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1.
Rev Assoc Med Bras (1992) ; 65(6): 880-885, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31340320

RESUMO

OBJECTIVE: To analyze the temporal trend and factors associated with adolescent pregnancy during ten years in Brasil. METHODS: Data were extracted from the Live Births Information System, of the Brazilian Health System and included information regarding live births from adolescent mothers from 2006 to 2015. The overall proportion of gestation in adolescence and the specific proportions according to the characteristics analyzed were calculated using the standardized reporting coefficients and the simple linear regression method. The study was approved by the ethics committee of the University of Southern Santa Catarina (UNISUL). RESULTS: The general proportion of Live Births from adolescent mothers varied from 21.4% in 2006 to 18.1% in 2015. This reduction occurred because of the negative variation observed among mothers aged 15 to 19 years. The indigenous group was the only that did not present a reduction. There was an increase in the proportion of adolescents with between four and seven years of formal education and in the proportion of adolescents living with partners. There was a reduction in all Brazilian Regions and in large part of the Federation Units. CONCLUSION: The analysis of the temporal trend identifies a reduction in the proportion of live births among adolescent mothers in Brasil. However, there is a growing trend among some specific groups.


Assuntos
Gravidez na Adolescência/estatística & dados numéricos , Adolescente , Distribuição por Idade , Brasil/epidemiologia , Feminino , Humanos , Nascimento Vivo/epidemiologia , Idade Materna , Gravidez , Fatores Socioeconômicos , Análise Espaço-Temporal , Fatores de Tempo
2.
Georgian Med News ; (289): 15-20, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31215872

RESUMO

Teenage pregnancy has been a target for prevention in many countries. Teen motherhood may adversely influence social determinants of health, including education attainment, employment and reliance on welfare support. We compared socioeconomic factors and geographical influencers affecting teenage pregnancy and birth outcomes across Georgia and Australia. Georgia has a teenage pregnancy rate three times higher than Australia. However, there are similar proportions of contraceptive use between Georgian and Australian teenagers as well as increasing rates of sexual health literacy in both countries. Both countries, however, show a comparative deficiency in sexual health literacy for rural populations resulting in earlier sexual experiences in Georgia and higher teenage pregnancy rates in Australia with Indigenous teenage mothers over-represented. More age-appropriate sexual health and contraception education is required in both Georgia and Australia, especially for rural areas, Indigenous populations and ethnic minorities. Further research is needed to supply teenage pregnancy and birth data from Georgian population.


Assuntos
Gravidez na Adolescência , Distância Social , Adolescente , Austrália , Feminino , Georgia , Humanos , Incidência , Gravidez
3.
Cad. Ibero Am. Direito Sanit. (Impr.) ; 8(1): 110-118, jan.-mar. 2019.
Artigo em Português | LILACS | ID: biblio-996367

RESUMO

Objetivo: evidenciar o conflito normativo sobre a capacidade da adolescente grávida de feto anencefálico e o não respeito a sua capacidade autônoma na tomada de decisões. Metodologia:foi utilizada análise documental, revisão bibliográfica e legislativa. A população estudada pertence à faixa etária compreendida entre 12 anos e 17 anos, por ser definida no Código Civil Brasileiro, respectivamente, como fases de incapacidade absoluta e capacidade parcial para atos da vida civil. Resultados: necessidade da construção de propostas de ação que garantam capacidade autônoma às adolescentes sobre o exercício do seu direito à privacidade e à saúde. (AU)


Objetivo: evidenciar el conflicto normativo sobre la capacidad de la adolescente embarazada de feto anencefálico y el no respeto a su capacidad autónoma en la toma de decisiones. Metodología: se utilizó análisis documental, con realización revisión bibliográfica y legislativa. La población estudiada pertence a la franja etaria comprendida entre 12 años y 17 años, por ser definida en el Código Civil Brasileño respectivamente como: fases de incapacidad absoluta y capacidad parcial para actos de la vida civil. Resultados: necesidad de la construcción de propuestas de acción que garantan la capacidad autónoma de las adolescentes sobre el ejercicio de su derecho a la privacidad ya la salud. (AU)


Objective: highlight the normative conflict about the capacity of pregnant adolescent anencephalic fetus and the lack of respect for their autonomous capacity in decision making. Methodology: documentary analysis with bibliographical and legislative revision. The population studied belongs to the age range between 12 years and 17 years, since it is defined in the Brazilian Civil Code respectively as: phases of absolute incapacity and partial capacity for acts of civil life. Results: need to construct proposals for action that guarantee the adolescentes their autonomous capacity on the exercise of their right to privacy and health. (AU)


