University Wide Seminar By Best Seminar of the year presented by Natnael Dechasa Gemeda at Dire Dawa University regarding the burden of unintended pregnancy among Ethiopia's higher education students and its possible solutions.

1. COLLEGE OF MEDICINE AND HEALTH
SCIENCES.
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Seminar topic
The burden of unintended pregnancy and related problems
among Ethiopia's higher institution students.
BY - Natnael Dechasa(MSc ,In Clinical Midwifery)

2. Welcome!
And Thanks for joining me!
Hear I present you an issue of concern not addressed
well in our health system .
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Presentation outline ...
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Introduction
Objective
Burden
World Health Organization
guidelines.
Recommendations ( Ethiopia
context)
08
05
04
Good experiences of
developed countries
07
A way forward
Causes
06

4. Introduction
Unintended pregnancy is pregnancy that is either mistimed or
unwanted at conception for at least one of the couple.(WHO,2018)
Mistimed is generally defined as a pregnancy that is desired
later in life.
Unwanted is defined as not wanted then or at any time in the
future. .
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5. Introduction
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Globally unintended pregnancies remains a major social and health
problems that affects women, their families, society and nation
Large proportion of unintended pregnancies end in abortion.
Abortion can result in serious long-term negative health effects
including infertility ,maternal death, and other complications.

6. Introduction...
Causes of unintended pregnancy .
Curiosity for experimentation of sex.
Peer pressure.
Lack of parental guidance.
Lack of information on birth control method and safe sex.
Economic problem.
Influence of alcohol ,chat or other drugs.
Rape.
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7. EFFECTS /IMPACTS/ OF …
Interruption of education
Financial burden.
Educational and job concerns
Medical problem.
Emotional problems
Effect on families & children
Impact on society.
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8. Global burden of
unintended pregnancy.
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12. Global burden...
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World wide
Globally 210 million pregnancies occur each year, 80 million of
them are unintended pregnancies,
About 45 million of which are terminated/aborted/.
30% of these abortions are unsafe. &
Every year about 68,000 women die from complications of
unsafe abortion (WHO facts,2020

13. National burden.../Ethiopia/
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Multilevel analysis done using 2016 EDHS data also shows the prevalence
of unintended pregnancy in Ethiopia is 26.6% (Damtie, Kefale et al. 2020)
Of total maternal death in Ethiopia 20 % maternal mortality is due to
unwanted pregnancy & abortion related complication (EDHS,2016)
Also incidence of unwanted pregnancies and abortion-related problems
are ,becoming more pronounced and increasing among Ethiopian higher
institution students. (Belay, Alem et al. 2020)
A systematic review conducted among university and college students on
risky sexual behavior indicates that 41.62% of the students have risky
sexual behaviors. (Abiy A. et al ,2019)

