1
|
Sarwinanti, Widyawati, Warsini S, Hakimi M, Ramdani WF. Identify mental health needs of adolescent pregnant women: a qualitative study. Int J Adolesc Med Health 2024; 36:259-267. [PMID: 38713895 DOI: 10.1515/ijamh-2024-0028] [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: 02/21/2024] [Accepted: 04/15/2024] [Indexed: 05/09/2024]
Abstract
PURPOSE The purpose of this study is to explore adolescent pregnant women related to their pregnancy experience about mental health needs during pregnancy for the prevention of depression during pregnancy. METHODS This research is a qualitative study design with a phenomenological approach. Data collection using interviews (in-depth interviews). This study involved 18 participants consisting of 12 pregnant women aged 15-19 years and 6 midwives who work at the health center. The criteria for informants of pregnant women are pregnant with Trimester I to III, age 15-19 years and not experiencing complications of pregnancy. RESULTS Based on interviews conducted with informants, five themes were obtained about the experiences and needs of pregnant women in adolescence. These themes are (1). Risk of depression, (2). Social and family support needs, (3). Needs of mental health services, (4). Obstacles for midwives in providing mental health services, and (5). needs of mental health information media. CONCLUSIONS Five needs of teenage pregnant women are factors that can support mental health to prevent depression during pregnancy.
Collapse
Affiliation(s)
- Sarwinanti
- Doctoral Program, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Widyawati
- Department of Pediatric and Maternity Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Sri Warsini
- Department of Mental Health Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Mohammad Hakimi
- Department of Medical and Health Sciences/Obstetrics and Gynaecology/Paediatrics and Reproductive, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Wawan Febri Ramdani
- Department of Nursing, Faculty of Health Science, Aisyiyah University Yogyakarta, Yogyakarta, Indonesia
| |
Collapse
|
2
|
Philibert L, Lapierre J, Mulatris P, Kiki GM, Prophète A, Ntanda GM. Healthcare professionals' experience of teenage pregnancy and motherhood in Haiti. Int J Adolesc Med Health 2024; 36:243-250. [PMID: 38575145 DOI: 10.1515/ijamh-2023-0157] [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: 09/28/2023] [Accepted: 03/17/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVES The aim of this study was to explore healthcare professionals' experience of pregnant and motherhood in adolescence in Haiti. METHODS The methodology for collecting and analyzing qualitative data was based on John Dewey's social survey. The study was conducted in nine health institutions in the North and North-East departments of Haiti from October 2020 to January 2021. Data were collected through individual semi-structured interviews with 15 healthcare professionals. All interviews were audio-recorded. The recordings were listened to carefully and transcribed in verbatim form. After checking and validation, the verbatims in Word format were exported to QDA Miner software version 6.0.5 for coding. The data were analyzed using Paillé and Mucchielli thematic analyses. RESULTS Health professionals such as gynecologists, nurses, midwives, nursing assistants, matrons and health workers took part in the study. These study participants indicate that teenage pregnancy and motherhood are social and public health problems whose negative consequences affect teenage girls, children, healthcare professionals, the healthcare system, and Haitian society in general. The services offered to adolescent girls are medical, educational, psychological, economic, and social in nature. When caring for pregnant adolescents during the transition to motherhood, healthcare professionals face many challenges that are linked to the socio-economic status and physiological reality of adolescents, as well as the healthcare system. CONCLUSIONS Programs involving home care visits should also be set up to offer ongoing support to pregnant or parenting teenagers. The distribution of food aid or materials such as clothing, hygiene products and baby kits should also be considered.
