FACTORS INFLUENCING PARENTAL DECISIONS ON ADOLESCENT PREGNANCY AMONG RURAL AND URBAN-BASED PARENTS OR GUARDIANS IN IBADAN, NIGERIA

Abstract

Adolescent pregnancy is an important public health problem on the increase in Nigeria. Few studies have investigated the circumstances and factors associated with parental decisions taken following an adolescent pregnancy, in spite of the implications of these on the adolescent. This study was designed to assess factors influencing parents’/guardians’ decisions on adolescent pregnancy.

A mixed method study involving the use of Key Informant Interviews (KII) and semi-structured interview was conducted. A four-stage sampling technique was used to select 261 and 244 respondents from Omi-Adio (rural) and Apata (urban) communities respectively. KII were conducted with twelve parents; (six each from urban and rural settings) who has had personal experiences of a pregnant adolescent. Descriptive and Chi-square statistics, and logistic regression were used for data analysis and qualitative data was analyzed using thematic analysis. The UK Registrar general’s classification of occupation and socioeconomic status was used.

Mean age of respondents from rural and urban communities were 50+9.4 years and 48+10.1 years respectively. Fifty-five percent of urban and 30.1% of rural respondents had tertiary education. More rural (70.3%) than urban respondents (35.4%) were in the low socioeconomic group. More rural (91.9%) than urban dwellers (88.9%) supported keeping an adolescent pregnancy. More urban (93.4%) than rural (76.3%) dwellers were of the view that an adolescent should continue school after delivery (p<0.05) while 25% of rural respondents and 18.0% of urban respondents mentioned that a pregnant adolescent be married to the person responsible for the pregnancy (p<0.05). Personal experience of adolescent pregnancy occurred in 17.2% and 16.4% of rural and urban respondents respectively. Adolescent pregnancy occurred in children and relations of respondents. Among rural respondents, the pregnant adolescents were either the respondents’ younger sibling (51.1%) or child (48.9%). In the urban area the pregnant adolescents were the respondents’ younger sibling (75.0%), child (20.0%) or the respondent/ his spouse (5%). More urban (85%) than rural respondents (60%) decided to keep the pregnancy (p<0.05). The decision to keep the pregnancy was mainly attributed to religious beliefs among the rural respondents (68%) and health reasons among their urban counterparts (76.5%). Urban dwellers were 5 times more likely to decide to keep the pregnancy than rural respondents (OR = 5.48, 95%CI = 1.71 - 17.59). Respondents in the high socio-economic group were less likely to decide to keep the pregnancy (OR = 0.20, 95% CI=0.06-0.65). The initial reactions of the key informant interviewees to discovery of pregnancy were disappointment. In the urban area, very few pregnant adolescents were said to have continued schooling till delivery and many of them resumed school thereafter while in the rural area, they all dropped out of school.

Place of residence, socio-economic status and religion were key factors influencing decision to keep adolescent pregnancy with urban dwellers more favourably disposed than rural dwellers. Intervention programmes thus need to target those in rural areas to change their views regarding keeping of adolescent pregnancies and encouraging re-integration of adolescents that get pregnant.