Perceived Facilitators and Barriers to Interventions Aimed at Reducing Unintended Pregnancies among Adolescents in Low and Middle Income (Developing) Countries: a Systematic Review of Qualitative Evidence

Enuameh, Yeetey; White, Sarahlouise; Adjei, George; Abokyi, Livesy; Owusu‐Agyei, Seth; Pearson, Alan

doi:10.11124/jbisrir-2012-19

Cited by 3 publications

(7 citation statements)

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“…The fear of perceived complications from FP use [14]- [16] [18] could prevent adolescents from accessing such services. Another relevant finding from this study was cost of services that did come up as a barrier in this study in contrast to an earlier review of experiences of young persons from LMICs [19].…”

Section: Discussioncontrasting

confidence: 62%

Making Family Planning Services Relevant to Adolescents: Perspectives from Rural Communities in Central Ghana

Enuameh¹,

Tawiah²,

Afari-Asiedu³

et al. 2014

OJPM

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In lower middle-income countries like Ghana, it is common to find low contraceptive use among adolescents with corresponding high pregnancy outcomes. Evidence points to the fact that the use of contraceptives prevents maternal, neonatal and infant deaths, but in most lower middle-income countries, socio-cultural practices inhibit adolescents' use. Ensuring the uptake of family planning among adolescents is deemed a necessary means of reducing maternal, neonatal and infant mortality. This manuscript seeks to provide contextually relevant approaches to satisfying family planning needs of adolescents in a population lacking it. We employed a qualitative study design from an interpretive paradigm with phenomenology as the methodology to understand societal attitudes towards family planning delivery to adolescents, so as to arrive at contextually appropriate ways of providing family planning to this needy group. Focused group discussions and in-depth interviews techniques were used in data collection among adolescents, relevant community opinion leaders and family planning & health services providers. Themes that emerged from data analysis with respect to "perspectives on family planning care delivery to adolescents" and "best ways in addressing adolescents' family planning needs" are presented, followed by discussion of the issues emerging. A significant and encouraging finding of the study was that opinion leaders and healthcare providers viewed family planning as a means of protecting adolescents against pregnancies and their complications. A key recommendation is for policy makers and political leaders to enact legislations that enable adolescents to have friendly family planning service delivery in all places and at all times.

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Section: Discussioncontrasting

confidence: 62%

Making Family Planning Services Relevant to Adolescents: Perspectives from Rural Communities in Central Ghana

Enuameh¹,

Tawiah²,

Afari-Asiedu³

et al. 2014

OJPM

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“…Females' contraceptive patronage was lower than that of males at their last sexual encounter. Possible reasons for this situation could be the fear of perceived complications from contraceptive use, and stigmatization from society and health workers [23] [24] The study observed that the male condom and withdrawal were popular and common to both sexes. Another interesting observation by the study was that females would have preferred using the pill and injectable in the future, in direct contrast to their current use of the methods.…”

Section: Discussionmentioning

confidence: 99%

Family Planning Needs of Adolescents in Predominantly Rural Communities in the Central Part of Ghana

Enuameh¹,

Nettey²,

Mahama³

et al. 2015

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The manuscript presents findings of a descriptive analysis of data from a cross-sectional study of adolescents aimed at identifying their family planning needs and the best approaches to addressing them in the Kintampo Districts of Ghana. Data for the paper were from the family planning module of a sexual and reproductive health survey carried out by the Kintampo Health and Demographic Surveillance System in 2011. Adolescents in this study recorded high marital (1.6% females and 0.4% males) and pregnancy rates (11.5% females and 1.5% males). Their knowledge of contraceptive methods was high (87.7% females and 82% males), but utilization was low (17.9% females and 6% males). Most study participants viewed family planning as important to their health and wellbeing (59.6% females and 58.6% males). A minority of adolescents were of the perception that contraceptive use was solely the responsibility of women (41.1% females and 32.4% males); and that the use of contraceptives could lead to promiscuity among women (43.8% females and 42.5% males). Those adolescents who previously had unwanted pregnancies would have accepted some help in preventing it (33.1% females and 9.1% males). Recommendations made by respondents included creating a friendly atmosphere by care providers for family planning services delivery to adolescents. Other suggestions were ensuring that family planning services are available and accessible to adolescents, and educating adolescents on the diverse methods available.

