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Background to the Study
Adolescence is a period of transition from childhood to adulthood and as these adolescents prepares to enter into adulthood. This stage is one of the most fascinating and complex transitions in the lifespan of man. It is a time of accelerated growth and change, a time of expanding horizons, a time of self-discovery and emergency independence (Adegoke, 2003). Adolescents are unquestionably at a vulnerable development stage as they attempt to navigate the difficult transitions from childhood to adulthood (Carnegie Council on Adolescents Development, 1992). This transition from childhood to adolescence is characterized by an increase in personal control responsibility and independence; adolescents frequently negotiate and adjust to increased demands of a more autonomous lifestyle. In this context, responses to societal sexual norms and expectations can be seen as one of the key tasks of adolescence. Traditional norms in most Nigerian cultures demand premarital sexual abstinence until entry into marital norms. Nevertheless, these norms have almost disappeared in all ethnic groups (Brinkman et al, 2011).
As described by Omololu (2007), adolescents are the most important groups in the society and a country’s most valuable future asset given their size and characters. The adolescents constitute a myriad group of persons at different stages of social, economic, physiological and psychological development. According to Herper et al (2009), adolescence is a developmental period marked by discovery and experimentation full of discovery, both physical and emotional changes. With rapid social change and accompanying social confusions, adolescents are often faced with conflicting and at times, contradicting social expectation. They are faced with challenges in an environment of rapid urbanization and social change which many of them are not prepared for. Adolescent’s reproductive health is an integrated approach to the health and development needs of adolescence which according to the International Conference on Population and Development in 1994 can be defined as a state of complete physical mental and social well being and not merely absence of disease or infirmity in all matters relating to the reproductive system and to its functions and process of the adolescents.
This period of transition from childhood to adulthood is characterized by adoption of lifestyles and behaviours which may have implications for future generations, at this stage, of their lives; they have increased personal control, responsibility and independence (Harper and Decarlo, 2009). However, different authors have irrevocably argued that the period of adolescence or transition to adulthood often involve periods of stress, experimentation and disorganization, thus, with rapid social change and accompanying social confusions, adolescents are often confronted with conflicting and at times, contradicting social expectations. Hence, the period of adolescence is characterized by tumultuous and riotous state of mind and affairs. The magnitude of adolescents’ sexual behaviour is growing and fast emerging as a public health concern in the country. The risks of pregnancy and childbirth among adolescents are numerous such as damage of the reproductive health organ, maternal mortality and infertility is equally common among adolescents.
The challenges adolescents face include coping with the physical, emotional and social changes that accompany this period of transition from childhood to adulthood, inadequate access to appropriate information, education and services to meet their peculiar needs during their transitional period, weakening of traditional norms and support systems in adolescence especially of the extended family due to urbanization, the globalization of communication and the mixed and confusing messages about male versus female sexuality portrayed in the mass media, decline in annual earnings of families resulting in pressure in young people to contribute to family income in the face of decreasing job and economic opportunities, gender inequities including the double standard on sex before marriage, where premarital sex is restricted for girls and tolerated for boys.
A great proportion of the adolescents are at risk of these health risks basically because the environment in which they live reflect poverty in the midst of unprecedented prosperity and financial and information linkages between countries, this made them to frequently negotiate and adjust to increased demands of a more autonomous lifestyle which at the end predispose them to poor health. Traditionally, in some parts of the country, their culture demand premarital sexual abstinence until entry into marital union that is, boys and girls are being encouraged to delay their first sexual intercourse until when they are married, but unfortunately, this is gradually fading away in all ethnic groups in the country (Orubuloye, 1992).
Also, adolescents have a higher prevalence of most reproductive health disease because of lack of accurate and adequate information, lack of access to appropriate and efficient health services and the necessary economic and social means of empowerment to make informed choices and take appropriate actions to protect their health when necessary (Olukoya et al, 2001). It is rather unfortunate that these uninformed and denied adolescents are left to make decisions on their own whether to keep a pregnancy or to terminate the pregnancy according to Tinuola (2001), the decision to do away with the pregnancies or to keep it, is often influenced by social, economic and cultural factors such as education, urbanization, socialization, family type and nature of the pregnancy.
In situations when such decision is in favour of abortion, the adolescents face the risk of abortion most especially in countries like Nigeria where abortion is illegal and as a result, facilities are not adequately provided by the existing health care delivery system. The Federal Ministry of Health in 2003, reported that about two-fifth of adolescents pregnancies in Nigeria are believed to end up in induced abortion and those adolescents constitute the majority of cases of abortion-related. Complications are heightened because adolescents are not bold to go to appropriate places for adequate services.
