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1.
Sultan Qaboos Univ Med J ; 24(3): 306-316, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39234325

RESUMEN

Adolescent mothers face numerous challenges while breastfeeding. This study aimed to assess the breastfeeding needs of adolescent mothers. For this systematic review, Web of Science, PubMed, Scopus, Cochrane Library, SID and Magiran databases were searched. The initial search yielded 2,290 studies, of which 41 were included in this review. Adolescent mothers' breastfeeding requirements were grouped into 8 categories: (1) social support from healthcare providers, partners and families; (2) school support for breastfeeding mothers; (3) breastfeeding counselling based on cultural sensitivities; (4) educational assistance from health providers for adolescent mothers' families; (5) changing harmful cultural values and judgments about adolescent mothers' breastfeeding; (6) additional home or outpatient visits in the days following hospital discharge; (7) peer support and counselling; and (8) economic needs. To promote breastfeeding, policymakers and healthcare providers should devise specifically tailored programmes and interventions to cater to the specific requirements of adolescent mothers.


Asunto(s)
Lactancia Materna , Madres , Humanos , Lactancia Materna/psicología , Lactancia Materna/estadística & datos numéricos , Lactancia Materna/métodos , Adolescente , Femenino , Madres/psicología , Madres/estadística & datos numéricos , Apoyo Social , Embarazo en Adolescencia/prevención & control , Embarazo en Adolescencia/estadística & datos numéricos , Embarazo en Adolescencia/psicología
2.
PLoS One ; 19(9): e0310025, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39240994

RESUMEN

BACKGROUND: Teenage pregnancy remains one of the major reproductive health problems, especially in sub-Saharan African countries. It can lead to maternal and neonatal complications and social consequences. The proportion of teenage pregnancy differs across regions of Ethiopia. Thus, this study aimed to determine the spatial variation in determinants of teenage pregnancy among adolescents aged 15-19 years in Ethiopia using the 2019 Demographic and Health Survey (DHS). METHODS: This study included a total weighted sample of 2165 teenage girls aged 15 to 19 years. A mixed-effect binary logistic regression model was employed to consider the hierarchical nature of the DHS data using STATA version 17. Adjusted odds ratios with 95% confidence intervals are reported, and a p-value less than 0.05 was used to identify significant predictors. The spatial analysis was conducted with ArcGIS version 10.7 and Python 3. To identify factors associated with the hotspots of teenage pregnancy, a multiscale geographically weighted regression (MGWR) was performed. Spatial regression models were compared using adjusted R2, the corrected Akaike information criterion (AICc), and the residual sum of squares (RSS). RESULTS: The prevalence of teenage pregnancy among adolescents aged 15 to 19 years was 12.98% (95% CI: 11.6%, 14.5%). It was spatially clustered throughout the country with a significant Moran's I value. Significant hotspot areas were detected in central and southern Afar; northern, central, and western Gambela; northeastern and southern central Oromia; and the eastern Somali region. The MGWR analysis revealed that the significant predictors of spatial variations in teenage pregnancy were being illiterate and being married. Based on the multivariable multilevel analysis, age 17 (AOR = 3.54; 95% CI: 1.60, 7.81), 18 (AOR = 8.21; 95% CI: 3.96, 17.0), 19 (AOR = 15.0; 95% CI: 6.84, 32.9), being literate (AOR = 0.57; 95% CI: 0.35, 0.92), being married (AOR = 22.8; 95% CI: 14.1, 37.0), age of household head (AOR = 0.98; 95% CI: 0.98, 0.99) and residing in the Gambela region (AOR = 3.27; 95% CI: 1.21, 8.86) were significantly associated with teenage pregnancy among adolescents aged 15 to 19. CONCLUSION: Teenage pregnancy is a public health problem in Ethiopia. Policymakers should prioritize addressing early marriage and improving teenage literacy rates, with a focus on the Gambela region and other hotspot areas. It is crucial to implement policies aimed at transforming the traditional practice of early marriage and to take measures to enhance literacy levels and promote awareness about sexual and reproductive health at the family and school levels. This will help ensure that young people have the opportunity to pursue education and make informed decisions about their reproductive health.


Asunto(s)
Encuestas Epidemiológicas , Embarazo en Adolescencia , Adolescente , Humanos , Embarazo en Adolescencia/estadística & datos numéricos , Etiopía/epidemiología , Femenino , Embarazo , Adulto Joven , Regresión Espacial , Factores Socioeconómicos , Prevalencia
3.
Afr J Reprod Health ; 28(8s): 115-121, 2024 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-39283478

RESUMEN

Togo, like other sub-Saharan African countries, is not spared from the phenomenon of teenage pregnancies. Each year, on average, about ten cases of teenage student pregnancies are recorded in schools. Despite multiple efforts by the Togolese government and non-governmental organizations to stem this phenomenon, it still persists and is growing. This paper aims to analyse the influence of the Vodou workshop practice on the occurrence of adolescent pregnancies. The paper relied on analysis of 105 Key Informant Interviews in four villages in the maritime region. The results reveal that the Vodou rites and initiations practices constitute a major preventable factor in the causation of early pregnancies among teenagers in rural Togo.


