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Fernandes CM, Conceição GMDS, da Silva ZP, Nampo FK, Chiaravalloti F. Socioeconomic factors increase the risk of teenage pregnancy: spatial and temporal analysis in a Brazilian municipality. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2024; 27:e240040. [PMID: 39082476 PMCID: PMC11290768 DOI: 10.1590/1980-549720240040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 05/12/2024] [Accepted: 05/13/2024] [Indexed: 08/02/2024] Open
Abstract
OBJECTIVE To evaluate the distribution of the proportion of teenage mothers (PTM) in time and space and its relationship with socioeconomic indicators and social vulnerability. METHODS An ecological study was carried out with teenage mothers living in 322 census tracts in Foz do Iguaçu (state of Paraná, Brazil) between 2013 and 2019. Spatial clusters of teenage mothers were identified by spatial scanning and grouped into strata with different prevalence. The association between these strata and the individual social vulnerability of the mothers was evaluated using the Pearson's Chi-square test. Linear regression models were adjusted to evaluate the association between PTM and socioeconomic factors by census tract and temporal trend in PTM in different strata. RESULTS We identified five high prevalence clusters in peripheral regions and six with low prevalence in the central region of the municipality. Proportionally, there were more teenage mothers with a worse vulnerability index in the high prevalence stratum than in the low prevalence stratum. Places with worse socioeconomic conditions present higher PTM, a profile that did not change over time. For the increase of one unit in the Brazilian Deprivation Index and proportion of women responsible for the household, the PTM increased, respectively, by 3.8 (95%CI 3.1-4.4) and 0.086% (95%CI 0.03-0.14). There was a reduction in the global PTM in part of the period, which occurred later in the higher prevalence strata, but the proportions were stable again in the last years of study. CONCLUSION Teenage pregnancy is concentrated in regions with worse socioeconomic conditions and greater maternal vulnerability and its behavior over time occurred differently in these areas.
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Affiliation(s)
- Camila Meireles Fernandes
- Universidade de São Paulo, School of Public Health, Department of Epidemiology – São Paulo (SP), Brazil
| | | | - Zilda Pereira da Silva
- Universidade de São Paulo, School of Public Health, Department of Epidemiology – São Paulo (SP), Brazil
| | - Fernando Kenji Nampo
- Universidade Federal da Integração Latino-Americana, Latin American Institute of Life and Natural Sciences – Foz do Iguaçu (PR), Brazil
| | - Francisco Chiaravalloti
- Universidade de São Paulo, School of Public Health, Department of Epidemiology – São Paulo (SP), Brazil
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Boateng AA, Botchwey COA, Adatorvor BA, Baidoo MA, Boakye DS, Boateng R. A phenomenological study on recurrent teenage pregnancies in effutu municipality- Ghana.the experiences of teenage mothers. BMC Public Health 2023; 23:218. [PMID: 36726092 PMCID: PMC9890793 DOI: 10.1186/s12889-023-15074-3] [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: 05/13/2022] [Accepted: 01/17/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Generally, recurrent teenage pregnancies are public health menaces that impede the quality of life of teenage mothers, their offspring, and society as a whole. However, there is paucity of information regarding factors influencing this social issue especially, in developing countries where Ghana is no exception. Moreover, this menace has been least investigated from the perspective of the teenager with multiple pregnancies. Hence, this study aimed at identifying the factors influencing recurrent teenage pregnancies and the challenges confronted by these teenage mothers. METHOD This study is a phenomenological qualitative study that was conducted in the Effutu Municipality in the Central Region of Ghana. Employing convenience and snowball sampling, 40 participants who were residents of the study area, had a child each, and were pregnant at the time of the study were included. Other participants included teenage mothers who had at least two (2) children. A face-to-face in-depth interview with the help of an interview guide was conducted. Proceedings were recorded, transcribed, and analysed using thematic analysis. Quotations were used in the result presentation. RESULTS The results of the study revealed that factors influencing recurrent teenage pregnancies are multifactorial. It includes peer pressure, parental neglect, poverty, living with a partner, and inadequate knowledge of family planning. The teenager with recurrent pregnancy is confronted with financial difficulties and is faced with stigmatisation in the society where she finds herself. CONCLUSION To this effect, it is important to intensify education on family planning and good parental practices among parents with teenage mothers while providing a similar form of sensitization for members of the society about the harmful effects of stigmatisation on the teenage mother and her children. Again, a social support network for teenagers with recurrent pregnancies could be formed to help curb this public health menace.
