Furthermore, increased accessibility to social media and pornographic sharing [ 8 ], cross cultural influences, and decreased supervision by adults, have led to early initiation of sexual activity by teenagers [ 13 ]. Within the same country there are differences in the proportion with Lira District having the highest rate in Northern Uganda [ 17 ].
Socio-cultural and religious norms promote abstinence until marriage. However, as in many other societies, a double standard concerning sexuality is prevalent whereby girls are expected to be modest, tender, submissive and passive, while boys are encouraged to engage in behaviours that assert their masculinity, autonomy, and ambition [ 18 ]. In addition to ensuring protection of the rights of adolescents to health, provision of legal and social protection against all forms of abuse and harmful traditional practices, promotion of gender equality and provision of quality care for adolescent sexual and reproductive health issues [ 19 ].
In spite of the implementation of available policies and other related laws, teenage pregnancies remain quite high in Uganda, especially in Lira District. The findings from this study will provide information that can be used by government institutions, health administrators and other relevant stakeholders to strengthen the implementation of the existing laws around national health policy, school health policy, national adolescent health policy and penal code act among others.
Furthermore, it will provide policy makers with context-specific information for formulating policies that promote education, use of contraceptive methods and support sexual and reproductive rights of teenage girls. This is a quantitative study using primary data from a case-control study of teenage girls conducted in Erute North County and Lira Municipal Council, Uganda. Uganda is a low income country whose economy is predominantly agricultural, with majority of the population dependent on subsistence farming.
It has a total population of Lira District is divided into three counties including one urban area, 13 Sub-counties, 89 parishes and villages. The study was, however, conducted in two counties, four sub-counties, eight parishes and 32 villages.
The total population of the District is , people with approximately This was a case-control study design using quantitative data analysis.
The sample size of participants was determined with cases n to controls 2n ratio [ 21 ], using standard normal value of 1. Simple random sampling without replacement using lottery method was used to identify 32 villages in two counties.
A list of teenage girls sampling frame of teenage girls which was generated from the National Population and Housing Census of Uganda, was obtained from planning unit in the District and samples proportionately distributed among selected villages. Simple random sampling was further used to identify participants in the household with more than two eligible teenage girls. The development of the questionnaire was informed by in-depth literature review and adaptation of related questions from the previous studies related to teenage pregnancy, questionnaire in Additional file 2.
The questionnaire was designed in English language and later translated into Luo language the first language of respondents and then translated back into English with the help of Lira District health educator and other experienced health workers in the district. The variables measured comprised of: demographic characteristics, behavioural, familial, and social factors as shown in Table 1. The variables used in the study were measured as follows detailed explanation in Additional file 1.
All of them were recruited by six research assistants. Each day, they proceeded to the homes of Village Health Teams VHTs who guided them to the households where the study participants live. Cases were first identified by probing their pregnancy status followed by the controls, and for every case, two controls were identified either within the same households or neighbouring households.
Sexual activity among controls was determined by asking: frequency of sex per week, number of concurrent sexual partners, and use of contraceptive methods during sex. The confidentially of information was guaranteed by using codes instead of names. Furthermore, interview of respondents were conducted in places with no interferences from other people. Similarly, informed consent was sought from cases, however, controls were administered assent forms due to the fact that they were minors.
Sexual activity among controls was determined by asking the frequency of sex per week, number of concurrent sexual partners, and use of contraceptive methods during sex. The study excluded those who were too ill or did not consent to participate in the study. Data collection was conducted for a total of 10 days in the month of July A total of participants cases and controls were recruited in the study but after thorough data checking, 15 questionnaires 5 for cases and 10 for controls were excluded due to incomplete information.
Final analyses were performed on participants cases and controls. Descriptive characteristics of participants were presented as frequencies and percentages. For bivariate analyses, cross tabulations were applied to study association between the predictor variables and the dependent variable.
Associations were tested using Pearson Chi-Square x 2 tests. Multicollinearity check was performed using the variance inflation factor error cut-off of below seven.
Hierarchical logistic regression analysis was conducted to predict teenage pregnancy using behavioural, familial and social factors as potential predictor variables. These variables were entered into the model block-wise [ 22 ], with the blocks designated based on the theory. Several models were presented with Model 1 including only demographic variables; Model 2 demographic and behavioural factors; Model 3 demographic, behavioural and familial variables; and Model 4 demographic, behavioural, familial and social variables.
Effect modification was performed on some of the independent factors in order to assess the interaction effects on the outcome.
