Reproductive awareness behaviour and profiles of adolescent post abortion patients in Blantyre, Malawi.

BACKGROUND Adolescent sexuality and its sequelae are now acknowledged as major public health, social and economic problems in Malawi, for which appropriate programmes and services are being designed and implemented. OBJECTIVES To identify the profiles of adolescent post abortion patients, their reproductive and contraceptive knowledge and factors related to the index pregnancy. SETTING Queen Elizabeth Central Hospital, Blantyre, Malawi. DESIGN Cross-sectional, descriptive study. METHODS All adolescents treated for incomplete abortion, January to December 1997 were eligible. Data was collected by means of interviewer-administered questionnaire, one for each, during reproductive health education and/or post abortion contraceptive counselling and service provision. This was subsequently analysed using EPI-INFO 6.0 data analysis packages. RESULTS Of the 465 adolescents treated during this period, 446 (95.9%) were enrolled in the study. Their mean age was 17.5 years (SD 1.3), that at menarche and sexual debut 14.3 years (SD 1.4) and 15.7 years (SD 1.75) respectively. The unmarried adolescents formed 43.9%, while students comprised 38.6% of the total. Their level and accuracy of knowledge on reproductive biology was poor. While their contraceptive knowledge was high, its use was very low, 70.9% vs 9.5% respectively. The number of sexual partners one had had ranged from 1 to 10 with a median of 1. The index pregnancy was reportedly unwanted by 45.1%. The young (< 16 years), more educated, single and students were more likely to have unwanted pregnancy. CONCLUSIONS Sexual activity starts early in Malawi, with poor contraception, thus predisposing to unwanted pregnancy. Lack of appropriate reproductive awareness appears to be partly responsible for that. These need to be addressed through the national reproductive health programmes and services.