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“…19 In Ghana, as in most LMICs, gender inequality was also mediated through social norms that subordinate adolescent girls to men and limits their ability to make independent SRH decisions. 6 Gender inequality was also reinforced by family poverty, a phenomenon that led some parents to force their daughters into early marriage while others encouraged their daughters to engage in sex for money to support the family. Family poverty has been shown to exacerbate gender inequalities in other LMICs.…”

Section: Discussionmentioning

confidence: 99%

“…As in Ghana, a deeply embedded sense of disapproval of adolescent sexual activity has been reported in other LMICs. 6 27 Conversely, some community members and adolescent girls themselves stigmatised late childbearing as a sign of infertility. The stigma of late childbearing was thought to create an environment which influenced some adolescent girls to engage in sexual activity despite prohibitionary social norms.…”

Section: Discussionmentioning

confidence: 99%

“…A systematic review of qualitative evidence linked the effectiveness of interventions to reduce adolescent pregnancy in low-income and middle-income countries (LMICs) with a number of local characteristics. 6 For example, interventions aimed at reducing unintended pregnancies in LMICs were shown to be more effective when adolescent girls have positive attitude towards family planning and are assertive to protect themselves from unplanned pregnancies, care providers address the needs of adolescents and family and community members support adolescents in ASRH decision-making. Implementation was deterred where adolescents felt alienated from health and educational programmes, parental supervision was ineffective and there was societal and religious abhorrence of open sexual discourse and adolescents use of family planning services.…”

Section: Introductionmentioning

confidence: 99%

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Barriers and facilitators regarding the implementation of policies and programmes aimed at reducing adolescent pregnancy in Ghana: an exploratory qualitative study

2022

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ObjectivesThis study explored the perceived barriers and facilitators regarding the implementation of policies and programmes aimed at reducing adolescent pregnancy among health and education professionals (‘professionals’), grassroots workers and adolescent girls in Ghana.Design and settingWe employed an exploratory qualitative study design involving interviews with professionals, grassroots workers and adolescent girls in the Central Region of Ghana.ParticipantsThis study involved 15 professionals employed in government or non-governmental organisations, 15 grassroots workers and 51 pregnant/parenting and non-pregnant adolescent girls.Data analysisThematic analysis was conducted deductively using the ecological framework for understanding effective implementation.ResultsEighteen themes mapped to the five domains of the ecological framework emerged. Perceived barriers included gender inequality, family poverty, stigma, community support for early childbearing and cohabitation, inadequate data systems, lack of collaboration between stakeholders and lack of political will. Effective implementation of community by-laws, youth involvement, use of available data, and collaboration and effective coordination between stakeholders were the perceived facilitators.ConclusionPolitical leaders and community members should be actively engaged in the implementation of adolescent sexual and reproductive health policies and programmes. Gender empowerment programmes such as education and training of adolescent girls should be implemented and strengthened at both the community and national levels. Community members should be sensitised on the negative effects of norms that support child marriage, gender-based violence and early childbearing.

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Perceived Facilitators and Barriers to Interventions Aimed at Reducing Unintended Pregnancies among Adolescents in Low and Middle Income (Developing) Countries: a Systematic Review of Qualitative Evidence

Abstract: IMPLICATIONS FOR RESEARCH: Further research should be conducted into the following.

Cited by 3 publications

References 43 publications

Making Family Planning Services Relevant to Adolescents: Perspectives from Rural Communities in Central Ghana

Making Family Planning Services Relevant to Adolescents: Perspectives from Rural Communities in Central Ghana

Family Planning Needs of Adolescents in Predominantly Rural Communities in the Central Part of Ghana

Barriers and facilitators regarding the implementation of policies and programmes aimed at reducing adolescent pregnancy in Ghana: an exploratory qualitative study

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