NAMES: MPOLOKENG MOTAKE

STUDENT NUMBER: 202101820

PROGRAM: BACHELOR OF NURSING SCIENCE

RESEACH TOPIC

Assessment of ing knowledge, perceptions and attitudes among women of childbearing

age about family planning commodities uptake especially long-term reversible methods
at Nts’ekhe Hospital.

PROBLEM STATEMENT

Introduction

Family planning is the consideration of the number of children a person wishes to have,
including the choice to have no children and the age at which they wish to have them
(source).

Background

According to Aliyu (2018), despite recent increase in contraceptive use, Sub-Saharan Africa
is still characterized by high fertility rate and a considerable unmet need for contraception. If
there was use of effective contraceptive, at least 90% of abortion-related and 20% of
pregnancy- related morbidity and mortality together with 32% maternal deaths could be
prevented as there would be no high birth rates. In Sub-Saharan Africa, it is estimated that
about 14 million unintended pregnancies occur each year, half of them occurring among
women aged 15-24 years. This age group is likely to be scholars which means this can result
to a lot of dropouts and teenage pregnancies and depression can be the end result when a
teenage mother cannot copy with their situation.

Furthermore, Ibrahim (2022), added that family planning is one of the services that has
positive influence on the social welfare and health of the mothers and directly contributes to
reduction of maternal morbidity and mortality. It is a major health issue in Africa and it has
degenerated more into socioeconomic problems like poverty, overpopulation and delinquent
children. Even though studies have shown that family planning is safe to use, it remains
obscure to most women in developing countries such as Nigeria. Fewer women have
knowledge and access to family planning but majority of Nigerians failed to adopt the habit
due to many factors like education, age, culture, religion, income and health status which
influence their attitude towards family planning uptake.

The Kingdom of Lesotho recognizes that supporting family planning and related
interventions have profound health, economic, and social benefits for families and
communities. So its mandate is to protect the health of women and adolescent girls by
reducing high-risk pregnancies, protecting the health of children by allowing sufficient time
between pregnancies, reducing abortions, as well as supporting women’s and adolescents’
rights and opportunities. Discontinuation rates are high being 22 percent, as most users prefer
short-term methods. HIV and AIDS prevalence has remained high at 25 percent, hence the
need for dual protection and integrated approach to care. According to the survey conducted
in 2017 supported by Ministry of Health and UNFPA only 66 percent of facilities provide
modern family planning methods, and so there is a need to provide complementary services
for facilities that do not. The survey also showed that a lot of healthcare providers were not
trained on long acting reversible methods and so not applying more effort in facilitating
women and young girls about such services. (Ministry of Health, 2021;1).

Nts’ekhe Hospital is therefore not exceptional in this case as it faces a lot of teenage
pregnancies and many women who are not allowing sufficient time between pregnancies. So
the purpose of the study is to assess the knowledge, perceptions and attitudes among women
of childbearing age about family planning commodities uptake at Nts’ekhe Hospital.

PROBLEM STATEMENT

Family planning is the most important health service required by consumers especially
women as stated by millennium development goal five which is about improving maternal
health (Source). According to United Nations (2020:1), in the last two decades, the
percentage of women accessing contraceptives in both developed and developing countries
has increased as the reports states that in 2019, 63 percent of women aged 15 to 49 were
using some form of contraception method and 58 percent were using modern contraception
method. However, in Lesotho teenage pregnancies remain high at 19 percent, with only 40
percent of sexually active using modern family planning method (Source). This will result in
………. Therefore the researcher……….. Despite these advancements, a lot of women still
lack access to modern contraceptives (source). This is evidenced by statistics that even
though contraceptive use is above 70 percent in Europe, Latin America and the Caribbean, as
well as Northern America, it is below 25 percent in Middle and Western Africa.

According to Aliyu (2018), despite recent increase in contraceptive use, Sub-Saharan Africa
is still characterized by high fertility rate and a considerable unmet need for contraception. If
there was use of effective contraceptive, at least 90% of abortion-related and 20% of
pregnancy- related morbidity and mortality together with 32% maternal deaths could be
prevented as there would be no high birth rates. In Sub-Saharan Africa, it is estimated that
about 14 million unintended pregnancies occur each year, half of them occurring among
women aged 15-24 years. This age group is likely to be scholars which means this can result
to a lot of dropouts and teenage pregnancies and depression can be the end result when a
teenage mother cannot copy with their situation.

