This study investigated the proportion of unintended pregnancies among mothers attending Glenview polyclinic in Zimbabwe. The study found that 31.6% of pregnancies were unintended. The first and second pregnancies had the highest proportion of unintended pregnancies. Factors significantly associated with unintended pregnancy included being unmarried, considering abortion, maternal age under 20 or over 30, and contraceptive failure. The study recommends that family planning organizations encourage alternative contraceptive methods after the second pregnancy and that the Ministry of Health prevent sales of contraceptives from unregistered sources.

1. The following presentation by fourth
year medical students (as presented
on October 27th 2007) won a prize in
the best young presenter category
at the University of Zimbabwe
Annual Medical Research Day.
NOTES
(The maximum allowable presentation time was 10 minutes)
It would have been apt to present baseline characteristics of participants
Odds ratios were unadjusted
Questions from the questionnaire(s) are available on request from the uploader

3. TITLE
An investigation of the proportion of
unintended pregnancies and associated
factors among mothers attending Glenview
polyclinic.
Masukume G, Mapondera H, Masuka J, Mhlanga T, Shamu S
(Department of Community Medicine)

4. PRESENTATION PLAN
1. Introduction
2. Literature review
3. Statement of problem
4. Objectives
5. Methodology
6. Results
7. Conclusion
8. Recommendations
9. Acknowledgements

5. Introduction
Unwanted Mistimed
Unintended1
1World Health Organisation; Sexual and reproductive health; Online
[http://www.who.int/whr/2002/chapter4/en/index5.html] Accessed 15-06-
2007

6. Literature review (1)
Table 1. Proportion of unintended pregnancies
C o u n t r y Y e a r P r o p o r t i o n % S e t t i n g
U S A 1 9 9 5 5 6 -
Z im b a b w e 2 1 9 9 7 4 1 H o s p i t a l - b a s e d
I r a n 1 9 9 8 3 3 . 9 H o s p i t a l - b a s e d
E g y p t 2 0 0 1 2 3 . 6 C o m m u n i t y - b a s e d
2Mbizvo MT, Bondeulle MM, Chadzuka S, Linmark G, Nystrom L; Unplanned
pregnancies in Harare, Zimbabwe: what is the contraceptive history and
awareness of the mothers?; Central African Journal of Medicine; 1997
Jul;43(7):200-5.

7. Literature review (2)
Numerous factors associated with unintended
pregnancies3,4,5,6
These include:
•not being married
•problems with the partner
•physical violence
•extremes of reproductive age
•spacing of children
•economic issues
•abortion
•low birth weight
3 G Sedgh, A Bankole, B Oye-Adeniran, IF Adewole, S Singh, R Hussain: Unwanted pregnancies
and associated factors among Nigerian women; International Family planning perspectives; Vol 32
No 4; December 2006; page 175-185
4 S Jahanfar, SM Hashemi, FR Tehrani: Unwanted pregnancy in Tehran, What are the risk factors?;
1998 Online [http://mwia.regional.org.au/papers/ull/18_jahanfar.htm] Accessed 15-06-2007

8. Literature review (3)
factors continued...
•substance misuse
•emotional neglect during childhood
•unqualified family planning services
•contraception failure (user or method)
•history of previous unintended pregnancy
•complications during pregnancy and delivery
•educational and occupational status of the couple
5 RM Youssef, II Moubarak, YA Gaffar, HY Atta; Correlates of unintended pregnancy in Beheira
governorate, Egypt; Eastern Mediterranean Health Journal ; Volume 8, No. 4&5 , September 2002.
6 S Faghihzadeh, GB Rochee, M Lmyian, F Mansourian, P Rezasoltani; Factors associated with
unwanted pregnancy; Journal of sex and marital therapy; 2003, vol. 29, No 2, pages 157-164

9. Statement of problem
•Antenatal polyclinic records ~ 35% of women,
experienced complications during pregnancy or will have
booked late or not at all.
•Were these women really concerned or did they want
their pregnancy?
•Could this be the core issue resulting in late booking and
subsequently, complications?
•Given the important associations of unintended
pregnancies - what was the situation at Glenview
polyclinic?

10. Objectives
1. To determine the proportion of unintended
pregnancies.
2. To characterise the proportion of unintended
pregnancies according to pregnancy number.
3. To ascertain the level to which certain factors are
related to unintended pregnancy.
4. To make recommendations to appropriate stake
holders.

