Abstract

This study aimed at assessing adolescents’ knowledge on the prevention of unintended pregnancy. The specific objectives were to identify the predisposing factors of unintended pregnancies, to determine the consequences of unintended pregnancy, and to seek preventive measures in order to eradicate or reduce unintended pregnancies in our country and Mutengene Community.

This work made use of a descriptive survey design. Specifically, tables, frequencies percentages, averages, standard deviations, and bar charts, were used to represent responses from questions on adolescents’ knowledge on the prevention of unintended pregnancies. The majority (64%) of the participants were from (13-15) years.

The majority of participants were educated with at least an advanced level certificate while a significant number of participants had from 1-2 sex partners.

Major predisposing factors of unintended pregnancy were early sexual activity, sex abuse, contraceptive failure, Peer pressure, and lack of sex education. Major consequences of unintended pregnancy were low birth weight and poor academic performance.

While Abstinence from sexual practices, knowledge on the reproductive system, knowledge about the various contraceptive methods and parents’ education to their adolescent on the risk factors of unintended pregnancies were major preventive measures to prevents unintended pregnancy.

Sex education should be introduced in primary and secondary school as compulsory subjects and adolescents should encourage to attend health talks organized by health professionals. Parents should also play an active role in educating their adolescents on the consequences of unintended sex

CHAPTER ONE

INTRODUCTION

This chapter is based on the background of the study, problem statement, general research question, research question, research objectives, general objective, specific objectives, the scope of the study, the significance of the study, definition of terms.

I.1 Background Of The Study

The world population of adolescents increases just as the total population of the world increases. It appears that concern with adolescents increases at the same time, and it, therefore, seems important for researchers to consider issues that are important for adolescents to find their place in the large society (WHO2014).

It is well recognized that the transition from adolescence to adulthood is a time of great personal changes and that the development of sexual identity and sexual activity is the most important part of this transition.

Sexual and reproductive health (SRH) rights are accepted as fundamental to the sustainable development of societies. The World Health Organization (WHO) developed sexual and reproductive health strategies for Europe in 2001 and reported a program of global strategies in 2004(Avery et al, 2008).

Teenage pregnancies are often unintended and there is a consensus world Wide among health care providers that every effort should be undertaken to prevent their occurrence (Amy et al, 2007). They also often have socio-economic consequences and can lead to abortion ( Churchill et al, 2000).

Teenagers experiencing an unintended pregnancy have been reported among teenage mothers (Danielson et al, 2001). Also, partners of teenage mothers have also experienced the same situation with more behavioral changes than other young men of the same ages. Unintended pregnancies are dependent mainly on the level of sexual activities, how contraceptives are used, and the lack of contraceptives used (Trussell, 2004).

Therefore in order to achieve a reduction of unintended pregnancy and abortion which is also common among teenagers, actions such as education in schools about sexual and reproductive health, establishing of Youth Clinic and subsidized contraceptives for teenagers have been undertaken in Sweden ( Santow et al, 1999).

The World Health Organization (WHO, 1980) defines adolescents as individuals between 10 and 19years of age. Adolescence is a period of transition, growth, exploration, and opportunities. During this phase of life, adolescents tend to develop an increased interest in sex: with the attendant risk of unintended pregnancies, health risks associated with early childbearing, abortion outcomes, and sexually transmitted infections (STIs), including HIV/AIDS.

Adolescents who have an unintended pregnancy face a number of challenges, including abandonment by their partners, inability to complete school education (which ultimately limits their future, social and economic opportunities), an increased adverse pregnancy outcome (kosunen, 2002).

Unintended pregnancy among adolescents is a common public health problem in industrialized, middle- and low-income countries (WHO, 1995). In the US for example, 9% of adolescents between the ages of 15 to 19years become pregnant each year, and about half of these pregnancies end in abortions (Darroch, 2001).

In India, adolescents pregnancies constitute 19% of total fertility (Mehta, 2004), and an Israeli study estimated the incidence of teenage pregnancy to be 32per 1000 adolescents girls in the country (Sikron, 2003).

Repeat pregnancies among adolescents are also common and are associated with an increased risk of adverse maternal and child health outcomes (Nelson, 1990). Unintended pregnancy is not only costly to teenagers and their families, it is a huge financial burden to societies as well.

Societal cost includes; welfare support for mothers experiencing financial difficulties, implementation programs (educational and skill training) to empower mothers to gain financial independence and lost tax revenues arising from reduced employability and earning (Rich Edwards, 2002).

Adolescents’ mothers are more likely to perform poorly in school come from low socio-economic homes and less advantageous environment; are themselves Children of mothers with limited school education and history of unintended pregnancies (Elfebein, 2003).

