Thursday, April 02, 2020

Teenage Parents in Central America

Teenage pregnancy is a challenge for poverty-stricken areas, because it reduces the chances the mother and child can escape that poverty. The mothers, of course, take on a disproportionate share of the responsibility, thus sacrificing other opportunities they might have. Teenage pregnancy is a huge issue in Latin America, and Honduras has one of the highest rates of the world. So why is this the case? My dad is co-author of a new study that examines it.

Holly B Shakya, Gary L Darmstadt, Kathryn M Barker, John Weeks, and Nicholas A Christakis, "Social normative and social network factors associated with adolescent pregnancy: a cross-sectional study of 176 villages in rural Honduras," Journal of Global Health 10, 1 (2020). Full text here.

This was a cross-sectional study looking at adolescent childbirth amongst women ages 15-20 years (N = 2990) in rural Honduras, using reproductive health data on all individuals ≥15 years of age (N = 24 937 of 31 300 population) including social network contacts, all of whom were interviewed as part of the study. The outcome, adolescent childbirth, was defined as having had a child < age 20 years. Predictors included whether a woman’s social contact had an adolescent childbirth and the social contact’s reported perception of community support for adolescent childbirth.
The idea here is that a girl's social networks are all telling her this is normal and good. If, however, a government wants to decrease teenage pregnancy rates--as they typically do--then you walk a very fine line.
 If, as this evidence suggests, a strong driver of adolescent childbirth is the frequency of the occurrence of adolescent childbirth both within the greater community and within a girl’s proximal social network, the challenge for intervention strategies is to encourage norms that prevent adolescent childbirth without stigmatising those who have had an adolescent childbirth. Programmatic efforts to counter prevailing norms that limit a woman’s role to motherhood, and that support and encourage strong norms for girls’ education may play an important role in addressing this situation.
As is often the case, education is essential. They note later that education must also apply to the fathers--norms of positive and supportive fatherhood would also be beneficial in the case of pregnancy. Contraception, by the way, would also be nice, but perhaps next to impossible in some cultural contexts.


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