PREVALENCE, AWARENESS AND FACTORS ASSOCIATED TO TEENAGE PREGNANCY

Summary
Background

Adolescent pregnancy remains a major challenge in both developed and developing
countries. Adolescence is a phase of transition of physical and mental maturation and
development that includes the biological, social and psychological parameters. It is between
10-19 years of age as per the World Health Organization (WHO). Early and unintended
pregnancies among adolescents are associated with several adverse healths, educational,
social and economic outcomes. The aim of this study is to determine the prevalence,
awareness and factors associated to teenage pregnancy among secondary and high school
students in the Bueal Health District.

Method: This study will be a cross-sectional community based study conducted from the
month of January 2023 to July 2023 in the Buea Health District to collect data. The
participants of this study will be secondary and high school teenagers. A multistage
sampling method will be used. 300 participants will be recruited for this study. Chi squared
test will be used to test association between variables, while multiple logistic regression
model will be used to determine associated factors. Statistical significance will be set at a
95% CI, with a p-value < 0.05.
Expected Outcome
The prevalence of the study, factors associated to teenage pregnancy will be used by policy
makers to come up with strategies to limit or prevent teenage pregnancy among secondary school
adolescent students in the BHD, SWR, Cameroon.
Keywords: Teenage pregnancy, Risk factors, Prevention, Awareness, Sexuality,
Adolescent

CHAPTER ONE
INTRODUCTION
1.1 BACKGROUND
Teenage pregnancy, also known as adolescent pregnancy, is pregnancy in
a female adolescent or young adult under the age of 20 years. This includes those who are
legally considered adults in their country[1],[2]. 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[3]. Teenage pregnancies constitute a serious health and social problem
worldwide[4].Teenage pregnancy and teenage motherhood are a call for concern
worldwide. Adolescence is a phase of transition of physical and mental maturation and
development that includes the biological, social and psychological parameters. It is between
10-19 years of age as per The World Health Organization (WHO)[5]. Among the social
consequences of adolescent pregnancies are school drop-out, juvenile violence, suicide and
sometimes homicide [6],[7],[8]. It carries major health and social issues with unique
medical and psychosocial consequences for both adolescents and society in general.
According to World Health Organization(WHO), about16 million girls aging between 15
and 19 years and about, one million girls younger than 15 years give birth every
year[9],[10]. WHO in 2014 report showed that the global adolescent birth rate was 49 per
1000 girls aged 15 to 19 years old[11].
Nowadays, the vast majority of teenage pregnancies occur in low- and middle- income
countries’ characterized by poor health-care services; therefore, complications during
pregnancy, birth and postpartum phase are the second cause of death among girls aging

between 15 and 19 years worldwide. Additionally, it is estimated that some three million
teenage girls undergo unsafe abortions, may result in consecutive reproduction problems or
even death [9].
Globally, 11% of all births result from adolescent pregnancies, with 95% of these births
occurring in low and middle income countries (WHO; 2014) [12]. Teenage pregnancy
remains an important and complex issue around the world [12]. It is estimated that about 16
million girls 15–19 years old give birth each year, contributing nearly 11% of all births
worldwide [13]. Pregnancy in adolescence is associated with higher risk of caesarean
deliveries, low infant birth weight, neonatal asphyxia and prematurity; consequently
increasing maternal and infant morbidity and mortality[14].
Teenage/Adolescent pregnancy is a global issue raising concerns for all who are interested
in the health and well-being of young women and their children. It carries major health and
social issues with unique medical and psychosocial consequences for both adolescents and
society in general[15].Teenage pregnancy rates have declined since 2001, although
progress has been uneven across regions and countries. Eastern Europe has a higher
average teenage pregnancy rate (41.7/1000) than Northern (30.7/1000), Western
(18.2/1000) and Southern Europe (17.6/1000). While data on teenage live births are
available across Europe, data on teenage abortions are unavailable or incomplete in more
than one-third of EU countries. Reported teenage pregnancy rates are generally lower for
countries where parental consent for abortion is not required[16]. About 12 million
adolescent girls aged 15-19 give birth every year – most in low- and middle-income
countries[17]. An estimated 3.9 million girls aged 15–19 undergo unsafe abortions every
year[17]. In low- and middle-income countries, complications from pregnancy and

