The determinants of teenage pregnancy in the Sekyere East District of Ashanti, Ghana: a case-control study

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Teenage pregnancy and childbearing is a major reproductive health problem in the Sekyere East District, Ghana, where teenage childbearing rate represents about 14% of all deliveries in the district Hospital at Effiduase. No scientific research has been conducted into the problem. The objective of the study is to identify the risk factors for teenage pregnancy in the district and the association of the risk factors to teenage pregnancy. A Case control study design, with 80 cases and 160 sexually active non- pregnant, ages - matched controls from the same neighbourhood or school was employed. The cases consisted of girls aged 13-19 years pregnant at time of the research or just delivered 3 months prior to study. The study subjects were recruited from 3 out of 5 sub-districts using the simple random sampling method. Cluster and purposive sampling techniques were employed in deciding which communities to survey. Total sampling was used in selecting the cases and controls as and where they could be found. A structured interviewer administered questionnaire was used to obtain information on risk factors on the part of teenagers, sexual behaviour, risk factors on the part of the parents and contraceptive knowledge and use. Conditional logistic regression was employed to analyze the relationship between teenage pregnancy and the factors. Teenage pregnancy was found to be strongly associated with teenagers’ level of education (X231.37 P0.04), marital status (X2=8.28; P0.00), teenage girls parents’ level of education: fathers (X2=29.22; P=0.00), mothers (X219.40 P0.00), profession; fathers (X218.76;P0.00), mothers (X2=6.87;P0.03), marital status (X2—9.85; P0.00), worshiping together with teenager (X26.28; P0.0l) and discussion of contraception with teenager (X24.05; P0.04). While 95% of the study subjects knew of at least one modern contraceptive method only 39% were using a modern method of contraception as at the time of the study. Approaches to preventing teenage pregnancy and child bearing in the Sekyere East District should involve improving the girl-child education, abstinence promotion, delaying sexual debut, modern contraceptive use as well as enhancing parental roles in addressing reproductive health issues in general and teenage pregnancy in particular.
A dissertation presented to the School of Graduate Studies, Kwame Nkrumah University of Science and Technology in partial fulfilment of the requirements for the award of in Public Health in Population and Reproductive Health, 2005