1 in 4 girls in Uganda will be pregnant by the age of 18 .
Pregnancy-related complications are the leading cause of death among girls 12 to 24 years. Girls between 15 and 19 years of age are three times more likely to die in pregnancy and childbirth than their counterparts aged 20 to 24. Stillbirths and child deaths are 50% more likely for babies born to mothers younger than 20 than for those aged 20-29
”Adolescent pregnancy contribute up to 28 percent of maternal deaths in Uganda .Very early motherhood not only increases the risk of dying in childbirth, it also jeopardizes the wellbeing of surviving mothers and their children.”
Younger girls are more likely to suffer complications like obstetric fistula because their bodies are not physiologically mature and ready to handle childbirth. Adolescents tend to seek abortion and resort to the use of less skilled providers, use more dangerous methods, and delay seeking care for complications. They are therefore more likely to suffer serious complications and even death, particularly the unmarried adolescents. All this is as a result of many young pregnant girls not seeking care from skilled health workers during pregnancy and within six weeks after pregnancy.
Young girls will be pregnant again within 24 months after their last pregnancy due to limited access and use of postnatal family planning services. Very often, there exist many barriers which hinder access to health facilities and yet many of the health problems associated with adolescent pregnancy and childbearing can be prevented and controlled with timely and appropriate care during and after the pregnancy.
Main barrier(s) to SRH information and services experienced by the adolescent/youth subgroup
International evidence suggests that good prenatal care can prevent up to a quarter of maternal deaths by increasing a woman’s awareness of potential complication and danger signs during pregnancy. In addition many mothers do not receive any postnatal check-up yet over 60% of maternal deaths occur 23-48 hours after delivery, mostly due to haemorrhage and hypertensive
disorders or after 48 hours because of sepsis. There is evidence which suggests that access to post-natal care increases uptake of family planning. However, the decision-making process surrounding a pregnant adolescent’s ability to seek care is complex, capacity is severely limited and their health and care during pregnancy rank low in family priorities.
In most cultures in Uganda the pregnant adolescent has even less autonomy and is totally dependent on her partner, mother-in- law or parents for approval and access to services.
Existing SRH interventions for young people are mainly premised on the assumption that young people will go out and seek services and information (supply driven approaches) for instance youth corners/youth centers. However, when a young girl is pregnant, often times they begin to see themselves as “adults” and hardly reach out to interventions labelled as for young people.
Social- Economic Barriers
Secondly, even when they are in situations where they need to seek health care during pregnancy, there are many socio-economic barriers which hinder them from seeking care.Furthermore, the mobility of adolescent girls is severely constrained, making it difficult for them to seek services especially in rural areas where most health services are not readily accessible. Evidence suggests that adolescents are less likely than older women to be able to visit different places without permission. This freedom of movement is curtailed to a greater extent after marriage. It is therefore critical that interventions are designed in such a way that they go out and find young pregnant girls where there are. It also important that interventions are designed to reach-out to the “gatekeepers” who in many cases have limited knowledge on the importance of seeking health care and possible implications of not seeking for skilled care.