Article type
Year
Abstract
Background:Pregnancy among adolescents is a contributing factor to the increase of infant and maternal mortality, school dropout rates, propagation of precarious health cycles and poverty. It’s a common issue in all social classes with a predominance in the most disadvantaged social set ups.
Objectives:The study aimed to identify and describe political options based on scientific literature to reduce unintended pregnancy among adolescents.
Methods:The problem, its magnitude and causes were interactively clarified through discussions between the authors, consultations with departments in the Brazilian Ministry of Health, key document reviews and research in a limited number of data bases. To identify the options, the databases consulted were PubMed, BSV-Adolec, BVS, Epistemonikos, Health Systems Evidence, Cochrane Library e EMBASE. Only systematic reviews with successful interventions in coping with unintended pregnancy among adolescents were included independent of the year of publication or language. Studies that addressed specific adolescent populations or other types of reviews were excluded. The search strategy yielded in 487 studies but only 11 met the inclusion criteria. Quality evaluation of these studies was done using AMSTAR 2.
Results:Four options were identified: implementation of comprehensive educational programs for adolescents in schools and communities, promoting the supply of contraceptives in the school environment, implementation of psychosocial interventions for behavioral changes and implementation of a group of interventions to increase knowledge about unintentional pregnancy. For each option, the main elements were listed, costs and cost effectiveness in relation to the context of the location where the study was executed, uncertainties, the perceptions and experiences of the interested parties in the theme and also the considerations about equity and implementation .
Conclusions:The options are complementary since the nature of unintended pregnancy among adolescents is multifactorial. The options adopted should be adapted to the particularities, behaviors and local contexts. Special attention is necessary for adolescents with vulnerability to develop risky behaviors. Moreover, the context of implementation of each intervention should be carefully chosen to increase effectiveness. Any policy aimed at investing in programs related to the theme should complement the existing actions. It is of fundamental importance to encourage adolescents to plan achievements in all areas of life especially in the academic field as well as to facilitate their access to the interventions adopted to cope with unintended pregnancy.
Patient or healthcare consumer involvement:Adolescents should be made aware of the existing interventions as well as involve them in decision making in relation to the option that best fits them.
Objectives:The study aimed to identify and describe political options based on scientific literature to reduce unintended pregnancy among adolescents.
Methods:The problem, its magnitude and causes were interactively clarified through discussions between the authors, consultations with departments in the Brazilian Ministry of Health, key document reviews and research in a limited number of data bases. To identify the options, the databases consulted were PubMed, BSV-Adolec, BVS, Epistemonikos, Health Systems Evidence, Cochrane Library e EMBASE. Only systematic reviews with successful interventions in coping with unintended pregnancy among adolescents were included independent of the year of publication or language. Studies that addressed specific adolescent populations or other types of reviews were excluded. The search strategy yielded in 487 studies but only 11 met the inclusion criteria. Quality evaluation of these studies was done using AMSTAR 2.
Results:Four options were identified: implementation of comprehensive educational programs for adolescents in schools and communities, promoting the supply of contraceptives in the school environment, implementation of psychosocial interventions for behavioral changes and implementation of a group of interventions to increase knowledge about unintentional pregnancy. For each option, the main elements were listed, costs and cost effectiveness in relation to the context of the location where the study was executed, uncertainties, the perceptions and experiences of the interested parties in the theme and also the considerations about equity and implementation .
Conclusions:The options are complementary since the nature of unintended pregnancy among adolescents is multifactorial. The options adopted should be adapted to the particularities, behaviors and local contexts. Special attention is necessary for adolescents with vulnerability to develop risky behaviors. Moreover, the context of implementation of each intervention should be carefully chosen to increase effectiveness. Any policy aimed at investing in programs related to the theme should complement the existing actions. It is of fundamental importance to encourage adolescents to plan achievements in all areas of life especially in the academic field as well as to facilitate their access to the interventions adopted to cope with unintended pregnancy.
Patient or healthcare consumer involvement:Adolescents should be made aware of the existing interventions as well as involve them in decision making in relation to the option that best fits them.