Perceptions of Health, Healthy Decision-Making, and Living: A Study of Young Mothers Living in Jamaica

Thursday, 27 July 2017: 2:30 PM

Katherine M. Haigh, MSN1
Judith Herrman, PhD, MS, BSN1
Kathleen Luckner, BSN2
(1)School of Nursing, University of Delaware, Newark, DE, USA
(2)University of Delaware, Newark, DE, USA

Purpose:  Adolescent health, including sexual health and pregnancy, are topics of concern for healthcare providers, family members, communities, and teens around the world. These concerns and their ramifications are apparent in the Caribbean nation of Jamaica. In a population based study done in Jamaica, of the total participants aged 15-19, one-third of females and half of the males reported being sexually active within the last year (Ishida, Stupp & McDonald, 2011). While the Age Specific Fertility Rate (ASFR) for adolescents in this same age group is declining, the Jamaica National Family Planning Board (JNFB) (2008), reports there are still 72 births per 1000 women identified in 2008, previously in 2002, there were 79 per 1,000. And, in 2008, approximately 82% of these pregnancies were unplanned (JNFB, 2008). Pregnancy is not the only a concern for these Jamaican teens, as teenage pregnancy is unlawful in the country and sexually transmitted infections (STIs) are still a veritable risk. With 79% of females between the ages of 15-24 reporting using contraception at first sexual intercourse a help to keeping pregnancy rates down, only 49% of females reported using a condom at last intercourse, and 48% of females reporting using a condom with each encounter with a non-steady partner. (Serbanescue, Ruiz & Suchdev, 2010; JNFB, 2008). This lapse in condom use and possibly barrier contraception use, is detrimental to the reproductive health of these young adults and gravely indicates the need for further education. While the literature is replete with sexual health information and curricula directed toward adolescents, there is a paucity of knowledge regarding this specific group of teenagers living in Jamaica. Identifying health interventions is crucial to this population’s well-being. Young mothers may incur health risks associated with lifestyle and decision-making; availability of supports and resources; and challenges related to stress and time limitations associated with pregnancy, breastfeeding and parenting. Teen perceptions about health, healthy decision-making and healthy lifestyles may guide development of interventions designed to promote health. Nursing students, as part of a service learning activity, traveled to Jamaica to provide health instruction to young mothers in a residential home. The young mothers participated in focus groups, which provided beneficial information identifying some of the gaps in knowledge of general and sexual health in this vulnerable population. Thematic analysis of focus group transcripts and study findings may be useful as they inform health intervention development.

Methods: This qualitative study was conducted at a residential home for young mothers’ in Kingston, Jamaica, during the spring of 2016. To be considered eligible to participate in the focus groups, the young women needed to be residents of the setting, aged 12-17 and either pregnant and/or parenting. The focus groups were conducted by the researchers and audiotaped; one researcher led the groups while another observed and took marginal notes during the process. The participants received $10 (US) and a healthy snack. Data were analyzed for content, then organized into topics with frequency of responses used to construct themes.

Results: The participants in the discussion included thirteen teenage mothers, whose ages ranged from twelve years old to seventeen years old. The ages of their babies ranged from two weeks to nine months old. All thirteen girls were either currently attending school or planned on returning to school when their babies were old enough. From the discussion with the young mothers, three themes emerged. The themes were: Personal Meaning of Health, Considerations in Health Decision-Making, and Thoughts on Healthy Living.

Conclusion:  The study of young mothers’ perceptions about health, health decision-making, and healthy lifestyles yielded important insights into the thoughts and behaviors of young women in Jamaica. Due to social and political laws and beliefs, young women in Jamaica who become pregnant experience marginalization and duress associated with isolation, financial stressors, and stigma. These exacerbate the vulnerability inherent of adolescence, pregnancy, and parenting. The nurse has an integral role to provide education, counseling, and resources to enhance the supports and reduce the challenges young mothers confront in their personal quests to attain and maintain health. Perhaps, even more important is the need for nursing advocacy to influence the gender issues associated with subjugating young women, with little stigma associated with fathering a pregnancy, to address bullying via empathy-building strategies, and providing interventions and resources to foster parenting, including mothering and fathering interventions, to ensure health of the current and future generations in Caribbean countries.