childbirth are a leading cause of death among girls aged 15–19 years[17]. A wide range of
factors contribute to the high rates of unintended pregnancy and unplanned births among
adolescents; Poor knowledge of sexual and reproductive health services, legal barriers to
accessing services, provider bias, stigma around premarital sex and lower decision making
autonomy of married adolescents are among the factors contributing to unintended
pregnancies[18],[19],[20]. The rate of teenage pregnancy in the United Kingdom is
relatively high, when compared with other developed countries; the only other Western
countries with higher teenage pregnancy rates are the United States and New
Zealand[21],[22].
Although in tradition societies, the majority of these pregnancies are socially desired,
several studies have pointed out the enormous risks which are associated associated with
teenage pregnancies, such as anemia, preterm labor, urinary tract infections, preeclampsia,
high rate of cesarean- sections, preterm birth, and low birth weight infants and even
maternal and new mortality [9].Several studies examined the risk and protective factors
associated with adolescent pregnancy using an ecological perspective, thus identifying
multidimensional factors at the individual, relational, familial and structural levels that
influence adolescent pregnancy. Among the several factors at the different levels,
systematic reviews showed that poverty, and lower educational attainment are consistently
associated with adolescent pregnancy[23].
Teenage pregnancies, however, still also occur in high-income countries and despite much
better medical care[9]. Teenage pregnancies are also considered as risky and policy tries to
avoid too early motherhood.[9]. This is not only due to medical problems, but first to all

social consequences of teenage motherhood. Therefore, the analysis of causes and
consequences of teenage pregnancies have been the topic of much research and debate[24].
Adolescent pregnancy is a major public health problem, particularly in Africa[25]. It is
associated with high maternal and child morbidity and mortality and affects the socioeconomic development of a country[25]. Evidence from sub-Saharan Africa indicates that
35 percent of pregnancies among 15-19- year (s)-olds were unplanned, unwanted, or
untimed and that the teenagers’ relationships were unstable[26].
Today, Sub Saharan African countries lead the world in teen pregnancies: With Niger on
the top list of 203.604 births per 100,000 teenage women. Mali follows with 175.4438,
Angola (166.6028), Mozambique (142.5334), Guinea (141.6722), Chad (137.173), Malawi
(136.972), and Cote d’Ivoire (135.464) [26].
Several studies have shown that the high level of maternal and perinatal morbidity and
mortality can be reduced by lowering the high rate of adolescent pregnancy in developing
countries[27], [28], [29].
Consequently, reducing the high rate of adolescent pregnancy and maternal mortality is
considered as the key Sustainable Development Goals (SDG), target[30].
The Cameroon Medical Council reports that 25 percent of pregnancies occur in girls of
school age, and 20 percent of pregnant teens do not return to school[31]. In Cameroon,
about 25% of 15 – 19 -year-old females are already sexually active[32] .The fertility rate in
this age group is 127 per 1000 women[32]. with 30% of these births resulting from
unplanned pregnancies[33]. The 2018 Demographic and Health Survey (DHS) in
Cameroon showed that adolescent girls contribute nearly 19% to fertility. Furthermore,

24% of these adolescent girls aged 15 to 19 had already begun their reproductive life[34] .A
prevalence of adolescence pregnancy of 13.3% has been revealed in a study conducted in
the Buea Health District of the Southwest Region of Cameroon[34].
Reproductive health in Cameroon remains a major public health challenge with an elevated
maternal mortality rate. The maternal mortality rate is estimated at 782 deaths per 100,000
live births[12] This high mortality rate remains a dilemma because it involves the young
mothers at the moment where they are given birth.
In addition, adolescents contribute 28% of maternal mortality in Cameroon [12]. Cameroon
has one of the highest adolescent fertility rates in West and Central Africa. According to
DHS 2011, 25.6% of adolescents 15-19 have started sexual intercourse and 21% of them
have had a child and 4% are pregnant for the first time.
Adolescent pregnancy constitutes a public health problem in Cameroon: 12 % and
deliveries at the University Teaching Hospital (CHU) are teenager [4]. However, the
country’s adolescent pregnancy rate is difficult to assess accurately, not least because
national statistics on legal abortion are unreliable. They are so because of the wide
differences in the local application of the law, and the discrepancies in public health data
from one region of Cameroon to the other[4]. Statistics from the Social Welfare Centre in
Buea, South West Region (SWR), Cameroon indicate that 5 % of girls in Buea terminate
schooling every academic year because of pregnancy.
1.2 Problem Statement