HEALTH BELIEFS AND PRACTICES OF PREGNANT TEENAGERS

TOWARDS HEALTH SERVICES

An Undergraduate Thesis Presented to the Faculty

Of the College of Health Sciences
Department of Nursing
Holy Name University
Tagbilaran City

by

Charlyn P. Cagampang
Ma. Vina C. Galorio
Leene Lorraine E. Gamayon
Mia Danica D. Goder

March 2020
 ii

APPROVAL SHEET

This thesis entitled, “Health Beliefs and Practices of Pregnant

Teenagers towards Health Services”, prepared and submitted by Charlyn P.
Cagampang, Ma. Vina C. Galorio, Leene Lorraine E. Gamayon, and Mia Danica
D. Goder, in partial fulfillment of the requirements for the degree, Bachelor of
Science in Nursing, has been examined and recommended for approval and
acceptance for oral examination.

JUDITH L. GODINEZ, RN, MAN

Content Adviser
Faculty, College of Health Sciences

LILY BETH LUMAGBAS, PhD, MPhil, EMMB

Technical Adviser

PANEL OF EXAMINERS

Approved by the Committee on Oral Examination with a grade of _________

RUVIH JOY P. GARROTE, RN, MN

Chairman
Dean/Chair, College of Health Sciences

LOUILA JOY V. DE CLARO RN, MAN TYRONE C. HORA, JD, RN, MAN
Member Member
Faculty, College of Health Sciences Academic Chairman,
College of Health Sciences
 iii

ACCEPTANCE SHEET

Accepted and approved in partial fulfillment of the requirements for the

degree of Bachelor of Science in Nursing.

TYRONE C. HORA, JD, RN, MAN

Academic Chairman, College of Health Sciences
______________________
Date

LOURDES T. BABOR, RN, MAN

RLE Chairman, College of Health Sciences
______________________
Date

RUVIH JOY P. GARROTE, RN, MN

Dean, College of Health Sciences
______________________
Date
 iv

ACKNOWLEDGEMENTS

This study would not have been possible without the guidance and the

help of several individuals who in one way or another contributed and extended

their valuable assistance in the preparation and completion of this study.

First and foremost, our utmost gratitude to Dr. Lily Beth Lumagbas, Ph.D,

NRES 1 adviser, whose knowledge and expertise helped us in constructing our

study.

Judith Godinez, RN, MAN, our content and theoretical adviser, whose

unfailing advice, knowledge and encouragement in giving corrections and some

suggestions for the improvement of our study.

Louila Joy de Claro, RN, MAN, NRES II adviser for her steadfast

encouragement to complete this study.

Ruvih Joy Garrote, RN, MN, Dean of College of Health Sciences,

Department of Nursing, for the words of encouragement to comply with the

requirements for our study.

Leonita Relamida, RN, former PopCom officer, and Lilia Campecino,

RM, Midwife II of Lower Cogon, Tagbilaran City, who helped us in gathering data

and information for our study.

The staff of the Rural Health Unit of Barangay Cogon for accommodating

our queries and for all the assistance they extended.

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DEDICATION

This study is dedicated to our supportive parents, who gave us strength

and source of inspiration throughout this journey.

To our brothers, sisters, relatives, mentors, friends, and classmates who

shared their heartfelt advice and words of encouragement to overcome the

struggles to finish this study.

And lastly, we dedicated this study to our Almighty God, we thank you for

the enlightenment, guidance, strength, protection, and skills that you bestowed

upon us. All of these, we offer to you.

 vi

Name: Cagampang, Charlyn

Galorio, Ma. Vina
Gamayon, Leene Lorraine
Goder, Mia Danica

Research Title: HEALTH BELIEFS AND PRACTICES OF PREGNANT

TEENAGERS TOWARDS HEALTH SERVICES

Date Defended: November 15, 2019

Adviser: Prof. Judith L. Godinez, RN, MAN

ABSTRACT

Teenage pregnancy has become a public concern which has generated a

great deal of attention in the locality, because of the need to address this public
issue this becomes a part of the concerns of a government program (Adolescent
Health and Development Program) of the Department of Health. It is one of the
key component programs of the Philippine Population Management Program
(PPMP).  
This study aims to help spread awareness regarding the programs and
services that can be rendered to teenage mothers and to know the hindrances
they have encountered that prevent them from availing these services. The
purpose of the study is to explore the reasons why they haven’t avail the
programs and teenage mother’s perception on Health Care Services.
This is a qualitative study with the aid of guide questions and one-on-one
interview as the main tool for gathering data from the respondents. Several
questions regarding their perceptions on their pregnancy and the reasons why
they didn’t avail the services offered by the government were asked. Feeling
ashamed was the major response but respondents were able to overcome the
shame and they accepted the criticisms thrown at them. Confidentiality issues
were also a common response. Most of the respondents do not know about
prenatal. Health care beliefs and practices and the availability of the programs of
the teenage pregnant mothers hinder them to avail the programs and services of
the provider.
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TABLE OF CONTENTS
PAGE
Title Page

