FACTORS OF TEENAGE PREGNANCY IN THE MUNCIPALTY OF BILIRAN A Research Proposal Presented to the Faculty of Biliran Science High School Biliran, Biliran In Partial Fulfilment of the Requirement for the Subject Practical Research II Researchers: VINCE JETH G. YU DAISY RIE ROSALES PRINCE CARL PALCONIT JOHN PAUL ANDOJAR FEBRUARY 2022 Chapter I INTRODUCTION Background of the Study Teen age pregnancy, also known as adolescent pregnancy, is pregnancy in female under the age of 20, according to the World Health Organisation (WHO.) Similarly, teen age pregnancy is defined according to the United Nations Children’s Fund (UNICEF) as pregnancy or childbearing usually within the ages of 13 – 19. The WHO reports that about 16 million adolescent females aged 15 – 19 give birth each year, roughly 11% of all births worldwide. Approximately 95% occur in developing countries. According to the Philippines National Demographic and Health Survey (NDHS) conducted by the Philippine Statistics Authority (PSA) in 2017, 9% of women age 15 – 19 had already begun childbearing. The proportion of teenagers who have begun childbearing rises rapidly with age, from 1% at age of 15 to 22% at age of 19. Compared to the rest of the world, the Philippines’ adolescent fertility rate is within the average range (Natividad, 2013). Compared to its neighbours in Southeast Asia, it is also midrange. With that, still, the Philippines has one of the highest adolescent birth rates among the ASEAN Member States. Adolescent pregnancy in any region is a major issue for both health and social reasons. Teenage childbearing females are subjected to numerous of health risks. According to the WHO, pregnancy during adolescence is linked with greater risk of health problems such as anemia, sexually transmitted infections (STIs), postpartum hemorrhage, and poor mental health outcomes like depression, and even suicide. One of the leading cause of death among women aged 15 – 19 is pregnancy and childbirth complications. In addition, some 3.9 million unsafe abortions among women in the same age group occur each year, leading to maternal mortality, morbidity and lasting health problems, (Darroch, Woog , Bankole , Ashford, 2016). In response to the situation, the researchers prompted to undertake this descriptive study to recognize the factors of teenage pregnancy in the Municipality of Biliran. Moreover, the findings of this study will provide a better understanding of the pending factors of teenage pregnancy. In addition, identify novel aspects created by the ongoing pandemic. This study could aid parents, teenagers, and policy makers alike, practice and create better and more effective preventive measures against unwanted adolescent pregnancy. Statement of the Problem This study generally aims to determine the major factors of teenage pregnancy. Specifically, it seeks to answer the following questions: 1. What is the profile of the teenage mom in terms of: 1.1 Age Group 1.2 Educational attainment of respondents during pregnancy 1.3 Number of siblings 1.4 Educational attainment of parents 1.5 Parent’s monthly income 2. What are the factors of teenage pregnancy in terms of: 2.1 Family factors 2.2 Individual factors 2.3 Socio-cultural factors Conceptual Framework This study aims to identify the factors of teenage pregnancy in the Municipality of Biliran. The researchers use survey questionnaire to be able to identify the factors of teenage pregnancy. PROCESS INPUT FACTORS OF TEENAGE PREGNANCY IN THE MUNICIPALITY OF BILIRAN SURVEY USING QUESTIONNAIRE PROFILING DATA TABULATION AND ANALYSIS OUTPUT IDENTIFIED FACTORS OF TEENAGE PREGNANCY Figure 1. Conceptual Framework Figure 1. Presents the conceptual framework of the study and how the research problem will be explored. It consists of the input, process and output of the factors of teenage pregnancy. The input is the factors of teenage pregnancy in the municipality of Biliran. It is the topic that is being investigated and explored. The aim of this study is to recognize or identify the factors of teenage pregnancy. The process if the gathering of data of the respondents that include their profile and the factors of teenage pregnancy. Evaluating the data needed should be tabulated and analysed to obtain the result using the survey questionnaire as the tool. The output of this study will be identifying the factors of teenage pregnancy in the municipality of Biliran. Theoretical Framework The researchers sees to anchor this study on Roy’s Adaption Model Theory by Sister Callista Roy (1980). The theory defines adaptation as the process by which an individual or group makes conscious decisions to cope with his or her situation. It also suggests that adaptive responses increase people’s ability to cope and achieve their goals, including survival, growth, mastery of their lives, and personal and environmental transformation. Although, Roy’s model stated that there are four modes: physiologic, selfconcept, role identity/function, and interdependence. However, Roy’s model sees a person as a biopsychosocial being constantly interacting with a changing environment. Therefore a person is an open, adaptive system who uses coping skills to deal with stressors. Roy then describes stressors as stimuli and employs the term residual stimuli to describe those stressors whose influence to a person is not clear. In relation