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Idris IB, Bin Sulaiman SK, Hod R, Khazaei H, Abdullah NN. A Qualitative Study to Explore the Determinants of Risky Sexual Behaviors and Pregnancy among Female Adolescents in Sabah, Malaysia. Obstet Gynecol Int 2022; 2022:1866326. [PMID: 36479302 PMCID: PMC9722311 DOI: 10.1155/2022/1866326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 10/29/2022] [Accepted: 11/16/2022] [Indexed: 11/22/2023] Open
Abstract
This investigation was performed in Kota Kinabalu, Sabah state, where the highest number of pregnancies is recorded. The purpose of this study was to determine variables associated with hazardous sexual activity and adolescent pregnancy in Sabah, Malaysia. The findings indicate that familial variables, peer interactions, self-esteem, psychiatric concerns, economic considerations, and sex knowledge all play a significant role in hazardous sexual conduct and adolescent pregnancy in Sabah, Malaysia. Information obtained from this study will help the Malaysian government and other officials to design and establish proper interventions that will help alleviate the challenge of high prevalence of teenage pregnancy. It is suggested that sex education be included in the high school curriculum, along with physical and health education in Sabah, Malaysia.
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Affiliation(s)
- Idayu Badilla Idris
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Shameer Khan Bin Sulaiman
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hamed Khazaei
- Malaysia-Japan International Institute of Technology, University Teknologi Malaysia, Kuala Lumpur, Malaysia
| | - Nik Nairan Abdullah
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
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Serván-Mori E, Cerecero-García D, Morales-Vazquez M, Sosa-Rubí S, Heredia-Pi I, Hernández-Serrato M. The Role of Effective Knowledge on Contraceptive Methods Use in the Replication of Mother-Daughter Adolescent Pregnancy in Mexico. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:4035-4046. [PMID: 36036869 DOI: 10.1007/s10508-021-02272-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 06/15/2023]
Abstract
An important gap in the literature is the analysis of the role of effective knowledge concerning use of contraceptive methods in the intergenerational reproduction of adolescent pregnancy in low- and middle-income countries. Using data from the 2014 Mexico National Survey of Demographic Dynamics, we conducted a retrospective cohort and complete case analysis of women aged ≤ 19 years cohabitating with their mothers and who self-reported having had sexual intercourse at the moment of the survey (n = 5143). We estimated instrumental variable probit models (IV-probit) to assess the association between effective knowledge concerning the use of contraceptive methods and adolescent pregnancy. We stratified our models according to parental history of adolescent pregnancy. Adolescent pregnancy prevalence in our sample was 58.7%. The IV-probit model showed that mothers with a history of adolescent pregnancy were 12.1 percentage points more likely to have daughters who experience adolescent pregnancy. In addition, daughters with effective knowledge concerning the use of contraceptive methods were 1.3 percentage points less likely to experience an adolescent pregnancy. Our findings carry relevant implications for policies seeking to reduce adolescent pregnancy. They highlight the need for policies and programs that tackle the intergenerational transmission of sexual and reproductive behaviors by increasing the information available to adolescents and enhancing their effective knowledge about the use of contraceptive methods. Identifying population groups at higher risk of adolescent pregnancy can contribute to the design of successful reproductive health policies in Mexico and other low- and middle-income countries.
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Affiliation(s)
- Edson Serván-Mori
- Center for Health Systems Research, National Institute of Public Health, Mexico, Universidad No. 655 Colonia Santa Maria Ahuacatitlan, Cerrada Los Pinos y Caminera, 62100, Cuernavaca, Morelos, México
| | - Diego Cerecero-García
- Center for Health Systems Research, National Institute of Public Health, Mexico, Universidad No. 655 Colonia Santa Maria Ahuacatitlan, Cerrada Los Pinos y Caminera, 62100, Cuernavaca, Morelos, México.
