Pooled prevalence and associated factors of teenage pregnancy among women aged 15 to 19 years in sub-Saharan Africa: evidence from 2019 to 2022 demographic and health survey data.

BACKGROUND: Teenage pregnancy is becoming one of the most common social and public health problems worldwide, with the highest prevalence in sub-Saharan Africa. Health risks and adverse outcomes of pregnancy and childbirth among adolescent girls are the commonest cause of the global burden of maternal morbidity and mortality. This study is intended to determine the pooled prevalence and determinants of teenage pregnancy in sub-Saharan Africa using the most recent demographic and health survey data (2019-2022). METHODS: A cross-sectional study was conducted using data from the most recent demographic and health surveys of four countries (Kenya, Tanzania, Gabon, and Cameroon) in sub-Saharan Africa conducted between 2019 and 2022. A total weighted sample of 12,829 teenagers aged 15 to 19 years was included in the study. Data extracted from demographic and health survey data sets were cleaned, recorded, and analyzed using STATA/SE version 14.0 statistical software. Multilevel mixed-effects logistic regression was used to determine the factors associated with the dependent variable. Finally, variables with a p-value ≤ 0.05 and an adjusted odds ratio with a 95% confidence interval were declared statistically significant. RESULTS: The pooled prevalence of teenage pregnancy among women aged 15 to 19 years was 18.15% (95% CI: 17.49, 18.83). Teenage pregnancy was positively associated with the respondent's age [AOR = 2.97; 95% CI (2.55, 3.46)], educational status [AOR = 2.21; 95% CI (1.62, 3.03)] and [AOR = 1.80; 95% CI (1.54, 2.12)], wealth status [AOR = 2.61; 95% CI (2.12, 3.22)] and [AOR = 1.65; 95% CI (1.33, 2.05)], relation to the household head [AOR = 2.09; 95% CI (1.60, 2.72)], and unmet need for contraception [AOR = 14.3; 95% CI (11.5, 17.8)]. On the other hand, it was negatively associated with marital status [AOR = 0.08; 95% (0.07, 0.10)], working status [AOR = 0.75; 95% CI (0.64, 0.88)], age at first sex [AOR = 0.68; 95% CI (0.58, 0.80)], contraceptive use [AOR = 0.25; 95% CI (0.20, 0.30)], contraceptive knowledge [AOR = 0.27; 95% CI (0.19, 0.40)], and community contraceptive utilization [AOR = 0.85; 95% CI (0.73, 0.99)]. CONCLUSION: In the current study, one out of six young women aged 15 to 19 experienced teenage pregnancy. Therefore, addressing unmet needs for family planning, improving women's educational status, and giving special attention to teenagers with low educational and economic status are recommended.

How to decrease teenage pregnancy: rural perspectives in Ecuador.

Introduction: This study aimed to understand the sociocultural context of teenage pregnancy in an Ecuadorian city with a large indigenous population, to gauge the acceptability of a multifaceted pregnancy prevention program for adolescents, and to elicit perspectives on the optimal program design from adolescents and adult key informants. Methods: We ascertained qualitative data via an online, electronic survey administered from August to September 2020. Open- and closed-ended questions elicited perspectives relating to burden of adolescent pregnancies, acceptability of pregnancy prevention programs, and optimal design of future programs. Twenty-four adolescents (13-19 years of age) and 15 adult key informants working in the healthcare, business, and education sectors in Cotacachi completed the survey. Survey responses were analyzed using a structural and in vivo coding, and an inductive approach to consensus-building around key themes. Results: Most adolescent survey respondents (75%) believed that teen pregnancy is "fairly common" in Cotacachi, and 41.7% believed differences in teen pregnancy rates are not associated with ethnicity. In comparison, 66.7% of adult survey respondents said teen pregnancy disproportionately occurs among indigenous teenagers. Additionally, 45.8% of adolescent and 80% of adult survey respondents believed that a comprehensive sexual education program would help reduce teenage pregnancy rates by imparting reliable sexual health knowledge. Adult respondents noted that the past programs were unsuccessful in preventing teenage pregnancy because of these programs' inability to fully engage teenagers' attention, very short time duration, or inappropriate consideration of cultural context. Discussion: In Cotacachi, Ecuador, a sexual health education program is both desired and feasible according to adult and teenager key informants. A successful program must adapt to the cultural context and engage youth participation and attention.

