ABSTRACT
Globally, about 11% of all births occur to mothers between
15-19 years with over 95% occurring in developing countries. The consequences
of adolescent pregnancies are very disheartening with respect to their physical
and mental well-being, education and economic progress. The health burden of
teen pregnancy is very huge with increased maternal mortality and morbidity
including obstetric fistulae, complicated induced abortions, preterm labour and
sexually transmitted infections among others.
Despite the fact that the burden of adolescent pregnancy is
huge in rural settings, little is known with regards to what its predictors
are. This study looked at the determinants of adolescent pregnancy in the
Amenfi West district, Ghana and its prevalence. The study used a case-control
approach that sampled 80 cases and 220 controls to find out the association
between the dependent variable adolescent pregnancy and the independent
variables such as socioeconomic status, contraceptive knowledge /use,
responsible parenthood and peer influence. The cases were defined as any girl
between 10-19 years (W.H.O) who is currently pregnant or delivered not more
than two years preceding the study. The controls were adolescent girls who have
never been pregnant.
The study showed that being in school, coming from a wealthy
household, contraceptive use at sex debut, parental monitoring of the
adolescents’ wherabouts at night, and the ability of the adolescent to talk to
parents about relationships with the opposite sex offered significant
protection against adolescent pregnancy (p<0 .05="" 15-19="" adolescent="" adolescents="" age="" and="" attitude="" been="" being="" boy="" demanding="" ever="" factors="" financial="" for="" friend="" from="" girl="" group="" house="" in="" late="" one="" parental="" predisposed="" pregnancy="" pregnant.="" relationship="" s="" span="" support="" that="" the="" to="" towards="" upkeep="" violent="" were="" years="">
Government should endeavor to introduce more social
interventions to improve the living conditions of the poor and parents must do
well to win the confidence of their wards. Contraceptive promotion and
infrastructural development should be given the necessary attention by all
stakeholders.
CHAPTER ONE
INTRODUCTION
1.1 BACKGROUND
Adolescent is often used
synonymously with teenager and hence adolescent pregnancy refers to pregnancy
that occurs between the ages of 10-19years. (WHO, 2004). It is a period when a
child transits into adulthood and is characterized by various transformation in
the make-up of the individual in the areas of psychological, social and
biological changes among others. It is a period when the individual is most
exposed to the risks in the environment due to the innate desire to experiment,
natural tendency to go against parental advice and the pseudo-feeling of
maturity. Prominent among these risks is adolescent pregnancy (GHS, 2008; Garfield,
2007).
Teenage mothers and their babies
are known to be exposed to both short and long term risks associated with
pregnancy at that age as a result of unpreparedness and physical immaturity.
Adolescent pregnancies have been a major public health issue worldwide and its
negative impact on health outcomes cannot be over-emphasized.
Literature has associated the level
of formal education of the adolescent, economic status, peer influence,
child/parent relationship, religious affiliation, knowledge and usage of
contraceptives to be among the major contributory factors to this menace.
1.2. PROBLEM STATEMENT
Globally, adolescent pregnancy is a
serious public health problem that needs immediate attention. It is estimated
that sixteen million adolescents deliver each year which is about 11% births
worldwide. A survey on 10,000 teenagers in the United States of America
suggested that many adolescent girls had their first sexual exposure at age
fifteen. Fifty -two percent of these teenage girls reported they had
unprotected sex, and twenty-four percent of adolescents
having STIs reported of still being engaged in unprotected sex (Coffey, 2008).
Unfortunately, this bleak picture is worse in low- and middle-income countries
as ninety- five percent of these births occur there (WHO, 2008)
Worldwide, as adolescent birth rate
stood at 65 per 1000 adolescents, in sub-Saharan Africa, adolescent birth rate
was high as 140 per 1000 adolescent with country variations, from 45 in
Mauritius to 212 in Angola. (WHO, 2004).Seven countries are known to be having
highest prevalence of teenage pregnancy and high birthrate namely Bangladesh,
Nigeria, Brazil, Congo, United States, Ethiopia and India.
In Ghana, the scenario is similar
to sub-Saharan Africa. In 2008, the adolescent birth rate stood at thirteen
percent and averagely one in ten adolescent 15-19 years began childbearing in
the urban areas, while double this rate exists in the rural communities. (GSS,
GHS &ICF, 2009).This trend continues to exist as the prevalence of
adolescent pregnancy is quoted to be 14% among the 15-19 year olds. Teenagers
residing in rural areas (17 percent), those living in the Brong Ahafo, Central,
and Volta regions (21-22 percent), those with no education (23 percent), and
those in the second wealth quintile (21 percent) tend to start childbearing
earlier than other teenagers. (GSS, GHS &ICF, 2015)
In the Western region, the trend is
a reflection of the national burden with Amenfi West being a high contributing
district. (Adesoka et al., 2008). In the 2014 Ghana Demographic and Health
Survey, Western region recorded 10.1% of adolescent pregnancy for those between
the ages of 15-19 and as much as 12.7% of that same age group had started
childbearing. The drivers of this phenomenon in Amenfi West district are
largely unknown.
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