| | - Mariana Morales-Vazquez
- Center for Health Systems Research, National Institute of Public Health, Mexico, Universidad No. 655 Colonia Santa Maria Ahuacatitlan, Cerrada Los Pinos y Caminera, 62100, Cuernavaca, Morelos, México
| | - Sandra Sosa-Rubí
- Center for Health Systems Research, National Institute of Public Health, Mexico, Universidad No. 655 Colonia Santa Maria Ahuacatitlan, Cerrada Los Pinos y Caminera, 62100, Cuernavaca, Morelos, México
| | - Ileana Heredia-Pi
- Center for Health Systems Research, National Institute of Public Health, Mexico, Universidad No. 655 Colonia Santa Maria Ahuacatitlan, Cerrada Los Pinos y Caminera, 62100, Cuernavaca, Morelos, México
| | - María Hernández-Serrato
- Center of Information for Public Health Decisions, National Institute of Public Health, Mexico, Universidad No. 655 Colonia Santa Maria Ahuacatitlan, Cerrada Los Pinos y Caminera, 62100, Cuernavaca, Morelos, México
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Huda MM, Finlay JE, O'Flaherty M, Al Mamun A. Transition in social risk factors and adolescent motherhood in low- income and middle- income countries: Evidence from Demographic and Health Survey data, 1996-2018. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000170. [PMID: 36962188 PMCID: PMC10021223 DOI: 10.1371/journal.pgph.0000170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 04/13/2022] [Indexed: 11/19/2022]
Abstract
Understanding the dynamics of social risk factors in the occurrence of adolescent motherhood is vital in designing more appropriate prevention initiatives in low-income and middle-income countries (LMICs). We aimed this study to examine the transition of social risk factors and their association with adolescent motherhood in LMICs since the initiation of the MDGs. We analysed 119967 adolescent girls (15-19 years) from 40-nationally representative Demographic Health Surveys in 20 LMICs that had at least two surveys: a survey in 1996-2003(baseline, near MDGs started) and another in 2014-2018(endline). Adolescent motherhood (having a live birth or being pregnant before age 20) was the outcome of interest, whereas social risk factors including household wealth, girls' level of education, and area of residence were the exposures. The association between adolescent motherhood and the social risk factors, as well as changes in the strength of the association over time were observed using multilevel logistic regression analysis. On an average, the proportion of adolescent mothers without education decreased by -15·61% (95% CI: -16·84, -14·38), whereas the poorest adolescent mother increased by 5·87% (95% CI: 4·74, 7·00). The national prevalence of adolescent motherhood remained unchanged or increased in 55·00% (11/20) of the studied countries. Comparing baseline to endline, the overall adjusted odds ratio (AOR) of adolescent motherhood increased for both poorest (AOR = 1·42, 95% CI: 1·28, 1·59) and rural residences (AOR = 1·09, 95% CI: 1·01, 1·17), and decreased, but not statistically significant for the low level of education (AOR = 0·92, 95% CI: 0·84, 1·01 for no education). Our study concludes that social risk factors of the adolescent mother had shifted in different directions during MDGs and SDGs eras, and adolescent mothers remained more disadvantaged than non-mothers in LMICs. Efforts need to be enhanced to improve adolescent girls' education. Intervention should be prioritised in disadvantaged communities to delay adolescent first birth and prevent adolescent motherhood in LMICs.
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Affiliation(s)
- M Mamun Huda
- Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Queensland, Australia
| | - Jocelyn E Finlay
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Martin O'Flaherty
- Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Queensland, Australia
| | - Abdullah Al Mamun
- Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Queensland, Australia
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Boamah-Kaali EA, Mevissen FEF, Owusu-Agyei S, Enuameh Y, Asante KP, Ruiter RAC. A Qualitative Exploration of Factors Explaining Non-Uptake of Hormonal Contraceptives Among Adolescent Girls in Rural Ghana: The Adolescent Girls' Perspective. Open Access J Contracept 2021; 12:173-185. [PMID: 34764703 PMCID: PMC8577562 DOI: 10.2147/oajc.s320038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/25/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Adolescent pregnancy remains a public health concern globally. The use of hormonal contraceptive methods are proven ways of preventing pregnancies and in turn unsafe abortions. However, research shows that use of hormonal contraceptive methods is rather low among African adolescent girls, of which Ghana is no exception. OBJECTIVE This manuscript uses the socio-ecological model to guide our understanding of the factors associated with non-use of hormonal contraceptives among adolescent girls in Ghana. METHODS An explorative study was done using qualitative data collection methods. Two focus group discussions and sixteen in-depth interviews were conducted among adolescent girls aged 15-19 years (N = 38) in the Kintampo area of Ghana to determine factors affecting uptake of hormonal contraceptives. RESULTS Adolescents showed a lack of in-depth knowledge related to the different hormonal contraceptive types. Negative attitudes towards adolescent hormonal contraceptive use, fear of real and perceived side effects of hormonal contraceptives, lack of self-efficacy to use contraceptives, fear of disclosure of use and fear of societal stigma related to sexual intercourse and its related issues among adolescents may explain why adolescent girls in this context do not use hormonal contraceptive methods. CONCLUSION To promote hormonal contraceptives among adolescent girls, a combination of multifaceted social-psychological, personal and community level interventions are needed.