The parental consent of pregnant adolescent girls was waived by the IRB due to the fact that they are emancipated minors and able to make their own decisions. All the girls who had experienced sexual abuse and needed help were referred to nearby health facilities for counselling and treatment, and those neglected by their parents were referred to police children and protection unit.
Phone contacts for principal investigators were given to them in case they needed help related to their situations under study. Data on teenage girls were analysed as presented in Table 2. Further characteristics showed that most of the parents were alive There was relatively high proportion Higher prevalence were also observed among participants who had peer pressure The prevalence of teenage pregnancy among older teenagers was higher than their younger peers, teenage girls living in rural areas had higher proportion of teenage pregnancy than those in urban areas, and the likelihood of teenage pregnancy was higher among non-school goers than those attending school.
The variables age at first sex, multiple sexual partners, frequency of sex and contraceptive use were all significantly associated with teenage pregnancy. Higher prevalence of teenage pregnancy was observed among younger teenagers who had experienced first sexual encounter in life, girls having multiple sexual partners, having sex more than twice a week, and those who rarely use contraceptive methods. The frequency of alcohol consumption was not significantly associated with teenage pregnancy, however, higher prevalence was observed among those who drink alcohol more than twice a week than those who drink alcohol less than twice a week.
All familial factors were significantly associated with teenage pregnancy. Higher prevalence was also reported among girls who experienced domestic violence and physical neglect.
Higher prevalence of teenage pregnancy was reported among girls who had intense peer pressure, had experienced sexual abuse and had no control over sex with partners than peers with no similar experiences. Similarly, the prevalence of teenage pregnancy was observed to be higher among girls who had no awareness on adolescent sexual and reproductive health than their counterparts who had such awareness.
The likelihood of teenage pregnancy was higher among girls who reported that their culture allows sex before age 18 as compared to those who reported the contrary. However, after effect modification by marital status, age of respondents and place of residence became significantly associated with teenage pregnancy.
Adjustment of behavioural factors in model 2 showed a few significant association of independent factors with teenage pregnancy. Age of teenage girls was found to be statistically insignificant with teenage pregnancy but after effect modification, older teenagers 15—19 were less likely to become pregnant as compared to younger ones.
Age at first sex was not significantly associated with teenage pregnancy when other factors were adjusted for in the logistic regression. Similarly, after effect modification by marital status, age at first sex still remained statistically insignificant.
Teenage girls who were not married were less likely to become pregnant as compared to those who were married. On the other hand, effect modification by marital status showed significant association with socio-economic status, domestic violence, parental divorce, and physical neglect. In model 4, independent factors that remained significantly associated with teenage pregnancy include: peer pressure and sexual abuse.
On the other hand, cultural perception on sex and awareness on adolescent sexual and reproductive health were not significantly associated with teenage pregnancy. Effect modification however, showed significant association of awareness with teenage pregnancy after interaction by marital status.
Generally, there was improvement in the models after adjusting with all other factors. A test of the full model against a constant model was statistically significant, indicating that the predictors reliably distinguished between cases and controls. At bivariate analyses, all variables except alcohol consumption were significantly associated with teenage pregnancy. In the paragraphs that follow, a discussion of the key findings is presented with respect to the sub-topics: demographic, behavioural, familial, and social factors.
The results showed that age of the respondents and place of residence of respondents were not significantly associated with teenage pregnancy after adjusting for all independent factors. Throughout the reading, Jonathan Swift gives out crazy ideas about the topic of many children being born into families who in a way can not support them. On the contrary, kids who bully are likely concerned with being popular, very aggressive, bossy, and view violence as a positive thing.
A school in Delaware did a survey in on random sample of students from the ages of The results showed that The problem with early childhood sex education in the community of Danville is that there is none. Unfortunately, there are students as young as being in second and third grade beginning to talk about sex because of their curiosity towards the topic.
When I attended their local school, their sexual education program did not begin until students reached the eighth grade. Also, the sexual education program that is taught in the eighth-grade health class does not goes as far as to talk about safe contraceptive use or the consequences that could happen if safe sex is not practiced effectively. Peer pressure negatively affects a lot of teens today because of how social media supports us causing depression and bad decisions.
In the movie Mean Girls, directed by Mark Waters, shows an example of how peer pressure affects teens in high school. The movie Mean Girls is about the stereotypical high school with cliques. According to Rewire. This shows that teens are going to be having sex to matter what, and it's not fair to consider them a sex offender for wanting to be intimate with the person they love.
