Open Access

Research
Factors associated with adolescent school girl’s pregnancy in Kumbo
East Health District North West region Cameroon

Layu Donatus1, Dohbit Julius Sama1, Joyce Mahlako Tsoka-Gwegweni2, Samuel Nambile Cumber2,3,&

1
Department of Reproductive Health, Faculty of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon, 2Faculty of Health
Sciences, University of the Free State, Bloemfontein, South Africa, 3Section for Epidemiology and Social Medicine, Department of Public Health,
Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

&
Corresponding author: Samuel Nambile Cumber, Section for Epidemiology and Social Medicine, Department of Public Health, Institute of Medicine,
The Sahlgrenska Academy at University of Gothenburg, Box 414, SE-405 Gothenburg, Sweden

Key words: Adolescents, factors, pregnancy, health district

Received: 21/08/2018 - Accepted: 16/10/2018 - Published: 25/10/2018

Abstract
Introduction: Teenage pregnancy is a social problem in Cameroon in general and in Kumbo East in particular. This results in physical,
psychological and socio-economic consequences on the teenage mother, family and the society as a whole. In spite of studies and interventions
that have been and are being implemented, the prevalence of unplanned teenage pregnancy in Kumbo East Health District is still high, suggesting
that more efforts are required to achieve effective preventive measures. The aim of this study was to determine factors associated with adolescent
school girl's pregnancy in Kumbo East health district. Methods: A cross-sectional descriptive study design was used and a simple random sampling
technique was used to select 293 respondents aged 15 to 19year. The district hospital antenatal clinics and the Health Centres were selected. Data
was obtained from 292 participants under the age of 20 years who were willing using a questionnaire administered through face-to-face
interviews. Results: The study show a high prevalence (60.75%) of teenage pregnancy in the sampled antenatal clinics of Kumbo East Health
District attributable to inadequate considerations given to factors associated with school girl's pregnancy. This study has indicated that the age of
teenager at first pregnancy, low contraceptive use, socio-economic status and physical violence are factors that are greatly associated with
teenage pregnancy. Among the reasons contributing to the low use of contraceptives are: sexually activity, lack of knowledge, fear of side effects,
including sterility, condoms disappearing in the womb and inequality of power with sexual partners. This study shows that teenagers obtain
information mainly from school (53%) and relatives (20%). Conclusion: The use of contraceptive alone may not reduce teenage pregnancy,
however double method is very effective but addressing the impact of poverty on teenagers, empowering them on their rights and information in
order to make right choices is very important.

Pan African Medical Journal. 2018; 31:138 doi:10.11604/pamj.2018.31.138.16888

This article is available online at: http://www.panafrican-med-journal.com/content/article/31/138/full/

© Layu Donatus et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original
work is properly cited.

Pan African Medical Journal – ISSN: 1937- 8688 (www.panafrican-med-journal.com)

Published in partnership with the African Field Epidemiology Network (AFENET). (www.afenet.net)