Children born to adolescents mothers are more likely to have low birth weight and became victims of physical neglect and abuse (Sorenson, 2003).On account of the short and long term consequences of unintended pregnancies for the adolescent, their families and the society at large(Russell,1997 ) government public health programs, bilateral agencies, and nongovernmental organizations (NGOs) have Implemented (and continue to implement) various interventions to address the problem, using a variety of approaches.

Such interventions include curriculum-based sex and STD/HIV education programs( safer choices (Coyle, 2001), Abstinence- alone programs (postponing sexual involvement( Kirby,1997b), sex can wait( Danny,2006); Comprehensive programs_ combination of multiple components example sexual Health and Relationships (SHARE)(Henderson, 2007),

Parents/teens sex and STD/HIV education programs( Dilorio 2006), Clinical protocol and one -on -one program which include  Advance promotion of emergency Contraceptive promotion ( Raymond 2006), Clinical based programs (Lindberg 2006), Interventions that are designed to reduce teen pregnancy appears to be most effective when a multifaceted approach is used, as the problem is multiple determined and multidimensional.

The Interventions should not only focus on sexual factors and related consequences, rather they should include non-sexual factors such as skills training and personal development as well. Further, stakeholders including pregnant teens, parents, health sectors, schools, and churches should work together to devise programs that are practical, evidence-based, culturally appropriate, and acceptable to the target population.

Some Interventions focus primarily on changing the psychosocial risk and protective factors that involve sexuality. One of such is the safer choices( Coyle 2001) which improves teens Knowledge about risks and Consequences of pregnancy and STD, values and attitudes regarding sexual values and beliefs, perceptions of peers, norms about sex and contraception, self-efficacy (ability to say ‘ no’ to unwanted sex), Consistent use of contraception including Condoms and their intensions regarding sexual behaviors.

Some Interventions promote abstinence-only(Denny 2006), and others add a comprehensive health education approach wherein safer sexual practices are also included (Jemmottlll, 1998). Parents/teens sex and STD/HIV education programs seek improved parents/ child communication regarding sexual health and sexuality and promote connectedness (Dilorio 2006).

Clinic protocols and one -on -one program promotes practices that provide advance provision of emergency contraceptive to high-risk adolescents (Orr, 1996), as well as providing health counseling for young men (Danielson, 1990).

Other Interventions focused on non-sexual factors such as the youth development endeavors to engender positive values in adolescents, inspiring hope for future aspirations, improving performance in school, and bolstering family relationships.

They also aim to reduce risky behaviors such as substance abuse and violence; promote learning programs that provide supervised volunteer community service opportunities as well as mentoring opportunities on skills building for adolescents( O’ Donnell, 2003).

Some make used of trained peer educators to conduct the health education sessions serving as mentoring/ role models in achieving sustainable behavioral changes (Borgia 2005). Experts suggest that in order to reduce teenage pregnancies, Interventions should be designed to address multiple sexual and non-sexual antecedents that correlate with adolescents sexuality, and which may  be related to the adolescents, their families, schools communities, and cultural factors -notably religion( Kirby 2002a )

1.2 Statement of the problem

Globally, unintended pregnancy among adolescents is a world wild problem especially in industrialized low- and middle-income countries (WHO, 1995). Studies have shown that most adolescents between the ages of 15- 19years become pregnant each year and most of the pregnancies end in abortion (Darroch, 2001).

On account of the short and long term consequences of unintended pregnancies for the adolescent, their families and the society at large(Russell,1997 ) government public health programs, bilateral agencies, and nongovernmental organizations (NGOs) have Implemented (and continue to implement) various interventions to address the problem, using a variety of approaches . Such interventions include curriculum-based sex and STD/HIV education programs (safer choices (Coyle, 2001),

Abstinence- alone programs (postponing sexual involvement (Kirby,1997b), sex can wait( Danny,2006); Comprehensive programs_ combination of multiple components example sexual Health and   Relationships       (SHARE)(Henderson ,2007), Despite all the interventions  During community my internship carried out in Mutengene community,

it was noticed that majority of the women pregnancy complications admitted during antenatal care clinic, a complication of unsafe abortions, pregnancy complications, Labor and delivery were adolescents with unintended pregnancies. Therefore, it was necessary for this work to assess the knowledge of adolescent girls on the prevention of unintended pregnancy in the Mutengene community.

1.3 General Research Question

Assessing the knowledge of adolescent girls on the prevention of unintended pregnancy in Mutengene.

1.3.1 Research Questions

1. Do adolescents know the predisposing factors of unintended pregnancies?
2. What do adolescents know about the consequences of unintended pregnancy?
3. Do adolescents have knowledge on the prevention of unintended pregnancies?