Impact of social environment on sexual behaviors of adolescent girls in 12 sub-Saharan African countries: a cross-sectional study.

BACKGROUND: Early sexual debut among adolescent girls may result in teenage pregnancy and sexually transmitted diseases. In sub-Saharan Africa (SSA), pregnancy among adolescent girls may adversely impact the continuation of their education, general health status, and birth outcomes. However, few cross-national studies have examined the role that the social environment plays in adolescent girls' sexual behaviors in SSA. In this study, we explored adolescent girls' social environment and the impact on their sexual behaviors.. METHODS: The country selection was based on availability of Global School-Based Student Health Survey (GSHS) national data (2003-2015). The total analytic sample was 22,067 adolescent girls from 12 countries in SSA. Descriptive statistics were generated to determine the characteristics of adolescent girls and independent samples t-test analysis were performed to determine whether there were differences between the social environment and age of sexual debut and sexual partners. Logistic regression models were used to determine the association between adolescent girls' social environment and sexual debut. RESULTS: The study results showed variations across the 12 countries. Almost one in five (19.9%) adolescent girls reported to have ever engaged in sexual intercourse. Their mean age of sexual debut was 13.21 (13.04-13.37) years and mean number of sexual partners was 2.19 (2.08-2.29). We found that adolescent girls who reported not being connected with their parents were more likely to debut sex (aOR = 1.32, 95% CI, 1.14-1.53, p < 0.000). Parental monitoring was significantly associated with sexual debut but after controlling for the confounding variables (age, class grade and drug use), the association was no longer significantly positively associated. Adolescent girls who felt supported by their peers had a significantly higher number of sexual partners than those who did not feel supported by their peers. CONCLUSION: The social environment of adolescent girls plays a very important role in sexual debut, age of sexual debut, and the number of sexual partners. Sexual health policies targeting adolescent girls are likely to achieve positive impacts if they focus on improving parental connectedness and peer support.

Adolescent girls in sub-Saharan Africa are at risk of dropping out of school when they get pregnant. There are also several health risks associated with adolescent pregnancies. This study explored factors in the adolescent girl's social environment which could impact their sexual behaviors. We examined data from adolescent girls in 12 sub-Saharan African Countries, namely, Kenya, Tanzania, Uganda, Ghana, Mauritania, Senegal, Swaziland, Zambia, Botswana, Namibia, Seychelles and Mozambique. After analyzing the data, we found that adolescent girls who reported not being close with their parents were more likely to debut sex. Adolescent girls who felt supported by their friends had a higher number of sexual partners. Thus, support from parents and peers play a vital role in the sexual behaviors of adolescent girls.

Factors Associated with Parental Intent not to Circumcise Daughters in Enugu State of Nigeria: An Application of the Theory of Planned Behavior.

This study explored intention of parents not to circumcise daughters in Enugu State, Nigeria using theory of planned behavior (TPB) as a framework. A survey of 1345 parents was carried out using structured questionnaire with FGM question items based on TPB constructs of attitude, subjective norm (SN), perceived behavioral control (PBC), and intention. Intention was dichotomized into two categories and logistic regression analysis was performed to examine the association between the constructs of TPB while controlling for some socio-demographic factors. 70% of respondents did not intend circumcising daughters. Constructs of TPB associated significantly, at p < 0.0001, with intention not to perform FGM on daughters with PBC having the strongest association. Having a post-secondary education (OR = 3.94; CI = 2.73-5.67) and absence of history of FGM in family (OR = 3.39; CI = 2.62-4.39) are the socio-demographic variables most significantly associated with the intention not to circumcise daughters. Homer-Lemeshow goodness-of-fit statistics indicated logistic regressions model 1 was significant (p < 0.05) making TPB a good theoretical basis for study of FGM. Intervention activity should focus on improving attitude of parents and especially those with less than post-secondary education and those with cases of FGM in their household.

Do Fruit and Vegetable Policies, Socio-Environmental Factors, and Physical Activity Influence Fruit and Vegetable Intake Among Adolescents?

PURPOSE: Several factors are known to influence the intake of fruits and vegetables (FV) among adolescents. However, few studies have examined the role that FV policies and associated factors (such as availability of food at home, parental support, and physical activity) play on consumption of FV, particularly among adolescents in low- and middle-income countries (LMICs). METHOD: Adolescent data (except for FV policy status) were obtained from the Global School-based Student Health Survey from 2004 to 2013. Information on FV policies was obtained from government ministries, World Health Organization databases, Scopus, and PubMed. Countries were designated as having the policy if the policy was issued at least a year before Global School-based Student Health Survey data collection (n = 13 LMICs). Countries without FV policies were based on the absence of a policy between 2004 and 2013 (n = 11 LMICs). The total analytic sample included 89,843 adolescents from 24 countries. RESULTS: Logistic regression models revealed a positive association between the presence of FV policy and the adequate consumption of FV (adjusted odds ratio [AOR] = 2.04; 95% confidence interval [CI]: 1.74-2.40; p-value < .001). Parental supervision was positively associated with sufficient intake of FV (AOR = 1.62; 95% CI: 1.42-1.84; p-value < .001). Physical activity was also positively associated with adolescents consuming ≥5 servings of FV daily (AOR = 1.30; 95% CI: 1.13-1.50; p-value < .001). CONCLUSION: Adolescents' physical environment (presence of FV policies, unavailability of food), social environment (parental connectedness, supervision, and bonding), and physical activity behavior are all significant predictors of adolescents' intake of FV.

A comparative study of fruit and vegetable consumption and physical activity among adolescents in 49 Low-and-Middle-Income Countries.

Physical inactivity and low consumption of fruits and vegetables (FV) during adolescence may persist through adulthood, putting adolescents at risk of developing chronic diseases. Although studies from high-income countries have reported differences in FV consumption and physical activity (PA) between adolescent boys and girls, few exist from low-and-middle-income countries (LMICs). In this study, we examined patterns of FV consumption and PA among adolescent boys and girls in LMICs. Country selection was based on availability of Global School-Based Student Health Survey (GSHS) data from 2004 to 2013. The total analytic sample was 164,771 adolescents from 49 LMICs. Descriptive statistics were generated to determine adolescents meeting the World Health Organization (WHO) recommendations for FV and PA. A Rao-Scott adjusted chi-square statistic was computed to assess gender differences. Less than 30% of adolescents across all countries met the WHO guidelines for FV consumption or PA. Morocco (29.5%) and India (29.5%) however had the highest percentage of adolescents meeting recommendations for FV and PA, respectively. Adolescent boys were more active than girls, and this difference was more notable in the Middle East and North African region. Adolescents achieving the WHO recommendations for daily consumption of FV and PA were consistently low in all countries.