Sexually transmitted infection and teenage pregnancy in adolescents having parents with schizophrenia: a retrospective cohort study of 64,350 participants.

BACKGROUND: The risks of sexually transmitted infections (STIs) and teenage pregnancy in the offspring of parents with schizophrenia remain unknown. METHODS: From the Taiwan National Health Insurance Research Database, 5,850 individuals born between 1980 and 1999 having any parent with schizophrenia and 58,500 age-, sex-, income- and residence-matched controls without parents with severe mental disorders were enrolled in 1996 or on their birthdate and followed up to the end of 2011. Those who contracted any STI or became pregnant in adolescence during the follow-up period were identified. RESULTS: Cox regression analyses demonstrated that offspring of parents with schizophrenia (hazard ratio [HR]: 1.21, 95% confidence interval [CI]: 1.02-1.44), especially daughters (HR: 1.30, 95% CI: 1.06-1.58), were more likely to contract any STI later in life than the control comparisons. In addition, daughters of parents with schizophrenia had an elevated risk of being pregnant in their adolescence (HR: 1.47, 95% CI: 1.29-1.67) compared with those having no parents with severe mental disorders. DISCUSSION: The positive relationship between parental schizophrenia and offspring STIs and teenage pregnancy necessitates clinicians and public health officers to closely monitor the sexual health in the offspring of parents with schizophrenia so that optimal and prompt preventive measures can be taken in the at-risk group.

Characteristics and Circumstances of Adolescents Obtaining Abortions in the United States.

The purpose of this study is to describe the sociodemographic and situational circumstances of adolescents obtaining abortion in the United States prior to the Dobbs decision. We use data from the Guttmacher Institute's 2021-2022 Abortion Patient Survey, a cross-sectional survey of 6698 respondents; our analytic sample includes 633 adolescents (<20 years), 2152 young adults (20-24 years), and 3913 adults (25+ years). We conducted bivariate analyses to describe the characteristics and logistical and financial circumstances of adolescents obtaining abortions in comparison to respondents in the other age groups. The majority of adolescents identified as non-white (70%), and 23% identified as something other than heterosexual. We found that 26% of adolescents reported having no health insurance, and two-thirds of adolescent respondents reported that somebody had driven them to the facility. Adolescents differed from adults in their reasons for delays in accessing care; a majority of adolescents (57%) reported not knowing they were pregnant compared to 43% of adults, and nearly one in five adolescents did not know where to obtain the abortion compared to 11% of adults. Adolescents were more likely than adults to obtain a second-trimester abortion, which has increased costs. This study found that this population was more vulnerable than adults on several measures. Findings suggest that adolescents navigate unique barriers with regard to information and logistics to access abortion care.

A 14-year-old girl with premature ovarian insufficiency but with a positive pregnancy test.

OBJECTIVES: Childhood cancer survivors are at risk for premature ovarian insufficiency, especially after treatment with alkylating agents. The objective of this report is to highlight a case in which this phenomenon caused a false-positive pregnancy test. CASE PRESENTATION: A workup was performed in a 14-year-old girl with a positive pregnancy test. She was diagnosed with stage IV neuroblastoma of the left adrenal gland at the age of 4 years. She received extensive treatment, including alkylating agents, and had been diagnosed with premature ovarian insufficiency. An LH/hCG suppression test was performed using high dose 17 bèta-estradiol: hCG levels normalized. CONCLUSIONS: The pregnancy test was false-positive due to production of low amounts of hCG by the pituitary gland as a result of high LH concentrations following premature ovarian insufficiency. It may be helpful to perform the LH/hCG suppression test to prove pituitary origin of the hCG overproduction.