Approval Sheet……………………………………………………………………….. ii

Acceptance Sheet……………………………………………………………………. iii

Acknowledgements…………………………………………………………………… iv

Dedication……………………………………………………………………………… v

Abstract……………………………………………………………………………….... vi

Table of Contents……………………………………………………………………... vii

CHAPTER I THE PROBLEM AND ITS SCOPE PAGE

Introduction

Rationale…………………………………………………………. 1

Theoretical Background………………………………………… 5

Statement of the Problem………………………………………. 15

Significance of the Study………………………………………. 16

Scope and Limitations………………………………………….. 17

 viii

Research Methodology

Research Design……………………………………………..... 18

Research Environment………………………………………… 18

Research Participants…………………………………………. 18

Research Instruments………………………………………….. 19

Research Procedure……………………………………………. 19

Treatment of Data………………………………………………. 19

Definition of Terms……………………………………………… 20

CHAPTER II RESULTS, PRESENTATION, AND ANALYSIS OF DATA …. 22

CHAPTER III SUMMARY, FINDINGS, CONCLUSION, AND

RECOMMENDATIONS

Summary………………………………………………………………….. 27

Findings…………………………………………………………………… 27

Conclusion………………………………………………………………... 28

Recommendations………………………………………………………. 28

REFERENCES…......................................................................................... 31

APPENDICES
 ix

A. Turnitin Result………………………………………………………... 34

B. Transmittal Letters…………………………………………………… 35

C. Guide Questions………………….………………………………….. 37

D. Responses of Participants…………………………………………… 38

CURRICULUM VITAE…………………………………………………………… 42
 CHAPTER I

THE PROBLEM AND ITS SCOPE

INTRODUCTION

Rationale

Humans constitute a society and we humans are influenced by varieties of

ideas or things. These ideas may have positive or negative effect to us and to the

society where we live in. The belief system is one of the main reasons that affect

people’s behavior. Religious, political, scientific and personal belief influence us

on how we live our lives. These interacting groups dictate how we deal with the

different situations in our lives. It is essential to understand what beliefs are from

the different points of view, according to the individual point of view it could be

inferred that personal belief could be identified through looking at the main

attitudes, values and ideas of human beings that makes up a substantive belief.

“A truth assumed by evidence”, when scientists talks about beliefs; academics

relate beliefs to ideas and philosophies in life. As evidenced by these

assumptions, values system are aligned to their activities in order to conduct a

regular life.

Teenage pregnancy is a communal, a personal and a family problem

combined into one family and personal problem which frequently goes hand in

hand with premarital sex.

 According to World Health Organization approximately 16 million girls

aged 15-19 years and 2.5 million girls under 16 years give birth each year in

developing
 2

regions. To the most recent National Demographic and Health Survey

(2017) from the Department of Health, the incidence of teenage pregnancies

remains at a considerable rate. One in ten young Filipino women aged 15-19 has

begun childbearing: 8 percent are already mothers and another 2 percent are

pregnant with their first child according to the results of the 2013 National

Demographic and Health Survey (NDHS). Adolescent pregnancies are a global

problem that occurs in high, middle, and low-income countries. Around the world,

adolescent pregnancies are more likely to occur in marginalized communities,

commonly driven by poverty and lack of education and employment opportunities

(UNFPA. 2015.).

Teenage pregnancy has become a public concern which has generated a

great deal of attention in the locality, because of the need to address this public

issue this becomes a part of the concerns of a government program (Adolescent

Health and Development Program) of the Department of Health. It is one of the

key component programs of the Philippine Population Management Program

(PPMP).  The overall goal of the AHD Program is to contribute to the

improvement and promotion of the total well-being of young Filipinos ages 10-14;

15-19 and 20-24 through their sexual and reproductive health.   Specifically, it

aims to contribute to the reduction of the incidence of teenage pregnancies and

sexually transmitted infections (STIs) and HIV/AIDS among young people.

Moreover, the teenage pregnancy rate in our country is increasing, which

makes it a reason that is should be abolished. According to the United Nations

Populations Fund (UNFPA) and Philippine Statistics Authority; Teen pregnancy

 3

in the Philippines increased by 65% from 2000 to 2010, an estimated 24 babies

are born to teen mothers every hour.

This issue comes with many downfalls for both the teen mom and child.

Maturity level and current lifestyle are some of the major categories in

determining if someone is already fit to become a mother and neither of these

categories is acceptable for teenage moms.

. In our world today, the causes of teenage pregnancy is different in the

sense that it is mostly outside marriage and carries lots of social stigma. Thus,

adolescent sexual behavior is one of the causes of teenage pregnancy. In the

developed world, having sex before 20 yrs. is the “in” thing, it is even normal all

over the world and this is brought about high levels of adolescent pregnancy

which creates sexual relationships among teenagers without the provision of

comprehensive information about sex.

In the year 2017, Dampas district Tagbilaran City gained the highest

number of teenage pregnant aging 14-19 and there were 28 teens recorded. In

the year 2018, barangay Booy gained the highest teenage pregnancy rate of 14

teenagers. Again 14 teenage mothers we're recorded and made barangay upper

cogon the barangay with the highest rate of teenage pregnancy, January – June

2019.