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Introduction determine factors associated with adolescent school girl's pregnancy
in Kumbo East Health District.
Teenage pregnancy is considered as one occurring in a young
woman who has not reached her 20th birthday. This definition is
applicable irrespective of the legal status of the marriage of the Methods
woman or legal age to consider an individual as adult [1]. 16 million
girls aged 15-19 years give birth each year, most prevalent in low A crossectional descriptive study was selected because it
and middle-income countries located in sub-Saharan Africa [1]. In incorporates a descriptive component that enables the calculation of
the developing world, one-third to one-half of women become the prevalence of teenage pregnancy in antenatal clinics of KEHD.
mothers before the age of 20 and pregnancy related complications The socio-economic status where measured by asking respondents
have become the leading causes of death among them [1, 2]. questions concerning their househood items they possessed;
Teenage pregnancies are a global phenomenon. The pregnancy rate bicycle, car , family income were collected and the knowledge was
among teenagers in USA was 6.78% of pregnancies per 1,000 assessed by structured questions to evaluate the knowledge of
women aged 15-19 in 2008. [3]. Among the countries in the respondents to factors associated with teenage pregnancy. The
Western Europe, the United Kingdom [UK] has the highest teenage questionnaire was adopted from WHO standard guide and from the
conception and abortion rates [2, 4]. The report presents an update research of other researchers. The questionnaire was then pre-
on the current situation of pregnancies among girls less than 18 tested and adjusted to fit the context. Four midwives' students who
years of age and adolescents 15-19 years of age; trends during the were in their final year and had some experience in data collection
last 10 years; variations across geographic, cultural and economic assisted in the study. They were given orientation on the process
settings; interventions available to minimize pregnancy among for data collection and management prior to the commencement of
adolescents; evidence for these programmatic approaches; and field studies. They were trained for a period of three days in the
challenges that nations will have to deal with in the next 20 years administering of the questionnaire and research ethics, with an
given current population momentum [5]. The concentration of emphasis on informed consent. Each research assistant was given a
adolescent girls aged 10 to 17 will also change significantly, with the code that was used for identification in case of any queries. Data
largest increase occurring in sub-Saharan Africa, where adolescent was then collected entered into the computer and stored in external
pregnancy is most common, and the rate of contraceptive use the hard drive and USB keys. Data was then assembling and the
lowest in the world [5]. A study conducted in Malawi showed that analysis started. Our research period was for 10 months with the
57% of teenage girls opt to risk pregnancy rather than asking a study population consisting of all school girl's pregnant aged [15-
partner to use a condom [2]. In Malawi, there is a high prevalence 19yrs] from Kumbo East Health District. The sample size were then
of casual sex among teenagers who shun condoms although they pregnant teens (15 to 19yrs) attending antenatal clinics in selected
engage in multiple relationships. Scholars in the field argue that, health centres in Kumbo East Health District at the time of data
because of the risk associated with high prevalence of early sexual collection. Antenatal and infant welfare clinics were used in order to
behaviour, low contraceptive use, and many early pregnancies, access pregnant adolescents.
adolescents in Cameroon are an important target group for sexual
and reproductive health programs [6, 7]. In order to prevent early Inclusion criteria: All school teens age 15 to 19 yrs who are
age pregnancies, it is important to make sure that adolescents have pregnant who attend: ANC consultation irrespective of their
the means to make informed and healthy choices concerning their trimester at SEGH and selected health centre, infant welfare clinics,
sexual and reproductive health. Yet, as it stands, reproductive and who give their consent.
health and family planning services in Cameroon mainly target older
married women, and adolescents often remain largely overlooked Exclusion criteria: Pregnant teens who came to the clinic and
[5]. didn't give their consent were excluded. Although teenage
pregnancy concerns both sexes, male teenagers were excluded as
Adolescent school girl's pregnancies vary from country to country they rarely attend antenatal services with their partners.
and in Cameroon, reproductive health remains a major public health
challenge with elevated maternal mortality rate. The maternal Sample method and sample type: The sampling method used
mortality rate is estimated at 782 deaths per 100,000 live births [8]. was a simple random technique; the names of the health centres
This high mortality rate remains a dilemma because it involves the within was written on a piece of paper and placed in a container,
young mothers at the moment where they are giving birth. In four names were picked at random from the container. Jakiri
addition, adolescent contribute 28% of maternal mortality in integrated health centre, sub-divisional hospital Jakiri, St. Jude clinic
Cameroon [8]. According to DHS 2011, 25.6% of adolescents 15 to and Shisong General Hospital. Our sample type was a convenience
19 have started sexual intercourse and 21% of then have had a sampling. The Kumbo East District Hospital [Shisong] represents
child and 4% are pregnant for their first pregnancy. Still from the urban teenage mothers who may have experienced different factors
same source fertility rate of this age group is 127‰ which increase from the rural setting. To obtain an adequate sample, all pregnant
rapidly and attained a maximum of 250‰ within the age group 25- women visiting the antenatal clinics and infant welfare clinics over a
29yrs, suggesting that teenage pregnancy may be on the increase. three-month period at the selected sites under the age of 20 were
The proportion of adolescents who have started fertility grow rapidly interviewed.
with age, 5% for 15yrs to 48% for 19yrs and the rate stood at 18%
in the north west region [8]. Therefore, reducing teenage Sample size in a cross sectional study: To calculate our sample
pregnancy, chiefly by promoting the use of contraceptives, will be size, we are going to use the Lorenz formula which stipulates, P=
necessary in order to prevent consequences that are associated with Prevalence of adolescent 15 to 19 (p = 0.25), t = confidence level
teenage pregnancy. Nevertheless, lessons from Zimbabwe and [95%= 1.96], e = error margin [0.05], N = Sample size.
South Africa suggest that promoting the use of contraceptives alone
does not necessarily reduce teenage pregnancy in developing as in
developed countries. Therefore, other factors may be playing a
major role as mentioned earlier. The general objective was to