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Affiliation(s)
- Ellen Abrafi Boamah-Kaali
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service Kintampo North Municipality, Kintampo, Ghana
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Fraukje E F Mevissen
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Municipal Public Health Service Rotterdam-Rijnmond, Department of Public Health, Rotterdam, the Netherlands
| | - Seth Owusu-Agyei
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service Kintampo North Municipality, Kintampo, Ghana
- Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Yeetey Enuameh
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service Kintampo North Municipality, Kintampo, Ghana
- Department of Epidemiology & Biostatistics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kwaku Poku Asante
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service Kintampo North Municipality, Kintampo, Ghana
| | - Robbert A C Ruiter
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
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Adeagbo MJ, Naidoo K. Exploring narratives and advocating support and peer mentorship to improve HIV-positive adolescent mothers' lives in South Africa. AJAR-AFRICAN JOURNAL OF AIDS RESEARCH 2020; 19:231-241. [PMID: 33119456 DOI: 10.2989/16085906.2020.1808486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Research on adolescent sexuality, health and parenting has gained much attention in recent years. This growing body of research, however, has arguably limited qualitative outputs on HIV-positive adolescent mothers' sexual and reproductive health choices, needs, and rights in South Africa that could lead to informed policymaking. Through in-depth interviews conducted with a select group of ten HIV-positive adolescents and three key informants, the article explores the sexual, motherhood, risk discourses and reproductive health issues and rights of HIV-positive adolescent mothers as they come to terms with choices they have made and the challenges ahead. The findings highlight the dominant narratives on what are deemed to be the forces that shape these adolescent mothers' new social realities. With existing policies in place for adolescents, it is argued that a "one-size-fits-all" policy approach does not work, especially for HIV-positive adolescent mothers. Drawing on this identified gap and the tensions between individual needs, and the public welfare provision, the article highlights the need for tailored policy that will accommodate and promote the overall well-being of HIV-positive adolescent mothers and their children.
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Affiliation(s)
| | - Kammila Naidoo
- Sociology Department, University of Johannesburg, South Africa
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Ajayi AI, Ezegbe HC. Association between sexual violence and unintended pregnancy among adolescent girls and young women in South Africa. BMC Public Health 2020; 20:1370. [PMID: 32894130 PMCID: PMC7487533 DOI: 10.1186/s12889-020-09488-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/31/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Unintended pregnancy has dire consequences on the health and socioeconomic wellbeing of adolescent girls and young women (AGYW) (aged 15-24 years). While most studies tend to focus on lack of access to contraceptive information and services, and poverty as the main contributing factor to early-unintended pregnancies, the influence of sexual violence has received limited attention. Understanding the link between sexual violence and unintended pregnancy is critical towards developing a multifaceted intervention to reduce unintended pregnancies among AGYW in South Africa, a country with high teenage pregnancy rate. Thus, we estimated the magnitude of unintended pregnancy among AGYW and also examined the effect of sexual violence on unintended pregnancy. METHODS Our study adopted a cross-sectional design, and data were obtained from AGYW in a South African university between June and November 2018. A final sample of 451 girls aged 17-24 years, selected using stratified sampling, were included in the analysis. We used adjusted and unadjusted logistic regression analysis to examine the effect of sexual violence on unintended pregnancy. RESULTS The analysis shows that 41.9% of all respondents had experienced an unintended pregnancy, and 26.3% of those unintended pregnancies ended in abortions. Unintended pregnancy was higher among survivors of sexual violence (54.4%) compared to those who never experienced sexual abuse (34.3%). In the multivariable analysis, sexual violence was consistently and robustly associated with increased odds of having an unintended pregnancy (AOR:1.70; 95% CI: 1.08-2.68). CONCLUSION Our study found a huge magnitude of unintended pregnancy among AGYW. Sexual violence is an important predictor of unintended pregnancy in this age cohort. Thus, addressing unintended pregnancies among AGYW in South Africa requires interventions that not only increase access to contraceptive information and services but also reduce sexual violence and cater for survivors.
