Factors associated with risk for pregnancy among secondary school girls in Ilala municipality, Dar es salaam, Tanzania

Abstract

Background: Adolescent pregnancy is a global public health problem and mainly affecting low income countries. In Tanzania, it is a major cause of drop-outs from schools. However, several factors have been associated with adolescent pregnancy but in general they include individual, home environment and school characteristics in relation to lack of knowledge, negative attitude and low self-efficacy towards pregnancy prevention. This study revealed that adolescents generally have moderate knowledge, negative attitude and low self-efficacy towards pregnancy prevention. Nevertheless, there was observed differences across different socio-demographic characteristics. Objective: This study was done to assess the magnitude and factors associated with risk for pregnancy in relation to knowledge, attitude and self-efficacy, among secondary school adolescent girls in Ilala Municipality, in Dar es salaam. Methodology: A cross sectional quantitative study was conducted. The study involved 340 participants. Self-administered structured questionnaires were used for data collection. Simple random sampling was used to select study participants and data analysis was done using SPSS version 23 where descriptive analysis was run to determine frequency and percentages and the degree of association was established using comparison of mean differences and chi squire. A p value of less or equal to 0.05 was used to measure the degree of association Results: About 4.4% (15) respondents were observe had exposure to sex and the large proportion were older adolescents. Participants had good knowledge on pregnancy (83.1%)and had low knowledge on pregnancy prevention, as the highest score was 39.1%. The attitude towards pregnancy was negative for (78.2%) as well as pregnancy prevention (64.1%). Lastly, perceived self-efficacy to pregnancy prevention was low (42.1%), with high percentages for the item observed in the neutral and don’t know responses. However, comparison of mean differences was done for the knowledge, attitude and self-efficacy in relation to the socio-demographic characteristics in order to establish the association between groups. As regards to the knowledge item, there was observed statistically significant association for age (p = 0.007); school grade (p = 0.000) and school composition (p=0.028). Likewise, statistical significant results for the attitude item was observed for the school grade (p=0.003). Comparison of mean differences between socio-demographic characteristics and perceived self-efficacy, revealed statistical significant association for religion (p=0.005); school grade (p=0.000) and school composition (p=0.000) The last measure was done to compare the mean differences between the risk factor for pregnancy (exposure to sex) and all three items (knowledge, attitude and perception). The knowledge item revealed statistical significant association (p=0.035) Conclusion: In this study participants were found to have moderate knowledge about pregnancy prevention, but generally had negative attitude low self-efficacy to pregnancy prevention. Those factors put them in high risk of getting pregnancy, if interventions are not taken to rectify the situation. Therefore; efforts done to address the deficiencies observed in this study so as to alleviate the situation and make girls achieve their education goals.

Recommendations: There is a need to ensure that sexuality education is strengthened in schools and parents are encouraged to hold open discussion with their adolescents about sexual reproductive health. It is recommended that reproductive health education and services are availed to adolescents in a more convenient way to them, order to prevent them from pregnancy and lastly, strategies should be laid down to address attitude and low self- efficacy towards pregnancy prevention, preferably through peer education.