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

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          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.

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          Most cited references28

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          Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990–2019

          Unintended pregnancy and abortion estimates document trends in sexual and reproductive health and autonomy. These estimates inform and motivate investment in global health programmes and policies. Variability in the availability and reliability of data poses challenges for measuring and monitoring trends in unintended pregnancy and abortion. We developed a new statistical model that jointly estimated unintended pregnancy and abortion that aimed to better inform efforts towards global equity in sexual and reproductive health and rights.
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            Prevalence and determinants of unintended pregnancy in sub-Saharan Africa: A multi-country analysis of demographic and health surveys

            Introduction Approximately 14 million unintended pregnancies are recorded annually in sub-Saharan Africa (SSA). We sought to investigate the prevalence and determinants of unintended pregnancies among women in sub-Saharan Africa. Materials and methods The study pooled data from current Demographic and Health Surveys (DHS) conducted from January 1, 2010 to December 31, 2016 from 29 countries in SSA. Logistic regression analysis was used to examine the factors that influence unintended pregnancies in SSA. Results were presented using odds ratios (OR). Results We found overall unintended pregnancy prevalence rate of 29%, ranging from 10.8% in Nigeria to 54.5% in Namibia. As compared to women aged 15–19 years, women of all other age categories had higher odds of unintended pregnancies. Married women were 6 times more probable to report unintended pregnancy as compared to women who had never married (OR = 6.29, CI = 5.65–7.01). The phenomenon had higher odds among rural residents as compared to urban residents (OR = 1.08, CI = 1.01–1.16). Women with primary (OR = 0.74, CI = 0.69–0.80) and secondary (OR = 0.71, CI = 0.65–0.77) levels of education had less chances of unintended pregnancies, compared to those with no education. Again, women in all other wealth categories had less probability of unintended pregnancy, as compared to women with poorest wealth status. Conclusion Our study contributes substantially towards the discourse of maternal wellbeing by unveiling the prevalence and determinants of unintended pregnancy across the SSA region. There is the need for SSA countries with high prevalence of unintended pregnancies to consider past and present successful interventions of other countries within the region such as health education, counselling, skills-building, comprehensive sex education and access to contraception. Much of these efforts rest with the governments of SSA countries.
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              Pregnancy and childbirth are leading causes of death in teenage girls in developing countries.

              S Mayor (2004)
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                Author and article information

                Journal
                Open Access J Contracept
                Open Access J Contracept
                oajc
                Open Access Journal of Contraception
                Dove
                1179-1527
                05 February 2023
                2023
                : 14
                : 15-21
                Affiliations
                [1 ]Department of Psychiatry, Lira University , Lira City, Uganda
                [2 ]Department of Nursing and Midwifery, Lira University , Lira City, Uganda
                [3 ]Department of Mental Health, Makerere University , Kampala City, Uganda
                Author notes
                Correspondence: Amir Kabunga, Department of Psychiatry, Lira University , P.O BOX, 1035, Lira City, Uganda, Tel +256777929576, Email amirkabs2017@gmail.com
                Article
                399973
                10.2147/OAJC.S399973
                9910206
                36776919
                6d1951dc-18a6-413a-b31b-9a9ce7719a73
                © 2023 Okalo et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 08 December 2022
                : 02 February 2023
                Page count
                Figures: 0, Tables: 2, References: 28, Pages: 7
                Funding
                Funded by: funding from the Center for International Reproductive Health Training;
                Funded by: the University of Michigan;
                Funded by: mainly supported the process of proposal development, data collection, and processing;
                Funded by: funder does not have any influence on the study findings or its processes;
                This research work was supported by seed funding from the Center for International Reproductive Health Training (CIRHT-UM), at the University of Michigan, it mainly supported the process of proposal development, data collection, and processing. The funder does not have any influence on the study findings or its processes.
                Categories
                Original Research

                adolescents,covid-19,crisis,unintended pregnancy
                adolescents, covid-19, crisis, unintended pregnancy

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