A Qualitative Analysis of Predictors of Sexo-Reproductive Health Needs of Adolescent Girls in the Kumbo West Health District of Cameroon

Abstract

Background: In Cameroon, adolescent girls’ knowledge on sexo-reproductive health and access to reproductive health services is important for their physical and psychosocial wellbeing. It has been established that, the lack of knowledge about the consequences of unprotected premarital sex among adolescent girls predisposed them to unwanted pregnancies, unsafe abortion and its complications, future reproductive health problems and sexually transmitted infections including HIV/AIDS.   Objectives: The aim of this study was to examine predictive factors associated with comprehensive categories of adolescent girl’s sexo-reproductive health, including sources of information and knowledge on sexo-reproductive health, sexual development, risky sexual behaviors, utility and perception of sexo-reproductive health services.   Methods: This was a qualitative study which adopted a narrative approach to qualitative enquiry and made use of the social ecological model. Eight focus group discussions (n=80) were conducted among both in-school and out-of-school adolescent girls aged 10-19 years. The discussions were stratified by sex, studentship and health area. In addition, fourteen in-depth interviews were conducted with various stakeholders in sexo-reproductive health services and community opinion leaders. Both the focus group discussions and in-depth interviews were recorded, transcribed and analysed using NVivo 11. Thematic analysis was employed in analysing data.   Results: The study found that knowledge on sexo-reproductive health issues was low among respondents with majority of them getting information on sexo-reproductive health from their peers. The issue of lack/insufficient sexo-reproductive health education in schools was reported. Having a sexual partner(s) and engaging in premarital sex was common. Adolescents engaged in unprotected sexual practices as a way of making money and for livelihood. Drinking dry marijuana mixed with water, concoctions and sachet whisky were identified as local methods employed by adolescent girls to induce abortion. Sexo-reproductive health services were available in the community but received low utilization because of perceived negative attitude and intrusiveness of the community health workers, confidentiality and social norms.   Conclusions: Adolescents in this study generally engaged in risky sexo-reproductive health behaviours that can negatively affect their reproductive health. Adolescent girls in this part of Cameroon have challenges utilizing available sexo-reproductive health services because of socio-cultural and health system barriers.