In our society today, it cannot be denied that teenage mothers generally

do not have the resources to care for a child and often they are not able to

sustain healthy habits throughout pregnancy to ensure they produce a healthy

baby. Oftentimes, these young females did not complete their education.
 4

The economic status of a young mother has a great effect. Teenage

mother’s poverty status is currently on the rise due to the decreased likelihood of

the teenager to complete school besides the lack of financial capacity of the

mother. Since the child would not get a better education because of the limited

opportunity for the parents to seek better employment, this poverty situation has

a tendency to be prolonged in life. There is also a huge possible or a higher rate

of infant mortality. Teens get involved in sexual activities at a young age there is

no one to guide and counsel them about the possible implications of early

pregnancy. Because young mothers never planned for it, when babies from

these teenagers are born, they are normally not healthy. Married individuals that

are yearning to have a baby anytime is a properly planned pregnancy. Most

cases of abandoning responsibilities involve teen parents who were not ready for

a child because they can’t afford to raise the baby. This situation may occur

when teenagers are poor or have no plans on how they will get financial support

to make life comfortable.

The researcher's motivation to conduct this study is to encourage teenage

mothers to participate and avail of the different programs and services of the

government and hopefully make them realize the importance of responsible

parenting. This study aims to help spread awareness regarding the programs

and services that can be rendered to teenage mothers and to know the

hindrances they have encountered that prevent them from availing these

services. The purpose of the study is to explore the reasons why they haven’t

avail the programs and teenage mother’s perception on Health Care Services.
 5

THEORETICAL BACKGROUND

The study is based on Rosenstock’s Health Belief Model describes the

relationship between a person’s belief and behavior. Individual perceptions and

modifying factors may influence health beliefs and preventive health behavior.

There are six concepts of Health Belief Model the perceived susceptibility,

perceived severity, perceived benefits, perceived barriers, cues to action, self-

efficacy. One’s belief in the efficacy of the advised action to reduce risk or

seriousness of impact is explained on the concept of perceived benefits.

Perceived severity explains one’s opinion of how serious a condition and its

consequences. Perceived benefits talks about one’s belief in the efficacy of the

advised action to reduce risk or seriousness of impact. One’s opinion of tangible

and psychological cause of the advised action is explained through the perceived

barriers. Cues to action are strategies to activate readiness. Self-efficacy is the

confidence in one’s ability to take action.

Pender (1982; 1996) defines health promotion model health as a positive

dynamic state not merely the absence of disease. It is designed to be a

complementary counterpart to models of health protection. Health promotion

aims to promote the well-being of a client. The promotion model describes the

nature of the person as multidimensional as they interact within their environment

to pursue health. Every person has unique personal characteristics and

experiences that affects subsequent actions as noted by the health promotion

 6

model. There are important motivational significance based on the set of

variables for behavioral

RA 10354

 Health Belief Model “The Responsible

 Social Learning Theory Parenthood and
 Health Promotion Model Reproductive Health Act of
2012” Sec. 14

Teenage Mothers and Pregnant Teens

HEALTH BELIEFS AND PRACTICES OF

PREGNANT TEENAGERS TOWARDS HEALTH
SERVICES
 Pre- natal Care
 Health Care Services
 Health beliefs and practice

Recommendations
 7

Figure 1

Conceptual Framework of the Study

specific knowledge and affect. These variables can be modified through nursing

action. Individual characteristics and experiences, behavior-specific cognition

and affect; and behavioral outcomes are the three area which the health

promotion model focuses on. Improved health, enhance functional ability and

better quality of life at all stages of development should be the results of health

promoting models.

In social learning theory, concur with the behaviorist learning theories of

operant conditioning and classical conditioning, were he adds 2 important ideas:

a. mediating process occurs between stimuli and responses and; b. behavior is

learned from the environment through the process of observational learning

(Bandura, 1977).

Children are very observant, they observe people around them behaving

in different ways. People that the children observed are called models. In our

society, children are surrounded by many influential models such as parents,

family members, and other children. These models give an example of behavior

to observe and imitate.

The Responsible Parenthood and Reproductive Health Act of

2012 (Republic Act No. 10354), informally known as the Reproductive Health

Law or RH Law, SEC. 14, Age- and Development-Appropriate Reproductive

Health Education. Guarantees that the State shall provide age- and

development-appropriate reproductive health education to adolescents which

shall be taught by adequately trained teachers informal and non-formal

 8

educational system and integrated in relevant subjects such as, but not limited to,

values formation; knowledge and skills in self-protection against discrimination;

sexual abuse and violence against women and children and other forms of

gender-based violence and teen pregnancy; physical, social and emotional

changes in adolescents; women’s rights and children’s rights; responsible

teenage behavior; gender and development; and responsible parenthood:

Provided, That flexibility in the formulation and adoption of appropriate course

content, scope, and methodology in each educational level or group shall be

allowed only after consultations with parents-teachers-community associations,

school officials and other interest groups. The Department of Education (DepED)

shall formulate a curriculum which shall be used by public schools and may be

adopted by private schools.

In most western countries, teenage childbearing is viewed as an important

public health problem (Botting et al., 1998). Majority population peers, like school

failure, low family socioeconomic status, intergenerational transmission of

teenage parenthood and family disruption are more prominent risk factors found

in studies of teenage childbirth (Barn et al., 2007).

Teenage child bearing is also a contextual phenomenon, although

teenage motherhood gradually has become more infrequent in many countries

due to enhanced employment opportunities and the accessibility of

contraception, elongated education (Robson & Berthoud, 2003). Teenagers

involved with the child welfare system have far higher rates than peers. Studies

of risk factors for teenage childbirths among child welfare youth have produced a
 9

considerable variation of result, mostly based on small sample studies. Several

factors are being stressed by several scholars like adverse family background

(often coupled with poverty), specific characteristics of OHC environments,

experiences or child maltreatment are highly frequent in this subgroup. The study

asks whether the pattern and strength of risk factors for teenage childbirth are

the same for young females that have been involved with the welfare system

during their formative years, as for their in the majority population (Olavsson et

al., 2001).

