Effectiveness of Structured Teaching Programme on Hazards of Teenage Pregnancy in Adolescent Girls

D. Koteswaramma¹, S. Swarna²

¹Vice Principal, Swatantra College of Nursing, Rajamandry, Andhra Pradesh, India.

²Associate Professor, College of Nursing, SVIMS, Tirupati, AP, India.

*Corresponding Author Email: swarnajayadeep10@gmail.com

ABSTRACT:

Teenage pregnancy is an important health issue with youngest mothers facing higher risk of maternal complications, death and disability along with their children. It is also an issue of human rights with adolescent pregnancy often resulting in an abrupt end of childhood, a curtailed education and lost opportunities. Teenage pregnancy is associated with maternal perinatal morbidity and mortality. There is an increase in need for creating awareness among the teenage girls regarding hazards of teenage pregnancy. In view of this pre experimental study was undertaken to assess the effectiveness of structured teaching programme on hazards of teenage pregnancy in selected junior college , Tirupati, India. The pre test data was collected from50 teenage girls by self administered pretested questionnaire . structured teaching was imparted and post test data was collected after one week. Findings revealed that adolescents(66%) are receiving information from mass media,28 % stated teachers have given knowledge about teenage pregnancy. Students have not received any information about teenage pregnancy from parents and health team members. Awareness on hazards of teenage pregnancy is inadequate ( Pretest mean knowledge is 16.98),which was improved after imparting education(post test knowledge 57.84). which is significant at 0.01 level( The paired t value - 23.37 ). The result suggested that imparting the structured teaching programme to teenage girls could enlighten their knowledge on hazards of teenage pregnancy that may result in best practices such as delay in early marriage and pregnancy. Therefore Nursing personnel can organize counseling and educational sessions at colleges to prevent teenage pregnancies.

KEYWORDS: Adolescent girls, Teenage pregnancy, Structured teaching programme, hazards of teenage pregnancy.

INTRODUCTION:

World Health Organization defines Teenage Pregnancy as “any pregnancy of a girl aged 10 to 19 years. Adolescent Pregnancy means pregnancy in a woman aged 10-19 years, the age being defined as her age at the time the baby is born^.1(Adolescent Pregnancy-WHO-2004).This is the period when structural, functional and psychological development occur in a girl to prepare her for assuming the responsibility of motherhood.

Biomedical determinants of health is influenced by many social and cultural factors. This influence is negative with a resultant increase in the number of social hazards, which finally aggravate the already poor health status of the developing societies. one such hazard of serious consequences on the nation as a whole is pregnancy in

an adolescent girl, who herself is yet to attain her full growth²(Rachakonda Lakshmi). Within South Asia ,the recorded teenage pregnancy rate is highest in Bangladesh (35%) followed by Nepal (21%) and India (21%).(Adolescent pregnancy2013).India is fast approaching to the most populous country in the world and increasing teenage pregnancy an important factor for population rise is likely to aggravate the problem. In India highest rate is in Jharkhand (28%), followed by West Bengal (25%) and Bihar (25%)³(IIIPS). Pregnancy in very young women is generally considered to be a very high risk event, because teenage girls are physically and psychologically immature for reproduction. Socio culturally pregnancy outside marriage bears a stigma and she does not get emotional support. Teenage pregnancies considered problematic because complications from pregnancy and child birth are leading causes of death. Teenage mothers are more likely to have children with low birth weight, inadequate nutrition and anaemia. And they are more likely to develop cervical cancer later in life. Early motherhood can affect the psychosocial development of the infant. The occurrence of developmental disabilities and behavioral issues are increased in children born to adolescent mothers. The risk of dying from pregnancy related cause is much higher for adolescents than for older women and greater is the risk for younger the adolescent. More than half of the girls (56%) in the 15-19 age group are anaemic.

Over half (58%) of Indian women are married before they attain 18 years of age. 16 percent of girls aged between 15-19 years have already begun child bearing and 12% have had a live birth. Only 14% of women in the age group 15-19 age group have received complete ANC.62% of currently married adolescents have had complications during pregnancy 52% women in the 15-19 age group have delivered at home. 8.3% of all pregnancies in this age group result in spontaneous abortions.45 percent of all maternal deaths take place among the 15-24 age group and Neonatal Mortality rate is as high as 54/1000 among those in the age group of 15-19 year. Neonatal Mortality Rate among rural adolescents is as high as 60/1000.50 percent higher risk of Infant deaths among mothers aged below 20 years. Only 66.2% of pregnant girls below 20 years of age have been given or purchased Iron and folate tablets as part of antenatal care.6000 adolescents mothers die every due to anaemia.47 per cent girls in this age group are underweight^.4(NFHS-3)

