Table 2.
Interview themes and corresponding case vignettes from adolescents who visited health facility for maternity care
| Domain, underlying dimension and theme | Vignettes from Interviews |
|---|---|
| 1. Experience of Pregnancy, acceptance/understanding implications | |
| a. Denial of the pregnancy | Tuliendelea kuwa marafiki mpaka wakati nilikosa periods kwa miezi 6, nikajua niko na mimba.Nilimwambia akasema nimekuwa na vijana wengine shuleni. “We continued as friends until I missed my periods for 6 months, I knew I was pregnant. I told him and he said I have been with other boys in our school.”-15 year old,9 months pregnant “Wazazi walinifukuza nyumbani ndiyo nikaanza kuishi na marafiki zangu” “I was sent me away from home that’s why I stay with friends”- 17 year old commercial sex worker,8 months pregnant living with friends Maisha ya ndoa ni ngumu sana, saa zingine akikasirika na mimi, anasema huyu mtoto sio wake, Marriage life is so hard, sometimes when he is annoyed with me; he says that the baby is not his.. 18 years old |
| b. Intention to put up the baby for adoption or ask the mother to raise the baby | Daktari akisema mtoto ako sawa, tungependa akizaa, mtoto achukuliwe na childrens’ home au mtu mwenye anamtaka ndio msichana arudi shule kwa vile siwezi kuwalea. “In case the doctor says the child is healthy, we would like to give him/her to a children’s home or somebody who needs a child so my daughter can go back to school because I cannot raise them” - 15 years old, 7 months pregnant Sijui kama kuna watu watanisaidia zaidi ya mama yangu kwa vile huyo kijana hafanyi kazi na anashinda akivuta bangi. Mama naye si mbaya lakini anafanya tu vibarua (Analia). I don’t know whether others will help me except for my mother because the boy does not have a job and he takes Marijuana. My mother is not bad but she does odd jobs. (Crying) -15 years old,9 months pregnant Nimegundua ni mimi ndio rafiki yake pekee na sitaki awe peke yake. Sote tuko sawa kama wazazi na mama in-law ananisupport. Makosa imefanyika. Sisi tutatunza mtoto, arudi shuleni. Mimi ni counselor, nasaidia wazazi wengi wanapitia haya, kwa nini nisisaidie mtoto wangu wa kipekee? I have realized that I am her only friend and I do not want her to be alone. We are all okay with this as parents and my mother-in-law supports me. The mistake has already happened so we are going to take care of the child and she goes back to school. I am a counselor and do this all the time for other parents and why not for my only child?-15 year old’s mother |
| c. End of education and need to look for job | Nilikuwa naishi na wazazi uko Kawangware lakini juzi walinifukuza sasa naishi na marafiki zangu tuna tafuta pamoja na kupata chakula. Nilifanya standard 8 lakini sikuenda Form 1 juu ya fees. I am 17 years old, not married. I was staying with my parents in Kawangware but they recently chased me away now I am staying with my friends hustling together and getting food to eat. I did standard 8 examinations but did not go to Form 1 because of school fees- 17 years old Niliacha shule standardi 8 ju sikulipiwa pesa za mtihani. Nimekuwa tu home naboeka bila kufanya chochote, kazi za nyumba tu. Shangazi hatupendi vile na hatusomeshi anashughulikia watoto wake tu. Nili patana na huyu boy last year na tunaishi na madhake hapa Kangemi. Juzi ndio niligundua niko na ball. I dropped out in Standard 8 because the exam fee was not paid. I have been home since, being bored without doing anything but house chores. My aunt does not love us that much because she does not educate us but only her children. I met this boy last year and we are staying with his mother here in Kangemi. Recently, I found out I was pregnant – 18 year old. Niko na 17 years,niliacha shule nikiwa class 6 ju wazazi hawangeweza kulipa fees. Sasa, leo unaenda tu poa na kesho unafukuzwa, nikaamua tu niache shule. I am 17 years old, I dropped out of school in class 6. My parents could not raise the fees, so today you go to school without incident but tomorrow you are chased away. I decided to drop-out of school. |
| d. I tried to abort but that didn’t work out well | Interviewer: Uja uzito huu ni wa nani na anakusaidia? Who is responsible for your pregnancy and does he support you? Interviewee: Ni mmoja wa mabeshte zangu. Nikizaa nitajua tu.Wazazi walinifukuza nyumbani ndiyo nikaanza kuishi na marafiki zangu. Nilijaribu kutoa hii ball mara mbili na ilikataa sasa nitazaa tu. It is one of my friends. When I give birth I will know. My parents chased me away from home, that’s why I stay with friends. I tried to abort twice but it refused now I will just give birth Interviewer: Ulijaribu na nini? What did you try it with? Interviewee:Juice conk na strong tea vile nilikuwa miezi tatu na nne Concentrated juice and strong tea when it was 3 and 4 months- 17 year old 8 months pregnant |