Collapse
Affiliation(s)
- Léonel Philibert
- 647717 Université de l'Ontario français , Toronto, ON, Canada
- Faculty of Nursing, 4440 Université Laval , Québec, QC, Canada
| | - Judith Lapierre
- Faculty of Nursing, 4440 Université Laval , Québec, QC, Canada
| | - Paulin Mulatris
- 647717 Université de l'Ontario français , Toronto, ON, Canada
| | | | | | | |
Collapse
|
3
|
Mahlangu ME, Ramalepa TN, Letswalo LO. Experiences of pregnant and parenting students at a university in Gauteng province. Health SA 2024; 29:2547. [PMID: 38726060 PMCID: PMC11079385 DOI: 10.4102/hsag.v29i0.2547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/01/2024] [Indexed: 05/12/2024] Open
Abstract
Background Pregnancy and parenting in tertiary institutions is a worldwide concern. The number of pregnancies among tertiary students is increasing globally. About 16 million young women between the ages of 15 years and 19 years around the world became mothers and two million girls under the age of 15 years are reported to be pregnant every year. South African universities continue to report high rates of student pregnancies, and are looking for solutions to the crisis that female students are facing. Aim The purpose of the study was to explore the experiences of pregnant and parenting students. Setting At a university in Gauteng province, South Africa. Methods A qualitative, exploratory and descriptive design was used in a study that was conducted at a university in Gauteng province, South Africa. Undergraduate pregnant and parenting students were sampled purposively, and the sample size was 15 participants. Semi-structured interviews were used to collect data and data were analysed using thematic analysis. Results The findings of the study produced four themes, namely emotional experience during pregnancy, academic challenges during parenting, experiences during antenatal care, and students' resilience during pregnancy and parenting. Conclusion Pregnant and parenting students require emotional, academic and social support from the university and other stakeholders. The university should offer on-campus medical services such as antenatal care and provide academic support for pregnant and parenting students to help them achieve their academic objectives. Contribution This study highlights the importance of developing support programmes that focus on pregnant and parenting students in universities.
Collapse
Affiliation(s)
- Moroti E Mahlangu
- Department of Nursing Science, School of Healthcare Sciences, Sefako Makgatho Health Sciences University, Tshwane, South Africa
| | - Tshiamo N Ramalepa
- Department of Nursing Science, School of Healthcare Sciences, Sefako Makgatho Health Sciences University, Tshwane, South Africa
| | - Lucky O Letswalo
- Department of Nursing Science, School of Healthcare Sciences, Sefako Makgatho Health Sciences University, Tshwane, South Africa
| |
Collapse
|
4
|
Gensa Geta T, Ahmed Abdiwali S, Farah MM. Magnitude and Factors Associated with Teenage Pregnancy in Somaliland: Evidence from Somaliland Health and Demographic Survey, 2020. Int J Womens Health 2023; 15:1443-1452. [PMID: 37724308 PMCID: PMC10505387 DOI: 10.2147/ijwh.s410489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/30/2023] [Indexed: 09/20/2023] Open
Abstract
Purpose Teenage pregnancy is estimated to be common in Somaliland. It is linked with adverse perinatal outcomes. However, no study has been conducted in the country on this subject. Therefore, this study intended to assess the magnitude and factors associated with teenage pregnancy in Somaliland. Patients and Methods Data from the 2020 Somaliland Health and Demographic Survey (SLHDS); were used in the current analysis. A total sample of 3,786 women in reproductive age groups were involved as participants. The survey used a two-level cluster sampling design, which included initial selection of enumeration areas followed by selection of households. To identify associated factors, binary logistic regression analysis was applied. Results The magnitude of teenage pregnancy was 47.2% (95%CI: 45.5-48.9%). Being a nomadic resident (AOR: 1.26; 95%CI: 1.12-1.71), being in the lowest wealth quintiles (AOR: 1.34; 95%CI: 1.01-1.77), being in the Sanaag region (AOR: 1.95;95%CI: 1.54-2.46) and having lower educational attainment (AOR: 2.29; 95%CI: 1.08-4.83) were significantly associated with teenage pregnancy. Conclusion Teenage pregnancy is highly prevalent in Somaliland and associated with a lower educational level, lower wealth quintiles and nomadic residence. Hence, governmental and non-governmental organizations should work on educating and financially empowering women by giving particular focus to nomadic people.
