000			05258nam a22002417a 4500
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040			_eNLM
060			_aTHS-00746
100			_aBhatta,Kusumsheela.
245			_aFactors associated with adolescent pregnancy and its health consequences among Chepang women in selected wards of Raksirang rural municipality, Makwanpur district: A mixed method study.
260			_cc2023.
300			_axix,260p.
500			_aThesis Report.
520			_aSUMMARY: Background: Adolescent pregnancy, which is defined as any pregnancy in a girl aged 10-19 years, is a matter of concern for public health and human rights. The Chepang people are an indigenous ethnic group and are one of the most marginalized and disadvantaged communities in Nepal. Maternal conditions are among the top causes of disability-adjusted life years (DALYs) and death among girls aged 15-19. Aim: This study aimed to determine the factors associated with adolescent pregnancy and its health consequences among Chepang women in selected wards of Raksirang Rural Municipality, Makwanpur District. Design: Concurrent triangulation mixed method design Methods: A cross-sectional study was conducted among 231 Chepang women selected from Wards 5 and 8 of Raksirang Rural Municipality. Chepang women aged 10 to 25 years who ever gave birth were included in the quantitative study. Simple random sampling was done to select the participants. A semi-structured questionnaire was used for interviewing the mothers. The data were coded, entered in Epidata Version 3.1, and analyzed using STATA MP 13 version and EZR software Version 4.0.4. Bivariate and Multivariate logistic regression using odds ratio with 95% CI was carried out. Variables with a VIF of more than 2 and a p-value of more than 0.25 were excluded from the final model. For the qualitative study, 40 participants (20 in-depth interviews and 20 key informant interviews) were recruited through judgmental sampling. An interview guide was used for interviewing the participants. All interviews were audio recorded, transcribed, translated, and analyzed using RQDA package. Braun and Clarke’s six steps thematic analysis was done for qualitative analysis. Result: The study revealed that the prevalence of adolescent pregnancy among Chepang women was 71.4% [CI 65.14-77.16]. A large proportion of respondents (72.73%) were married before the age of 18 years. Early age at marriage (AOR= 236, CI: 71.46-472.67), poor knowledge of adolescent pregnancy (AOR=10.3, CI 8.42 14.87), unplanned pregnancy (AOR=13.3, CI 10.76-19.2), and lack of sex education (AOR=6.57, CI 3.85-11.27) were significantly associated with adolescent pregnancy. 21.8% of adolescent mothers had an abortion and 73.3% of adolescent mothers had delivered their first child at home. 24.8% of adolescent mothers had experienced health problems during pregnancy, 29.1% had health problems during delivery and 22.4% had health problems during the postpartum period. The factors affecting adolescent pregnancy from qualitative study were identified as lack of access and use of sexual and reproductive health services, programs and policies, elopement marriages, discontinuation of education, poor knowledge and understanding of marriage pregnancy and childbirth, and existing socio-cultural beliefs and norms. Likewise, adolescent mothers mostly opted for home delivery, had miscarriages, sought abortion care due to unwanted pregnancy, and feared consuming iron tablets during pregnancy. The triangulation of the data from qualitative and quantitative study validated that early marriage, unplanned pregnancy, knowledge of adolescent pregnancy, and sex education were the factors influencing adolescent pregnancy. The areas of divergence identified during triangulation were elopement marriage, education level, distance to the health facility, societal family and peer pressure, socioeconomic status, and contraceptive use, where qualitative findings contradicted quantitative findings. The areas of expansion were identified as women's position in society, the role of men in family planning, fear of not having a child later using contraception, hesitancy and fear of the service provider, programs and policies, repercussion of media and technology, immaturity and unfilled desires, schooling after marriage as a stigma, children subjected to forced labor and fear to consume iron tablets. Conclusion: The prevalence of adolescent pregnancy among the Chepang community was high. Increasing awareness of the consequences of adolescent pregnancy, providing comprehensive sexuality education to adolescents, improving access to reproductive health services, and taking legal action to stop child marriage could prevent adolescent pregnancy among Chepang women. Keywords: adolescent pregnancy, factors, Chepang, sexual and reproductive health, Nepal
650			_aAdolescent pregnancy.
650			_aFactors.
650			_aChepang.
650			_aSexual and reproductive health.
650			_aNepal.
856			_yhttps://www.nhrc.gov.np/
942			_2NLM _cTR
999			_c3276 _d3276