Implications of power imbalance in antenatal care-seeking among pregnant adolescents in rural Tanzania: a qualitative study
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Abstract Background: Adolescent girls (age 10-19 years) are at increased risk of morbidity and mortality due to pregnancy and childbirth complications, compared with older mothers. Low and middle-income countries, including Tanzania, bear the largest proportion of adolescent perinatal deaths globally. Most adolescent girls in Tanzania do not access antenatal care at health facilities, but the reasons for lack of antenatal care attendance are poorly understood. Methods: We conducted a qualitative thematic analysis study of the experiences of pregnant adolescents with accessing antenatal care in Misungwi district, Mwanza Region, Tanzania. We recruited 22 adolescent girls who were pregnant or parenting a child aged less than 5 years, using purposive sampling, and collected data about their lived experiences using in-depth individual interviews (IDIs). IDI data were triangulated with data from eight focus group discussions (FGDs) involving young fathers and elder men/women, and nine key informant interviews (KIIs) conducted with local health care providers. FGDs, KIIs and all but two IDIs were conducted and audiotaped in Swahili. All Swahili recordings were transcribed verbatim in Swahili. Two IDIs were conducted in local vernacular (Sukuma), and were transcribed into Swahili (as Sukuma is uncommon), by bilingual research assistants. All Swahili transcripts were then translated to English. A team of researchers analysed transcripts using emergent thematic analysis and constant comparison technique. Results: We identified four main themes: 1) Lack of maternal personal autonomy (Diminished power for decision making, Lack of financial and personal independence), 2) Stigma and judgment, 3) Vulnerability to violence and abuse, and 4) Knowledge about antenatal care. Conclusion: Pregnant adolescent care seeking for antenatal services is compromised by a complex power imbalance that involves financial dependence, lack of choice, lack of personal autonomy in decision making, experiences of social stigma, judgement, violence and abuse. Multi-level interventions are needed to empower adolescent girls, and to address policies and social constructs that may contribute to observed power imbalance; addressing these barriers can improve access to antenatal care among pregnant adolescents, and potentially reduce maternal morbidity and mortality.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.001 | 0.008 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it