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Tembo CP, Portsmouth L, Burns SK. Mapping the contextual mental health interventions for perinatal adolescent mothers with self-reported common mental symptoms (anxiety and depression) in sub-Saharan African countries: a scoping review. J Child Adolesc Ment Health 2024:1-18. [PMID: 38828874 DOI: 10.2989/17280583.2024.2323922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
Introduction: Early preventive interventions may support adolescent mothers' mental health during the perinatal period. However, adolescent maternal mental health interventions have received little empirical research attention. This scoping review maps the evidence on interventions appropriate for adolescent mothers during the perinatal period in Sub-Saharan African countries.Methods: The process was guided by the Joanna Briggs Institute's methodology for scoping reviews. Five databases, MEDLINE, EMBASE, PsycInfo, CINAHL, Google Scholar, and ProQuest, were searched for citations of studies published from 2000. The reporting is according to Preferred Reporting for Systematic Reviews and Meta-analysis (PRISMA).Results: The initial search of databases resulted in 2 757 records. After duplicates were removed, 311 records were screened, and eight records included. Interventions included five key strategies: cognitive behavioural therapy; group problem-solving; psychoeducation; psychosocial group counselling; and integrated mothers and babies course and early childhood development group-based intervention. None of the interventions specifically targeted adolescent mothers, however.Discussion and conclusion: There is limited evidence of interventions specific to adolescent mothers. There is a need for the development, implementation and evaluation of specific interventions relevant to this population group.
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Affiliation(s)
- Chimwemwe Pindani Tembo
- Saint John of God College of Health Sciences, Mzuzu Malawi
- Population Health, Curtin University, Perth, Australia
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Posey I, Nsiah-Asamoah C, Fergusson Russell N, Darkwa Entwi E, Okronipa H. Experiences of Food Insecurity Among Pregnant Adolescents and Adolescent Mothers in Ghana: A Photovoice Method. Int J Public Health 2024; 69:1607043. [PMID: 38808213 PMCID: PMC11130365 DOI: 10.3389/ijph.2024.1607043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 04/30/2024] [Indexed: 05/30/2024] Open
Abstract
Objectives: Food insecurity (FI) remains a major public health problem globally. However, there is limited information about adolescents' experiences. The current study explored FI experiences of pregnant adolescents and adolescent mothers in Cape Coast, Ghana using a Photovoice method. Methods: This study recruited 34 pregnant adolescents and adolescent mothers from communities in Cape Coast, Ghana. Each participated in a training session then was provided prompts to take photos that portrayed food access barriers, facilitators and coping strategies. In a debrief session, each participant selected two pictures they took and explained the image, followed by a group discussion of the selected photos. Debrief sessions were audio recorded and transcribed verbatim to develop themes using a theory-driven approach. Results: Most participants reported several or many experiences with FI (64.7%) in the previous month. Participants discussed money, unwanted pregnancy, and unstable work as barriers to obtaining food and working, selling goods, and family support as facilitators to obtaining food. Coping strategies mentioned include providing services to others, borrowing food and goods, meal stretching, pawning personal items and trading. Conclusion: The FI experience of this population is complex; interventions, including trade training or school retention, should be multifaceted.