Teenage pregnancies represent a high risk group in reproductive terms because of double burden of reproduction and growth. Pregnancy in this age group adds to the national hazards by contributing to population explosion especially in our country^.5(Dr Raja V Takkar et al).study of Mukhopadhyay Prianka et al⁶ revealed that teenage mothers had a high proportion (27.7%) of preterm deliveries compared to 13.1% of adult mothers and had low birth weight babies (38.9%,vs 30.4%) respectively. Still birth also significantly high in teenage deliveries (5.1% vs 0.9%) respectively. Social determinants for maternal and child mortality include marriage and child mortality include marriage and child birth at a very young age⁷(Rmncha).The data shows that adolescents and youth have limited awareness about sexual and reproductive health matters. For instance only 15% of young men and women (15-24 years) reported receiving family life or sexual education³(IIIPS). Knowledge on hazards of teenage pregnancy during adolescent essential for prevention early marriage and pregnancy, hence quasi experimental study was carried out in selected junior college Tirupati.

METHODS AND MATERIALS:

Pre experimental one group pretest-post test design was used to carry out the study. pretest includes pre assessment of knowledge on hazards of teenage pregnancy, followed by intervention on structured teaching on hazards of teenage pregnancy.post test reassess the knowledge after seven days. The study was conducted in the Academy of Gandhian studies, junior college which is situated in Tirupati, Andhra Pradesh, India. The sample comprised of 50 teenage girls in the age group of 15-18 years. simple random sampling technique was applied to select tha sample.

The Bi. PC students were excluded from the study as they have prior knowledge on the topics of the study. Structured questionnaire was developed from an extensive review of literature, it was validated and pretested. The score of 48 to62 (76-100%) indicates adequate knowledge, a score between 32-47 indicates moderate knowledge, a score between 0 and 31 interprets as inadequate knowledge (0-50%). The reliability was found with Karl Pearson formula, co-relation was 0.99 which was high. Structured teaching programme was developed with extensive review of literature and the guidance of experts.

Final structured teaching programme consists of anatomy and physiology of male and female reproductive systems, puberty and pregnancy related aspects, hazards of teenage pregnancy, management and prevention of hazards of teenage pregnancy. After explaining about the study investigators made the teenage girls to sit comfortably and oral consent was taken. Pre test data was collected from 50 teenagers in the period of four weeks, 12 to 13 girls per day Structured teaching was implemented with group approach.post test data was collected from the same sample after one week using the same tool used for the pre test.

FINDINGS:

Table 1 reveals most of the students are in the age group of 15 years. belongs to hindu religion Majority Parents of girls are literates, employees. Information about teenage pregnancy was not received from parents and health team members.

Table 1.Demographic profile of Teenage girls

S. No	Demographic variable	Percentage
1	Age
	15	70
	16	30
2	Religion
	Hindu	84
	Muslim	10
	Christian	6
3	Educational status of participant’s mother
	Illeterates	28
	Literates	72
4	Education of participants father
	Illeterates	10
	Literates	90
5	Occupation of mother
	Home makers	26
	Employee	42
	Business	6
	Labourer	26
6	Occupation of Father
	Employee	58
	Business	14
	Cultivation	2
	Laborer	26
7	Source of Information
	Friends	6
	Teachers	28
	Parents	0
	Health team members	0
	Mass Media	66

Table-2.Pre-test knowledge of teenage girls about hazards of Teenage pregnancy

S. No	Knowledge variables	Inadequate	moderate	Adequate
1.	Anatomy and physiology of male and female reproductive system, including puberty and pregnancy related aspects	88%	4%	8%
2.	Hazards of teenage pregnancy	84%	14%	2%
3.	Management and prevention of hazards of teenage pregnancy	92%	2%	6%
	Total knowledge	82%	14%	4%

Table 2 reveals 82 percent of girls had inadequate knowledge regarding various aspects of teenage pregnancy.14 percent had moderate knowledge,4 percent had inadequate knowledge about various aspects of teenage pregnancy.

Table 3. Post-test knowledge of teenage girls about hazards of teenage pregnancy post-test

S. No	Knowledge variables	Inadequate	Moderate	Adequate
1.	Anatomy and physiology of male and female reproductive system, including puberty and pregnancy related aspects	0%	2%	98%
2.	Hazards of teenage pregnancy	8%	8%	84%
3.	Management and prevention of hazards of teenage pregnancy	8%	0%	92%
	Total knowledge	4%	12%	84%

Table 3 shows 84 percent gained adequate knowledge after imparting structured teaching programme. 12 percent had moderate knowledge.4percent had inadequate knowledge.

