Abstract

According to the United Nations Emergency Fund (UNICEF), teenage pregnancy refers to pregnancy in girls within the ages 13 and 19. That is, it is a situation whereby a girl under the age 20 gets pregnant.teenage pregnancy is also known as adolescent pregnancy and is a global problem that creates issues for all those concerned about young women and their childrens well-being.

Though NGOs and INGOs have constantly intervened to help these teenagers, teenage pregnancy is still an alarming issue in this communities.the objectives of this study are to identiy the causes of teenage pregnancy and to examine the effects of teenage pregnancy among IDPs in Tole and Liongo and to propose strategies that can be used to mitigate the prevalence of teenage pregnancy in this communities.

From key findings, it has it that causes of teenage pregnancy in these communities are cultural norns, peer pressure and social influence, children neglected by their parents. For effects, it retards their education attainment, increase rates of abortions, risk during child birth and rejection.

To mitigate this, sexual education be taught, early marriages be eradicated. To conclude therefore, teenagers in this community who get pregnant face a lot of discrimination and stigma. Also I would recommend the community make teenage mothers not feel lesser of themselves. I will also recommend NGOs and INGOs together with the government to come in and intervene and help empower these teenagers in skills that they can explore and be able to take care of their children.

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

According to the United Nations Children Emergency Fund (UNICEF), teenage pregnancy refers to pregnancy in girls within the ages 13 to 19. That is, it is a situation whereby a girl under the age of 20 gets pregnant. Teenage pregnancy also known as adolescent pregnancy is a global problem that creates issues for all those concerned about young women and their children’s health and well-being. This is because, it carries major health and social issues with unique medical and psychosocial consequences for both adolescent and the society in general.

Adolescent pregnancy is an international dilemma affecting not just the adolescent and her infant but the entire society. Of almost 300 million female adolescents worldwide, 16 million give birth yearly, accounting for 11 percent of all births worldwide. The Millennium Development Goal number 5 incorporates reducing adolescent births worldwide.

Teenage pregnancy rates in Europe vary widely from country to country, but overall, the rate has been declining in recent years. According to data from the European Statistical Office, the average teenage pregnancy rates in the European Union (EU) was 7.8 per 1000 in 2015 then to 6.9 per 1000 girls aged 15 to 19 in 2019. Some countries have much higher rates of teenage pregnancy than others. For example, in Bulgaria, the teenage pregnancy rate was 21.7 per 1000 in 2019, while in Netherlands, the rate was just 2.4 per 1000. Other countries with relative high rates of teenage pregnancy include the United Kingdom (16.8 per 1000 in 2019), Romania (16.6 per 1000), and Latvia (14.8 per 1000), (European Parliamentary Research Service, 2021).

In the United States (US), more than 750,000 teenage pregnancies occur yearly, costing over $9 billion per year. Even though health disparities exist, whites had 11, blacks had 32 and Hispanics had 41 per 1000 births. There is therefore a need to introduce programs to reduce teenage pregnancy which should incorporate family planning, contraception and abstinence education, and sustained commitment of media, businesses, religious and civic organizations. (Wiley Publishing Asia Pty Ltd, 2014)

In addition, in the United Kingdom (UK), a lack of consistent targeted sex education, delay in access to contraception and contraceptive use failure are associated with high teenage pregnancy rate whereas in Dutch and Scandinavian countries, there are national sex education programs and family planning clinics run by nurse midwives with direct authorities to prescribe contraceptives. In Japan, strong conservative norms exist about premarital sex.

Teenage pregnancy is a disturbing issue in Africa, with many countries experiencing high rates of adolescent pregnancy. According to the World Health Organization (WHO), the highest rates of adolescent pregnancy occur in Sub-Sahara Africa, where the adolescent birth rates is 112 per 1000 girls aged 15 to 19. Annually, about 21 million girls aged 15 to 19 years in developing regions become pregnant and approximately 12 million of them give birth. Around half of these pregnancies are unintended, unplanned and more than half end up in abortion, often in unsafe conditions. Globally, ABR has decreased from 64.5 births per 1000 women in 2000 to 42.5 births per 1000 women in 2021 (World Health Organization,2022). Here are some examples of the situation of teenage pregnancy in Africa.