Conocimientos y prácticas sobre sífilis materna y congénita en adolescentes embarazadas en un Hospital General de Paraguay: estudio cualitativo

Introducción: La sífilis en embarazadas, sigue siendo un gran problema de salud pública en todo el mundo, y en Paraguay, no es la excepción. La sífilis congénita puede provocar abortos, muertes fetales y neonatales, peso bajo al nacer, prematuridad y otras anomalías congénitas, el conocimiento general de la población en edad fértil es fundamental. Objetivo: Analizar los conocimientos y prácticas sobre sífilis materna y sífilis congénita en adolescentes embarazadas en un Hospital General de Paraguay. Metodología: Se realizó un estudio cualitativo, fenomenológico descriptivo. Para la recolección de datos se utilizó la entrevista, simple que fue grabada con previa autorización del participante, la conclusión y recomendación serán entregados a la institución y a las adolescentes embarazadas. Resultados: Participaron diez adolescentes, en su mayoría de 19 años de edad, cinco conocen que la sífilis se transmite a través de las relaciones sexuales, sin embargo, desconocen acerca de cómo se transmite la sífilis congénita. Cinco de las adolescentes menciona haber iniciado las relaciones sexuales a los 16 años. Dos adolescentes a los 15 años, dos a los 14 años y una a los 17 años, nueve de las adolescentes embarazadas mencionan acudir a sus controles prenatales de forma periódica. Dos aún no se han realizado el test de VDRL. Discusión: Se concluye en cuanto al conocimiento, que solo cinco de diez adolescentes conocen acerca de la sífilis, sin embargo, no conocen sobre la sífilis congénita. En cuanto a las prácticas preventivas, 10 acuden de forma periódica a sus controles prenatales.

Introduction: Syphilis in pregnant women continues to be a major public health problem throughout the world, and in Paraguay, it is no exception. Congenital syphilis can cause abortions, fetal and neonatal deaths, low birth weight, prematurity, and other congenital anomalies; general knowledge of the population of childbearing age is essential. Objective: To analyze the knowledge and practices about maternal syphilis and congenital syphilis in pregnant adolescents in a General Hospital in Paraguay. Methodology: A qualitative, descriptive phenomenological study was carried out. A simple interview was used to collect data, which was recorded with prior authorization from the participant. The conclusion and recommendation will be delivered to the institution and to the pregnant adolescents. Results: Ten adolescents participated, mostly 19 years of age, five know that syphilis is transmitted through sexual relations, however, they do not know how congenital syphilis is transmitted. Five of the adolescent's mention having started sexual relations at the age of 16. Two adolescents at 15 years old, two at 14 years old and one at 17 years old, nine of the pregnant adolescent's mention attending their prenatal check-ups periodically. Two have not yet been tested for VDRL. Discussion: It is concluded in terms of knowledge that only five out of ten adolescents know about syphilis; however, they do not know about congenital syphilis. Regarding preventive practices, 10 attend their prenatal check-ups periodically.

Exploring mental health problems and support needs among pregnant and parenting teenagers in rural areas Of Limpopo, South Africa.

BACKGROUND: Globally, teenage pregnancy is among the most social problems, affecting 21 million adolescents aged 15-19. Due to the increased responsibility of prenatal and postnatal care for their infants without support, pregnant and parenting teenagers, tend to experience mental health problems. Factors contributing to these problems among pregnant and parenting teenagers in rural African settings have hardly received scholarly attention and, therefore, are less understood. The purpose of the study was to explore mental health and challenges among pregnant and parenting teenagers,. METHOD(S): The study adopted a qualitative descriptive, exploratory, and phenomenological design. Purposive sampling was used to select 22 pregnant and parenting teenagers 18 years or older. Data were collected in ten selected clinics within the Demographic Surveillance Systems (HDSS) of DIMAMO and analysed using qualitative content analysis. RESULTS: The findings reveal that pregnant and parenting teenagers in rural areas experience various mental challenges such as depression. These challenges are caused by social problems such as stigmatisation, lack of support from families and friends, as well as parenting demands that contribute to poor progress at school or dropouts. Pregnant teens expressed concerns about the lack of spousal support resulting from abandoning their partners. CONCLUSIONS: Stress and depression were self-reported as mental problems among participants with various psychosocial implications, such as school dropout and miscarriage. There are various contributing factors to the mental health problems identified among pregnant and parenting teenagers, including inadequate family and spousal support. Access to integrated reproductive, psychosocial, and mental health services could be essential for these pregnant and parenting teenagers, to improve their mental well-being and improve the support system.

