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Contemporary pathways to adolescent pregnancy in Indonesia: A qualitative investigation with adolescent girls in West Java and Central Sulawesi
In the last decade, reduction in adolescent fertility rates in Indonesia has slowed despite national programmes and policies focused on addressing child marriage. Indonesia currently has the highest number of births to adolescent girls aged 15–19 years in Southeast Asia. There is a need to develop a...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10610479/ https://www.ncbi.nlm.nih.gov/pubmed/37889888 http://dx.doi.org/10.1371/journal.pgph.0001700 |
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author | Ayuandini, Sherria Habito, Marie Ellis, Steven Kennedy, Elissa Akiyama, Maki Binder, Gerda Nanwani, Sandeep Sitanggang, Margaretha Budiono, Neira Ramly, Ali Aulia Humphries-Waa, Karen Azzopardi, Peter S. Hennegan, Julie |
author_facet | Ayuandini, Sherria Habito, Marie Ellis, Steven Kennedy, Elissa Akiyama, Maki Binder, Gerda Nanwani, Sandeep Sitanggang, Margaretha Budiono, Neira Ramly, Ali Aulia Humphries-Waa, Karen Azzopardi, Peter S. Hennegan, Julie |
author_sort | Ayuandini, Sherria |
collection | PubMed |
description | In the last decade, reduction in adolescent fertility rates in Indonesia has slowed despite national programmes and policies focused on addressing child marriage. Indonesia currently has the highest number of births to adolescent girls aged 15–19 years in Southeast Asia. There is a need to develop a more nuanced understanding of the drivers of adolescent pregnancy in Indonesia to inform programmes and policies tailored to young people’s needs and priorities. This study explored adolescent girls’ pathways to pregnancy across two provinces (Central Sulawesi and West Java) in Indonesia. We conducted participatory timeline interviews with 79 girls aged 15–21 years from urban, peri-urban, and rural communities and inquired about their relationships and life experiences leading up to pregnancy. We conducted follow-up interviews with 19 selected participants to validate and clarify preliminary findings. We identified six pathways to adolescent pregnancy which were broadly differentiated by the timing of pregnancy relative to marriage. Three pregnancy pathways within marriage were further differentiated by the main motivation for marriage–financial reasons, protecting the girl and family’s reputation, or to progress a romantic relationship. Three pregnancy pathways outside marriage were distinguished by the nature of the sexual relationship preceding pregnancy–consensual sex, unwanted or pressured sex, and forced sex. Drivers of adolescent pregnancy include the acceptability of child marriage and stigma surrounding premarital pregnancy, family and social expectations of pregnancy following marriage, harmful gender-based norms and violence, and lack of sexual and reproductive health information and access to services. Adolescents follow varied pathways to pregnancy in Indonesia. The idealisation and acceptance of child marriage is both a catalyst and outcome of adolescent pregnancy, which is occurring amid stigma surrounding premarital sex and pregnancy, harmful gender-based norms and violence, and barriers to contraceptive access and use. Our findings emphasise that there are many drivers of adolescent pregnancy and different pathways will require intervention approaches that address child marriage alongside other key contributors. |
format | Online Article Text |
id | pubmed-10610479 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-106104792023-10-28 Contemporary pathways to adolescent pregnancy in Indonesia: A qualitative investigation with adolescent girls in West Java and Central Sulawesi Ayuandini, Sherria Habito, Marie Ellis, Steven Kennedy, Elissa Akiyama, Maki Binder, Gerda Nanwani, Sandeep Sitanggang, Margaretha Budiono, Neira Ramly, Ali Aulia Humphries-Waa, Karen Azzopardi, Peter S. Hennegan, Julie PLOS Glob Public Health Research Article In the last decade, reduction in adolescent fertility rates in Indonesia has slowed despite national programmes and policies focused on addressing child marriage. Indonesia currently has the highest number of births to adolescent girls aged 15–19 years in Southeast Asia. There is a need to develop a more nuanced understanding of the drivers of adolescent pregnancy in Indonesia to inform programmes and policies tailored to young people’s needs and priorities. This study explored adolescent girls’ pathways to pregnancy across two provinces (Central Sulawesi and West Java) in Indonesia. We conducted participatory timeline interviews with 79 girls aged 15–21 years from urban, peri-urban, and rural communities and inquired about their relationships and life experiences leading up to pregnancy. We conducted follow-up interviews with 19 selected participants to validate and clarify preliminary findings. We identified six pathways to adolescent pregnancy which were broadly differentiated by the timing of pregnancy relative to marriage. Three pregnancy pathways within marriage were further differentiated by the main motivation for marriage–financial reasons, protecting the girl and family’s reputation, or to progress a romantic relationship. Three pregnancy pathways outside marriage were distinguished by the nature of the sexual relationship preceding pregnancy–consensual sex, unwanted or pressured sex, and forced sex. Drivers of adolescent pregnancy include the acceptability of child marriage and stigma surrounding premarital pregnancy, family and social expectations of pregnancy following marriage, harmful gender-based norms and violence, and lack of sexual and reproductive health information and access to services. Adolescents follow varied pathways to pregnancy in Indonesia. The idealisation and acceptance of child marriage is both a catalyst and outcome of adolescent pregnancy, which is occurring amid stigma surrounding premarital sex and pregnancy, harmful gender-based norms and violence, and barriers to contraceptive access and use. Our findings emphasise that there are many drivers of adolescent pregnancy and different pathways will require intervention approaches that address child marriage alongside other key contributors. Public Library of Science 2023-10-27 /pmc/articles/PMC10610479/ /pubmed/37889888 http://dx.doi.org/10.1371/journal.pgph.0001700 Text en © 2023 Ayuandini et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Ayuandini, Sherria Habito, Marie Ellis, Steven Kennedy, Elissa Akiyama, Maki Binder, Gerda Nanwani, Sandeep Sitanggang, Margaretha Budiono, Neira Ramly, Ali Aulia Humphries-Waa, Karen Azzopardi, Peter S. Hennegan, Julie Contemporary pathways to adolescent pregnancy in Indonesia: A qualitative investigation with adolescent girls in West Java and Central Sulawesi |
title | Contemporary pathways to adolescent pregnancy in Indonesia: A qualitative investigation with adolescent girls in West Java and Central Sulawesi |
title_full | Contemporary pathways to adolescent pregnancy in Indonesia: A qualitative investigation with adolescent girls in West Java and Central Sulawesi |
title_fullStr | Contemporary pathways to adolescent pregnancy in Indonesia: A qualitative investigation with adolescent girls in West Java and Central Sulawesi |
title_full_unstemmed | Contemporary pathways to adolescent pregnancy in Indonesia: A qualitative investigation with adolescent girls in West Java and Central Sulawesi |
title_short | Contemporary pathways to adolescent pregnancy in Indonesia: A qualitative investigation with adolescent girls in West Java and Central Sulawesi |
title_sort | contemporary pathways to adolescent pregnancy in indonesia: a qualitative investigation with adolescent girls in west java and central sulawesi |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10610479/ https://www.ncbi.nlm.nih.gov/pubmed/37889888 http://dx.doi.org/10.1371/journal.pgph.0001700 |
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