Assuntos
Humanos , Feminino , Gravidez , Gravidez na Adolescência , Aborto Eugênico , Feto/anormalidades
4.
BMC Public Health ; 19(1): 601, 2019 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-31101101

RESUMO

BACKGROUND: In Ethiopia, pregnancy, and childbearing begin at an early age. Teenage pregnancy has long-term implications for girls, their families, and communities. However, multilevel predictors of teenage pregnancy are not well studied yet. Several studies are focused only on the effects of individual-level characteristics but ignored the community level effect. This, in turn, could result in biased estimation of predictors of teenage pregnancy. Therefore, this study aimed to identify the individual and community level factors that determine teenage pregnancy in Ethiopia. METHOD: The data were extracted from the 2016 Ethiopian Demographic and Health Survey. The study included a sample from 645 clusters of 2679 (weighted) women aged 20-24 years. The data were collected using a two-stage cluster design that includes selection of enumeration areas as a first stage and selection of households as a second stage. A two-level mixed-effect logistic regression model was fitted to determine the individual and community level factors associated with teenage pregnancy. RESULT: The study revealed that 2134(79.6%) of women aged 20-24 years experienced pregnancy during their adolescent stage. Being sexually active before age 15[AOR = 7.9; 95%CI: 4.5, 13.8]; being married before age 15[AOR = 30; 9%CI: 16.7, 53.9] and being a rural dweller [AOR = 2.2; 95%CI: 1.4, 3.6] were positively associated with teenage pregnancy. A woman living in a community with a lower proportion of contraceptive users [AOR = 2.3; 95%CI: 1.5, 3.5]; had also a statistically significant association with teenage pregnancy. CONCLUSIONS AND RECOMMENDATION: Various factors at both the individual and community level determined teenage pregnancy. Therefore, the government should work on the prevention of early marriage, early sexual initiation and on improving the utilization of family planning in the community to protect them from pregnancy that occur at early age.


Assuntos
Gravidez na Adolescência/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Adolescente , Fatores Etários , Análise por Conglomerados , Comportamento Contraceptivo/estatística & dados numéricos , Demografia , Etiópia/epidemiologia , Feminino , Humanos , Modelos Logísticos , Análise Multinível , Gravidez , Fatores de Risco , População Rural/estatística & dados numéricos , Adulto Jovem
5.
S D Med ; 72(3): 131-132, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31018060

RESUMO

This article discusses the historical trauma and modern struggles of Oglala Lakota Sioux tribal members on the Pine Ridge Indian Reservation in southwestern South Dakota. In order for healthcare providers to understand why patients from this region have soaring rates of diabetes, teen pregnancies and premature death, it is important to have exposure to their culture and daily life. As part of their medical school curriculum, students at the Sanford School of Medicine take part in cultural immersion trips in order to better understand and relate to the people on the Pine Ridge Reservation. These experiences are led by local Lakota people and allow students to be exposed to the modern healthcare and government facilities, and also take part in traditional ceremonies such as drumming circles and art shows. By the end of the journey, future physicians leave with a better understanding of day-to-day Lakota life and increased empathy and understanding for their Native American counterparts.


Assuntos
Assistência à Saúde Culturalmente Competente , Diabetes Mellitus/etnologia , Diabetes Mellitus/prevenção & controle , Índios Norte-Americanos , Gravidez na Adolescência , Adolescente , Adulto , Assistência à Saúde , Feminino , Humanos , Masculino , Gravidez , Gravidez na Adolescência/etnologia , Gravidez na Adolescência/prevenção & controle , South Dakota
6.
Afr J Reprod Health ; 23(1): 73-87, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31034174

RESUMO

In the era of HIV/AIDS, repeat pregnancies among adolescents indicate the growing problem of high-risk sexual behavior and the status of reproductive health services. A cross sectional survey was conducted to establish the prevalence and risk factors of repeat pregnancies among South African adolescents. A total of 326 adolescents participated in this study at a district hospital in, KwaZulu-Natal, South Africa from June 2017 to November 2017. Data was analysed using R Software. Out of the 326 adolescents, 19.9% had experienced a repeat pregnancy. The risk factors associated with adolescent repeat pregnancy included a history of spontaneous abortion (p <0.001) and previous contraceptive use (p <0.001). A higher level of education (p <0.001) and emotional support from family (p=0.007) were found to be significant protective factors against adolescent repeat pregnancy. These findings have implications for future interventions aimed at reducing repeat pregnancy among adolescents.