Furthermore, Ibrahim (2022), added that family planning is one of the services that has
positive influence on the social welfare and health of the mothers and directly contributes to
reduction of maternal morbidity and mortality. It is a major health issue in Africa and it has
degenerated more into socioeconomic problems like poverty, overpopulation and delinquent
children. Even though studies have shown that family planning is safe to use, it remains
obscure to most women in developing countries such as Nigeria. Fewer women have
knowledge and access to family planning but majority of Nigerians failed to adopt the habit
due to many factors like education, age, culture, religion, income and health status which
influence their attitude towards family planning uptake.

The Kingdom of Lesotho recognizes that supporting family planning and related
interventions have profound health, economic, and social benefits for families and
communities. So its mandate is to protect the health of women and adolescent girls by
reducing high-risk pregnancies, protecting the health of children by allowing sufficient time
between pregnancies, reducing abortions, as well as supporting women’s and adolescents’
rights and opportunities. However, teenage pregnancies remain high at 19 percent, with only
40 percent of sexually active using modern family planning method. Discontinuation rates are
high being 22 percent, as most users prefer short-term methods. HIV and AIDS prevalence
has remained high at 25 percent, hence the need for dual protection and integrated approach
to care. According to the survey conducted in 2017 supported by Ministry of Health and
UNFPA only 66 percent of facilities provide modern family planning methods, and so there
is a need to provide complementary services for facilities that do not. The survey also showed
that a lot of healthcare providers were not trained on long acting reversible methods and so
not applying more effort in facilitating women and young girls about such services. (Ministry
of Health, 2021;1).

Nts’ekhe Hospital is therefore not exceptional in this case as it faces a lot of teenage
pregnancies and many women who are not allowing sufficient time between pregnancies. So
the purpose of the study is to assess the knowledge, perceptions and attitudes among women
of childbearing age about family planning commodities uptake at Nts’ekhe Hospital.

Research questions
RESEACH TOPIC

ASSESSING FACTORS CONTRIBUTING TO TEENAGE PREGNANCY AT

NTS’EKHE HOSPITAL

INTRODUCTION

Teenage pregnancy iscan be defined as pregnancy that occurs in young girls below the age of
twenty, regardless of whether they are married or of adult age (source). Teenage pregnancy
has been increasing at an alarming rate especially in the United States, Africa and United
Kingdom. It has become a global concern because it not only affects the teenager and her
family, but the society in general. An increase in teenage pregnancy can lead to increased
child poverty as well as degradation of the child’s well-being (source). One of the causes of
teenage pregnancy is absence of affectionate supervision from parents or guardians (source).
In the current society, parents are either too busy to take care of the adolescents children or
too permissive (source). Another major cause of teenage pregnancy is peer pressure where a
girl maybe pushed by others in having sex in order to fit well in their group (source). Sexual
abuse as well as drug and alcohol abuse can also lead to teenage pregnancy as they may not
have an understanding of what they are getting themselves into. Lack of sex education in
schools can also contribute to teenage pregnancy as they might indulge in sexual activity
without understanding the possible effects (IvyPanda, 2023:1). Apart from doing daily health
education and providing family planning services to adolescent, Nts’ekhe Hospital is doing
school health educating teenagers about dangers of teenage pregnancy

PROBLEM STATEMENT

According to UNFPA (2021:1-2), teenage pregnancy remains a challenge in Lesotho. The

adolescent birth rate is high, at 94 per 1000 girls aged 15 to 19 as per 2003 to 2018 statistics.
A 2017 report by the United Nations Education, Scientific and Cultural Organization
(UNESCO) listed Lesotho among the leading countries on early and unintended pregnancies.
60% of girls aged 15 to 19 are mothers or pregnant with their first child, which places
Lesotho second to Namibia which is at 70% for high rates of unintended pregnancies among
the East and Southern African countries.