| e. Poverty impact on their pregnancy – absence of nutritious food | Ni katika hali ya kujitafutia ju home hauwezi pata vitu madame wanaitaji na kulala njaa mara mob. Mimi ndiye msoo kwetu kwa hivyo nikileta ata masisters zangu watakuwa poa. Baba anafanya kazi lakini ni mlevi na mama anaoshea wadosi nguo lakini haitoshi. It was in the course of hustling because at home I could not get what girls need and we were sleeping hungry all the time. I am the eldest and so if I bring even my sisters will be alright. My father works but he is a drunkard and my mother washes clothes for rich people but it’s not enough Stress kubwa ni kukosa do, inabidi madhake atupe kila kitu na siku hizi naona inaleza kelele sana- 17 years old 8 months pregnant The biggest stress is lack of money. His mother has to provide everything and these days I see it causing a lot of noise- 18 year old married. Babu ndiye kama baba saizi ju baba yetu alituacha. Tuko watoto sita kwa familia. Kwa wakati huu, sijanunua chochote cha mtoto. Sina pesa. My Grandfather is like our father now because my father left us. We are six siblings. Upto this moment, I have not bought anything for the baby. I don’t have money - 15 years old 9 months pregnant |
| 2. Attitude of and support from the boyfriend | |
| a. Denial of pregnancy | Mimi na huyu kijana tumekuwa marafiki kwa miaka mmoja na miezi saba. Nilifikiria huyu kijana ndiye rafiki yangu na ananipenda.nikakubali kuwa naye……. Nimepata wakati mgumu sana kwa vile nilikuwa niko class 8 najitayarisha kufanya mtihani. Nilificha kwa miezi tano lakini ikaanza kuonekana. Kijana pia amekataa huyu mtoto. We have been friends for 1 year and 7 months. I thought the man was my friend and loved me that’s why I accepted to be with him……………I have had a very hard time since I was in class 8 preparing for my exams. I hid it for 5 months but it started to show. The boy has denied the child.- 15 year old 7 months pregnant Tulikuwa tumezoeana kama majirani. Siku moja nilienda kumtembelea akanishawishi tufanye hiyo maneno na nikakubali. Tuliendelea kuwa marafiki mpaka wakati nilikosa periods kwa miezi 6, nikajua niko na mimba.Nilimwambia akasema nimekuwa na vijana wengine shuleni. We used to get along as neighbours. One day I went to visit him, he convinced me to do that thing and I agreed. We continued as friends until I missed my periods for 6 months, I knew I was pregnant. I told him and he said I have been with other boys in our school- 15 year old, 9 months pregnant |
| b. Even the boy’s family denies any responsibility |
I am thinking that when she gives birth, I will take the child to his/her father,
leave him/her in their doorstep. I do not have a job. I am dependent on my husband. We have 3 children; the last 2 were twins 10 months old. It’s been hard living with her and this pregnancy. I cannot take care of another child- 15 year old’s mother, 7 months pregnant I wrote a letter and took to their home, his mother was also shocked,. In the letter I told them as the mother, I will inform you of her progress, but I would also like you to talk to your son so we all see the way forward. I wrote the letter because I didn’t want to talk too much out of anger. So far I have not got any positive feedback. My husband does not want me to call them.-15 year old’s mother, 6 months pregnant |
| c. He is very supportive and trying his best |
He supports me a lot so I see that I will be fine – 18 year old married He is a friend of mine since primary school, since I got pregnant, he has not given me stress, he has accepted and even come to speak to my parents- 17 year old I have known my husband for a while and when I told him that I am pregnant, he said we stay together and be a family – 17 year old |
| 3. Attitude and support from mothers and significant caregivers | |
| a. Mother is quite angry and disappointed |
Interviewer: Mara ya kwanza kusikia hii maneno, ulijiskia aje? The first time you heard about it, how did you feel? Interviewee: Imenikera sana. It has annoyed me very much – 15 year olds mother(7 months pregnant) Msichana wangu ni mmoja tu,nimemlea kanisani, hata sijui nini ilifanyika? My daughter is my only girl, I have brought her up in the church, I just do not know what happened – 15 year old’s mother(6 months pregnant) |
