Adolescent and adult first time mothers' health seeking practices during pregnancy and early motherhood in Wakiso district, central Uganda

被引：76

作者：

Atuyambe L. ^{[1
,2
,4
]}

Mirembe F. ^{[2
]}

Tumwesigye N.M. ^{[3
]}

Annika J. ^{[4
]}

Kirumira E.K. ^{[5
]}

Faxelid E. ^{[4
]}

机构：

[1] Makerere University School of Public Health, Department of Community Health and Behavioural Sciences, Kampala

[2] Makerere University School of Medicine, Department of Obstetrics and Gynecology, Kampala

[3] Makerere University School of Public Health, Department of Biostatistics and Epidemiology, Kampala

[4] Karolinska Institutet, Department of Public Health Sciences, Division of International Health

[5] Makerere University, Faculty of Social Sciences, Kampala

来源：

Reproductive Health | / 5卷 / 1期

关键词：

Reproductive Health; Adolescent Mother; Maternal Health Service; Reproductive Health Service; Child Health Service;

D O I：

10.1186/1742-4755-5-13

中图分类号：

学科分类号：

摘要：

Background: Maternal health services have a potentially critical role in the improvement of reproductive health. In order to get a better understanding of adolescent mothers'needs we compared health seeking practices of first time adolescent and adult mothers during pregnancy and early motherhood in Wakiso district, Uganda. Methods: This was a cross-sectional study conducted between May and August, 2007 in Wakiso district. A total of 762 women (442 adolescents and 320 adult) were interviewed using a structured questionnaire. We calculated odds ratios with their 95% CI for antenatal and postnatal health care seeking, stigmatisation and violence experienced from parents comparing adolescents to adult first time mothers. STATA V.8 was used for data analysis. Results: Adolescent mothers were significantly more disadvantaged in terms of health care seeking for reproductive health services and faced more challenges during pregnancy and early motherhood compared to adult mothers. Adolescent mothers were more likely to have dropped out of school due to pregnancy (OR = 3.61, 95% CI: 2.40-5.44), less likely to earn a salary (OR = 0.43, 95%CI: 0.24-0.76), and more likely to attend antenatal care visits less than four times compared to adult mothers (OR = 1.52, 95%CI: 1.12-2.07). Adolescents were also more likely to experience violence from parents (OR = 2.07, 95%CI: 1.39-3.08) and to be stigmatized by the community (CI = 1.58, 95%CI: 1.09-2.59). In early motherhood, adolescent mothers were less likely to seek for second and third vaccine doses for their infants [Polio2 (OR = 0.73, 95% CI: 0.55-0.98), Polio3 (OR = 0.70: 95% CI: 0.51-0.95), DPT2 (OR = 0.71, 95% CI: 0.53-0.96), DPT3 (OR = 0.68, 95% CI: 0.50-0.92)] compared to adult mothers. These results are compelling and call for urgent adolescent focused interventions. Conclusion: Adolescents showed poorer health care seeking behaviour for themselves and their children, and experienced increased community stigmatization and violence, suggesting bigger challenges to the adolescent mothers in terms of social support. Adolescent friendly interventions such as pregnancy groups targeting to empower pregnant adolescents providing information on pregnancy, delivery and early childhood care need to be introduced and implemented.

引用

共 40 条

[31] Kaye D.K., Mirembe F.M., Bantebya G., Johansson A., Ekstrom A.M., Domestic violence during pregnancy and risk of low birthweight and maternal complications: A prospective cohort study at Mulago Hospital, Uganda, Trop Med Int Health, 11, 10, pp. 1576-1584, (2006)
[32] Kaye D.K., Mirembe F.M., Bantebya G., Johansson A., Ekstrom A.M., Domestic violence as risk factor for unwanted pregnancy and induced abortion in Mulago Hospital, Kampala, Uganda, Trop Med Int Health, 11, 1, pp. 90-101, (2006)
[33] Naved R.T., Azim S., Bhuiya A., Persson L.A., Physical violence by husbands: Magnitude, disclosure and help-seeking behavior of women in Bangladesh, Social Science & Medicine (1982), 62, 12, pp. 2917-2929, (2006)
[34] Jonzon R., Vung N.D., Ringsberg K.C., Krantz G., Violence against women in intimate relationships: Explanations and suggestions for interventions as perceived by healthcare workers, local leaders, and trusted community members in a northern district of Vietnam, Scandinavian Journal of Public Health, 35, 6, pp. 640-647, (2007)
[35] Thaddeus S., Maine D., Too far to walk: Maternal mortality in context, Social Science & Medicine (1982), 38, 8, pp. 1091-1110, (1994)
[36] Tsu V.D., Antenatal screening: Its use in assessing obstetric risk factors in Zimbabwe, Journal of Epidemiology and Community Health, 48, 3, pp. 297-305, (1994)
[37] Kyomuhendo G.B., Low use of rural maternity services in Uganda: Impact of women's status, traditional beliefs and limited resources, Reproductive Health Matters, 11, 21, pp. 16-26, (2003)
[38] Engebretsen I.M., Wamani H., Karamagi C., Semiyaga N., Tumwine J., Tylleskar T., Low adherence to exclusive breastfeeding in Eastern Uganda: A community-based cross-sectional study comparing dietary recall since birth with 24-hour recall, BMC Pediatrics, 7, (2007)
[39] Wamani H., Astrom A.N., Peterson S., Tylleskar T., Tumwine J.K., Infant and young child feeding in western Uganda: Knowledge, practices and socio-economic correlates, Journal of Tropical Pediatrics, 51, 6, pp. 356-361, (2005)
[40] Luther N.Y., Mother's tetanus immunisation is associated not only with lower neonatal mortality but also with lower early-childhood mortality, National Family Health Survey Bulletin, 10, pp. 1-4, (1998)

← 1 2 3 4 →