Harada et al. Reproductive Health (2024)
21:143 Reproductive
https://doi.org/10.1186/s12978-024-01872-4 Health
RESEARCHOpen Access
The reasons for and influences
of unintended teenage pregnancy in
Kericho county, Kenya: a qualitative study
Rio Harada1, Atsuko Imoto1, Louisa Ndunyu2 and Ken Masuda1*
Abstract
Background Unintended teenage pregnancies are associated with greater health and socio-economic
risks for teen- age mothers and newborns. In Kenya, the government has declared a target for ending
teenage pregnancy by 2030. However, the prevalence of teenage pregnancy has only decreased
slightly, demonstrating the need for further efforts. Understanding teenage mothers’ own experiences
and perspectives is necessary to design appropriate interventions.
Methods A community-based qualitative study was conducted from March to May 2023. Two focus
group discus- sions were conducted with community health volunteers and the mothers of teenage
girls. Semi-structured inter- views were conducted on the case histories of 19 teenage mothers and 18
key informants. Thematic analysis was sub- sequently performed using MAXQDA 2022.
Findings Four major reasons emerged for unintended teenage pregnancies: (1) lack of knowledge
or awareness about the human reproductive system, (2) lack of knowledge about family planning
(FP), (3) financial challenges, and (4) low access to FP. At the study site, cultural norms and
stereotypes, such as “infertility caused by FP,”“free- dom of sex by promoting FP,” and “cultural
taboos on having sex before marriage and talking about sexuality,” were observed as barriers in
promoting FP to teenagers. In addition, teenagers from low socio-economic backgrounds were found
to be more vulnerable because they can be easily exploited by men who can afford to provide for
some of their basic needs. Regarding the influences of unintended teenage pregnancy on teenage
mothers’ lives, the 19 cases were classified into four categories: (1) dropping out of school, (2)
financial challenges, (3) changing relation- ships with parents, and (4) no major influence. Crucially,
unintended teenage pregnancies negatively influenced
most study participants. Continuing education, supportive parental attitudes, positive perceptions of
the relationship with the child’s father, and having future perspectives were identified as factors
mitigating the negative influences.
Conclusions Strengthening culturally appropriate comprehensive sexuality education and the school
re-entry policy with a supportive environment may prevent unintended teenage pregnancy and
mitigate its negative influences. As financial challenges can be both a reason for and a negative
influence of unintended teenage pregnancy, economic empowerment interventions are necessary.
Keywords Teenage pregnancy, Adolescent pregnancy, Unintended pregnancy, Family planning,
Qualitative study
*Correspondence:
Ken Masuda
Full list of author information is available at the end of the article
© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-
NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and
reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the
source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do
not have permission under this licence to share adapted material derived from this article or parts of it. The
,images or other third party material in this article are included in the article’s Creative Commons licence, unless
indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons
licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will
need to obtain permission directly from the copyright holder. To view a copy of this licence, visit
http://creativecommons.org/licenses/by-nc-nd/4.0/.
, Harada et al. Reproductive (2024) Page 2 of
Health 21:143 21
Plain English summary
Teenage girls becoming pregnant unexpectedly face higher health and socio-economic risks,
which can affect both the lives of teenage mothers and newborns. In Kenya, the government
has targeted ending teenage pregnan- cies by 2030, but the decrease has been limited.
Although understanding teenage mothers’ experiences and per- spectives is important for
designing appropriate interventions, only a few studies have been conducted. This study
focused on 19 teenage mothers and other key participants to gain a deeper understanding of
their backgrounds.