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Statistical application of this formula, resulted to a sample size of Sources of information on sexual and reproductive
293, implying that the study will recruit a total of 293 participants health: Despite the diversity of the sources of information on a
from the selected hospitals. variety of issues, 20.48% and 2.05% claimed ignorance of
information on sex and sexuality as well as the use of
Data collection technique: Data was collected over a period of 3 contraceptives. However, a majority of the participants; 79.52% and
months from August to October 2017, because of the Anglophone 97.95% had at least one of the variety of sources of information on
crisis with numerous "ghost towns" that reduce Antennal sex and sexuality and use of contraceptives. A majority of the
consultation by pregnant women difficult and hence leading to a participants had learned of sex and sexuality as well as use of
long period of time to collect data. Using a standardized contraceptives from school; 38.20% and 52.90%, respectively. Only
questionnaire administered through face-to-face interviews. The 13.31%, of mothers educated their daughters on sex and sexuality.
Questionnaire consisted mostly of closed questions. Each Books, Counsellors, local radio and peers respectively served as
questionnaire took 20-40 minutes to administer. There were no 6.83%, 19.80%, 13.65% and 20.48%, sources of information on
refusals - all participants willingly consented to participate in the sex and sexuality to adolescents. Out of the 293 respondents,
study. The arrangements for confidentiality and privacy ensured 11.60%, 13.31%, and 20.14% had learned of contraceptives from
that respondents accepted to be interviewed and spoke more freely friends, hospital, and relatives respectively (Table 2).
on the subject. In addition, it was also possible that respondents felt
that there was somebody to listen to their problems. The face-to- Knowledge of information on sexual and reproductive
face interviews facilitated responses and the quality of information health (SRH): Considering the respondents answers to question
and this method was convenient since most of the participants had ask on whether their menstrual and reproductive characteristics ,
low literacy levels. their knowledge of information on sexual and reproductive health
(SRH) was assessed, a majority of the respondents; 66.2%, 66.6%,
Statistical consideration: Data collected were entered into the 59.7% and 93.2% out rightly admitted that it is true that;
CDC-Epi-Info version 7.2.2.2, transferred to MS-Excel and then amenorrhoea leads to accumulation of dirt and sickness,
exported to SPSS version 21.0 software. Data cleaning was disappearance of a condom into a woman during sex, most
performed with MS-Excel to check for inconsistencies in data entry pregnancies occur in the middle of the menstrual cycle as well as,
and responses, prior to analyses. Associations between planed [Yes/ one can become pregnant during the first sexual intercourse.
No] pregnancy and various variables were evaluated using Pearson Another majority; 93.2%, 53.2%, 65.9% and 53.6% actually
and Yate's chi square [φ2] tests. Measures of association; OR and admitted as outright false the fact that; frequent sex prevents
Pearson's chi square [φ2] tests were calculated by use of CDC-Epi- pregnancy, sterility arises from the use of contraceptive use,
info version 7.2.2.2 and SPSS version 21.0 for the establishment of washing of genitals after sex prevents pregnancy and the
associations or differences (un) planed pregnancy and various consumption of sachet whisky prevents conception (Table 3).
variables.
Factors associated with unplanned teenage pregnancy in
Ethical considerations: in order to protect the rights of the KEHD: A list of factors were provided in the questionnaire for the
interviewees and meet requirements for research involving people, respondent to tick and out of the 293 respondents, 61.09% claimed
clearances were obtained from authorities and informed consent never to have used the condom, and 52.56% said their partner was
from the participants. The authorization was also obtained from the not the father of their child. 46.42% of the 293 participants said
North West Regional Delegation of Health. Ethical clearances were they do not use contraceptives, 13.65% failed to disclose the
obtained from the Committee for Research on Human Subjects of method of contraceptive used, by simply saying "none of the
the Catholic University of Central Africa (UCAC). Clearances to use above", when asked, when they started using contraceptive,
health facilities were also obtained from the Kumbo East District 58.02%, said they have never used contraceptives (Table 4).
Health Office. The following points were clarified: participation in
the study was voluntary; participants were free to withdraw at any Lack of knowledge on sexual reproductive health,
time without coercion and there were neither direct benefits nor circumstances of first sex, physical, sexual and substance
known risks at any time. To ensure anonymity and privacy, numbers abuse: From the answers provided by the respondent concerning
were used instead of names on the questionnaires. Interviews were knowledge assessment, 20.48% of the respondents had information
conducted in private rooms which were provided at the clinics for on sex and reproductive health from their peers and, another 20.8%
this purpose. The completed questionnaires that were not entered could not really identify their source of information on sex and
to the computer were locked in a cupboard accessible to the reproductive health. 11.60% and 2.05% of the respondents learned
researcher only to ensure confidentiality. of how to use contraceptives from friends and no defined sources
(Table 5).