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Affiliation(s)
- Isabelle Posey
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, United States
| | | | | | - Esther Darkwa Entwi
- Department of Clinical Nutrition and Dietetics, University of Cape Coast, Cape Coast, Ghana
| | - Harriet Okronipa
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, United States
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Hoseini ASS, Maleki M, Mardani A, Abbasi S. Developing the concept of maternal in teenage mothers: a hybrid model. Front Psychol 2024; 14:1246882. [PMID: 38259549 PMCID: PMC10801042 DOI: 10.3389/fpsyg.2023.1246882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/12/2023] [Indexed: 01/24/2024] Open
Abstract
Objectives Maternal transition is a challenging developmental process requiring physical, mental, social, and cognitive preparedness. Therefore, the transition to motherhood is even more challenging for teenagers who are exposed to both the maturation process and adaptation to the parenting role. Therefore, the present study was conducted to provide a deeper understanding of the maternal role in Iranian teenage mothers. Methods A three-phase hybrid model was adopted for concept analysis. In the theoretical phase, 50 articles were analyzed. In the fieldwork phase, 10 participants were interviewed. In the final phase, the findings of the previous two stages were analyzed. This study was conducted between October 2021 and November 2022. After determining the attributes, antecedents, and consequences, a final definition was presented for parenting in teenage mothers. Results The concept of motherhood for teenage mothers was described as "a process-oriented phenomenon in nature," "complex, challenging and multidimensional," "development with immature transition," "a turning point in life," "a stressful event," "affected by several factors," and "bidirectional effects on life" according to antecedents, including "the level of received social support," "reaction to teenage motherhood," "teenage mother's characteristics," and "family structure" leading to "positive psychological consequences," "negative psychological consequences," and "loss of educational and career opportunities." Conclusion This study provides a suitable ground for evaluating the concept of motherhood in teenage mothers and employing it in nursing care of teenage mothers and children by identifying this concept.
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Affiliation(s)
- Akram Sadat Sadat Hoseini
- School of Nursing and Midwifery and Member of Research Center of Quran, Hadith and Medicine of Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Maleki
- Pediatric and Neonatal Intensive Care Nursing Education Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Mardani
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Soheila Abbasi
- Pediatric and Neonatal Intensive Care Nursing Education Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Mohammed S. Analysis of national and subnational prevalence of adolescent pregnancy and changes in the associated sexual behaviours and sociodemographic determinants across three decades in Ghana, 1988-2019. BMJ Open 2023; 13:e068117. [PMID: 36931665 PMCID: PMC10030779 DOI: 10.1136/bmjopen-2022-068117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/19/2023] Open
Abstract
OBJECTIVE Understanding the determinants of adolescent pregnancy and how they have changed over time is essential for measuring progress and developing strategies to improve adolescent reproductive health. This study examined changes over time in the prevalence and determinants of adolescent pregnancy in Ghana. METHODS A total of 11 nationally representative surveys from the Ghana Demographic and Health Survey (1988, 1993, 1998, 2003, 2008, 2014), Multiple Indicator Cluster Survey (2006, 2011, 2017-2018) and Malaria Indicator Survey (2016 and 2019) provided data on 14 556 adolescent girls aged 15-19 for this analysis. A random-effect meta-analysis, time trends and multivariable logistic regression models were used to track the prevalence and determinants of adolescent pregnancy. RESULTS The pooled prevalence of adolescent pregnancy in Ghana was 15.4% (95% CI=13.49% to 17.30%). Rural areas (19.5%) had a higher prevalence of adolescent pregnancy than urban areas (10.6%). In the overall sample, middle adolescents (15-17 years) (aOR=0.30, 95% CI=0.23 to 0.39), adolescents in urban areas (aOR=0.56, 95% CI=0.43 to 0.74), large households (aOR=0.62, 95% CI=0.49 to 0.78), not working (aOR=0.62, 95% CI=0.43 to 0.90) and those unaware of contraceptive methods (aOR=0.49, 95% CI=0.27 to 0.90) were less likely to become pregnant. Adolescents from middle-income (aOR=0.91, 95% CI=0.67 to 1.24) or high-income (aOR=0.59, 95%CI=0.36 to 0.94) households, those who were semiliterate (aOR=0.56, 95%CI=0.39 to 0.82) or literate (aOR=0.28, 95%CI=0.21 to 0.37) and those with fewer previous sex partners were less likely to become pregnant. Not all determinants in the overall sample were consistently associated with adolescent pregnancy in the last three decades. Between 1988 and 1998, determinants of adolescent pregnancy were age, literacy, employment, household size and whether the mother was alive. Between 2003 and 2008, age, literacy, household size, income, age of last sexual partner, number of previous partners and contraception knowledge determined adolescent pregnancy. From 2011 to 2019, age, residence, literacy and menstrual cycle knowledge were determinants of adolescent pregnancy. CONCLUSION Interventions and policies to prevent adolescent pregnancy should prioritise adolescents from disadvantaged backgrounds.
