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《COVID-19 大流行期间怀孕和育儿的青少年和年轻女性的经历:肯尼亚女孩和妇女中的一项混合方法研究》

Experiences of Pregnant and Parenting Adolescents and Young Women During COVID-19 Pandemic: A Mixed-Methods Study Among Girls and Women in Kenya.

机构信息

Population Council, Nairobi, Kenya.

Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

出版信息

J Adolesc Health. 2024 Dec;75(6S):S35-S42. doi: 10.1016/j.jadohealth.2024.09.011.

Abstract

PURPOSE

This study examines the experiences of pregnant/parenting adolescents and young women during the first two years of the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

This explanatory sequential mixed-methods study leverages quantitative data collected among a cohort of adolescents and young people aged 15-22 years in three Kenyan counties; Nairobi, Kisumu, and Kilifi at three time points (2020, 2021, 2022), and two rounds of qualitative interviews in the same settings conducted in 2020 and 2022.

RESULTS

Among 2337 (2020), 1438 (2021), and 1669 (2022) respondents, pregnant/parenting adolescents and youth comprised 140 (6%), 101 (7%), and 83 (5%) individuals, respectively. Across the three time points, the experience of depressive symptoms was similar between pregnant/parenting adolescents and those not pregnant/parenting. Pregnancy and parenting was associated with twice the odds of skipping health services (adjusted odds ratio [aOR] 2.18, 95% confidence interval [CI] 1.43-3.35), in 2020, and 85% higher odds (aOR 1.85, 95% CI 1.14-3.02) in 2021, and 90% higher odds of skipping meals (aOR 1.90, 95% CI 1.19-3.03) in 2022. Qualitative findings indicated experiences of psychological distress, food insecurity, and inadequate access to health care services among pregnant/parenting young people during the pandemic.

DISCUSSION

The pandemic increased pre-existing challenges associated with adolescent and young people's health, predisposing young pregnant/parenting women to greater adversity than their nonpregnant/parenting counterparts. Targeted and responsive approaches during emergencies and crises such as social protection, food security, and mental health programs for this group of vulnerable people are required and need to be integrated into disaster response plans.

摘要

目的

本研究旨在探讨在 2019 年冠状病毒病(COVID-19)大流行的头两年中,怀孕/育儿青少年和年轻女性的经历。

方法

本解释性顺序混合方法研究利用了在肯尼亚三个县(内罗毕、基苏木和基利菲)的一组 15-22 岁青少年和年轻人中收集的定量数据;在 2020 年、2021 年和 2022 年三个时间点进行了三次调查,并在 2020 年和 2022 年在同一地点进行了两轮定性访谈。

结果

在 2337 名(2020 年)、1438 名(2021 年)和 1669 名(2022 年)受访者中,怀孕/育儿青少年和青年分别占 140 名(6%)、101 名(7%)和 83 名(5%)。在三个时间点,怀孕/育儿青少年和非怀孕/育儿青少年的抑郁症状经历相似。怀孕和育儿与错过卫生服务的可能性增加两倍相关(调整后的优势比[aOR]2.18,95%置信区间[CI]1.43-3.35),2020 年,2021 年的可能性增加 85%(aOR 1.85,95%CI 1.14-3.02),2022 年错过进餐的可能性增加 90%(aOR 1.90,95%CI 1.19-3.03)。定性研究结果表明,在大流行期间,怀孕/育儿的年轻人经历了心理困扰、粮食不安全和获得医疗保健服务不足等问题。

讨论

大流行增加了与青少年和年轻人健康相关的先前存在的挑战,使年轻怀孕/育儿的年轻女性比非怀孕/育儿的年轻女性更容易遭受更大的逆境。在紧急情况和危机期间,需要针对这群弱势群体采取有针对性和响应性的方法,例如社会保护、粮食安全和心理健康方案,并且需要将这些方案纳入灾害应对计划。

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