The sole purpose for birth control is it is the practice of prevention from an unsought pregnancy. Unwelcome pregnancies are arising on a day to day basis, and as a result, children are being born into families where they can either not afford to care for a child, or the child is mistreated because the parent never sought to have them in the first place. Generally, the age where birth control is sought out is in teenagers.
Adolescent pregnancies are a global problem but occur most often in poorer and marginalised communities. Many girls face considerable pressure to marry early and become mothers while they are still a child. Teenage pregnancy increases when girls are denied the right to make decisions about their sexual and reproductive health and well-being.
Girls must be able to make their own decisions about their bodies and futures and have access to appropriate healthcare services and education. Girls who have received minimal education are 5 times more likely to become a mother than those with higher levels of education. Pregnant girls often drop out of school, limiting opportunities for future employment and perpetuating the cycle of poverty. In many cases, girls perceive pregnancy to be a better option than continuing their education.
In addition, the unique risks faced by girls during emergencies increase the chances of them becoming pregnant. Factors include the desire to compensate for the loss of a child, reduced access to information and contraception and increased sexual violence.
A new smartphone app is helping combat teenage pregnancy in Timor Leste by providing teenagers with sexual and reproductive health information. Learn more. Adolescent pregnancy is a serious medical and public health problem. Modern approach to prevention through education, warning, learning about methods of contraception through schools, the media and of course the Internet is needed.
The aim is to increase the usability of all contraceptive methods, especially hormone, in the form of a pill or patch. Adolescent pregnancy can also have negative social and economic effects on girls, their families and communities.
Unmarried pregnant adolescents may face stigma or rejection by parents and peers and threats of violence. Similarly, girls who become pregnant before age 18 are more likely to experience violence within marriage or a partnership. With regards to education, school-leaving can be a choice when a girl perceives pregnancy to be a better option in her circumstances than continuing education, or can be a direct cause of pregnancy or early marriage. Nationally, this can also have an economic cost, with countries losing out on the annual income that young women would have earned over their lifetimes, if they had not had early pregnancies.
Laws and policies can create an enabling environment for the promotion and protection of health, including sexual health and the prevention of EUP Early and unintended pregnancy , but they also may pose barriers, particularly for young people in terms of accessing education and health services, leading to detrimental consequences for sexual health, including EUP [13].
Such policies also need to address the practical support necessary to allow parenting girls to return to school — for example, through the provision of cash transfers to girls or by providing child care - and consequently require allocated budgets to support their implementation. Finally, data should be collected to monitor the implementation and adherence of these national policies at school level. Moralists who judge actions by their consequences alone could argue that abortion is equivalent to a deliberate failure to conceive a child and, since contraception is widely available, abortion should be too.
Some think that even if the fetus is a person, its rights are very limited and do not weigh significantly against the interests of people who have already been born, such as parents or existing children of the family. The interests of society at large might outweigh any right accorded to the fetus in some circumstances, such as if, for example, overpopulation or famine threatened that society.
In such cases, abortion might be seen as moving from a neutral act to one which should be encouraged. Such an attitude about the termination of pregnancy of an adult woman respects her opinion of this complex problem. The question is what to do when an adolescent pregnancy occurred, what rights an adolescent pregnant girl has. The following important questions are asked in front of pregnant girl:.
Most adults have the capacity to make complex decisions by strategically allocating their mental energy toward finalizing their decision [15]. This is important given the time-limited window for making a decision to terminate a pregnancy. However, much controversy surrounds the cognitive ability of adolescents to make similar decisions. Thus, the counselor or therapist working with an adolescent who announces her pregnancy has even more of a responsibility to assure that the adolescent is capable of making such a difficult decision.
Although there has been a trend to grant adolescents some limited legal rights, for example, in adjudicating juvenile criminal actions, the opposite trend has been witnessed in adolescent abortion cases where minors are required to obtain permission from or notify at least one parent or else be prepared to justify their secrecy by going before a judge in a special bypass procedure.
Despite the testimony of psychologists about adolescent competence to make such decisions, the legal field has supported parental notification as a minimum standard.
It appears that public policy differs from scientific knowledge in this case. These are the figures that worry, and when teenagers engage in sexual relationships, they do not think about the consequences. The consequences for health can be terrible.
Therefore, it is necessary to invest much in the prevention of reproductive health. Prevention should not only be directed at preventing sexually transmitted diseases and preventing pregnancy in adolescence because it should be geared towards adopting attitudes about responsible sexual behavior.
This primarily refers to the delay in the beginning of the sexual life of young people because too early accession into sexual relationships can seriously harm the health. Order for reprints. Toggle navigation. ISSN: Author and article information. DOI :
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