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Affiliation(s)
- Shamsudeen Mohammed
- Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
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Senkyire EK, Boateng D, Boakye FO, Logo DD, Ohaja M. Socio-economic factors associated with adolescent pregnancy and motherhood: Analysis of the 2017 Ghana maternal health survey. PLoS One 2022; 17:e0272131. [PMID: 36584169 PMCID: PMC9803283 DOI: 10.1371/journal.pone.0272131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 07/12/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Adolescent pregnancy and motherhood have been linked to several factors stemming from social, cultural and to a large extent economic issues. This study examined the socio-economic factors associated with adolescent pregnancy and motherhood in Ghana. DESIGN This was a secondary analysis of the 2017 Ghana Maternal Health Survey, which was a nationally representative cross-sectional survey. Data from 4785 adolescents aged between 15-19 years were included in the analysis. Adolescent pregnancy was defined as adolescents who have ever been pregnant, whiles adolescent motherhood was defined as adolescents who have ever given birth. Weighted logistic regression was used to assess the association between the socio-economic variables and adolescent pregnancy and motherhood. RESULTS Of the 25062 women aged between 15 and 49 years included in the 2017 maternal health survey, 4785 (19.1%) were adolescents between 15-19 years. Adolescent pregnancy was reported in 14.6% (CI:13.2% -16.1%) of the respondents, whereas 11.8% (CI: 10.5% -13.1%) of the respondents had ever given birth. In the multivariate regression analysis, zone (p<0.001), wealth index (p<0.001), age (p<0.001), marital status (p<0.001) and level of education (p<0.001) were all significantly associated with adolescent pregnancy and motherhood. The odds of pregnancy and motherhood were significantly higher in the Middle and Coastal zones (p<0.001), and among older adolescents (p<0.001). However, the odds of pregnancy and motherhood was significantly lower among adolescents from households with the highest wealth index (p<0.001), among those who were never married (p<0.001) and among adolescents who had secondary/higher education (p<0.001). CONCLUSION Several socio-economic variables including education, household wealth, marital status and zone of residence were significantly associated with adolescent pregnancy and adolescent motherhood. Sexual and reproductive health education should be intensified among these populations. Adolescent friendly corners should be made available and accessible to all adolescents in Ghana irrespective of where they live or their age.
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Lambonmung A, Acheampong CA, Langkulsen U. The Effects of Pregnancy: A Systematic Review of Adolescent Pregnancy in Ghana, Liberia, and Nigeria. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010605. [PMID: 36612928 PMCID: PMC9819978 DOI: 10.3390/ijerph20010605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/15/2022] [Accepted: 12/22/2022] [Indexed: 05/13/2023]
Abstract
There is a high incidence of adolescent pregnancy in West Africa. The objective of this study is to highlight the health impacts of adolescent pregnancy through a systematic review. A search was conducted in the electronic databases of Google, Google Scholar, SCOPUS, EBSCO, CINAHL, Web of Science, African Journals Online (AJOL), and the Demographic Health Surveys (DHS) Program. The study found anemia, complications of pregnancy, obstetric and gynecological risks, unsafe abortions, and psychological effects to adversely impact the health of adolescent girls in Ghana, Liberia, and Nigeria. Pregnancy could be deleterious to the health and well-being of adolescent girls in various forms. In addition, adolescent pregnancy could expose adolescent girls to gender-based violence, exclusions, and inequities, be detrimental to upholding women's sexual and reproductive health rights, and could also have implications for Sustainable Development Goal 3. Targeted interventions to prevent pregnancy in young women and mitigate these effects by stakeholders are encouraged.