Perceptions of community health workers on teenage pregnancy in rural Limpopo: A qualitative study.

BACKGROUND:  Despite measures put in place to combat teenage pregnancy, the rate remains high. Community health workers (CHWs) are a cadre of health workers that can help put measures in place to reduce teenage pregnancy in the communities in which they live and work. AIM:  This article aims to gain a deeper understanding of CHWs' perceptions regarding teenage pregnancy in the rural districts of Limpopo province. METHODS:  An exploratory qualitative study approach was employed to collect data from CHWs in two rural districts of Limpopo. A non-probability purposive sampling approach was used to choose 81 CHWs. Eight focus group discussions (FGDs) were organised, and audio recorded to collect data from participants. The discussions were 2-3 h long and conducted in English, and data saturation was attained by the fifth FGDs. RESULTS:  An eight-step tech's content analysis approach was employed to deductively code, analyse and summarise data into themes. Three themes emerged: the prevalence of teenage pregnancy in rural villages, factors contributing to teenage pregnancy and challenges faced by CHWs when dealing with teenage pregnancy. CONCLUSION:  The study's findings revealed that CHWs face challenges in their communities when offering appropriate teen pregnancy services and CHWs believe that teen pregnancy numbers remain high. There is a significant barrier in combating teenage pregnancy; if contraceptives are not acceptable to the community, the only solution and option for combating teenage pregnancy is abstinence.Contribution: The CHWs presented their insights of teenage pregnancy in rural communities. The outcomes of this study could help clinical practise, schools, communities, youth-friendly services, policymakers and other non-governmental organisations reduce teenage pregnancy.

Healthcare professionals' experience of teenage pregnancy and motherhood in Haiti.

OBJECTIVES: The aim of this study was to explore healthcare professionals' experience of pregnant and motherhood in adolescence in Haiti. METHODS: The methodology for collecting and analyzing qualitative data was based on John Dewey's social survey. The study was conducted in nine health institutions in the North and North-East departments of Haiti from October 2020 to January 2021. Data were collected through individual semi-structured interviews with 15 healthcare professionals. All interviews were audio-recorded. The recordings were listened to carefully and transcribed in verbatim form. After checking and validation, the verbatims in Word format were exported to QDA Miner software version 6.0.5 for coding. The data were analyzed using Paillé and Mucchielli thematic analyses. RESULTS: Health professionals such as gynecologists, nurses, midwives, nursing assistants, matrons and health workers took part in the study. These study participants indicate that teenage pregnancy and motherhood are social and public health problems whose negative consequences affect teenage girls, children, healthcare professionals, the healthcare system, and Haitian society in general. The services offered to adolescent girls are medical, educational, psychological, economic, and social in nature. When caring for pregnant adolescents during the transition to motherhood, healthcare professionals face many challenges that are linked to the socio-economic status and physiological reality of adolescents, as well as the healthcare system. CONCLUSIONS: Programs involving home care visits should also be set up to offer ongoing support to pregnant or parenting teenagers. The distribution of food aid or materials such as clothing, hygiene products and baby kits should also be considered.

The impact of juvenile curfews on teenage birth rates.

I examine the effect of city-level juvenile curfews on teenage birth rates using the National Center for Health Statistics birth data from 1982 to 2002. I compare differences in birth rates between younger and older age groups in cities with and without curfew ordinances. Before curfew adoption, the age differential in birth rates trended similarly for cities that did and did not adopt a curfew. There were significant decreases in the age differential birth rates in cities that adopted a curfew relative to cities that did not. Curfews reduced birth rates by approximately 3 births per 1000 women ages 15-17. I find a decrease in birth rates among white women. The main results are corroborated using a variety of robustness checks and specifications.

