Adversities and mental health needs of pregnant adolescents in Kenya: Identifying interpersonal, practical, and cultural barriers to care

Judith Osok, Pius Kigamwa, Keng-Yen Huang, Nancy Grote, Manasi Kumar

Research output: Contribution to journalArticle

Abstract

Background: Adolescent pregnancies present a great public health burden in Kenya and Sub-Saharan Africa (UNFPA, Motherhood in Childhood: Facing the challenge of Adolescent Pregnancy, 2013). The disenfranchisement from public institutions and services is further compounded by cultural stigma and gender inequality creating emotional, psychosocial, health, and educational problems in the lives of vulnerable pregnant adolescents (Int J Adolesc Med Health 15(4):321-9, 2003; BMC Public Health 8:83, 2008). In this paper we have applied an engagement interview framework to examine interpersonal, practical, and cultural challenges faced by pregnant adolescents. Methods: Using a qualitative study design, 12 pregnant adolescents (ages 15-19) visiting a health facility's antenatal services in Nairobi were interviewed. All recruited adolescents were pregnant for the first time and screened positive on the nine-item Patient Health Questionnaire (PHQ-9) with 16% of 176 participants interviewed in a descriptive survey in the same Kangemi primary health facility found to be severely depressed (Osok et al., Depression and its psychosocial risk factors in pregnant Kenyan adolescents: a cross-sectional study in a community health Centre of Nairobi, BMC Psychiatry, 2018 18:136 https://doi.org/10.1186/s12888-018-1706-y). An engagement interview approach (Social Work 52(4):295-308, 2007) was applied to elicit various practical, psychological, interpersonal, and cultural barriers to life adjustment, service access, obtaining resources, and psychosocial support related to pregnancy. Grounded theory method was applied for qualitative data sifting and analysis (Strauss and Corbin, Basics of qualitative research, 1990). Results: Findings revealed that pregnant adolescents face four major areas of challenges, including depression, anxiety and stress around the pregnancy, denial of the pregnancy, lack of basic needs provisions and care, and restricted educational or livelihood opportunities for personal development post pregnancy. These challenges were related both to existing social and cultural values/norms on gender and traditional family structure, as well as to service structural barriers (including prenatal care, mental health care, newborn care, parenting support services). More importantly, dealing with these challenges has led to negative mental health consequences in adolescent pregnant girls, including feeling insecure about the future, feeling very defeated and sad to be pregnant, and feeling unsupported and disempowered in providing care for the baby. Conclusions: Findings have implications for service planning, including developing more integrated mental health services for pregnant adolescents. Additionally, we felt a need for developing reproductive education and information dissemination strategies to improve community members' knowledge of pregnant adolescent mental health issues.

Original languageEnglish (US)
Article number96
JournalBMC Women's Health
Volume18
Issue number1
DOIs
StatePublished - Jun 15 2018

Fingerprint

Kenya
Mental Health
Pregnancy in Adolescence
Pregnancy
Emotions
Health Facilities
Health
Public Health
Interviews
Depression
Psychology
Social Adjustment
Community Health Centers
Prenatal Care
Information Dissemination
Qualitative Research
Africa South of the Sahara
Parenting
Mental Health Services
Social Work

Keywords

  • Depression
  • Kenya
  • Parenting
  • Poverty
  • Pregnant adolescents
  • Stigma

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Adversities and mental health needs of pregnant adolescents in Kenya : Identifying interpersonal, practical, and cultural barriers to care. / Osok, Judith; Kigamwa, Pius; Huang, Keng-Yen; Grote, Nancy; Kumar, Manasi.

In: BMC Women's Health, Vol. 18, No. 1, 96, 15.06.2018.

Research output: Contribution to journalArticle

Osok, Judith ; Kigamwa, Pius ; Huang, Keng-Yen ; Grote, Nancy ; Kumar, Manasi. / Adversities and mental health needs of pregnant adolescents in Kenya : Identifying interpersonal, practical, and cultural barriers to care. In: BMC Women's Health. 2018 ; Vol. 18, No. 1.
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