According to the National Campaign website, the teenage birth rate is

highest in the United States compared to their industrialized countries. About # to

10 teenagers get pregnant and the teenage birth rate was on a decline for 15

years, but in 2010, the rate started to increase. Many teens engage in unhealthy

activities so that their peers will notice them or so that they may fit in. according

to Psychology today, boys feel pressure to have sex before they are ready.

Teens were more likely to get easily pregnant if they were living with only

one parent, guardian r relatives and have family problems (Vermon et al., 1983).

An intact family was related positively to teen’s educational attainment and age of

family formations. Moreover, the father’s presence in the home was related to

delayed sexual activity in teen daughters (Moore et al., 1980).

Young people who have been disadvantaged and have poor expectations

of either their education or the job market teenage pregnancy is more common.

Issues such as puberty, contraception and, pregnancy are revealed that teenager

to be ignorant (Mwaba, 2000). Unnecessary heartache for many young women is

 10

caused by ignorance, aggravated by cultural taboos to discuss sex with one’s

parents, combined with real or perceived peer group’s pressure to engage in

sexual activities (Morate, 2011).

The increased risk of early pregnancy is strongly associated with and

contribute to several factors this factors include lack of knowledge about sex and

how to use contraceptives, barriers to access contraceptives including negative

attitudes of health staffs, sexual coercion, low self-esteem, peer pressure, low

educational expectations, family breakdown, poverty and heightened sex based

messages in the media. Receiving the injectable contraceptives ends stated that

condoms were not their birth control method of choice as expressed by teenage

girls as their preference. Sex with a condom is not enjoyable that is why teenage

boys refused to used condoms. Lack of knowledge about contraception and

many other misconceptions was the result of teenage pregnancies. Other

reasons for not utilizing the contraceptives were that teenagers were reluctant to

take contraceptive precautions for fear of complications and parenteral infections

despite their knowledge about the importance of the use of those contraceptives.

Those who were knowledgeable about contraceptives chose not to use them or

keep the use of any contraceptives a secret. It was said that injectable

contraceptives cause weight gain and watery discharges that is why

contraceptive pills were only taken when they planned sexual intercourse or only

after the engagement because it could prevent them from becoming pregnant

(Mwaba, 2000).
 11

One of the major problems that occur in high, middle and low-income

countries is adolescent pregnancies. Adolescent pregnancies are more likely to

occur in marginalized communities around the world, commonly driven by a lack

of education, poverty and employment opportunities (UNFPA, 2015). A major

contributor to maternal and child mortality, and to an intergenerational cycle of ill-

health and poverty is adolescent pregnancy. The leading cause of death among

15 to 19-year-old girls worldwide is pregnancy and childbirth complications, with

low and middle-income countries accounting for 99% of global maternal deaths

of young mother’s ages15 to 49 years (WHO, 2016). Pregnancy and childbirth

are neither planned nor wanted for many adolescents. Twenty-three million girls

aged 15-19 years in developing countries have an unmet need for modern

contraception. Half of pregnancies among girls aged 15 to 19 years in developing

regions are estimated to be unintended (Darroch et al., 2016).

Restrictive laws and policies regarding provisions of contraceptives based

on age or marital status, adolescents’ own inability to access contraceptives

because knowledge financial constraints and transportation, health worker bias

and lack of willingness to acknowledge adolescents’ sexual health needs are

some of the barriers that adolescents face. Adolescents face barriers that

prevent use or consistent and correct use of contraception’s, even when

adolescents are able to obtain contraceptives; lack of knowledge on correct use;

stigma surrounding non- marital sexual activity and contraceptive use, fear of

side effects and pressure to have children (WHO, 2013).

 12

In a study on health care access to sexual and reproductive health

services remains a critical challenge. In some places, reproduction health

services are inaccessible or limited. The study conducted focused on pregnant

teenagers where they viewed condoms as ineffective for pregnancies. They are

also afraid of being judged by the society where they live in. Privacy in the clinic

is also an issue for young females, it looks like they do not trust the way

personnel handle the confidentiality of their clients, this is one of the reasons also

that young mothers are discouraged to seek reproductive healthcare services.

Since the healthcare access is limited and because of the stigma the Tanzanian

Ministry of Health, recommends that the local health management should

introduce youth-friendly reproductive health services into Public Health Offices.

This is to seek ways on how to improve and how to have realistic interventions

that are effective to increase care-seeking for young mothers (Hokororo ,2015.).

There are many barriers to contraceptive use. Some women were not able

to access contraceptive because they lack knowledge about it, poo-quality

service and especially they lack resources or they don’t have the budget for it.

There is also involvement from the Catholic Church since the Philippines is a

catholic country, and valuing life is a golden value of the Filipino mindset. The

government also failed to improve access to health care including contraceptive

services for the economically challenged people. The LGU has not fully met their

responsibility. The aid is not that enough to support the needs of the people

especially those who are living in far-flung areas where most of the mothers have

limited access to healthcare (Ron et al., 2010)

 13

The word mother means a female parent who brings up a child, takes care

of her and loves absolutely by potting the needs of her children over her own.

