Teenage pregnancy remains an important and complex issue
around the world, with reports indicating that Africa has higher rates than
other continents. Studies have indicated that social and economic determinants
are associated with these higher rates. Therefore this study aims to identify
the social and economic influencers of teenage pregnancy which would help
develop a best-practice approach to reduce its incidence in Africa.
About 11% of all births worldwide are still girls aged 15–19
years old. According to the World Health Statistics 2014, the average global
birth rate among 15–19 year olds is 49 per 1000 girls, whereas country rates
range from 1 to 299 births per 1000 girls. Rates were highest in Sub-Saharan Africa.
The 10 highest-risk countries for teenage motherhood are
still Niger, Liberia, Mali, Chad, Afghanistan, Uganda, Malawi, Guinea,
Mozambique, and the Central African Republic. In these countries, teenage birth
rate (births per 1000 women aged 15–19) ranges from 233 in Niger to 132 in the
Central African Republic. In Niger, more than 50% of teenage girls (15–19
years) are married.
Approximately 25% of teenage girls gave birth between 15 and
19 years. This is mainly due to the fact that childbearing among teenagers is
socially desired in some traditional societies and in developing countries. Therefore,
a substantial proportion of teenage pregnancies and births are therefore
intended in developing countries.
Teenage pregnancies and teenage motherhood are a cause for
concern worldwide. From a historical point of view, teenage pregnancies are
nothing new. For much of human history, it was absolutely common that girls
married during their late adolescence and experienced first birth during their
second decade of life.
This kind of reproductive behavior was socially desired and
considered as normal. Nowadays, however, the prevention of teenage pregnancies
and teenage motherhood is a priority for public health in nearly all developed
and increasingly in developing countries. For a long time, teenage pregnancies
were associated with severe medical problems; however, most of data supporting
this viewpoint have been collected some decades ago and reflect mainly the
situation of per se socially disadvantaged teenage mothers.
In developed countries, most teenage pregnancies, especially
those during early adolescence (<15 years), are unplanned and unintended.
For a long time, teenage pregnancies were interpreted as major medical problems
and obstetrical risk factors. More recently, however, obstetrical risks of
teenage pregnancies are predominantly interpreted as results of adverse social
and economic factors rather than chronological age.
This, however, is no reason to deny that teenage pregnancies
are currently still an important public health problem all over the world.
There is no doubt that obstetrical problems can be managed by modern medicine
and so the risk of teenage pregnancies can be diminished.
In Austria, an improved sexual education and the
legalization of abortions since the early 1970s reduced teenage motherhood
dramatically. On the other hand, special support programs—including medical
care, financial, and social support—for pregnant teenage girls and teenage
mothers were introduced.
First of all, special consulting hours for young girls free
of charge at hospitals and private practices of gynecologists improved the
access to contraceptives and advanced sexual education. Governmental financial
support for young mothers reduced poverty among teenage mothers dramatically.
Despite these improvements of the situation of teenage
mothers in Austria, we should not forget that the development of strategies to
reduce teenage pregnancy rate and teenage motherhood, especially among young
adolescents, effectively should be a goal of public health worldwide.
According to more recent studies, teenage pregnancies are
not per se risky ones. A clear risk group are extremely young teenage mothers
(younger than 15 years) who are confronted with various medical risks, such as
preeclampsia, preterm labor, and small for gestational age newborns but also
marked social disadvantage, such as poverty, unemployment, low educational
level, and single parenting.
Several social and economic factors appear to be the causes
of teenage pregnancy in Africa. Therefore, understanding the association
between teenage pregnancy and various social and economic factors would help
reduce teenage pregnancy rate in Africa. Further analysis reveals that female
literacy rate is the most important predictor of teenage pregnancy in Africa
Strategies to decrease teenage pregnancy rates and
improve teenage pregnancy outcome
Some recent studies have demonstrated that a well-acting
social welfare system including appropriate psychosocial support and prenatal
care improves the obstetric outcome in teenage mothers significantly. In this
case, teenage pregnancy outcome may be comparable with, or even better than,
that in older mothers. The second goal is the efficient reduction of teenage
pregnancies per se. The World Health Organization published guidelines in 2011
to prevent early pregnancies and reduce poor reproductive outcomes.