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Affiliation(s)
- Anthony Idowu Ajayi
- Population Dynamics and Sexual and Reproductive Health, Africa Population and Health Research Center, Off Kirawa Road, Manga Close, Nairobi, Kenya
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Adeagbo MJ, Naidoo K. Turning the Lens Toward Emotions: Considering HIV-Positive Adolescent Mothers in South Africa. JOURNAL OF ADOLESCENT RESEARCH 2020. [DOI: 10.1177/0743558420945182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The idea that adolescence, an important developmental stage in human life is embodied in emotions is not new. However, the association between adolescence, unplanned motherhood, and HIV infection, which often lead to unanticipated transitions, may influence a rethink toward understanding the emotional and mental states of adolescent mothers. Using a sociological lens, this article draws on the concept of “emotionality” and the importance of paying attention to “emotions” in offering analysis of the new reality, which HIV-positive adolescent mothers find themselves in South Africa. Specifically, this article shifts the social research focus from behavioral (e.g. sexual behaviors) research to exploring HIV-positive adolescent mothers’ feelings, thus paying heed to a subjective emotional landscape. Through an inductive thematic analysis, the emotional accounts and unifying themes extracted from 13 (10 HIV-positive adolescent mothers and three key informants) semistructured in-depth interviews present an understanding of the various needs of an emerging youthful generation living with HIV, rather than a narrow, conventional focus on costs, risks, and impending mortality.
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Yakubu I, Garmaroudi G, Sadeghi R, Tol A, Yekaninejad MS, Yidana A. Assessing the impact of an educational intervention program on sexual abstinence based on the health belief model amongst adolescent girls in Northern Ghana, a cluster randomised control trial. Reprod Health 2019; 16:124. [PMID: 31416450 PMCID: PMC6694566 DOI: 10.1186/s12978-019-0784-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 07/29/2019] [Indexed: 12/28/2022] Open
Abstract
Background Adolescent pregnancy is a worldwide problem because of its health, social, economic and political repercussions on the globe. Even though the rates of adolescent pregnancy have declined over the decade, there is still unacceptably high rates especially in lower and middle-income countries including Ghana. Although the problem has been widely investigated, there is little information on the effectiveness of different methods to improve adolescent sexual abstinence based on theoretical models. This study is aimed to assess an educational intervention program on sexual abstinence based on the Health Belief Model (HBM) among adolescent girls in Northern Ghana. Methods A cluster randomized control trial was conducted in Ghana from April to August 2018. Participants within the ages of 13–19 years were enrolled voluntarily from six randomly selected Senior High Schools (3 for intervention and 3 for control). A total of 363 adolescent were enrolled. A self-structured questionnaire was administered to both groups of participants at baseline and endpoint of the study. Control participants received their normal classes whiles the intervention group additionally received comprehensive sexuality education for 1 month. Qualified midwives conducted the health education program. At least two sessions were conducted for each participating class weekly. The lessons focused on perceived susceptibility, perceived severity of adolescent pregnancy, perceived benefits, perceived barriers to adolescent pregnancy prevention, personal and family values, perceived self-efficacy and knowledge of contraceptives. Educational strategies such as discussions, demonstrations, role-play and problem solving techniques were used to deliver the lessons. Sexual abstinence was the outcome variable of the study and it was measured after 3 months of the intervention. Binary logistic regression was used to assess the impact of the intervention on sexual abstinence practice. Results At baseline, there was no difference between control and intervention groups. The mean score of Knowledge and attitude for control were (58.17 and 139.42) and intervention (60.49 and 141.36) respectively. Abstinence practice was 69.4% for control and 71.6% in the intervention group. However, after the intervention, the mean score of knowledge and attitude for control were (87.58 and 194.12) respectively. Sexual abstinence in the control was 84.4% and intervention was 97.3% respectively. The educational interventions resulted in a significant difference in sexual abstinence between intervention and control groups (OR = 13.89, 95% Confidence Interval (2.46–78.18, P < 0.003). Conclusion Educational intervention, which was guided by HBM, significantly improved sexual abstinence and the knowledge of adolescents on pregnancy prevention among the intervention group. Provision of comprehensive sex education guided by behavioural theories to adolescents at Senior High Schools in Ghana is recommended. Trial registration This trial was retrospectively registered in Protocol Registration and Results System (PRS) with trial number NCT03384251.