Results Characteristics of sexual partner and gender power

relations in partnership: The sexual partners of respondents
were of the age range 16-32 years (mean age of 22.815). At their
Socio-demographic characteristics: A total of 293 participants
age, a majority 67.24% of the respondents claimed their partners
of average age 18.88yrs were sampled from 13 shortlisted localities
do not use drugs, while 6.49%, 15.02% and 3.75% respectively
of KEHD; Jakiri had the highest proportion 65 [22.18%] of
claimed their partners; do any injectable drugs, any other drugs and
participants while Noi and Tan had the lowest 11 [3.75%] each. Out
marijuana. On alcohol consumption frequency; 49.83% claimed not
of the 293 participants, 154 [52.56%] admitted currently schooling.
to know the drinking rate of their spouses, 7.85%, 20.82% and
Out of the 293 ladies sampled, 153 (52.22%) were single. Out of
21.50% said their partners drink at the rate of; only at weekend,
293 sampled in the study, 175 [59.73%] who had not delivered,
less than once a month and a few times a month respectively (Table
while the remainder had delivered at least a child, either in marriage
6).
or out of marriage. Socio-demographic data was collected for
variables such age, marital status, alcohol and drug/substance
attitudes, as well as information concerning partner (Table 1).

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Discussion and low levels of awareness. This is conformity with a similar study
Contraceptive prevalence in Cameroon is low among married
women and shows uneven distribution varying from 2.6% in North
General patterns of teenage pregnancy in Kumbo East
Cameroon to 43.9% in Yaoundé [6, 7]. The low prevalence use
Health District
among married couples suggests that once a woman is married she
is exposed to pregnancy irrespective of her age. In Cameroon,
The prevalence of teenage pregnancy in Cameroon is 28% and in
unmet needs for family planning are 22%. And the use of modern
Kumbo East Health District the results on this study shows that the
contraception in Cameroon is about 16%. Reasons for non-
prevalence of unplanned teenage pregnancy is 60.75% which very
contraceptive use include, religious and cultural beliefs, poor quality
high this could be attributed to the fact that schools were not
of services, including the negative attitude of service providers, fear
operational at the time of this study due to political unrest in the
of exposure of their bodies, having adults at the same services and
country at the time of data collection. Out of the 293 respondents,
inability to negotiate contraceptive use with sexual partners.
61.09% claimed never to have used the condom, and 52.56% said
Furthermore, misconceptions, fear of side effects and stigma
their partner was not the father of their child. 46.42% of the 293
associated with the use of contraceptives as adolescents may be
participants said they do not use contraceptives, 13.65% failed to
labelled as being promiscuous can also be considered as
disclose the method of contraceptive used, by simply saying "none
contributing factors for non-contraceptive use [1]. Similarly, in
of the above", when asked, when they started using contraceptive,
South Africa, a study revealed that teenage pregnancy is attributed
58.02% said they have never used contraceptives. This implies that
to the low utilization of contraceptives, especially on their first
there is still a need for more efforts. Possible factors contributing to
intercourse, due to the lack of access to medical information on
the high prevalence in this study area include age at first
reproductive system, inaccessible family planning services, gender
pregnancy, low contraceptive use, educational levels and socio-
inequality and decision on the social life, fears about contraception
economic status, circumstances at first sex, lack of knowledge on
on fertility and menstruation and condoms could be left inside the
reproductive and sexual health and physical and sexual violence.
vagina or womb [4]. It was therefore envisaged that the use of
contraceptives among teenagers in the study area could be low,
Knowledge and sources of information on reproductive and
making it a factor for pregnancy.
sexual health
Levels of education, cultural practices and economic factor
Considering the respondents answers to question ask on whether
