution each year.” • - a report by End Child Prostitution, Child Pornography and Trafficking of Children for Sexual Purposes (ECPAT) Philippines in 2011 Reference: Jose, C.S. (2018). How to save our children from becoming victims of sexual exploitation. [online] NOLISOLI. Available at: https://nolisoli.ph/48026/how-to-save-children-victims-of- sexual-exploitation/ [Accessed 3 Feb. 2022]. 17
  • 19. • Complications during pregnancy and childbirth are the leading cause of death for 15 to 19- year-old girls globally - World Health Organization, 2015 • Every year, some 3.9 million girls aged 15 to 19 years undergo unsafe abortions - Guttmacher institute, 2016 Reference: Sandesh Adhikari (2019). Teenage Pregnancy: Causes, Effects and Preventive Measures. [online] Public Health Notes. Available at: https://www.publichealthnotes.com/teenage-pregnancy-causes-effects-and-preventive-measures/ . 19
  • 20. • Adolescent mothers (ages 10 to 19 years) face higher risks of eclampsia, puerperal endometritis, and systemic infections than women aged 20 to 24 years do. Reference: Sandesh Adhikari (2019). Teenage Pregnancy: Causes, Effects and Preventive Measures. [online] Public Health Notes. Available at: https://www.publichealthnotes.com/teenage-pregnancy-causes-effects-and-preventive-measures/ . 20
  • 21. • Eclampsia - a rare but serious condition where high blood pressure results in seizures during pregnancy. Reference: Brindles Lee Macon (2018). Eclampsia. [online] Healthline. Available at: https://www.healthline.com/health/eclampsia. 21
  • 22. • PUERPERAL ENDOMETRITIS – Synonym: Postpartum Endometritis - it is a uterine infection, typically caused by bacteria ascending from the lower genital or gastrointestinal tract. - Symptoms are uterine tenderness, abdominal or pelvic pain, fever, malaise, and sometimes discharge. Reference: Merck Manuals Professional Edition. (n.d.). Postpartum Endometritis - Gynecology and Obstetrics. [online] Available at: https://www.merckmanuals.com/en-ca/professional/gynecology-and- obstetrics/postpartum-care-and-associated-disorders/postpartum-endometritis?redirectid=4068?ruleredirectid=30 [Accessed 4 Feb. 2022]. 22
  • 23. • SYSTEMIC INFECTION - An infection in which the infecting agent or organisms circulate throughout the body. - It can be life-threatening Reference: TheFreeDictionary.com. (n.d.). systemic infection. [online] Available at: https://medical-dictionary.thefreedictionary.com/systemic+infection. 23
  • 24. • Adolescent pregnancy remains a major contributor to maternal and child mortality. Reference: Sandesh Adhikari (2019). Teenage Pregnancy: Causes, Effects and Preventive Measures. [online] Public Health Notes. Available at: https://www.publichealthnotes.com/teenage-pregnancy-causes-effects-and-preventive-measures/ . 24
  • 25. • “Women who get pregnant during their adolescence may experience health problems, such as high blood pressure or increased blood sugar, which can cause organ damage. There is also a high probability for the babies to be born premature or even die. If they survive, children born to young mothers may also be prone to infection and diseases" - Amelita Pangilinan, Regional Director, DOH-CAR Reference: DOH-CAR launches projects to prevent teen pregnancies. [online] www.pna.gov.ph. Available at: https://www.pna.gov.ph/articles/1053897 . 25
  • 26. • High risk of Low Birth Weight (LBW) child • High chances of premature infants • Anemia • High risk of Infant mortality • Drop out of school • Lower school accomplishment • Unemployment as a young adult • Lack of proper emotional support and cognitive stimulation by the children who are born to teen mothers. • Behavioral problems and chronic medical conditions of the children • Higher chances of foster care settlement of the children. Reference: Sandesh Adhikari (2019). Teenage Pregnancy: Causes, Effects and Preventive Measures. [online] Public Health Notes. Available at: https://www.publichealthnotes.com/teenage-pregnancy-causes- effects-and-preventive-measures/ . 26
  • 27. Teen mom goes through various mental stress due to unplanned pregnancy such as: • Sleepless nights • Insomnia • High chances of postpartum depression • Baby blues: Woman experiences symptoms like mood swings, anxiety, sadness, overwhelm, difficulty concentrating, trouble eating, and difficulty sleeping for one to two weeks after giving birth which collectively known as ‘Baby Blues’. Reference: Sandesh Adhikari (2019). Teenage Pregnancy: Causes, Effects and Preventive Measures. [online] Public Health Notes. Available at: https://www.publichealthnotes.com/teenage-pregnancy-causes- effects-and-preventive-measures/ . 27