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Affiliation(s)
- Ibrahim Yakubu
- Department of Health Education And Promotion, School of Public Health Tehran University of Medical Sciences, Tehran, Iran. .,Department of Nursing, Nursing and Midwifery Training College, Gushegu, Ghana.
| | - Gholamreza Garmaroudi
- Department of Health Education And Promotion, School of Public Health Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sadeghi
- Department of Health Education And Promotion, School of Public Health Tehran University of Medical Sciences, Tehran, Iran
| | - Azar Tol
- Department of Health Education And Promotion, School of Public Health Tehran University of Medical Sciences, Tehran, Iran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health Tehran University of Medical Sciences, Tehran, Iran
| | - Adadow Yidana
- Department of Community Health and Family Medicine, School of Medicine, University for Development Studies, Tamale, Ghana
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Ahinkorah BO, Hagan JE, Seidu AA, Mintah JK, Sambah F, Schack T, Hormenu T. Examining Pregnancy Related Socio-Cultural Factors Among Adolescent Girls in the Komenda-Edina-Eguafo-Abrem Municipality in the Central Region of Ghana: A Case-Control Study. Front Public Health 2019; 7:93. [PMID: 31069207 PMCID: PMC6491621 DOI: 10.3389/fpubh.2019.00093] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 04/04/2019] [Indexed: 11/29/2022] Open
Abstract
Background and Purpose: Given that Ghana continues to record higher rates of adolescent pregnancy among rural dwellers, notably, those living in the Brong Ahafo, Central and Volta regions, it is surprising that scholarly information related to socio-cultural determinants of this sequel in these mentioned areas of the country is limited. This study sought to examine the socio-cultural factors associated with pregnancy among adolescent girls in Komenda-Edina-Eguafo-Abrem (KEEA) Municipality in the Central Region of Ghana. Methods and results: Using a matched case-control design with a 1:1 ratio, a facility-based sampling approach was used to select 400 adolescent females aged between 15 and 19 years. Chi-square analyses on the strictness level of rules and regulations in family [χ2(1) = 62.010, p < 0.05], freedom within the family to discuss issues related to sexuality [χ2(1) = 9.600, p < 0.05], religious support of sex before marriage [χ2(1) = 4.312, p < 0.05], peer influence to engage in sexual intercourse [χ2(1) = 7.793, p < 0.05], reaction of parents toward pregnancy [χ2(1) = 70.064, p < 0.05], and reaction of siblings toward pregnancy [χ2(1) = 66.702, p < 0.05] were significantly related to adolescents' pregnancy status. Additionally, binary logistic regression analysis also showed that non-pregnant adolescents were seven times more likely to belong to families with strict rules and regulations compared to pregnant adolescents [OR = 0.14, 95% CI = (0.07–0.25), p ≤ 0.01]. Non-pregnant adolescents were 3 times more likely to have freedom within the family to discuss issues related to sexuality compared to pregnant adolescents [OR = 0.33, 95% CI = (0.18–0.59), p ≤ 0.01]. However, pregnant adolescents were 3 times more likely to be influenced by their peers to engage in sexual intercourse [OR = 2.63, 95% CI = (1.46–4.74), p ≤ 0.001] and 3 times more likely to have parents with positive reaction toward adolescent pregnancy compared to non-pregnant adolescents [OR = 2.97, 95% CI = (1.15–7.70), p ≤ 0.05]. Additionally, these pregnant adolescents were eight times more likely to have siblings with positive reaction toward adolescent pregnancy [OR = 7.74, 95% CI = (2.59–21.4), p ≤ 0.001] compared to their non-pregnant counterparts. Conclusion: Adolescent pregnancy heightens the risk of negating birth outcomes that is independent of recognized confounding variables. Therefore, adolescent girls in the KEEA Municipality are likely to experience continuous exposure to the risk of pregnancy with the existence of negative socio-cultural norms. Specific strategies need to involve multifaceted interventions that include education, competency-based skill training and support for young people, especially pregnant adolescents. Further research ought to determine which other factors would help us better understand circumstances that may lead to adolescent pregnancies in other areas of the region and perhaps among other subgroups.
