Adolescents' perspective regarding adolescent pregnancy, sexuality and contraception

Strategies to enhance sexual health education for prevention of teenage pregnancy in Vhembe District, Limpopo Province: different stakeholder's perspectives, a co-operative Inquiry qualitative protocol paper

BACKGROUND

South Africa is reporting higher rates of adolescent pregnancy as compared to other countries. There are different types of interventions that are in place to address teenage pregnancy. However, these interventions were developed using top-down strategy without the inclusion of different stakeholders and adolescents which makes it hard to implement those interventions particularly in countries like South Africa. Hence, this study aimed to develop strategies to enhance sexual health education for prevention of teenage pregnancy in Vhembe District, Limpopo Province of South Africa.

METHODS

The research design of this study will be Co-operative Inquiry.The study will take place in Vhembe District in Limpopo province of South Africa through collaborating with a Non-governmental Organisation (NGO). The study population will be the teenagers and all the different stakeholders caring for teenagers in their areas of specialization. Purposive sampling will be used to sample the targeted participants of the study. The data collection method will be done in phases and focus group discussions will be used to collect data. Content analysis will be used to analyse data.

DISCUSSION

This study will add to the body of knowledge regarding the strategies that maybe used to enhance sexual health education for prevention of teenage pregnancy.

Impact of individual and environmental factors on academic performance of pregnant adolescent

BACKGROUND

Teenage pregnancies continue to disrupt teenage girls' academic development. As a result, teenage mothers are at risk of unemployment, maternal death, and poverty. Previous research, however, has shown that both individual and environmental factors can have a significant impact on the prevalence of adolescent pregnancy. However, there has been little rigorous research on the impact of these factors on pregnant students' academic performance.

OBJECTIVES

The purpose of this study was to determine the relationship between environmental (neighbourhood) and individuals (sexual attitudes, peer attachment) factors. It also examined the influence of individual factors on the academic performance of pregnant teens.

METHODS

The study included a cross-sectional study of 400 pregnant adolescent students aged 15-19 years. The target groups were drawn from three major cities in Nigeria. Respondents were identified through targeted snowballing. Pregnant participants were a combination of married and unmarried girls attending school from home. Data were collected using a structured and self-completed questionnaire. Thus, frequency, mean and standard deviation were used for descriptive analysis. Pearson correlation analysis was applied to show the relationship between variables.

RESULTS

The study found that neighbourhood (r=-.125, p = .12) had a negative and significant relationship with peer attachment. However, there was no significant evidence of a relationship between sexual attitudes and neighbourhood (r=-.040, p = .422). There was, however, a significant relationship between sexual attitudes and academic performance (r = .236, p = .000). There was also a relationship between peer attachment and academic performance (r=-.401, p = < 0.001).

CONCLUSION

This study suggests that the academic performance of pregnant teenagers necessitates a combination of approaches, which includes changes in personal and prosocial behaviour, and environmental reforms. This can be achieved through, peer education, school day-care, subsidised or free contraceptives, free or subsidized education, and community programmes that positively influence young adults in the neighbourhood. These approaches can indirectly boost self-efficacy, motivation, and confidence to achieve higher academic feat, while reducing school dropout rate among the target groups.

Socio-cultural factors influencing adolescent pregnancy in Ghana: a scoping review

Background

Adolescent pregnancy is a public health challenge that has well-defined causes, associated health risks, and social and economic consequences for adolescent, their families, communities, and society. The purpose of this scoping review is to summarize studies published on socio-cultural determinants of adolescent pregnancy in Ghana.

Methods

Search for records was done in four major databases, including PubMed CENTRAL, Science Direct and JSTOR. Records from Google and Google Scholar were also added, and results and findings from published and unpublished studies were included. All the 22 studies that met the eligibility criteria, were critically appraised. The guidelines for conducting scoping reviews by Arksey and O’Malley were followed.

Results

The result revealed that poverty, peer influence, low level of education, dysfunctional family, lack of communication between parents and their daughters, lack of sexual and reproductive health education, child marriage, coerced sex, misconception and non-usage of contraceptives, and decline in cultural values such as puberty rites and virginity inspection are some of the determinants of adolescent pregnancy in Ghana. The study also showed that there is a lack of high-quality observational studies that adjust for confounding variables.

Conclusion

Interventions and policies should be designed to take into consideration the needs, context, and background of adolescents. Programmes to enhance adolescent reproductive health need to consider multilevel factors such as person, family, community, institutions, national, and global issues that affect such programmes.

Knowledge and attitudes of adolescent girls and their mothers about early pregnancy: a cross-sectional study

Background

Adolescent pregnancy is an important public health problem and a socio-economic challenge in diverse societies. As a tremendously important problem, this issue has caused major concerns, as it exposes adolescent girls to social isolation and physical and psychological harm. So, this study aimed to determine the knowledge and attitude of adolescent girls and their mothers about early pregnancy, its causes, consequences, and predictors in Tabriz-Iran in 2020–21.