their menstrual and reproductive characteristics , their knowledge of
The ages of the partners of participants ranged from 16-32 years;
information on sexual and reproductive health [SRH], a majority of
Half, 50.17% of partners of adolescent school girls were in the age
the respondents; 66.2%, 66.6%, 59.7% and 93.2% out rightly
group 20 - < 25 years. 17.41% were in the age group 16 -< 20
admitted that it is true that; amenorrhoea leads to accumulation of
years, 25.26% in the group 25 -< 30 years and 7.17% in the age
dirt and sickness, disappearance of a condom into a woman during
group 30 - 32 years. With 51.88% of the 293 participant's partners
sex, most pregnancies occur in the middle of the menstrual cycle as
had secondary school education, followed by those with tertiary
well as, one can become pregnant during the first sexual
education 40.27%, those with no formal education were 6.83% and
intercourse. Another majority, 93.2%, 53.2%, 65.9% and 53.6%
primary education were 1.02%. Of the 293 participants, the
actually admitted as outright false the fact that; frequent sex
partners of 44.37%, 40.96% and 14.68% were respectively
prevents pregnancy, sterility arises from the use of contraceptive
studying, unemployed and working (Table 2). The study agrees that
use, washing of genitals after sex prevents pregnancy and the
Teenage girls may indulge in sexual activity in exchange for goods,
consumption of sachet whisky prevents conception (Table 4).
money and experiences such as taking meals in hotels [1]. A study
in Malawi, found that 66% of adolescents had accepted money or
Age of the teenagers
gifts in exchange for sex and in some cases, parents may encourage
their daughters into relationships with men for consumer goods or a
The ages of participants ranged from 15-27 years, with mean age
girl may go out with men because her parents cannot give her the
18.88 years and modal age group of 15 -< 20 years with 227 [<
basic needs. Teenagers with unplanned pregnancy are more likely
77.41%]. A large majority of participants 59.73% had no child,
to come from low socio-economic status than with planned
while 32.42% had one child, 0.68% had two children, 6.14% had
pregnancy [1]. The level of education of parents, especially the
three children and 1.02% had four children. In Cameroon, Kenya,
mother, may have an influence on the adolescent towards teenage
South Africa and Canada, the average age difference between
pregnancy as she acts as a role model [9] which may be a
teenagers and their sexual partners is 15, 7, 5 and 2.6 years,
preventive factor of teenage pregnancy. In Kenya it was reported
respectively. In addition, teenagers who marry older men often
that women with no education had first sexual intercourse three
have less power in decision making around sexual intercourse,
years earlier than their counterparts with at least a secondary
childbearing and the use of contraceptive [1].
school education [1]. The low literacy levels may lead to low paying
jobs, causing early marriage and influencing non-contraceptive use,
Knowledge contraceptive use
thereby increasing the prevalence of teenage pregnancy. Therefore,
it was expected in the study area that the low literacy levels may
On the usage of contraceptives, 15.02% used the condom, 5.12%
have an impact on unplanned teenage pregnancy. Culturally,
claim to use implants, 8.19% claim to use IUCD, while 11.60% use
amongst factors associated with unplanned teenage pregnancy
pills. On when they began using contraceptives; 2.05% began this
were, age at onset of menstruation, age at first sex, who they live
year, 24.23% began last year, 7.51% began in the year 2015,
with as well as the marital status of their parents. It was difficult to
2.73% began in 2014 and 2013 as well as 2012 (Table 4).
prove that culture is a factor. Economically, these were age,
Respondents also advanced possible fears and reasons for not using
religious and delivery status of participants (Table 1), marital status
contraceptive; 6.83, were scared of nurses, 20.14% were scared of
of participants and parents, partner's educational and occupational
their parents, 6.83% claimed it was against their religion and
status.
12.97% admitted their partners were not in favour of it (Table 1).
The fears, beliefs and perceptions of sexual inactivity associated
with contraceptive use may be attributed to the lack of knowledge

