Background
In Africa, most recorded maternal fatalities are evident among adolescents. Despite attempts to control this public health issue, African adolescent maternal mortality rates remain unacceptably high. African adolescent maternal mortality is a public health crisis that has proven a menace over the years. Teenage pregnancy—pregnancy between 13 and 19—is a global health issue. It can cause serious health, social, and economic problems for individuals, families, and communities. 21 million 15-19-year-old girls got pregnant in developing countries. Over 50% of unexpected pregnancies end in abortion. (Eyeberu, 2022). Pregnancy and delivery complications kill roughly one-third of African adolescent girls. These findings show the urgent need for study into African adolescent maternal mortality factors.
Kassa et al. (2018) analyzed 52 studies with 254,350 individuals from 24 African nations and sub-regions. Their research found an 18.8% pooled prevalence of adolescent pregnancy in Africa (95%CI: 16.7, 20.9), with 19.3% in Sub-Saharan Africa (95%CI: 16.9, 21.6). East Africa had the highest prevalence (21.5%) and Northern Africa had the lowest (9.2%). Living in rural areas (OR: 2.04), being married (OR: 20.67), not attending school (OR: 2.49), having no maternal or father education (OR: 1.88 and 1.65, respectively), and lacking parent-adolescent communication on sexual and reproductive health (SRH) issues were all associated with adolescent pregnancy.
African adolescent pregnancy and maternal mortality rates are high due to socioeconomic and cultural reasons. Poor females are more likely to become pregnant because they lack education, healthcare, and other resources. Early marriage and female genital mutilation increase the risk of maternal morbidity and mortality in adolescent girls (November & Sandall, 2018). Adolescent girls have significant maternal death rates due to a lack of family planning, sexual education, and healthcare.
In another study conducted by Ahinkorah et al., (2021), Congo had 44.3% of first adolescent pregnancies, whereas Rwanda had 7.2%. However, 36.5% in Rwanda and 75.6% in Chad were sexually active teens. The study also found that first adolescent pregnancy rose with age, employment, marriage/cohabitation, elementary education only, early sexual initiation, awareness of contraceptives, no unmet contraception need, and being in the poorest wealth quintile. Rural and West African teens were less likely to have their first pregnancy.
Poverty, a measure of a country’s economic standing, has been connected to adolescents’ coerced sexual interactions with older males to meet their financial demands. Poverty and compelled sexuality are linked in Ghana, South Africa, and Tanzania. These countries’ adolescent girls may purposefully become pregnant to collect government rewards for teenage moms without contemplating the consequences. Nigeria, Africa’s largest economy, with 106 adolescent births per 1,000 people in 2021, is a rising trend (Maharaj, 2022).
This qualitative study will be responsible for investigating African adolescent maternal mortality. The phenomenological study will focus on examining African adolescent moms’ delivery experiences. It will also illuminate this population’s maternal mortality factors. Therefore, reducing African adolescent maternal mortality justifies this process and thus the primary aim of this study. To minimize maternal morbidity and death, effective interventions need to understand this population’s maternal mortality issues (Kaiser et al., 2019).
This research will also help address the psychosocial needs of vulnerable adolescent moms by shedding light on their delivery experiences. This study seeks to explore African adolescent maternal mortality variables. By looking into adolescent mothers who survived childbirth, which will be studied using phenomenology. This study will help create strategies to reduce maternal morbidity and death among African adolescent girls.
Literature Review
This literature review identifies and critically evaluates factors affecting African adolescent maternal mortality. The review searched PubMed, Scopus, and Google Scholar using the search terms “Maternal mortality,” “Adolescents Pregnancy,” “Preterm Birth,” “Factors,” “Africa,” “Perinatal Mortality,” and “Adverse Pregnancy Outcomes.” Articles published between 2015 and 2023, in English, and on maternal mortality among adolescents in Africa were included.
Early marriage, lack of maternal health services, poor education, and poverty are major issues contributing to adolescent maternal mortality in Africa (Kaiser et al., 2019). According to multiple research studies, adolescent mothers in Africa face social and cultural barriers to maternal healthcare access and quality.
Early marriage is the leading cause of adolescent pregnancy and maternal mortality in most African countries. Early marriage affects adolescent moms’ educational and economic options, limiting their healthcare access.
It is common knowledge that adolescents are likely to avoid maternal health services due to social stigma. The reason is, premarital sex and parenting customs and beliefs shame adolescent pregnancy. Therefore, adolescent moms may feel immoral or irresponsible, preventing them from accessing maternal health services (November & Sandall, 2018). Thus, many African adolescent mothers give birth at home without a birth attendant.
African maternal mortality is also linked to adolescent moms’ poor education. Adolescent moms typically lack the information and skills essential to maintain good maternal health and care for their infants. Therefore, factors such as poor education, early marriage, and poverty contribute to this issue too.
Poverty is also another major factor contributing to African adolescent maternal mortality. Poor maternal health services impede prenatal, birth, and postnatal care. Therefore, poor maternal health care increases maternal morbidity and mortality. With most adolescents facing poverty, there is reduced access to food, water, and sanitation, thus increasing maternal morbidity and mortality (Fantaye et al., 2019).
So, the research suggests addressing cultural and social issues that cause maternal mortality in African teenagers. The evidence also suggests that enhancing maternity healthcare availability and quality is crucial in reducing maternal mortality among adolescents in Africa. However, most research is qualitative and limited to certain localities. Therefore, it is necessary to undertake more research to understand the individual experiences and views of teenagers towards maternal health services.
The literature study asserts that early marriage, lack of maternal health services, poor education, and poverty lead to maternal mortality among African adolescents. The evaluation stresses the need of addressing cultural and societal variables that cause maternal mortality and increase maternal healthcare access and quality (Sumankuuro et al., 2017). However, adolescent experiences and attitudes toward maternal health services need further study.
Goals and Objectives
Africa’s maternal mortality rate is high, especially for adolescent moms. Sub-Saharan Africa has high adolescent pregnancy rates for several reasons. Sociocultural and economic, individual, and health service-related aspects are major contributors as discussed by Yakubu and Salisu (2018). Community sensitization, sex education, and girls’ education can minimize adolescent pregnancies. Schools and healthcare organizations must also offer adolescent-friendly health services and empower teens.