  • 28. More chances to experience post-traumatic stress disorder (PTSD) that includes more severe and significant symptoms than baby blues. Likewise, the teen mom can have additional symptoms of postpartum depression like- • Difficulty bonding with baby • Overwhelming fatigue • Feeling of worthless • Anxiety • Panic attacks • Thinking of harming own self or the baby • Difficulty in enjoying activities Reference: Sandesh Adhikari (2019). Teenage Pregnancy: Causes, Effects and Preventive Measures. [online] Public Health Notes. Available at: https://www.publichealthnotes.com/teenage-pregnancy- causes-effects-and-preventive-measures/ . 28
  • 29. • Adolescent pregnancy, according to Plan International, remains a major contributor to maternal and child mortality. • Some 3.9 million unsafe abortions occur each year to girls aged 15 to 19 in developing regions. Reference: Teen mothers can be productive under new protection program. [online] www.pna.gov.ph. Available at: https://www.pna.gov.ph/articles/1143247 [Accessed 3 Feb. 2022]. 29
  • 30. • Complications relating to pregnancy and childbirth are the leading cause of death for girls aged 15 to 19 globally as they suffer from complications due to their immature bodies. Reference: Teen mothers can be productive under new protection program. [online] www.pna.gov.ph. Available at: https://www.pna.gov.ph/articles/1143247 [Accessed 3 Feb. 2022]. 30
  • 31. • “Adolescent pregnancy can also have negative social and economic effects on girls, their families, and communities. Unmarried pregnant adolescents may face stigma or rejection by parents and peers as well as threats of violence. Girls who become pregnant before age 18 are also more likely to experience violence within a marriage or partnership.” - A study by Plan International Reference: Teen mothers can be productive under new protection program. [online] www.pna.gov.ph. Available at: https://www.pna.gov.ph/articles/1143247 [Accessed 3 Feb. 2022]. 31
  • 32. A CALL TO ADDRESS THE PROBLEM OF TEENAGEPREGNANCY 32
  • 33. • “We want our children to be children and to actually have a childhood. It is our duty, not only as legislators, but also as parents, to equip them with the knowledge they need to navigate the new and seemingly vast terrain of puberty and reproductive health and to guide them as they grow into adulthood that is not jarred by expectations of parenthood,” - Senator Risa Hontiveros, Sponsor of Senate Bill 1888 Reference: Ismael, J.J. (2018). Prevention of teen pregnancy bill pushed. [online] The Manila Times. Available at: https://www.manilatimes.net/2018/12/02/news/top- stories/prevention-of-teen-pregnancy-bill-pushed/476615/ . 33
  • 34. • “This requires more than a whole-of-government approach. Thus, we are calling on the private sector, LGUs, development partners and relevant government agencies to collaborate closely with us in arresting this social menace grappling our youth,” - Juan Antonio Perez III Health Undersecretary and POPCOM Chairman Reference: Suacillo, G. (2021). An unexpected COVID-19 side effect: More teenage pregnancies. [online] NOLISOLI. Available at: https://nolisoli.ph/94233/popcom-teen-pregnancy-bn- asuacillo-20210211/ [Accessed 3 Feb. 2022]. 34
  • 35. PUT A STOP TO THE GROWING PROBLEM OF TEENAGEPREGNANCY 35
  • 36. • Reference: Reference: Jose, C.S. (2018). How to save our children from becoming victims of sexual exploitation. [online] NOLISOLI. Available at: https://nolisoli.ph/48026/how-to-save-children- victims-of-sexual-exploitation/ . 36 IT STARTS AT HOME "It helps to re-evaluate our view that exploitation only happens in brothels and in the streets. In reality, it can happen inside the house, in your child’s bedroom, when they open Facebook, and even at school. As such, she suggests that intervention and prevention begin at home. Sometimes when I give advice to parents I feel like I am scaring them. But then again it may be good to scare them enough to do something,” - Dr. Protacio-De Castro
  • 37. • Reference: Reference: Jose, C.S. (2018). How to save our children from becoming victims of sexual exploitation. [online] NOLISOLI. Available at: https://nolisoli.ph/48026/how-to-save-children- victims-of-sexual-exploitation/ . 37 SEX EDUCATION AS A FOUNDATION • WHEN?: “As soon as they ask no matter what age.” • Answers that are deemed age-appropriate so your child can understand them given their level of comprehension. • If parents avoid discussing the topic of sex with their children, they might consult with peers who often have a lot of misconceptions about sex.