Being a mother can be extremely fulfilling but it has got its fair share of

challenges. Some mothers have difficulty while pregnant and in giving birth to

their babies. The vision of the National Safe Motherhood Program is for the

Filipino women to have full access to health services towards making their

pregnancy and delivery safer. This is to improve maternal and neonatal health.

To improve quality and access to family planning and maternal health care

services. Let mothers to safely give birth in health facilities near their homes

(Department of Health Philippines).

In 1997, the pregnancy rate among 15- to 17-year-old adolescents in

Minneapolis was 79.4 per 1000 (unpublished data, Minneapolis Department of

Health and Family Support, 1997), compared with state and national rates of

32.0 and 57.1, respectively.1 In response to this major public health concern, the

Minneapolis Department of Health and Family Support looked to its high school–

based clinics to help improve pregnancy prevention. The Minneapolis

Department of Health and Family Support operates comprehensive school-based

clinics (SBCs) in 5 traditional high schools. Parents have the choice of allowing

their child to receive (1) any SBC service, (2) any service other than

contraceptive counseling and birth control prescriptions, or (3) no services. In the

past, students requesting contraceptives from SBCs had been given vouchers to

pick up the contraceptives at community clinics at no cost. Because many

vouchers went unfilled, a new policy involving direct on-site distribution of

 14

contraceptives was instituted in May 1998. (Appointments were necessary for

requesting contraceptives.) In the present study, we sought to evaluate the

effects of the change in distribution systems on students’ receipt of requested

contraceptives and demand for contraceptives from SBCs (Sidebottom et al.,

2003).

Nutrition and wellbeing may be affected by many factors for adolescent

mothers in rural Eastern Uganda. Informing community-based strategies is

important to identify individual and environmental needs and obstacles at the

local level. This empirical research used interviews based on social cognitive

theory concepts. In the sub-county of Budondo (district of Jinja), Eastern

Uganda, 101 teenage parents, family members, health-related staff and

community workers were interviewed. Young mothers had needs related to

returning to school, home-based small businesses; social needs, family support,

jobs, housing, food, personal land and animals, medical care and supply

materials. Obstacles to meet their needs including: lack of income generation

and food preparation skills, harsh treatment, the cost of childbirth and childcare,

lack of academic qualifications, lack of adequate shelter and property, lack of

complementary feed for children, insufficient access to medications, personalized

health care and adequate communications. Using the social cognitive context,

this study identified a myriad of young mothers ' needs and obstacles to

improving nutrition and health for mother/child. Findings can help direct potential

strategies for better nutrition and health of adolescent maternal / child

(Nabugoomu et al., 2018).

 15

Behind many of the barriers to service delivery are the perceptions that

young pregnant women have about health service providers. These perceptions

are informed by low self-confidence, fear, and expectation of being judged.

Across service types for all young pregnant women and mother, barriers that

were common are literacy problems, lack of knowledge, cost, transport,

characteristics of local neighborhoods that discouraged service access, a lack of

time or routine, lack of social and family support and previous negative

experiences with health service providers. The major barrier is constituted by the

lack of available services since the absence of service necessarily mean that the

service will not be accessible. Other barriers to childcare are cost and local

availability. Feeling uncomfortable near older mothers in waiting rooms and

finding individual nurses as too judgmental and bossy were the barriers to the

use of early childhood health centers, in addition to feeling as though the

services were unnecessary (Deborah Loxton et al., 2007).

THE PROBLEM

Statement of the Problem

 16

The purpose of this study is to explore the health beliefs and practices of

pregnant teenagers towards the programs and services under public health

centers.

Specifically, it will answers the following:

1. What is the personal and family profile of the respondents in terms of:

1.1 Educational attainment;

1.2 Family Companion

2. Guide Questions

 What is your perception or belief regarding your situation as

pregnant teenager?

 What are the programs that you know and are familiar with that are

offered by the rural health unit for pregnant teenagers?

 Having this situation, what is your belief or perception towards the

services and programs offered by the rural health for pregnant

teenagers?

SIGNIFICANCE OF THE STUDY

The result of the study would be of importance to the following entities

who may be affected by the untimely pregnancy of the teenagers:

Teenagers/Students. It would provide awareness to the pregnant

teenagers and mothers that there are government programs and health services
 17

available to help them cope up with their pregnancy. With this awareness, they

would realize that pregnancy should be carefully planned and taken care of.

Parents. The parents should also be made aware that their role as

parents does much to prevent pregnancy to occur during the teen years of their

daughters. To prevent early pregnancy among their daughters, it is important for

the parents to be aware.

Community/Society. The community/society should also be involved and

supportive in the promotion of social support of the health of the adolescents, the

family unit and all the residents in a community. They should be participative in

the safeguard of untoward pregnancy.

Nursing Students. The result of the study would be significant for student

nurses. Through authentic and objective data on teenage pregnancy, they could

formulate a health teaching program which would educate the community

especially the teenagers of the consequences of an untimely pregnancy.

Rural Health Workers. They would be provided with exact data on

teenage pregnancy for them to be warned so, they could plan for intervention

strategies to curb this undesirable phenomenon.

Future Researchers. This study will become a venue for the researchers

to apply their study and creative skills. This will also serve as a reference to the

future researchers in pursuing parallel studies.