Le Togo, à l'instar d'autres pays de l'Afrique sub-Saharienne, n'est pas épargné du phénomène des grossesses précoces. Chaque année, en moyenne, une dizaine de cas de grossesses des élèves d'adolescentes est enregistrée dans les établissements scolaires. Malgré de multiples efforts déployés par le gouvernement togolais et les organisations non gouvernementales pour endiguer ce phénomène, il persiste toujours, et prend de l'ampleur. L'objectif de cet article est d'analyser l'influence de la pratique du culte Vodou sur la survenue des grossesses des adolescentes initiées. La recherche est basée sur l'analyse de 105 interviews individuels conduites dans quatre localités dans la région maritime. Les résultats révèlent que les rites et initiations pratiqués dans les couvents Vodou constituent un facteur de prévention des grossesses précoces chez les adolescentes initiées.


Asunto(s)
Embarazo en Adolescencia , Población Rural , Humanos , Femenino , Togo/epidemiología , Embarazo , Adolescente , Embarazo en Adolescencia/estadística & datos numéricos , Embarazo en Adolescencia/prevención & control , Incidencia , Conducta Sexual , Conocimientos, Actitudes y Práctica en Salud , Adulto Joven , Conducta Anticonceptiva/estadística & datos numéricos
4.
Afr J Reprod Health ; 28(8s): 122-129, 2024 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-39283587

RESUMEN

This article shows how certain traditional socio-cultural practices that influence the root causes of teenage pregnancy violate the rights of adolescents. The data came from the action-research entitled "Multisectoral and transformative approaches to rites and initiations for adolescent sexual and reproductive health rights", conducted by the Togolese Association for Family Welfare (ATBEF) in May 2022. The option is made for a qualitative approach. The information collected was recorded on dictaphones and then transcribed from the local languages of collection into French. Content analysis was used to write the research report. The results reveal that these practices, which are still prevalent in the localities of the study, and which exert pressure on adolescent girls, are also products of violations of many girls' rights.


Cet article montre en quoi certaines pratiques socio-culturelles traditionnelles qui influencent les causes profondes de la survenue des grossesses chez les adolescentes, constituent une violation des droits de ces dernières. Les données proviennent de la recherche action titrée « Approches multisectorielles et transformatrices des rites et initiations pour les droits en santé sexuelle et de la reproduction des adolescentes ¼, menée par l'Association Togolaise pour le Bien-Etre Familial (ATBEF) en mai 2022. L'option est faite pour une approche qualitative. Les informations collectées ont été enregistrées sur dictaphones puis transcrites des langues locales de collecte vers le français. L'analyse de contenu a été utilisée pour la rédaction du rapport de recherche. Les résultats révèlent que ces pratiques encore prégnantes dans les localités de l'étude et qui exercent des pressions sur les adolescentes, sont aussi des produits des violations de nombreux droits des filles.


Asunto(s)
Embarazo en Adolescencia , Normas Sociales , Humanos , Femenino , Adolescente , Embarazo , Normas Sociales/etnología , Togo , Conducta Sexual , Conducta del Adolescente/psicología , Investigación Cualitativa , Derechos Sexuales y Reproductivos , Cultura
5.
Afr J Reprod Health ; 28(8s): 145-154, 2024 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-39283680

RESUMEN

This study aims to measure the level of entry into motherhood among internally displaced adolescent girls in Kaya and Kongoussi communes, Burkina Faso, and to analyze the factors associated with it. Data were collected from 404 adolescent girls aged 12-19 years in a cross-sectional survey conducted between July and August 2021. The proportion of internally displaced adolescent girls who had started childbearing was 26.5%. Age, marital status and current use of modern contraception were found to be significantly associated with entry into motherhood among internally displaced adolescent girls. Marital status mediates the effect of religion and employment on entry of the adolescents into motherhood. The results suggest that actions aimed at preventing early marriage and improving employment opportunities among adolescent girls could potentially prevent their early entry into motherhood.


Cette étude vise à mesurer le niveau de l'entrée en vie féconde chez les adolescentes déplacées internes dans les communes de Kaya et Kongoussi, Burkina Faso, et d'analyser les facteurs qui y sont associés. Les données étaient recueillies auprès de 404 adolescentes âgées de 12-19 ans dans une enquête transversale réalisée entre juillet et août 2021. Le niveau de l'entrée en vie féconde chez les adolescentes déplacées internes était de 26,5%. L'âge, le statut matrimonial et l'utilisation actuelle de la contraception moderne ont été trouvés être significativement associés à l'entrée en vie féconde chez les adolescentes déplacées internes. Nous avons montré que le statut matrimonial médiatise l'effet de la religion et de l'emploi sur l'entrée en vie féconde. De tels résultats suggèrent que les actions visant à prévenir le mariage précoce et à améliorer les possibilités d'emploi chez les adolescentes pourrait potentiellement prévenir leur entrée précoce en vie féconde.


Asunto(s)
Refugiados , Humanos , Femenino , Adolescente , Burkina Faso , Estudios Transversales , Refugiados/psicología , Adulto Joven , Madres/psicología , Niño , Embarazo , Embarazo en Adolescencia/psicología , Conducta Anticonceptiva/psicología , Conducta Anticonceptiva/estadística & datos numéricos , Estado Civil , Factores Socioeconómicos
6.
Afr J Reprod Health ; 28(8s): 185-191, 2024 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-39284224

RESUMEN

Teenage pregnancy and marriage are major concerns in many schools in Togo, due to the large number of cases recorded each year by the Ministry of Primary, Secondary, Technical Education, and Handicrafts. The aim of this article is to describe the rites associated with early pregnancy and the perceptions held by the populations of Gando in the Savannah region. The study was based on documentary research and interviews with several actors, including initiating priests, canton chiefs, and young initiates. The results show that the rites: Okpenkpen, Tkonte, Ignogues have a link with early pregnancy, and the populations perceive them relatively well.


