Autor/a:
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Shahabuddin, A. S. M.; Nostlinger, Christiana; Delvaux, Therese; Sarker, Malabika; Delamou, Alexandre; Bardají, Azucena; Broerse, Jacqueline E. W.; Brouwere, Vincent De
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Abstract:
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BACKGROUND: The huge proportion of child marriage contributes to
high rates of pregnancies among adolescent girls in Bangladesh.
Despite substantial progress in reducing maternal mortality in
the last two decades, the rate of adolescent pregnancy remains
high. The use of skilled maternal health services is still low
in Bangladesh. Several quantitative studies described the use of
skilled maternal health services among adolescent girls. So far,
very little qualitative evidence exists about attitudes and
practices related to maternal health. To fill this gap, we aimed
at exploring maternal health care-seeking behavior of adolescent
girls and their experiences related to pregnancy and delivery in
Bangladesh. METHODS AND FINDINGS: A prospective qualitative
study was conducted among thirty married adolescent girls from
three Upazilas (sub-districts) of Rangpur district. They were
interviewed in two subsequent phases (2014 and 2015). To
triangulate and validate the data collected from these married
adolescent girls, key informant interviews (KIIs) and focus
group discussions (FGDs) were conducted with different
stakeholders. Data analysis was guided by the Social-Ecological
Model (SEM) including four levels of factors (individual,
interpersonal and family, community and social, and
organizational and health systems level) which influenced the
maternal health care-seeking behavior of adolescent girls. While
adolescent girls showed little decision making-autonomy,
interpersonal and family level factors played an important role
in their use of skilled maternal health services. In addition,
community and social factors and as well as organizational and
health systems factors shaped adolescent girls' maternal health
care-seeking behavior. CONCLUSIONS: In order to improve the
maternal health of adolescent girls, all four levels of factors
of SEM should be taken into account while developing health
interventions targeting adolescent girls. |