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Affiliation(s)
- Agartha Afful Boateng
- Department of Health Administration and Education, Faculty of Science Education, University of Education, Post Office Box 25, Central Region, Winneba, Ghana.
| | - Charles Owusu-Aduomi Botchwey
- grid.442315.50000 0004 0441 5457Department of Health Administration and Education, Faculty of Science Education, University of Education, Post Office Box 25, Central Region Winneba, Ghana
| | | | - Michael Afari Baidoo
- grid.442315.50000 0004 0441 5457Department of Health Administration and Education, Faculty of Science Education, University of Education, Post Office Box 25, Central Region Winneba, Ghana
| | - Dorothy Serwaa Boakye
- grid.442315.50000 0004 0441 5457Department of Health Administration and Education, Faculty of Science Education, University of Education, Post Office Box 25, Central Region Winneba, Ghana
| | - Richard Boateng
- grid.442315.50000 0004 0441 5457Department of Health Administration and Education, Faculty of Science Education, University of Education, Post Office Box 25, Central Region Winneba, Ghana
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Amongin D, Kaharuza F, Hanson C, Nakimuli A, Mutesi S, Benova L, Atuyambe L. "… I would have left that man long time ago but, …" exploring circumstances of and motivators for repeat adolescent birth in Eastern Uganda. ACTA ACUST UNITED AC 2021; 79:142. [PMID: 34362439 PMCID: PMC8344224 DOI: 10.1186/s13690-021-00662-9] [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: 03/18/2021] [Accepted: 07/16/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND First birth before 18 years has declined in Uganda unlike repeat adolescent birth (=second or more births before age 20 years). We explored the circumstances of and motivators for repeat adolescent birth in Eastern Uganda. METHODS Between January and March 2020, we conducted a qualitative study involving 70 individual in-depth interviews with purposively selected respondents - 20-25-year-old women with and without repeat adolescent birth, their partners, and parents, in the communities of Teso sub-region. We conducted latent content analysis. RESULTS Four major themes emerged: poverty, vulnerability, domestic violence, and demotivators. Sub-themes identified under poverty were: "limited provisions", "peasantry", "large families", "dropping out of school", "alcohol abuse", and "broken family structure". Vulnerability included "marital entrapment" and "partner coercion". Demotivators included: "abandonment", "stern warning", "objection to marriage", and "empowerment". Extreme poverty resulted in inadequate provision of basic needs leading to unprotected sexual activity in a bid to secure financial support. Following the first birth, more than three quarters of the women with repeat adolescent birth reported increased economic distress that forced them to remain in unwanted marriage/union, often characterized by partner coercion, despite wanting to delay that repeat birth. Women without repeat adolescent birth avoided a second birth by empowerment through: an economic activity, contraception use, and resumption of schooling. CONCLUSION Repeat adolescent birth in Uganda is premised around attempts to address the economic distress precipitated by first birth. Many women want to delay that repeat birth but the challenges robbed them of their reproductive autonomy. Beyond efforts to prevent first birth, programs need to address economic empowerment, ensure contraceptive access, and school re-integration for adolescent mothers in order to prevent shortly-spaced repeat births.
