Determinants of adolescent pregnancy and access to reproductive and sexual health services for married and unmarried adolescents in rural Lao PDR: a qualitative study
Open Access
- 8 June 2018
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Pregnancy and Childbirth
- Vol. 18 (1), 1-12
- https://doi.org/10.1186/s12884-018-1859-1
Abstract
Early marriage and pregnancy is a risk factor for poor maternal and child health and socio-economic outcomes. Bokeo and Luang Namtha provinces in northern Lao People’s Democratic Republic (PDR) has high rates of teenage pregnancy. The purpose of this research was firstly to explore factors contributing to teenage pregnancy in rural Lao. Secondly, to understand the specific challenges adolescent mothers face in accessing maternal health services. Qualitative interviews were undertaken with adolescent mothers and unmarried adolescents aged 12 to 19 years, living in rural areas, and from different ethnic groups. In total, we undertook six focus group discussions with adolescents aged 13–19 years, twenty in-depth interviews with unmarried/married adolescents aged 12–19 years. In addition, we interviewed husbands of the adolescent mothers (N = 8) and mothers-in-law of both male and female adolescents (N = 9), community leaders and healthcare providers (health providers N = 17 and community leaders N = 12). Thematic analysis was used to analyze the data, based on a conceptual framework identified at the outset of the study. The findings suggest that pre-marital sex, early marriage and pregnancy are the norm in these settings. Determinants of teenage pregnancy included liberal attitudes to teen pre-marital sexual intercourse, early marriage and pregnancy, incomplete knowledge of sexual and reproductive health and limited access to appropriate services. The determinants of teenage pregnancy in this setting are multi-dimensional, and require a range of responses. As some of the determinants are deeply embedded in the system of local values, beliefs and practices, and form part of the logic of what it is to become a healthy woman, these practices are deeply entrenched and may be resistant to new knowledge. The challenge therefore is to find culturally responsive strategies that enable individual and collectively agency.Keywords
Funding Information
- World Bank Group
This publication has 36 references indexed in Scilit:
- Psychometric properties of the Swedish childbirth self-efficacy inventory (Swe-CBSEI)BMC Pregnancy and Childbirth, 2014
- “Be kind to young people so they feel at home”: a qualitative study of adolescents’ and service providers’ perceptions of youth-friendly sexual and reproductive health services in VanuatuBMC Health Services Research, 2013
- Health workers' attitudes toward sexual and reproductive health services for unmarried adolescents in EthiopiaReproductive Health, 2012
- Inequity in maternal health care utilization in VietnamInternational Journal for Equity in Health, 2012
- Cultural Reproduction and “Minority” Sexuality: Intimate Changes among Ethnic Akha in the Upper MekongAsian Studies Review, 2011
- Generating demand and community support for sexual and reproductive health services for young people: A review of the Literature and ProgramsReproductive Health, 2010
- Teenage pregnancy: A socially inflicted health hazardIndian Journal of Community Medicine, 2009
- Adolescents perception of reproductive health care services in Sri LankaBMC Health Services Research, 2008
- Nurse-Midwives' Attitudes towards Adolescent Sexual and Reproductive Health Needs in Kenya and ZambiaReproductive Health Matters, 2006