Awareness and Attitude Regarding Teenage Pregnancy among Adolescent Girls of Chandannath Municipality, Jumla

Aim: To assess the awareness and attitude regarding teenage pregnancy among adolescent girls. Methods: A descriptive cross- sectional design was carried out among 334 adolescent girls of school students of Chandannath Municipality, Jumla. Results: Awareness of teenage pregnancy was inadequate in 68% of adolescent girls, moderate in 26% and adequate in only 6%. Attitude to denounce teenage pregnancy was good in 58.1%, neutral in 34.4% and unfavorable in7.5%. There was no relation between awareness and attitude regarding teenage pregnancy and types of family, level of education of father and mother. Conclusion: Despite of favourable attitude against teenage pregnancy, the awareness level is low in adolescent girls. There was no significant difference between demographic variables with awareness and attitude regarding teenage pregnancy.

pregnancy. Birth rate among adolescent of age 15-19 years was 49 per 1000 in 2014. 1,2 Around 1 in 6 persons in the world is an adolescent and the complications linked to pregnancy and childbirth is the second cause of death for 15 to19 years old girls

INTRODUCTION
Adolescence is the period between childhood and adulthood from ages 10 to19 years with three phases like early (10-13 years), mid (14-16 years) and late (17-19 years); and the pregnancy and child birth at this vulnerable age group is teenage sample of five schools were taken and grade 9 and 10 students of 13-19 years were taken with informed consent.

RESULTS
There were 334 participants and the age range was 13-17 years (15.09±0.95). Majority (97.6%) were unmarried. More than half of the mothers were illiterate (54.5%) and farmers (65.6%). [  worldwide. 3,4 Much of teenage pregnancy occurs within marriage, especially in Bangladesh, India and Nepal, where early marriage of girls is still common. The median age that girls marry is 17.8 years in Nepal which is one of the causes of teenage pregnancy. 5,6 Adolescents make up about 24.19% of the population in Nepal. Around 17% of girls from 15-19 years are already mothers or pregnant with their first child. This percentage is increasing rapidly from one percent among those aged 15 to 39 % in those aged 19. In the hill region 16% of pregnancies were in adolescents compared to terai (18%). 5 Some of the studies reported that pregnant teenagers had significantly higher knowledge compared to non-pregnant teenagers and most of adolescents held negative attitude towards teenage pregnancy. 7,8 Teenage pregnancy has adverse pregnancy outcome and considered a high-risk pregnancy as death due to pregnancy related causes is double among women aged 15 to 19 years compared to women in their twenties; and lack of education and unawareness of contraceptive methods make the situation worse. 9 Knowledge and attitude of target group is low and should be addressed programmatically. [10][11][12][13] The aim of the study was to assess the awareness, attitude and the associated variables towards teenage pregnancy among adolescent girls.

METHODS
A descriptive cross-sectional quantitative study performed to identify the awareness and attitude regarding teenage pregnancy among adolescent girls of higher secondary school of Chandannath Municipality Jumla from May There is no statistically significant association between awareness and types of family, education level of respondents' fathers and mothers (x 2 =4.64, p=0.4), (x 2 =11.27, p=0.18), (x 2 =7.58, p=0.47). However, there was significant association between participants grade and level of awareness (x 2 =17.52, p <0.001). [

DISCUSSION
In this study, more than half of the respondents 227 (68 %) had inadequate awareness while 87 of adolescent girls (26%) had moderate awareness and only 20 respondents (6%) had adequate awareness regarding teenage pregnancy. The mean score of awareness was 21.57±7.39. The reason for moderate and inadequate level of awareness among adolescent girls might be due to education level, cultural acceptance for early marriage, living in rural areas and less strictness by guardians in trying to monitor activities were contributing factor of teenage pregnancy. 15 In our study more than half of the participants (55.9%) were beginning of grade nine and a chapter about adolescence sexual and reproductive health is included in the text book of secondary level (grade 9). A study conduc-  and have a negative effect on parent and child. Likewise, this study is supported by another study that revealed adolescents had neutral attitude towards teenage pregnancy. 12 Limitations: This study was conducted in a selected school of Chandanath Municipality with a sample of only nine and ten grades female students.

CONCLUSION
Based on the findings, the study concluded that more than half of girls had inadequate awareness regarding teenage pregnancy even though majority of them had favorable attitude regarding teenage pregnancy. Need of adolescent friendly health services and early introduction of information in school curriculum is envisioned.
ted by Siddharth & Kirubamani 16 concluded that lack of formal education (91%) was the most common cause regarding awareness on adolescent pregnancy.
A phenomenological study on lived experiences of early pregnancy among teenagers was conducted in Philippines that included ten teenage mothers, which showed that curiosity, lack of sexual knowledge that had big impact in teenagers who engaged in early sexuality, financial and family problems and uncontrolled emotions cause pregnancy among teenagers. The informants revealed that they did not get any responsible sexual information at school. This study concluded that sex and sexuality education should not just be a concept but should be developed further as a complete discipline. 17 In present study, the findings on attitude regarding teenage pregnancy showed that among total adolescent girls more than half (58.1%) of them had favorable attitude, that they believed teenage pregnancy as wrong while only (34.4%) of them had neutral attitude and least (7.5%) of them had unfavorable attitude which support teenage pregnancy which might be due to their negative feelings towards teenage pregnancy. This was similar to study by Osaikhuwuomwan and Osemwenkha 8 that showed majority of respondents held a negative attitude about adolescent pregnancy with over 85% regarding it as wrong and considered it to be associated with medical, socio-economic and educational problems. Similarly, study conducted in Eastern Poland, 18 supports the findings of this study where participants' attitude towards pregnancy was that they think teenage pregnancy as a problem