Adolescent girls tend to be at greater risk of complications as their bodies are not yet fully
developed. Such complications can be cephalopelvic disproportion which can lead to
caesarean section having to be performed to deliver the baby safely. In Lesotho, the maternal
mortality ratio is high, at 618 deaths per 100000 live births as shown by 2016 census. Studies
have shown that 33% of women in Lesotho mostly die of obstetric haemorrhage, 24% die of
hypertension-related conditions and 6% die of puerperal sepsis. Due to high rate of maternal
deaths, UNFPA, the United Nations and reproductive health agency, supports the government
of Lesotho’s efforts to increase access to quality sexual and reproductive health and rights
(SRHR) services that are integrated and youth friendly (UNFPA 2021:2). Irrespective of any
measures taken to overcome teenage pregnancy Nts’ekhe Hospital still has high rate of
teenage pregnancy, therefore the researcherstudy is aimsed ato assessing factors contributing
to teenage pregnancy at Nts’ekhe Hospital.

.
BACKGROUND

According to American Pregnancy Association (2023:1), teenage pregnancy is one that

occurs for a woman under the age of 20. Even though a young woman aged 12 or under who
is pregnant falls under this definition technically she is not a teenager. With over 200000
babies being born to teenage women in the United States, teenage pregnancy is not
uncommon occurrence. However, that does not stop teenage women who are expecting from
feeling daunted by their pregnancy more especially if it was unplanned. Freedman and Jane
(2020:1) added that, despite a successful ten year strategy to reduce teenage pregnancies
implemented by the Labour Government between 1999 and 2010, the United Kingdom still
has one of the highest teenage pregnancy rates in Western Europe. Low educational
attainment is both a cause and consequence of teenage pregnancy (source).

Furthermore, teenage pregnancies are higher in developing countries than developed

countries, and more so in the sub-Saharan Africa of 28% of adolescents give birth before the
age of 18. 28% of girls in West and Central Africa have had a live birth by the age of 18
while Eastern and Southern Africa has 25% (source). In Uganda, more than one out of four
adolescents aged 15 to 19 become pregnant with higher rate of 27% in rural areas than urban
areas which is 19% and this raises public health concern (Nabugoomu, Seruwagi and
Hanning, 2020:2). Amoadu, Ansah, Assopiah, Acquah, Ansah, Berchie, Hagan and Amoah
(2022:2), continued to say that in developing countries, an estimated 21 million adolescent
girls aged 15 to 19 become pregnant and about 12 million of them give birth each year. 2.5
million adolescent girls below the age of 16 give birth early according to the reports. In
Ghana, two out of ten girls become pregnant or welcome their first child before they reach
the age of 18years (source).

As indicated by (Ndlovu, 2022:1), the latest adolescent pregnancy data from Statistics South
Africa shows that 90037 girls aged 10 to 19 gave birth from March 2021 to April 2022,
across all provinces. Moreover, Save the Children (2021:1), showed that the number of
children born to teen mothers in South Africa’s most populous province, Gauteng, has
jumped 60% since the start of Covid-19 pandemic, with Save the Children concerned for the
well-being of both mothers and babies. New figures from the Gauteng Department of Health
(year) show that more than 23000 girls aged under 18 gave birth between April 2020 and
March 2021 of which 934 were aged under 14 compared to 14577 girls aged 19 and under
having babies in the same period a year earlier. Early pregnancy and motherhood in South
Africa forces many girls to drop out of schools, traps many in a cycle of poverty dependant
on public assistance, and leaves many stigmatised by society for being teenage mothers or
forced into early marriage.

According to UNFPA (2021:1), teenage pregnancy remains a challenge in Lesotho. The

adolescent birth rate is high, at 94 per 1000 girls aged 15 to 19 as per 2003 to 2028 statistics.
A 2017 report by the United Nations Education, Scientific and Cultural Organization
(UNESCO) listed Lesotho among the leading countries on early and unintended pregnancies.
60% of girls aged 15 to 19 are mothers or pregnant with their first child, which places
Lesotho second to Namibia which is at 70% for high rates of unintended pregnancies among
the East and Southern African countries.

RESEARCH QUESTIONS

What are the factors contributing to teenage pregnancy among teenagers at Ntsekhe hospital?

What are the perceived complications of that can result from teenage pregnancy?

What are strategies that can be implemented to overcome teenage pregnancy?

RESEARCH QUESTIONS

AIM

OBJECTIVES

SIGNIFICANCE OF THE STUDY

VARIABLES

DEFINITION OF CONCEPTS

SUMMARY