  • 38. • Reference: Reference: Jose, C.S. (2018). How to save our children from becoming victims of sexual exploitation. [online] NOLISOLI. Available at: https://nolisoli.ph/48026/how-to-save-children- victims-of-sexual-exploitation/ . 38 TEACH THEM ABOUT CONSENT We have the lowest age of consent (the age at which a person's, typically a girl's, consent to sexual intercourse is valid in law) at 12 in Asia, according to UNICEF, which means that sexual intercourse with children of this age is not considered statutory rape. Dr. Protacio-De Castro said that for children to have the capacity to have consent they must be psychologically and developmentally prepared, and this is not happening at 12 years old. In the meantime, given the faulty laws and the freedoms afforded to the youth, what she suggests is early intervention. “As elders, we, parents, and members of the family have a responsibility to teach and inform children about the consequences of their action, especially the case of sexual consent.”
  • 39. • Reference: pcw.gov.ph. (n.d.). Amending the Anti-Rape Law | Philippine Commission on Women. [online] Available at: https://pcw.gov.ph/amending-the-anti-rape-law/. 39 AMMENDING THE ANTI-RAPE LAW: Raising the Age of Sexual Consent Article 266-A 1(d) of the Republic of the Philippine Congress as amended by R.A. No. 8353: - Age for determining statutory rape at “below 12 years old”. - Any sexual intercourse with a minor who has not reached the age of 12 is automatically regarded as rape, even if the minor consented or appeared to have voluntarily engaged in the sexual act. - Once a child reaches the exact age of 12, he or she is legally deemed mature enough to give sexual consent to another person. Are we really protecting the children here? - the law leaves them vulnerable to sexual predators especially those who are significantly older than them and who may take advantage of their impressionability.
  • 40. • Reference: pcw.gov.ph. (n.d.). Amending the Anti-Rape Law | Philippine Commission on Women. [online] Available at: https://pcw.gov.ph/amending-the-anti-rape-law/. 40 The Philippines has the lowest age of sexual consent in Southeast Asia (12 years old). Other countries like Brunei, East Timor, Indonesia, Malaysia, Singapore, and Taiwan peg the age of consent at 16. Japan and Vietnam set it at 13 years old. PROPOSAL: That the legal age of sexual consent in the country which is set too low at 12 years old, be raised to at least 16 years old.
  • 41. • Reference: Jose, C.S. (2018). How to save our children from becoming victims of sexual exploitation. [online] NOLISOLI. Available at: https://nolisoli.ph/48026/how-to-save-children- victims-of-sexual-exploitation/ . 41 TEACH THEM ABOUT CONSENT Given the faulty laws and the freedoms afforded to the youth, an early intervention is suggested: “As elders, we, parents, and members of the family have a responsibility to teach and inform children about the consequences of their action, especially the case of sexual consent.”
  • 42. • Reference: Jose, C.S. (2018). How to save our children from becoming victims of sexual exploitation. [online] NOLISOLI. Available at: https://nolisoli.ph/48026/how-to-save-children- victims-of-sexual-exploitation/ . 42 STRENGTHEN THEIR LIFE SKILLS “By life skills, I mean, in terms of self-assertion, the art of saying no; attitude towards relationships and partners, as well as with others. We have to equip them with abilities to surmount these problems on their own because, at the end of the day when we are not there, they will have to help themselves.” - Dr. Protacio de Castro Self-Assertion- the confident and forceful expression or promotion of oneself, one's views, or one's desires.
  • 43. • Reference: Jose, C.S. (2018). How to save our children from becoming victims of sexual exploitation. [online] NOLISOLI. Available at: https://nolisoli.ph/48026/how-to-save-children- victims-of-sexual-exploitation/ . 43 FAMILY VALUES ARE CRUCIAL "The formation of the personality and characteristics of a child are highly dependent on what kind of family they have and how they are raised." - Dr. Protacio-De Castro - How you are as parents make a huge difference for your kids - the least parents can do is to find a middle ground, which psychologists call as “positive parenting.” - training those who play an integral part in raising the family: caregivers, and helpers as “psychological first-aid.”
  • 44. • Reference: Jose, C.S. (2018). How to save our children from becoming victims of sexual exploitation. [online] NOLISOLI. Available at: https://nolisoli.ph/48026/how-to-save-children- victims-of-sexual-exploitation/ . 44 COMMUNICATE AND LISTEN IN NEW WAYS Example: “Listen to them, look at the way they communicate, read between the lines when they post something (such as on Facebook). Di ba minsan alam mo na, meron ka nang nabasa, meron nang warning. Why didn’t anyone call, pick up the phone or message the person? It’s not that they are not communicating but they do, just in new ways.” - Anthony Pangilinan, OIC-“Called to Rescue” (a worldwide organization helping prevent human trafficking through education and training)
  • 45. • Reference: Sandesh Adhikari (2019). Teenage Pregnancy: Causes, Effects and Preventive Measures. [online] Public Health Notes. Available at: https://www.publichealthnotes.com/teenage-pregnancy-causes-effects-and-preventive-measures/ . 45 Abstinence Self-restraint from sexual activity at early age is the best way to prevent teenage pregnancy. Contraceptives Using contraceptive devices or emergency pills during a sexual intercourse helps in preventing teenage pregnancy and early parenthood. Communication Active and positive interaction between child-parent regarding sex education or difficulties may prove beneficial to step down the barriers of early pregnancy.
