Authors: Bako, John .Chukwudi, Gabriel C. Okere, Nwamaka Joy Joseph, Joy Ojirika, Ume I.
Institute(s):Society for Family Health, Rivers State Ministry of Education, State Universal Basic Education Board
Conference: International Conference on Family Planing 2016, Bali, Indonesia
Session Theme: Context Matters: Adolescent Reproductive Health Needs
Presentation Date: Tuesday, January 2016 from 4:20-5:40 pm room Legian 5
Issues: Teenage pregnancy is pregnancy in females under the age of 20 at the time that the pregnancy ends. Pregnant teenagers face many of the same obstetrics issues as other women. There are additional medical concerns for mothers aged under 15. For mothers aged 15–19, risks are associated more with socioeconomic factors than with the biological effects of age. Risks of low birth weight, premature labor, anemia and pre-eclampsia are connected to the biological age itself as it was observed in teen births even after controlling for other risk factors.
The highest rate of teenage pregnancy in the world is in sub-Saharan Africa where women tend to marry very early. In Nigeria teenage pregnancies are often associated with social issues including lower educational levels, sexual abuse, higher rates of poverty and other poorer life outcomes in children of teenage mothers.
Teenage pregnancy in Southern Nigeria is usually outside of marriage and carries a social stigma. Teenagers who had been sexually abuse are less likely than their non-abused peers to engage in prostitution, survival sex and to use condoms and other forms of birth control.
Description: Supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria, SFH (from 2013-2015) partnered with FMoE/SMoE/SUBEB and CBO to reduce teenage pregnancy, expand access to reproductive health and HIV/STI prevention using 2 prong strategy; FLHE (Curriculum-based-Intervention) and MPPI (Co-Curricular-based-Intervention).
MPPI/Zip Up Plus meets students specific needs using 3 strategies – Peer Education, Peer Education Plus and Community awareness. Zip Up Plus as a youth focus initiative worked with the state structure to achieve the objective of the State Strategic Plan (2010-2015) by encouraging students to improve and maintain high self esteem, postpone sexual debut and adopt responsible behavior.
Methodology: This intervention employed report review, experience sharing, Focus Group Discussion and Key In-depth interviews involving students, teachers and Education Ministry HIV/AIDS desk officers.
Over 20 schools in more than 30 communities in South-South Nigeria participated in the In-school Youth programme. Data were collected on a monthly basis by Community Based Organization members and Community Facilitators who were anchoring the project.
Results/key findings Rape was identified to be common but one issue that nobody wants to talk about not even the victims non-their parents would want to expose their child who has fallen victim to rape. According to the students who participated in the programme most of the teenage mothers seen in their communities had unwanted sexual experiences preceding their pregnancy as majority of first-intercourse experiences among females are reported to be non-voluntary.
Poverty was also found to be associated with increased rates of teenage pregnancy in rural and hard to reach communities in south -south Nigeria. Substance use and abuse was identified as one of the social problem which increases the risk for multiple partners and unprotected sex. Many of the students involved in the programme who said they have heard about condoms before reported not to have used or seen it prior to the commencement of the programme.
Contraceptives knowledge among them was found to be low so is access to conventional methods of preventing pregnancy. Drug and alcohol abuse which was widely reported may encourage unintended sexual activity and influence teenagers to engage in riskier behavior including engaging in unsafe sex.
Program implications/lessons To reduce teenage pregnancy rates in South-south Nigeria, interventions must be targeted to those at increased risk. Sexual health curricula in schools should take into account the likelihood that some students both males and females have been sexually abused and, should include information to help reduce the stigma of this hidden trauma and to connect teenagers to appropriate resources.
There is need to advocate for the promotion of a culture that does not allow sexual abuse with the sole aim of stopping it before it occurs. Health education and counseling for sexually active teenagers should address the needs of sexually abused youth and should explore their risk behaviours and methods of coping with the abuse.