CHAPTER ONE

1.0 Introduction

This chapter includes different historical aspects related to teenage pregnancy, starting from the background of the study, followed with the problem statement, objectives research questions the justification of the study, the significance and the scope of the study.

1.1 Background of study

Teenage pregnancy refers to a pregnancy occurring in a female adolescent, typically between the ages of 13 and 19, who has not yet reached adulthood (WHO, 2021). Early marriages, substance abuse, early sexual activity, having multiple sexual partners, poverty lack of parental support, social media are among a few causes for teenage pregnancy (Bain LE et al., 2020). Girls with teenage pregnancy are at increased risk of preeclampsia, anemia, unsafe abortions, birth complications, sexually transmitted diseases, maternal deaths (Kawakita T, et al., 2016). Apart from the medical perspective, pregnant teenage girls also suffer from guilt, financial constraints, abuse by family, peers, friends, inability to continue school education, and disgrace from society. Adverse neonatal outcomes, such as low birth weight, prematurity, and early neonatal demise. These pregnancies can be reduced by, providing sex education, easy accessibility to contraceptives, the use of condoms, and reducing the number of early marriages before the age of 18, This can have a big impact on their future. In addition, children born to parents who cannot care for them face additional dangers (WHO et al., 2022).

The Greek physician Soranus of Ephesus (98-138 CE) is often been credited with being the first person to write extensively on teenage pregnancy. In his book ‘Gynecology’, Soranus discussed the risk of pregnancy     in young girls and provided guidance on prenatal care and childbirth. (Soranus et al., 2004). The first recorded instance of a teenager getting pregnant is not exactly known, as teenage pregnancies have likely occurred throughout human history, but documentation and awareness of it became more common in modern times. However, one notable early case of a teenage pregnancy in the modern era was Lina Medina, a Peruvian girl who became pregnant at the age of 5 years and 7 months in 1939. Her case is the youngest known pregnancy in recorded history, and it is often cited in discussions about early childbearing, although it is not typical of what is referred to as “teenage pregnancy “ (Anderson et al., 2021). One of the most significant consequences of teenage pregnancy is the increased risk of maternal and infant health complications, teenage mothers are less likely to receive adequate prenatal care, which further increases the likelihood of negative health outcomes for both mother and child (Ganchimeg et al., 2014). One of the most effective strategies for preventing teenage pregnancy is comprehensive sex education, which empowers adolescents with the knowledge to make informed decisions about their sexual health, research indicates that when teenagers receive accurate information about contraception, sexual consent, and the potential consequences of early pregnancy, they are more likely to delay sexual activity and use contraception effectively (Kirby et al., 2007). This study will be making use of Dorothy Orem’s self-care deficit theory which is based on the concept that individuals have a natural ability to care for themselves, but when they are unable to do so due to deficiency or a need for help.

Adolescent pregnancies have decreased globally, from 64.5 per 1000 women in 2000 to 42.5 per 1000 women in 2021. However, there are huge differences in levels between and within countries. While the estimated global teenage birth rate has decreased, the actual number of childbirths to teenagers continues to be high. Pregnancy in girls under the age of 19 is severe in every aspect and requires very complex and long-term solutions (WHO 2023). Teenage pregnancy is a major health issue in Africa. Even though teenage pregnancy has declined in the past few decades, it remains a health concern and priority for many African countries. There are few studies assessing the overall burden of teen pregnancy in African countries. Those that have been conducted showed that the prevalence of teen pregnancy was between 18% in Kenya to 29% in Malawi and Zambia (Wado et al., 2019). In Cameroon, the health burden of adolescent pregnancies and deliveries is significant with a high proportion of women attending delivery services being teenagers. This prevalence of adolescent deliveries varies greatly in different regions of the country; with studies showing a prevalence of 9.3–9.9% in several urban settings and as high as 26.5% recorded in the north of the country and some rural areas where early marriages are engraved in the cultural values (Fouelifack et al., 2014). A study carried out in the limbe health area shows a prevalence rate of 56.1% of teenage pregnancy (Myra et al., 2023)

A study by Ganchimeg explored the prevalence of teenage pregnancy across multiple countries in Sub-Saharan Africa, where the rates are significantly higher compared to other regions. The study reported that nearly 20% of adolescent girls aged 15-19 had experienced pregnancy in several countries within the region. The research highlighted that the prevalence of teenage pregnancy was particularly high in rural areas, where limited access to education and contraceptive methods contributed to early sexual activity and pregnancy. Furthermore, the study found that teenage pregnancy in these areas often led to poor maternal outcomes, including increased risks of maternal mortality and complications during childbirth. The authors concluded that there is an urgent need for targeted interventions, including the provision of comprehensive sexual education and access to reproductive health services, to reduce the prevalence of teenage pregnancies in these areas (Ganchimeg et al., 2014). A community-based cross-sectional study conducted in Wogedi, northeast Ethiopia, shows that, there is high prevalence of teenage pregnancy in the area due to peer influence, school drop outs Age, residence, contraceptive nonuse, and parental divorce Strengthening contraceptive use by giving special attention to rural dwellers and showing the consequences of divorce to the community (Yohannes et al., 2018). It was possible to evaluate the causes associated with teenage pregnancy, the most relevant causes for teenage pregnancy were exposure to violence, family functionality, age of mother’s first pregnancy and their parents sentimental situation, whereas parents level of education acted as a risk factor with a minor magnitude of effect (Jennifer Castaneda Parades et al., 2020). In rural Kathmandu Respondents had knowledge shows that abortion is the maternal consequences of teenage (Rupa et al., 2022).

1.2 Statement of problem

Teenage pregnancy has long been a worldwide social and educational concern for the developed, developing and underdeveloped countries. Many countries continue to experience high incidence of teenage pregnancy despite the intervention strategies that have been put in place (Choley et al., 2021). In Cameroon the health burden of adolescent’s deliveries is significant, where prevalence varies across regions in Cameroon with the Far North region having the highest rate of teenage deliveries (26.51%) (Kemfang et al., 2020). During the researcher’s community internship in the Bakingili community, many persons who attended antenatal care were teenagers aged 15-19. Many of them lacked knowledge regarding reproductive health, contraception and safe sex practices, some of them lacked money to take care of themselves, others were forced into early marriage. Adolescents knowledge on their reproductive health stands as an important point on the reduction of teenage pregnancy, thus this study aims at assessing adolescent’s knowledge on the causes, consequences and prevention of teenage pregnancy in the Bakingili community.

1.3 Research Objective

1.3 .1 Main Research objective

To assess adolescent’s knowledge on the causes, consequences and prevention of teenage pregnancy in the Bakingili community.

1.3.2 Specific objectives

1. To assess adolescent’s knowledge on the causes of teenage pregnancy in Bakingili community.
2. To evaluate adolescent’s knowledge on the consequences of teenage pregnancy in

the Bakingili community.

3. To examine adolescent’s knowledge regarding teenage pregnancy prevention in the Bakingili community.

1.4, Specific Research Questions

1. What do adolescents in Bakingili community know about the causes of teenage pregnancy?
2. What do adolescents in Bakingili community know about the consequences of teenage pregnancy?
3. What do adolescents in Bakingili community know about how to prevent teenage pregnancy?