Risk factors for unwanted / unplanned teenage pregnancy in Zomba District, Malawi

Abstract

ABSTRACT Teenage pregnancy is a health and social problem in Malawi as a result of physical, psychological and socio-economic consequences on the teenage mother, family and the society as a whole. Although studies have been conducted on the prevalence and risk factors that cause teenage pregnancy in Malawi before, detailed reports are scanty, especially for Zomba district. In spite of studies and interventions that have been and are being implemented, the prevalence of unplanned teenage pregnancy in Malawi is still high, suggesting that more efforts are required to achieve effective preventive measures. The aim of this study was to explore risk factors such as cultural issues, non-use of contraceptives, lack of knowledge on sexual and reproductive health, circumstances of first sex, gender power dynamics, sexual and physical violence, age difference between teenage girls and their partners and socio-economic status for unplanned teenage pregnancy in Zomba district of Malawi. A cross-sectional analytic design was used. Five antenatal clinics were selected using a stratified and simple random sampling technique. Data were obtained from 505 participants under the age of 20 years using a questionnaire administered through face-to-face interviews. Descriptive statistics were used to analyse data and comparisons between planned and unplanned teenage pregnancy were conducted using the Chi-squared (P ≤ 0.05) and logistic regression model to predict factors for unplanned pregnancy. Findings reveal that unplanned pregnancy accounted for 76.4% of teenagers attributable to early sex and marriage, low contraceptive use, educational levels and socio-economic status, lack of knowledge of reproductive and sexual health, physical and sexual violence and substance abuse, transactional

sex due to poverty, early school dropout, misleading counselling causing a lack of knowledge on sexual and reproductive health and gender inequalities. Recommendations made are aimed at eliminating myths and misconceptions surrounding the use of contraceptives and condoms, empowering teenagers economically and in decision making, promoting career guidance, awareness on human rights, including sexual and reproductive rights and implications of early marriage and training of traditional counsellors. A multisectoral approach, including government, Non-Governmental Organisations (NGOs) and communities, is required to implement these recommendations.