This study examines African adolescent maternal mortality variables. The research question will be: What causes maternal mortality in African adolescents?
This research seeks to reduce African adolescent maternal mortality by identifying its causes. A qualitative technique will be used to interview and focus group adolescent mothers, healthcare providers, and other healthcare system stakeholders. This study will also discuss African teenage maternal health policies.
The following are the research goals:
- To identify the risk factors associated with maternal mortality among adolescents in Africa.
African adolescent mothers confront many risk factors that increase maternal mortality. Poor maternal health services, limited education, poverty, and cultural practices that constrain decision-making are risk factors (Muriithi et al., 2022). This objective seeks to identify these risk factors and their interrelationships to explain African adolescent maternal mortality.
- To explore the experiences and perceptions of adolescents towards maternal health services in Africa.
Adolescents use maternal health care based on their experiences. Positive experiences and impressions increase uptake, while negative ones decrease it. This objective examines African adolescent moms’ views on maternal health services, including quality, accessibility, and provider attitudes.
- To understand the barriers to accessing maternal health services among adolescents in Africa.
African adolescent mothers confront various hurdles to maternal health services. Lack of transport, great distances to health facilities, cost, and cultural norms limit their mobility (Fantaye et al., 2019). This purpose is to explore adolescent mothers’ experiences and strategies for overcoming barriers to maternal health services in Africa.
- To develop recommendations for improving maternal health services for adolescents in Africa.
This research aims to improve African teenage maternal health services. The research will provide suggestions to address risk factors and barriers to maternal health services. The proposals will help governments, healthcare professionals, and other stakeholders solve Africa’s adolescent maternal death crisis.
The high death rate of children under five underscores the long-term implications of inadequate educational and livelihood prospects for adolescent moms, according to Noori et al. (2021). Young moms may endure societal stigma, which can contribute to mental health and poverty cycles in their families. Unintended adolescent pregnancies must be reduced in countries with high rates to meet the Sustainable Development Goals (SDG) of reducing neonatal and under-5 mortality. Adolescent girls and young women should also have access to sexual and reproductive health services to make informed fertility choices and regulate pregnancies. Wado et al. (2019) recommend a multi-sectoral approach to adolescent pregnancy. Wider development programs can improve females’ educational and career options, which can influence their birthing decisions. To overcome barriers to adolescent sexual and reproductive health services, policies and activities that promote access and usage are essential.
Sub-Saharan Africa has one of the highest rates of teenage pregnancy, which puts both moms and children in danger. This causes medical, social, and economic issues for them, their families, and society. Although some sub-Saharan nations have taken steps to address adolescent pregnancy, it remains a major public health issue (Gunawardena et al., 2019). Few studies have examined Sub-Saharan African teen pregnancy predictors. Therefore, this study seeks to reduce African adolescent maternal mortality by examining these teen pregnancy predictors. The research objectives are to identify risk factors for maternal mortality, explore the experiences and perceptions of adolescent mothers towards maternal health services, understand barriers to accessing these services, and develop recommendations for improving maternal health services for adolescents in Africa (Muriithi et al., 2022). This research will inform evidence-based policies and initiatives to improve maternal health outcomes for African adolescents.
Methods
The primary focus of this phenomenological study is examining the causes of maternal mortality in African adolescents. The proposal’s research design will look into adolescent females’ views of maternal health services. Worku et al. (2021) found that Demographic and Health Survey (DHS) datasets are useful for research in 12 East African nations. A multilevel binary logistic regression analysis was used to determine characteristics related to adolescent pregnancy in 17,234 sexually active girls. Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) was used to identify factors associated with adolescent pregnancy. This research is best suited to phenomenology since it focuses on subjective experiences and how people interpret them.
The research will follow the PICO (Population, Intervention, Comparison, Outcome) framework. This study will include 15-19-year-old African female teenagers to conduct the research. For data variety, these adolescents will be chosen from across Africa. The intervention will investigate and get female teenage views on maternal health services. Adolescents without maternal mortality will be also compared. The project will then determine the African adolescent maternal mortality variables.
The research team will use purposive sampling based on inclusion criteria to represent the study population. Female adolescents aged 15-19 who have had at least one pregnancy, maternal mortality, or neither will be included. Social media, local health facilities, and youth organizations will invite eligible participants to the study.
A screening questionnaire will be responsible for determining eligibility. The questionnaire will cover age, pregnancy history, and the mother’s health. The responses that are gathered will then determine study eligibility. To make this project a success, it would recruit all adolescent girls who use maternal health care in health institutions and communities.
The study team will describe the context and data collection process to ensure transferability. Triangulation—gathering data from numerous sources and analyzing it by multiple researchers—who will boost the study’s credibility. Peer debriefing and member verification will verify that the research team’s findings appropriately reflect participants’ experiences and perceptions of maternal health services.
This study must address ethics and moral values. The study will follow the Helsinki Declaration, which demands informed permission, anonymity, and participant rights (World Medical Association, 2013). Ethical review boards will look into and approve the study before starting. Before conducting the study, participants must complete written informed consent forms. The participants need to confirm they are willing to participate in this process and are aware of the project’s aim. By providing unique identifying numbers and securely storing data, the study will protect participants’ privacy and confidentiality.
In-depth interviews and focus groups will be used to gather data. In-depth interviews provide rich, detailed data about participants’ experiences and perceptions, while focus group discussions allow participants to interact and share their thoughts. The study will combine semi-structured interview guidelines with open-ended questions about maternal health service experiences and perceptions. Face-to-face interviews and focus groups will be held privately. Participants will discuss their experiences with maternal health services in the focus groups.
The data will be transcribed verbatim and analyzed thematically. The thematic analysis finds, analyses, and reports data patterns. It is normally applied in cases whereby, there is categorizing of data themes and patterns. The inductive analysis will also be used as it reveals themes and patterns too. With these, it is easy to familiarize yourself with the data, generate initial codes, search for themes, review and refine themes, define and name themes, and write the report. Then two separate research experts will analyze the data to further verify reliability and validity.
In terms of rigour, the study will aim to demonstrate dependability, confirmability, and transferability. Dependability refers to the stability and consistency of the data over time. Therefore, the study will utilize a clear methodology and standardised data collection to ensure reliability. Confirmability refers to the objectivity and neutrality of the findings. The reflexive approach will critically reflect on the researcher’s preconceptions and views and how they may affect the research process and findings to ensure confirmability. Finally, transferability is how well the findings can be applied elsewhere. In this case, purposive sampling and unambiguous and transparent findings will ensure transferability.
