Teenagers are young people between the ages of 10 and 19 years. Around 1.2 billion people ,or 1 in 6 of world’s population ,are adolescents A (WHO,2018). Most teenagers are healthy, but there is still significant premature injury, illness, and death among them. the main cause of this problems is the unhealthy practice during this period, such alcohol or tobacco use, lack of physical activity, unprotected sex, exposure to violence, and early pregnancy. All of this problems can affect their ability to grow and develop to their full potential, and can threaten not only their current health but also their health as adults, and even the health of their future children, for this they are one of the vulnerable group. Adolescent pregnancy is defined as a teenage girl, usually between the ages of 13-19, becoming pregnant (Akella, &Jordan, 2014). Early pregnancy and its complication considered as the second cause of death for 15-19-year-old girls (WHO,2014). Although they face as other women the same pregnancy-related issues. they become at higher risk, because they are one of the vulnerable group and their body is not fully developed to sustain a healthy pregnancy or to give birth. In addition, the critical social issues which they are faces. Teenage pregnancies are a global problem, that occurs all over the world in high, middle and low income countries. But most of the time its occurs in marginalized communities, where the poverty, lack of education and lack of opportunity of employment are widespread (WHO,2018).
Teenage pregnancy prevalence
Around 1 million girls under 15 years give birth yearly mostly in low- and middle-income countries(WHO,2018). In 2010, public spending for teenage births results around $9.4 billion (National Campaign To Prevent Teen Pregnancy, 2014). The occurrence of teenage pregnancy differs dramatically between different countries. depending on cultural factors, female education, religion, and access to contraceptives. The teenage birth rate according to WHO estimation is 11% of total birth around world, and the majority of these are from low- and middle- income. According to The United Nations Population Fund (UNFPA) report between 2006-2015, The adolescent birth rate in the world per 1,000 women aged 15 to 19, is 51 birth, 18 birth in more developed region ,56 birth in less developed region, and 109 at the least developed region, around 20,000 girls under age 18 give birth daily in developing countries, which equal to 7.3 million births a year (UNFPA,2017)
In the US, at 2015, a whole of 229,715 babies was born for adolescent’s women, and at 2016 the number of adolescent birth decreased to 209,480 births (National Campaign To Prevent Teen Pregnancy, 2016). In 2017 the birth rate was 22.3 per 1,000 women in 10-19 years age group(CDC,2017). It was estimated that the rates of teen pregnancy are 20 times higher in developing countries than the ones reported in developed countries (UNFPA,2017). In Egypt the rate of teenage pregnancy ranges from 4.1% in urban societies to 11.3% in rural areas (Abbas, Ali, Ali, Fouly, & Altraigey, 2017). In Jordan, the rate of teenage marriage was 10.6% in 1990 and dropped to 6.3% in 2012 (Khader, Batieha, Al-Hader, & Sa’ad,2017). And in 2015 the percent was raised again to reach 18,1%, which equal 414353 case of early marriage. The percent of teenage marriage before the 18 year between 2010 and 2015 was 15.1%, the highest percent was in al-Mafraa 24.5%, followed by Al-Zarqa with 18.8% and then Irbid with 17.7%. The remaining nine governorates did not exceed the national level, with rates for the rest of the governorates ranging from 13.3% (HPC,2017). One of the causes of this rising in adolescent birth was related to Syrian refuges entrance to Jordan. Among the cases of early marriage in 2015 which mentioned before there were 11.6% Jordanian case, and 43.7 % were Syrian (JNCW,2015). The rate of teenage marriage among the Syrian women were 33.2% in 2010, and this percent increased to 43.7% in 2015. The highest percent was in Al-Balqaa 51.7%, followed by Al-Tafela 50% (DOS,2015).
Teenage pregnancy factors
High incidence of teenager’s pregnancy related to a myriad of factors, that are closely linked to culture and norms. In addition to the main factors which are mutual between most countries regardless to the cultures, such as, early sex and marriage, low contraceptive use, low educational levels, low socio-economic status, lack of knowledge of reproductive and sexual health, gender inequity, and physical/sexual violence(Kaphagawani, & Kalipeni, 2017). According to systematic review conducted in 2014 over seven countries in south Asia, the main risk factors of teenage pregnancy in this area are socioeconomic factors, low education attainment, culture and family structure (Acharya, Bhattarai, Poobalan, Teijlingen & Chapman. 2014). The low education level lead to increase the teenage pregnancy, Conversely, teenage pregnancy increases the school dropout (De Witte, Cabus, Thyssen, Groot, & van den Brink, 2013). Thirty percent of teenage girls who dropout of high school cite pregnancy or parenthood as a primary reason(NCSL,2017). By increasing of the birth rate the school dropout percent will increase too (Marcotte, 2013).
In Jordan around 66.7% of Jordanian teenage women and 69.3% of Syrian teenage women are in primary education. And this mean there opportunity to have good job with high income will decrease. 1.3% of teenage women have job, and 45.3% of their husband have job, 32.9% don’t have job, and 10.1% don’t have fixed job (DOS,2015). That mean these families will enter the poverty cycle And by decrease the socioeconomic status ,monthly income, the incidence of adolescent pregnancy increases (Penman-Aguilar, Carter, Snead, & Kourtis, 2013). In Jordan and according to HPC survey, the main causes for early marriage among Jordanian and Syrian families, and Palestinian and Syrian refugee, were poverty and the elimination of the girl’s economical liability, frequent study failure, the girls honor protection, TV programs and the social media (HPC,2017) There is a lot of factor increase the incidence of teenage pregnancy among the Syrian refugees in the al-Zaatari camp, such as the inability of the women and girls to make a decision about their reproductive health. Because the parent’s percept they have the right to marry off their daughters against their will, and the husband decides when to have children on behalf of his wife (Sahbani, Al-Khateeb, & Hikmat, 2016).