Mental health outcomes beyond the post-partum period among adolescent mothers: a systematic review and meta-analysis.

Background: Adolescence is the most crucial part of life. The vulnerability of adolescent mothers is even more pronounced and can affect various health aspects. While they suffer from social and emotional stresses shortly after giving birth, the long-term effect after the post-partum period of adolescent pregnancy on the mental outcomes holds prime importance. Thus, this systematic review aims to ascertain the association between adolescent pregnancy on mental health outcomes. Methods: The search strategy was run in June 2023 on databases including PubMed, CINAHL, Scopus, Psych Info, and Embase . Quality assessment of the studies was done using the National Institute of Health (NIH)'s National Heart, Lung and Blood Institute (NHLBI) tool for observational studies. For studies that measured similar outcomes, a meta-analysis was conducted. Findings: The search strategy yielded 21 results from all databases and cross-referencing. Of these, all except for one (case-control) were cross-sectional and cohort studies. The pooled analysis found a significant association between adolescent pregnancy and depression (RR 1.34; 95% CI 1.05, 1.72, 6 studies, heterogeneity: Chi2 P 0.01; I2 = 60%); however, no association was found in anxiety (RR 1.05; 95% CI 0.26, 4.14, 2 studies; heterogeneity: Chi² P = 0.0003; I2 = 93%) and suicidal ideation (RR 3.21; 95% CI 0.17, 59.33; 3 studies; heterogeneity: Chi2 P < 0.00001; I2 = 98%). Implication: These findings suggest that the mental health needs of adolescent mothers must be addressed and innovative and effective interventions that support and address the mental health needs of adolescent mothers are needed to improve their mental health.

Unintended pregnancies in the lives of young people in Luwero, Uganda: a narrative analysis.

Using a feminist narrative approach, this article explores how unintended pregnancy can rupture young lives, and how young people respond to and navigate these ruptures. We analyse qualitative data from a longitudinal cohort study in Luwero, Uganda, focusing on narratives of a girl and a boy about their recent experiences of unintended and unwanted pregnancy during COVID-19 school closures. We argue that laws, policies and norms relating to education, sexual and reproductive health, and the family in Uganda position young people in complex and contradictory ways, that create the conditions for unintended pregnancies, and restrict the choices open to them. The analysis traces how pregnancy ruptures their everyday lives, their identities, and relationships. Their narratives reveal gendered ways in which they enact identities to manage the ruptures. Families are sites of contestation, where gender and sexuality are regulated, but are also mobilised by young people to support their efforts to repair the ruptures. Our analysis underscores the importance of working with young people to understand their positionalities, resource environments and social networks as they make and navigate decisions about pregnancy, and of addressing the structural forces that underpin the rupturing effects of pregnancy on teenage lives.

Teenage pregnancy in Tambogrande, Peru: causes, consequences and cycles of violence and disadvantage.

Teenage pregnancy carries adverse consequences for health and well-being. In this article, we investigate the perceived causes, consequences and cycles of violence and disadvantage associated with teenage pregnancy in Tambogrande, Peru using an applied anthropological approach. Data were drawn from a larger project investigating the relationship between water insecurity and gender-based violence in Indonesia and Peru. The analysis presented here is derived from 49 semi-structured interviews and 5 focus groups with local community members and stakeholders in Peru. Study participants highlighted two main factors contributing to teenage pregnancy in Tambogrande: machismo and religious deterrents to contraceptive use. Participants described how these factors overlapped, resulting in gendered power imbalances that increased the risk of violence, decreased educational opportunities, and reduced the economic independence of women. However, study participants stated that educational interventions targeting machismo could reduce teenage pregnancy and break the associated cycle of disadvantage. Future research will further investigate local social and gender norms to inform the design of a rights-based educational intervention, targeting upstream factors associated with teenage pregnancy in this area.

Comparing maternal factors associated with postpartum depression between primiparous adolescents and adults: A large retrospective cohort study.

