Introduction
Pregnancies among the adolescent is a norm among many societies in the world. According to a Neelofur-Khan (2007) approximately 14 million teenagers, aged 15-19 get pregnant each year. In the sub-Saharan Africa, more than half of the populations of women give birth before they attained the age of 20.
The regional birth rate among the sub Saharan adolescents is approximately 115 births per 1000 pregnancies (Neelofur-Khan 2007). However, this reality is not limited to the developing countries in the sub Saharan region only; some of the developed nations are acutely affected by the menace of teenage pregnancies.
While the concepts of modernization, law, and other controls have led to a slight decrease in cases of adolescent pregnancy, teen pregnancy remain prevalent in most regions of the world. The number of girls getting pregnant during their teens, all over the world, remains high despite the worldwide campaigns launched to discourage teen pregnancy.
Adolescent pregnancy affects all communities and countries in the world. In fact, both the developed and the developing nations encounter the problem of adolescent pregnancies. In the United States, for instance, adolescent pregnancies remain higher than in most of the developed countries.
Although the number of pregnancies among adolescents between aged 15 to 19 has decreased by an estimated twenty-one percent in developed nations, the number of adolescent pregnancies in the America remains high (Rothenberg and Weissman 2002). Approximately 40% of women below the age of twenty in America get pregnant annually (Dangal, 2006).
National statistic records in the United States indicate that an approximate 12,000 female below the age of 15 are pregnant (Rothenberg and Weissman 2002). With these staggering figures seen in the United States seeming hard to beat, it is astonishing to learn that the numbers of adolescent pregnancies in the sub-Saharan Africa are higher. Research conducted in the 1990s show that sub-Saharan Africa has the highest number of teen pregnancies (Demographic health surveys 1995).
The sub Saharan region is affected by various factors that encourage teen pregnancies. Factors such as poverty, sexual abuse, and lack of career opportunities among other causatives lead to early pregnancies among the sub Saharan adolescents. Teenage pregnancies are accompanied by various risks. Some of the risks include potential death of the mother, spread of HIV to among the adolescents and high potential death of the infant (Matson 2002).
Adolescents may suffer death in case they try to abort under unsafe conditions. According to a report released World Health Organization, the number of abortions in the United States range between 2 and 4 million per year. Adolescents resort to unsafe procedures performed non-professional doctors because abortion is illegal in most countries of the world. The unsafe procedures performed these doctors increase the risk of teenagers contracting HIV and AIDS.
Winter (1997) in his paper ‘why teenage girls become pregnant’ revealed that, a number of factors might lead to pregnancies of the adolescents. He noted that most teenagers became pregnant because they lacked ambition.
Moreover, Poor grades, low self-esteem, unrealistic expectations, and lack of proper parental control lead the teenagers into the trap of early pregnancies (Harrington 2004). This paper discusses some determinants of adolescent pregnancy. Moreover, this article describes an intervention program that has had some success in reducing morbidity and mortality associated with pregnancy in adolescent.
Adolescent Pregnancies in Sub-Saharan Africa
Teenage pregnancies in the sub Saharan countries is almost a norm in most societies. Poverty in these countries is very high and most children, especially the girl child, do not get sufficient education to sustain their future needs.
Therefore, by the time a girl attains the age of 14, she may be married or pregnant (Sarri & Phillips 2004). In some communities, the parents are free to marry off their daughters when they attain a certain age. With this in mind, it is easier to understand why this region has the highest number of adolescent pregnancies.
In the sub Saharan region, teenage pregnancies are a major concern because it has a number of well-known negative socioeconomic and health impacts. To begin with, teenage pregnancies are known to reduce productivity in any society. Since most of the teenagers are usually dependants, they tend to increase the burden of their caretakers when they get pregnant. Furthermore, they become less productive because they drop out of school. Therefore, teenage pregnancies increases poverty in the sub Saharan countries.
Health care services in the sub Saharan region are still in the process of developing. Furthermore, the laws of most sub Saharan countries are against abortion. Therefore, when a pregnant adolescent chooses to abort, she may be risking her life by exposing herself to the poor medical care in the region.
Therefore, teenage pregnancies decrease the chances of death and morbidity especially when they opt to undertake an abortion. In countries where abortion is illegal, the teenagers tend to use their own means or consult non-professions. The poor health care combined with use of unprofessional means of aborting explains the reason why the number of deaths due to abortion is high in the region.
In order to discuss the concept of teenage pregnancies comprehensively then discussion on determinants of teenage pregnancies cannot be avoided. In the sub-Saharan Africa, there are a number of determinants of teenage pregnancies. In this article, we will discuss community structure, exposure to sexual content, sexual abuse, standards of living, and future expectations as the major determinants of teenage pregnancies.