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Gender power relations in partnerships engage in transactional sex. Based on the study it is clear that
teenagers have no control over sexual and reproductive health since
There were a variety of circumstances that could lead to sex; their sexual partners are the sore decision makers making physical
partner violence, reasons for involvement in a relationship and first and sexual violence a factor for teenage pregnancy. However, the
sexual experience. For partner violence; 19.80%, had their funds influence of cultural practices and religion, substance abuse,
managed by their partners, 33.11% were forced by their partners relationship control, and fear of parents and intimidating attitude of
into sex, 20.14% would be hit by their partners and 40.27% had health service providers have been supported as factors. The
their funds managed by their partners. 6.48%, 13.65% and 12.97% associations suggested by the study point towards a need for
of respondents respectively got involved in a relationship to be greater emphasis in reproduction and sexual health promotion
provided with clothes, to be married and to have a good time. For interventions. In addition, strengthening awareness and giving
the first sexual experience; 46.42% were persuaded either by a information to dispel fears, misconceptions and rumours about
relation or boyfriend, 6.48% were raped, 21.84% were raped, contraceptive use will prepare teenagers for the physical changes
7.51% were willing and collaborated or 17.75% refused to disclose they might experience when adopting contraceptive methods.
their first sexual experience (Table 5). This means that male partner Nevertheless, contraceptive use alone may not reduce teenage
is the one who decides what happen in a relationship. pregnancy, but addressing the impact of poverty on teenagers,
empowering them on their rights and information in order to make
Lack of knowledge on sexual reproductive health, right choices is very important.
circumstances of first sex, physical, sexual and substance
abuse Recommendations: The study recognizes efforts being made by
government and non-governmental organizations to solve the
20.48% of the respondents had information on sex and problem of teenage pregnancy in north west region and Kumbo East
reproductive health from their peers and, another 20.8% could not in particular. These efforts include promoting the use of
really identify their source of information on sex and reproductive contraceptives, education of girls and poverty alleviation. However,
health. 11.60% and 2.05% of the respondents learned of how to the low use of contraceptives and socio-economic status, continued
use contraceptives from friends and no defined sources (Table 3). sexual and physical violence, the feeling of inferiority due to age
Most studies conducted in developing countries report that differences with sexual partners and early marriages indicate that
adolescent girls often lack basic knowledge about reproductive and factors for teenage pregnancy still persist in the study area.
sexual health [1]. This study contrast with that of findings of Nanze. Therefore, there is a need to develop programmes to address
C.C (2006 on risk factors of unwanted/uplanned pregnancy in factors identified in this study. Solutions to the problem require
zomba district, Malawi) indicate that communication about multidisciplinary implementing teams, including parents, schools,
reproductive and sexual matters within families is limited, forcing communities, NGOs and government sectors. The following
girls to get information chiefly from peers, boyfriends and teachers. recommendations are suggested.
On drug and substance use, a wide majority (80.55%, said they do
not take drugs 12.97% said they took any drug, while 6.48% What is known about this topic
admitted smoking "banga" (Table 7). Similar findings have been
reported in South Africa [9]. Unlike wise in Cameroon, it is not  Knowledge of this geographic distribution can provide
common for teenage girls to use drug substances due to cultural useful information for updating and strengthening
values. However, there may have been underreporting since drug adolescent reproductive health strategies in Cameroon;
use is illegal, making it a sensitive topic.
 In Cameroon, the prevalence of adolescent pregnancy is
between 40% to 50%;
 Adolescent age 15 to 19 contribute to 28% of maternal
Conclusion mortality in Cameroon.