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Affiliation(s)
- Bright Opoku Ahinkorah
- Australian Centre for Public and Population Health Research, University of Technology Sydney, Ultimo, NSW, Australia
| | - John Elvis Hagan
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana.,Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Bielefeld, Germany
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Joseph Kwame Mintah
- Australian Centre for Public and Population Health Research, University of Technology Sydney, Ultimo, NSW, Australia
| | - Francis Sambah
- Australian Centre for Public and Population Health Research, University of Technology Sydney, Ultimo, NSW, Australia
| | - Thomas Schack
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Bielefeld, Germany
| | - Thomas Hormenu
- National Institutes of Health, Section of Ethnicity and Health, DEOB, NIDDK, Bethesda, MD, United States
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Asare BYA, Baafi D, Dwumfour-Asare B, Adam AR. Factors associated with adolescent pregnancy in the Sunyani Municipality of Ghana. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2019. [DOI: 10.1016/j.ijans.2019.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Nalukwago J, Alaii J, Borne BVD, Bukuluki PM, Crutzen R. Application of Core Processes for Understanding Multiple Concurrent Sexual Partnerships Among Adolescents in Uganda. Front Public Health 2018; 6:371. [PMID: 30622938 PMCID: PMC6308184 DOI: 10.3389/fpubh.2018.00371] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 12/04/2018] [Indexed: 12/29/2022] Open
Abstract
Introduction: Adolescents in Uganda, as in other sub-Saharan countries, engage in sex with multiple concurrent partners, thus placing them at risk for HIV and unplanned pregnancies, but it is not clear why. This study explored why adolescents in Uganda engage in multiple concurrent sexual partnerships (MCSP). Methods: This study used a Core Processes methodology. We used the processes of brainstorming, and identification of evidence and theoretical support, in various phases/steps of intervention planning, to provide possible explanations for adolescent MCSP. Results: Adolescents were found to have limited knowledge of the risks associated with MCSP and perceived a low risk for HIV. Peer influence to engage in MCSP exacerbated the problem among adolescents. Poor communication with sexual partners and parents and societal indifference to multiple sexual partnerships increased permissive attitudes toward infidelity. The unclear adolescent sexual and reproductive health policies hampered access to services, and transactional sexual relationships with older (polygamous) sexual partners increased the HIV risk. Adolescents were found to be more concerned about unplanned pregnancies than HIV risk. Discussion: From the empirical evidence, adolescent health programs in Uganda should incorporate comprehensive sexual health education on HIV and teenage pregnancy risk-reduction strategies. Programs should strengthen parental and community support through enhanced collaborative training on communication with and for adolescents. Forming strategic partnerships with various stakeholders for concerted efforts to address the MCSP problem among adolescents is critical.
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Affiliation(s)
- Judith Nalukwago
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
- Family Health International 360 (Uganda), Kampala, Uganda
- Department of Social Work and Social Administration, Makerere University, Kampala, Uganda
| | - Jane Alaii
- Context Factor Solutions, Nairobi, Kenya
| | - Bart Van Den Borne
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Paul Mukisa Bukuluki
- Department of Social Work and Social Administration, Makerere University, Kampala, Uganda
| | - Rik Crutzen
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
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Berliana SM, Kristinadewi PAN, Rachmawati PD, Fauziningtyas R, Efendi F, Bushy A. Determinants of early marriage among female adolescent in Indonesia. Int J Adolesc Med Health 2018; 33:/j/ijamh.ahead-of-print/ijamh-2018-0054/ijamh-2018-0054.xml. [PMID: 30500778 DOI: 10.1515/ijamh-2018-0054] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 05/17/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND While studies on reproductive health issues are discussed widely, until recently early marriage among adolescent has not received enough attention across stakeholders in Indonesia. This research aims to analyze the determinants of early marriage among female adolescents in Indonesia. METHODS This study employs data from the Indonesia Demographic and Health Survey (IDHS) 2012 on females aged 15-19 years (n = 7207). The analytical methods used to determine factors of early marriage were chi-square and multiple logistic regression. RESULTS The results from this research revealed that four determinants are significantly related to early marriage among female adolescent. Females who have not completed primary school tend to be involved in an early marriage more often than those who graduated from high school. Furthermore, underprivileged females tend to get married earlier than those with a high socio-economic status. Additionally, females living in rural areas are more prone to early marriage than those living in urban areas. Finally, well-informed females tend not to get married as early as females who do not have access to media information. CONCLUSION A stakeholder policy is required that promotes the status of females by improving access to national education, particularly for females in rural areas and those who live in poverty. Marketing and advertising media campaign targeting adolescent are needed to ensure greater access to information.