Reliability/Validity and Trustworthiness
Qualitative research examines people’s subjective feelings and perspectives. Thus, rigorous research procedures that yield valid and dependable data are essential. We’ll explore the study’s reliability, validity, and trustworthiness in this part. Credibility, dependability, transferability, and confirmability will guide our qualitative study to ensure rigour.
Qualitative studies require researchers to build trust with participants to allow them to share their thoughts and feelings. We will triangulate the findings utilizing interviews, observations, and document analysis. This will allow us to verify participant data and guarantee the findings are correct. To analyze data reliably, we’ll use a coding framework. A second coder will check the coding framework. This will keep the findings consistent over time and context.
We will describe the study context, methodologies, and data collecting to improve transferability. This lets others assess our findings’ applicability. To represent a variety of experiences and opinions, we will purposively sample individuals. An audit trail will ensure data gathering and analysis confirmability. Keep field notes, interview transcripts, and other pertinent data. The audit trail will allow us to link study conclusions to data and verify them.
To improve confirmability, we will also evaluate the researcher’s prejudices and views. To do this, we will reflect on our assumptions, prejudices, and beliefs that may affect the study findings. This will help us uncover biases and lessen their effects on study findings. Qualitative research must use rigorous methodologies matched to its context and goals to be reliable, valid, and trustworthy. Credibility, dependability, transferability, and confirmability ensure that our study findings accurately reflect our participants’ experiences and perceptions and can be trusted to provide insights that are relevant and useful to other contexts and populations.
Strengths and Limitations
Any research effort must assess its strengths and weaknesses. This research seeks to investigate African adolescent maternal mortality-causing factors. This study’s qualitative technique will help the research team understand adolescents’, healthcare professionals, and other stakeholders’ views on maternal healthcare. Qualitative research allows individuals to communicate their views and experiences in their own words, enabling a more nuanced understanding of complicated and sensitive topics like maternal mortality.
The study’s focus on African adolescent maternal mortality is another merit. Adolescents—10–19-year-olds—have distinct healthcare needs, including sexual and reproductive health (Ramulumo, 2019). Maternal healthcare research typically excludes this age range. Thus, this proposed research will address a vacuum in the literature by examining the causes of maternal mortality in African adolescents.
This study’s findings will also help guide African adolescent maternal mortality reduction programs. It will help build more effective and culturally relevant maternal healthcare interventions by revealing healthcare providers’, adolescents’, and other stakeholders’ experiences, views, and beliefs.
This study’s setting and population will be limited. The study will examine African adolescents, thus the results may not apply to other populations. Thus, the study’s findings should not be used to draw global implications concerning adolescent maternal mortality.
The sample size may also limit generalizability. The study team will recruit different adolescents, healthcare practitioners, and other maternal healthcare stakeholders. Time and resource restrictions may limit the sample size. This may affect the study’s generalizability and require further research to validate the results.
Social desirability bias may limit the study. Participants may lie about their experiences, views, and beliefs. This may underestimate or overestimate African teenage maternal mortality factors. Therefore, the study team will ensure participants’ anonymity and confidentiality, create relationships with them to foster open communication and use open-ended questions to encourage honest responses.
It is crucial to take note that qualitative research limits quantification. Qualitative data is descriptive but difficult to analyze and generalize to bigger populations. The research team will employ thematic analysis to carefully and objectively analyze the findings. Thus, the suggested research project’s qualitative technique and population emphasis are its assets. Its shortcomings include limited generalizability and social desirability bias. This study’s strengths and weaknesses should be considered before interpreting its conclusions, and more research may be needed to confirm them.
Timetable
The following table outlines the key milestones of the research project:
Milestone | Timeframe |
Obtain ethical approval | Month 1 |
Develop interview guide | Month 2 |
Conduct pilot study | Month 3 |
Recruitment of participants | Months 4-5 |
Data collection | Months 6-9 |
Data analysis | Months 10-12 |
Write-up and dissemination of results | Months 12-14 |
Teen pregnancy is common in Sub-Saharan Africa. Social programs like comprehensive sex and relationship education and family planning can be improved by identifying the causes of teenage pregnancies. These interventions can improve the health of adolescents, families, and communities in sub-Saharan Africa (Ahinkorah et al., 2021). Therefore, a timeframe for this project is necessary to promote efficiency and effectiveness. Success requires a detailed research project timeline. This study’s timeline is as follows;
Ethical approval comes first. This step ensures ethical and legal research. An ethical committee analyzes the research proposal for ethical compliance. Ethical approval for this study project takes one month. The research team will submit the proposal to the ethics committee, address any concerns, and gain ethical approval before starting the research.
The interview guide is step two. This milestone requires preparing an interview guide to collect participant data. Research questions and objectives will inform the interview guide. A month is enough time to build a complete and relevant interview guide.
Piloting is the third step. A small-scale study to evaluate the interview guide, find flaws, and make modifications is this milestone. The pilot study will last one month to test the interview guide and make any required changes before data collection.
Participant recruitment comes forth. Choosing research subjects is this milestone. Advertising, social media, and referrals will help recruit candidates. Two months is enough time to find and choose participants.
Data collecting is fifth. Interviewing people utilizing the guide is this milestone. Four months is enough time to acquire enough pertinent data.
Data analysis comes sixth. The data is analyzed using theme analysis in this milestone. Three months is enough time to analyze data and draw conclusions.
Results writing and distribution are the final steps. This milestone entails writing up and sharing study findings with stakeholders. Two months is enough time to create a full report, make presentations, and disseminate findings.
Any research endeavour needs a clear, well-structured timetable. This research project has a clear timeline for ethical approval, preparing the interview guide, running a pilot study, recruiting participants, data collection, data analysis, and dissemination of the results. Each milestone has a timetable that allows for thorough and efficient completion. The research team can efficiently complete the study, meet its goals, and create valuable findings that will advance the area by following the timetable.