Assuntos
Aborto Espontâneo/epidemiologia , Comportamento do Adolescente , Infecções por HIV/prevenção & controle , Gravidez na Adolescência/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Adolescente , Anticoncepção , Comportamento Contraceptivo , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Humanos , Gravidez , Prevalência , Fatores de Risco , África do Sul/epidemiologia , Adulto Jovem
7.
MCN Am J Matern Child Nurs ; 44(3): 150-156, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31034454

RESUMO

PURPOSE: The purpose of the study was to explore the associations among mastery, self-esteem, and HIV risk reduction behaviors in a culturally diverse group of adolescent girls. It is important to identify and assess psychological determinants of HIV risk reduction behaviors such as mastery and self-esteem so that healthcare interventions may be tailored to maximize an adolescent's preventive efforts. STUDY DESIGN AND METHODS: Black, Latina, and White adolescent girls were recruited from an urban primary care setting in a tertiary care center. A descriptive, correlational design was used. Measures included the Pearlin Mastery Scale, Rosenberg Self-Esteem Scale, and the Adolescent Problem Severity Index. Data were collected through written surveys completed anonymously. Data were analyzed using multiple regression analysis. RESULTS: There were 224 participants. Mastery and self-esteem, variables that commonly explain health-enhancing behaviors, were not associated with HIV risk reduction behaviors either in the entire sample or cultural subgroups. There was an inverse relationship between age and HIV risk reduction behaviors in all cultural groups. There were no significant differences in HIV risk reduction behaviors among the three cultural groups. CLINICAL NURSING IMPLICATIONS: Findings suggest HIV prevention efforts by nurses should be universal regardless of an adolescent girl's presumed level of mastery and self-esteem, and that these efforts need to intensify as they age.


Assuntos
Infecções por HIV/diagnóstico , Gravidez na Adolescência/psicologia , Comportamento de Redução do Risco , Adolescente , Comportamento do Adolescente/psicologia , Grupos de Populações Continentais/psicologia , Grupos de Populações Continentais/estatística & dados numéricos , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Humanos , Gravidez , Psicometria/instrumentação , Psicometria/métodos , Assunção de Riscos , Autoeficácia , Inquéritos e Questionários , Adulto Jovem
8.
Artigo em Inglês | MEDLINE | ID: mdl-30959770

RESUMO

It has been proposed that, in the Mexican culture, family support can be a factor that contributes to protect the maternal and child health of pregnant adolescents. There may be complex associations between family support and the circumstances of a pregnancy during adolescence. The aim of the study was to analyze the association between the family support network (FSN) characteristic and the maternal and neonatal outcomes in Mexican adolescents. A cross-sectional study was conducted, and 352 pregnant adolescents participated; their FSN during pregnancy was assessed. The gestational weight gain and birth weight/length of newborns were registered. The size of the FSN was described and divided into quartiles; the main members for each quartile were identified. Then, sociodemographic and clinical variables were compared by FSN quartiles. Logistic regression models were performed to assess the association of FSN size and pregnancy and neonatal outcomes. Our results indicate that the mean age was 15 ± 1 year old. The primary support member in the FSN was the mother of the adolescent in each quartile, except for quartile 3, where the primary support was the mother-in-law. In quartile 3 there was a significantly lower gestational weight gain compared to quartile 4 (11.8 ± 5 vs. 13 ± 5 kg, p = 0.054). According to the regression model, a higher risk of small for gestational age (OR 2.99, CI 95% 1.25⁻7.15) newborns was found in quartile 3. We conclude that the maternal and neonatal outcomes did not differ between quartiles of FSN size, except for quartile 3. Small for gestational age newborns were observed when a non-blood relative was present in the FSN. The quality rather than the network size might be more important for improving pregnancy outcomes.


