16 July 2011

Nigeria: Teenage Pregnancy Prevention

analysis

The reality in recent times that there is a rapid decline in the age at menarche, that is, age at which young girls see their menstruation as well as increased schooling among girls are two key events that have prolonged the period of adolescence.

Increased schooling in particular has made teenagers less dependent on parents and family, and has postponed the age at marriage, and thereby the age of socially sanctioned sexual relations.

Sub-Saharan Africa in general and Nigeria in particular are facing the grim impact of this growing problem as increased sexual activity among teenagers has resulted in many unplanned pregnancies and induced abortions.

Maternal mortality rate in Nigeria especially among teenagers is on the rise and unsafe abortion has been noted as a risk factor for maternal death. Teenagers contribute up to 80 per cent of abortion-related complications in hospitals.

Further still, complications of pregnancy and childbirth are the leading causes of mortality among women between the ages of 15 and 19 in developing countries.

Maternal mortality rate in Nigeria especially among teenagers is on the rise and unsafe abortion has been noted as a risk factor for maternal death. Teenagers contribute up to 80 per cent of abortion-related complications in hospitals.

Further still, complications of pregnancy and childbirth are the leading causes of mortality among women between the ages of 15 and 19 in developing countries.

Many factors lead to teenagers becoming pregnant, some of which include:

Early marriage, increased (unprotected) sexual activity, inadequate knowledge of or access to conventional methods of contraception, contraceptive failure due to incorrect/inappropriate use, sexual abuse (e.g. rape, poverty (economic hardship) leading to promiscuity and prostitution.

Unhealthy childhood environment (women exposed to abuse, domestic violence and family strife in childhood are more likely to become pregnant as teenagers).

The impact of teenage pregnancy on the teenager, the child and the society as a whole is enormous.

Teenagers face a higher risk of some complications of pregnancy (e.g. hypertensive disorders, obstructed labour, anaemia, malaria, malnutrition) than do older women.

Complications of pregnancy result in the death of an estimated 70,000 teen girls in developing countries each year. The World Health Organisation estimates that the risk of death following pregnancy is twice as great for women between 15 and 19 years than in those between the ages of 20 and 24. The maternal mortality rate (MMR) can be up to five times higher for girls aged between 10-14 than for women of about 20 years of age.

Illegal abortion also holds many risks for teenage girls in areas such as Sub-Saharan Africa.

Teenage pregnancy could also impact negatively on the teenager in the following ways:

Higher school drop-out rates, lower levels of educational attainment, reduced opportunities for well paying jobs, lower incomes, psychological distress due to stigmatisation, lack of social support networks and the overwhelming burden brought about by indecision as to whether to have the child or to terminate it.

The burden of raising a child, especially for a teenager who herself is still growing can also be overwhelming.

Children born to teenage mothers are more likely to be born preterm, low birth weight, and small-for-gestational age. They are also more likely to have suffered intrauterine growth restriction than those born to adult mothers. These factors thus lead to an increased risk of infant morbidity and mortality.

Early motherhood can also affect the psychosocial development of a child.

The occurrence of developmental disabilities and behavioural issues is increased in children born to teenage mothers.

Children of teenage mothers may also show poor academic performance.

Daughters born to adolescent mothers are also more likely to become teenage mothers themselves thus repeating the cycle.

Increased sexual activities among teenagers not only leads to an increase in the number of teenagers getting pregnant but also contributes to population explosion which has negative implications for national growth and economic development.

Increased sexual activities also lead to an increasing prevalence of sexually transmitted infections including HIV/AIDS thus contributing to the national burden of disease.

National productivity is also negatively affected as high school drop out rates due to teenage pregnancy and low education levels means lower human capital development, consequently leading to lower incomes and reduced contributions to the Gross Domestic Product.

Nigeria also faces a grim hope of achieving the United Nations' Millennium Development Goals especially MDGs 4 and 5, if this problem is not checked by appropriate and effective interventions.

Increased political will and support can greatly address the issue of teenage pregnancy in the following ways:

Increased budgetary allocations to the Ministry of Youth development., Increased funding for Youth Friendly Service Centres so that they offer a more comprehensive and integrated package to teenagers taking into consideration all aspects of their health (physical, mental, social and spiritual/moral wellbeing). The integrated package should include: Health services (sexual and reproductive health, prevention, detection, counseling and follow up of teenagers at risk of gender-based and sexual violence, especially women, nutrition education and counselling and general health check-ups), Social Services (educating on life building skills, vocational training and skill acquisition, career counseling, legal counselling and services, shelter and rehabilitation services, referral linkages to other Youth programmes and services).

Policies that support Family Life Education programmes in schools that expose teenagers to age-appropriate comprehensive sexuality education could also be enacted and enforced.

The Media is also a valuable tool in winning the fight against teenage pregnancy in the following ways:

National policies that serve as a guideline to restrict the sexual content of media programmes and articles with penalties for defaulters, could also be put in place. The enforcement of such penalties is also of great importance. Government-sponsored media programmes that emphasise the consequences of early sexual activity and encourages morality among youth.

This is an advocacy message by Ezeogu, Adanna Uzomaka (MPH) Department of Human Nutrition, University of Ibadan, Ibadan.

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