Peer-reviewed article
Socio-structural influences on unintended pregnancy among girls aged 15-17 years in Papua New Guinea.
Mitchell E, Aeno H, Ase S, Ofi P, Nake Trumb R et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This qualitative study explores why adolescent girls aged 15-17 in Papua New Guinea experience unintended pregnancies. Researchers interviewed 19 girls across rural, peri-urban and urban areas and found that barriers to sexual and reproductive health services, lack of education about contraception, poor communication between generations, and unavailable modern contraceptives all increase the risk. Despite these obstacles, girls showed they wanted to prevent pregnancy but needed better access to confidential health services and accurate information.
Key points
- Barriers to accessing sexual and reproductive health services are a major factor in unintended pregnancies among adolescent girls
- Girls lack information about reproduction, fertility, and contraception because schools and communities do not provide this education
- Communication between girls and adults about sex and family planning is constrained by gender, age and marital status norms
- Modern contraceptives are not available or accessible in many communities
- Girls demonstrated agency and desire to prevent pregnancy, but needed confidential, non-judgemental health services to do so
Limitations
This qualitative study cannot measure the prevalence of different barriers or their relative importance in causing unintended pregnancy. The findings are based on 19 girls' experiences and may not represent all adolescents in Papua New Guinea.
Abstract
Introduction Unintended pregnancy among adolescent girls is a public health priority globally, particularly in Papua New Guinea (PNG), where low contraceptive use among young people has resulted in some of the highest adolescent fertility rates in the Asia-Pacific region. This paper investigates the socio-structural influences on adolescent girls' ability to prevent unintended pregnancies in PNG. Methods Qualitative research conducted between 2019 and 2021; inductive thematic analysis of in-depth interviews with 19 adolescent girls aged 15-17 years living in rural, peri-urban and urban research sites in PNG. Results Socio-structural influences were identified that increased the likelihood of unintended pregnancy: barriers to accessing health services for sexual and reproductive health (SRH) purposes; a lack of provision of SRH information and education in school or community settings, leading to misunderstanding of reproduction and fertility, pregnancy prevention and contraception; poor interactions with health service providers that discourage future service use; constrained intergenerational communications about sex, relationships and family planning between girls and adults based on norms and expectations associated with gender, age and marital status; reliance on informal peer and community information sources; lack of availability and accessibility to modern contraceptives; and a lack of adolescent-centred SRH services. Despite this, girls demonstrated agency through attempts to use modern and traditional contraceptive strategies to prevent pregnancy, often with the support of others within their familial and social networks. Their agency was constrained by a lack of school-based and community-based education about sex and relationships, and access to confidential, non-judgemental SRH services, where they can learn about and access modern contraceptives. Conclusion Adolescent girls' access to contraceptive services-at an earlier age, in time for their first sexual experiences-requires action in policy and community settings to elicit socio-structural change that is supportive of young women's SRH and well-being.