  • 46. • Reference: Sandesh Adhikari (2019). Teenage Pregnancy: Causes, Effects and Preventive Measures. [online] Public Health Notes. Available at: https://www.publichealthnotes.com/teenage-pregnancy-causes-effects-and-preventive-measures/ . 46 Provision of sex education in higher secondary schools along with the consequences. Targeting messages at teen boys, not just at the girls. Increasing the availability of condoms to teens. Encourage mentoring by older teens to younger teens regarding teenage pregnancy and consequences.
  • 47. • Reference: Sandesh Adhikari (2019). Teenage Pregnancy: Causes, Effects and Preventive Measures. [online] Public Health Notes. Available at: https://www.publichealthnotes.com/teenage-pregnancy-causes-effects-and-preventive-measures/ . 47 • Organizing community-based programs on teenage pregnancy and adverse effects. • Schools should provide adolescent-friendly health services along with counseling.
  • 49. • Reference : Teen mothers can be productive under new protection program. [online] www.pna.gov.ph. Available at: https://www.pna.gov.ph/articles/1143247 [Accessed 3 Feb. 2022]. 49 Social Protection Program for Teenaged Mothers and their Children (SPPTMC) - an information system to identify young mothers - a collaboration of the Department of Social Welfare and Development (DSWD) and the Commission on Population and Development (PopCom) that will address the needs of Teenaged mothers, especially those of minor age,
  • 50. • Reference : Teen mothers can be productive under new protection program. [online] www.pna.gov.ph. Available at: https://www.pna.gov.ph/articles/1143247 [Accessed 3 Feb. 2022]. 50 Social Protection Program for Teenaged Mothers and their Children (SPPTMC) - provides beneficiaries access to health services like nutrition and mental health support, opportunity to return to school, and a social amelioration program for those belonging to the lowest socioeconomic bracket until they are able to find gainful work or livelihood.
  • 52. • Reference: Ismael, J.J. (2018). Prevention of teen pregnancy bill pushed. [online] The Manila Times. Available at: https://www.manilatimes.net/2018/12/02/news/top- stories/prevention-of-teen-pregnancy-bill-pushed/476615/ . 52 Senate Bill (SB) 1888 or the “Prevention of Adolescent Pregnancy Act,” - seeks to ensure that young mothers would get the necessary healthcare they need throughout their pregnancy. -it reiterates the importance of education in the prevention of teenage pregnancy and reminds educational institutions that suspension, expulsion, dismissal and denial of admission to pregnant girls are prohibited.
  • 53. • Reference: Ismael, J.J. (2018). Prevention of teen pregnancy bill pushed. [online] The Manila Times. Available at: https://www.manilatimes.net/2018/12/02/news/top- stories/prevention-of-teen-pregnancy-bill-pushed/476615/ . 53 Senate Bill (SB) 1888 or the “Prevention of Adolescent Pregnancy Act,” - Strategies and programs aimed at preventing incidence of teenage pregnancies shall also be integrated in the Sangguniang Kabataan (Youth Council) programs at the local and community level using 10 percent of SK funds.
  • 54. • Reference: Ismael, J.J. (2018). Prevention of teen pregnancy bill pushed. [online] The Manila Times. Available at: https://www.manilatimes.net/2018/12/02/news/top- stories/prevention-of-teen-pregnancy-bill-pushed/476615/ . 54 Senate Bill (SB) 1888 or the “Prevention of Adolescent Pregnancy Act,” - The Department of Education, with assistance from the council and in collaboration with other relevant agencies, shall be required to develop and promote educational standards, modules and materials for Comprehensive Sexuality Education (CSE) in schools, communities and other youth institutions.
  • 55. • Reference: Ismael, J.J. (2018). Prevention of teen pregnancy bill pushed. [online] The Manila Times. Available at: https://www.manilatimes.net/2018/12/02/news/top- stories/prevention-of-teen-pregnancy-bill-pushed/476615/ . 55 Senate Bill (SB) 1888 or the “Prevention of Adolescent Pregnancy Act,” Legislative status : Pending in the Committee (10/14/2020)
  • 56. 56 Proverbs 22:6 “Train up a child in the way he should go; even when he is old he will not depart from it.” Titus 2:6 “Likewise, urge the younger men to be self-controlled.”
  • 57. 57 1 Thessalonians 4:3-5 ” For this is the will of God, your sanctification: that you abstain from sexual immorality; that each one of you know how to control his own body in holiness and honor, not in the passion of lust like the Gentiles who do not know God;”
  • 58. THANKYOU ROMMEL LUIS C. ISRAEL III My presentations (slideshare.net) 58