Collapse
Affiliation(s)
- Teshome Gensa Geta
- Department of Public Health, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
- Department of Public Health, School of Medicine and Health Sciences, Gollis University, Hargeisa, Somaliland
| | - Saad Ahmed Abdiwali
- Department of Public Health, School of Medicine and Health Sciences, Gollis University, Hargeisa, Somaliland
| | - Mustafe Mohamoud Farah
- Department of Nutrition, School of Medicine and Health Sciences, Gollis University, Hargeisa, Somaliland
| |
Collapse
|
5
|
Ajayi AI, Athero S, Muga W, Kabiru CW. Lived experiences of pregnant and parenting adolescents in Africa: A scoping review. Reprod Health 2023; 20:113. [PMID: 37537592 PMCID: PMC10401816 DOI: 10.1186/s12978-023-01654-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/26/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Previous studies have not synthesized existing literature on the lived experiences of pregnant and parenting adolescents (aged 10-19) in Africa. Such evidence synthesis is needed to inform policies, programs, and future research to improve the well-being of the millions of pregnant or parenting adolescents in the region. Our study fills this gap by reviewing the literature on pregnant and parenting adolescents in Africa. We mapped existing research in terms of their substantive focus, and geographical distribution. We synthesized these studies based on thematic focus and identified gaps for future research. METHODS We used a three-step search strategy to find articles, theses, and technical reports reporting primary research published in English between January 2000 and June 2021 in PubMed, Jstor, AJOL, EBSCO Host, and Google Scholar. Three researchers screened all articles, including titles, abstracts, and full text, for eligibility. Relevant data were extracted using a template designed for the study. Overall, 116 studies met the inclusion criteria and were included in the study. Data were analyzed using descriptive and thematic analyses. RESULTS Research on pregnant and parenting adolescents is limited in volume and skewed to a few countries, with two-fifths of papers focusing on South Africa (41.4%). Most of the studies were African-led (81.9%), received no funding (60.3%), adopted qualitative designs (58.6%), and were published between 2016 and 2021 (48.3%). The studies highlighted how pregnancy initiates a cycle of social exclusion of girls with grave implications for their physical and mental health and social and economic well-being. Only 4.3% of the studies described an intervention. None of these studies employed a robust research design (e.g., randomized controlled trial) to assess the intervention's effectiveness. Adolescent mothers' experiences (26.7%) and their education (36.2%) were the most studied topics, while repeat pregnancy received the least research attention. CONCLUSION Research on issues affecting pregnant and parenting adolescents is still limited in scope and skewed geographically despite the large burden of adolescent childbearing in many African countries. While studies have documented how early pregnancy could result in girls' social and educational exclusion, few interventions to support pregnant and parenting adolescents exist. Further research to address these gaps is warranted.
Collapse
Affiliation(s)
- Anthony Idowu Ajayi
- Sexual, Reproductive, Maternal, New-Born, Child, and Adolescent Health (SRMNCAH) Unit, African Population and Health Research Center, Nairobi, Kenya.
| | - Sherine Athero
- Sexual, Reproductive, Maternal, New-Born, Child, and Adolescent Health (SRMNCAH) Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Winstoun Muga
- Sexual, Reproductive, Maternal, New-Born, Child, and Adolescent Health (SRMNCAH) Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Caroline W Kabiru
- Sexual, Reproductive, Maternal, New-Born, Child, and Adolescent Health (SRMNCAH) Unit, African Population and Health Research Center, Nairobi, Kenya
| |
Collapse
|
6
|
Gebrekristos LT, Groves AK, McNaughton Reyes L, Moodley D, Beksinska M, Maman S. Intimate partner violence victimization during pregnancy increases risk of postpartum depression among urban adolescent mothers in South Africa. Reprod Health 2023; 20:68. [PMID: 37131269 PMCID: PMC10155407 DOI: 10.1186/s12978-023-01605-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 03/29/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND It is estimated that 38.8% of mothers develop postpartum depression (PPD) in South Africa. While empirical evidence documents an association between intimate partner violence (IPV) victimization in pregnancy and PPD among adult women, the association has been underexamined among adolescent mothers (< 19 years). The study's purpose is to examine whether IPV victimization during pregnancy is associated with PPD among adolescent mothers. METHODS Adolescent mothers (14-19 years) were recruited at a regional hospital's maternity ward in KwaZulu Natal, South Africa between July 2017-April 2018. Participants completed behavioral assessments at two visits (n = 90): baseline (up to 4 weeks postpartum) and follow-up (6-9 weeks postpartum, when PPD is typically assessed). The WHO modified conflict tactics scale was used to create a binary measure of any physical and/or psychological IPV victimization that occurred during pregnancy. Participants with scores ≥ 13 on the Edinburgh Postpartum Depression Scale (EPDS) were classified as having symptoms of PPD. We used a modified Poisson regression with robust standard errors to assess PPD in association with IPV victimization during pregnancy, controlling for relevant covariates. RESULTS Nearly one-half (47%) of adolescent mothers reported symptoms of PPD by 6-9 weeks post-delivery. Further, IPV victimization during pregnancy was highly prevalent (40%). Adolescent mothers who reported IPV victimization during pregnancy had marginally higher risk of PPD at follow-up (RR: 1.50, 95 CI: 0.97-2.31; p = 0.07). The association was strengthened and significant in covariate-adjusted analysis (RR: 1.62, 95 CI: 1.06-2.49; p = 0.03). CONCLUSIONS Poor mental health was common among adolescent mothers, and IPV victimization during pregnancy was associated with PPD risk among adolescent mothers. Implementing IPV and PPD routine screenings during the perinatal period may aid in identifying adolescent mothers for IPV and PPD interventions and treatment. With the high prevalence of IPV and PPD in this vulnerable population and the potential negative impact on maternal and infant outcomes, interventions to reduce IPV and PPD are needed to improve adolescent mothers' well-being and their baby's health.