Assuntos
Saúde da Criança , Saúde Materna , Resultado da Gravidez , Gravidez na Adolescência/psicologia , Gestantes/psicologia , Rede Social , Apoio Social , Adolescente , Peso ao Nascer , Criança , Estudos Transversais , Feminino , Ganho de Peso na Gestação , Humanos , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Modelos Logísticos , México , Gravidez
9.
Sex Reprod Healthc ; 19: 50-55, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30928135

RESUMO

OBJECTIVE: This longitudinal study examined access to, and factors associated with, receipt of sexual and reproductive health services deemed essential by the World Health Organization among pregnant adolescents in New York City. METHODS: Participants included 649 pregnant adolescents, ages 14-21 who were enrolled in a clustered randomized controlled trial from 2008 to 2012. Data were collected via medical record abstraction and structured surveys during the second and third trimesters of pregnancy and 12-months postpartum. We used multivariable logistic regression to test associations between measures of social and economic vulnerability (age, race/ethnicity, immigration status, food and housing security, relationship status, perceived discrimination) and access to core sexual and reproductive health services (perinatal care, contraception, HIV testing, sexual health knowledge). RESULTS: Only 4% of participants received all four core aspects of sexual and reproductive health assessed. Adolescents <18 years old had lower odds of contraception use (OR = 0.46, CI 0.27-0.78), having had an HIV test (OR = 0.35, CI 0.16-0.78), and high sexual health knowledge (OR = 0. 59, CI 0.37-0.95), compared to those ≥18 years. Black women were significantly more likely to have high sexual health knowledge compared to other women (OR = 1.84, CI 1.05, 3.22). Immigrants had higher odds of adequate perinatal care (OR = 1.60, CI 1.09-2.36) and contraception use (OR = 1.64, CI 1.07-2.53), but lower likelihood of high sexual health knowledge (OR = 0.52, CI 0.34-0.81), compared to US-born counterparts. Food insecurity was associated with lower likelihood of comprehensive perinatal care (OR = 0.63, CI 0.45-0.90). CONCLUSIONS: Access to sexual and reproductive health services in New York City is poor among vulnerable adolescents. Health practice and policy should assure access to fundamental sexual and reproductive health services among vulnerable populations in the United States.


Assuntos
Comportamento Contraceptivo/estatística & dados numéricos , Infecções por HIV/diagnóstico , Conhecimentos, Atitudes e Prática em Saúde , Acesso aos Serviços de Saúde , Assistência Perinatal , Serviços de Saúde Reprodutiva/provisão & distribução , Adolescente , Fatores Etários , Anticoncepcionais/provisão & distribução , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Abastecimento de Alimentos , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Humanos , Estudos Longitudinais , Cidade de Nova Iorque , Gravidez , Gravidez na Adolescência , Saúde Sexual , Inquéritos e Questionários , Adulto Jovem
10.
BMC Res Notes ; 12(1): 116, 2019 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-30832719

RESUMO

OBJECTIVE: There have been many studies on the nutritional status of under-fives and factors responsible but very few looks at this special group of women. This study assessed the breastfeeding practices of teenage mothers and determined its association with the nutritional indices of their under-five children. The study was a descriptive cross-sectional survey. A total of 300 mother-child pair was selected using a multi-stage sampling technique from Primary Health Care centres in Ondo West Local Government Area, Ondo State, Nigeria. Bivariate and multivariate logistic regression were done to identify predictors' of poor nutritional status at p < 0.05. RESULTS: About 87% initiated breastfeeding less than 1 h after birth while 31.9% breastfed their children exclusively for 6 months. Prevalence of stunting, wasting and underweight among the under-fives were 18.6%, 25.3%, and 29.5% respectively. Initiation of breastfeeding more than 1 h after birth increased the odds of stunting (OR = 9.551, CI = 1.279-16.310) and underweight (OR = 6.674, CI = 3.159-14.097) by about 10 and 7 times respectively. Whereas odds of wasting (OR = 2.346, CI = 1.228-4.480) was 2 times higher with breastfeeding duration less than 6 months. Therefore, education of teenage mothers on breastfeeding initiation and duration is vital in reducing malnutrition among under-fives.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Fenômenos Fisiológicos da Nutrição Infantil , Transtornos do Crescimento/epidemiologia , Estado Nutricional , Gravidez na Adolescência/estatística & dados numéricos , Magreza/epidemiologia , Síndrome de Emaciação/epidemiologia , Adolescente , Adulto , Fenômenos Fisiológicos da Nutrição Infantil/fisiologia , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Nigéria , Estado Nutricional/fisiologia , Gravidez , Adulto Jovem
11.
Reprod Health ; 16(1): 35, 2019 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-30890170