OBJECTIVES: This study aimed to estimate the prevalence of diagnosed postpartum depression (PPD) and the likelihood of PPD among primiparous women. We also evaluated differences in the influence of various maternal factors associated with PPD in adolescent versus adult mothers. METHODS: We conducted a retrospective cohort study using electronic health records linked to birth certificates to evaluate the associations between maternal factors and PPD diagnosis. The study population was stratified into adults and adolescents based on age at delivery. We evaluated socioeconomic, demographic, psychological, and clinical factors associated with PPD in each of the age-defined maternal cohorts using multivariable logistic regression analyses. RESULTS: A total of 61,226 primiparous women, including 6435 (11%) mothers younger than 20 years old, were included in the study. The overall PPD rate was 4.0%, with the age-specific PPD rate measuring 1.6 times higher in adolescents than in adult women (6.1% vs. 3.8%). Compared with adults, adolescents were less likely to obtain firsttrimester prenatal care (33% vs. 16%), more likely to have recent tobacco use (11% vs. 6%), and more likely to have had an infection during pregnancy (5% vs. 1%). In adjusted models, significant factors for PPD in both groups included a history of depression or anxiety, tobacco use, and long-acting reversible contraception use. CONCLUSIONS: In this cohort of first-time mothers, adolescents had higher rates of PPD diagnosis as well as PPD-associated maternal factors than adults. Increased awareness of PPD risk in adolescents and early intervention, including integrating mental healthcare into prenatal care, may help benefit adolescents and reduce the risk and severity of PPD.

Gender role beliefs and adolescent pregnancy in Colombia: findings from the 2015 DHS survey.

This study investigated the association between gender role beliefs and the prevalence and likelihood of experiencing pregnancy among 8525 young women and girls aged 13-19 years in Colombia. The primary outcome of interest was adolescent pregnancy. Retrospective cross-sectional analysis utilised data from the 2015 Demographic and Health Survey (DHS) in Colombia, which included an add-on questionnaire on gender relations. Our analysis measured both pregnancy prevalence and pregnancy likelihood in relation to gender role beliefs. With one exception, young women who disagreed with traditionally conforming gender roles had a lower prevalence of pregnancy and were less likely to experience pregnancy than those who agreed with them. The highest likelihood of pregnancy prevalence and likelihood was found among those who agreed with statements suggesting male dominance and those who agreed with women's homemaking responsibilities. The greater the adherence to traditionally conforming gender role beliefs, the higher the likelihood of experiencing pregnancy during adolescence. Girls' and young women's adherence to traditional gender role beliefs appeared to be a risk factor for adolescent pregnancy. Our findings support Colombia's current sex education policies and practices within the framework of gender equity, and evidence the link between gender equity and girls' and young women's reproductive health.

Parturientes adolescentes em Cruzeiro do Sul, Acre, Brasil: características socioeconômicas e obstétricas / Adolescent pregnancy in Cruzeiro do Sul, Acre, Brazil: socioeconomic characteristics, prenatal and obstetric care

Resumo O objetivo do estudo foi investigar as características socioeconômicas e obstétricas de parturientes adolescentes e suas complicações sobre a saúde materna e neonatal. Trata-se de uma análise de dados da linha de base da coorte de nascimentos MINA-Brasil conduzida no município de Cruzeiro do Sul, estado do Acre. Utilizou-se teste qui-quadrado para comparar características das puérperas adolescentes com as adultas e modelos múltiplos de regressão de Poisson com variância robusta para avaliar fatores associados. Entre as puérperas estudadas, 26,2% (IC95%: 24,0-28,4) eram adolescentes. Os fatores associados ao parto na adolescência foram ter nove anos ou menos de estudo (RPaj:1,36; IC95%: 1,14-1,61), pertencer aos menores quartis do índice de riqueza (1° quartil: RPaj:1,40; IC95%: 1,08-1,80) (2° quartil: RPaj:1,37; IC95%: 1,08-1,74), ser primigesta (RPaj:3,69; IC95%: 2,98-4,57), baixo IMC pré-gestacional (RPaj:1,28; IC95%: 1,04-1,57), infecção urinária na gravidez (RPaj:1,25; IC95%: 1,07-1,46) e menos de seis consultas de pré-natal (RPaj:1,42; IC95%: 1,21-1,66). Pobreza, baixa escolaridade, primigestação, baixo IMC pré-gestacional, infecção urinária na gestação e menor número de consultas de pré-natal foram associados ao parto na adolescência em município da região Norte do Brasil.

