Abstract:

Background: Teenage pregnancy remains a critical public health issue globally, impacting maternal and child health, education, and socio-economic development. Data from 2022 highlighted a 22% rate of teenage pregnancy in Tanzania, with the Tanga region at 16% and Korogwe District Council at 12.2%. This high prevalence underscores the need for targeted interventions. Peer-led educational programs have shown potential to improve adolescent knowledge and practices regarding teenage pregnancy prevention, yet their effectiveness in this context has not been thoroughly investigated.

Objective: This study aimed to evaluate the effect of peer-led education on adolescents' knowledge and practices related to teenage pregnancy prevention in Korogwe District Council, Tanga.

Methods: A cross-sectional comparative design was employed to assess and compare knowledge and practices between adolescents who received peer-led education and those who did not. The study was conducted in selected centers offering youth-friendly health services in Korogwe DC involving 456 adolescents aged 10-19 years. Data were collected using a structured selfadministered questionnaire, and statistical analyses were performed with SPSS-25 to test hypotheses and identify factors associated with knowledge and practices, considering variables with a p-value less than 0.05 as statistically significant.

Results: The study found that among the 228 participants who attended the peer-led programs, 157 (68.9%) had high knowledge, while 71 (31.1%) had low knowledge. Regarding practice levels, 204(89.5%) had high practice levels and 24(10.5%) had low practice levels. Conversely, among the 228 participants who did not attend peer-led programs, 62 (27.2%) had high knowledge and 166 (72.8%) had low knowledge. With practices, 135(59,2%) had high practice and 93(40.8%) exhibited low practice levels. The Pearson Chi-Square test indicated a significant association between participation in peer-led education programs and knowledge levels (χ² = 87.952, df = 2, p < .001) and peer led programs with practice levels (χ² = 54.737, df = 1, p < .001). Other significant predictors of high knowledge regarding teenage pregnancy prevention included age, gender and educational attainment.Older adolescents were more likely to have high knowledge (AOR = 0.23, 95% CI: 0.134, 0.572, p = 0.021). Males were more likely to possess high knowledge compared to females (AOR = 1.23, 95% CI: 1.021, 2.39, p = 0.039). The highest-grade level achieved (if not a student) continued to be significant, correlating with increased knowledge (AOR = 0.52, 95% CI: 0.303, 0.87, p = 0.049). Importantly, participation in peer-led education programs had a substantial effect, with adolescents who participated being significantly more likely to have high knowledge (AOR
= 4.24, 95% CI: 3.90, 7.21, p < 0.001).

Conclusion: Peer-led education significantly enhances both knowledge and practices related to teenage pregnancy prevention among adolescents. Implementing and expanding such programs could be crucial in addressing teenage pregnancy in Korogwe DC and similar contexts. Further research should explore long-term effects and additional factors influencing the effectiveness of these interventions.

Keywords: Teenage pregnancy, peer-led education, adolescents, knowledge, practices