Collapse
Affiliation(s)
- Luwam T Gebrekristos
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, 3215 Market Street, Philadelphia, PA, 19140, USA.
| | - Allison K Groves
- Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA
| | - Luz McNaughton Reyes
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Dhayendre Moodley
- Department of Obstetrics and Gynaecology, University of KwaZulu-Natal Nelson R. Mandela School of Medicine, Durban, South Africa
| | - Mags Beksinska
- MatCH Research Unit (MRU), Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Suzanne Maman
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA
| |
Collapse
|
7
|
Msipu Phiri T, Nyamaruze P, Akintola O. Perspectives about social support among unmarried pregnant university students in South Africa. PLoS One 2023; 18:e0284906. [PMID: 37093843 PMCID: PMC10124874 DOI: 10.1371/journal.pone.0284906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 04/11/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND Pregnant young women in an academic environment are susceptible to stressors associated with unintended pregnancy and academic demands of universities. The challenges they face may be exacerbated by lack of social support, putting them at risk of psychological disorders such as depression. Women who receive social support during pregnancy and postpartum experience less emotional distress and report greater maternal satisfaction. However, very little is known about the perspectives about social support among unmarried pregnant students in tertiary institutions. METHODS Participants were purposively selected among unmarried pregnant students and those in the puerperal period at the time of the study. We conducted semi-structured qualitative interviews to explore the perspectives of unmarried pregnant students on the type of support that they need during pregnancy and the puerperium and the period when most support is needed. The data were audio-recorded and transcribed verbatim, then analysed using thematic analysis. RESULTS The findings show that social supports (emotional, instrumental, informational, and financial) were highlighted as important resources to cope with stressors during pregnancy and post-birth. Emotional support from male partners was the most important type of support needed as it entailed a sense of being loved and cared for. Social support was identified as important throughout the different phases of pregnancy and post birth, with different support needs expressed at each of these phases. CONCLUSION This study identified support needs of unmarried pregnant university students in their transition to motherhood. Given the several challenges that they are faced with, unmarried pregnant students need social support, including male partner support to enhance wellbeing as they try to cope with academic and pregnancy-related stressors.
Collapse
Affiliation(s)
- Thandiwe Msipu Phiri
- School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| | - Patrick Nyamaruze
- School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| | - Olagoke Akintola
- School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| |
Collapse
|
8
|
Santos JS, Neill S, Mello DFD. Mães adolescentes, autocuidado e cuidado infantil: validação de conteúdo de um calendário histórico de eventos. Rev Esc Enferm USP 2023. [DOI: 10.1590/1980-220x-reeusp-2022-0314pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
RESUMO Objetivo: Validar o conteúdo da ferramenta Event History Calendar Mãe Adolescente: fortalecendo o autocuidado e o cuidado da criança. Método: Estudo metodológico com a técnica Delphi, realizado em duas rodadas, envolvendo 37 especialistas de enfermagem. Na coleta de dados, de dezembro/2019 a agosto/2020, foi utilizado um questionário semiestruturado composto por 47 itens relacionados às duas dimensões da ferramenta: Autocuidado e Cuidado da criança. O Índice de Validade de Conteúdo ≥ 0,80 foi utilizado para avaliar a concordância entre os especialistas. Elementos qualitativos foram analisados quanto à clareza e abrangência do conteúdo. Resultados: Na primeira rodada, 46 itens apresentaram Índice de Validade de Conteúdo ≥ 0,80. Os elementos qualitativos apontaram necessidade de maior clareza para o público adolescente. Após as alterações, a ferramenta apresentou 30 itens. Na segunda rodada, os 30 itens avaliados alcançaram Índice de Validade de Conteúdo ≥ 0,80. As considerações qualitativas foram traduzidas em modificações no conteúdo e sequência na versão final da ferramenta. Conclusão: A ferramenta validada obteve avaliação adequada dos itens de cada dimensão, relacionados ao autocuidado da mãe adolescente e cuidado da criança, com alto grau de compreensibilidade.