Four major reasons were identified for unintended teenage pregnancies: (1) lack of knowledge
or awareness about the human reproductive system, (2) lack of knowledge about birth control
methods, (3) financial challenges,
and (4) low access to birth control methods. At the study site, cultural norms and stereotypes
were observed as bar- riers in promoting the use of birth control methods to teenagers. In
addition, teenagers from poor backgrounds were found to be more vulnerable because they
can be easily taken advantage of by men who can afford to provide for some of their basic
needs. Regarding the influences of unintended teenage pregnancy on teenage mothers’ lives,
the 19 cases were classified into four categories: (1) dropping out of school, (2) financial
challenges, (3) changing
relationships with parents, and (4) no major influence. In this study, unintended teenage
Background
pregnancies negatively influ- enced most In Kenya, the government has declared the goal of
Teenage pregnancy, also known as adolescent preg- participants. Continuing education, supportive
parental ending teenage pregnancy by 2030 [9]. However, the
nancy andattitudes,
defined aspositive
deliveryperceptions of the relationship
occurring between with the child’s father, and having
future decrease in their prevalence has been slight from 18%
the agesperspectives
of 10 and 19,were identified
remains as factors
a significant publicmitigating the negative influences.
in 2014 [10] to 15% in 2022 [11]. During the COVID-
health concern in Low- and Middle-Income Countries
19 pandemic, it was estimated that 152,000 teenage
(LMICs) [1]. Every year, approximately 21 million preg-
girls became pregnant, representing a 40% increase during
nancies occur among girls aged 15–19 in LMICs, with
the three months of lockdown [12]. Furthermore,
50% being unintended pregnancies that lead to an esti-
evidence indicated that the risk of pregnancy among
mated 3.9 million unsafe abortions [1, 2]. Unintended
female stu- dents in secondary schools was twice as
pregnancy refers to an unplanned and unexpected preg-
high compared to female students who graduated
nancy [3], defined as unwanted or occurring earlier than
before the COVID-19 pandemic [13]. The prevalence of
desired [4]. When teenagers conceive, the health risks of
teenage pregnancy var- ies by county in Kenya, where the
eclampsia, puerperal endometritis, and systemic infec-
national average is 15%; the lowest is 4.3% in Nyandarua
tions increase compared to those of women aged 20–24.
County and the high- est is 41.5% in Samburu County
Moreover, the risks of low birth weight, preterm birth,
[14]. In the study site of Kericho County, the
and severe neonatal conditions to their newborns also
prevalence of teenage pregnancy is 14.5% [14].
increase [2]. The majority of maternal deaths among
Regarding policy implementation, Kenya has imple-
women aged 15–49 occur in LMICs, and complications
mented several policies related to sexual and reproduc-
related to pregnancy and delivery are the main causes
tive health (SRH). In 2015, the National Adolescent
of death among teenagers globally. Additionally, teenage
Sexual and Reproductive Health Policy was imple-
mothers face adverse socio-economic consequences,
mented to focus on SRH among teenagers [15]. The
such as dropping out of school, which causes the loss of
policy includes actions for the prevention of early and
employment opportunities, a decline in position in the
unintended pregnancy, such as: providing accurate
family and community, stigmatization, rejection, vio-
SRH information, providing accurate information and
lence, and forced marriage [5]. In Sub-Saharan Africa
services of family planning (FP) methods, reinforcing
(SSA), the prevalence of unintended pregnancy among
programs to delay first sexual intercourse and promote
those aged 15–24 is 30% with Southern Africa having
abstinence, promoting male and community
the highest rate at 60% and Eastern Africa having the
involvement, support- ing school re-entry policy, etc.
lowest rate at 20% [6]. More than half of the pregnancies
With regard to the school re-entry policy, it was
among girls aged 15–19 in five East African countries,
enforced in 1994 [16]. The current national guideline
including Kenya, were unintended [7]. The prevalence
for school re-entry targets students who dropped out of
of teenage pregnancies in SSA remains high, and it is
school due to early pregnancy, HIV/ AIDS, gender-
predicted to rise further by 2030 with the increasing
based violence, Female Genital Mutila- tion, child labor,
numbers of teenagers. [8].