The six main
objectives were defined as follows:
·
reducing marriage before the age of 18;
·
creating understanding and support to reduce
pregnancy before the age of 20;
·
increasing the use of contraception by
adolescents at the risk of unintended pregnancy;
·
reducing coerced sex among adolescents;
·
reducing unsafe abortion among adolescents.
·
The main purpose of this program is to avoid getting
pregnant. Unfortunately, sex education is lacking in many countries and
consequently young girls are not aware about physiological basis of
reproduction and contraceptives. Furthermore, many girls may feel too inhibited
or ashamed to seek contraception services. On the other hand, contraceptives
are sometimes too expensive or not widely or legally available. Consequently,
the most important strategies to avoid teenage pregnancies are improved
education of girls, the introduction or improvement of sexual education, and
the availability of cheap and easy to use contraceptives.
A cornerstone in reducing adolescent sexual-risk behaviors
and promoting reproductive health is sex education programs. School-based
programs have the potential to reach the majority of adolescents in developed
countries and large number of adolescents in countries where school enrollment
rates are high. European countries prefer school-based sex education because
schools in industrialized countries are the only institution in these societies
regularly attended by nearly 95% of all youth aged between 6 and 16 years. It
is well documented that sex education programs may increase knowledge of human
reproduction and methods of contraception.
Developed countries with the lowest rates of teenage
motherhood are characterized by advanced school-based sex education but also
broad availability of contraceptives including postcoital emergency contraception,
and a liberal abortion law. Since not all adolescents are in school especially
in developing countries, sex education programs have also to be implemented in
clinics, community organizations, and youth-oriented community agencies.
Asides the medical consequences, there are several economic
and social consequences associated with high teenage pregnancy rate. This is
because teenage pregnancy causes an upsurge in a nation's population which
places a burden on other sectors of the economy, hence, impeding the economic
and social progress of such nations6; furthermore, this can lead to extreme
poverty especially in lower income countries.
CONCLUSION
Teenage pregnancy remains an important and complex issue
around the world. This is majorly attributed to the numerous health
consequences such as pregnancy related illness, high infant mortality rate, low
birth weight babies, maternal mortality and exposure to sexually transmitted
diseases.
The rate of teenage pregnancy varies between developed and
developing countries. The World Health Statistics review indicates that
the average teenage pregnancy rate across Africa is about 118 per 1000 females
and this figure is very high when compared to the rate in other continents.
Some researchers have stated that the high teenage pregnancy rate in Africa can
be attributed to Africa being amongst the poorest continents of the world with
most countries underdeveloped.
This study indicated that determinants of teenage pregnancy
in Africa are multifaceted with social and economic determinants such as: GDP
per capita, literacy rate, contraceptive prevalence rate and healthcare
expenditure rate emerging as great influencers of teenage pregnancy in Africa.
However, in other to prioritize due to the limited available
resources, particularly in Africa where a number of the countries are
developing countries, a policy pathway based on the best predictor of teenage
pregnancy in Africa has been suggested by the authors.
A policy pathway to reduce teenage pregnancy rate in Africa
is one that puts in place policies and strategies to increase female literacy
rate. This will increase both the use of contraception amongst female and the
healthcare expenditure. The overall effect would be an increased GDP per capita
of the nation.
Besides an increase in literacy rate would also reduce
rural-urban migration as more educated females within the rural region would utilize
the skills and knowledge gained while in education to develop their
communities. Furthermore, policies that increase female literacy rate in Africa
would help ensure that: schools are located in the right site; trained
individuals are available; free and affordable education are given to
citizenry; as well as ensuring individuals are literate enough to understand
the sex and relationship education given. #EndTeenagePregnancy #RaiseAwareness
#StandforYoungGirls #SupportGirls #SDG5 #HumanRights #HealthRights #Empowerment
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