Beschrijving

Background:
Pregnancy among adolescents occurs with varying frequency across regions, countries, within countries and income groups. Ninety five percent of the total adolescents’ births occur in developing countries [1]. Each year 7.3million girls under age of 18give birth in developing countries [2]. Among them around 2 million girls give birth before the age of 15. Early marriage and motherhood is considered as a social and health problem in Nepal. In South Asia, Nepal has the second highest rate of adolescent pregnancy after Bangladesh. Around 17% of adolescent women in Nepal start childbearing by the age of 19 years [3]. Low socio- economic status, limited education, cultural factors, social norms and extended family structure all appeared to be related to teenage pregnancy [4]. Teenage marriage has a long tradition in Bangladesh which enhances the chance of early childbearing. Though legal age of marriage for women is 18years, around 66%of Bangladeshi female adolescents get married before the age of 18 and among them 33%arebecoming pregnant by the age of 19 [5]. Almost all the births take place within the bounds of marriage. Complications in pregnancy and childbirth are the leading cause of death among adolescent girls [6]. Annually70, 000 adolescent women die of causes related to pregnancy and childbirth in developing countries [7]. The risk of pregnancy related death among the adolescent is double compared to the women in their twenties [8]. In developing countries, adolescent pregnancy has been associated with maternal complications, including anemia, caesarian delivery, but also with complications for infants such as, premature birth, low birth weight, perinatal mortality and increased infant mortality [9]. The major factors which contribute directly or indirectly for maternal and perinatal morbidity and mortality are: age at marriage, poverty, lack of education, lack of access of routine and obstetric care from skilled care providers, malnutrition, physical immaturity, cultural factors that restrict women’s autonomy, low decision making power, inadequate health-care behavior or use of services [10,11, 12]. Early transition to motherhood is also associated with wide-range of social and individual negative consequences for young mothers. Compared to older mothers, the life course consequences of adolescent mothers tend to be characterized by fewer life opportunity and higher rates of psychosocial disadvantage, including leaving school early, under achievement of education (leads to unemployment), prolonged welfare dependence, less competent and more punitive parenting, maternal depression and greater exposure to partner violence [13]. Several studies conducted in Asia have revealed that health care-seeking behavior varies among adolescent and adult married women. Regular use of antenatal care (ANC)and use of skilled birth attendance are less common among women married at an age lower than 17 years than those married at an age higher than 18 years [14, 15]. Rural younger mothers are also less likely to seek care from a medically trained provider compared to urban younger mothers [16]. A study in Nepal indicated that the frequency of antenatal check-up among teenage pregnant women is poor compared to the mothers in their twenties [17]. Newborn care practices (complete cord care, complete thermal protection, breast feeding and postnatal check-up for new born) and postpartum care of mothers are relatively low among the married adolescent in Bangladesh [18, 19]. Maternal education of young mothers and use of antenatal care affects the utilization of postpartum care services by timing and type of providers. A recent study found that mother’s age at delivery, residence, education, antenatal care, place of delivery, wealth, husband’s occupation, husband’s concern about pregnancy complications and mother’s permission to go to health center alone were likely to affect utilization of postpartum care services [20].
General objective of the research project: To analyze the patterns of health care-seeking behavior among adolescent pregnant women in Nepal and Bangladesh.
Specific Objectives of the research project: To measure and compare the trends of utilization of maternal and newborn healthcare services among adolescent and adult women in Nepal and Bangladesh. To identify and explore the factors affecting health care-seeking behavior of adolescent women during pregnancy, delivery and post-partum care in Nepal and Bangladesh. To identify the critical areas that will require additional focus for reducing maternal and perinatal mortality and morbidity among adolescent pregnant women in terms of their health care-seeking behavior and to propose a target specific intervention accordingly, here by contributing to policy generation by respective health authorities.
StatusVoltooid
Effectieve start/einddatum13/02/1417/11/17

    Expertisedomeinen

  • B680-volksgezondheid

ID: 1366950