Adolescent Girls Reproductive Health Situation in Nepal: A Case Study from Mahottari District

Abstract

Background: Adolescence is a crucial age and full of curiosity about sexuality. Knowledge of adolescents regarding puberty, reproduction, masturbation, premarital sex, contraceptives and STD/HIV/AIDS is low. There are several factors contributing to low level of Sexual and Reproductive Health knowledge among adolescent girls in Nepal. The main objective of this study therefore is to understand the knowledge, attitude and practice of adolescent girls in Mahottari district on Sexual and Reproductive Health needs. Methods: The study was carried out in Mahottari district and two VDCs from the northern side of the district and two VDC from the southern side of the district were purposively selected. In the first stage, wards were selected from the selected VDCs. From each VDC, three wards were selected by using lottery methods. In the second stage, 25 households were selected using the simple random sampling procedure. In the third stage, one adolescent girl aged 10-19 years irrespective of the marital status was interviewed in each sampled household. Tools of data collection included semi-structured interview questionnaire, focused group discussions and key informant interview. Data were entered in SPSS/PC. In case of qualitative data, the issues were reviewed; they were translated from Nepali language to English and contextualized. Results: Knowledge of contraceptive method among adolescent girls is low in the study VDCs with about 57 per cent of the total adolescent girls knowing at least one method of family planning. Knowledge on the ANC among the adolescent girls is poor: 37 percent have knowledge about TT Vaccine, 36 per cent in ANC check up, 35 per cent in Iron/Folic and 4 per cent in Calcium. With regard to delivery care, more than two-thirds of adolescent girls delivered their births at home with 79 per cent for Madheshi groups and 55 per cent for hill groups. About half of the adolescent girls interviewed had heard about abortion. However, this proportion is much lower among Madheshi groups (23%) compared to the hill groups (73%). Of the total adolescent girls, 54 percent have knowledge on infertility with 83 percent for hill groups and 75 per cent for Madheshi groups. Of the total respondents, an overwhelming majority of adolescent girls (89%) have knowledge on physical changes with increasing ages. Of the total respondents, around 53 percent have knowledge of STIs. With regard to knowledge of HIV/AIDS, 65 percent have heard of HIV/AIDS with 87 per cent for hill groups and 41 per cent for Madheshi groups. Almost half of the respondents have knowledge about some form of gender discrimination practiced in the family and in the community. Conclusions: Adolescent girls of Madheshi groups are of low level of knowledge on any of the Sexual and Reproductive Health components compared to the hill groups. The study indicates that adolescents need appropriate information and advice to cope with the changes that they are experiencing physically, mentally, emotionally and socially. The finding of the study justifies in developing a differentiated approach to intervene effectively in the backward communities regarding Sexual and Reproductive Health needs among adolescent girls. Keywords: adolescents; attitude; knowledge; practice; reproductive health; sexual and reproductive health.