ASSESSMENT OF ADOLESCENT’S KNOWLEDGE ON THE RISK FACTORS, CONSEQUENCES AND PREVENTION OF TEENAGE PREGNANCY IN THE MOLYKO COMMUNITY

Abstract

Background: Adolescent birth rates have been decreasing globally but they remain high in parts of Africa and Asia. Teenage pregnancy is a high-risk condition that requires skilled antenatal care for a good outcomes.

In developing countries, complications of pregnancy and childbirth are the leading cause of death in young women aged between 13 and 19. In Cameroon, about 12 % of all births are to adolescent mothers.

Objective: To assess adolescent’s knowledge on risk factors, consequences, and prevention of teenage pregnancy

Method: This study was a descriptive cross-sectional community-based study conducted from April 2021 to June 2021. A pre-tested structured questionnaire was used to collect data. A sample of 187 participants was recruited for this study. Random sampling was used to select the study participants. Data collected was cleaned, coded, entered, and analyzed using the Epi-Info and Microsoft excel sheet 2010

Results: The study revealed that almost all participants that are 161(86.1%) knew the correct definition of teenage pregnancy. Then 178(95.2%) had adequate knowledge of risk factors of teenage pregnancy and 186(99.5%) had adequate knowledge on consequences of teenage pregnancy. Also, 153(81.8%) were aware of contraceptive methods and condoms, 53(86.8%) was the contraceptive mostly used among sexually active adolescents.

Conclusion: Adolescents of the Molyko community have adequate knowledge of the risk factors, consequences, and prevention of teenage pregnancy.

RECOMMENDATION: Sex education for adolescents should be encouraged in our communities.

CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND

Teenage pregnancy remains an important public health concern both in developing and developed countries. Adolescent or teenage pregnancy refers to pregnancy occurring in a girl 13 to 19 years [1]. It is currently a global phenomenon in world with serious consequences on mothers, babies, and the economy.

According to World Health Organization (WHO)2018, there are about 16 million yearly cases of teenage pregnancy with an estimated 3 million unsafe abortions [2]. In the developing world, one-third to one-half of women become mothers before the age of 20, and pregnancy-related complications have become the leading cause of death among them [3].

Although the number of births to teenagers has decreased from 65 births per 1000 women in 1990 to 47 births per 1000 women in 2015, considering the adolescent population globally increasing estimated pregnancy rate among adolescents will continue to increase in 2030, World Health Organization (WHO), 2017[4].

The pregnancy rate among teenagers in USA was 6.78% of pregnancies per 1000 women aged 15-19 in 2008[5]. Among the countries in Western  Europe, the United Kingdom has the highest teenage conception and abortion rate[6].

The concentration of adolescent girls aged 10 to 17 will also change significantly, with the largest increase occurring in sub-Saharan Africa, where adolescent pregnancy is most common, and the rate of contraceptive use the lowest in the world[7].Chemuru and Srinivas (2015) made clear that teenage pregnancy could pose problems to the health, social and economic status of a nation [8].

This view is further reiterated by the WHO (2016) stating that teenage pregnancy could pose numerous detrimental health problems to teenage mothers such as: higher risk of preeclampsia, puerperal endometritis, and systematic infections than women aged 20 to 24 years, and babies of adolescent mothers face a higher risk of low birth weight, preterm delivery, and severe neonatal conditions. [9].

In Africa, South Africa is home to approximately 9.86 million adolescents and the adolescent pregnancy rate there is 47 births per 1000 females per year [10]. A study conducted in Malawi showed that 57% of teenage girls opt to risk pregnancy rather than asking a partner to use a condom[6].

In Malawi, there is a high prevalence of casual sex among teenagers who shun condoms although they engage in multiple relationships. Scholars in the field argue that, because of the risk associated with the high prevalence of early sexual behavior, low contraceptive use, and many early pregnancies, adolescent in Cameroon are an important target group for sexual and reproductive health programs. Yes, as it stands reproductive health and family planning services in Cameroon mainly target older married women, and adolescents often remain largely overlooked [7].

Like all other low-income countries, the situation in Cameroon is marked by a high prevalence of adolescent pregnancies and poor health outcomes for both the mother and her unborn baby [11]. In Cameroon reproductive health remains a major public health challenge with an elevated maternal mortality rate.

Cameroon’s adolescent fertility rate of 138 per 1000 women aged less than 19 years is the highest in central Africa with a maternal mortality rate estimated at 782 deaths per 100000 live births [12]. This high mortality rate remains a dilemma because it involves the young mother at the moment where they are giving birth.

According to DHS 2011,25.6% of adolescents aged 15 to 19 years have started intercourse and 21% of them have had a child and 4 % are pregnant for their first pregnancy. Still from the same source, fertility of this age group is 127 per 1000 which increases and attained a maximum of 250 per 1000 within the age group 25-29 years, suggesting that teenage pregnancy may be on the increase. The proportion of adolescents who have started fertility grow rapidly with age, 5% for 15 years to 48% for 19 years [13].

