Autor/a:
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Shahabuddin, A. S. M.; Nostlinger, Christiana; Delvaux, Therese; Sarker, Malabika; Bardají, Azucena; Brouwere, Vincent De; Broerse, Jacqueline E. W.
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Abstract:
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BACKGROUND: Bangladesh has the highest rate of adolescent
pregnancy in South Asia. Child marriage is one of the leading
causes of pregnancies among adolescent girls. Although the
country's contraceptive prevalence rate is quite satisfactory,
only 52% of married adolescent girls use contraceptive methods.
This qualitative study is aimed at exploring the factors that
influence adolescent girls' decision-making process in relation
to contraceptive methods use and childbearing. METHODS AND
RESULTS: We collected qualitative data from study participants
living in Rangpur district, Bangladesh. We conducted 35 in-depth
interviews with married adolescent girls, 4 key informant
interviews, and one focus group discussion with community health
workers. Adolescent girls showed very low decision-making
autonomy towards contraceptive methods use and childbearing.
Decisions were mainly made by either their husbands or
mothers-in-law. When husbands were unemployed and financially
dependent on their parents, then the mothers-in-law played most
important role for contraceptive use and childbearing decisions.
Lack of reproductive health knowledge, lack of negotiation and
communication ability with husbands and family members, and
mistrust towards contraceptive methods also appeared as
influential factors against using contraception resulting in
early childbearing among married adolescent girls. CONCLUSIONS:
Husbands and mothers-in-law of newly married adolescent girls
need to be actively involved in health interventions so that
they make more informed decisions regarding contraceptive use to
delay pregnancies until 20 years of age. Misunderstanding and
distrust regarding contraceptives can be diminished by engaging
the wider societal actors in health intervention including
neighbours, and other family members. |