Professional Documents
Culture Documents
Comprehensive Understanding
of Risk and Protective Factors
for Adolescent Pregnancy
in Low- and Middle- Income
Countries
2019.03.26
Chung, H. W., Kim, E. M., & Lee, J. E. (2018). Comprehensive understanding of risk
and protective factors related to adolescent pregnancy in low-and middle-income
countries: A systematic review. Journal of Adolescence, 69, 180-188.
2
RESEARCH BACKGROUND
4
AN ANALYSIS FRAMEWORK
5
a person’s profile that
both active and passive directly tells his/her
behavior of adolescents current situation (e.g., age,
(e.g., sexual risk behavior, education, economic status)
substance use, abuse)
Criterion Inclusion
Year 2000 – 2015
Language English
Geographic area Low- and middle- income countries (based on
classification of the World Bank)
Outcome measured Factors related to adolescent pregnancy or childbearing
Study population Study group includes adolescents aged between 10-19
Study type Qualitative, quantitative or mixed method
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Figure 3. Flow of search process. 9
RESULTS: CHARACTERISTICS OF INCLUDED STUDIES
• Country: Asia (7), Africa (11), Latin America (9), Europe (1), others
as a group (39)
• Research methods: Analytical cross-sectional (35), qualitative
(5), case-control (7), cohort (3), randomized controlled trials (2), panel
(1), cross-sectional survey (9), descriptive (3), mixed method (2)
• Study population:
– Many studies included adolescents aged from 10 to 19 years, but
the most commonly used age group was between 15-19 years old.
– Some studies included young people aged 20-24 years or adults
aged over 25 years for one of the following reasons:
1) to compare adolescents and adults; 2) to examine adults who
gave birth during their adolescence; and 3) to compare both groups
and separate the result of adolescents from that of adults.
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RESULTS:
FACTORS ASSOCIATED WITH
ADOLESCENT PREGNANCY
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1) SELF-STATUS
Risk factors Protective factors
Age Older age, younger age (for unwanted or
unintended pregnancy)
Education No formal education, long-term school Higher level of
absences, school failure, attending educational attainment,
public school (vs. private school) being a student
Economic Low economic status, poverty, smaller Higher levels of family
status income, income inequality income
Marital married in adolescence, not being
status married (for unintended or unplanned
pregnancy)
Psycholog Depression, low self-esteem, higher
ical status locus of control
Religion No religion (vs. Catholic), Muslim (vs. Religiously affiliated,
Protestant) protestants (vs. Catholics)
Attitudes Having strong gender bias, concerns Think important to
about the side-effects of contraceptive protect self against
methods pregnancy 12
2) SELF-BEHAVIOR
Risk factors Protective factors
Sexual risk Early sexual debut, having many lifetime
behavior sexual partners,
having first partner who is older than the
girl, ever engaging in transactional sex
Contracepti No use or inconsistent use of Consistent condom
on* contraceptive method, use, using condom
ever used a contraceptive method or at first sex
family planning**
Substance Alcohol, smoking, drug use, etc.
use
Abuse Sexual or physical abuse during
childhood to adolescence,
coerced sex by boyfriend, forced first sex
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4) FRIENDS
Risk factors Protective factors
Pressure Peer or partner’s pressure
to have sex
15
*Studies have showed mixed results.
5) SCHOOL/COMMUNITY
Risk factors Protective factors
Group Unsupervised activities after School activities,
activities school, less participated community group
extra activities at school meetings
16
*Studies have showed mixed results.
6) MACRO-LEVEL FACTORS
Risk factors Protective factors
Income inequality, Strict laws setting the minimum-
low human development index, age-of-marriage at 18,
low Municipal development index, population reduction policies,
low social responsibility index, education subsidy program,
government's safe sex programs free education by government)
did not target adolescents
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DISCUSSION
For example:
Religion
Contraceptive use
Contraceptive Rural-urban Peer
Rural-urbanuseresidence residence communication
(not significant) substance use, orphan-hood, and income
19
EXAMPLE (2): PEER COMMUNICATION
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2) Only few studies have examined complex interactions
among these factors.
For example:
Low self-esteem?
Vulnerable to sexual
Mediating factor
abuse?
Transactional sex?
22
EXAMPLE (1): AGE
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References
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adolescent pregnancy in low-and middle-income countries: A systematic review. Journal of adolescence, 69, 180-188.
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