|Year : 2014 | Volume
| Issue : 1 | Page : 48-52
Determinants and outcome of teenage pregnancy in a rural community in Jos, Plateau State, Nigeria
Esther A Envuladu1, Hadiza A Agbo1, Victor A Ohize2, Ayuba I Zoakah1
1 Department of Community Medicine, Faculty of Medical Sciences University of Jos, Jos, Plateau State, Nigeria
2 Jos University Teaching Hospital, Jos, Plateau State, Nigeria
|Date of Submission||23-Aug-2013|
|Date of Acceptance||30-Sep-2013|
|Date of Web Publication||24-Mar-2014|
Esther A Envuladu
Department of Community Medicine, Faculty of Medical Sciences University of Jos
Background: In Nigeria, the rate of teenage mothers was reported in 2008 to be 22.9% and the poor socio-demographic status of the pregnant teens play a major role in the poor maternal and child health indices and contribute to the slow pace of attainment of the related Millennium Development Goals (MDGs). This study was designed to determine the proportion of teenagers who have been pregnant, the outcome of the pregnancy and the socio-demographic determinants of the affected teens in the community. Materials and Methods: It was a community-based cross-sectional study in which an interviewer administered questionnaires was administered to 192 respondents aged 13-19 years. Results: the proportion of those who have ever been married was 25.5%, with significant association found between the age of the teenagers and being pregnant (P < 0.001). Most of the teenagers were single (75.6%) and a significant association was found between TP and teenage marriage (P < 0.001). Although 72.9% were still in school, TP was significantly associated with teenagers that were out of school (P = 0.001). TP was observed to be higher among teens with lower level of parental education though not statistically significant. (Father- none-33% and primary-36.4%; Mother: Primary-30.4%). TP was also found to be higher among teens of unskilled parent (30.4%), from polygamous family setting (42.3%) and teens in tertiary level of education (40.7%), though no statistical significant association was observed. Conclusion: Teenage pregnancy still remains a major issue in our environment and the socio-demographic characteristics of both the parents and the teenagers were found to be determinants of teenage pregnancy.
Keywords: Determinants, marriage, pregnancy, socio-demographic, teenage
|How to cite this article:|
Envuladu EA, Agbo HA, Ohize VA, Zoakah AI. Determinants and outcome of teenage pregnancy in a rural community in Jos, Plateau State, Nigeria. Sub-Saharan Afr J Med 2014;1:48-52
|How to cite this URL:|
Envuladu EA, Agbo HA, Ohize VA, Zoakah AI. Determinants and outcome of teenage pregnancy in a rural community in Jos, Plateau State, Nigeria. Sub-Saharan Afr J Med [serial online] 2014 [cited 2020 Feb 24];1:48-52. Available from: http://www.ssajm.org/text.asp?2014/1/1/48/129319
| Introduction|| |
Teenage pregnancy (TP) is a global phenomenon and of public health importance, affecting both high and low income nations with the highest prevalence in sub-Saharan Africa.  Prevalence of TP varies greatly across the globe ranging from 2.9 per 1000 in South Korea to 143 per 1000 in sub-Saharan Africa.  It has been estimated that 13 million children are born to women under age 20 years worldwide annually and more than 90% of these occur in sub-Saharan Africa. 
The often associated poor obstetric outcome and decline in socio-demographic development of pregnant teens play a major role in the poor maternal and child health indices. These contribute to the slow pace of attainment of the related MDGs in sub-Saharan Africa with a World Health Organization (WHO) estimate of 70,000 teens in the developing nations dying from pregnancy complications annually and the risk of death being twice in the age group 15-19 than those between the ages of 20-24.  Moreover, it has been shown that teenage mothers are more likely to be poor, unemployed, less likely to complete their secondary education and less likely to proceed to higher education.  This subsequently affects employment opportunities and their social class as evidenced in the United Kingdom-based study where 89% of teenage mothers were unemployed and most live in poverty with nearly half being in the bottom fifth of income distributions. Some other unfortunate outcomes of TP include different forms of abuse like subsequent forced marriages besides the social stigma especially in the setting of TP outside of marriage.
The Nigerian national statistics shows that teenage mother (Percent of women aged 15-19 years who have had children or are currently pregnant) was 22.9% in 2008.  With an estimated adolescent (teenage) population of over 23 million in Nigeria  and premarital sexual intercourse of 46.2% among females aged 15-19 years and modern contraceptive use in less than 4 of every 10 sexually active female aged 15-19 years, it is no surprise that TP remains a burden to Nigeria. 