Collapse
|
9
|
Santos JS, Neill S, Mello DFD. Adolescent mothers, self-care and childcare: content validation of an Event History Calendar. Rev Esc Enferm USP 2023; 57:e20220314. [PMID: 37011286 PMCID: PMC10081628 DOI: 10.1590/1980-220x-reeusp-2022-0314en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 01/30/2023] [Indexed: 04/05/2023] Open
Abstract
OBJECTIVE To validate the content of the tool Event History Calendar Adolescent Mother: strengthening self-care and child care. METHOD Methodological study using the Delphi technique, conducted in two rounds, involving 37 nursing specialists. In data collection, from December/2019 to August/2020, a semi-structured questionnaire composed of 47 items related to the two dimensions of the tool: Self-care and Child Care was used. The Content Validity Index ≥ 0.80 was used to assess agreement among the experts. Qualitative elements were analyzed for clarity and comprehensiveness of content. RESULTS In the first round, 46 items showed Content Validity Index ≥ 0.80. The qualitative elements pointed out more clarity for the adolescent audience. After the changes, the tool presented 30 items. In the second round, the 30 items evaluated achieved Content Validity Index ≥ 0.80. The qualitative considerations were translated into modifications in the content and sequence in the final version of the tool. CONCLUSION The validated tool obtained adequate evaluation of the items of each dimension, related to adolescent mother self-care and child care, with a high degree of comprehensibility.
Collapse
Affiliation(s)
- Jaqueline Silva Santos
- Secretaria de Estado de Saúde de Minas Gerais, Superintendência Regional de Saúde de Passos, Passos, MG, Brazil
| | - Sarah Neill
- University of Plymouth, Faculty of Health, School of Nursing and Midwifery, Plymouth, United Kingdom
| | - Débora Falleiros de Mello
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Ribeirão Preto, SP, Brazil
| |
Collapse
|
10
|
The prevalence of unintended pregnancy and its association with HIV status among pregnant women in South Africa, a national antenatal survey, 2019. Sci Rep 2021; 11:23740. [PMID: 34887462 PMCID: PMC8660789 DOI: 10.1038/s41598-021-03096-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 11/29/2021] [Indexed: 12/26/2022] Open
Abstract
To describe the prevalence of unintended pregnancy and its association with HIV status among pregnant women in South Africa. A cross-sectional survey was conducted between October and mid-November 2019 among pregnant women aged 15–49 years in 1589 selected public antenatal care facilities. Pregnancy intention was assessed using two questions from the London Measure of Unplanned Pregnancy. Survey logistic regression examined factors associated with unintended pregnancy. Among 34,946 participants, 51.6% had an unintended pregnancy. On multivariable analysis, the odds of unintended pregnancy was higher among women who knew their HIV-positive status before pregnancy but initiated treatment after the first antenatal visit (adjusted odds ratio [aOR], 1.5 [95% confidence interval (CI):1.2–1.8]), women who initiated treatment before pregnancy (aOR, 1.3 [95% CI:1.2–1.3]), and women with a new HIV diagnosis during pregnancy (aOR, 1.2 [95% CI:1.1–1.3]) compared to HIV-negative women. Women who were single, in a non-cohabiting or a cohabiting relationship, and young women (15–24 years) had significantly higher risk of unintended pregnancy compared to married women and women aged 30–49 years, respectively. A comprehensive approach, including regular assessment of HIV clients’ pregnancy intention, and adolescent and youth-friendly reproductive health services could help prevent unintended pregnancy.
Collapse
|