with this study, the person represents the teenage mothers. Roy’s model then sees the environment as all conditions, circumstances and influences that surround and affect the development and behaviour of the person (Andrews & Roy, 1991). The so called environment then may sum up the challenges of the respondents in facing life with early pregnancy and motherhood. Although, Roy's goal for nursing is the promotion of adaptation in each of the four modes, thereby contributing to the person's health, quality of life and dying with dignity (Roy, 1980) Significance of the Study The researchers believe that this study will be of great help to the following: Teenagers. This study may encourage awareness among teenagers or adolescents alike of the underlying factors that cause this phenomena, teenage pregnancy Parents. This study may pave the way for a better understanding of the phenomena of teenage pregnancy and it’s causing factors among parents of teenage mothers and non-teenage mothers. Policy makers. This study will provide important data that will serve as primary source of ideas on how to improve existing policies regarding the phenomena of teenage pregnancy. Additionally, serve as basis for the formation of new policies anchored on the matter. Future Researchers. The result of the study will serve as their reference for related studies using other variables. Scope and Delimitation of the Study This study mainly focuses on identifying the factors that influence teenage pregnancy in the Municipality of Biliran. The study is focused on teenage mothers that are pregnant at the time of the survey under the age of 19 years. Due to limited circumstances the researchers will decide through cluster sampling on which barangays or clusters to visit to carry out the study. Definition of Terms To fully understand the meaning of the words used in this study, the following terminologies are defined: Factors. Refers to a circumstance, fact, or influence that contributes to a result or outcome. Teenager. Refers to a person aged between 13 and 19 years. Adolescent. Refers to a young person in the process of developing from a child to an adult. Childbearing. Refers to the process of giving birth to children Teenage pregnancy. Refers to the development of fetus inside a womb of a female aged between 13 and 19 years. Review of Related Literature This part presents the related literatures pertaining to the phenomenon of teenage pregnancy and its relevance to the study to be conducted. Teenage pregnancy is characterized as childbearing of young females occurring between the ages of thirteen and nineteen, generally females under 20 years of age (WHO, 2017). In this context, teenage pregnancy was surprisingly far more prevalent and was considerably more normal in previous centuries. It was then common in developed countries in the 20th century. By the 1970s, almost 25 percent of Norwegian women born in early 1950s became teenage mothers (Lappegård, 2000). An estimation by the WHO (2020), revealed that approximately 22 million females in developing countries aged 15 to 19 years become pregnant and roughly 12 million of them give birth. At least 777,000 births occur among adolescent females younger than 15 years in developing countries. While estimated global adolescent fertility rate has declined, the actual number of child births has not, this is due to largely growing population of young females aged 15 to 19. Although global birth rates has declined, it has remained static or even increased in South East Asia, with a broad-spectrum of variations between countries. In the region, the average birth rate among females aged 15 to 19 is 47 births per 1000 females, considerably higher than the average of South Asia and is close to the global average of 50. The counties that stand out in terms of high birth rates at the country level are observed in Cambodia with 57, Thailand at 50, Indonesia with 48, and Philippines at 47. (UNESCO Bangkok, 2018). In 2008, the pregnancy rate in the Philippines was 10 percent, down to 9 percent in 2017. Over the course of three years the country has experience a slow decline in teenage live births aged 10 to 19. In 2016 totaled 203,085, slightly decreased to 196,478 in 2017, and 183,000 in 2018. Even so, the Philippines remains to have one of the highest adolescent birth rates annually among ASEAN members. The country has an annual birth rate of 47 per 1000 adolescent female aged 15 to 19 years, which means that more than 500 Filipino adolescent females are getting pregnant and giving birth every day (UNFPA, 2020). Females that are childbearing at an early age are subjected to various health risks and consequences. Pregnancy complications are the leading cause of death globally among females aged 15 to 19 years and with middle - low income countries accounting for 99 percent of maternal deaths globally (Neal, Matthews, Frost, et al. 2015). Adolescent mothers are also faced with high risks of eclampsia, puerperal endometritis and systemic infections (WHO, 2016). Additionally, pregnant adolescents are put through social consequences. These are characterized by stigma, rejection by partners, parents and peers. Females who become pregnant under the age of 18 are more likely to experience violence within partnership or marriage. Also, adolescent pregnancy often lead to school dropout that