Very young adolescent perceptions of growing up in rural southwest Uganda: Influences on sexual development and behavior

Viola N Nyakato, Charlotte Achen, Destinie Chambers, Ruth Kaziga, Zina Ogunnaya, Maya Wright, Susan Kools

Abstract

Very young adolescents (VYAs) are at the beginning of major physical, cognitive, emotional, and social changes that will set the course for a lifetime of health risks or resilience and yet, they have been largely an invisible group in global health research. The study explored perceptions of VYAs of the context for adolescence in rural Uganda and how these perceptions relate to sexual and reproductive health. Twenty VYAs, aged 11-14 from a southwest province in Uganda participated; 10 girls and 10 boys. All were of low socioeconomic status and attending school. With Institutional Review Board approval, a community-based participatory design was used with community advisory board (CAB) guidance. Community mapping and photovoice were data collection strategies as deemed developmentally appropriate for this age group. VYAs narrated their maps and photographs in focus groups. Field notes were taken on observations of adolescent life in the villages. The CAB assisted in the interpretation of data. Focus group interview transcripts and field notes were thematically analyzed and triangulated with observational field notes to verify and amplify findings. VYAs dichotomized people and places that offered support and protection or exposure to risk and vulnerability. Cultural norms (gendered expectations for roles and responsibilities, the primacy of work), the influences of significant others (peers, family, other important adults) and places in their environment that represented either safe havens or danger zones comprised the major themes. VYA perceptions of their context and experiences will contribute to design of developmentally appropriate and community tailored interventions to promote their health. (Afr J Reprod Health 2021; 25[2]: 50-64).

Full Text:

PDF

References

World Bank. Empowering Uganda’s youth to be job

creators. The World Bank. 2015; Retrieved from http://www.worldbank.org/en/news/feature/2015/08/04/empowering-ugandas-youth-to-be-job-creators.

Republic of Uganda and UNFPA Uganda. The state of Uganda population report 2013. Population and social transformation: Addressing the needs of special interest groups. Republic of Uganda Ministry of Health Knowledge Management Portal. 2013; Retrieved from http://library.health.go.ug/publications/leadership-and-governance-monitoring-and-evaluation/population/state-uganda-populatio-6.

UNICEF. UNICEF Uganda: Annual report. UNICEF

Uganda. 2018; Retrieved from https://www.unicef.org/uganda/media/4161/file.

World Bank. Education statistics Country at a glance –

Uganda. The World Bank; 2017; Retrieved from http://datatopics.worldbank.org/education/country/uganda.

World Bank. Uganda - World Bank data. The World Bank.

; Retrieved from https://data.worldbank.org/country/uganda.

Benson PL, Scales PC, Hamilton SF, Sesma Jr A, Hong

KL and Roehlkepartain EC. Positive youth development so far: Core hypotheses and their implications for policy and practice. Search Institute Insights & Evidence. 2006; 3(1):1-3.

World Atlas. Thirty countries with the youngest

populations in the world. World Atlas. 2019; Retrieved from https://www.worldatlas.com/articles/the-youngest-populations-in-the- world.html.

UNICEF. The national strategy to end child marriage and

teenage pregnancy, 2014/2015 – 2019/2020. UNICEF Uganda. 2015; Retrieved from http://www.unicef.org/uganda/NATIONAL_STRATEGY_ON_CHILD_MARRIAGE-PRINT_READY.pdf.

Kates J, Wexler A and Lief E. Donor government funding

for HIV in low-and middle-income countries in 2016. Menlo Park, CA: The Henry J Kaiser Family Foundation and UNAIDS. 2017; Retrieved from https://www.kff.org/global-health-policy/fact-sheet/the-global-hivaids-epidemic/

Kharsany AB and Karim QA. HIV infection and AIDS in

sub-Saharan Africa: current status, challenges and opportunities. The open AIDS journal. 2016;10:34.

Republic of Uganda and UNFPA Uganda. The state of

Uganda population report 2014. Harnessing Uganda’s demographic dividend for socio-economic transformation. Republic of Uganda Ministry of Health Knowledge Management Portal. 2014; Retrieved fromhttp://library.health.go.ug/publications/leadership-and-governance-monitoring-and-evaluation/population/state-uganda-populatio-7.

Roosblad S. Uganda battles increase in HIV infections.

Voice of America. July 21, 2015. Retrieved from https://www.voanews.com/a/uganda-battles-increase-hiv- infections/2872315.html.

Newton-Levinson A, Leichliter JS and Chandra-Mouli V.

Sexually transmitted infection services for adolescents and youth in low-and middle-income countries: perceived and experienced barriers to accessing care. Journal of Adolescent Health. 2016 Jul 1;59(1):7-16.

Gideon R. Factors associated with adolescent pregnancy

and fertility in Uganda: analysis of the 2011 demographic and health survey data. Am J Sociol Res. 2013;3(2):30-5.

World Health Organization (WHO). Adolescent

pregnancy: Unmet needs and undone deeds: A review of the literature and programmes. World Health Organization. 2007; Retrieved from http://apps.who.int/iris/bitstream/10665/43702/1/9789241595650_eng.pdf.