RESUMO

BACKGROUND: Humanitarian crises and migration make girls and women more vulnerable to poor sexual and reproductive health (SRH) outcomes. Nevertheless, there is still a dearth of information on SRH outcomes and access to SRH services among refugee girls and young women in Africa. We conducted a mixed-methods study to assess SRH experiences, knowledge and access to services of refugee girls in the Nakivale settlement, Uganda. METHODS: A cross-sectional survey among 260 adolescent girls 13-19 years old was conducted between March and May 2018. Concurrently, in-depth interviews were conducted among a subset of 28 adolescents. For both methods, information was collected regarding SRH knowledge, experiences and access to services and commodities. The questionnaire was entered directly on the tablets using the Magpi® app. Descriptive statistical analysis and multinomial logistic regression were performed. Qualitative data was transcribed and analysed using thematic content analysis. RESULTS: A total of 260 participants were interviewed, with a median age of 15.9 years. The majority of girls were born in DR Congo and Burundi. Of the 93% of girls who had experienced menstruation, 43% had ever missed school due to menstruation. Regarding SRH knowledge, a total of 11.7% were not aware of how HIV is prevented, 15.7% did not know any STI and 13.8% were not familiar with any method to prevent pregnancy. A total of 30 girls from 260 were sexually active, of which 11 had experienced forced sexual intercourse. The latter occurred during conflict, in transit or within the camp. A total of 27 of 260 participants had undergone female genital mutilation (FGM). The most preferred sources for SRH information was parents or guardians, although participants expressed that they were afraid or shy to discuss other sexuality topics apart from menstruation with parents. A total of 30% of the female adolescents had ever visited a SRH service centre, mostly to test for HIV and to seek medical aid for menstrual problems. CONCLUSIONS: Adolescent refugee girls lack adequate SRH information, experience poor SRH outcomes including school absence due to menstruation, sexual violence and FGM. Comprehensive SRH services including sexuality education, barrier-free access to SRH services and parental involvement are recommended.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Acesso aos Serviços de Saúde , Refugiados/psicologia , Serviços de Saúde Reprodutiva , Comportamento Sexual/psicologia , Adolescente , Estudos Transversais , Feminino , Humanos , Gravidez , Gravidez na Adolescência , Delitos Sexuais , Saúde Sexual , Migrantes , Uganda , Adulto Jovem
12.
Midwifery ; 72: 74-79, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30825792

RESUMO

BACKGROUND: Uganda has one of the highest teenage pregnancy rates in Sub-Saharan Africa and the world. About a quarter of teenagers become pregnant annually. This is much higher than the global rate of 11%. When a teenager becomes pregnant, caring responsibilities are usually shared between the teenage mother and the baby's grandmother. Previous research has largely focused on the experiences of teenagers, leaving out the parents and caregivers. This paper describes parents and caretakers' perceptions and concerns about accessibility of antenatal services by pregnant teenagers in three divisions of Mbarara Municipality in southwestern Uganda. METHODS: This was a qualitative cross-sectional descriptive study. Thirty in-depth interviews with parents and caregivers were conducted. The study was conducted in the Nyamitanga, Kakoba and Kamukuzi divisions in Mbarara Municipality, southwestern Uganda. Data analysis was done manually by identifying emergent themes which were then coded and organized into concepts which were later developed into explanations. RESULTS: According to parents and other caregivers, teenage pregnancy is considered a significant challenge both for themselves and for the teenagers. Often, pregnant teenagers lack information on the available antenatal care services. They struggle with stigma and also lack social and financial support from parents. In addition, the teenagers lack support from reproductive health workers. The parents and caregivers also struggle with the stigma of their children's pregnancy and are often unaware of any available teenager friendly ANC services. CONCLUSIONS: Parents and caregivers find it difficult to cope with their children's pregnancy. They are not aware of any existing teenager-friendly antenatal services, yet antenatal services specifically targeting teenagers are necessary. In planning programs for antenatal services, parents and caregivers also need to be equipped with knowledge and skills required for them to guide and support the pregnant teenagers.