In some regions of the country like the North, early marriages are promoted as part of their culture and it is a popular belief that adolescents who are married have more favorable outcomes than their single counterparts [11].

In fact, the complications of adolescent pregnancy and childbirth are a leading cause of death among girls aged 15_19 years worldwide [14]. Factors such as customs and traditions that encourage early pregnancies, poor knowledge of reproductive sexual health, wrong contraceptive use have been attributed to teenage pregnancy [15 16 17].

Deliveries in adolescence are associated with a high risk of hypertensive disorders, cesarean delivery, low birth weight, neonatal asphyxia, prematurity, and stillbirth [ 12, 16, 18]. Adolescent girls constitute 23.2% (5.4 million) of the total Cameroonian population, 44.5% of whom reside in rural areas.

About 84% of the married, and half of the unmarried, sexually active adolescent girls in Cameroon are not on any contraceptive method [17]. Contrasting prevalence of adolescent pregnancy has been reported throughout the national territory ranging from 2.8–26.5% [12,18,19]; with a national prevalence of 14.2% [20].

A lack of pregnancy-related knowledge among adolescent girls can adversely affect their lives as well as those of their unborn children. A study conducted in South Africa showed that lack of information appears to be the most significant factor resulting in adolescent pregnancy [21].

Therefore, adolescent girls should be equipped with knowledge so that they will be able to engage in good reproductive health practices. However, knowledge of SRH and pregnancy among adolescents has remained inadequate, and therefore adolescent pregnancy is considered a high health risk.

These all point to a need to access if most adolescents are knowledgeable enough about teenage pregnancy in our setting. Especially as presently information about the awareness of teenage pregnancy among adolescent in Cameroon remains relatively unknown.

And notably teenage pregnancy constitutes a major public health problem in Cameroon and denies most teenagers mothers of their education. Thereby establishing the importance of this study which aims at assessing adolescent knowledge on the risk factors, consequences, and prevention of teenage pregnancy in the Molyko Community.

1.2 Statement Of The Problem

Teenage pregnancy has long been a worldwide social and educational concern for developed, developing, and underdeveloped countries. Teenage pregnancy and its consequences in social-economic development have been increasing over time in most developing countries irrespective of the measures to reduce it that have been taken by the government and other stakeholders.

The high social and economic costs of teen pregnancy and childbearing can have short- and long-term negative consequences for teen parents, their children, and their community. Many countries continue to experience high incidence of teenage pregnancy despite the intervention strategies that have been put in place [22].

In Cameroon, the health burden of adolescent deliveries is significant with a high proportion of women attending delivery services being teenagers. The prevalence of adolescent deliveries varies greatly in different regions of the country; with studies showing a prevalence of 9.3-9.9% [6,4] in several urban areas and as high as 26.5% recorded in the North of the country and some rural areas where early marriages are engraved in the cultural values.

Adolescent girls are more vulnerable and are growing up in a context marked by limited educational opportunities, weak. social controls, pervasive poverty, widespread conflicts and high Human Immunodeficiency Virus (HIV) prevalence [23].

A quantitative study carried out in Kumbo West Health District, in Cameroon among pregnant teenagers who attended ANC consultation in the District Hospital and the surrounding health centers, reported that knowledge on sexual-reproductive health is low among adolescent girls which are marked by a very high prevalence of teenage pregnancy (60.75%) in the sampled area [24].

Adolescent knowledge on their reproductive health stands as an important point in the reduction of teenage pregnancy prevalence, thus the aim of this study was to assess adolescents s knowledge on the risk factors, consequences and prevention of teenage pregnancy in the Molyko community.

1.3 Objectives of the study

  1.3.1 General objective

The aim of this study is to assess adolescent’s knowledge on the risk factors, consequences and prevention of teenage pregnancy in the Molyko community.

1.3.2 specific objectives,

1. To assess the adolescent’s understanding of the risk factors leading to teenage
2. To investigate the adolescent’s knowledge concerning the consequences of teenage pregnancy.
3. To determine adolescent’s knowledge regarding teenage pregnancy prevention strategies.

1.4 Research Questions.

1. What is adolescents’ level of knowledge about predisposing factors that can lead to teenage pregnancy?
2. What are adolescents’ levels of awareness about the consequences or implications associated with teenage pregnancy?
3. What do adolescents know concerning the strategies aimed at the prevention of teenage pregnancy?

1.5 Hypothesis

Null: Adolescents in Molyko have no knowledge of the risk factors and consequences of teenage pregnancy.

Alternate: Adolescents in Molyko have adequate knowledge of the risk factors and consequences of teenage pregnancy.