Methods

This cross-sectional study was done with 540 people (270 adolescent girls and 270 mothers) in the health centers of Tabriz. Data were collected using the questionnaires of sociodemographic information, knowledge, and adolescent girls’ attitudes and their mothers about early pregnancy, its causes, and consequences. Multivariate logistic regression was used to determine the predictors of adolescent girls and their mothers’ attitudes toward early pregnancy.

Results

The mean (SD: Standard Deviation) of knowledge of adolescent girls and their mothers about early pregnancy was 5.17 (3.11) and 5.57 (3.01), respectively (score range: 0 to 9). Most girls (94.1%) and mothers (87.1%) opposed pregnancy before 18. There was a statistically significant relationship between the knowledge and attitudes of girls (p < 0.001) and mothers (p < 0.001) about pregnancy at a young age. Adolescent girls and their mothers mentioned the lack of sufficient knowledge about sexual relations (57.4% of girls and 66.3% mothers agree) and the lack of knowledge about contraceptive methods (51.9% girl and 59.2% mother agree) important reasons for early pregnancy. Based on the multivariate logistic regression model and controlling for potentially confounding variables, girls whose parents were married under the age of 18 were about three times more likely to agree to early pregnancy than girls whose parents married over the age of 18 (OR = 3.10; 95% Cl: 0.90 to 10.69; p = 0.037). Also, mothers whose other children were married before 18 were almost five times more likely to agree to early pregnancy than women whose other children were not married before 18 (OR = 4.91; 95% Cl: 1.60 to 15.10; p = 0.045).

Conclusions

The current study results indicate that despite the negative attitude of adolescent girls and their mothers towards early pregnancy, they had a low level of knowledge about early pregnancy. Consequently, increasing the level of knowledge of girls and their families about the consequences of marriage and pregnancy at an early age and creating a culture to correct cultural and social misconceptions to prevent marriage and pregnancy of children can reduce the severity of this damage.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12884-022-04551-z.

Identify Key Determinants of Contraceptive Use for Sexually Active Young People: A Hybrid Ensemble of Machine Learning Methods

Sexually active young people face an increasing public health burden of unintended pregnancies and sexually transmitted diseases due to improper contraception. However, environmental and social factors related to young people's contraception remain unclear. To identify the key factors, we applied ensemble machine learning methods to the data of 12,280 heterosexual Chinese college students who reported sexual intercourse experience in the National College Student Survey on Sexual and Reproductive Health in 2020 (NCSS-SRH 2020). In the order of variable importance, convenient access to contraceptives, certain attitudes towards sex, sexual health knowledge level, being an only-child, and purchasing a bachelor's or master's degree were positively associated with a high frequency of contraceptive use. In contrast, smoking, free access to contraceptives, a specific attitude towards marriage, and negotiation with a sexual partner were negatively associated with a higher frequency of contraceptive use. Our analysis provides insights into young people's contraceptive use under a typically conservative culture of sexuality. Compared to previous studies, we thoroughly investigated internal and external factors that might impact young people's decision on contraception while having sex. Under a conservative culture of sexuality, the effects of the external factors on young people's contraception may outweigh those of the internal factors.

Prevalence and correlates of contraceptive use among vocational schools adolescents in Northern Thailand

Purpose

This study aimed to determine the prevalence of and factors associated with contraceptive use among school-going adolescents.

Design/methodology/approach

A cross-sectional study was conducted among vocational school students in Phitsanulok, Northern Thailand. The study employed a multistage random sampling technique to select 391 students from three schools that were purposively selected.

Findings

The prevalence of contraceptive use during the most recent sexual intercourse was 75.8%. The condom was the most commonly used contraceptive method, followed by emergency pills and the rhythm/calendar method. Being male, in the second academic year, sexual communication with parents, sex with a casual partner or sex worker and contraceptive use at sexual initiation were significant risk factors for contraceptive use (p < 0.05). The preventive factors were subdistrict municipality area residency, extended family, medium or high income and partners who drank (p < 0.05).

Originality/value

The authors found a high prevalence of contraceptive use among school-going adolescents. Maintaining and improving this trend would require a concerted effort from all stakeholders to promote early sexuality communication and ensure access and use of contraceptive services.

