Experiences of pregnant adolescents--voices from Wakiso district, Uganda.

BACKGROUND In Uganda, morbidity and mortality among adolescent mothers and their children are high. Social factors behind this problem need to be better understood. OBJECTIVE To explore problems that pregnant adolescents face in order to design appropriate policies and interventions. METHODS This was a descriptive study that utilized qualitative methods for data collection. The study population comprised of pregnant adolescents, adolescent mothers, opinion leaders, In-charge of health unit, and Traditional Birth Attendants (TBAs) in Wakiso district, Uganda. Six Focus Group Discussions (FGDs) with adolescent mothers and pregnant adolescents, and six key informant interviews were conducted with leaders in-charge of health units and TBAs. A moderator and a note taker facilitated the FGDs, which were tape recorded with consent from participants. Qualitative content analysis was done. RESULTS Discussions revealed that pregnant adolescents faced domestic physical violence. Furthermore, they were psychologically violated by parents and partners, and the community within which they lived. Pregnant adolescents were treated inhumanely and overworked with household chores and had inadequate food to eat. Adolescents experienced stigma and as a result some had carried out unsafe abortions. Key informant interviews and FGDs revealed that health workers were rude and unsympathetic to pregnant adolescents. This significantly contributed to delayed health care seeking when adolescents were ill. CONCLUSION Pregnant adolescents lack basic needs like shelter, food and security. They also face relational problems with families, partners and the community. There is, therefore, a need to sensitize the community and school personnel about adolescent reproductive health issues. In addition, adolescent friendly services need to be established/strengthened. Continuous in-service training for health workers with emphasis on counseling skills for young people is urgently needed.