Socio-cultural factors influencing adolescent pregnancy in Ghana: a scoping review.

BACKGROUND: Adolescent pregnancy is a public health challenge that has well-defined causes, associated health risks, and social and economic consequences for adolescent, their families, communities, and society. The purpose of this scoping review is to summarize studies published on socio-cultural determinants of adolescent pregnancy in Ghana. METHODS: Search for records was done in four major databases, including PubMed CENTRAL, Science Direct and JSTOR. Records from Google and Google Scholar were also added, and results and findings from published and unpublished studies were included. All the 22 studies that met the eligibility criteria, were critically appraised. The guidelines for conducting scoping reviews by Arksey and O'Malley were followed. RESULTS: The result revealed that poverty, peer influence, low level of education, dysfunctional family, lack of communication between parents and their daughters, lack of sexual and reproductive health education, child marriage, coerced sex, misconception and non-usage of contraceptives, and decline in cultural values such as puberty rites and virginity inspection are some of the determinants of adolescent pregnancy in Ghana. The study also showed that there is a lack of high-quality observational studies that adjust for confounding variables. CONCLUSION: Interventions and policies should be designed to take into consideration the needs, context, and background of adolescents. Programmes to enhance adolescent reproductive health need to consider multilevel factors such as person, family, community, institutions, national, and global issues that affect such programmes.

Adverse obstetric and neonatal outcomes of adolescent pregnancies in Africa: a scoping review.

BACKGROUND: Adolescent pregnancy is a public health issue with well-defined causes and health risks with social and economic implications. Aim of this review was to examine adverse pregnancy outcomes and risk factors associated with adolescent pregnancy in Africa. METHOD: PubMed Central, Science Direct and JSTOR were the main databases for the literature review. Other online sources and experts were consulted for relevant studies. In all, 11,574 records were identified and 122 were considered as full-text studies for evaluation after thorough screening and removal of duplicates. Finally, 53 studies were included in this review for thematic synthesis. RESULTS: The 53 studies sampled 263,580 pregnant women, including 46,202 adolescents (< 20 years) and 217,378 adults (> 20 years). Adolescent pregnancy was associated with higher risks of adverse pregnancy outcomes. Factors of poor pregnancy outcomes included low socioeconomic and educational status, poor utilization of antenatal care, risky lifestyles such as alcohol consumption, and unattractive health care factors. Maternal health care utilization was identified as an important factor to improve pregnancy outcomes among adolescents in Africa. CONCLUSION: To prevent adolescent pregnancy, stakeholders need to help lower socioeconomic inequalities, poor utilization of antenatal care, alcohol consumption, and improve adolescents' health care and their educational status. Issues such as child marriage, abortion, poor health care infrastructure and non-adolescent friendly health facilities need to be addressed.

Determinants of parents' decisions on childhood immunisations at Kumasi Metropolis in Ghana.

OBJECTIVE: To describe factors that influence parents' decisions on childhood immunisations at Kumasi Metropolis in Ghana. STUDY DESIGN: Quantitative cross-sectional survey. METHODS: A sample of 303 parents was obtained from a monthly accessible population of 1420 individuals from the five district hospitals through convenience sampling of respondents at immunisation sessions in Kumasi. Data obtained from the survey were analysed with SPSS version 21 software. RESULTS: Most parents were aware of child immunisations, but they had limited knowledge on vaccines and immunisation schedules. Antenatal nurses constituted the most accessible source of vaccine information. The study established a high percentage of complete immunisation, influenced by parents' fear of their children contracting vaccine-preventable diseases. Remarkably, some parents indicated that they immunised their children because they wanted to know the weight of their children. Forgetfulness and lack of personnel or vaccine at the centres were the reasons given by the few parents who could not complete immunisation schedules for their children, whereas the socio-demographic variables considered did not influence parents' decision on immunisation. CONCLUSION: Knowledge on immunisation could not influence immunisation decisions but parents' fear of vaccine-preventable diseases, awareness on the benefits of immunisations and sources of vaccine information were the main factors that influenced immunisation decision at Kumasi in Ghana.