Student Perspectives on Teaching Adolescents Maturation and Reproductive Health in Rural Paraguay

BACKGROUND: Teenage pregnancy is a challenge throughout the world. Adolescents living in poverty are much more likely to experience unplanned pregnancy (Goicolea, Wulff, Õhman, & San Sebastian, 2009). In Paraguay, more than a third of the population lives below the poverty line (PAHO, 2017), creating a large group of adolescents at risk simply because of their status. Our College of Nursing has collaborated with a non-profit organization in Paraguay who has had a concern with the increased incidence of adolescent pregnancy in the poorer areas of the communities. A qualitative research trip to Paraguay involving seven undergraduate nursing students took place in August 2018. It was successful in finding many risk factors that lead to teenage pregnancy among indigenous/non-indigenous girls. Some of the largest risk factors identified are the lack of education for adolescents about maturation, adolescent and reproductive health. Some reasons for the lack of education are cultural factors, parental absence in the home (primarily due to work), and ineffective communication about these topics between parents and their daughters. Families (especially mothers) who were interviewed expressed a desire for these topics to be taught to their daughters. While in Paraguay, we also taught about maturation and adolescent health to over 100 girls and young women in the school setting using the program “Days for Girls,” which also includes distribution of washable re-usable menstrual kits.

METHOD: A qualitative descriptive study was used to identify risk factors that are contributing to adolescent pregnancy. The sample for the study was a convenience sample of community leaders and educators who work with youth. Interviews were recorded and transcribed prior to data analysis. Members of the research team are presently analyzing data separately to identify preliminary themes. Analysis will continue as a team to finalize themes arising from the narrative data.

RESULTS: Initial findings indicate that community leaders feel adolescent pregnancy results from a lack of education about the female reproductive system and pregnancy prevention and/or lack of structured activities for youth. Other findings include lack of long-term goals outside of parenthood for indigenous youth, which includes a cultural acceptance of pregnancy as an adolescent norm. These initial findings will be corroborated through the continued translations and the data analysis will be presented. We will also share challenges and successes about teaching the “Days for Girls” program.