Conclusion
Teenage pregnancies are most common in sub-Saharan Africa, although rigorous reviews are lacking (Sama et al., 2017). Accurate epidemiological data on adolescent pregnancy rates, predictors, and negative effects on mothers and newborns may help achieve the Sustainable Development Goals. Therefore, this project investigates African adolescent maternal mortality variables. The proposed qualitative study investigates adolescents, healthcare practitioners, and other stakeholders in maternal healthcare’s experiences, perceptions, and beliefs. This study could inform African adolescent maternal mortality policies.
We will undertake a qualitative study using in-depth interviews and focus group discussions with a purposive sample of adolescents, healthcare practitioners, and other stakeholders in maternal healthcare to meet the goals of this research proposal. The responses will then be analyzed thematically. Nursing practice and policy will be considered to address primary healthcare nurses helping adolescent children with responsible sexual behaviour when their parents lack the abilities (Mashia et al., 2019). Nurses should implement mobile healthcare programs at their typical hangouts to improve their ties with adolescents. Management should also fund nurses’ multimedia engagement with adolescents. This research aims to increase knowledge of the causes of maternal death among African adolescents and guide policies and strategies to reduce maternal mortality in this vulnerable demographic.
The study could improve the lives of African adolescent girls and young women. Maternal mortality is a substantial public health concern, and adolescent girls are particularly vulnerable to unfavourable maternal health outcomes due to several biological, social, and economic variables (Kaiser et al., 2019). By understanding the experiences, perceptions, and beliefs of adolescents, healthcare providers, and other stakeholders in maternal healthcare, we can identify gaps in current policies and interventions and develop evidence-based recommendations to improve maternal health outcomes for this population. For instance, health-seeking can minimize the risk of adolescent pregnancy, which lowers child survival rates, according to Noori et al. (2021). Biological and sociocultural factors may explain this. Understanding the risk to babies born to extremely young moms requires accurate maternal age reporting. More biological and social data can illuminate this relationship. Preventing unplanned pregnancies in younger adolescents improves child survival.
21 million adolescent females are pregnant each year in LMICs (low- and middle-income countries). These pregnancies in females aged 10–19 are linked to maternal mortality, severe newborn problems, and low birth weight (Maharaj, 2022). Adolescent pregnancies significantly impact emotional, physical, and social health and are the top cause of death for adolescent girls worldwide. This study could inform African teenage maternal health policies and programs. The results could be used to build targeted interventions to improve access to quality maternal healthcare, increase teenage awareness of maternal health, and address cultural and societal norms that may hinder care. The study could also inform policies and programs that target poverty, education, and gender inequality as social determinants of maternal health.
Adolescent pregnancy is a global concern, especially in poor socio-economic circumstances where it contributes to a complex social inequality network. In South Africa, adults have devised and taught school prevention programs without considering the views of the adolescents who benefit (Wood & Hendricks, 2017). This project engaged school-aged teens in research and preventative efforts that met their needs. Therefore, this research proposal aims to contribute to our understanding of the factors that contribute to maternal mortality among adolescents in Africa. We aim to improve maternal health outcomes in vulnerable adolescents by conducting a qualitative study on adolescents, healthcare providers, and other stakeholders in maternal healthcare (Geleto et al., 2018). The findings of this study have the potential to inform policies and interventions aimed at lowering maternal mortality among adolescents in Africa and to contribute to the formulation of larger public health policies aimed at improving maternal health outcomes more broadly.
References
Ahinkorah, B. O., Kang, M., Perry, L., Brooks, F., & Hayen, A. (2021). Prevalence of first adolescent pregnancy and its associated factors in sub-Saharan Africa: A multi-country analysis. PloS one, 16(2), e0246308. https://doi.org/10.1371/journal.pone.0246308
Eyeberu, A., Getachew, T., Sertsu, A., Sisay, M., Baye, Y., Debella, A., & Alemu, A. (2022). Teenage pregnancy and its predictors in Africa: A systematic review and meta-analysis. International journal of health sciences, 16(6), 47–60
Fantaye, A. W., Okonofua, F., Ntoimo, L., & Yaya, S. (2019). A qualitative study of community elders’ perceptions about the underutilization of formal maternal care and maternal death in rural Nigeria. Reproductive Health, 16(1). https://doi.org/10.1186/s12978-019-0831-5
Geleto, A., Chojenta, C., Musa, A., & Loxton, D. (2018). Barriers to access and utilization of emergency obstetric care at Health Facilities in sub-saharan Africa: A systematic review of the literature. Systematic Reviews, 7(1). https://doi.org/10.1186/s13643-018-0842-2
Gunawardena, N., Fantaye, A. W., & Yaya, S. (2019). Predictors of pregnancy among young people in sub-Saharan Africa: a systematic review and narrative synthesis. BMJ global health, 4(3), e001499.
Kaiser, J. L., Fong, R. M., Hamer, D. H., Biemba, G., Ngoma, T., Tusing, B., & Scott, N. A. (2019). How a woman’s interpersonal relationships can delay care-seeking and access during the maternity period in rural Zambia: An intersection of the social-ecological model with the three delays framework. Social Science & Medicine, 220, 312–321. https://doi.org/10.1016/j.socscimed.2018.11.011
Kassa, G. M., Arowojolu, A. O., Odukogbe, A. A., & Yalew, A. W. (2018). Prevalence and determinants of adolescent pregnancy in Africa: A systematic review and meta-analysis. Reproductive Health, 15(1). https://doi.org/10.1186/s12978-018-0640-2
Maharaj N. R. (2022). Adolescent pregnancy in sub-Saharan Africa – a cause for concern. Frontiers in reproductive health, 4, 984303. https://doi.org/10.3389/frph.2022.984303
Mashia, E. O., van Wyk, N. C., & Leech, R. (2019). Support adolescents to resist peer pressure and coercion to sexual activity. International nursing review, 66(3), 416–424. https://doi.org/10.1111/inr.12512
Muriithi, F. G., Banke-Thomas, A., Gakuo, R., Pope, K., Coomarasamy, A., & Gallos, I. D. (2022). Individual, health facility and wider health system factors contributing to maternal deaths in Africa: A scoping review. PLOS Global Public Health, 2(7). https://doi.org/10.1371/journal.pgph.0000385
Noori, N., Proctor, J. L., Efevbera, Y., & Oron, A. P. (2021). The effect of adolescent pregnancy on child mortality in 46 low- and middle-income countries. https://doi.org/10.1101/2021.06.10.21258227
November, L., & Sandall, J. (2018). ‘Just because she’s young, it doesn’t mean she has to die’: exploring the contributing factors to high maternal mortality in adolescents in Eastern Freetown; a qualitative study. Reproductive health, 15(1), 31. https://doi.org/10.1186/s12978-018-0475-x
Ramulumo, M. R. (2019). Causes and factors responsible for teenage pregnancy. Socio-Cultural Influences on Teenage Pregnancy and Contemporary Prevention Measures, 44–63. https://doi.org/10.4018/978-1-5225-6108-8.ch003
Sama, C. B., Ngasa, S. N., Dzekem, B. S., & Choukem, S. P. (2017). Prevalence, predictors and adverse outcomes of adolescent pregnancy in sub-Saharan Africa: a protocol of a systematic review. Systematic reviews, 6(1), 247. https://doi.org/10.1186/s13643-017-0650-0
Sumankuuro, J., Crockett, J., & Wang, S. (2017). Maternal health care initiatives: Causes of Morbidities and mortalities in Two rural districts of upper west region, Ghana. PLOS ONE, 12(8). https://doi.org/10.1371/journal.pone.018364
Wado, Y. D., Sully, E. A., & Mumah, J. N. (2019). Pregnancy and early motherhood among adolescents in five East African countries: a multi-level analysis of risk and protective factors. BMC Pregnancy and childbirth, 19(1), 59. https://doi.org/10.1186/s12884-019-2204-z
Wood, L., & Hendricks, F. (2017). A participatory action research approach to developing youth-friendly strategies for the prevention of teenage pregnancy. Educational action research, 25(1), 103-118.