Les grossesses et mariages chez les adolescentes constituent une vive préoccupation dans beaucoup d'établissements scolaires au Togo en raison du nombre important de cas recensés chaque année par le Ministère des enseignements primaire, secondaire, technique et de l'artisanat. L'objectif de cet article est de décrire les rites ayant un lien avec les grossesses précoces et les perceptions qu'ont les populations de Gando dans la région des Savanes. Pour y parvenir, la méthodologie utilisée est basée sur la recherche documentaire et les entretiens avec plusieurs acteurs, entre autres, les prêtres initiateurs, les chefs de cantons et les jeunes initiés. Les résultats montrent que les rites : Okpenkpen, Tkonte, Ignogues ont un lien avec les grossesses précoces et les populations les perçoivent relativement bien.


Asunto(s)
Embarazo en Adolescencia , Conducta Sexual , Humanos , Femenino , Embarazo en Adolescencia/psicología , Togo , Adolescente , Embarazo , Conducta Sexual/psicología , Conducta del Adolescente/psicología , Catolicismo , Matrimonio/psicología
7.
Afr J Reprod Health ; 28(8s): 93-98, 2024 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-39270034

RESUMEN

The aim of this article is to understand the significance of the gender socialisation of adolescents and its impact on sexuality. This socio-anthropological study is based on qualitative surveys conducted as part of two action-research programmes implemented between 2018 and 2022 in Togo. The empirical data comes from individual semi-directed interviews, group interviews and life stories relating to the themes of sexuality, early pregnancy and gender-based violence. The results show that in these patriarchal societies, the socialisation of adolescents is structured around gender relations. The social construction of masculinity is based on a position of decision-making power for young boys, while that of femininity inculcates submissive behaviour in young girls. In these contexts, many young girls, even if they do attend school, find it difficult to express their opinions on matters of love and sex.


L'objectif de cet article consiste à appréhender la prégnance de la socialisation des adolescents.es et son impact sur la sexualité. Cette étude socio-anthropologique s'appuie sur des enquêtes qualitatives conduites dans le cadre de deux programmes de recherche action mis en œuvre entre 2018 à 2022 au Togo. Les données empiriques sont issues d'entretiens individuels semi-directifs, d'entretiens de groupes et de récits de vie relatifs aux thèmes de la sexualité, des grossesses précoces et des violences basées sur le genre. Les résultats indiquent que dans ces sociétés patriarcales, la socialisation des adolescents.es est structurée sur des rapports de genre. La construction sociale de la masculinité s'établit sur une position de pouvoir de décision des jeunes garçons tandis que celle de la féminité inculque aux jeunes filles des conduites de soumission. Dans ces contextes, de nombreuses jeunes filles, bien que scolarisées éprouvent des difficultés à exprimer leurs avis sur les questions amoureuses et sexuelles.


Asunto(s)
Masculinidad , Embarazo en Adolescencia , Conducta Sexual , Socialización , Humanos , Femenino , Adolescente , Embarazo en Adolescencia/psicología , Embarazo , Togo , Masculino , Conducta Sexual/psicología , Investigación Cualitativa , Conducta del Adolescente/psicología , Violencia de Género/psicología , Identidad de Género , Feminidad
8.
Afr J Reprod Health ; 28(8s): 11-14, 2024 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-39269190

RESUMEN

The African Journal of Reproductive Health is pleased to publish these compendiums of original research in this special edition that document new findings in adolescent sexual and reproductive health and rights from the West and Central African region (WCA). While sub-Saharan Africa has some of the worst indicators of sexual and reproductive health and rights (SRHR) in the world, the indicators are more daunting in the WCA region. To date, the WCA is recognized to have the highest rates of unwanted pregnancy, unsafe abortion, and human immunodeficiency virus (HIV) and other sexually transmissible infections, as well as the lowest contraceptive prevalence rates among adolescents worldwide.1 Despite the high rate of adverse adolescent reproductive health outcomes in WCA, there has been limited documentations of the socio-cultural and economic circumstances that perpetuate these adverse consequences. There have also been no purposefully designed interventions that provide strong scientific evidence for developing strategies to reverse the trend.


Le Journal africain de la santé reproductive est heureux de publier ces recueils de recherches originales dans cette édition spéciale qui documentent les nouvelles découvertes sur la santé et les droits sexuels et reproductifs des adolescents de la région de l'Afrique de l'Ouest et du Centre (WCA). Alors que l'Afrique subsaharienne possède certains des pires indicateurs au monde en matière de santé et de droits sexuels et reproductifs (SDSR), les indicateurs sont plus intimidants dans la région AOC. À ce jour, l'AOC est reconnue pour avoir les taux les plus élevés de grossesses non désirées, d'avortements à risque, de virus de l'immunodéficience humaine (VIH) et d'autres infections sexuellement transmissibles, ainsi que les taux de prévalence contraceptive les plus faibles parmi les adolescents dans le monde.1 Malgré le taux élevé de En dépit des résultats négatifs en matière de santé reproductive des adolescents en AOC, il existe peu de documentation sur les circonstances socioculturelles et économiques qui perpétuent ces conséquences néfastes. Il n'y a pas non plus d'interventions spécialement conçues qui fournissent des preuves scientifiques solides pour élaborer des stratégies visant à inverser la tendance.