Ochan W, Nalugwa C and Apuuri FA. Too young for

motherhood: Profile, consequences and drivers of teenage pregnancy in Uganda. Republic of Uganda and UNFPA The State of Uganda Population. 2013. Retrieved from http://library.health.go.ug/publications/leadership-and-governance-monitoring-and- evaluation/population/state-uganda-populatio-6.

United Nations International Children’s Emergency Fund

(UNICEF). State of the world’s children 2015 country statistical information. UNICEF. 2015; Retrieved from http://www.unicef.org/infobycountry/uganda_statistics.html.

Santhya KG and Jejeebhoy SJ. Sexual and reproductive

health and rights of adolescent girls: Evidence from low-and middle-income countries. Global public health. 2015 Feb 7;10(2):189-221.

Muhwezi WW, Katahoire AR, Banura C, Mugooda H,

Kwesiga D, Bastien S and Klepp KI. Perceptions and experiences of adolescents, parents and school administrators regarding adolescent-parent communication on sexual and reproductive health issues in urban and rural Uganda. Reproductive Health. 2015 Dec;12(1):110.

Malimbwi DP. Socio-economic Factors Influencing

Adolescents’ Pregnancies in Secondary Schools: The Case of Mvomero District (Doctoral dissertation, The Open University of Tanzania).

Gavin LE, Catalano RF amd Markham CM. Positive youth

development promoting adolescent sexual and reproductive health: a review of observational and intervention research. Journal of Adolescent Health. 2010;46 (3 suppl. 1).

Chong E, Hallman K and Brady M. Investing when it

counts: Generating the evidence base for policies and programmes for very young adolescents: Guide and tool kit. New York, NY: UNFPA; 2006.

Fisher JR and de Mello MC. Using the World Health

Organization's 4S-Framework to Strengthen National Strategies, Policies and Services to Address Mental Health Problems in Adolescents in Resource-Constrained Settings. International journal of mental health systems. 2011 Dec 1;5(1):23.

Uganda Bureau of Statistics (UBOS). Uganda

Demographic and Health Survey 2016/17; Uganda Bureau of Statistics: Kampala, Uganda, 2016; Retrieved from https://dhsprogram.com/pubs/pdf/FR333/FR333.pdf

Cuesta J, Jellema J, Chzhen Y, Ferrone L and Unicef.

Commitment to equity for children (ceq4c): fiscal policy, multidimensional poverty, and equity in Uganda. UN; 2018 Apr 1.

Peralta KJ. Toward a deeper appreciation of participatory

epistemology in community-based participatory research. PRISM: A Journal of Regional Engagement. 2017;6(1):4.

Wallerstein N and Duran B. Community-based

participatory research contributions to intervention research: the intersection of science and practice to improve health equity. American journal of public health. 2010 Apr;100(S1):S40-6.

Schenk KD and Williamson J. Ethical approaches to

gathering information from children and adolescents in international settings: Guidelines and resources. Washington, DC: Population Council. 2005; Retrieved from http://www.popcouncil.org/uploads/pdfs/horizons/childrenethics.pdf.

Braun V and Clarke V. Using thematic analysis in

psychology. Qualitative research in psychology. Qualitative Research in Psychology. 2006;3(2):77-101.

Nobelius AM. Adolescent Pregnancy in Uganda.

International Handbook of Adolescent Pregnancy 2014 (pp. 627-641). Springer, Boston, MA.

Fentiman A and Warrington M. Gender in East Africa:

Women role models in Uganda. The Centre for Commonwealth Education. 2011:1-27; Retrieved from http://www.educ.cam.ac.uk/centres/archive/cce/publications/CCE%20Report%20No8-Gender%20Report3_final_v2_.pdf

Blum RW and Mmari KN. Risk and protective factors

affecting adolescent reproductive health in developing countries: an analysis of adolescent sexual and reproductive health literature from around the world: summary. In Risk and protective factors affecting adolescent reproductive health in developing countries: an analysis of adolescent sexual and reproductive health literature from around the world: summary 2004 (pp. 13-13).

Kemigisha E, Ivanova O, Ruzaaza GN, Ninsiima AB,

Kaziga R, Bruce K, Leye E, Coene G, Nyakato VN and Michielsen K. Process evaluation of a comprehensive sexuality education intervention in primary schools in South Western Uganda. Sexual & Reproductive Healthcare. 2019 Oct 1;21:51-9.

Sekiwunga R and Whyte SR. Poor parenting: teenagers’

views on adolescent pregnancies in Eastern Uganda. African journal of reproductive health. 2009;13(4).

Kemigisha E, Bruce K, Nyakato VN, Ruzaaza GN,

Ninsiima AB, Mlahagwa W, Leye E, Coene G and Michielsen K. Sexual health of very young adolescents in South Western Uganda: a cross-sectional assessment of sexual knowledge and behavior. Reproductive health. 2018 Dec 1;15(1):148.

Refbacks

  • There are currently no refbacks.