Media Seminar on Media Seminar on preventing school girls preventing school girls

pregnancies and keep girls pregnancies and keep girls in schoolin school

in Tanzania in Tanzania Ubungo Plaza Ubungo Plaza 29 29thth July, 2010 July, 2010

Isaac Njau – MoHSW/RCHSIsaac Njau – MoHSW/RCHS

SituationSituationof Adolescent Healthof Adolescent Health

About 65 per cent of Adolescents are below 25 years while those aged 10 – 24 years constitute 31 percent.

A high percentage of adolescents are sexually active and practice unsafe sex.

Situation of Adolescent Situation of Adolescent Health…Health…

Consequently the majority are highly vulnerable to SRH problems that;include adolescent pregnancy and early child bearing,the complications arising from unsafe abortion,STIs including HIV/AIDS.

OVC girls are slightly more likely to initiate sex before age of 15, while OVC boys initiate sex later than non OVC boys (THMIS 2007/08)

Situation of Adolescent Situation of Adolescent Health…Health…

Sexual BehaviourAdolescents develop an interest in sex

as their bodies change and mature. The median age at first intercourse for women is 17.3 and 18.5 years for men.

Many girls are coerced into having sex as they lack the power, confidence and skills to refuse unwanted sex or to negotiate safer sex. Poverty often forces girls into commercial sex work.

Adolescent Pregnancy and Adolescent Pregnancy and child bearing child bearing

In Tz a quarter of girls btwn 15-19 of young women are pregnant or already mothers

Perinatal mortality rate is significantly higher for young women under the age of 20 (56 per 1,000 pregnancies, than for aged 20-29(39/1000) - (TDHS 2004/05 )

Teenage pregnancy and the subsequent dropout of girls from school has a negative implications in their health and development and for the country to achieve MDG , 4 and 5

Adolescent Adolescent pregnancy………..pregnancy………..

In developing countries Maternal mortality among adolescents girls under 18 yrs is 2-5 times higher than those aged 18-25yrs.

Pregnancy complications are the main cause of deaths for 15 -18 yrs old girls worldwide

Children born to adolescents aged 15-19 are at higher risks of death during the first 5 yrs of life (28%),compared to age 20-29

Adolescent pregnancy……… Adolescent pregnancy………

Risks associated with Adolescent Pregnancy and Child Bearing

Adolescent pregnancy carry a greater risk to the health of both mother and baby,than adult women.

Adolescent pregnancies are currently a major sexual and reproductive health concern in Tanzania.

Young Maternal Age,Low social status, and Inadequate access to health care, contribute to high Maternal Mortality.

Adolescent Adolescent pregnancy……….pregnancy……….

Risks during antenatal Period Pregnancy Induced hypertension

( hyperternsive disease of pregnancy )

Anaemia:caused by nutritional deficiencies, malaria, and intestinal parsites.Vit A deficiency, and HIV Infection may also contribute.

STIs/HIV:Youth (15 – 24) accounts for 60 percent of the new HIV infections (THMIS 2007/8) Young women aged 15 - 19 years are 4 times more likely to contract HIV than their male counterparts.

Antenatal Risks Antenatal Risks cont……..cont……..

Higher severity of Malaria:Most important cause of anaemia during pregnancy.

Labour and delivery Labour and delivery

Pre –term births:Women under 19 yrs of age ,are at increased risk of pre term delivery (immaturity of genital ograns,social factors-poverty, lack optimal antenatal care.

Obstructed labour: Due to cephalopelvic disproportion in girls 15 yrs and below- immaturity of pelvic bones,small size of birth canal and fistula

Risks during Post Partum Risks during Post Partum period period

AnaemiaPre – enclampsia: first postpartum

daysToo early repeated pregnancies:Due

to limited access to contraceptive,unproted intercourse and repeated pregnancy have been found in as many as 50% of those young women within 24 months of delivery.

Post partum depression, or other mental depression.

Low birth weight : Higher incidence of low birth weight ( less than 2500 gms) among infants of adolescents mothers.

Perinatal and neonatal mortality: Higher rates of Perinatal and Neonatal mortality rates in infants of adolescents mothers, compared to older women.

Problems affecting the babyProblems affecting the baby

Problems affecting baby…….Inadequate child care and

breastfeeding practices: Young mothers and single, in diff. socio economic situation, make it hard to provide proper care to their children.

Why complications worse in adolescents than adults?1.Biologically young adolescents are

not mature enough for strain imposed on them by pregnancy.

2.Less empowered to make decisions about matters affecting their health.

3.Are likely to be enrolled later and to make fewer health facility visits for ANC.

4.In many places adolsecents delver at home. They visit h/f only as alast resort, often with serious complications.

Why worse than……..Factors to deliver at home: Social and cultural norms.Afraid of hospital.Discouraging stories about

mistreatment by hospt.staff.May be unable to bear hospital

charges.5.In many places unmmaried

adolescents are treated with scant respect by medical and nursing staff.

UNSAFE ABORTION

Magnitude of unsafe abortion.In Tz, it is estimated that abortion

contribute about a third of all maternal deaths and leaves a substantial number of women with debilitating consequences of abortion.( Kinoti et al 1994).

In a study of 300 respondents, 72 (24 %) of respondents were young girls less than 20 yrs/

Unsafe abortion……..¾ of them agreed that their

pregnancies had not been planned and re –wanted.

50% of them did induced abortion.

Consequences of unsafe abortion.

Medical consequencesMajor short term complications:Cervical or vaginal lacerations.Sepsis/infectionHaemorrhage /excessive blood

lossPerforation of the uterus or bowelTetanusPelvic infection or abscess

Medical conseq……..Excessive blood loss leads to

anaemia.Both infection and anaemia are

common cause of deaths.

Long term medical complications:Secondary infertility- a

particularly heavy life long burden

Spontanous abortion in a subsequent pregnancy,

Increased likelihood of both ectopic pregnancy and pre term labour.

Psychological consequencesA sense of loss and reactions of

grief.Guility that extends beyond the

abortion itself, for being engaged in sexual relations

Social and economic conseq….Leave school, and face

disapproving attitudes.Thrown out by their familiesMarry earlyGet poorly paid jobsTempted or forced into

prostitution.

CONCLUSION The need to invest in adolescent

Sexual and Reproductive Health ( SRH ) Services including HIV/AIDs is paramount; given the fact that SRH needs are not only basic human rights, but adolescents form a significant section of the population and been a disproportionate burden of disease with regards to reproductive ill – health and HIV prevalence.

THANK YOU FOR LISTENING

TOGETHER WE CAN MAKE A DIFFERENCE.

‘’TOO OLD FOR TOYS, TOO YOUNGER FOR MOTHERHOOD’’