Asunto(s)
Salud Reproductiva , Derechos Sexuales y Reproductivos , Salud Sexual , Humanos , Adolescente , Femenino , Embarazo , África Central/epidemiología , Embarazo en Adolescencia/estadística & datos numéricos , Infecciones por VIH/epidemiología , Conducta Sexual , Salud del Adolescente , África Occidental/epidemiología , Masculino , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/prevención & control , Aborto Inducido/legislación & jurisprudencia , Aborto Inducido/estadística & datos numéricos , Embarazo no Deseado
9.
J Pak Med Assoc ; 74(5 (Supple-5)): S74-S77, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-39221806

RESUMEN

Objective: To develop a software application for early detection of adolescent's risky behaviour, and promotion of safe reproductive health. METHODS: The multi-stage study was conducted from September 20, 2018, to April 3, 2019, at Rumbai District Pekanbaru, Riau-Indonesia. The planned software application was developed using the waterfall design model which is a sequential process. Every progress was acknowledged to be flowing downwards, like a waterfall, by going through the phases of requirements, design, implementation, verification and maintenance. The application software was pilot-tested on a group of adolescents after it was first tested for validity. The adolescents were given a questionnaire at baseline and 2 weeks after the intervention to assess the application's effectiveness. The data was analyzed using SPSS version 21. RESULTS: Validation of the tool was confirmed by Aiken's V values >0.85, with sensitivity 84.8% and specificity 75%. Of the 45 adolescents tested, majority respondens were girls 38(84,4%), early adolescent 18(40%), middle adolescent 16(35,5%) and late adolescent 11(24,4%). About 5(11.1%) were found to be positive, and 28(62.2%)were truly positive, while 3(6.7%) were found negative and 9(20%) were truly negative. There was a significant difference between the pre-test and post-test assessments (p=0.0001). Conclusion: The application proved to be effective for the early detection of risky behaviour, and for the promotion of safe reproductive health.


Asunto(s)
Embarazo en Adolescencia , Asunción de Riesgos , Programas Informáticos , Humanos , Adolescente , Femenino , Embarazo en Adolescencia/prevención & control , Embarazo , Masculino , Conducta del Adolescente/psicología , Conducta Sexual , Encuestas y Cuestionarios
10.
BMC Health Serv Res ; 24(1): 983, 2024 Aug 26.
Artículo en Inglés | MEDLINE | ID: mdl-39187823

RESUMEN

BACKGROUND: Integration of maternal mental health into primary health care is considered a strategy to improve access to mental health support in low- and middle-income countries (LMICs). Health care workers' (HCWs) and traditional practitioners' (traditional healers, herbalists, traditional birth attendants, spiritual healers, prophets, and community health volunteers) perceptions of the availability and management of adolescent mothers' maternal mental health care were explored in rural Malawi. Recognizing and identifying the barriers associated with access to maternal mental health support is essential to improving the mental health of adolescent mothers. METHODS: A descriptive qualitative design (DQ) was used to explore HCWs' and traditional practitioners' perceptions of maternal mental health services for adolescent mothers. In-depth interviews were conducted with HCWs (n = 6), and three focus group discussions were conducted with 30 community-based traditional practitioners. Participants were purposefully recruited because they provide formal or informal health services to adolescent mothers during the postnatal period at Mitundu Rural Hospital and its catchment area in Lilongwe District, in Malawi. Interviews were analyzed using reflective thematic analysis and inductive thinking. RESULTS: Thematic analysis found four themes to describe access to maternal mental health care for adolescent mothers. Participant perceptions were themed around health system challenges and how cultural background and beliefs influence access to mental health care and support. The themes were: (1) Inadequate staff development; (2) Limited resources (medication and infrastructure); (3) Limited policy and guidelines implementation; and (4) Cultural background and belief influence on help-seeking. HCWs suggested improving pre-service and in-service training to improve mental health assessment of mothers, while traditional practitioners wanted to increase their awareness of mental health issues. CONCLUSION: Participants emphasized that multifaceted factors influenced access to mental health support. These factors affect the assessment, treatment, and support of adolescent mothers and help-seeking by mothers. Therefore, strengthening the healthcare system and empowering providers with the knowledge and skills to recognize at-risk mothers and provide timely support is essential.


Asunto(s)
Grupos Focales , Accesibilidad a los Servicios de Salud , Servicios de Salud Materna , Madres , Investigación Cualitativa , Humanos , Malaui , Femenino , Adolescente , Madres/psicología , Trastornos Mentales/terapia , Servicios de Salud Mental , Entrevistas como Asunto , Actitud del Personal de Salud , Embarazo , Personal de Salud/psicología , Adulto , Embarazo en Adolescencia/psicología
11.
BMC Public Health ; 24(1): 2309, 2024 Aug 26.
Artículo en Inglés | MEDLINE | ID: mdl-39187826