The study factors associated with adolescent school girl's pregnancy What this study adds
in KEHD was aimed at examining the factors associated with teens
pregnancy. A descriptive study was used and the teens 15 to 19yrs  Study will help provide few answers to this problem and
were selected. Teenage pregnancy whether planned or unplanned is may be prick health leaders to react towards the
detrimental to the health and socio economic status of the amelioration of some of their health strategies concerning
teenagers. This study shows that there is a high prevalence reproductive health especially adolescent health in rural
(60.75%) of teenage pregnancy in the sampled antenatal clinics of areas of Cameroon;
Kumbo East Health District attributable to the low contraceptive use
and socio-economic status, lack of reproductive and sexual
 Moreover, it will also go a long way to convince national
and international partners to continue to largely invest in
knowledge, circumstances at first sex, including force and rape,
the reproductive health section;
physical and sexual violence, early marriage, age of sexual partner
and alcohol abuse. Among reasons contributing to the low use of  This will stand as a pillar to help adolescent to adopt
contraceptives are; lack of knowledge, fear of side effects, including responsible behaviours in regard to adolescent pregnancy
sterility, condoms disappearing in the womb and inequality of power especially at individual, community and health systems
with sexual partners. Teenagers obtain information mainly from levels.
school (53%) and relatives (20%). The high prevalence of
unplanned teenage pregnancy, low contraceptive use, myths and
misconceptions surrounding the use of contraceptives indicate that Competing interests
teenagers are receiving inaccurate information about reproductive
and sexual health, a problem which may be compounded by low Authors declare no competing interests.
educational levels. Therefore, the lack of knowledge about
reproductive health is a factor for teenage pregnancy. The lack of
basic necessities is one of the factors that force teenagers to

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Table 1: Demographics; age, religion, school attendance and parity
Variable Attribute Frequency Percent (%)
15 - < 20 227 77.47
20 - < 25 48 16.38
Age groups (years) 25 - < 27 2 0.68
≥ 27 16 5.46
Total 293 100.00
Jakiri 65 22.18
Kouwong 21 7.17
Kumbo 19 6.48
Mantum 26 8.87
Ngoilum 20 6.83
Nkar 17 5.80
Noi 11 3.75
Quarter of residence
Nsom 29 9.90
Ntutiy 14 4.78
Shisong 23 7.85
Shiy 20 6.83
Tan 11 3.75
Waitakwar 17 5.80
Total 293 100.00
ATR* 39 13.31
Catholic 95 32.42
Religion Muslim 74 25.26
Protestant 85 29.01
Total 293 100.00
Yes 154 52.56
Currently schooling No 139 47.44
Total 293 100.00
None 175 59.73
One 95 32.42
Two 2 0.68
Parity
Three 18 6.14
Four 3 1.02
Total 293 100.00
*ATR = African Traditional Religion

Table 2: Sources of information on SRH and contraceptive use

Source(s) of
Attribute Frequency Percent
information
Books 20 6.83
Mother 39 13.31
Counsellor 58 19.80
On sex & sexuality* School 134 38.20
Radio 40 13.65
Peers 60 20.48
None of these 60 20.48
Friends 34 11.60
Hospital 39 13.31
On use of Relatives 59 20.14
contraceptives* School 155 52.90
None of the
6 2.05
above
Total 293 100.00
* Dichotomy group tabulated at value 2

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Table 3: Knowledge of information on sexual and reproductive health (SRH)
Knowledge PT (%) T (%) PF (%) F (%)
Most common cause of infertility is STI 40 (13.7) 77 (26.3) 38 (13) 138 (47.1)
Sex during menstruation can lead to
58 (19.8) 19 (27.0) 20 (6.8) 136 (46.4)
pregnancy
A woman can become sterile upon using
78 (26.6) 117 (39.9) 20 (6.8) 78 (26.6)
depo
Amenorrhoea leads to accumulation of
59 (20.1) 194 (66.2) 0 (0.0) 40 (13.7)
dirt and sickness
Intercourse in water cannot prevent
19 (6.5) 116 (39.6) 60 (20.5) 98 (33.4)
pregnancy
Condom usage can disappear into the
58 (19.8) 195 (66.6) 0 (0.0) 40 (13.7)
woman
Frequent sex prevents pregnancy 0 (0.0) 0 (0.0) 20 (6.8) 273 (93.2)
Use of pills after pregnancy can lead to
39 (13.3) 58 (19.8) 60 (20.5) 136 (46.4)
abortion
The use of contraceptives is promiscuity 39 (13.3) 60 (20.5) 58 (19.8) 136 (46.4)
Most pregnancy occurs in the middle of
19 (6.5) 175 (59.7) 0 (0.0) 99 (33.8)
the cycle
No pregnancy in 4 months after
0 (0.0) 97 (33.1) 40 (13.7) 156 (53.2)
contraception is sterility
One can be pregnant at first sex 20 (6.8) 273 (93.2) 0 (0.0) 0 (0.0)
Washing genitals after sex prevents
40 (13.7) 40 (13.7) 20 (6.8) 193 (65.9)
pregnancy
Sachet whisky consumption prevents
58 (19.8) 78 (26.6) 0 (0.0) 157 (53.6)
pregnancy