| b. Lack of family support | Nilikuwa naishi na nyanya na shangazi zangu kule ushago kwa sababu mama alioewa hapa Nairobi. Walikasirika sana na wakanirudisha kwa mama yangu, I used to live with my grandmother and aunties in rural home because my mother is married here in Nairobi……….My grandmother and aunties were very annoyed with me and told my mother- 15 year old-7 months pregnant Babu alisema anakuja kunichapa kwa vile nimehaibisha familia. Yeye ndiye kama baba saizi ju baba yetu alituacha. Tuko watoto sita kwa familia…… Sijui kama kuna watu watanisaidia zaidi ya mama yangu kwa vile huyo kijana hafanyi kazi na anashinda akivuta bangi. Mama naye si mbaya lakini anafanya tu vibarua My grandfather said he will come to Nairobi and beat me up because I have embarrassed the family. He (grandfather) is like our father now because my father left us. We are six siblings…….. I don’t know whether others will help me except for my mother because the boy does not have a job and he takes Marijuana. My mother is not bad but she does odd jobs. – 15 year old 9 months pregnant. “I am 17 years old, not married. I was staying with my parents in Kawangware but they chased me away now I am staying with my friends” Nikituma pesa nyumbani pia anakasirika na mimi. Nikichelewa kutoka kazini anasema niko na vijana wengine huko nje. Mdosi aliniambia nikifanya kazi vizuri, ataniongeza pesa. Nafikiria kukomboa nyumba yangu lakini wazazi nyumbani pia wananitegemea nitume pesa If I send money home, he also gets annoyed with me. If I am late from work, he says I am with other men outside. My boss says if I work well, she will give me a raise. I am thinking of renting a house but my parents at home rely on me to send them money- 18 year old I understand that my parents are upset but see it as my first big mistake. I have been a good student all through……..so I don’t know why my parents, especially dad is still upset- 17 year old just cleared Form 4 |
| c. Get support from social and community health workers |
Interviewer: Unadhani utaweza kulea mtoto pekee yako? How do you think you will manage to raise the child on your own? Interviewee: Mimi ni volunteer social worker Napata huku na kule na niko na savings sio mingi lakini nitamanage. I volunteer as a social worker and have some savings from a previous job and I think it may not be enough but I can manage on my own Interviewer: Unajihisi aje juu ya huyu mtoto? How do you feel about your baby? Interviewee: Napenda mtoto wangu sana na natamani kumuona. Babake ndio sitaki. I love my child and long to see him/her. It’s the father that I do not want Interviewer: Hiyo ni vizuri, unaishi peke yako kwa sasa? Are you staying alone now? Interviewee: Ndiyo naishi peke yangu Yes I am staying alone Interviewer: Je, unapata support? Do you get social support currently? Interviewee: Ndiyo, napata support kutoka kwa marafiki na social workers wezangu kama Lilian. “I get support from my friends, social workers here at the hospital like Lilian”- 18 year old |
| 4. Other challenges impacting depression | |
| a. Experiencing domestic violence |
Marriage life is so hard, sometimes when he is annoyed with me; he says that the baby
is not his. When I talk to neighbours, he gets annoyed and beats me. My husband said I use his name and not my father’s name. If I send money home, he also gets annoyed with me. If I am late from work, he says I am with other men outside. My boss says if I work well, she will give me a raise. I am thinking of renting a house but my parents at home rely on me to send them money – 18 year old married,5 months pregnant employed No, he slaps me on the cheeks- 18 year old 9 months pregnant |
| (b) Substance use - consuming Miraa (Khat)everyday |
It’s normal where I come from and it doesn’t affect you at all……. Me and my husband
sell it, he gets from home and I can take it anytime I want Interviewer:- I would just like to advise you that Khat is a stimulant just like other drugs and it can affect the health of the child. Would you consider stopping for the duration of the pregnancy? I can try but I know it doesn’t affect because people in my area take it every day. − 16 year old married |
| Plans for the future | |
| a. Will have to plan a life independently | I volunteer as a social worker and have some savings from a previous job and I think it may not be enough but I can manage on my own…..I don’t see him thinking ahead and preparing for the future life together-18 year old social worker |
| b. Parents/partner plan to send me back to school | Makosa imefanyika. Sisi tutatunza mtoto, arudi shuleni The mistake has already happened so we are going to take care of the child and she goes back to school- 15 year old’s mother Mimi pia nataka kupeana mtoto kwa vile siwezi mulea na nataka nirudi shule. I would also like to give up my child because I cannot take care of it and I also want to go back to school- 15 year old Interviewer:“Did you want to continue with school but you were unable to that’s why you went to get married?” Adolescent: “Yes, he had promised to take me to school after delivery” - 16 year old |
| c. We live on meagre resources so don’t know how we will look after the baby | “I do not have a job. I am dependent on my husband. We have 3 children; the last 2 were twins 10 months old. It’s been hard living with her and this pregnancy. I cannot take care of another child”– 15 year old’s mother |