Determinants of Adolescent Pregnancies
There is a great amount of literature addressing the question on direct and indirect determinants of adolescents’ pregnancy. Kingsley and Blake (1956) came up with a framework that is useful in finding out determinants of teenage pregnancies. In their work, they identified three important factors that can be used to explain pregnancies among the adolescents.
These factors included, factors affecting birth control, fecundity and sexual unions (Kingsley and Blake 1956 p. 211). Direct determinants of pregnancies include ability to have intercourse, ability to conceive and ability to carry pregnancies (Fathi 2003 pp. 10). From Kingsley and Blake’s framework, researchers have refined the determinants of teen pregnancies to specific causatives.
Standards of Living (Level of Poverty)
The standards of living in a society determine the manner of life that the society will adopt. Poor communities adopt a life style that generally encourages teen pregnancies. Therefore, the level of poverty in a community is one of the major factors that determine whether an adolescent will become pregnant or not (Rosen 1997 p. 58).
Research shows that the poorer the community or society the higher the chances of adolescent pregnancies. A number of explanations are available to support this concept. To begin with, poor communities lack sufficient resources to educate their children (Hao & Cherlin 2004). Lack of proper education on means of preventing pregnancies may lead to early pregnancies.
Poverty may also lead to some unethical practices that lead to early pregnancies. In most poor societies, early marriages are common (Franklin & Corcoran 2000). The parents usually want to get rid of the burden they have and may give out their daughters at an early age for marriage. Such practices lead to an increase in the number of teenage pregnancies in the sub Saharan communities.
Community Structure
Community structure is one of the major factors that contribute to adolescent pregnancies and early motherhood (Rosen 1997). Community structure usually determines how the family structure will be in many societies. In sub Saharan Africa the family structure is very important in determining whether the girl child will get pregnant at an early age or not.
Adolescent women who live in unstable families have a higher likelihood of getting pregnant during their teens than those living in stable families. This is because the adolescents in unstable families indulge in sexual intimacy for the purpose of short-term comfort (Rosen 1997 p. 56). Rejection by the parents interferes with the morale and the self-esteem of adolescents. These adolescents will seek early relationships outside the family to boost their morale and esteem (Santelli et al 2004).
On the other hand, stronger family ties and good parental care from both parents has been known to lower the risks of adolescent pregnancies (Weisfeld and Woodward 2004). Parental influence is a significant variable in determination of adolescent pregnancy.
Parents who dwelled on educating their children about the negative impacts of teen pregnancies encountered fewer levels of pregnancies in their families. Absence of a father in a family structure is a primary reason for teen pregnancies in most sub Saharan families. According to Manlove et al. (2002), adolescents with mothers who gave birth at a young age have higher probability of engaging in early sexual intercourse.
Exposure to Sexual Content
Today children are exposed to sexual material at a younger age than they previously were. In addition to this, puberty occurs much earlier in the adolescents (Desirae and Karen 2007 p.6).
Therefore, sexual activities begin at an earlier age and the result is that the adolescents become more sexually experienced (Raphael 2005). A survey conducted in 2003 showed that the number o adolescents who had sexual encounters by the age of 14 doubled between 1988 and 1995 (Desirae and Karen 2007 p.6).
However, no relation has been established between the time a girl reaches puberty and the time likelihood of her getting pregnant. Nevertheless, early puberty plus other factors such as poor parental control, early exposure to sexual material, and peer pressure is known to increase the chances of teenagers getting pregnant (Farber 2003).
Some factors in the social set up of a teenage life collude to increase the chances of early adolescent pregnancies. Early exposure to sexual content leads to early experimentation and may lead to early pregnancies among the adolescents.
Sexual Abuse
Sexual abuse alters the teenagers mind about sexual behaviors. Sexually abused adolescents, especially girls, initiate sexual activities earlier than their counterparts do. The act of sexual abuse in its own may be a causative of teen pregnancies. However, most of the adolescent pregnancies are as a result of unresolved issues and feelings associated with sexual abuse in the earlier life.
Farber (2003) found out that nearly 40 percent of the adolescents who had their first sexual encounter at the age of 13 or 14 intimated that the intercourse was involuntary. In the sub Saharan Africa, the likelihood of adolescent pregnancy increased in cases where the child was sexually abused. Therefore, adolescents who were sexually abused are likely to get involved in sexual activities at an earlier age, leading to the risk of pregnancy and HIV infection (Mayer & Pizer 2009).
Sexually abused adolescents have low self-esteem and therefore, they are likely to indulge in sexual activities in order to lessen the feeling of being unwanted in the society. These activities are likely to lead to early pregnancies that have various harsh implications in the teenager’s life. Research shows that a high number of pregnant adolescent girls had partners aged over twenty years. Therefore, sexual abuse accounts for a sizeable number of teenage pregnancies.
