Menu
Menu
Menu
Menu
For adolescent mothers in rural Eastern Uganda, nutrition and health may be compromised by many factors. Identifying individual and environmental needs and barriers at local levels is important to inform community-based interventions. This qualitative study used interviews based on constructs from social cognitive theory. 101 adolescent mothers, family members, health-related personnel and community workers in Budondo sub-county (Jinja district), eastern Uganda were interviewed. Young mothers had needs, related to going back to school, home-based small businesses; social needs, care support and belonging to their families, employment, shelter, clothing, personal land and animals, medical care and delivery materials. Barriers to meeting their needs included: lack of skills in income generation and food preparation, harsh treatment, pregnancy and childcare costs, lack of academic qualifications, lack of adequate shelter and land, lack of foods to make complementary feeds for infants, insufficient access to medicines, tailored health care and appropriate communications. Using the social cognitive framework, this study identified myriad needs of young mothers and barriers to improving maternal/child nutrition and health. Adolescent-mother-and-child-friendly environments are needed at local levels while continuing to reduce broader socio-cultural and economic barriers to health equity. Findings may help direct future interventions for improved adolescent maternal/child nutrition and health.
This was a qualitative study using semi-structured face-to-face interviews with adolescent mothers and other stakeholders. The social cognitive theory (SCT) (Figure 1) was selected to understand how personal (or individual) factors and environmental factors interact reciprocally with behaviors [3,4,5,6] of adolescent mothers to influence their health and nutrition. The study, from an epistemological stance of postpositivism, sought to identify and understand determinants of the nutrition and health of adolescent mothers and their offspring, not limited to the research team’s prior knowledge or values [7,8,9,10,11,12,13]. The study therefore used both a deductive approach through a set of close ended questions reflecting constructs from the SCT [7,8,9,10,11,12,13] and an inductive approach through open ended research questions for freely given views of stakeholders [8,14]. Social cognitive theory framework of perceived needs and barriers of adolescent maternal/child nutrition and health. The study was conducted among rural communities of Budondo sub-county, Jinja district of Busoga region in Eastern Uganda [15]. A 2014 report found that Eastern Uganda has a poverty rate of 24.5% [16,17] making it the poorest of regions in the country [16]. The main occupation of the residents in Jinja is subsistence farming [15]. Budondo sub-county is located 25 km from Jinja Town, has a population of 51,560 (51.8% being females and 48.2% males) [15] and 36.3% of its residents are below the poverty line [18]. The sub-county has 6 government owned health centers [15]. All participants in the study had signed the study consent forms and had resided within Budondo sub-county or Jinja district for at least 3 years. In addition, adolescent mothers were aged 10–19 years, carrying their first pregnancy or with their first baby (0–12 months), and were attending or had attended school in Budondo sub-county at least 3 years prior to study. Study participants who met the inclusion criteria were recruited through purposive sampling [8,19,20] by six community based Village Health Team members (VHTs) who served as study guides who assessed eligibility and invited eligible persons to participate in the study. Individual interviews were conducted with 101 individuals (Table 1) including 25 adolescent mothers plus family members, health personnel, community leaders and workers, and district administrators. Demographics of Study Respondents (n = 101). Interview guides, tailored to specific target study participants and translated into the Lusoga language, were used as data collection instruments for this study. Key questions were themed on individual factors and environmental factors (social, economic, physical, nutrition, and health service) relevant to needs and barriers of adolescent mothers. Interview guides were pre-tested in rural Butagaya sub-county with a few persons representative of the target groups. Interviews were conducted in privacy at the residences or work places of participants. Interviews were conducted from March to May 2016 by the researcher (JN) and took an average of 40 min. At the start of each interview, participants were welcomed by the researcher, told of the purpose of the interviews and assured of anonymity and confidentiality. Interview recordings were transcribed word for word then translated into English by a transcriber who was well versed in the Lusoga language. Codes were created from the transcribed interviews based on the constructs of the SCT model and a priori themes of needs and barriers under the categories of environmental factors and personal factors affecting adolescent mothers. Some inductively derived codes were added to label other information. Data management and analysis employed Atlas.ti 7.5.4 software; phrases in each transcript were linked to the created codes which were networked towards the major theme of adolescent maternal/child nutrition and health using thematic analysis [8,21,22,23] as shown in Figure 2. The Atlas.ti software which is manufactured by the ATLAS.ti Scientific Software Development was provided and uploaded by the Ugandan trainer who trained the researcher (JN) in qualitative data analysis in Uganda. Thematic Network of Needs and Barriers of Adolescent Mothers as Perceived by Teenage Mothers and Stakeholders. Adapted from: [21].
N/A