eventually may lead to jeopardizing future education and employment opportunities. CHAPTER II METHODOLOGY This chapter provides a description of methods, procedures and instruments that were used to gather data and how the data were analysed. Research Design The researchers will be using a quantitative approach on this study. A quantitative research design is a formal, objective, systematic process to describe and test relationships and examine cause and effect interactions among variables (Burns and Grove 1993). The researchers will be utilizing a descriptive quantitative approach. Descriptive research essentially describes what exists and may help to unveil new facts and meaning. The purpose of descriptive research is to observe, describe and document aspects of situation as it occurs (Polit & Hungler 1999). In this study the data will be collected through personally distributed survey questionnaires to the respondents by the researchers. Research Locale Source: www.googlemaps.com Figure 2. Satellite Image of the Research Locale This study will be conducted in the Municipality of Biliran, Province of Biliran. The researchers prompted to make the Municipality of Biliran as the chosen locale for two reasons: It is the place at which the researchers are residing, enabling faster data gathering. Second, it appears that such data anchored on the subject is insufficient with respect to the locale. Research Respondents The target respondents of this study will be adolescent pregnant mothers residing in selected Barangays in the Municipality of Biliran. Research Instruments The researchers utilized a structured survey questionnaire. The structured survey questionnaire contains the following: Part A. background characteristics. Part B. family factors of teenage pregnancy. Part C. Individual factors of teenage pregnancy. Part D. Socio-cultural factors of teenage pregnancy. Data Gathering Procedure Prior to the conduct of the study, the researchers will send letters requesting the permission from the respondents. The letter shall state that the data obtained will be used for research purposes only and will be treated with utmost confidentiality, rest assured that the researchers will follow the standard health protocols such as wearing of face mask, face shield and social distancing as per required by the IATF and DOH. Upon approval of such request the researchers shall start gathering the data of the study. The researchers will administer a survey questionnaire about the factors of teenage pregnancy to adolescent mothers with the population of … The survey questionnaire will be distributed to selected barangays in Biliran Municipality sampled by cluster random sampling where adolescent mothers reside, following the standard health protocols set by the IATF. The result of the survey will be statistically analysed to determine the factors that influence teenage pregnancy. Sample & Sampling Technique For the sample size of the total population of adolescent pregnant mothers, the researchers used the Slovin’s Formula to compute. 𝑛= 𝑁 1 + 𝑁𝑒 2 where: 𝑛= sample size 𝑁= population size 𝑒= margin of error (5%) The researchers will use a single stage cluster random sampling technique to get the respondents of the study. Data Scoring & Interpretation The variables to be used in the study are measured as follows. The descriptive characteristics of participants are to be presented as frequencies and percentages Main Sub-variables variables Dependent Currently pregnant variable Demographic Age of teenage girl characteristics Place of residence School attendance Parental educational level Parental occupation Behavioural factors Parents alive Age at first sexual intercourse Multiple sexual partners Frequency of sexual intercourse Contraceptive use Familial factors Household socio-economic status Marital status Parental divorce/separation Person teenage lived with Social factors Domestic violence Physical neglect Peer pressure Sexual abuse Control over sex Awareness on adolescent sexual and reproductive health Measurements Yes/no Age in completed years Rural/urban area Still in school or not No education, primary education, secondary education or post-secondary education Farmer, business, government/nongovernmental organisation or others… Father/mother alive or dead Age in completed years Having concurrent number of sexual partners Average number of sexual intercourse per week Regular use of contraceptive methods during sexual intercourse – yes/no Ownership of households properties, categorized as; high socio-economic status, medium socio-economic status or low socio-economic status Currently married or not Father/mother divorced/separated Father, mother, both parents, relative or husband Yes/no Yes/no Yes/no Yes/no Yes/no Yes/no Perception of cultural norm on sex before 18 years Yes/no Statistical Tool The data of this study will be analysed using JASP (Jeffrey’s Amazing Statistical Program). The descriptive characteristics of participants will be presented as frequencies and percentage. To determine the demographic profile of respondents, the researcher will use a frequency count. The formula is shown below. 