Scope and Limitation

 18

This study was conducted at one of the barangays in Tagbilaran City. This

study covers first time teenage mothers age ranges 14-19 years old. During the

conduct of the study, the limitations includes those participants already

transferred to another place. These pregnant teenage mothers and they are

aware that there are programs from the primary health care services but didn’t

avail.

RESEARCH METHODOLOGY

Research Design

The study is qualitative research with the aid of guide questions and one-

on-one interview as the main tool for gathering data from respondents. The data

would the present perception of the respondents on the barriers to the access of

teenage pregnancy program/health services.

Research Environment

The study was conducted in Barangay Cogon, Tagbilaran City. It has a

plain and rolling land terrain. The highest point of elevation is only 55 meters

(180 ft) above sea level. The total land area is 204 hectares (500 acres).

According to the 2015 census, it has a population of 17,750 – the most in the

city. It is generally believed that more than half of its present population is not

native Cogonhanons. According to the City Health Office, Barangay Cogon has
 19

the highest teenage pregnancy cases last January – June 2019 among all the

barangays in Tagbilaran City.

Research Participants

The investigation included 10 teenagers who already are pregnant at the

moment and teenagers who are already a mother within the range of 14-19 years

old with a child 0-1-year-old.

Research Instruments

The researcher used a guide questions to gather data from the target

respondents. The question items were formulated based on the specific

problems posed in the study. Items were carefully selected from the review of

literature and related studies.

Research Procedure

Gathering of data. A written communication was signed by the Dean of the

Nursing Department and was used as an endorsement to the barangay Captain

for asking permission to gather data and conduct a one-on-one interview with the

respondents.

The researchers also seek the help of the barangay health workers to

identify pregnant teenagers and mothers in the barangay.

 20

A cover letter accompanies the guide questions to explain the

respondents as to the purpose of the inquiry. The one-on-one interview with

respondents were done personally by the researchers themselves.

Treatment of Data

A qualitative data were gathered, iterated until all categories had been

exhausted. After the interview, the researchers transcribed the interview. After

the transcription, they were presented to the interviewees to ensure that the

transcription is true to their words. Once the checking was done, analysis and

interpretation began.

Definition of Terms
The following terms are defined operationally in the study to make it study

easy to comprehend:

Teen age pregnancy.

It refers to a state of being pregnant at ages between 14-19 years old.

Services.

Work done or help provided, especially for the public or for a person or an

organization.
 21

Prenatal Care

Is antenatal care, is a type of preventive health care, regular check-ups

that allow doctors or midwives to treat and prevent potential health problems

throughout the course of the pregnancy and to promote healthy lifestyles that

benefit both mother and child.

Shame

Is an unpleasant self-conscious emotion typically associated with a

negative evaluation of self, powerlessness, and worthlessness.

Confidentiality

The state of keeping or being kept secret or private.

Traditions
The transmission of customs or beliefs from generation to generation, or

the fact of being passed on in this way.

22
 CHAPTER II

RESULTS PRESENTATIONS AND ANALYSIS OF DATA

This chapter presents the analysis and interpretation of the gathered data
that answer the inquiries raised in the study. The presentation provides
information on the Barriers on the Access on the Teenage Pregnancy
Program/Health Services. This chapter presents the hindrances that the
respondents encountered.

I. Personal and Family profile

The personal and family profile of the respondents in terms of educational

attainment and family companion.

Four out of school youth teenage mothers, three Junior high school level

and three Senior high level. All of them are staying with their parents.

II.

1. Acceptance because of perception and family support.

A. Acceptance based on their perception.

R1 – “No, I’m proud of having my child because is a gift from God.”

R7 – “No, dawat man nako ug gi suportahan ko sa amahan sa akong

anak.”

R3 – “No, I have to think of the welfare of my child.”

R4 – “No, dawaton nalang nako ang nahitabo.”

 23

R9 – “No, I just accepted it as a consequence of my action.”

R10 – “No, dawaton kay grasya man ni sa Ginoo.”

R3 – “Yes, I only know about prenatal care.”

R2 – “Yes, to monitor about my pregnancy.”

R3 – “Yes, to ensure for the health of the unborn baby.”

Analysis: All the respondents except respondent 8 accepted their pregnancy

through their perception.

A. Family Support

R2 – “Yes, my mother accompanied me to the health for prenatal

care.”

R1 – “parents, and they provided my daily needs.”

R2 – “parents and partner, they provided my needs.”

R3 – “parents, yes provided.”

R4 – “ginikanan, gi hatag nila ang tanan.”

R5 – “sila mama ug papa, o nahatag nila akong panginahanglanon.”

R7 – “ginikanan, gidawat ug gi suportahan nila akong pagbuntis.”

R6 – “ginikanan, gesuportahan nila akong pagbuntis.”

R8 – “parents, yes they supported my pregnancy.”

R9 – “parents, they provided my daily needs.”

R10 – “silang tatay ug nanay, gihatag man nila akong gipangayo labina

sa panginahanglan sa bata.”
 24

Analysis: All the respondents stated that they were supported financially by their

parents. R2 stated that she was accompanied by her mother to have prenatal

care which shows acceptance.