Nigerian adolescents are also subjected to the growing influence of globalization, through satellite broadcasting and other media outlets, Western consumption patterns habits and tastes and other values are being imbibed by them. With particular reference to sexual orientation for instance, “the virtue of freedom that range from freedom to contract and dissolve marriages, freedom to disregard the family authority system and freedom to choose one’s own sexual orientation which in that context means or may include either to be bi-sexual, gay or lesbian” (Egwu, 2008).
Cultural and religious moves are also used regularly to deny the adolescents access to reproductive health information and services. Other obstacles are parental complicity in adolescents sexuality, this also takes the form of signing contracts with prostitution ring which recruit young girls to Europe particularly Italy (Ofuoko, 2006). The reproductive health practices of these adolescents also rely on peer counsel and uses of common everyday items for prevention of pregnancy, as abirtificent and self-medication for the treatment of infections (Alubo, 2000). The general impression is that many of the current problems of adolescents are due to a seeming abandonment of these set of people within the entire population by Government Policy makers and families.
Statement of the Problem
Adolescent sexuality and reproductive health are important concerns most especially for reproductive health problems such as unintended pregnancy, maternal mortality and sexually transmitted infections (STIs,) including HIV/AIDS. It has been discovered that adolescents have a higher prevalence of most of these reproductive health problems, reasons being that adolescents lack necessary and adequate information; they also have poor access to reproductive health services (Alubo, 2009). Adolescents in Nigeria are contributory to unfavourable indices of sexual and reproductive health ranging from sexually transmitted infection, unwanted pregnancies, and unsafe abortions to maternal mortality.
Sexual behaviour of adolescents is influenced by many aspects of reproductive health, notably pregnancy risk, and the high incidence of STDs including HIV infection. This in turn is determined by the cultural and social context in which the adolescents find themselves. Most adolescents have their first sexual exposure outside marriage under circumstances of low and inadequate knowledge of sexual and reproductive health and with very little use of family planning or other protective measures. This pattern of high risk sexual behaviour that is associated with an increased incidence of sexually transmitted infections including HIV infections, unwanted pregnancies, unsafe abortion and high fertility rates among adolescents.
Despite this associated problems to this risky sexual behaviour of the adolescents, there is very little understanding of what needs to be done in order to reduce the scale of the pattern.
Justification of the Problem
Most adolescents are sexually active, but are often extremely uninformed about their reproductive system, this lack of information more often than not; lead them to take risks which can lead to long term damage to their sexual and reproductive health or even death in some cases (Madunagu, 2008).
Adolescents’ first sexual intercourse is often experimentation and they usually do not prepare for it, they don’t take any protective measures. By the age of twenty years majority of them have had sexual intercourse (Adebusoye, 2010). A greater proportion of unsafe induced abortion related complications are recorded among adolescents mainly because adolescents make up the majority of those who procure unsafe abortions in Nigeria. Since abortion is not yet legalized in Nigeria and these adolescents cannot come up boldly to seek abortion in any hospital, they therefore end up with untrained personnel thereby resulting into complications that may lead to permanent damage to the lives of these adolescents.
Based on the above identified problems faced by adolescents concerning their reproductive health seeking behaviour, the researcher deemed it fit that adolescents should be given adequate information appropriately on their sexuality and reproductive health matters, to strive to practice what they have learnt and have access to reproductive health services, individuals also need assertiveness training and should learn to be contented with whatever they have and it is believed that thus research will make the government, policymakers and families have a deeper understanding and knowledge of sexual behaviours and health outcomes of adolescents.
The general objectives of this study is to determine the factors influencing adolescents’ sexuality and reproductive health seeking behaviour in Ibadan Southeast Local Government Area of Oyo State.
The specific objectives of the study are:
1. to determine the adolescents knowledge about their sexuality and reproductive health matters;
2. to determine where adolescents seek help whenever they are faced with any
reproductive health problem/challenge;
3. to identify the attitudes of the health care providers towards the adolescents whenever they come for assistance in their health centres;
4. to determine the effect of significant orders in decision making concerning adolescents reproductive health matters; and
5. to identify the influence of culture and religion on adolescents reproductive health matters.
1. What is the level of awareness of adolescents about sexuality and reproductive health matters?
2. Where do adolescents seek for assistance whenever they are faced with reproductive health challenges?
3. What is the attitude of the health care providers towards adolescents whenever they come for any assistance in their health centres?
4. Who make decisions concerning sexuality and reproductive health matters for the adolescents?
5. What are the effects of culture and religion in adolescents’ sexuality and reproductive health matters?
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