RESUMEN

Teen mothers are more susceptible to the negative consequences of pregnancy, due to system-wide and socio-cultural barriers to accessing needed services, posing higher pregnancy complications and health risks to the babies and mothers. Understanding their lived experience can inform context-specific health programs and interventions that address their needs and improve the health outcomes. Twenty-three women who had delivered her first child before the age of 18 years were interviewed using semi-structured interview guide. The transcripts were coded, categorized and summarized into four major themes: 1) Many pregnant teen girls were disadvantaged by the system from accessing the healthcare services, 2) Although being judged, many found the health care services positive and important, 3) Faced financial difficulty in accessing health services, despite most medical services are covered by community based health insurance, 4) Health care services focuses mostly on the medical health of pregnancy, the social and psychological needs were mostly not available. The study highlighted the gap in providing mental health services, financial support to the teen mothers as part of a comprehensive health services. Some of them consulted health services for the first time with and did not return for follow up if perceived the services was bad. More sensitive and targeted materials and ANC services can be offered to this unique group of clients. More acceptance training to the health care providers and the public is needed. For health facilities, there is a need to also check their psychological wellbeing when seeking ANC services. Online or mobile phone-based mental health interventions may provide some solutions to the issue. Government should re-evaluate the health insurance system to avoid unintentional exclusion of this group of population. Policy to facilitate men to take responsibilities on teen pregnancy issue is needed.


Asunto(s)
Accesibilidad a los Servicios de Salud , Embarazo en Adolescencia , Humanos , Femenino , Adolescente , Embarazo , Embarazo en Adolescencia/psicología , Rwanda , Investigación Cualitativa , Entrevistas como Asunto , Madres/psicología , Madres/estadística & datos numéricos , Adulto Joven
12.
Cien Saude Colet ; 29(9): e10582024, 2024 Sep.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-39194112

RESUMEN

The objective was to analyze the spatial distribution of pregnancy in children under 14 years and six months by Brazilian region and municipality and sociodemographic and health characteristics of pregnant women and live births. Ecological study analyzing the Live Birth Information System (SINASC) from 2011 to 2021 in three age groups (< 14 years and six months, 15-19 years, and 20 years and above) by demographic and birth variables. We applied the Global and Local Moran. A total of 127,022 live births to girls aged 10-14 years were identified during the period, most of whom were Black, 21.1% in common-law or married relationships, with a lower proportion of seven prenatal care appointments and enrollment in the first trimester, a higher proportion of low birth weight and low Apgar score, residing in the North and Northeast. The mean live birth rate for 10-to-14-year-old girls was significantly autocorrelated with space, especially in municipalities of the Midwest and North. Pregnancy from 10 to 14 years of age reveals several vulnerabilities suffered by these girls due to pregnancy at an early age, which is more common among Black women, with implications for morbimortality for them and their children and the presumed violence in these cases, including denied access to legal abortion.


O objetivo foi analisar a distribuição espacial da gravidez em menores de 14 anos e seis meses segundo regiões e municípios brasileiros e características sociodemográficas e de saúde das parturientes e nascidos vivos. Estudo ecológico, analisando o Sistema de Informação sobre Nascidos Vivos (SINASC), 2011-2021, em três grupos etários (<14 anos e 6 meses, 15-19 e 20 anos e mais), segundo variáveis demográficas e do parto. Foram aplicados os Índices Global e Local de Moran. No período foram 127.022 nascidos vivos de meninas 10-14 anos, na maioria negras, 21,1% em união estável ou casadas, com menor proporção de 7 consultas de pré-natal e captação no primeiro trimestre, maior proporção de baixo peso ao nascer e baixo índice de Apgar, residentes nas regiões Norte e Nordeste. A taxa média de nascidos vivos de 10-14 anos mostrou autocorrelação significativa com o espaço, especialmente em municípios do Centro-Oeste e Norte. A gravidez de 10 a 14 revela uma sequência de vulnerabilidades sofridas por essas meninas, pela gravidez em idade precoce, maior frequência entre negras, com implicações na morbimortalidade para ela e seus filhos; e pela violência presumida nesses casos, incluindo o acesso negado ao aborto legal.


Asunto(s)
Nacimiento Vivo , Atención Prenatal , Análisis Espacial , Humanos , Brasil , Femenino , Embarazo , Adolescente , Niño , Adulto Joven , Atención Prenatal/estadística & datos numéricos , Recién Nacido de Bajo Peso , Embarazo en Adolescencia/estadística & datos numéricos , Lactante , Recién Nacido , Tasa de Natalidad/tendencias , Factores de Edad , Puntaje de Apgar , Población Negra/estadística & datos numéricos , Factores Socioeconómicos
13.
Afr J Prim Health Care Fam Med ; 16(1): e1-e11, 2024 Jul 16.
Artículo en Inglés | MEDLINE | ID: mdl-39099268

RESUMEN

BACKGROUND:  Poor access to contraception influences adolescent health outcomes and may lead to sexual and reproductive health challenges. Unmet sexual and reproductive health should contribute to unplanned adolescent pregnancies, sexually transmitted infections, and other conditions. Therefore, it is crucial to enable adolescents to access appropriate contraceptive methods easily. AIM:  This study explored factors influencing adolescents' access to contraceptive methods from the perspective of primary healthcare providers in South Africa. SETTING:  This study was conducted in two health districts of the Western Cape province in South Africa: the City of Cape Town Metropolitan Municipality and the West Coast district. METHODS:  Using a qualitative research design, in-depth semi-structured interviews were conducted with 24 healthcare providers who work in primary healthcare clinics. Subsequently, the interviews were transcribed and verified for errors. Braun and Clarke's thematic analysis model guided the data analysis using ATLAS.ti software (version 22). The study adhered to the consolidated criteria for reporting qualitative studies checklist for qualitative research. RESULTS:  Four themes emerged through the data analysis: (1) personal influences, (2) community-level influences, (3) health system influences, and (4) policy-level influences. Representative quotations were used to illustrate the themes and sub-themes. CONCLUSION:  Adolescence is shaped by various influences that affect adolescents' ability to access contraception. These factors include their awareness of contraception, social environment, provider biases and school policies. Understanding these influences is crucial for addressing unintended pregnancies and promoting sexual and reproductive health among this age group.Contribution: This study highlights strategies that facilitate and hinder adolescents' access to contraception.


