000			03446nam a22002897a 4500
003			OSt
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028			_b Phone: +255 28 298 3384
028			_b Fax: +255 28 298 3386
028			_b Email: vc@bugando.ac.tz
028			_b Website: www.bugando.ac.tz
040			_bEnglish _cDLC
041			_aEnglish
100			_aWemaeli Mweteni _920431
222			_a Power imbalance, Adolescent pregnancy, Antenatal care, Maternal mortality, Maternal morbidity, Rural Tanzania
245			_aAdolescents in rural Tanzania: a qualitative study
260			_aMwanza, Tanzania: _bResearch Square & _b Catholic University of Health and Allied Sciences [CUHAS – Bugando] _c2020
300			_aPages 1-38
520			_aAbstract; Background: Adolescent girls (age 10-19 years) are at increased risk of morbidity and mortality due to pregnancy and childbirth complications, compared with older mothers. Low and middle-income countries, including Tanzania, bear the largest proportion of adolescent perinatal deaths globally. Most adolescent girls in Tanzania do not access antenatal care at health facilities, but the reasons for lack of antenatal care attendance are poorly understood. Methods: We conducted a qualitative thematic analysis study of the experiences of pregnant adolescents with accessing antenatal care in Misungwi district, Mwanza Region, Tanzania. We recruited 22 adolescent girls who were pregnant or parenting a child aged less than 5 years, using purposive sampling, and collected data about their lived experiences using in-depth individual interviews (IDIs). IDI data were triangulated with data from eight focus group discussions (FGDs) involving young fathers and elder men/women, and nine key informant interviews (KIIs) conducted with local health care providers. FGDs, KIIs and all but two IDIs were conducted and audiotaped in Swahili. All Swahili recordings were transcribed verbatim in Swahili. Two IDIs were conducted in local vernacular (Sukuma), and were transcribed into Swahili (as Sukuma is uncommon), by bilingual research assistants. All Swahili transcripts were then translated to English. A team of researchers analysed transcripts using emergent thematic analysis and constant comparison technique. Results: We identified four main themes: 1) Lack of maternal personal autonomy (Diminished power for decision making, Lack of financial and personal independence), 2) Stigma and judgment, 3) Vulnerability to violence and abuse, and 4) Knowledge about antenatal care. Conclusion: Pregnant adolescent care seeking for antenatal services is compromised by a complex power imbalance that involves financial dependence, lack of choice, lack of personal autonomy in decision making, experiences of social stigma, judgement, violence and abuse. Multi-level interventions are needed to empower adolescent girls, and to address policies and social constructs that may contribute to observed power imbalance; addressing these barriers can improve access to antenatal care among pregnant adolescents, and potentially reduce maternal morbidity and mortality.
700			_aJulieth Kabirigi _923170
700			_a Dismas Matovelo _922780
700			_aRose Laisser _922811
700			_aVictoria Yohani _923171
856			_uhttps://idl-bnc-idrc.dspacedirect.org/bitstream/handle/10625/60485/IDL-60485.pdf
942			_2ddc _cVM
999			_c19755 _d19755