This study was designed to determine the proportion of teenagers who have been pregnant, the outcome of the pregnancy and the socio-demographic determinants of the affected teens in the community.
| Materials and Methods|| |
A community-based descriptive cross-sectional study was conducted among 192 teenage girls in Gyel village of Jos South LGA in Plateau State. The community was selected purposively following a couple of reports of teenage pregnancy from that community. In the community, all the female girls within the ages of 13-19 years were invited to the village hall to be given a talk after obtaining permission from the relevant authorities and explaining the aim of the study to the parents and guardians.
The teenagers that were addressed by the research team that explained the aim of the study and assured them of confidentiality especially the fact that their names were not needed and afterwards, all who gave informed verbal consent in addition to the informed verbal consent from their parents/guardians were included in the study. The sample size was calculated using the formula Z 2 pq/d 2 and a prevalence of teenage pregnancy in the sub-Saharan region of 14.3% was used to arrive at a minimum sample size of 185 and a 10% non- response rate was calculated to arrive at 204 but those that consented for the study were 192 and they were all included in the study. Using an interviewer-administered questionnaire, data on their socio-demographic characteristics, the socio-demographic characteristics of their parents/guardians, pregnancy and the outcome was collected from the teenagers and analysed using SPSS version 17 statistical software with a 95% confidence interval and a margin of error of 5% used. Chi-square test was used to determine association between the socio-demographic characteristics and the prevalence of teenage pregnancy and a p-value of less than or equal to 0.05 was considered significant and the result was presented in tables.
Ethical clearance was gotten from the Jos University Teaching Hospital before commencement of the.
| Results and Tables|| |
The study had a total of 192 respondents aged 13-19 years, most were unmarried (75.0%), had secondary education (71.9%) and still in school (72.9%). Most were born into monogamous family settings (83.3%) and live with their parents (71.9%). [Table 1] and [Table 2] present the sociodemographic characteristics of study respondents and their parents respectively. [Table 3] presents pregnancy and pregnancy outcomes of study respondents while [Table 4] presents the association between teenage pregnancy and selected demographic characteristics.
|Table 4: Association of teenage pregnancy with selected socio-demographic characteristics|
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Most of the respondents had at least one of the parents alive (92.7%) with most having secondary education (father 51.0%, mother 47.4%). Parent/Guardian occupation was mainly unskilled (47.9%) and 87.5% of Parent/Guardian staying together.
About 26% of the respondents had ever been pregnant (TP rate) of which 44.9% had induced abortion. Of those that aborted, 72.7% had it at home and in the chemist and at-least 68.2% was performed by nurses and others. Post-abortion complication occurred in 81.8% of cases. The education of about 61% of the teens was affected as a result of pregnancy.
TP was found to be associated with age with most occurring within the ages of 18 and 19 years, (P < 0.001), being married (P < 0.001) and being out of school (P < 0.001).
However, TP was found to be higher for teenagers with no formal education and primary educational level (33.3% each), teenagers born into polygamous family settings (42.3%), unskilled and semiskilled parents (30.4% and 26.7%, respectively), fathers with no formal education and primary level of education (33.3% and 37.8%, respectively) and mothers with primary and secondary level of education (29.8% and 27.5%).
| Discussion|| |
Teenage pregnancy rate in this study was found to be 25.5%, this is slightly higher than the national statistics of 22.8% prevalence for teenage mothers in Nigeria in 2008 , and exceeds the figure quoted for the sub-Saharan region.  A similarly rate of 22.9% was found in a study carried out in a rural town in western Nigeria  and a much higher finding of 45.4% was obtained in a study in a rural town in eastern Nigeria.  The persisting high level of TP in Nigeria despite present effort to reduce the prevalence calls for review of the effectiveness and efficiency of the present measures in place for TP control and prevention. There is need for a holistic reassessment of the determinants of TP and peculiarities of the affected population to ensure that interventions are precise. This study also found a significant association between TP with age, teenage marriage and being out of school respectively (P < 0.001). Similar associations have been proven in other studies with older adolescents, non-schooling teenagers or those with primary education being more vulnerable to getting pregnant. , Most of the TP was seen to have occurred at the later teenage years (about 80% at age 18 and 19 years) which is the age group in which the teenagers begin to feel like adults and would want to act like one without weighing the consequences and this demonstrates the urgent need to introduce sex education early in teenage years. Again for this age group, we cannot ignore the important rule in which culture plays where teenage marriage is encouraged and girls around this age would have been betrothed to a man in most culture thereby exposing them to teenage pregnancy.
The proportion of TP in this study was found to be higher among teenagers from polygamous family setting than those from monogamous setting though not statistically significant, which agrees with other studies that have shown that TP tend to occur more in teenagers from large families.  It is believed that teenagers from large families may lack parental guidance  which may explain the high proportion of pregnant teens from polygamous setting in this study despite most respondents being of monogamous family setting.