Asunto(s)
Anticoncepción , Accesibilidad a los Servicios de Salud , Embarazo en Adolescencia , Investigación Cualitativa , Humanos , Sudáfrica , Adolescente , Femenino , Anticoncepción/psicología , Anticoncepción/estadística & datos numéricos , Masculino , Embarazo , Embarazo en Adolescencia/psicología , Actitud del Personal de Salud , Adulto , Personal de Salud/psicología , Entrevistas como Asunto , Atención Primaria de Salud , Conducta Anticonceptiva/psicología , Conducta Anticonceptiva/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud
14.
Int J Qual Stud Health Well-being ; 19(1): 2386715, 2024 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-39099139

RESUMEN

PURPOSE: Teenage pregnancy remains a significant global public health concern worldwide. However, it presents a complex phenomenon in developed countries, carrying potential short- and long-term consequences for both mothers and children. METHODS: This mixed method study used data from the French cross-sectional study "Portraits of adolescents", which included 6000 girls aged between 13 and 17 years. The quantitative approach involved comparisons between a subgroup with an history of pregnancy and their peers, examining their lived-experience and mental health. The qualitative approach investigated the question "What does being a teenager mean for you?" specifically for the girls who reported an history of pregnancy. RESULTS: Teenage pregnancies presented elevated rates of mental health disorders, including dark thoughts, depression, self-harm, participating in dangerous games, attempting suicide and increased use of psychoactive substances. With limited support, in comparison to their peers. The qualitative approach revealed three major themes: "being in action", "a way of feeling", and "quality of relationship". CONCLUSION: This vulnerable subgroup of adolescents suggests the need for a coordinated multidisciplinary healthcare approach, given their limited parental and friend support, with a high risk of experiencing poor mental health. Additionally, these findings portray a "silent sufferer" population characterized by difficulties recognizing or managing emotions due to difficulties in expressing their emotional distress.


Asunto(s)
Salud Mental , Embarazo en Adolescencia , Humanos , Adolescente , Femenino , Embarazo en Adolescencia/psicología , Francia , Embarazo , Estudios Transversales , Investigación Cualitativa , Conducta del Adolescente/psicología , Trastornos Mentales , Depresión , Trastornos Relacionados con Sustancias , Emociones , Intento de Suicidio , Conducta Autodestructiva/psicología , Grupo Paritario
15.
Midwifery ; 137: 104128, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39111123

RESUMEN

PROBLEM: Worldwide, 16 million girls give birth during adolescence each year, which has negative health, social, and economic consequences for adolescent women's future. BACKGROUND: Childbirths occurring between the ages of 13-19, before teenage girls have reached the age of maturity to handle the parenting role, are often unplanned. OBJECTIVE: The aim of this study was to gain a comprehensive understanding of lived childbirth experiences, identify the challenges of early motherhood, and explore the coping strategies employed by teenage mothers to overcome these challenges during the transition to motherhood. METHODS: Six commonly cited databases were used to retrieve articles using the SPIDER framework. We utilized the Walsh and Downe quality appraisal tool, which is considered the most appropriate fit for the current qualitative meta-synthesis. The thematic analysis approach was used to draw conclusions and generate hypotheses. RESULTS: This meta-synthesis showed that teenage mothers often encounter negative reactions from their partners, families, and communities due to their early childbirth. They face numerous challenges, including parenting incompetency, school dropout, conflict between adolescent interests and maternal responsibilities, emotional disturbance, and financial problems. Social support and self-efficacy are the main coping strategies to navigate these challenges and attain maternal competencies. CONCLUSION AND IMPLICATIONS: Families, peers, and midwives play a crucial role in providing parenting lessons for teenage mothers. Encouraging teenage mothers to believe in their capacities is an important coping strategy to facilitate a smoother motherhood transition. Further studies are needed to test the effectiveness of self-efficacy and social support interventions on teenage mothers' parenthood role attainment and in preventing mental health problems following childbirth.