Assuntos
Acesso aos Serviços de Saúde/normas , Pais/psicologia , Percepção , Gravidez na Adolescência/psicologia , Adolescente , Comportamento do Adolescente/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Gravidez , Cuidado Pré-Natal/métodos , Cuidado Pré-Natal/normas , Pesquisa Qualitativa , Uganda
13.
Artigo em Inglês | MEDLINE | ID: mdl-30897835

RESUMO

Adolescent pregnancy rates are high worldwide. However, insufficient information exists regarding the frequency of birth control methods used before the first pregnancy and postpartum. In the current study, we analyzed the association of sociodemographic factors with the knowledge of birth control methods and their use before and after pregnancy in a sample of adolescents in Mexico City. A cohort study was conducted on 600 pregnant adolescents in Mexico City, from 2013 to 2017, at a health care institution providing prenatal care. Participants were assessed during the second trimester and four months postpartum. The questionnaire explored the knowledge of birth control methods, their use, and other associated factors. Two logistic regression models were implemented to identify potential variables associated with the lack of birth control method use before and after pregnancy. The mean age of participants was 15.4 + 1 years, of which, 48% and 65.2% used a birth control method before pregnancy and postpartum, respectively. We found that the main factors associated with increased risk of not using any birth control method before pregnancy included being under the age of 15 years, school dropout, having an educational lag, initiation of sexual life before the age of 15, and having a mother who did not inform their child about contraceptives. By contrast, variables associated with a higher risk of not using any contraceptive methods after pregnancy included educational lag, lower level of education, and the fact that the adolescent had not used any birth control prior to the pregnancy.


Assuntos
Anticoncepção/estatística & dados numéricos , Gravidez na Adolescência/estatística & dados numéricos , Adolescente , Fatores Etários , Estudos de Coortes , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Modelos Logísticos , México , Gravidez , Cuidado Pré-Natal , Comportamento Sexual , Fatores Socioeconômicos , Evasão Escolar , Inquéritos e Questionários
14.
Artigo em Inglês | MEDLINE | ID: mdl-30791604

RESUMO

As reported by the World Health Organization in 2017, there are 2 million+ young people living with HIV worldwide. The World Health Organization also reported that a third of all new HIV infections around the world are estimated to occur among youths (aged 15⁻25). and teen pregnancy rates are on the rise in many places. These worrying trends suggest that existing sexuality education programs and interventions may be inadequate and/or ineffective. Although the 1994 International Conference on Population and Development's (ICPD) Programme of Action highlighted the roles of Governments to offer sex education to young people to promote teenage reproductive health, yet inconsistency exists in the related initiatives in the global context. The present article aims to provide a comprehensive literature review of the existing sexuality programs in selected places in both English-speaking (i.e., the United States of America, the United Kingdom) and Chinese-speaking contexts (i.e., Hong Kong, Mainland China, and Taiwan). Based on the review, observations and implications for sexuality education policy and practice, as well as recommendations for future research for youths are outlined.


Assuntos
Características Culturais , Educação Sexual , Adolescente , Adulto , China , Feminino , Infecções por HIV/epidemiologia , Hong Kong , Humanos , Gravidez , Gravidez na Adolescência , Saúde Reprodutiva , Comportamento Sexual , Sexualidade , Taiwan , Reino Unido , Estados Unidos , Organização Mundial da Saúde , Adulto Jovem
15.
Artigo em Inglês | MEDLINE | ID: mdl-30736271

RESUMO

A clear need exists for teen pregnancy prevention programs that are responsive to the specific needs and cultural contexts of Native American communities. Recent data indicates that the birth rate for Native teens is nearly two and a half times the rate for White teens (32.9 versus 13.2). To address this disparity, we conducted formative research with Northern Plains Native American community members, resulting in My Journey, a culturally attuned curriculum for 6⁻8th graders. My Journey is grounded in traditional values and teachings to promote self-efficacy in sexual health decision-making and engagement in prosocial behaviors. We conducted a pilot study with 6⁻8th grade students (n = 45), aged 11⁻14 years (22 females, 23 males). Pilot study findings confirm program feasibility and acceptability. The process evaluation revealed that teachers liked the curriculum, particularly its adaptability of cultural components and ease of student engagement. The outcome evaluation demonstrated that My Journey provided an avenue for NA youth to increase their sex refusal self-efficacy. Application of the culture cube framework revealed My Journey has made a meaningful practice-based evidence contribution as a community-defined, culturally integrated curriculum that is effective. Future directions include broader implementation of My Journey, including adaption for additional populations.