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Affiliation(s)
- Dinah Amongin
- Department of Health Policy Planning and Management, Makerere University College of Health Sceinces, Kampala, Uganda. .,Department of Obstetrics and Gynaecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
| | - Frank Kaharuza
- Department of Community Health and Behavioral Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Claudia Hanson
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden.,Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
| | - Annettee Nakimuli
- Department of Obstetrics and Gynaecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Susan Mutesi
- Department of Community Health and Behavioral Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Lenka Benova
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.,Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Lynn Atuyambe
- Department of Community Health and Behavioral Sciences, Makerere University School of Public Health, Kampala, Uganda
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Souza FMDLC, Santos WND, Santos RSDC, Silva VLMD, Abrantes RMD, Soares VFR, Silva RARD. Effectiveness of mobile applications in pregnant women's adherence to prenatal consultations: randomized clinical trial. Rev Bras Enferm 2021; 74Suppl 5:e20190599. [PMID: 33729371 DOI: 10.1590/0034-7167-2019-0599] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 10/12/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to evaluate the effectiveness of a mobile application for cell phones in the adherence of pregnant women to prenatal consultations. METHOD a randomized controlled clinical trial, simple-blind with two parallel groups, conducted from January to December 2018. Data collection was carried out through a structured interview at the end of the third trimester of pregnancy. For analysis, Chi-Square and Mann-Whitney tests were used. The sample consisted of 88 pregnant women from 2 Family Health Strategies in Northeast Brazil. Participants were randomized into two groups: intervention (IG), who used the application, and control (CG), who attended prenatal consultations. RESULTS pregnant women who used the application (IG) attended a greater number of consultations when compared to participants in the CG, identifying a statistical difference between the groups (p<0.05). CONCLUSION the application showed to be an effective health technology to improve adherence to prenatal care. Brazilian Registry of Clinical Trials: RBR-74SNST.
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Amongin D, Nakimuli A, Hanson C, Nakafeero M, Kaharuza F, Atuyambe L, Benova L. Time trends in and factors associated with repeat adolescent birth in Uganda: Analysis of six demographic and health surveys. PLoS One 2020; 15:e0231557. [PMID: 32287303 PMCID: PMC7156070 DOI: 10.1371/journal.pone.0231557] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 03/25/2020] [Indexed: 11/20/2022] Open
Abstract
Background Information on repeat adolescent birth remains scarce in sub-Sahara Africa. We investigated the prevalence and time trends in repeat adolescent birth in Uganda, and associated factors. Methods We analyzed Uganda Demographic and Health Survey data of women age 20–24 years collected on 6 surveys (1988/89-2016) to estimate repeat adolescent birth (first live birth <18 years of age followed by another live birth(s) <20 years). Further, we estimated the wantedness of the second order birth and the prevalence of short birth intervals birth (<13 months) between the first and second such birth. On the 2016 survey, we examined factors associated with repeat adolescent birth using bivariate and multivariate modified Poisson regression. Results At the 1988/89 survey, 58.9% of women with first birth <18 years reported a repeat adolescent birth. This percentage increased to 66.8% in 2006 (+7.9 percentage points [pp], p = 0.010) and thereafter declined to 55.6% by 2016 (-11.2 pp, p<0.001), nevertheless, no change occurred between 1988/89 and 2016 (-3.3pp, p = 0.251). Among women with repeat adolescent births, the mean number of live births by exact age 20 years (2.2 births) and prevalence of short birth intervals (3.5% in 1988/89, 5.4% in 2016) (+1.9pp, p = 0.245) did not change. Increasingly more women with repeat adolescent births preferred to have had the second child later, 22.5% in 1995 and 43.1% in 2016 (+20.6pp, p = <0.001). On the 2016 survey, women from poorer households and those of younger age at first birth were significantly more likely to report repeat adolescent birth. Conclusion Following a first birth <18 years, more than half of the women report a repeat adolescent birth (<20 years), with no decline observed in 30 years. Increasingly more women wanted the second adolescent pregnancy later, highlighting the need to support adolescents with improved family planning services at each contact.
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Affiliation(s)
- Dinah Amongin
- Department of Obstetrics and Gynaecology School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
- Department of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda
- * E-mail:
| | - Annettee Nakimuli
- Department of Obstetrics and Gynaecology School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Claudia Hanson
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, England
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Mary Nakafeero
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda
| | - Frank Kaharuza
- Department of Community Health and Behavioral Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Lynn Atuyambe
- Department of Community Health and Behavioral Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Lenka Benova
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, England
- Department of Public Health, Institute of Tropical Medicine, University of Antwerp, Antwerp, Belgium
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