child trafficking, special needs, drug and substance use,
mental health, and emergencies such as
21:143 Reproductive
https://doi.org/10.1186/s12978-024-01872-4 Health
RESEARCHOpen Access
The reasons for and influences
of unintended teenage pregnancy in
Kericho county, Kenya: a qualitative study
Rio Harada1, Atsuko Imoto1, Louisa Ndunyu2 and Ken Masuda1*
Abstract
Background Unintended teenage pregnancies are associated with greater health and socio-economic
risks for teen- age mothers and newborns. In Kenya, the government has declared a target for ending
teenage pregnancy by 2030. However, the prevalence of teenage pregnancy has only decreased
slightly, demonstrating the need for further efforts. Understanding teenage mothers’ own experiences
and perspectives is necessary to design appropriate interventions.
Methods A community-based qualitative study was conducted from March to May 2023. Two focus
group discus- sions were conducted with community health volunteers and the mothers of teenage
girls. Semi-structured inter- views were conducted on the case histories of 19 teenage mothers and 18
key informants. Thematic analysis was sub- sequently performed using MAXQDA 2022.
Findings Four major reasons emerged for unintended teenage pregnancies: (1) lack of knowledge
or awareness about the human reproductive system, (2) lack of knowledge about family planning
(FP), (3) financial challenges, and (4) low access to FP. At the study site, cultural norms and
stereotypes, such as “infertility caused by FP,”“free- dom of sex by promoting FP,” and “cultural
taboos on having sex before marriage and talking about sexuality,” were observed as barriers in
promoting FP to teenagers. In addition, teenagers from low socio-economic backgrounds were found
to be more vulnerable because they can be easily exploited by men who can afford to provide for
some of their basic needs. Regarding the influences of unintended teenage pregnancy on teenage
mothers’ lives, the 19 cases were classified into four categories: (1) dropping out of school, (2)
financial challenges, (3) changing relation- ships with parents, and (4) no major influence. Crucially,
unintended teenage pregnancies negatively influenced
most study participants. Continuing education, supportive parental attitudes, positive perceptions of
the relationship with the child’s father, and having future perspectives were identified as factors
mitigating the negative influences.
Conclusions Strengthening culturally appropriate comprehensive sexuality education and the school
re-entry policy with a supportive environment may prevent unintended teenage pregnancy and
mitigate its negative influences. As financial challenges can be both a reason for and a negative
influence of unintended teenage pregnancy, economic empowerment interventions are necessary.
Keywords Teenage pregnancy, Adolescent pregnancy, Unintended pregnancy, Family planning,
Qualitative study
*Correspondence:
Ken Masuda
Full list of author information is available at the end of the article
© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-
NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and
reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the
source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do
not have permission under this licence to share adapted material derived from this article or parts of it. The
,images or other third party material in this article are included in the article’s Creative Commons licence, unless
indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons
licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will
need to obtain permission directly from the copyright holder. To view a copy of this licence, visit
http://creativecommons.org/licenses/by-nc-nd/4.0/.
, Harada et al. Reproductive (2024) Page 2 of
Health 21:143 21
Plain English summary
Teenage girls becoming pregnant unexpectedly face higher health and socio-economic risks,
which can affect both the lives of teenage mothers and newborns. In Kenya, the government
has targeted ending teenage pregnan- cies by 2030, but the decrease has been limited.
Although understanding teenage mothers’ experiences and per- spectives is important for
designing appropriate interventions, only a few studies have been conducted. This study
focused on 19 teenage mothers and other key participants to gain a deeper understanding of
their backgrounds.