𝑓 P= 𝑛 × 100 where: P= percentage 𝑓= frequency 𝑛= total number of students To identify the common factors that causes teenage pregnancy, the researchers use the weighted mean. The formula of weighted mean is shown below 𝑊𝑋 = 𝑓1 (𝑊1 ) + 𝑓2 (𝑊2 ) + 𝑓3 (𝑊3 ) + ⋯ 𝑓𝑛 (𝑊𝑛 ) 𝑛 Where: 𝑊𝑋 = Weighted Mean 𝑓1 to 𝑓𝑛 = frequencies of each category 𝑊1 to 𝑊𝑛 = number of respondents 𝑛= total number of respondents Research Questionnaire Structured Questionnaire of factors associated with teenage pregnancy among girls aged 13-19 years Notes to data collector: A case is a female teenager of age group (13-19 years) who is pregnant at the time of the interview. Name(Optional):____________________ Date:__ / __ / 2022 Baranggay: ____________________________________________________________ A: Background characteristics 1. Residence: a) Rural b) Urban 2. What is your age (in completed years)? ____ 3. What is the level of your education? a. No education b. primary education c. secondary education d. post-secondary education 4. Are you still in school? a. Yes b. No 5. Marital status: a. Married b. Not married 6. What is your religion? a. Catholic b. Protestant c. Islam d. Anglican e. Others, specify__________________________________ 7. Are your parents alive? a. Yes both of them are alive b. Yes only the father is alive c. Yes only the mother is alive d. None of them is alive 8. Do you live with your parents/relatives? a. I live with both parents c. I live with only the mother b. I live with only the father d. I live with relative B: Family factors for teenage pregnancy 9. What is the level of education of your father? a. No education b. Primary education c. Secondary education d. Tertiary education 10. What is the level of education of your mother? a. No education b. Primary education c. Secondary education d. Tertiary education 11. What is the occupation of your parents/guardian? a. Farmer b. Business person c. Government/NGO employee d. carpenter/welder e. Others, specify……………….. 12. Do you have the following items at home (tick all that apply)? a. Permanent building b. Electricity c. Vehicle d. Vehicle e. Motorcycle f. Bicycle g. Television h. Radio i. Animals (cattle, goats) j. Monthly cash income 13. Has any of your family member ever experienced teenage pregnancy? a. Yes b. No C: Individual factors for teenage pregnancy 14. Have you ever had sexual intercourse? ( if No skip to question 21) a. Yes b. No 15. At what age did you have first sexual intercourse? ________________ 16. Are you currently pregnant? a. Yes b. No 17. How many times do you have sexual intercourse, say in a month? a. One time b. Two times c. Three times d. More than three times 18. Have you ever had sexual intercourse with more than one partner? a. Yes b. No 19. If yes, how often do you use contraceptives when having sexual intercourse? a. Always b. Sometimes 20. Have you ever had any sexual education on the use of contraceptive methods? a. Yes b. No 21. Have you ever been involved in alcohol consumption? a. Yes b. No 22. If yes, how often do you drink, say in a week? a. One time b, two times c. Three times d. Four times e. every day f. Occasionally when at functions E: Socio-cultural factors for teenage pregnancy 23. Do you feel any pressure from friends to do things you don’t want to? a. Very often b. Never c. Quite often d. Rarely often 24. Is it acceptable for somebody to have sexual intercourse before they are 18 years? a. I strongly agree b. I strongly disagree c. somewhat I agree d. somewhat I disagree 25. Is it culturally acceptable for a girl to get marriage at the age below 18 years? b. I strongly agree b. I strongly disagree c. somewhat I agree d. somewhat I disagree 26. Did you ever live with anyone who has a problem drinker or alcoholic? a. Yes b. No 27. Did your parent, stepparent or adult living in your home push, grab, slap or throw something at you? a. Not a victim of physical abuse b. Victim of physical abuse at home c. Victim of physical abuse in a foster home d. physically abused by family member e. Physically abused by someone outside the family f. Attacked with a weapon 28. Has any adult, relative, family friend or stranger older than you ever; a. Touched or fondled your body in asexual way? b. Made you to touch his body in a sexual way? c. Attempted to have any type of sexual intercourse (oral, anal or vaginal) with you? d. Actually had any type of sexual intercourse (oral, anal or vaginal) with you? 29. Have you ever been faced with any of these situations at home? a. Didn’t have enough food to eat, Yes No b. There was someone there to take care of me and protect me Yes No c. My parents were too drunk or too high to take care of me Yes No d. I had to wear dirty clothes or torn clothes Yes No e. There was someone to take me to the clinic/health unit if I needed it Yes No 30. Have you ever experienced any level of conflict or violence between parents, between youth and parents, among siblings? a. Sometimes, often or very often pushed, grabbed, slapped or had something thrown at you b. Sometimes, often or very often kicked, bitten, hit with a fist or hit with something hard c. Ever repeatedly hit over at least a few minutes d. Ever threatened with or hurt by a knife or other tools Based on the Survey from “Predictors of teenage pregnancy among girls aged 13– 19 years in Uganda: a community based case-control study” by Ochen, A.M., Chi, P.C. & Lawoko, S. Bibliography Natividad, J. (2014). Teenage Pregnancy in the Philippines: Trends, Correlates and Data Sources. 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