Worku, M. G., Tessema, Z. T., Teshale, A. B., Tesema, G. A., & Yeshaw, Y. (2021). Prevalence and associated factors of adolescent pregnancy (15–19 years) in East Africa: A Multilevel Analysis. BMC Pregnancy and Childbirth, 21(1). https://doi.org/10.1186/s12884-021-03713-9
World Medical Association (2013). World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA, 310(20), 2191–2194. https://doi.org/10.1001/jama.2013.281053
Yakubu, I., & Salisu, W. J. (2018). Determinants of adolescent pregnancy in sub-Saharan Africa: a systematic review. Reproductive health, 15(1), 15. https://doi.org/10.1186/s12978-018-0460-4
How Social Change Impacted Legalization Of Marijuana In Massachusetts Sample Essay
Over 10 decades ago, marijuana, also known as cannabis, had been prohibited in the state of Massachusetts. Although its prohibition was based on very limited scientific information on the effects the drug could potentially have and to prevent the future use of stronger drugs like opium. Later, medical researchers found that marijuana had some medical benefits when used as a sedative. Medical students also admitted that after use, they registered signs of happiness and feelings of pleasure (Whitehill et al., 2019). However, they were accompanied by feelings of nausea and general discomfort. Around 1971, Massachusetts adopted the Uniform Controlled Substances Act instead of completely making it illegal. People were not allowed to possess more than one ounce of the drug failure, leading to serving time for close to six months plus a fine. So many people had been convicted by 2006 for possession, and citizens started asking the government to allow its use legally (Kealy, 2021). Petitions went around for people to sign to allow this proposal to become law. After continuous efforts to gather the highest number of voters to vote in favor of the proposal, it finally became fully legalized in 2016. The legalization of marijuana was a form of social change that was heavily influenced by various concepts of social advocacy, community psychology, systems change, policy and legal initiatives, and community protests.
One of the most common concepts that influenced the legalization of marijuana in Massachusetts was social advocacy. Social Advocacy promotes social change through organized efforts aimed at promoting the creation of a socially just society. It influences policies, laws, and people’s attitudes toward a cause of concern. Through social advocacy, the advocates for the legalization of marijuana argued that the approval of this policy would help manage the use of marijuana. It was already being used, so making it legal would allow its regulation to prevent its misuse, especially by the younger generation. Those advocating for its legalization conducted public awareness campaigns, and used lobbying and community organization to try and change the attitudes of those who were against it (Kealy, 2021). They convinced them that medical marijuana has positive benefits, including dealing with chronic pain. Legalizing it also meant that law enforcers would focus on other crimes instead of chasing down drug offenders. This method helped to increase the numbers of those supporting its legalization hence just and fairness for those who already advocated for it.
Furthermore, community psychology also impacted the legalization of marijuana in Massachusetts. Community psychology has a holistic approach to promoting social change. It is guided by principles that consider every community member by understanding every individual in it and their relationship with each other. It strives for inclusion, fairness, and accepting diversity and believes that how an individual is affected by society shapes the community and how it functions (Prilleltensky, 2021). While pushing for the legalization of marijuana, the bottom-up approach was used where the citizens/voters were the ones who helped design the policies that surrounded this law. The responsibility was not up to the government alone but the public; the highest number of voters got to decide whether the law should be passed. Those who advocated for its legalization began using the Massachusetts initiative petition process. This petition process existed in Massachusetts since 1919, and it was there to allow the public/voters to address pressing issues, but the Legislature left it unattended. Initially, people fought for the decriminalization of possessing ounces of the drug, and it was decriminalized in 2008. Years later, people advocated for the sale and use of medical marijuana, a law that was passed in 2012.
Another concept that was used to impact the legalization of marijuana was systems change. The movement to legalize marijuana in Massachusetts began around 1989 when the first freedom rally occurred. It allowed the reformation/ review of marijuana laws that existed. Using systems change concepts was to help focus on the outcomes that the legalization would bring. The advocates for marijuana legalization argued that it would help maintain and restrain the existing policies on the illegal distribution of the drug to people below the legal age, growing marijuana, drug trafficking, and driving under its influence. It would also increase the state’s savings by over $100 million annually since much money was going into marijuana (Dills et al., 2021). These arguments proved that legalization would have more positive outcomes; it just needs to be controlled. So many laws and regulations had to change to suit the changing situations. The Legislature had to lift its prohibition law on seeing that it was causing more harm than good and focus on the outcome that legalizing marijuana would bring. In efforts to regulate marijuana use, the government had to create new employment opportunities, tax marijuana and establish legal frameworks for its usage. The state government had to ensure that marijuana would be treated similarly compared to alcohol in terms of regulations and taxation, and this required significant changes to the existing laws.