Some determinants of teenage pregnancy from other studies included, poverty, family structure, parenting practices, and parental supervision and early marriage which is a normal practice in some communities. ,,,
The role of parental socio-economic status in the occurrence of TP was judged in this study using parental occupation and educational level and though statistically significant association was not proven, it is worthy of note that the proportion of TP was higher among teens with parents of lower socioeconomic status (unskilled and semiskilled occupation and lower education levels) probably because most were unlikely to provide for the upkeep of the teenage girls or unable to afford education for the teenage girls leaving them vulnerable to TP which also agrees with findings from other studies. , The high prevalence of teenage marriage in Nigeria  also remains a major contributor to TP. The concerted effort at all levels of Government in the pursuit of the second MDG to ensure Universal basic education coupled with strengthening the education system to provide related adolescent reproductive health services as part of the school health services will go a long way to reduce the prevalence of TP
| Conclusions|| |
The prevalence of TP in Nigeria remains high with teenage marriage and being out of school contribute significantly to the rising burden of TP, while low parental socioeconomic status may also be implicated. Prompt intervention during the early teenage years will go a long way to reduce the rising occurrence of TP observed with advancing teenage years.
| References|| |
|1.||Ayuba II, Gani O. Outcome of teenage pregnancy in the Niger Delta of Nigeria. Ethiop J Health Sci 2012;22:45-50. |
|2.||Mayor S. Pregnancy and childbirth are leading causes of death in teenage girls in developing countries. BMJ 2004;328:1152. |
|3.||World Bank. indicators-Nigeria- Reproductive health. Teenage mothers percent. Available from http://www.tradingeconomics.com/.../teenage-mothers-percent-of-women_ages_15-19_who_have_had_children_or_are_currently_pregnant. [Last accessed on 2012 Nov 12]. |
|4.||Jamin DZ. National Population commission on Adolescents and Youths (Nigerian experience). Delivered at the 45 th session of the United Nations Commission on Population and Development. New York. April 24 th 2012. Available from: www.un.org/esa/populatiion/cpd/cpd2012/.../Nigeria_item4.pdf. [Last accessed on 2012 Nov 12]. |
|5.||United Nations Fund for Population Activities. Factsheet: Young People's Health and Development in Nigeria. Available from: http://www.nigeria.unfpa.org/pdf/factshhetactionpointsyout.pdf. [Last accessed on 2012 Nov 12]. |
|6.||Amoran OE. A comparative analysis of predictors of teenage pregnancy and its prevention in a rural town in Western Nigeria. Int J Equity Health 2012;11:37. |
|7.||Uwaezuoke AI, Uzochukwu BS, Nwagbo DF, Onwujekwe OE. Determinants of teenage pregnancy in rural communities of Abia State, South East Nigeria. J Coll Med 2004;9:28-33. |
|8.||Okonofua FE. Factors associated with adolescent pregnancy in rural Nigeria. J Youth Adolesce 1995;24:419-38. |
|9.||Maureen W. Determinants of teenage pregnancy: The case of Busia District in Kenya. Econ Hum Biol 2007;5:322-39. |
|10.||Alade MO. Teenage pregnancy in Ile-Ife, western Nigeria. West J Nurs Res 1989;11:609-13. |
|11.||Fatusi AO, Blum RW. Predictors of early sexual initiation among a nationally representative sample of Nigerian adolescents. BMC Public Health 2008;8:136. |
|12.||Haidre K, Rahu K, Rahu M, Karo H. Individual and familial factors associated with teenage pregnancy: An interview study. Eur J Public Health 2009;19:266-70. |
|13.||Chen XK, Wen SW, Fleming N, Demissie K, Rhoads GG, Walker M. Teenage pregnancy and adverse birth outcomes: A large population based retrospective cohort study. Int J Epidemiol 2007;36:368-73. |
|14.||Paranjothy S, Broghton H, Adapa R, Fone D. Teenage pregnancy: Who suffers? Arch Dis Child 2009;94:239-45. |
|15.||Odu BK, Ayodele CJ. The Incidence of Teenage Pregnancy in Ekiti State, Nigeria. Niger J Guid Counc 2006;11:25-33. |
|16.||Olorunfemi EA. A comparative analysis of predictors of teenage pregnancy and its prevention in a rural town in Western Nigeria; 2012. Available from http://www.equityhealthj.com/content/11/1/37. [Last accessed on 2012 Nov 12]. |
[Table 1], [Table 2], [Table 3], [Table 4]