Future Expectations
Intentional pregnancies among the adolescents are limited to low income earning teenagers with no future prospects (McWhirter et al. 2000). These adolescents usually perceive their future as bleak and opt for motherhood. In his research, Davies et al (2004) explained that adolescents, who decide to become mothers usually, get poor grades in school or are attempting to escape bad condition at home.
Therefore, adolescents whose future are not well planned or have no promise indulge in sexual activities that are likely to lead to early pregnancies. This concept explains the reason behind the high number of pregnancies in the sub Saharan Africa. In this region most adolescents to do have very many future options especially the girls. In some communities, the girls are not even educated and therefore, by the age of fifteen the girl may be married.
A study conducted by the United States bureau of census (1995) showed that 1 out of 4 women aged between 15 and 19 is married. Moreover, the sexual activity in this group of adolescents is higher in the sub Saharan region than in any other region in the world. Adolescent girls with brighter futures tend to restrain from sexual encounters because they are well aware of the consequence of teenage motherhood and are not willing to risk their future (Meade & Ickovics 2005).
Intervention Program
Various intervention programs have been adopted in order to combat the problem of adolescent pregnancies. The most notable of these programs is education (Yampolskaya et al. 2004). In the twentieth century, schools, governments, communities, and non-governmental organizations have worked hard to assist to eliminate the problem of adolescent pregnancy.
Education is as one of the most successful intervention methods because it is multi-faceted (Jones et al. 2006). It incorporates different concepts to ensure that the adolescents are equipped with sufficient knowledge to combat the problem of early pregnancies. Among the concepts incorporated in education is abstinence. Most education programs, aimed at reducing the rate of teenage pregnancies, address the question abstinence as a major way of reducing pregnancy.
In addition to abstinence, education encourages other concepts such as delayed sexual encounters. Most educators advise the adolescents to wait for the right time before engaging in sexual activities (Brown & Barbosa 2001). Education also teaches life skills, which enhances the ability of the teenagers to think outside the box, look past their fears, and esteem issues.
Schools have extended their educational opportunities and they currently offer great learning environments for pregnant teenagers. Alternative programs have been designed to meet the needs of adolescents with children. These programs provide education on parenting, pregnancy issues, and childbirth. Students in the alternative programs are allowed to gain graduation credits. Moreover, they have access to counseling sessions, on site nursing and quality health care services.
Strengths and Weaknesses of Education
Adolescent pregnancy prevention services, especially the long-term services, offer a lot of support services to the adolescents. These education programs can be tailored to meet the needs of the needs of groups or the needs of an individual (Sarkees-Wircenski & Scott 2003). Education has many advantages when used to combat adolescent pregnancies. According to a report written by WHO (2009) education ensures that some objectives, that assist in eliminating adolescent pregnancies, are met.
To begin with, education reduces the number marriages that occur before attainment of legal age. Well-educated adolescents girls rarely consent to getting married before they attain the legal age. Therefore, the numbers of pregnancies reduce in such cases. Education encourages the use of contraceptives which reduce the risk of pregnancy among the teenagers aged 15 to 19 (Spear 2004).
Properly designed education programs ensure that risk of adverse reproductive outcomes is minimized. This is because a good education programs provides information on unsafe abortions among the adolescents and the risks associated with such cases of abortions.
Moreover, education minimizes the risk of potential death among the adolescents by providing information on proper antenatal care, childcare, and postnatal care. Impregnated adolescents can use this information to avoid unnecessary risks thus reducing the potential risk of death.
However, education is not without its weaknesses. For instance, the cost of disseminating information to the youth is very high. Education can be disseminated through the media, campaigns, and schools but the use of these channels cost a lot of money (Bissell 2000). These costs reduce the likelihood of information reaching the target groups. In sub Saharan countries, where poverty is prevalent and corruption in most of the countries is high, the chances of educating all the adolescents are very low.
In addition to the costs, education requires other forms interventions to increase its chances of success. Education on its own accord cannot reduce the risk of adolescent pregnancy; incorporation of counseling programs is required in order to complement education programs (Brindis & Philliber 2003). Counseling addresses the deeply rooted psychological problems that affect the adolescents.
Conclusion
Cases of adolescent pregnancy are common around the world. Sub Saharan Africa has the highest level of adolescent pregnancy in the world. The sub Saharan region is affected by various factors that have encouraged teen pregnancies. Factors such as poverty, sexual abuse, and lack of career opportunities among other causatives lead to early pregnancies among the sub Saharan adolescents. There is a great amount of literature addressing the question on direct and indirect determinants of adolescents’ pregnancy.
Community structure is one of the major factors that contribute to adolescent pregnancies and early motherhood. Various intervention programs have been put forward to combat the problem of adolescent pregnancies. The most notable of these programs, which try to eliminate this problem, is education.
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