Four major reasons were identified for unintended teenage pregnancies: (1) lack of knowledge
or awareness about the human reproductive system, (2) lack of knowledge about birth control
methods, (3) financial challenges,
and (4) low access to birth control methods. At the study site, cultural norms and stereotypes
were observed as bar- riers in promoting the use of birth control methods to teenagers. In
addition, teenagers from poor backgrounds were found to be more vulnerable because they
can be easily taken advantage of by men who can afford to provide for some of their basic
needs. Regarding the influences of unintended teenage pregnancy on teenage mothers’ lives,
the 19 cases were classified into four categories: (1) dropping out of school, (2) financial
challenges, (3) changing
relationships with parents, and (4) no major influence. In this study, unintended teenage
Background
pregnancies negatively influ- enced most In Kenya, the government has declared the goal of
Teenage pregnancy, also known as adolescent preg- participants. Continuing education, supportive
parental ending teenage pregnancy by 2030 [9]. However, the
nancy andattitudes,
defined aspositive
deliveryperceptions of the relationship
occurring between with the child’s father, and having
future decrease in their prevalence has been slight from 18%
the agesperspectives
of 10 and 19,were identified
remains as factors
a significant publicmitigating the negative influences.
in 2014 [10] to 15% in 2022 [11]. During the COVID-
health concern in Low- and Middle-Income Countries
19 pandemic, it was estimated that 152,000 teenage
(LMICs) [1]. Every year, approximately 21 million preg-
girls became pregnant, representing a 40% increase during
nancies occur among girls aged 15–19 in LMICs, with
the three months of lockdown [12]. Furthermore,
50% being unintended pregnancies that lead to an esti-
evidence indicated that the risk of pregnancy among
mated 3.9 million unsafe abortions [1, 2]. Unintended
female stu- dents in secondary schools was twice as
pregnancy refers to an unplanned and unexpected preg-
high compared to female students who graduated
nancy [3], defined as unwanted or occurring earlier than
before the COVID-19 pandemic [13]. The prevalence of
desired [4]. When teenagers conceive, the health risks of
teenage pregnancy var- ies by county in Kenya, where the
eclampsia, puerperal endometritis, and systemic infec-
national average is 15%; the lowest is 4.3% in Nyandarua
tions increase compared to those of women aged 20–24.
County and the high- est is 41.5% in Samburu County
Moreover, the risks of low birth weight, preterm birth,
[14]. In the study site of Kericho County, the
and severe neonatal conditions to their newborns also
prevalence of teenage pregnancy is 14.5% [14].
increase [2]. The majority of maternal deaths among
Regarding policy implementation, Kenya has imple-
women aged 15–49 occur in LMICs, and complications
mented several policies related to sexual and reproduc-
related to pregnancy and delivery are the main causes
tive health (SRH). In 2015, the National Adolescent
of death among teenagers globally. Additionally, teenage
Sexual and Reproductive Health Policy was imple-
mothers face adverse socio-economic consequences,
mented to focus on SRH among teenagers [15]. The
such as dropping out of school, which causes the loss of
policy includes actions for the prevention of early and
employment opportunities, a decline in position in the
unintended pregnancy, such as: providing accurate
family and community, stigmatization, rejection, vio-
SRH information, providing accurate information and
lence, and forced marriage [5]. In Sub-Saharan Africa
services of family planning (FP) methods, reinforcing
(SSA), the prevalence of unintended pregnancy among
programs to delay first sexual intercourse and promote
those aged 15–24 is 30% with Southern Africa having
abstinence, promoting male and community
the highest rate at 60% and Eastern Africa having the
involvement, support- ing school re-entry policy, etc.
lowest rate at 20% [6]. More than half of the pregnancies
With regard to the school re-entry policy, it was
among girls aged 15–19 in five East African countries,
enforced in 1994 [16]. The current national guideline
including Kenya, were unintended [7]. The prevalence
for school re-entry targets students who dropped out of
of teenage pregnancies in SSA remains high, and it is
school due to early pregnancy, HIV/ AIDS, gender-
predicted to rise further by 2030 with the increasing
based violence, Female Genital Mutila- tion, child labor,
numbers of teenagers. [8].
child trafficking, special needs, drug and substance use,
mental health, and emergencies such as