Abstract The present study aimed to investigate the socioeconomic and obstetric characteristics of adolescent mothers and the complications they cause to maternal and neonatal health. This baseline data analysis of the MINA-Brazil birth cohort was conducted in the municipality of Cruzeiro do Sul, state of Acre, Brazil. The chi-square test was used to compare characteristics of adolescent and adult postpartum women, and multiple Poisson regression models with robust variance were used to assess associated factors. Among the postpartum women, 26.2% (95%CI: 24.0-28.4) were adolescents. Factors associated with childbirth in adolescence included: nine years or less of schooling (adjPR:1.36; 95%CI: 1.14-1.61), belongs to the lowest quartiles of the wealth index (1st quartile: adjPR:1.40; 95%CI: 1.08-1.80) (2nd quartile: adjPR:1.37; 95%CI: 1.08-1.74), primigravidae (adjPR:3.69; 95%CI: 2.98-4.57), low pre-pregnancy BMI (adjPR:1.28; CI95%: 1.04-1.57), urinary tract infection during pregnancy (adjPR:1.25; CI95%: 1.07-1.46) and less than six prenatal consultations (adjPR:1.42; 95%CI: 1.21-1.66). Poverty, little schooling, primigravidae, low pre-pregnancy BMI, urinary tract infection during pregnancy and few prenatal consultations were associated with childbirth during adolescence in a municipality in the Northern region of Brazil.

Fast-track interventions for HIV and AIDS epidemic control among key populations: A rapid review

Background: Despite measures put in place to combat teenage pregnancy, the rate remains high. Community health workers (CHWs) are a cadre of health workers that can help put measures in place to reduce teenage pregnancy in the communities in which they live and work. Aim: This article aims to gain a deeper understanding of CHWs' perceptions regarding teenage pregnancy in the rural districts of Limpopo province. Methods: An exploratory qualitative study approach was employed to collect data from CHWs in two rural districts of Limpopo. A non-probability purposive sampling approach was used to choose 81 CHWs. Eight focus group discussions (FGDs) were organised, and audio recorded to collect data from participants. The discussions were 2­3 h long and conducted in English, and data saturation was attained by the fifth FGDs. Results: An eight-step tech's content analysis approach was employed to deductively code, analyse and summarise data into themes. Three themes emerged: the prevalence of teenage pregnancy in rural villages, factors contributing to teenage pregnancy and challenges faced by CHWs when dealing with teenage pregnancy. Conclusion: The study's findings revealed that CHWs face challenges in their communities when offering appropriate teen pregnancy services and CHWs believe that teen pregnancy numbers remain high. There is a significant barrier in combating teenage pregnancy; if contraceptives are not acceptable to the community, the only solution and option for combating teenage pregnancy is abstinence. Contribution: The CHWs presented their insights of teenage pregnancy in rural communities. The outcomes of this study could help clinical practise, schools, communities, youth-friendly services, policymakers and other non-governmental organisations reduce teenage pregnancy.

Perceptions of community health workers on teenage pregnancy in rural Limpopo: A qualitative study

