title: Qualitative evaluation of the Teenage Mothers Project in Uganda: a community-based empowerment intervention for unmarried teenage mothers.
abstract: BACKGROUND
  A large proportion of unmarried teenage mothers in Uganda face physical, psychological, and social problems after pregnancy and childbirth, such as obstetric complications, lack of education, and stigmatisation in their communities. The Teenage Mothers Project (TMP) in Eastern Uganda empowers unmarried teenage mothers to cope with the consequences of early pregnancy and motherhood. Since 2000, 1036 unmarried teenage mothers, their parents, and community leaders participated in economic and social empowerment interventions. The present study explored the changes resulting from the TMP as well as factors that either enabled or inhibited these changes.
  
  
  METHODS
  Semi-structured interviews (N = 23) were conducted with former teenage mothers , community leaders, and project implementers, and lifeline histories were obtained from former teenage mothers (N = 9). Quantitative monitoring data regarding demographic and social characteristics of teenage mother participants (N = 1036) were analysed.
  
  
  RESULTS
  The findings suggest that, overall, the TMP seems to have contributed to the well-being of unmarried teenage mothers and to a supportive social environment. It appears that the project contributed to supportive community norms towards teenage mothers' position and future opportunities, increased agency, improved coping with early motherhood and stigma, continued education, and increased income generation by teenage mothers. The study findings also suggest limited change in disapproving community norms regarding out-of-wedlock sex and pregnancy, late active enrolment of teenage mothers in the project (i.e., ten months after delivery of the child), and differences in the extent to which parents provided support.
  
  
  CONCLUSIONS
  It is concluded that strengths of the community-based TMP seem to be its socio-ecological approach, the participatory planning with community leaders and other stakeholders, counselling of parents and unmarried teenage mothers, and the emphasis on education and income generation. The project can improve by earlier active participation of unmarried pregnant adolescents and increased support for parents.
authors.affiliation: Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands. joanne.leerlooijer@wur.nl.
authors.forename: Joanne N
authors.initials: JN
authors.lastname: Leerlooijer
authors.forename: Arjan E R
authors.initials: AE
authors.lastname: Bos
authors.forename: Robert A C
authors.initials: RA
authors.lastname: Ruiter
authors.forename: Miranda A J
authors.initials: MA
authors.lastname: van Reeuwijk
authors.forename: Liesbeth E
authors.initials: LE
authors.lastname: Rijsdijk
authors.forename: Nathan
authors.initials: N
authors.lastname: Nshakira
authors.forename: Gerjo
authors.initials: G
authors.lastname: Kok
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000294:Adolescent Behavior; D003153:Community Health Services / Q000458:organization & administration; D003906:Developing Countries; D005069:Evaluation Studies as Topic; D005260:Female; D006266:Health Education / Q000458:organization & administration*; D006801:Humans; D008425:Maternal Behavior; D011209:Power, Psychological; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control / Q000523:psychology / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012657:Self-Help Groups / Q000458:organization & administration*; D015406:Single Parent; D012847:Single Person / Q000523:psychology / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013315:Stress, Psychological; D014454:Uganda; D055815:Young Adult