Policy and Legal initiatives were also key in the legalization process of marijuana. Policies affect almost every aspect of our lives and how we do things. In most cases, for social change to occur, there has to be the formation of new policies, reforming existing ones, or both. These policies often address the issues that face society in all areas. They act as solution providers, and in Massachusetts, it took plenty of research and advocacy to come up with policies that will favor/ grant people what they want but still be in line with the laws. In 2018, the state had to create a new body to regulate and oversee the marijuana industry, The Cannabis Control Commission. The roles of this body included creating and enforcing all the laws that were related to marijuana, from how it was produced to its distribution and sale (Dills et al., 2021). Some of the policies that were put in place included; people being allowed to buy up to 28grams at a particular time, each household could only grow up to six plants that were to be away from the street, licenses were also available for application by cultivators who could only sell to dispensaries and not directly to customers with no prescription, and they banned the smoking of marijuana in places of public.
Lastly, community protests also impacted marijuana legalization in Massachusetts. “We are here today to protest over the injustice that the Department of public health is causing the people of Massachusetts; corruption has made it impossible for patients to access medical marijuana.”, “We are losing patients from our families every day over something that this department would have prevented if they had gone through with the legalization plans, something they had promised to do two years ago.” These are words from protestors who turned put in large numbers in front of the office of the Department of Public Health (Swinburne et al., 2019). There were so many campaigns from around 1989 when people began the movement for this legalization. People came out in large numbers and formed campaign groups meant to fight for this cause. They were successfully organized, and each had a sense of collectiveness that encouraged participation since people now believed that they and their community could get what they wanted; they could be heard. There was the ‘Yes on 4 campaign’ to urge the state government to regulate marijuana like alcohol. This campaign led to the passing of Question 4, which was the legalization and regulation of marijuana in Massachusetts for people over the age of 21 years.
Just like any other movement, the movement for the legalization of marijuana in Massachusetts had its challenges. The community member faced various problems that pushed them to protest and even challenges during their protests. One of the challenges faced was opposition from the Legislators and society’s influential people. According to Rick Steves, a television host and travel blogger, Massachusetts was not progressive politically; those opposing the legalization presented arguments that made no sense. Continuous efforts by the legalization advocates seemed frustrating every time the Legislature rejected their legalization bill. They found that there was a limited representation since comparing their bill to legalization efforts that had been there before; those seemed to be well known and had so many supporters among voters; hence their terms were well respected and quickly passed (Kealy, 2021). During debates to support the decriminalization of marijuana, the legislators and those that were against its legalization acted rationally despite what was at stake. So many people of power were against its legalization and challenged their efforts; church leaders, law enforcers, and economically influential people. This was a challenge because these were people that the public looked up to for guidance in various ways, and their being against marijuana legalization meant the masses would follow and listen to them.
Another challenge that the legalization advocates faced was the stigma and pessimism that was associated with the use of marijuana. Marijuana is a drug, and many negative stereotypes and attitudes toward it exist. People were afraid that it would promote the use of drugs and drug dealers would have an excuse to keep dealing; it would cause an increase in criminal cases like theft, car accidents from people driving under the influence of marijuana, and so on. These were mostly from parents who were afraid their children would become victims of addiction. Finding a way to persuade these opponents to see the benefits that the legalization of marijuana would bring was much work since they needed their votes to pass the bill (Kealy, 2021). This made it hard for the legalization to go through, and it took years before the number of voters who were in favor of the law to be more than those who were against it. However, they used various ways to minimize the problem, like creating public awareness, sensitization, and understanding the individual needs of opponents and why they were against legalization. In the long run, they managed to balance the problem.
The lack of evidence and information to support the legalization of marijuana during debates before legislatures was also a challenge. For a bill to be passed, much information and evidence to support the argument and in its favor was needed to be able to debate over it. Advocates for legalization did not have enough information regarding the benefits of legalizing marijuana. They could barely prove that the benefits of legalizing it outweighed the risk of not decriminalizing it. It was hard to convince the Legislature that this bill had to be passed. They needed to find reliable evidence that the criminalization and over-enforcement of possession of marijuana were done based on incorrect information (Kealy, 2021). This problem kept delaying the process. Information had to be found via research on its usage, its source, who was safe to use it, its effects, and how it compares to alcohol and other drugs. The Legislature did not get all the information needed to pass this bill on time, which explains why it was passed in stages before being fully legalized. Legalization advocates kept campaigning consistently and painted a rosy picture of what the legalization would do, eventually convincing the legislatures.
The legalization of marijuana in Massachusetts is a historic movement and an example of how various factors contribute to social change. Certain concepts related to social advocacy, community psychology, systems change, policy and legal initiatives, and community protests impacted the legalization of marijuana. In 2016, Massachusetts became the first state on the East Coast to legalize recreational marijuana for people over the age of 21. After a number of campaigns and policy changes to try and do away with the effects drug wars had on people’s lives and support that the resources put into fighting drug users be used to find responsible ways to control drug use, it finally came into effect. The movement also took years due to the challenges faced during the protests and campaigns. However, community members came together to challenge these challenges. For example, community organizations worked to ensure that regulations were implemented to prevent underage use and address the impact of the war on drugs. Additionally, community members worked to ensure that the revenue generated from the sale of marijuana was reinvested in communities impacted by drug criminalization. Marijuana was legalized in Massachusetts, but there are still changes in policies and guidelines to make the laws that govern this rule better for both the state and the public.
References
Dills, A. K., Goffard, S., Miron, J., & Partin, E. (2021). The effect of state marijuana legalizations: 2021update.CatoInstitute,PolicyAnalysis,(908).https://www.jstor.org/stable/pdf/resrep30177.pdf
Kealy, S. J. (2021). Marijuana Legalization and the Role of the Massachusetts Legislature. BUL Rev.,101,1173.https://heinonline.org/hol-cgi-bin/get_pdf.cgi?handle=hein.journals/bulr101§ion=35
Prilleltensky, I. (2021). Value-based praxis in community psychology: Moving toward social justice and social action. American Journal of community psychology, 29, 747-778. https://link.springer.com/article/10.1023/A:1010417201918
Swinburne, M., & Hoke, K. (2019). State Efforts to Creative an Inclusive Marijuana Industry in the Shadow of the Unjust War on Drugs. J. Bus. & Tech. L., 15, 235. https://heinonline.org/hol-cgibin/get_pdf.cgi?handle=hein.journals/jobtela15§ion=14
Whitehill, J. M., Harrington, C., Lang, C. J., Chary, M., Bhutta, W. A., & Burns, M. M. (2019). Incidence of pediatric cannabis exposure among children and teenagers aged 0 to 19 years before and after medical marijuana legalization in Massachusetts. JAMA network open, 2(8),e199456-e199456. https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2748051
Identity And Empowerment Essay Example
Introduction
The narrative follows Mrs. Mallard, who experiences unexpected liberation following her husband’s death but sees it curtailed when he appears alive and well. The narrative focuses on a woman called Mrs. Mallard who learns of her husband’s death and unexpectedly experiences a sense of liberation, only to have her newfound freedom cut short when her husband appears alive and well. This story’s reflection on female identity and Empowerment within a patriarchal context reflects themes in America’s feminist movements by the end of the 1800s.
