title: Becoming pregnant during secondary school: findings from concurrent mixed methods research in Anambra State, Nigeria.
abstract: OBJECTIVE
  Pregnancies among teenagers and problems associated with premarital births have raised concerns in many countries. It is important to explore unintended pregnancy from the viewpoints of local stakeholders such as students, schools/teachers, and community members. This study assessed reported cases of unintended pregnancy among students and perceptions of these pregnancies by members of the community.
  
  
  METHODS
  This study took place in a rural community in Anambra state, southeastern Nigeria. A cross-sectional survey of 1,234 students and 46 teachers in five secondary schools was carried out using self-administered questionnaires. In addition, focus group discussions (FGD) involving 10 parents and in-depth interview (IDI) with a student who became pregnant were conducted.
  
  
  RESULTS
  Reports of pregnancy were more common during second and third years of junior secondary school than other school years or level. According to teachers, ignorance was the main reason given by students who became pregnant. Students who became pregnant were reported to have performed poorly academically and lived with both parents, who were either subsistence farmers or petty traders. In the IDI, the ex-student opined that pregnant students faced shame, marital limitations and lack of respect from community members. Participants in the FGD suggested that teenagers should be provided with sex education in schools and in churches; parents should communicate with teenagers about sexual matters and make adequate financial provision; and the male partners should be held more accountable for the pregnancies.
  
  
  CONCLUSIONS
  Poor sexual knowledge and poor socioeconomic conditions play important roles in teenage pregnancy. Male participation may enhance effectiveness of prevention programmes.
authors.affiliation: Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, P.O.Box 1627, FI-70211 Kuopio, Finland. ifeoma.onyeka@uef.fi
authors.forename: Ifeoma N
authors.initials: IN
authors.lastname: Onyeka
authors.forename: Juhani
authors.initials: J
authors.lastname: Miettola
authors.forename: Amobi L
authors.initials: AL
authors.lastname: Ilika
authors.forename: Tuula
authors.initials: T
authors.lastname: Vaskilampi
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D003430:Cross-Sectional Studies; D005260:Female; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D009549:Nigeria; D010290:Parents; D010465:Perception; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000523:psychology*; D049168:Pregnancy, Unplanned / Q000523:psychology; D011287:Prejudice; D036301:Qualitative Research; D012424:Rural Population; D012574:Schools; D012725:Sexual Behavior; D057545:Social Stigma; D012944:Social Support; D012959:Socioeconomic Factors; D013334:Students / Q000523:psychology*; D011795:Surveys and Questionnaires