2. Ignoring the stigma because of trust

A. Trust to the health care providers

R1 - “Yes, because it is part of their job”

R2 – “Yes, because they can be trusted”

R3 – “Yes, because I trust them”

R8 – “Yes, because I trusted them”

R9 – “Yes, they handle their work professionally”

Analysis: Half of the respondents stated that they trust the health care providers

to keep their pregnancy private.

B. Ignore other people’s judgment

R4 – “Wala nako seryosoha ug unsa ilang gipang ingon nga dautan

bahin naku”

R8 – “I never listened to their assumptions”

Analysis: Among the respondents R4 and R8 stated that they ignored the

criticisms and judgments from other people.

3. Fear of judgment due to breach of confidentiality

A. Fear of breach of confidentiality

R10 – “Yes, kay daghan ug chismosa ani among dapit”

R4 – “No, mahadlok ko basin itabi sa uban”

R5 – “No, kay chismosa man sila”

 25

R7 – “No, dili kalikayan na mang chismis sila”

R10 – “No, dili malikayan na masulti sa uban labi na sa ilang mga

kauban”

Analysis: Half of the respondents states that they are afraid that when they seek

medical attention, their pregnancy may be divulged to other people.

B. Fear of Judgment

R8 – “Yes, because of judgment”

R6 – “Dili mogawas sa balay”

R5 – “Yes, mahadlok ko e-judge sa mga tawo”

R3 – “Yes, I’m afraid to be judge by other people”

R4 – “Yes, mahadlok ko na malain ang pagtan-aw sa ubang tao nako

kay nabuntis ko ug sayo”

R5 – “Yes, mahadlok ko e-judge sa makakita”

R6 – “Yes, mauwaw ko sa unsay maingon sa ubang tao naku”

R8 – “Yes, because of judgment”

Analysis: Half of the respondents stated that they fear that the health care

provider would tell other people about their pregnancy.

4. Knowledge Deficit

R2 – “No, I’m not familiar of any programs”

R4 – “No, wala gyud koy nahibaw-an”

Analysis: Almost all of the respondents are not aware that prenatal program is a

service offered by the government and perceived that they only have to go once

in order to access the government facilities when they give birth.

 26

5. Belief

R7 – “Dili pwede mogawas ug Lunar eclipse. Dili mogawas kay

mamatay ang bata”

R8 – “Dili mogawas ug gabie kay nay wak-wak. Wala man pud

mawala ug motuo”

R10 – “Magpalina sa dili pa manganak. Para daw dili maglisod ug

panganak”

Analysis: Three (3) of the respondents (R7, R8, R10) stated that they still follow

several beliefs and tradition when it comes to their pregnancy.

 CHAPTER III

SUMMARY, FINDINGS, CONCLUSION, AND RECOMMENDATIONS

The following sections detail the summary, findings, conclusion, and

recommendations of this research.

SUMMARY

This study aimed to know the Health Beliefs and Practices of Pregnant

Teenagers towards Services. The respondents answered some guide questions

about their perception regarding their pregnancy. They were asked about the

government programs for pregnant teenagers that they availed and the

respondents’ beliefs and perception about the said program.

FINDINGS

Based on the analysis of the data, the following findings were determined:

1. Of the ten (10) respondents, four (4) were out of school youth, three (3)

were junior high school level and another three (3) senior high school.

Eight (8) of them are living with their family and two (2) of them are living

with their partners.

2. The majority of them, seven (7) respondents expressed that they felt

ashamed of their status and three (3) of them said that they are not

shamed;
 28

the seven (7) respondents who answered that they were ashamed said

that to overcome shame they accepted the criticisms that was thrown at

them. In terms of confidentiality issues, half of the respondents believed

and trusted the health care providers while the other half did not trust

them. In terms of knowledge about programs, only two (2) respondents

know about prenatal. The respondents are supported by their parents

financially. Regarding belief and traditions, only three (3) respondents

answered that they observe several cultural services.

CONCLUSION

It is therefore concluded that the health care beliefs and practices and the

availability of the programs of the teenage pregnant mothers hinders them to

avail the programs and services of the provider.

RECOMMENDATIONS

In view of the conclusion drawn out of the findings of the study, the

following recommendations are presented:

1.) The public health officials are encouraged to give more importance on the

programs for the youth intended to disseminate information in the hope of

preventing teenage pregnancy from increasing.

 29

2.) The teenage pregnancy prevention programs like You for You caravan,

youth summit, and heart-to-heart talk should not only be limited to schools

but there is also a need to localize it to each barangays in the city in order

to reach those out of school youths.

3.) The deployment of communications technology (eg. Internet, SMS) be

used by health care providers in order to advertise services and

communicate with young pregnant women and mothers.

4.) The patient must be visited by the BHW to their respective houses to

disseminate important information about new government programs for

them to avail the program.

5.) To give assurance for the confidentiality of their personal information.

6.) To enhance interpersonal relationships with the patients and health

workers to gain their cooperation.

CONCLUSION

It is therefore concluded that the health care beliefs and practices and the

availability of the programs of the teenage pregnant mothers hinders them to

avail the programs and services of the provider.

REFERENCES
 31

REFERENCES

Brännström, L.,Vinnerljung, B., & Hjern, A. (2015). Risk factors for teenage
childbirths among child welfare clients: Findings from Sweden. Child and
Youth Review Services, 53, 44-51. Retrieved from
https://www.sciencedirect.com/science/article/pii/S0190740915001012.
Accessed on June 30, 2019.

