Department of Epidemiology and Biostatistics, The University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
Universidad Peruana Cayetano Heredia, Lima, Peru.
BMJ Glob Health. 2024 Apr 30;9(4):e012391. doi: 10.1136/bmjgh-2023-012391.
Due to COVID-19, schools were closed to mitigate disease spread. Past studies have shown that disruptions in education have unintended consequences for adolescents, including increasing their risk of school dropout, exploitation, gender-based violence, pregnancy and early unions. In Peru, the government closed schools from March 2020 to March 2022, declaring a national emergency that affected an estimated 8 million children. These closures may have unintended consequences, including increased adolescent pregnancy, particularly in Peru's rural, largely indigenous regions. Loreto, located in the Peruvian Amazon, has one of the highest adolescent pregnancy rates in the country and poor maternal and child health outcomes. The underlying causes may not be fully understood as data are limited, especially as we transition out of the pandemic. This qualitative study investigated the downstream effects of COVID-19 on adolescent education and reproductive health in Loreto's districts of Nauta and Parinari. In-depth interviews (n=41) were conducted with adolescents and community leaders. These were held in June 2022, 3 months after the reinstitution of in-person classes throughout Peru. Focus group discussions (FGDs) were also completed with community health workers and educators from the same study area in October 2022 to supplement our findings (3 FGDs, n=15). We observed that the economic, educational and health effects of the COVID-19 pandemic contributed to reduced contraceptive use, and increased school abandonment, early unions and adolescent pregnancy. The interplay between adolescent pregnancy and both early unions and school abandonment was bidirectional, with each acting as both a cause and consequence of the other.
由于 COVID-19，学校关闭以减轻疾病传播。过去的研究表明，教育中断对青少年有意外后果，包括增加他们辍学、被剥削、性别暴力、怀孕和早婚的风险。在秘鲁，政府从 2020 年 3 月至 2022 年 3 月关闭了学校，宣布国家进入紧急状态，这影响了大约 800 万名儿童。这些关闭可能会产生意外后果，包括青少年怀孕率增加，特别是在秘鲁农村、主要是土著地区。洛雷托位于秘鲁亚马逊地区，是该国青少年怀孕率最高的地区之一，母婴健康状况不佳。潜在原因可能尚未完全了解，因为数据有限，尤其是在我们走出大流行之际。这项定性研究调查了 COVID-19 对洛雷托的瑙塔和帕里纳里地区青少年教育和生殖健康的下游影响。对青少年和社区领导人进行了深入访谈（n=41）。这些访谈于 2022 年 6 月进行，当时秘鲁各地重新开始面对面上课 3 个月后。2022 年 10 月还与来自同一研究地区的社区卫生工作者和教育工作者完成了焦点小组讨论（FGD），以补充我们的研究结果（3 次 FGD，n=15）。我们观察到 COVID-19 大流行的经济、教育和健康影响导致避孕措施减少，以及辍学、早婚和青少年怀孕增加。青少年怀孕与早婚和辍学之间的相互作用是双向的，彼此既是原因又是结果。