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Affiliation(s)
- Augustine Lambonmung
- Faculty of Public Health, Thammasat University, Pathum Thani 12120, Thailand
- Tamale Teaching Hospital, Ministry of Health, Tamale P.O. Box TL 16, Ghana
| | | | - Uma Langkulsen
- Faculty of Public Health, Thammasat University, Pathum Thani 12120, Thailand
- Correspondence: ; Tel.: +66-8-7078-5123
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Palfreyman A, Gazeley U. Adolescent perinatal mental health in South Asia and Sub-Saharan Africa: A systematic review of qualitative and quantitative evidence. Soc Sci Med 2022; 313:115413. [PMID: 36215926 DOI: 10.1016/j.socscimed.2022.115413] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/14/2022] [Accepted: 09/27/2022] [Indexed: 01/26/2023]
Abstract
Despite the contribution of mental ill-health to perinatal morbidity and mortality, the experiences of adolescent girls and young women (AGYW) in low- and middle-income countries remain overlooked. This review explores potential intersecting vulnerabilities for perinatal mental health to identify the prevalence, risk factors, interventions, and implications for health services and future research. We searched mixed-methods English-language studies in four databases (MEDLINE, PsycInfo, Global Health, Embase) published between January 1, 2000 and April 30, 2022 reporting age-disaggregated data on the prevalence, risk factors, and interventions for AGYW's mental health during pregnancy through one year postpartum (quantitative) and/or the mental health experiences of AGYW in the perinatal period (qualitative). Our search yielded 3205 results, of which 48 met the inclusion criteria. Both regions observe a paucity of robust evidence and intervention evaluations, particularly South Asia. While meta-analysis was infeasible due to study heterogeneity, quantitative studies do identify individual-level risk factors for perinatal depression. Qualitative studies emphasise stigma's impact, among other societal-level social risk factors, on diverse perinatal mental health outcomes of importance to AGYW themselves. Rigorous evaluations of interventions are lacking bar two protocols with forthcoming results. Evidence gaps persist concerning prevalence of outcomes beyond depression and implications of AGYW's perinatal experiences including pregnancy/perinatal loss and obstetric and postpartum complications. High-quality research, including comparable prevalence and multi-method evidence identifying risk and protective factors and promising interventions is urgently needed to improve adolescent wellbeing in the perinatal period. A key strength of this review is our assessment of available evidence for both regions. In doing so, we address a critical blind spot of prior reviews that focused either on adult perinatal mental health in low- and middle-income countries, or on AGYW perinatal mental health in high-income settings but neglected the intersection of these potential vulnerabilities for these high-burden, low-resource contexts.
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Affiliation(s)
- Alexis Palfreyman
- Institute for Global Health, University College London, London, WC1N 1EH, UK.
| | - Ursula Gazeley
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
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Anima PA, Kumi-Kyereme A, Mariwah S, Tampah-Naah AM. Reflections on lived experiences of teenage mothers in a Ghanaian setting: a phenomenological study. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2022. [DOI: 10.1080/02673843.2022.2085052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Prisca Ama Anima
- Department of Geographic Science, University of Energy and Natural Resources, Sunyani, Ghana
| | - Akwasi Kumi-Kyereme
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Simon Mariwah
- Department of Geography and Regional Planning, University of Cape Coast, Cape Coast, Ghana
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Tembo CP, Burns S, Portsmouth L. Maternal mental health of adolescent mothers: a cross-sectional mixed-method study protocol to determine cultural and social factors and mental health needs in Lilongwe, Malawi. BMJ Open 2022; 12:e056765. [PMID: 35568496 PMCID: PMC9109123 DOI: 10.1136/bmjopen-2021-056765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Adolescence marks a transition of life from childhood to adulthood. Becoming a mother during adolescence presents unique challenges that have a significant mental and physical burden and may increase the likelihood of developing common mental disorders (CMDs). Untreated CMDs have serious effects on both the mother and her child. Culture constitutes an important context for most experiences, and affects how individuals seek help. However, there is limited research that has investigated how culture and social factors influence the adolescent mother's mental health during the postpartum period in Malawi. METHODS/DESIGN A cross-sectional sequential mixed methods design will be carried out in four phases. Phase one will include the preparatory phase and scoping review. The second phase will comprise a survey with adolescent mothers. The sample for the survey consists of adolescent postpartum mothers aged 14-19 years (with infants of up to 6 months of age) who have the capacity to consent for the study. Phase three will be a qualitative study in which in-depth interviews and focus group discussions will be employed to collect data from health workers and informal healthcare providers in the community (eg, traditional healers, traditional birth attendants). The fourth phase will involve developing recommendations for policy and practice ETHICS AND DISSEMINATION: This study will provide an understanding of the impact of culture and social factors that influence adolescent mother's mental health and well-being, including the identification of potential risk and protective factors. The findings will inform recommendations for an appropriate, culturally accepted spectrum of interventions, including universal, selective and indicated prevention strategies. The findings will be disseminated to stakeholders working in maternal health in Malawi. Ethical approval was received from the Curtin University Human Research Ethics Committee (HRE2021-0223) and (P.05/21/575) Malawian Ethics Board National Committee on Research Ethics in the Social Sciences and Humanities.