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Affiliation(s)
| | | | | | | | - Ferry Efendi
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Angeline Bushy
- College of Nursing, University of Central Florida, Orlando, FL, USA
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Islam MM, Islam MK, Hasan MS, Hossain MB. Adolescent motherhood in Bangladesh: Trends and determinants. PLoS One 2017; 12:e0188294. [PMID: 29176807 PMCID: PMC5703513 DOI: 10.1371/journal.pone.0188294] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 11/04/2017] [Indexed: 11/18/2022] Open
Abstract
Background While studies on fertility and contraceptives issues are available, until recently adolescent motherhood has not received enough attention among policy makers in understanding adolescent motherhood in Bangladesh. We aimed to examine the trends and determinants of adolescent motherhood among women aged 15–49 years. Methods For trend analysis we used all the 7 waves of Bangladesh Demographic and Health Survey (BDHS, 1993–2014) data but for multivariate analysis 4 waves of BDHS (2004–2014). Two separate analyses were carried out on ever married women aged 15–49: (1) teenage girls aged 15–19 and (2) adult women aged 20 and above. Results The prevalence of adolescent motherhood had declined to a slower pace from 1993 to2014 (from 33.0% to 30.8%). Lower spousal age gap and higher education were found to be associated with lower likelihood of adolescent motherhood both among teenage girls [OR 0.447 (0.374–0.533)] and adult women [OR 0.451 (0.420–0.484)]. Teenage girls in the poorest wealth quintile [OR 1.712 [1.350–2.173] were more likely to experience adolescent motherhood than the richest wealth quintile. Teenage girls who had no education were found to have 2.76 times higher odds of adolescent motherhood than their counterparts who had higher than secondary education. Concerning the time effect, the odds of adolescent motherhood among adult women was found to decline overtime. Conclusions Despite substantial decrease in total fertility rate in Bangladesh adolescent motherhood is still highly prevalent though declining from 1993 to 2014. Social policies including those addressing poverty, ensuring greater emphasis on education for women; and adolescent mothers in rural areas are needed.
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Affiliation(s)
| | - Md. Kamrul Islam
- Department of Population Sciences, University of Dhaka, Dhaka, Bangladesh
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Who's that girl? A qualitative analysis of adolescent girls' views on factors associated with teenage pregnancies in Bolgatanga, Ghana. Reprod Health 2016; 13:39. [PMID: 27080996 PMCID: PMC4832526 DOI: 10.1186/s12978-016-0161-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 04/07/2016] [Indexed: 11/10/2022] Open
Abstract
Background Adolescent pregnancy remains a public health concern, with diverse serious consequences, including increased health risk for mother and child, lost opportunities for personal development, social exclusion, and low socioeconomic attainments. Especially in Africa, teenage pregnancy rates are high. It is important to find out how girls without pregnancy experience differ in their contraceptive decision-making processes as compared with their previously studied peers with pregnancy experience to address the high rate of teenage pregnancies. Methods We conducted semi-structured in-depth interviews with never been pregnant girls (N = 20) in Bolgatanga, Ghana, to explore the psychosocial and environmental factors influencing the sexual decision making of adolescents. Themes such as relationships, sex, pregnancy, family planning and psychosocial determinants (knowledge, attitudes, self-efficacy, norms, risk perceptions) derived from empirical studies and theories related to sexuality behavior guided the development of the interview protocol. Results Results showed that the girls did talk about sexuality with their mothers at home and did receive some form of sexual and reproductive health education, including the use of condoms discussions in school. Participants reported high awareness of pregnancy risk related to unprotected sex, were positive about using condoms and indicated strong self-efficacy beliefs towards negotiating condom use. The girls also formulated clear future goals, including coping plans such as ways to prevent unwanted pregnancies to reach these targets. On the other hand, their attitudes towards family planning (i.e., contraceptives other than condoms) were negative, and they hold boys responsible for buying condoms. Conclusion An open parental communication on sexuality issues at home, comprehensive sex education in school and attitude, self-efficacy, risk perception towards contraception, alongside with goal-setting, seem to be protective factors in adolescent girls’ pregnancy prevention efforts. These factors should be targets in future intervention programs at the individual, interpersonal, and school and community levels.
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