In Nigeria, the teenage pregnancy rate was estimated to be 44% in 2018 with many of these pregnancies occurring outside of marriage and being associated with maternal and infant mortality (Mumah et al 2017). Meanwhile in South Africa, teenage pregnancy rates have declined in recent years but the country still has one of the highest rates of teenage pregnancy in the world, with an estimated 67 per 1000 girls aged 15 to 19 becoming pregnant in 2017 (National Department of Health, 2019).

Teenage pregnancy rate in Ethiopia was estimated to be around 16% with many girls dropping out of school as a result of early marriage and pregnancy (Berhane et al,2019). The case was not different in Tanzania, with over 27% pregnancies occurring as a result of sexual violence and exploitation, Kenya 18% and Malawi and Zambia with 29% (UNICEF,2019).

Although teenage pregnancy has declined in the last decade, it remains a major public health issue in Africa. Maternal mortality is common among teenagers due to their increase risk of obstetric and medical complications. In Africa, there is a lack of robust and comprehensive data on the prevalence and predictors of teenage pregnancy. As a result, this systematic review and meta-analysis were carried out to summarize evidence that will assist concerned entities in identifying existing gaps and proposing strategies to reduce teenage pregnancy in Africa. Furthermore, a study conducted in South Africa found that nearly half of female teens in Africa experienced an unintended pregnancy, with 26.3% of those unintended pregnancies ending in abortions. Similarly, statistics from Nigeria showed that, about 33% of maternal mortality attributes to teenage pregnancy with teenagers facing a higher risk for eclampsia, anemia, hemorrhage, prolonged labor, and cesarean section (UNICEF, 2016).

Sub-Saharan Africa recorded the highest prevalence of teenage pregnancy in the world in 2013 specifically from Niger, Mozambique, Malawi, Uganda and Cameroon. Teenage mothers accounted for more than half of the births in this region. It is estimated that 101 births per 1000 women stems from girls aged 15 to 19. This almost doubles the global average. The continent accounts for over half of the world’s burden of material, newborn and child deaths.

Teenage pregnancy is a major public health concern in Cameroon, with an estimated 28% of girls aged 15 to 19 having given birth or pregnant with their first child (National Institute of Statistics, 2019). In the Far North Region of Cameroon, the teenage pregnancy rate is estimated to be as high as 38% with many girls becoming pregnant as a result of early marriage and poverty (Ministry of Public Health, 2019). On the other hand this situation is associated with higher rates of maternal and infant mortality with complications during pregnancy and childbirth being a leading cause of death for adolescent girls (United Nations Population Fund, 2017).

Teenage pregnancy constitutes a public health problem in Cameroon.12% and 9.3% of all deliveries at the University Teaching Hospital (CHU) and Central Hospital Yaounde respectively are teenagers. Cameroon has one of the highest adolescent fertility rates in West and Central Africa. Teenage pregnancy is a significant public health issue in Tole and Liongo with many girls becoming pregnant as a result of early marriages. A study carried out in Buea in 2018 found that the prevalence of teenage pregnancy was 26%, with many of these pregnancies occurring as a result of sexual violence and exploitation (Agbor et al, 2018).

Teenage pregnancy should be one of the main issues in every health care system since early pregnancy can have harmful long-lasting implications on girl’s physical psychological, economic and social status. The global maternal mortality ratio in 2017 is estimated at 211 deaths per 100,000 live births, showing a reduction of 38% since 2000

Teenage pregnancy can bring about major health and social problems with unique medical and psychological consequences for the adolescent and society at large. For instance, it prevents teenagers from achieving their full potentials and enjoy their basic human rights. The effects of teenage pregnancy also adversely affect future earning potentials and leads to lifelong poverty. Such negative impacts continue throughout a teenager’s entire life and carry over to the next generation.

Above all, it contributes to rapid population growth, especially in countries where contraceptive use is not well embrace and increases individual lifetime fertility. The contributing factors to teenage pregnancy are multiple and complex, categorized as socio-demographic, familial, cultural and reproductive behavior. Different literature reported that factors associated with teenage pregnancy include living in rural areas, not attending school, early marriage, lack of communication between parents and adolescents about sexual and reproductive health issues, educational level of teenagers, and family history of teenage pregnancy.