Asunto(s)
Adaptación Psicológica , Parto , Embarazo en Adolescencia , Investigación Cualitativa , Humanos , Femenino , Adolescente , Embarazo , Embarazo en Adolescencia/psicología , Parto/psicología , Madres/psicología , Apoyo Social , Adulto Joven , Habilidades de Afrontamiento
16.
Reprod Health ; 21(1): 125, 2024 Aug 30.
Artículo en Inglés | MEDLINE | ID: mdl-39215327

RESUMEN

With a keen awareness of the size and health needs of the global adolescent population, governments, nongovernment organizations and the technical and funding agencies that support them continue to seek innovative answers to persistent programming challenges to increasing contraceptive use among sexually active adolescents. Adolescents 360 (A360) is a project implemented by Population Services International (PSI) and partners with funding from the Bill and Melinda Gates Foundation (BMGF) and the Children's Investment Fund Foundation (CIFF). The first phase of the project was implemented from 2016 - 2020 in Ethiopia, Nigeria, and Tanzania. A360 hypothesized that human centered design (HCD) could catalyze new insights into identifying and solving problems that limit adolescents' use of contraception. Despite initial promising results, A360 demonstrated very limited impact on modern contraceptive uptake among adolescents. The authors of this commentary were members of a technical advisory group to A360 and are uniquely positioned to provide insights on this project to complement those of A360's staff and evaluators, which are already in the public arena. Our analysis suggests that all stakeholders should take steps to rebalance their programs and investments to not only seek new solutions (i.e. game changers), but to also invest in the institutionalization of the solutions that have been generated over the past 40 years, prioritizing those that have shown evidence of effectiveness (i.e. adolescent responsive health service delivery) and those that demonstrate significant promise (i.e. social norm change).


Asunto(s)
Conducta Anticonceptiva , Servicios de Planificación Familiar , Humanos , Adolescente , Femenino , Anticoncepción , Conducta del Adolescente , Embarazo en Adolescencia/prevención & control , Masculino , Embarazo , Etiopía
17.
J Matern Fetal Neonatal Med ; 37(1): 2391490, 2024 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-39183188

RESUMEN

THE PURPOSE OF THE ARTICLE: The article aims to indicate the interdisciplinary and complex nature of the problem of adolescent pregnancy. MATERIALS AND METHODS: An analysis of materials contained in the literature on adolescent pregnancy was used. RESULTS: Adolescent pregnancy is both a serious health and social challenge. Lack of proper sex education, regressive age of sexual initiation, emotional immaturity and limited access to contraception are the main reasons for teenage pregnancy. It can also be the result of sexual abuse, which is a punishable offense. Pregnancy in minors is associated with a higher risk of complications for both the mother and the fetus, such as hypertension, preterm birth, low birth weight, fetal growth restriction, and preeclampsia. Pregnancy is a significant psychological burden and a major trauma for girls. Low socioeconomic status and lack of support from the family or partner exacerbate this problem, increasing the risk of depression and substance abuse. As a multidisciplinary problem, it requires action on multiple fronts to prevent it and to reduce the number of adolescent pregnancies. Increasing access to contraception, medical care, and sexual education is crucial in combating this issue. Adolescent pregnant women are a group of women who require special antenatal care. When planning educational activities for these patients, one should remember about the specific needs of said girls related to key nutrients such as iodine, iron, folic acid, and calcium. A poor diet may result from difficult living conditions and conflicts with family and partners. Moreover, this pregnancy is often unplanned. CONCLUSIONS: A good solution for pregnant adolescents would be the possibility of specialized assistance not only in gynecology and obstetrics, sexology, but also pedagogical, psychological, sociological and dietary.


Asunto(s)
Embarazo en Adolescencia , Humanos , Femenino , Embarazo , Embarazo en Adolescencia/psicología , Adolescente , Complicaciones del Embarazo/psicología , Complicaciones del Embarazo/epidemiología , Educación Sexual
18.
Eur J Psychotraumatol ; 15(1): 2387521, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39165197

RESUMEN

Background: The alarming prevalence of teen mothers' exposure to perinatal intimate partner violence (IPV, 8.3-67%) and attachment disorders (ADs) among their children is a global concern, especially in sub-Saharan Africa with high teenage pregnancy rates. This study, therefore, aimed to examine the link between teen IPV and AD in their offspring. We sought also to explore the mediating roles of postpartum depression symptoms, maternal sensitivity, parenting stress, and perceived social support in the relationship between perinatal IPV and children's ADs.Method: This cross-sectional study selected a random sample of 309 teen mothers from Nyanza district. This sample size was determined using Yamane's formula, with random sampling. Various instruments were used for data collection, including questionnaires on intimate partner violence, social support, maternal sensitivity, postpartum depression symptoms and parenting stress and early trauma-related disorders. The data was analysed using SPSS, with mediation analyses performed using the PROCESS macro (version 4.1).Results: IPV was found to be significantly associated with attachment disorders. Simple mediation models showed that parenting stress completely mediated these relationships, while postpartum depression, perceived social support, and maternal sensitivity partially mediated the relationship between IPV and children's ADs. In parallel mediation model, the combined roles of all mediators fully mediated the associations between IPV and ADs.Conclusion: These findings offer valuable insights in designing or strengthening the appropriate interventions to prevent and mitigate the perinatal intimate partner violence and its detrimental impact on children's attachment disorders. Combating intimate partner violence in post-conflict situations is challenging in teen mothers, however, our results suggest that efforts to address maternal mental health and parenting practices may protect children from attachment disorders.


Parenting stress was identified as a significant mediator, fully mediating the relationship between perinatal IPV and children's attachment disorders.Postpartum depression, perceived social support, and maternal sensitivity partially mediated the link between perinatal IPV and children's attachment disorders.The study underscores the necessity for multifaceted support programmes for adolescent mothers to address IPV, alleviate parenting stress, and enhance maternal mental health and social support, promoting better attachment outcomes for their children.