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Affiliation(s)
| | - Sharyn Burns
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Linda Portsmouth
- School of Population Health, Curtin University, Perth, Western Australia, Australia
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Luttges C, Leal I, Huepe G, González D, González E, Molina T. Pregnant again? Perspectives of adolescent and young mothers who and do not experience a repeat pregnancy in adolescence. Int J Qual Stud Health Well-being 2021; 16:1898317. [PMID: 33779521 PMCID: PMC8009116 DOI: 10.1080/17482631.2021.1898317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction: Teen pregnancy remains a major social and public health issue in developing countries. Each additional child compromises the development of both the mother and children. Scarce studies have been performed in Latin America. Purpose: This study explores and analyzes individual and family factors associated with repeat pregnancies during adolescence to better elucidate the phenomenon. Methods: Qualitative-descriptive study. Thirty semi-structured interviews were conducted with mothers 20 years of age or younger from urban areas of Santiago, Chile. Participants were divided into Repeat Pregnancy (RP) and No Repeat Pregnancy (NRP) groups. Qualitative data analysis was based on elements of grounded theory. Results: The RP group generally related life stories reflecting greater psychosocial vulnerability. Most of the RP group dropped out of school after their first pregnancy to focus on parenting and had a passive attitude towards contraception. In contrast, members of the NRP group actively sought long-term contraceptive methods, motivated largely by the desire to continue their education to improve their living conditions and achieve greater personal fulfilment. They tended to have family support networks that facilitated school retention. Conclusion: Key differences between groups included use of contraception, focus on life projects, and motivation to finish school. Prevention strategies should promote long-term contraceptive methods, offer strategies to help young mothers continue their education, facilitate achievement of personal projects, and provide support for parenting.
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Affiliation(s)
- Carolina Luttges
- Center for Reproductive Medicine and Comprehensive Attention of Adolescents (Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente CEMERA), Faculty of Medicine, University of Chile (Universidad de Chile), Santiago de Chile, Chile
| | - Ingrid Leal
- Department of Psychiatry and Mental Health. Department of Bioethic and Medical Humanities, Faculty of Medicine, University of Chile (Universidad de Chile), Santiago de Chile, Chile
| | - Gabriela Huepe
- Center for Reproductive Medicine and Comprehensive Attention of Adolescents (Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente CEMERA), Faculty of Medicine, University of Chile (Universidad de Chile), Santiago de Chile, Chile.,Department of Psychiatry and Mental Health. Department of Bioethic and Medical Humanities, Faculty of Medicine, University of Chile (Universidad de Chile), Santiago de Chile, Chile
| | - Daniela González
- Center for Reproductive Medicine and Comprehensive Attention of Adolescents (Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente CEMERA), Faculty of Medicine, University of Chile (Universidad de Chile), Santiago de Chile, Chile
| | - Electra González
- Center for Reproductive Medicine and Comprehensive Attention of Adolescents (Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente CEMERA), Faculty of Medicine, University of Chile (Universidad de Chile), Santiago de Chile, Chile
| | - Temístocles Molina
- Center for Reproductive Medicine and Comprehensive Attention of Adolescents (Centro de Medicina Reproductiva y Desarrollo Integral del Adolescente CEMERA), Faculty of Medicine, University of Chile (Universidad de Chile), Santiago de Chile, Chile
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