Equal treatment was demanded by women in America during this period which comprised being allowed to have an education, own assets and vote (Chan 40). The challenge of traditional roles and expectations for women by feminists led to the encouragement of asserting one’s individuality and independence. In this context, Chopin’s portrayal of Mrs. Mallard’s internal struggle to define herself apart from her husband and societal expectations resonated with many women at the time.
Chopin herself was a product of this movement. Born in 1850 in St. After her husband died in 1882, Chopin focused more on her writing. The identity-forming influence that would come to shape much of Chopin’s adult life came early: at just five years old, she found herself bereft of a parent – but also firmly under the guidance of increasingly important female figures like that presented through Old Granny, whom never doubted both the intellectual capability nor imagination capacity among non-males. Following her husband’s death in 1882, Chopin committed herself more to writing. Her frequent subject was women’s lives, whose frank description vividly caught the reader’s attention.
With its nuanced portrayal of a woman’s internal struggle for independence and self-discovery, “The Story of an Hour” is a powerful example of Chopin’s feminist writing. Kate Chopin’s composition titled The Story of an Hour is employed in this analysis. The late 19th Century saw limited female Empowerment with only nascent growth of feminism, during which Kate Chopin resided as an American writer (Hussein 7). Through her literary contributions, Kate Chopin frequently touched upon topics regarding sexuality and women’s suffrage that challenged the existing patriarchal norms of society during her era.
Through her use of various literary devices- including ironies-Chopin employs dramatic tension-building strategies, which lead to how she showcases the themes around female figures seeking opportunities for self-discovery amid patriarchal oversight. The focus on protagonist Mrs. Mallard and her emotions throughout an hour forms a distinctive structure that enhances Chopin’s theme about female identity and Empowerment. Through Ms. Mallard’s emotional experience in 60 minutes, Chopin examines female identity and Empowerment. To achieve its dramatic ending, ‘The Story of an Hour’ effectively uses various literary tools, including but not limited to irony and foreshadowing.
She lives within male-dominated surroundings, which have shaped how she views herself limiting agency; however, acceptance allows personal strength to shine through, leading to personal power after realizing who she truly is outside domestic conventions. While solely recognized as a spouse initially, discovering herself and embracing her individuality led Mrs. Mallard towards extraordinary strength counteracting gender-based limitations. Mrs. Mallard’s identification with a male-dominated culture limited herself and others. Despite societal norms being detrimental to Mrs. Mallard’s self-realization, it emphasizes how as humans, we are capable of surmounting all obstacles with conviction and resilience.
Chopin’s attention to female identity and Empowerment indicates her reflection on key themes within 19th-century feminism. Chopin challenged societal norms, especially regarding traditional views on gender roles, by exploring societal constraints in marriage. Readers are still moved by the powerful portrayal of gender dynamics in The Story of An Hour. Chopin’s portrayal of how individuals struggle for self-identity amidst various societal pressures at different times and junctures finds meaning even today.
Female identity
In The Story of an Hour by Kate Chopin, the character introduction presents Mrs. Mallard primarily as a married woman. Her role initially defines Mallard as a wife. Mrs. Mallard’s identity is firmly linked with her husband, and she is depicted as a meek and obedient spouse. Despite this initial portrayal as a submissive wife, Mrs. Mallard only comprehends her sense of self after she learns about the passing away of her husband. Mrs. Challenging traditional gender roles, Mallard’s newfound identity holds great importance for understanding societal norms and expectations during that era. During that era, a woman’s primary responsibility was considered a wife or mother, which required them to be subservient to their husband.
Still, Mrs. In realizing the loss of her significant other, Mrs. Mallard realizes there are greater things than obeying societal expectations as a woman. Mrs. In reflecting the ideals of the feminist movement from this time, Mrs. Mallard’s recognition of her own identity has significance. Like Mrs. Mallard, many women during this time desired to challenge traditional gender roles and assert their identities. Mrs. Reflecting on the values of feminism at that time, Mrs. Mallard wished to carve out a life for herself in which she was independent and capable.
Through Mrs. By examining Mrs. Mallard’s character, Chopin addresses the theme of women establishing their identities within patriarchal societies. Despite societal expectations, Mrs. Mallard’s sudden self-recognition highlights a woman’s potential to lead independent and self-sufficient lives. Through Chopin’s portrayal of Mrs. Mallard, one comes across a clear message – women indeed hold within themselves the capability to break away from traditional gender roles and become free.
Empowerment
In The Story of an Hour by Kate Chopin, Mrs. Learning that her husband has died, Mrs. Mallard becomes empowered. The idea that women were expected to be subservient to their husbands during this era further emphasizes Mrs. Mallard’s newfound sense of Empowerment. Given societal norms at the time, experiencing such power made it especially noteworthy. Mrs. Mallard’s strong sense of Empowerment is notable when considering societal expectations for women during the late 19th Century. Traditional expectations for women during Mrs. Mallard’s lifetime centered around homemaking after marriage instead of emphasizing their potential career path. In those days (late 19th Century), marriage meant duty-bound work dedicated exclusively to family life; pursuing career paths or acquiring education had no standing except managing a household correctly.
