ABSTRACT

Background: Teenage pregnancy is a common public health problem with global estimates of 16 million teenage births yearly. It is one of the major causes of maternal and neonatal mortality worldwide with the majority of the cases seen in the low and middle-income countries. Cameroon has recorded the highest fertility rate among teenagers in the entire Central African region as of 2017. Thus is study aims at assessing the knowledge, prevention challenges and risk behaviors associated to teenage pregnancy in the Tole community. Methods: A cross-sectional descriptive study was conducted whereby data was collected using self-administered questionnaires from 100 systematically sampled participants from Tole community. Data was analyzed using SPSS version 29. Results: This study employed 100 participants .The overall Knowledge of abstinence as the best means of preventing teenage pregnancy was 84%.A good majority agreed that at their age having sex was safe and healthy and would create problems .A total of 84% participants were sexually active, 60% sometimes use preventive measures before having sex (condom ).After adjusting the confounders early exposure to media was an associated risk factor for teenage pregnancy. Stigma/shy to buy, limited finance and not being sure of its effectiveness/side effects were some potential barriers to contraceptive use. Conclusion: Exposure to media was a social risk factor to teenage pregnancy. The majority of adolescents had considerate ideas of teenage pregnancy, its prevention, and its consequences. However, a good number of them lack adequate knowledge of a comprehensive sexuality education. Thus, measures have to be put in place to provide better sex education to adolescents.

CHAPTER ONE

INTRODUCTION

1.1 Background

According to the United Nations International Children’s Emergency Fund (UNICEF), Teenage pregnancy is defined as a pregnancy in girls within the ages 13-19 years. It is a global issue raising concerns for all who are interested in the health and wellbeing of young women and their children. Although it is considered a serious problem globally approximately95% occurs in girls aged 15-19 years become pregnant around half of these pregnancies were unintended and more than half ended in abortion.(WHO 2022)

Sub-Saharan Africa recorded the highest prevalence of teenage pregnancy in the World in 2013. Over 15 countries identified. For more than 30% of women giving birth before the age of 18 World Wide, 14 of them were found in Sub-Saharan Africa including Niger, Mozambique, Malawi, Uganda and Cameroon. Factors contributing to teenage pregnancy are multifactorial ranging from individual behavior, traditional, socio-cultural and religious in nature. Including increased accessibility to social media and pornographic sharing have led to early initiation of sexual activity by teenagers (Ochen, A.M., et al 2019). Ethopia is one of the African countries where the highest teenage pregnancy has been recorded. According to Ethopiaan Demographic and health Survey (EDHS 2016), the prevalence was most common in rural than in urban areas 15% and 5% responsively. Prevalence among those without education 28%, Primary level education 12% and secondary level education 3%. (Mezmuih et al., 2021). Uganda is estimated to have about 25% of teenage pregnancy within the same country. There are differences in the proportion With Lira District having the highest rate in Northern Uganda, Insights from National consultative dialogues, survey and other reports have shown a worrying increase in the number of teenage pregnancy. According to UNFPA report on teenage pregnancy in Uganda during and post Covid-19 lockdown Eastern Uganda had the highest reported cases with Luuka District alone reporting more than 600 cases. According to the ministry of health 25% of Ugandan teenagers became pregnant by the age of 19 and close to half are married before 18years. The schools that have been safe spaces for the girls where on lockdown during Covid-19 outbreak thus exposing them to the “predators” and sex offenders. According to police report 4.442 cases of defilement were reported between January and April 2020. The South and online Platform by the Uganda Adolescent Health Forum reported 800 cases of sexual abuse between Januarys to May 2020. (K.Conco.M 2021)

Adolescent Pregnancy constitutes a Public Health Problem in Cameroon, 12% and 9.3% of all deliveries at the University Teaching Hospital and central hospital Yaounde respectively are teenagers. Cameroon has one of the highest adolescent fertility rates. According to data collected in 2004 as part of the DHS, 22.7% of adolescents under 20 were mothers of at least one child. Cameroons adolescent fertility rate of 138 birth per 1000 women aged <19 is the highest in central Africa (Thomas et al., 2015). Adolescent pregnancy is still a major public health challenge with a national prevalence of 14.2%. According to the US president, Emergency Plan for AIDS Relief (PEPFAR) the HIV prevalence in Cameroon among adolescent 14-19 years in 2018 was 3.4% with about 2% of young people between 15-24years living with HIV (Rita et al., 2022).

According to UNPFA Cameroon fertility rate represented at 12% of general fertility in 2015 while in 2018 this rate was at 16.31%. In Cameroon the prevalence of teenage pregnancy was 40%-50% (District Health Survey statistics 2009) in the South West Region of Cameroon the prevalence of teen pregnancy in Buea health District was 13-32% (Halle-Ekane, 2015).

In addition, adolescent contribute 28% of maternal mortality in Cameroon. 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 their first pregnancy. According to (Fosmanx et al.,  2013) Cameroon adolescent engage themselves in unprotected sexual practice and having more than one partner at very tender ages existing data on Cameroon indicated that adolescents represent 21% of total population and contributed 13.8% of deliveries. Statistics from the social Welfare Centre in Buea, South West Region (SWR) Cameroon indicate that 5% of girls in Buea terminate schooling every year because of Pregnancy.

Teenage pregnancy is an undesirable phenomenon affecting middle and low income countries including Cameroon. The purpose of this research was identified to assess the knowledge, prevention challenges and risky behavior exposing adolescents to teenage pregnancy in tole community.

 1.2 Problem Statement

Every year, an estimated 21 million girls aged 15-19 years in developing region become pregnant and approximately 12 million of them give birth (WHO, 2022). When a girl becomes pregnant her life can change radically, her education may end, her job prospects diminish, becomes vulnerable to poverty and exclusion. These teens turn to develop a social stigma which goes a long way to hinder their progress in future (Malika, 2012)

Adolescent pregnancy is generally not the result of deliberate choice rather it is a consequence of little or no assess to school (UNFPA). Works to address these issue by focusing and protecting girl’s right which include supporting comprehensive sexual education and reproductive health to help girls avoid pregnancy. Based on observation as a nursing student on community internship at Tole integrated health center, the health burden of Tole is significant with a high proportion of women attending delivery service being teenagers

1.3 Rationale

This study will help generate data on the knowledge on prevention, risky behaviors that might expose teenagers to pregnancy,contraceptive methods use and barriers in getting contraceptive by teenagers at tole

This research could serve as basis for healthcare workers and the government to improve on curbing and negative effects of teenage pregnancies in Tole community. Moreover, it is important to have knowledge and effects of teenage pregnancy in order to identify any gaps and to enable them to understand the benefits of overcoming teenage pregnancy.

Finally, this information will contribute to the existing body of literature and serve as reference for future research.

1.4 Research Questions

1. What is the description of adolescents knowledge and attitude in the prevention of teenage pregnancy in the tole community
2. What are the risk factors associated to teenage pregnancy in the tole community
3. What are the contraceptives used and challenges in getting these contraceptive by teenagers in tole community

1.5 Objectives

1.5.1 General Objectives

To assess the knowledge, prevention challenges and risk behaviors to teenage pregnancy amongst adolescent in the Tole community.

1.5.2 Specific Objectives

1. To asses the knowledge and attitude of adolescent on abstinence as a preventive approach of teenage pregnancy in the tole community
2. To identify risky behavior that might expose teenagers to pregnancy at the tole community
3. To identify contraceptive methods used and challenges in acquiring the contraceptives by teenagers in the tole community