Int J Adolesc Med Health 2003; 15(4):331 -340. ©Freund Publishing House Ltd. Teenage pregnancy experiences in rural Kenya Negussie Taffa, MD, PhD 1 , David Omollo, MD, MPH 1 and Zoe Matthews, PhD 2 1 African Population and Health Research Center (APHRC), Shelter Afrique Center, Nairobi, Kenya; 2 Department of Social Statistics, University of Southampton, United Kingdom Abstract: This community-based survey describes the socio-economic determinants of teenage pregnancy, experiences of health problems during pregnancy, and health care utilization patterns among adolescents (12-19 years old) in rural Kenya. Characteristics of adolescents with repeated pregnancy experiences were compared with first-time pregnancies. The survey covered 3,132 households from 32 randomly selected communities and 1,247 adolescents were interviewed Data were collected retrospectively through quantitative and qualitative methods. Results showed that 572 (45.9%) adolescents had had sexual intercourse in the past, and of these, 245 (42.8%) had been pregnant at least once. A significant majority of adolescents who had been pregnant were not attending school during the survey period. Fifty-six percent of the first pregnancies occurred while the girl was single. Compared with repeat pregnancies, first pregnancies were more likely to be reported as unwanted (OR=2.4; 95% CI= 1.1, 5.3). Antenatal care attendance, place of delivery and pregnancy outcomes were not significantly different for first-time and repeat pregnancies. Adolescents' reports on health problems during pregnancy, labour and in the post-partum period were not associated with parity or with age (<16 years old). A lower proportion of younger Primigravidae sought medical attention for health problems that arose during pregnancy (OR=2.3; 95% CI= 1.1, 4.8) and labor (OR=3.6; 95% CI= 1.5, 8.7). In conclusion, the study highlighted major unmet reproductive health needs of adolescents in this region. Age and gravida influenced health care seeking which could increase the chances of serious life threatening complications among young Primigravidae. Keywords: adolescents, pregnancy, health care seeking, Kenya Correspondence: Negussie Taffa, MD. PhD African Population and Health Research Center (APHRC), Shelter Afrique Center, P. O. Box 10787. 00100 GPO, Nairobi, Kenya. Tel: +254 20720400; Fax: +254 20720380; E-mail: ntafTa@aphrc.org Submitted: June 10, 2003. Revised: July 02, 2003. Accepted: July 04, 2003. INTRODUCTION While a significant decline is being seen in other regions of the world (1-3), the prevalence of teenage pregnancy in sub- Saharan Africa still remains high (4,5). The urge to scale-up existing successful reproductive health programs is now becoming critical in a number of settings, especially where the number of adolescents in need of services is still growing. The current 'euphoria' associated with the effectiveness of HIV prevention in some countries (6) has fuelled the impetus for improved and more attuned reproductive health services in sub-Saharan Africa. Preventing unwanted pregnancies among adolescents is not an end in itself. Society and the health care system should enhance their efforts to provide basic support and services to those who are pregnant - whether married or unmarried. Current knowledge of the social and health problems of adolescent pregnancies comes mostly from clinic-based data on complicated pregnancy outcomes from adolescents who managed to seek professional assistance (7-10). Less is known about how representative these cases Brought to you by | Carleton University OCUL Authenticated Download Date | 6/22/15 8:46 PM