Linking Female Adolescents' Knowledge, Attitudes and Use of Contraceptives to Adolescent Pregnancy in Ghana: A Baseline Data for Developing Sexuality Education Programmes

(1) Background: Nearly one out of ten Ghanaian female adolescents aged 15–19 has experienced childbearing in urban settlements compared to twice this number in the rural populations due to unintended pregnancies. This study assessed the linkages between knowledge, attitudes, and use of contraceptives and adolescent pregnancy in one of the highly affected Municipalities (i.e., Komenda-Edina-Eguafo Abrem [KEEA]) in Ghana. (2) Methods: Employing a facility-based sampling method, 378 female adolescents aged 15–19 were selected. Unadjusted odds ratio (uOR) and adjusted odds ratio (aOR) at 95% confidence intervals (CI) and p-values were used for significant variables at p < 0.05. (3) Results: Pregnant adolescents were 2 times more likely to indicate that the procedure of procuring contraceptives is quite uncomfortable (aOR = 2.42, 95% CI = [1.29–4.55]; p = 0.006). Also, pregnant adolescents were 5 times more likely to have ever used traditional contraceptive methods than their non-pregnant counterparts (aOR = 5.02, 95% CI = [2.60–9.71]; p < 0.001). On the contrary, pregnant adolescents had lower odds of indicating that contraceptives are for only married people (aOR = 0.38, 95% CI = [0.20–0.70]; p = 0.002) and that it feels bad to receive contraceptive information from parents and relatives than non-pregnant adolescents (aOR = 0.42, 95% CI = [0.24–0.74]; p = 0.003). Pregnant adolescents were less likely to use modern contraceptives than their non-pregnant adolescents (aOR = 0.18, 95% CI = [0.11–0.31]; p < 0.001). (4) Conclusions: The findings indicate that female adolescents’ use of traditional contraceptives is associated with the risk of pregnancy in KEEA Municipality within the Central Region of Ghana. However, adolescents who had the perception that contraceptives are for married people and those who used modern contraceptives were less likely to get pregnant. Government and non-governmental organizations in Ghana should implement educational policies and programmes aimed at educating sexually-active female adolescents on modern contraceptives and the need to use them to prevent pregnancies. The basis for such policies and programmes should be based on evidence that compared to traditional contraceptives, modern contraceptives are more effective. In addition, there is the need to provide accurate information regarding the use of contraceptives to adolescents that will help change their attitudes towards the use of contraceptives.

Predictors of young people's use of sexual and reproductive health services in Nigeria: a mixed-method approach

Background

Sexual and Reproductive health Services (SRHS) are essential for the prevention and control of SRH problems among young people and the achievement of sustainable development goal 3. These services may be available but certain factors interfere with their access and utilization by the young people. This study sought to determine factors that predict the utilization of SRHS among young people in Enugu State, Nigeria.

Methods

The study adopted mixed-method research employing a cross-sectional research design. The population of the study comprised young people between the ages of 12 and 22 years. A multi-stage sampling procedure was used to select 1447 young people used for the study. A questionnaire, in-depth interview, and focus group discussion were used for data collection. Percentages, Chi-square, and logistic regression were used to analyse quantitative data, while qualitative data were thematically analysed using NVivo software.

Results

Socio-demographic factors of gender, age, education, income, and living status (p = < .05) were significant predictors of utilization of SRHS. Psycho-cultural and health system factors (p = < .05) were also significant predictors of utilization of SRHS.

Conclusion

The study concluded that some socio-demographic factors (of gender, age, level of education, income, and living status), psycho-cultural, and health system factors can be used to predict young people’s utilization of SRHS. These predictors could be addressed through home sex education, regular training of health care providers on youth-friendly services delivery, and policy reforms.

Adolescents' Responses to an Unintended Pregnancy in Ghana: A Qualitative Study

STUDY OBJECTIVE

To investigate the experiences and perceptions of adolescents who have experienced a recent pregnancy and undergone a termination of pregnancy.

DESIGN

A vignette-based focus group approach was used to have adolescents reflect on scenarios that happen to others during an unwanted pregnancy.

SETTING

The study was conducted in public health facilities in the 3 major urban areas of Ghana-Accra, Kumasi, and Tamale.

PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES

Adolescents, aged 10-19 years, who had a recent termination of pregnancy were recruited from public health facilities in the 3 sites. Fifteen focus groups were conducted and digitally recorded in English, Twi, Ga, and Dagbani. Transcripts were transcribed and translated, and thematic analysis was used for the analysis.

RESULTS

Adolescents reported that the characters in the vignettes would feel sadness, depression, and regret from an unintended pregnancy and some male partners would "deny" the pregnancy or suggest an abortion. They suggested some parents would "be angry" and "sack" their children for becoming pregnant while others would "support" them. Parents might send the pregnant girl to a distant friend or grandparents until she delivers to avoid shame and gossip. Health professionals might encourage the pregnant girl or insult/gossip about the girl.

CONCLUSION

Adolescent unintended pregnancies in Ghana are met with a range of reactions and these reactions influence the pregnancy choices young women make for continuation or termination of pregnancy.