Therefore, society upheld being subordinate yet happy playing unique roles such as Mother or mate. As per societal expectations that prescribed women’s roles within the household only, Mrs.Mallard is subjected to conformism when she breaks down into unrestrained tears upon hearing about her spouse. Reflecting on this newly discovered freedom as Mrs. Mallard did, Reflecting on the newly found freedom leads to an empowering realization for Mrs. Mallard. As Chopin puts it, there will be nobody else Mrs. Mallard has to consider during those forthcoming years; henceforth, only she surpasses everything important. As Chopin writes, There would be no one to live for during those coming years; she would live for herself.
The significance of Mrs. Mallard’s newfound freedom challenges traditional gender roles. In addition, Empowerment for women like Mrs. Mallard offers a critical opposition to patriarchal expectations. Mrs. Mallard’s newly found independence suggests that females are more than what they are based on in relation only to men, rather it advocates for them being seen as unique individuals capable of self-identification (Abdullah Alajlan 125)
Male-dominated society
In Kate Chopin’s The Story of an Hour, men are portrayed as dominating and controlling figures. Mr. Mallards’s demonstration conveys his warm love towards his wife, yet it portrays him directing her activities and restrictions toward self-discovery. Mrs. Mallard’s experience highlights how traditional gender roles in late 19th-century America negatively impacted women. Identity and Empowerment are elusive for Mrs. Mallard, who struggles to find them. The expectation for women during the late 19th-century society was to adhere firmly to conventional gender norms; this made it challenging to explore personal growth while limiting educational or work-based opportunities (Wang 96).
The societal norms of males’ superiority over females affected Mrs. Mallard deeply leading her struggle towards finding identity where she felt inferior due to constraints that demanded female submission in marriage akin to evidence from this era requiring married women to prioritize family first. The sudden understanding of Mrs. Mallard about herself as a separate entity directly challenges the norms of an oppressive and patriarchal society. A renewed sense of power comes over Mrs. Mallard thanks to her late partner, whose passing ends restrictive gender conventions.
Not only does Mrs. Mallard achieve personal freedom and liberation, but she also makes a statement about oppressive patriarchal societies. One significant theme discussed throughout The Story of an Hour is how entrenched patriarchy shapes individuals’ perceptions and relationships and hinders females’ growth and self-discovery (Biswas 11). Similarly, it highlights the value of defying conventional societal norms that repress growth opportunities for women through promoting their Empowerment. The Story of an Hour underscores how patriarchy limits growth and self-discovery among females, stressing the need to empower them and highlighting the challenges they face in these societies. Additionally, Chopin critiques such structures by portraying men as bossy.
Feminism in the late 19th Century
The rise of feminism during this period primarily focused on advocating for gender balance and securing equitable treatment of females. Ladies needed help to secure their voting rights, employment opportunities beyond domestic boundaries and self-determination. Themes including female identity and Empowerment reflecting the ideals behind feminism were omnipresent in Kate Chopin’s work, authored The Story of an Hour during this period.
The Story of an Hour reflects the feminist movement of the late 19th Century. The influence of patriarchy limits the expression and sense of self-experience by women such as Mrs.Mallard, initially portrayed mainly through how she viewed herself based on social limitations set for married women. As news of her spouse’s death broke, though, through realizing self-identity comes Empowerment for the protagonist, Mrs. Mallard. Incorporating themes central to the feminist movement, Mrs. Mallard challenges societal norms and perceptions about women.
In contrast to societal norms, Mrs. Mallard acquires a newfound autonomy that defies traditional feminine roles in Late Victorian society. It was deemed normal for women in the late 19th Century to prioritize men’s demands over theirs while also being submissive. Still, Mrs. Mallard’s newfound sense of agency challenges these expectations and departs from traditional gender roles. A male-dominated society is depicted in The Story of an Hour, underlining how gender inequality impacts female identity and Empowerment. Throughout The Story of an Hour, we see evidence of women being relegated to secondary positions while men remain in control. Mrs. Mallard realizes that true Empowerment means breaking free from the oppressive grasp of male domination.
Conclusion
The theme of female identity and Empowerment in a patriarchal society is explored through Kate Chopin’s The Story on an Hour- effectively mirroring beliefs espoused by feminists throughout the later years of nineteenth-century America. The story portrays Mrs. as depicted in Chopin’s The Story of an Hour; the change in women’s identities was evident with Mrs. Mallards’ discovery of herself beyond the designated roles for wives. The portrayal of men emphasizes their impact on limiting women’s identities under patriarchal structures, reflecting societal norms at the time by incorporating themes such as female independence and Empowerment; the Story of An Hour showcases influences from the feminist movement empowering ideologies.
Following themes advocated by feminists at that period, The Story of an Hour celebrates autonomy for women, whereas it challenges conventional patriarchy. Focusing on challenging societal expectations restraining womanhood, The Story Of An Hour remains pertinent, underscoring a continual quest for an equal standing among genders. Chopin’s portrayal of feminine power and identity is a testament to how far we have come in promoting women’s rights while also showcasing how much ground we need to cover to attain equal opportunities regardless of Gender. Its female identity and empowerment themes challenge societal norms and highlight the need for gender equality. As a reminder of the progress toward gender equality, its exploration of themes like female Empowerment remains pertinent today. This story bears witness to the persistent struggle for women’s liberation and reminds us of our advancements in establishing gender equity.
Works Cited
Abdullah Alajlan, Lama. “The Awakening of Female Consciousness in Kate Chopin’s the Story of an Hour (1894) and Charlotte Perkins Gilman’s the Yellow Wallpaper (1892).” Alajlan, LA, & Aljohani, F.(2019). The Awakening of Female Consciousness in Kate Chopin’s The Story of an Hour (1894) and Charlotte Perkins Gilman’s The Yellow Wallpaper (1892). Arab World English Journal for Translation & Literary Studies 3.3 (2019): 123-139.
Biswas, Banani. “Choice between Creative and Procreative Functions: A Female Artist’s Struggle with Cultural Burdens in Rubaiyat Hossain’s Feature Film Under Construction.” Quarterly Review of Film and Video (2022): 1-18.
Chan, Jasmine S. “The status of women in a patriarchal state: The case of Singapore.” Women in Asia. Routledge, 2020. 39-58.
Hussein, Nada Kadhim. “The Analysis of Psychological Aspect in Cho-pin’s” The Story of an Hour.” Review of International Geographical Education Online 11.7 (2021).
Wang, Haiqiong. “On the Spatial Narrative of “The Story of an Hour.” Asian Journal of Social Science Studies 7.3 (2022): 96.