Assuntos
Comportamento do Adolescente/psicologia , Competência Cultural , Índios Norte-Americanos/educação , Índios Norte-Americanos/psicologia , Gravidez na Adolescência/prevenção & controle , Autoeficácia , Educação Sexual/métodos , Adolescente , Criança , Currículo , Tomada de Decisões , Feminino , Humanos , Masculino , Grupos Minoritários/educação , Grupos Minoritários/psicologia , Projetos Piloto , Gravidez , Gravidez na Adolescência/etnologia , Estados Unidos/etnologia
16.
Int J Gynaecol Obstet ; 145(1): 54-61, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30706467

RESUMO

OBJECTIVE: To evaluate the risk of adverse maternal outcomes among adolescents experiencing a repeat pregnancy in the Philippines. METHODS: Data were analyzed from four waves (1998-2013) of a cross-sectional nationally representative survey. We included 2518 non-nulliparous and non-pregnant women aged 15-44 years with an interpregnancy interval (IPI) of 24 months or less. Multivariate logistic regression was used to measure the association of repeat pregnancy with adverse maternal outcomes by age group (11-19, 20-24, and 25-45 years), accounting for clustering within each respondent. A stratified analysis by IPI (≤24 vs >24 months) was conducted among 11-19 year olds. RESULTS: No association was observed between repeat pregnancy and low birthweight among adolescent mothers. A second pregnancy increased the risk of pregnancy (adjusted odds ratio [OR] 10.49, 95% confidence interval [CI] 4.00-27.49) and labor (adjusted OR 3.61, 95% CI 1.61-8.09) complications among adolescent women (11-19 years). Interaction tests showed there was a significant increase in these risks as compared with older women. Stratified analysis by IPI did not modify the observed effect for either outcome. CONCLUSION: Repeat pregnancy among Filipino adolescents increased the risk of pregnancy and labor complications irrespective of IPI.


Assuntos
Número de Gestações , Complicações do Trabalho de Parto/epidemiologia , Gravidez na Adolescência , Adolescente , Adulto , Fatores Etários , Criança , Estudos Transversais , Feminino , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Idade Materna , Razão de Chances , Filipinas/epidemiologia , Gravidez , Resultado da Gravidez/epidemiologia , Fatores de Risco , Adulto Jovem
17.
BMC Public Health ; 19(1): 226, 2019 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-30795754

RESUMO

BACKGROUND: Adolescents from rural areas in low-middle income countries face increasing physical and mental health challenges that are not well characterized or addressed due to resource limitations. We used the Global School-based Student Health Survey (GSHS) to describe adolescent health behaviors, and to inform prioritization of health promotion efforts in a resource-limited, rural, agricultural region in Guatemala. METHODS: In July 2015, a group of volunteers administered the GSHS to students from seven schools in four communities in the southwest Trifinio region of Guatemala. Prevalence and predictors of nutritional, mental, and sexual health behaviors were calculated from survey responses, and summarized in region- and school-level reports. Facilitated discussion of survey results with local leadership in January 2016 led to the identification of priorities for school-based health interventions. RESULTS: Five hundred fifty-four out of 620 (87%) students aged 12-18 years completed the survey. Prevalence of unhealthy dietary behaviors and body size was high: 61% reported high current soft drink intake, 18% were overweight, and 31% were moderate-severely stunted. In multivariable regression models, being food insecure was marginally associated with being underweight/stunted (OR = 1.95, 95%CI = 0.95-4.0). Boys were more likely than girls to report being sexually active (25% versus 6.4%, p < 0.001). Local school leadership identified food insecurity and sexual education as priority areas for intervention, and made plans for providing breakfast in schools, sexual education curriculum development and teacher training, and continued adolescent health reporting and evaluation. CONCLUSIONS: The GSHS is a rapid, cost-efficient, useful tool for surveillance of adolescent health behaviors in vulnerable, resource-limited populations. Results of a locally-administered GSHS informed school-based interventions to decrease food insecurity, early sexual initiation, and teen pregnancy in a rural Guatemalan region.