11. Methodology (1)
DESIGN: Descriptive cross-sectional study
SETTING: Glenview polyclinic
SUBJECTS: Mothers attending child
immunisation, growth and
development monitoring sessions
SAMPLE SIZE: n > (1.96)2 x 0.20(1-0.20)
(0.05)2
n > 246
SAMPLING METHOD: Convenience systematic
sampling where all mothers from
whom informed consent had
been obtained were interviewed

12. Methodology (2)
METHOD: Face-to-face interview using a
questionnaire
Shona questionnaire - (21 questions)
•Section A, towards mother
•Section B, partner details

13. Data management
DATA ENTRY: - Tally sheet
QUALITY CONTROL: - Verification between groups
DATA ANALYSIS: - Epi info version 6
analysed as case-referent study:
cases = unintended pregnancies
referents = intended pregnancies
PRESENTATION: - PowerPoint
descriptive statistics
tables
graphs

14. Results (1)
Table 2. Pregnancy results
Number
Pregnancies 266
Mothers interviewed 135
Unintended pregnancies 84
Intended pregnancies 182
Mean pregnancies per woman = 1.97
Proportion of unintended pregnancies = 31.6%

15. Results (2)
•Attributable to contraceptive failure (33/84) = 39.3%
[Attributable to oral contraceptives (29/33) = 87.9%]
•Acquired contraceptives from unregistered sources such
as vendors at some point in their lives ~ 10%

16. Results (3)
51.2
22.6
11.9 10.7
2.4 1.2
60
50
40
30
20
10
0
1 2 3 4 5 6
Percent
Pregnancy number
Figure 1. Proportion of total unintended pregnancies contributed by
each pregnancy number

17. Results (4)
31.9
24.4
33.3
52.9
50.0 50.0
60
50
40
30
20
10
0
1 2 3 4 5 6
Percent
Pregnancy number
Figure 2. Proportion of unintended pregnancies encountered in
relation to the total number of pregnancies (unintended + intended) for
each pregnancy number

18. 51.2
22.6
11.9 10.7
2.4 1.2
60
50
40
30
20
10
0
1 2 3 4 5 6
Percent
Pregnancy number
31.9
24.4
33.3
52.9
50.0 50.0
60
50
40
30
20
10
0
1 2 3 4 5 6
Percent
Pregnancy number
Figure 3. Comparison of absolute contribution and probability of
unintended pregnancies by each pregnancy number

19. Table 3. Factors where p value < 0.05
Odds
ratio
Confidence
interval
 2
1. Considered abortion 16.76 4.48-73.82 31.91
2. Not married 8.64 4.31-17.18 52.23
3. Booked late or not at all 3.14 1.44-6.99 10.1
4. Age greater than 30 2.76 1.54-6.75 6.32
5. Age less than 20 2.48 1.37-4.51 10.45
6. Partner drank alcohol or smoked 2.38 1.34-4.21 10.24
7. Partner age greater than 30 0.19 0.11-0.33 41.65
Factors where p value > 0.05
8. Complications 1.7 0.95-3.06 3.64
9. Mother dead 1.48 0.81-2.71 1.9
10. Low birth weight 1.87 0.77-4.51 2.33
11. Drank alcohol or smoked 1.19 0.69-5.20 1.93
12. HIV test not done or collected 1.39 0.80-2.42 1.51
13. Partner education greater than Form 4 1.29 0.75-2.22 0.98
14. Education less than Form 4 1.29 0.69-2.41 0.72
15. Partner education less than Form 4 1.64 0.36-7.23 0.53
16. Unemployed 1.2 0.67-216 0.43
17. Partner age less than 20 0.75 0.03-8.20 0.06

20. Conclusions
•31.6% unintended pregnancies
•?? 2nd pregnancy most desired
•Associated factors:
e.g. considering abortion, not unmarried, age < 20,
age > 30 and contraception failure significantly
associated
Two major groups affected:
1. Women not married below the age of 20, not using
contraception and with a possibly deceased mother.
2. Married women beyond their second pregnancies, who
are using contraceptive pills and possibly more than 30
years old.

21. Recommendations
•ZNFPC - encourage use of
other methods beyond 2nd
pregnancy.
•Ministry of Health – Prevent
sales of contraceptives from
unregistered sources.

22. Acknowledgements and thanks
•Participants
•Nurses and staff at Glenview
Polyclinic
•Supervisor - Mr S. Shamu
•Mr Ngulube – Shona translation
•Community Medicine Department

23. THANK YOU!!!