Matrix 1: Critical analysis summaries of the five peer-reviewed articles

Consequences and

Indicators/points Peer-reviewed articles

1 2 3 4 5
Title Adolescent fertility Unsafe abortion
and family planning requiring hospital
in East Asia and the admission in
Pacific: A review of the Eastern Highlands
Demographic of Papua New Guinea -
Health Survey a
reports. descriptive study of
women’s and health
care
workers’ experiences
Authors Elissa Kennedy, Lisa M Vallely,
Natalie Gray, Peter Primrose Homiehombo,
S Azzopardi and Angela Kelly-Hanku and
Mick Creati. Andrea Whittaker
Journal Reproductive Vallely et al.
health, 8, 11. Reproductive Health
(2015) 12:22
DOI 10.1186/s12978-
015-0015-x
Country where research was DHS report were Papua New Guinea
undertaken taken in 11
countries:
Cambodia,
Indonesia, Marshall
Island, Nauru,
Papua New Guinea,
Philippines, Samoa,
Solomon Island,
Timor-Leste, Tuvalu
and Vietnam.
Aim/Objective The aim or objective Overall aim of the study
of this study is to: this literature is to
identify accessible describe, from one
information about setting in PNG, the
adolescent fertility reasons why women
and current use, resort to unsafe
 knowledge and abortion, the
access to family techniques used, the
planning consequences leading
information to hospital admission
services. and the reasons behind
both the abortion and
seeking post abortion
care.
Objectives Summarizes key -Identify majority of
finds from available maternal deaths that
data to provide an occurred over a 40-
overview of month retrospective
adolescent fertility period that were
and family planning attributable to
in the region; complications of unsafe
identify potential abortion.
targets for further - identify the majority of
research to better women presenting for
inform policy and post abortion care that
programs. had used misoprostol to
end unwanted
pregnancies.
- Soughed to identify all
women admitted to the
hospital with suspected
or confirmed abortion
including both
spontaneous and
induced abortion
Brief study background Pregnant Induced abortion in
adolescent women Papua New Guinea is
have significant restricted under the
health and socio- Criminal Code Law
economic therefore unsafe
consequences that abortion are in PNG are
also affect their known to be widely
families and practiced and sepsis
communities. When related to unsafe
trying to prevent abortion is the second
adolescent leading cause of
pregnancy, policy maternal mortality in
makers and PNG. Despite the
programmers criminal law that
should rely on restricts abortion,
accurate induced, unsafe
 information about abortions are known to
adolescents’ be practiced although
knowledge, documented evidence is
behaviors and limited. A number of
access to family societies within PNG
planning, however use traditional, herbal
available data are abortifacients and
limited in some physical or mechanical
settings. Policy means to end unwanted
makers and pregnancies.
programmers
should use
recognized data
reports like the
Demographic and
Health Survey(DHS)
because they are
recognized as
providing nationally
representative
reports for low or
lower middle
income countries in
East Asia and
Pacific to determine
what information
regarding
adolescent fertility
and family planning
is available and
summarizes key
findings.
Persuasiveness (influence) of its
argument
Gaps in the available Much less in known
knowledge about access to
family planning and
contraceptive use in
South Pacific.
Its overall coherence (logic, Available data
reason, consistency, rationality) indicate that
adolescent sexual
activity and
pregnancy are
 common in East
Asia and the Pacific
in the context of low
contraceptive
prevalence.
Adolescents also
appear to have
lower use and
higher unmet need
for contraception,
poorer knowledge
of family planning
and less access to
information and
services than older
women. Adolescent
pregnancy
prevention should
be an integral
component of
efforts to improve
maternal health and
ensure universal
access to
reproductive health
but it cannot be
assumed that
adolescent will
automatically
benefit from policies
and programs that
are aimed at the
general population.
Research methodology x X x x x
-Study location 11 countries in the Eastern Highlands
South Pacific Province
-Research design used - The DHS research
design consist of
survey questions
and reporting of
age-disaggregated
data and marital
status.
- Reviewed the
 available DHS
report and
identified all
indicators relevant
to: sexual activity,
fertility and
unintended
pregnancy;
contraceptive
prevalence and
unmet need for
contraception; and
problems accessing
health services.
-Data for age-
aggregated
indicators as
mentioned above
were soughed from
the DHS reports to
determine what
information about
adolescent (10-19)
is accessible to
policy makers and
programmers.

-Sample size & selection All women,

currently married
and ever-married
adolescent women (
age 10-19)
-Variables used Dependent-
unmarried
adolescents
Independent- all
married and
unmarried women
-Data analysis All the reported
data disaggregated
by age were
entered into an
Excel [24] database
to identify outcomes
 for adolescent and
where possible
compare with adult
women for each
country.
-Ethics
-Data collection techniques survey questions
and reporting of
age-disaggregated
data and marital
status.
Limitations - Some
surveys were
conducted
more than
five to ten
years ago
and it is
likely that
adolescent
fertility and
contraceptiv
e use have
changed in
time.
- DHS reports
had some
limitations
including;
the non-
inclusion of
adolescent,
the non-
inclusion of
unmarried
adolescent
or failure to
report on
separate
ages for
some
important
indicators,
particularly
 contraceptiv
e
preferences
and
discontinuati
on.
- Analysis of
primary data
was beyond
the scope of
this review,
- The DHS is
particularly
relevant to
those
indicators
not
separated by
age such as
contraceptiv
e
preferences
and
discontinuati
on, as well as
exploring
outcomes for
unmarried
sexually
active
adolescent.
- Sampling
populations,
survey
questions
and
reporting of
age-
disaggregate
d data and
marital
status vary
between
countries for
some
 indicators,
limiting the
ability to
make
comparisons.
- Failure to
report data
for
unmarried
sexually
active
adolescents
or report
age-
disaggregate
d data for
some
indicators
Recommendations for further - If further
research researches were to
be done, they
should consider the
gaps and the
limitations in this
research to fully
complete the DHS
so that policy
makers and
programmers could
fully utilize the data
and provide the
best health possible
for the maternal.
- Further research
is required to better
understand the
barriers that both
married and
unmarried
adolescents face
accessing
reproductive health
information and
services, and their
information and
service delivery
preferences, so that
interventions can be
effectively targeted
to meet their needs