Ethiopia is one of the African countries where the highest teenage pregnancies have been recorded. According to Ethiopian Demographic and Health Survey (EDHS) in 2016, the prevalence of teenage pregnancy was 16%. Teenage pregnancy was also highly common among those without any education or of low economic status. Also, there is slower progress in reducing adolescent first births among these and other vulnerable groups, leading to increasing inequity.

Child marriage and child sexual abuse place girls at a higher risk of getting pregnant, often unintended. There is growing attention being paid to improving access to quality maternal care for pregnant and parenting adolescents. World Health Organization (WHO) works with partners to advocate for partners to advocate for attention to adolescent pregnancy, to build an evidence base for action, to develop policy and program support tools, to build capacity and to support countries to address teenage pregnancy properly.

Every year an estimated 21 million girls aged 15-19 years in developing regions become pregnant and approximately 12 million of them give birth. Adolescent mothers aged 10-19 years face higher risks of eclampsia, puerperal and systematic infections than women aged 20-24 years, and babies of adolescent mothers face higher risk of low birth weight, preterm birth and severe neonatal conditions.

1.2 Statement of the problem

About 16 million girls aged 15 to 19 years old give birth each year. Ever since the crisis in Cameroon broke out in 2016, teenagers have fled from their places of origin considered insecure to more stable towns like Limbe, Mutengene, Tiko and Buea, with Buea registering a high number of IDPs. This has caused a lot of pressure on the IDPs in terms of lack of access to health care, lack of access to sexual education and contraception use poverty, low education attainment, early sexual initiation, cultural and social norms that condone early marriage and childbearing, lack of sensitization among many others. Additionally, in the case of internally displaced persons, factors like displacement related stress, limited access to health care and social services, and disruption of social support networks have exacerbated the risk of teenage pregnancies.

Teenage pregnancy is a significant public health issue in the Buea municipality specifically Liongo and Tole. Some of these pregnant teenagers are forced to live with the fathers of their children against their will which causes them to suffer from gender-based violence in the hands of the men, while some of these girls do not even know whose child     they are carrying. Statistics from the Social Welfare Center in Buea, South West Region of Cameroon indicates that over 5% of girls in Buea terminate schooling every academic year because of early pregnancy. The case of Tole and Liongo is not an exception because out of every 30 teenagers 10 are either pregnant or breast feeding mothers.

As a result of this massive presence of IDPs in Buea municipality precisely Tole, Muea, Liongo and Bomaka, several humanitarian international organizations and non-governmental organizations such as The United Nation’s High Commission for Refugees (UNHCR), UNICEF, TeenAlive Organization and LUKMEF, UNFPA, DRC, The Norwegian Refugee Council and many others have made efforts in meeting the needs of these teenage pregnant IDPs. Though these NGOs, the government and individuals put up effective strategies and mechanisms to meet the socio-economic activities and needs of internally displaced pregnant teens, there is still a very huge gap. It is therefore a problem because these girls are young and vulnerable and as such, this problem cannot be overemphasized.

From personal observation while on internship in Tole and Liongo, it was observed that there were many teenage mothers and pregnant teenagers who had similar but different reasons for getting pregnant at young ages. Hence, the purpose of this study is therefore to examine the prevalence of teenage pregnancy among internally displaced persons in the Buea Municipality specifically Tole and Liongo in order to develop interventions aimed at reducing the incidences teenage pregnancies among this vulnerable population.

 1.3 Objectives of the study

1.3.1 Main Objective

The main objective is to examine the prevalence of teenage pregnancy among IDPs in Tole and Liongo villages in the Buea Municipality

1.3.2 Specific Objectives

1. To identify the causes of teenage pregnancy among IDPs in Tole and Liongo villages.
2. To examine the effects of teenage pregnancy among IDPs in Tole and Liongo villages
3. To propose possible strategies that can be used to mitigate the prevalence rate of teenage pregnancy among IDP’s in Tole and Liongo villages.

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