Table .4. Pre and post- test knowledge on hazards of teenage pregnancy among teenage girls

S.N0.	Knowledge variables	Pre test		Post-test		t-value
S.N0.	Knowledge variables	Mean	S.D	Mean	S.D	t-value
1.	Anatomy and physiology of male and female reproductive system, including puberty and pregnancy related aspects	2.200	2.691	10.580	0.896	21.397**
2.	Hazards of teenage pregnancy	9.700	5.791	31.120	6.553	19.048**
3.	Management and prevention of hazards of teenage pregnancy	5.100	2.816	16.140	2.891	20.895**
	Total knowledge	16.980	10.187	57.840	9.153	23.369**

**= Significant at 0.01 level Table 4 reveals significant difference in pre test and post test knowledge at 0.01 level (p value-23.369).

Association between pretest, post test knowledge with selected demographic variables of teenage pregnancy:

Significant association was found with pre test knowledge of teenage girls with educational status of participant’s mother(chi-square value=16.4 ,at 1% level) and source of information at 5 percent level(chi-square value-12.9).Relationship was found between post test knowledge of teenage girls and educational status of participants mothers at 5% level(chi-square alue-12.7) source of information at 1% level (chi-square value14.8) .Literate mothers may have more information about teenage pregnancy and may influence in the family in deciding to care of children.

DISCUSSION:

Teenage pregnancy is a worldwide problem bearing serious and medical implications relating to maternal and child health. proper education about reproductive health is essential for prevention of untoward social and health problems .pretest knowledge is less with a mean score 16.98 which is correlated with the findings of Dhital AD et al⁸with a pretest mean score of 39.83.This could be due to inadequate education about teenage pregnancy. because of socio cultural and economic factors reproductive health is considered as biomedical construct rather than an important aspect of complete wellbeing. use of structured teaching programme is an innovative idea. it creates enthusiasm among adolescents and helps in presenting the material with interaction. Because significant improvement was found in knowledge on hazards of teenage pregnancy as post test knowledge was increased to 57.84 which is consistent with the findings of Dithal AD et al⁶ study post test knowledge was increased 84.6. t test showed significant difference between pre and post knowledge at 0-01 level. This is supported by same study pretest and post knowledge significant at 0.001 level. planned teaching programme on reproductive health was found effective in a study carried out by Padhy Gouri Kumar et al.⁹

CONCLUSION:

Teenage pregnancy is an important public health issue causing negative impact on mother, baby family as well as society. Teenage women face a greater risk of obstetric complications than women in their twenties. Teenage pregnancy is a multifaceted problem, it demands multidimensional solutions. Education of teenagers can play a significant role in delaying marriage and hence delaying childbearing. It is also important to educate parents about consequences of early marriage and childbearing. Adolescent women health needs are different from those of adult women. Therefore attention should be paid to adolescent reproductive health programmes

ACKNOWLEDGMENT:

Authors acknowledge the teenage girls who cooperated in data collection.

CONFLICT OF INTEREST:

Nil.

SOURCE OF FINANCIAL SUPPORT:

Nil

ETHICAL CONSIDERATIONS:

Research topic approved by Research Committee College of Nursing SVIMS, Tirupati. Formal permission was obtained from Principal Junior College Ghandian Studies. Tirupati, AP. Oral consent was taken from students.

REFERENCES:

1. Adolescent pregnancy. Issues in adolescent health and development, WHO Discussion Papers on Adolescence. WHO, 2004,86.

2. Lakshmi Rachakonda et al .Teenage Pregnancy. International Journal of Current Medical And Applied Sciences .4(2).2014.59-63.

3. International Institute of Population Sciences. Youth in India; situation and needs.2006-2007.

4. National Family Health Survey-3

5. Rajal V, Thaker et al. Study of Feto-Maternal outcome of teenage pregnancy at Tertiary care hospital. Gujarat Medical Journal.2013.68.2.100-103.

6. Prianka Mukhopadhyay et al. Hospital based perinataloutcomes and complications in teenage pregnancy in India. Journal Health Population Nutrition. 2010. 28(5);494-500.

7. Ministry o Health Family Welfare, GOI .A strategic Approach to Reproductive Maternal Newborn, Child and Adolescent Health.2013.

8. Dhital AD et al. Effectiveness of structured teaching Programme in improving knowledge and attitude of school going adolescents on reproductive health. Kathmandu University Medical Journal.3(4)12,380-383

9. Padhy Gouri K Umar et al. Effectiveness of Planned Teaching Programme on Reproductive Health Among Adolescents Girls. Indian Medical Gazette.2013.287-291.

Received on 06.10.2015 Modified on 17.10.2015

Asian J. Nur. Edu. and Research. 2016; 6(2): 229-232.

DOI: 10.5958/2349-2996.2016.00043.4