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Influential Elements Impacting Adolescent Pregnancy in Teen Mothers Seeking Antenatal Care at Fort Portal Regional Referral Hospital, Kabarole District

Apili Everlyne

Faculty of Clinical Medicine and Dentistry Kampala International University Western Campus Uganda.

ABSTRACT

In sub-Saharan Africa, approximately 14 million pregnancies arise annually, with almost half occurring among women aged 15–19. Uganda saw 25% of young women in that age bracket beginning childbearing in 2015. The primary aim of the study was to identify factors influencing teenage pregnancy among adolescent mothers receiving antenatal care at Fort Portal Regional Referral Hospital in Kabarole district. Using a cross-sectional descriptive design, 288 teenage girls were randomly selected for participation. The majority (51.4%) fell within the 17-19 age range, 72.9% were unmarried, 54.5% had attained a Secondary education level, and most (60.4%) lived in rural areas. The teenage pregnancy rate stood at 25.7%. Individual factors significantly linked to teenage pregnancy included inadequate contraceptive use and alcohol misuse. Household-related factors associated with teenage pregnancy encompassed orphanhood, low-income status (poverty), absence of parental guidance, and teenage girls not residing with their parents. Community factors significantly tied to teenage pregnancy among those attending antenatal care at Fort Portal regional referral hospital included peer influence, exposure to pornographic content, limited access to reproductive health services, and cultural norms. These cultural practices involved early and arranged marriages, along with coerced sex with witch doctors disguised as healers.

The researcher suggested that Uganda’s government establish additional centers, particularly in rural areas, to address limited access to reproductive health services. Additionally, regulating alcohol and drug use among teenagers by restricting access to these substances was recommended.

Keywords: Teenage Pregnancies, Antenatal care, teenage mothers, teenage girls, Parents.

INTRODUCTION

Globally, and largely in low and middle-income countries, an estimated 16 million young women aged 15 to 19, and about a million girls under 15 years of age give birth every year [1]. Each year, about 14 million pregnancies occur across sub-Saharan Africa, with nearly half of them occurring among women aged 15–19 years [2]. In Uganda, 25 percent of young women age 15–19 had begun childbearing in 2015 [3]. Adolescent childbearing (intended or not) has adverse effects at the individual, community, and societal level. Compared with their peers who delay childbearing, young women who have babies are less likely to finish high school, more likely to be poor as adults, and more liable to have kids who have poorer behavioral, educational, and health outcomes over the course of their lives than do children born to adult parents [4]. Babies born to teenage mothers also face a substantially higher risk of dying than those born to women aged 20 to 24 [5]. Also, adolescent pregnancies are more likely to be aborted [2]. In Africa, where pre-marital sex is not accepted, especially for young women, unintended pregnancies mostly happen outside marriage. This often implies secret, unsafe abortions under unhygienic conditions performed by people who lack the necessary skills and in places that do not meet minimal medical standards [6]. Teenage pregnancies could be avoided by using condoms or other. Most sexually active young people in Uganda, however, do not use contraceptives: among those who are sexually active, 31% of those aged 12–18 years were not using any contraceptive method at their last sexual encounter [7]. If the majority of the pregnancies among teenagers are unwanted, this raises the question about why young people are not protecting themselves. Findings from studies conducted in sub-Saharan Africa indicate that young women’s use of contraceptive methods is limited by several factors including violent and coercive sexual relationships, lack of knowledge, limited access to contraceptive methods, lack of control over contraception decisions, and concerns over the perceived side effects of family planning methods [8]. In Uganda, knowledge of the existence of contraceptives and where to obtain them seems to be high among the youth population [3]. However, this knowledge seems superficial as evidence shows that 21% of young women and 46% of young men who knew the pill did not know that it has to be taken daily for it to be effective [3]. Beyond this knowledge gap, studies show that contraceptive usage in Uganda is also influenced by young women feeling too inhibited and ashamed to seek contraception services or because contraceptives are not easily available [9]. However, the situation in Uganda is not well researched [10]. The specific factors and beliefs that lead to contraceptive non-use remain obscure and up to date, evidence-based data on personal such as knowledge, attitudes, and skills) and environmental such as social and structural influences such as social support, reinforcements and access to contraceptives) determinants of teenage pregnancy are lacking. This is more so in rural areas like Kabarole district as most researchers tend to concentrate in urban areas. Thus, makes thus study important in exploring the factors contributing to teenage pregnancies. The study was carried out among teenage mothers attending antennal care at Fort Portal regional referral hospital in Kabarole district.

Despite the fact that teenage pregnancy in Uganda has been on a steady decline from 43% in1995 to 31% in 2002 and to 24.6% in 2006, the most recent [3] showed that the prevalence has increased to 25% [3]. This rate is unacceptably high. According to the [3], teenage child bearing is one of the main factors that explains the high fertility rates in Uganda and unless this is checked, the high maternal and child mortality rate and the negative impacts of teenage child bearing like school drop outs still threatens to undermine the remarkable improvement made by government and other stake holders to improve the household standards of living for the vast majority of people in Uganda [3]. It also threatens to undermine the socio-economic development since the vast majority of young mothers miss out on opportunities to advance academically and therefore undermine their future competencies in contributing to development. This is because many of them drop out of school and hence fail to develop skills competencies for gainful engagement in economic activities. Interventions to curb the situation include the introduction of Universal Primary Education (UPE) in 1997, Universal Secondary Education (USE) in 2007 and the affirmative action at public universities, vocational and technical institutes to help prolong their stay in school. In addition, there was a directive by the President and Ministry of Education and Sports in 2002 that sex education should be taught in primary schools and during school assemblies and the launch of the Abstinence Till Marriage drive by the first lady respectively. In relation, the government put in place the program for Enhancing Adolescent Reproductive Life (PEARL) and the provision of free condoms through the Ministry of Health. Other partners include the religious institutions especially the church, Straight Talk Foundation through its publications of “Young Talk” and “Straight Talk”, Radio talk Shows, “Straight Talk Clubs in schools and communities, sensitization seminars and workshops, campaigns and movements among others, but the rates of teenage pregnancy show a slight decline [11]. All these interventions have yielded little progress which requires that a study be carried out to establish the actual causes of teenage pregnancy so as to come up with appropriate interventions. It is thus paramount to carry out a study to establish the influencing teenage pregnancies. If this crisis is not checked, the future of the young generation is doomed. Fighting teenage pregnancy thus could be one way of saving a young and productive generation. However, this study will determine factors influencing teenage pregnancy among teenage mothers attending antenatal care at Fort Portal Regional Referral Hospital in Kabarole district.

Recommendations

The incidence of teenage pregnancy was as high as (25.7%), poor use of contraceptives and alcohol abuse, poverty, lack of parental guidance, limited access to Reproductive health services and early marriages contributed to this high incidence. There is need to improve specific knowledge about reproductive health on a wide range and address related concerns of teenage pregnancies. The government of Uganda needs to establish more Centers especially in rural areas so as to curb the problem of limited access to Reproductive health services. The Government of Uganda needs to regulate alcohol and drug abuse among teenagers by limiting access to alcohol and drugs.                                                 

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CITE AS: Apili Everlyne (2023). Influential Elements Impacting Adolescent Pregnancy in Teen Mothers Seeking Antenatal Care at Fort Portal Regional Referral Hospital, Kabarole District. INOSR APPLIED SCIENCES 11(1):13-24. https://doi.org/10.59298/INOSRAS/2023/2.6.4000 

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