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乌干达北部奥亚姆区第二波新冠疫情期间少女意外怀孕的预测因素

Predictors of Unintended Pregnancy Among Adolescent Girls During the Second Wave of COVID-19 Pandemic in Oyam District in Northern Uganda.

作者信息

Okalo Ponsiano, Arach Anna Agnes, Apili Brenda, Oyat Jimmy, Halima Namata, Kabunga Amir

机构信息

Department of Psychiatry, Lira University, Lira City, Uganda.

Department of Nursing and Midwifery, Lira University, Lira City, Uganda.

出版信息

Open Access J Contracept. 2023 Feb 5;14:15-21. doi: 10.2147/OAJC.S399973. eCollection 2023.

Abstract

BACKGROUND

In Uganda, unintended pregnancies are responsible for one in three births with detrimental consequences, a situation that worsened during COVID-19. Thus, the present examined unplanned pregnancy and its associated risks in Oyam district, northern Uganda during the COVID-19 epidemic.

METHODS AND METHODS

This study employed a cross-sectional study among adolescent girls aged 15-19 years who had a pregnancy during the second phase of COVID-19 in Oyam district, northern Uganda in November 2022. A consecutive method was employed to recruit the participants attending health facilities. A structured questionnaire was utilized to collect data. For data analysis, both bivariate and multivariable regression methods with adjusted odds ratio and 95% CI were used. A p-value of 0.05 was used to determine the significance level.

RESULTS

Of the total respondents, 292 (69.5%) were aged between 18 and 19 years of age, 295 (70.2%) lived in rural areas, and 222 (52.9%) had no formal education. The results also show that 293 (69.8%) of the respondents had unintended pregnancies during COVID-19. The results indicate that participants who lacked knowledge of the ovulation period (AOR: 0.242; 95% CI: 0156-0376; P<0.001), sex education during COVID-19 (AOR: 0.563; 95% CI:: 0.365-0.869; P=0.024) and lacked the freedom to discuss family planning-related issues with family members during COVID-19 (AOR: 0.228; 95% CI: 0.138-0.376; P<0.001) were more likely to have an unintended pregnancy compared to their counterparts.

CONCLUSION

Our study shows that unwanted pregnancies among adolescent girls remain a public health issue in Oyam district with more than two-thirds of adolescents having unwanted pregnancies during the crisis of COVID-19. The major correlates of unwanted pregnancies among adolescent girls during COVID-19 pandemic were inadequate knowledge of the ovulation period, sex education, and lack of freedom to discuss family planning-related issues with family members. There is a need to prioritize interventions, especially in rural settings. Sex education to improve contraceptive use and delay sexual debut. In light of the possibility that social and cultural norms in the Oyam district prohibit parents and children from discussing sexual subjects, it is crucial to promote sexual health education through the mass media, including newspapers, television, radio, and social media.

摘要

背景

在乌干达,意外怀孕占三分之一的分娩案例,会产生有害后果,这种情况在新冠疫情期间有所恶化。因此,本研究调查了乌干达北部奥亚姆区在新冠疫情期间的意外怀孕情况及其相关风险。

方法

本研究对2022年11月在乌干达北部奥亚姆区处于新冠疫情第二阶段时怀孕的15至19岁少女进行了横断面研究。采用连续抽样方法招募到卫生机构就诊的参与者。使用结构化问卷收集数据。数据分析采用双变量和多变量回归方法,并调整比值比和95%置信区间。以p值0.05确定显著性水平。

结果

在全部受访者中,292人(69.5%)年龄在18至19岁之间,295人(70.2%)生活在农村地区,222人(52.9%)未接受过正规教育。结果还显示,293名(69.8%)受访者在新冠疫情期间意外怀孕。结果表明,对排卵期缺乏了解的参与者(调整后比值比:0.242;95%置信区间:0.156 - 0.376;P<0.001)、在新冠疫情期间未接受性教育的参与者(调整后比值比:0.563;95%置信区间:0.365 - 0.869;P = 0.024)以及在新冠疫情期间缺乏与家庭成员讨论计划生育相关问题自由的参与者(调整后比值比:0.228;95%置信区间:0.138 - 0.376;P<0.001)相比其他参与者更有可能意外怀孕。

结论

我们的研究表明,奥亚姆区少女意外怀孕仍是一个公共卫生问题,在新冠疫情危机期间超过三分之二的青少年意外怀孕。新冠疫情大流行期间少女意外怀孕的主要相关因素是对排卵期了解不足、性教育以及缺乏与家庭成员讨论计划生育相关问题的自由。有必要优先开展干预措施,特别是在农村地区。开展性教育以提高避孕措施的使用并推迟首次性行为。鉴于奥亚姆区的社会和文化规范可能禁止父母和子女讨论性话题,通过包括报纸、电视、广播和社交媒体在内的大众媒体推广性健康教育至关重要。

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