Asunto(s)
Violencia de Pareja , Madres , Embarazo en Adolescencia , Humanos , Femenino , Violencia de Pareja/estadística & datos numéricos , Violencia de Pareja/psicología , Adolescente , Estudios Transversales , Embarazo en Adolescencia/psicología , Embarazo en Adolescencia/estadística & datos numéricos , Embarazo , Rwanda , Madres/psicología , Madres/estadística & datos numéricos , Depresión Posparto/epidemiología , Depresión Posparto/psicología , Apoyo Social , Encuestas y Cuestionarios , Apego a Objetos , Responsabilidad Parental/psicología , Relaciones Madre-Hijo/psicología , Niño
19.
PLoS One ; 19(8): e0297317, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39088467

RESUMEN

OBJECTIVE: Adolescent pregnancy is a major social and public health problem that burdens affected families, the communities and societies globally. It has been associated with a higher prevalence of adverse pregnancy outcomes compared to pregnancy in adults. To compare adverse pregnancy outcomes in adolescents (13-19 years) and those in adults (20 to 35 years) at the Korle-Bu Teaching Hospital in Accra, Ghana and investigate the associated factors among adolescents. METHODS: This comparative study involved 110 adolescents (13-19 years) and 220 adults (20 to 35 years) who delivered at the Maternity Unit of the Korle-Bu Teaching Hospital between November 2016 and February 2017. Participants were recruited using the convenience sampling method. After study protocol was explained to the parturient, informed voluntary consent and assent were obtained. Participants who met the inclusion criteria were recruited in the study. Sociodemographic characteristics, antenatal and delivery records; and maternal and perinatal outcomes were collected using an interviewer administered questionnaire and the participants' records. Data analysis was done using SPSS version 16.0. RESULTS: The prevalence of adolescent pregnancies during the study period was 5.1%. Compared to adults, adolescents were about 3 times more likely to have eclampsia although preeclampsia occurred more in adults. Adolescents that resided in sub-urban dwellings were more likely to have an adverse perinatal outcome compared to their adult counterparts. CONCLUSION: Our study found that, in addition to their socioeconomic and biophysical disadvantages, adolescents were likely to have exceptionally high risk of eclampsia.


Asunto(s)
Resultado del Embarazo , Embarazo en Adolescencia , Humanos , Femenino , Embarazo , Adolescente , Adulto , Adulto Joven , Resultado del Embarazo/epidemiología , Embarazo en Adolescencia/estadística & datos numéricos , Recién Nacido , Ghana/epidemiología , África del Sur del Sahara/epidemiología , Madres/estadística & datos numéricos , Preeclampsia/epidemiología , Complicaciones del Embarazo/epidemiología , Prevalencia , Eclampsia/epidemiología
20.
PLoS One ; 19(8): e0306170, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39088572

RESUMEN

BACKGROUND: Various governmental and non-governmental organizations in Ethiopia are striving to decrease adolescent pregnancy by enacting laws against early marriage, developing a national youth and adolescent reproductive health strategy, legalizing abortion, and developing an HIV/AIDS policy for youth; however, the issue of teenage pregnancy& early motherhood remains a major concern. METHODS: Data were obtained from the Ethiopian Demographics and Health Survey (EDHS) in 2019. A total sample of 2210 adolescents was included in our study. Spatial autocorrelation, hotspot analysis, and spatial interpolation were used to observe significant spatial variation and clustering and to predict the prevalence of pregnancy in an unsampled area among adolescent girls in Ethiopia; a multilevel binary logistic regression model was fitted to identify factors associated with the outcome variable. The adjusted odds ratio was calculated with a 95% confidence interval, and the variables with a p-value 0.05 in the multivariable multilevel logistic regression were determined to be statistically significant. RESULTS: Global spatial autocorrelation analyses showed that the spatial distribution of late-adolescent pregnancy and early motherhood varied across Ethiopia (the Global Moran's Index I value showed GMI = 0.014, P 0.001). The spatial distribution revealed a high cluster (hot spot) of late-adolescent pregnancy and early motherhood in most parts of Gambella, Afar, Benishangul-Gumuz, the eastern part of Oromia, and Somalia. In the multivariable multilevel analysis, being 17 years old (AOR = 3.43; 95% CI: 1.54-7.59), 18 years old (AOR = 14.92; 95% CI: 6.78-32.8), and 19 years old (AOR = 8.44; 95% CI: 4.06, 17.56), married (AOR = 25.38; 95% CI: 15.33, 42.02), having completed primary, secondary, and higher education (AOR = 0.45; 95% CI: 0.21-0.95), and being at Gambela (AOR = 3.64; 95% CI: 1.04, 12.75) were significant predictors of late adolescent pregnancy and early motherhood. CONCLUSION: Overall, the prevalence of late-adolescent pregnancy and early motherhood was found to be high. At the individual level, marital status, educational attainment, and age of adolescents were significant predictors of pregnancy and early motherhood, and regions were found at a community level associated with pregnancy and early motherhood among late adolescents. Therefore, late-adolescent girls should be educated about menstruation, sexual intercourse, pregnancy, and contraceptives before they reach early adolescence.


Asunto(s)
Encuestas Epidemiológicas , Análisis Multinivel , Embarazo en Adolescencia , Análisis Espacial , Humanos , Adolescente , Femenino , Etiopía/epidemiología , Embarazo , Embarazo en Adolescencia/estadística & datos numéricos , Adulto Joven , Madres/estadística & datos numéricos , Adulto , Prevalencia
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