Background: Despite measures put in place to combat teenage pregnancy, the rate remains high. Community health workers (CHWs) are a cadre of health workers that can help put measures in place to reduce teenage pregnancy in the communities in which they live and work. Aim: This article aims to gain a deeper understanding of CHWs' perceptions regarding teenage pregnancy in the rural districts of Limpopo province. Methods: An exploratory qualitative study approach was employed to collect data from CHWs in two rural districts of Limpopo. A non-probability purposive sampling approach was used to choose 81 CHWs. Eight focus group discussions (FGDs) were organised, and audio recorded to collect data from participants. The discussions were 2­3 h long and conducted in English, and data saturation was attained by the fifth FGDs. Results: An eight-step tech's content analysis approach was employed to deductively code, analyse and summarise data into themes. Three themes emerged: the prevalence of teenage pregnancy in rural villages, factors contributing to teenage pregnancy and challenges faced by CHWs when dealing with teenage pregnancy. Conclusion: The study's findings revealed that CHWs face challenges in their communities when offering appropriate teen pregnancy services and CHWs believe that teen pregnancy numbers remain high. There is a significant barrier in combating teenage pregnancy; if contraceptives are not acceptable to the community, the only solution and option for combating teenage pregnancy is abstinence. Contribution: The CHWs presented their insights of teenage pregnancy in rural communities. The outcomes of this study could help clinical practise, schools, communities, youth-friendly services, policymakers and other non-governmental organisations reduce teenage pregnancy

Factors contributing to rise in teenage pregnancy in Sekhukhune district, Limpopo province

Background: The Department of Health in South Africa has reported an alarming total of 90 037 teenage girls between the ages of 10 years and 19 years who gave birth from March 2021 to April 2022, across all provinces and districts. The rise in teenage pregnancy is of serious concern as adolescents girls are more likely to experience difficult pregnancies and deliveries which could lead to detrimental effects on their health. Objectives: The study aimed to explore and describe factors contributing to the increase in teenage pregnancy in the Sekhukhune district of Limpopo. Method: The study was conducted in the healthcare facilities of Sekhukhune area. A qualitative, exploratory design was followed. Participants were purposively selected, and data were gathered through face-to-face individual interviews. Data analysis employed Tesch's inductive, descriptive coding method. Results: Negligence, peer pressure, ambiguity, choice, lack of contraceptive use, and lack of family attachment were identified as exacerbating factors in the district's surge in teenage pregnancy. Conclusion: To reduce teen pregnancy, it is crucial to promote contraception, enhance cooperation between schools and the government, involve families in sexual and reproductive health discussions, prioritise a supportive home environment, advocate for child support grants, revitalise school health services, and empower teenagers to make informed choices and resist peer pressure. Contribution: The study will provide guidance to policy makers and other stakeholders in developing appropriate programmes to address the problem and improve the health and socioeconomic status of adolescents in rural areas. This will reduce healthcare costs associated with complications and premature birth. Keywords: factors; teenager; pregnancy; tee

Adherence to Modern Contraceptives Among Female Refugee Adolescents in Northern Uganda: A Prospective Single Cohort Study.

Background: Contraceptive adherence is the current and consistent use of a contraceptive method as prescribed by a health worker or family planning provider so as to prevent pregnancy. Globally, adherence is lowest among adolescents. This has greatly contributed to the high burden of adolescent pregnancies. Adherence and reasons for discontinuation among refugee adolescents are poorly understood. The aim of this study was to determine the rates and predictors of adherence to modern contraceptives among female refugee adolescents in northern Uganda. Methods: This was a prospective single cohort study, nested into a randomised controlled trial (RCT) assessing the effect of peer counselling on acceptance of modern contraceptives. The RCT was conducted among female refugee adolescents in Palabek refugee settlement, northern Uganda. The study involved 272 new starters of modern contraceptives who were followed up for six months from May 2019 to January 2020. The outcome was measured at one, three, and six months after receiving a contraceptive method, and the predictors of adherence were determined using Generalised Estimating Equations (GEE). Data were analysed using STATA version 14.0. Results: Adherence rates were low and reduced over time. By the end of the six months, only 44% of the participants were using a contraceptive method. Participants using long-acting reversible contraceptives (LARC) were more likely to adhere compared to those who were using short-acting reversible contraceptives (SARC) (OR: 3.37, 95% CI: 1.914-5.937, p<0.001). Conclusion: Adherence to modern contraceptives was low, leaving adolescents at risk of unintended pregnancies. Participants using LARC were more likely to adhere than those using SARC. Interventions addressing fear of side effects and partner prohibition should be studied and implemented to enable adherence to modern contraceptives.