14. Objectives of this seminar.
Stating the current burden and severity of the problem among
Ethiopian university students.
Discussing on pathways and drivers of the problem.
Sharing the good experiences of developed countries in combating
unwanted pregnancy.
Describe WHO guidelines on preventing adolescent pregnancy in
developing countries.
Making recommendation to minimize the burden(in our context).
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15. Burden of ... among Ethiopian higher
institutions students.
Madawalabu University students
Among participants 16 % of the females ever had sexual intercourse.
The median age for sexual debut was 18±3.6 SD years.
Among those who ever had sexual intercourse 27.9% started sexual
intercourse after joining the campus.
The overall prevalence of pregnancy was 8.1% from total
respondents.
Almost more than 90% of this pregnancies were unintended.(Motuma et
al BMC 2019)
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16. Burden of unintended pregnancy among
Ethiopian university students.
Bahir dar university students.
The prevalence of pregnancy was 10%. (Belay, Alem et al. 2020).
Wachamo University students
The prevalence of pregnancy was 16 %,(Mitiku, Demissie et al.
2019).
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17. Determinant factors for unintended pregnancy
Socio demographic related factors
Pocket money below 400 birr per month
Absence of engagement in religious service
Engagement in risky behaviors related factors
Drinking alcohol
Smoking cigarette,
Watching pornographic film
(Arega et al. BMC (2019)(Mohammed et al ,2017)(Sorato M, Belijo Z,2019)(Tomas T, Asfew
E, Anteneh K ,2018) G. Teferi Mengistu et al ,2022)
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18. Determinant factors of unintended pregnancy...
Communication related factors
Poor exposure to reproductive health information
Poor parental communication on sexual & reproductive
health.
Personal related factors
Having many friends ( male /female)
Living out side the university (non dorm)
Having sexual experienced friends.
Mohammed et al ,2017)(Sorato M, Belijo Z,2019)(Tomas T, Asfew E, Anteneh K ,2018) G. Teferi
Mengistu et al ,2022)
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19. World Health Organization
guidelines on preventing adolescents
pregnancy in developing countries.
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20. WHO guidelines on preventing....
1.Comphrensive sexuality education provision.
Interventions such as health education and creation of supportive
environments.
Ensuring provision of correct information regarding contraceptive use
and services.
2. Prevention of violence against girls support and care
Interventions for adolescent to resist coerced sex.
Implement programs aimed at developing life skills in communication
,negotiation and improving their links to social networks and their
ability to obtain support if they experience coerced sex.
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21. WHO guidelines on preventing....
3. Prevention of harmful traditional practice
 Encourage political leaders, and community leaders to formulate laws
and policies to prohibit marriage of girls before 18 years of age.
 Interventions to delay marriage of girls until 18 years of age by
influencing family and community norms.
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22. WHO guidelines on preventing...
4.Contraception counseling and provisions
Undertake interventions to influence community to support access to
contraceptives for adolescents.
Implement interventions to improve health service delivery to
adolescents as a means of facilitating their access and use of
contraceptive services.
Implement interventions to reduce the financial cost of
contraceptives to adolescents.
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23. Good experiences of developed countries in
combating unintended pregnancy in higher
institution students.
(UNICEF and UNFPA ,2020)
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24. Experiences developed countries.
1.Using different approaches for different patterns
Adolescent pregnancy observed across the world require different
intervention strategies.to address different drivers and patterns of
adolescent pregnancy.
Using multi intervention tailored to the country context .
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25. Experiences developed countries...
2. Overview of global evidence for Interventions
 Globally, there is growing evidence for effective interventions to
address adolescent pregnancy .
Examples of intervention.....
 Sex education in curriculum.
 Economic Incentives .
 Keeping students in school.
.
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26. Experiences developed countries...
4. Concerns on pathways and drivers.
 Research on the patterns, pathways and drivers of adolescent
pregnancy is needed in each country context.
5. Designing intervention strategies
 Engaging stakeholders in policy development and programs
interventions.
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27. RECOMMENDATIONS /OUR CONTEXT/....
Ethiopian ministry of education
Incorporating sexual and reproductive health education as part of
curriculum.
Economic support for female students.
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28. RECOMMENDATIONS /OUR CONTEXT/....
To universities
Non dorm should not be allowed.
Functional Sexual & reproductive health service.
Attractive recreation centers.
Youths encouragement against pressure from their peer to practice
sexual activities.
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29. RECOMMENDATIONS /OUR CONTEXT/....
To universities...
Step up reproductive health club at the university to bring behavior
change among the students.
Have strong legislation against rape and other sexual activity within
the university..
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30. RECOMMENDATIONS /OUR CONTEXT/.......
To CMHS and gender office
 Have to organize different programs targeting at bringing
behavioral changes.
 Information dissemination should be given with particular attention
to viewing pornography ,alcohol drinking, chat chewing to reduce
sexual and reproductive health bad consequences.
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31. RECOMMENDATIONS /OUR CONTEXT/....
To Families
 To focus important things during developing child such as
restricting access to games and films & that is appropriate to their
age only.
 To have open discussion regarding sexual issues with in the family.
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32. RECOMMENDATIONS /OUR CONTEXT/.......
To religious centers
 Strength students connectedness to their own religions.
To researchers
 Calls for future studies that are strong enough to determine
causality of unintended pregnancy to peak out the real deterrent
behind.
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33. Discussion points
1. How can Dire Dawa university minimize the risk of unintended
pregnancy.
2. What is the role of other stakeholders, and how can we engage
. them to minimize the burden of problem.
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A WAY FORWARD

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THANK YOU !
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