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Table 4: Factors associated with adolescent school girl’s pregnancy
Non use of contraceptives
Have you ever used
Frequency Percent (%)
condom?
Yes 114 38.91
No 179 61.09
Total 293 100.00
Is partner father of this
child?
Yes 139 47.44
No 154 52.56
Total 293 100.00
Contraception and method
Condom 44 15.02
I don't use contraceptives 136 46.42
Implant 15 5.12
IUCD 24 8.19
Pill 34 11.60
None of the above 40 13.65
Total 293 100.00
When did you first use
contraceptives?
This year/ 2017 6 2.05
1 year ago/ 2016 71 24.23
2 years ago/ 2015 22 7.51
3 years ago/ 2014 8 2.73
4 years ago/ 2013 8 2.73
5 years ago/ 2012 8 2.73
Never 170 58.02
Total 293 100.00
Sources of knowledge of
contraceptive
Friends 34 11.60
Hospital 39 13.31
Relatives 59 20.14
School 155 52.90
None of these sources 6 2.05
Why I have never used
contraceptives
I am scared of nurses at the
20 6.83
clinic
I was scared my parents
59 20.14
would find out
It is against my religion 20 6.83
My boyfriend/ partner did not
38 12.97
want me to
None of these 156 53.24
Total 293 100.00

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Table 5: Circumstances of first sex, first sexual experience, relationship control
and duration of relation
Why you relate to partner Frequency Percentages (%)
Have A Good Time 38 12.97
Be Married 40 13.65
Be Provided With Clothes 19 6.48
Be Provided With Cosmetics 0 0
Be Provided With Food 0 0
Be Provided With Money 0 0
Drug/ substance use by partner
Marijuana 11 3.75
He doesn't use drugs 197 67.24
Any other drug 44 15.02
Any injectable drug 19 6.48
Drug/ substance use by me
Any Other Drug 38 12.97
I don't use drugs 236 80.55
Marijuana 19 6.48
Total 293 100.00
First sexual experience
I was persuaded 136 46.42
I was raped 19 6.48
I was tricked 64 21.84
I was willing 22 7.51
None of the above 52 17.75
Total 293 100.00

Table 6: alcohol/ drug attitude of partner

Partners drinking
Frequency Percent
frequency
A few times in a month 63 21.50
I don’t Know 146 49.83
Less than once a month 61 20.82
Only at weekends 23 7.85
Total 293 100.00
Drug/ substance
Marijuana 11 3.75
Any other drug 44 15.02
Any injectable drug 19 6.48
He doesn't use drugs 197 67.24

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Table 7: circumstances of first sex, first sexual experience, relationship
control and duration of relation
Why you relate to partner Frequency Percentages (%)
Have A Good Time 38 12.97
Be Married 40 13.65
Be Provided With Clothes 19 6.48
Be Provided With Cosmetics 0 0
Be Provided With Food 0 0
Be Provided With Money 0 0
Drug/ substance use by partner
Marijuana 11 3.75
He doesn't use drugs 197 67.24
Any other drug 44 15.02
Any injectable drug 19 6.48
Drug/ substance use by me
Any Other Drug 38 12.97
I don't use drugs 236 80.55
Marijuana 19 6.48
Total 293 100.00
First sexual experience
I was persuaded 136 46.42
I was raped 19 6.48
I was tricked 64 21.84
I was willing 22 7.51
None of the above 52 17.75
Total 293 100.00

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