Assuntos
Comportamento do Adolescente , Saúde do Adolescente , Dieta , Comportamentos Relacionados com a Saúde , População Rural , Instituições Acadêmicas , Comportamento Sexual , Adolescente , Criança , Comportamento Infantil , Saúde da Criança , Feminino , Guatemala , Promoção da Saúde , Inquéritos Epidemiológicos , Humanos , Masculino , Sobrepeso/etiologia , Gravidez , Gravidez na Adolescência , Assunção de Riscos , Estudantes , Magreza/etiologia , Populações Vulneráveis
18.
BMC Pregnancy Childbirth ; 19(1): 59, 2019 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-30727995

RESUMO

BACKGROUND: Adolescent pregnancy remains a major challenge in both developed and developing countries. Early and unintended pregnancies among adolescents are associated with several adverse health, educational, social and economic outcomes. The aim of this study was to identify the contextual factors that influence adolescent pregnancy and early motherhood in five East African countries. METHODS: We use DHS data from five East African countries to examine trends and risk factors associated with adolescent pregnancy. DHS surveys collect detailed information on individual and household characteristics, sexual behavior, contraception, and related reproductive behaviors. Our analysis focuses on a weighted subsample of adolescent's age 15-19 years (Kenya, 5820; Tanzania, 2904; Uganda, 4263; Malawi, 5263; Zambia, 3675). Multilevel logistic regression analysis was used to identify the net effects of individual, household and community level contextual variables on adolescent pregnancy after adjusting for potential confounders. RESULTS: Adolescent pregnancy and early motherhood is common in the five countries, ranging from 18% among adolescents in Kenya (2014) to 29% in Malawi (2016) and Zambia (2014). Although all five countries experienced a decline in adolescent pregnancy since 1990, the declines have been largely inconsistent. More than half of the adolescent's most recent pregnancies and or births in these countries were unintended. The regression analysis found that educational attainment, age at first sex, household wealth, family structure and exposure to media were significantly associated with adolescent pregnancy in at least one of the five countries after adjusting for socio-demographic factors. CONCLUSION: The study highlights the importance of considering multi-sectoral approaches to addressing adolescent pregnancy. Broader development programs that have positive impacts on girls educational and employment opportunities may potentially influence their agency and decision-making around if and when to have children. Likewise, policies and programs that promote access to and uptake of adolescent sexual and reproductive health services are required to reduce barriers to the use of adolescent Sexual and Reproductive Health (SRH) services.


Assuntos
Mães/estatística & dados numéricos , Gravidez na Adolescência/estatística & dados numéricos , Adolescente , África Oriental/epidemiologia , Coito , Demografia , Escolaridade , Características da Família , Feminino , Humanos , Renda , Modelos Logísticos , Meios de Comunicação de Massa , Análise Multinível , Gravidez , Gravidez não Planejada , Fatores de Proteção , Fatores de Risco , Adulto Jovem
19.
Pediatr Ann ; 48(2): e51-e55, 2019 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-30747979

RESUMO

Contraceptive management is occurring more frequently in the primary care setting. Pediatricians should be familiar with the most common methods of contraception due to the fact that families are comfortable seeking care for their adolescents at the primary care office for these types of concerns. Contraceptive methods are often used for noncontraceptive benefits as well, which makes it even more important to feel comfortable prescribing contraceptives at pediatricians' offices. [Pediatr Ann. 2019;48(2):e51-e55.].


Assuntos
Anticoncepção/métodos , Aconselhamento/métodos , Gravidez na Adolescência/prevenção & controle , Atenção Primária à Saúde/métodos , Adolescente , Serviços de Saúde do Adolescente , Feminino , Humanos , Pediatras , Médicos de Atenção Primária , Gravidez
20.
Pediatr Ann ; 48(2): e78-e85, 2019 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-30747984

RESUMO

Contraception and sexual health form a key part of comprehensive health care for all adolescents, including those who suffer from chronic illness. Multiple studies have shown that adolescents with chronic illness have rates of sexual activity equal to or greater than their healthy counterparts. Primary care pediatricians have the most comprehensive view of the health of their medically complex patients and the benefit of a longstanding relationship. The Centers for Disease Control and Prevention have created a comprehensive guide that provides advice on safe contraceptive options for patients with complex medical conditions. Here we review three cases of adolescents with common chronic medical conditions: von Willebrand disease, systemic lupus erythematosus, and sickle cell disease. [Pediatr Ann. 2019;48(2):e78-e85.].


Assuntos
Doença Crônica/terapia , Anticoncepcionais/administração & dosagem , Necessidades e Demandas de Serviços de Saúde , Gravidez na Adolescência/prevenção & controle , Saúde Sexual , Adolescente , Anemia Falciforme/complicações , Anemia Falciforme/terapia , Feminino , Humanos , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/terapia , Gravidez , Comportamento Sexual , Adulto Jovem , Doenças de von Willebrand/complicações , Doenças de von Willebrand/terapia
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