Cook, S. M. (2017). Social issues of teenage pregnancy., Obstetrics,

Gynaecology, & Reproductive Medicine, 27(11), 327-332.
https://www.sciencedirect.com/science/article/pii/S1751721417301707.
Accessed on July 24, 2019.

Hockaday, C. M. (1998). “A prospective study of teen pregnancy”. Retrieved from

https://lib.dr.iastate.edu/cgi/viewcontent.cgi?article=12836&context=rtd.
Accessed on July 12, 2019.

Loxton, D., et al. (2007). Barriers to Service Delivery for Young Pregnant Women
and Mothers. Retrieved from
https://docs.education.gov.au/system/files/doc/other/barriers_to_service_d
elivery_for_young_pregnant_women_and_mothers.pdf . Accessed on 21
August 2019.

Maravilla, J. C., Betts, K., Cuoto e Cruz, A., &. Alati, R. (2017). “Factors
influencing
repeated teenage pregnancy: a review and meta-analysis”, American
Journal of Obstetrics and Gynaecology 217(5), 527-545.e31. Retrieved
from
https://www.sciencedirect.com/science/article/pii/S0002937817305227.
Accessed on July 23, 2019.

Nabugoomu, J. Seruwagi, G.K… Hanning, R. (2018). Needs and Barriers of

Teen
Mothers in Rural Eastern Uganda: Stakeholders’ Perceptions Regarding
Maternal/Child Nutrition and Health, International Journal of Environment
Research and Public Health, 15(12): 2776. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6314007/. Accessed on 23
July 2019.

Sidebottom, A., Birnbaum, A., & Nafstad, S.S. (2003). Decreasing Barriers for
Teens: Evaluation of a New Teenage Pregnancy Prevention Strategy in
School-Based Clinics, American Journal of Public Health, 93(11), 1890-
1892. Retrieved from:
 32

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1448070/ Accessed on
July 22, 2019.

Summers, L., Lee, Y-M., & Lee, H. “Contributing factors of teenage pregnancy
among African-American females living in economically disadvantaged
communities”, Applied Nursing Research, 37, 44-49. Retrieved from:
https://www.sciencedirect.com/science/article/pii/S0897189716301318.
Accessed on 19 July 2019.

Pender, N.J. (2011). Health Promotion Model. Retrieved from

http://currentnursing.com/nursing_theory/health_promotion_model.html .
Accessed on August 18, 2019.

UNFA. Adolescent pregnancy: A review of the evidence. New York: UNFA, 2013.

Videbeck, S. L. (2011). Psychiatric – Mental Health Nursing, 5 th ed. , 47.

Singapore: Lippincott Williams & Wilkins.

https://www.scielo.org.za/pdf/cura/v35n1/09.pdf

https://www.simpltpsychology.org/bandua.html
33
APPENDICES
 34

APPENDIX A
 35

APPENDIX B
Letter to the Barangay Captain of Cogon District Tagbilaran City
Hon. Nicanor S. Besas
Barangay Captain
Cogon District Tagbilaran City

October 4, 2019

RE: PERMISSION TO CARRY OUT SOME RESEARCH

Dear Sir,

We, level IV of Bachelor of Science in Nursing students of the Holy Name

University are conducting a research entitled Barriers on the Access on
Teenage Pregnancy Program/Services as one of our terminal requirements.
As we gathered Teenage Pregnancy rate data, it was found out that Brgy. Cogon
has the highest rate for this year (January- June). Hence, we would humbly ask
for your permission for our research to be conducted in your Barangay.
We are looking forward that our request would merit your positive response.

Respectfully Yours,
Ma. Vina C. Galorio Charlyn P. Cagampang

Mia Danica D. Goder Leene Lorraine E.

Gamayon

Noted by:

Mrs. Judith Godinez, RN, MAN

Adviser

Approved by:

Mrs. Ruvih Joy P. Garrote, RN, MN

Dean, College of Health Sciences
 36

APPENDIX B-2

Letter to the City Health POPCOM Officer

Hon. Nicanor S. Besas

Barangay Captain
Cogon District Tagbilaran City

September 16, 2019

RE: PERMISSION TO GATHER DATA

Dear Ma’am,

We, level IV of Bachelor of Science in Nursing students of the Holy Name

University are conducting a research entitled Barriers on the Access on
Teenage Pregnancy Program/Services as one of our terminal requirements.
We would like to request to give us the data we need in our research.
We are looking forward that our request would merit your positive response.

Respectfully Yours,
Ma. Vina C. Galorio Charlyn P. Cagampang

Mia Danica D. Goder Leene Lorraine E.

Gamayon

Noted by:

Mrs. Judith Godinez, RN, MAN

Adviser

Approved by:

Mrs. Ruvih Joy P. Garrote, RN, MN

Dean, College of Health Sciences
 37

APPENDIX C
GUIDE QUESTIONS
THE QUESTIONNAIRE

Age:
Educational Attainment:

Holy Name University College of Health Sciences is conducting a

research regarding HEALTH BELIEFS AND PRACTICES OF PREGNANT
TEENAGERS TOWARDS HEALTH SERVICES. The study aims to spread
awareness among teenage pregnant/teenage mothers about the availability of
Government programs and Health Services and how will help them to cope up
with this issue.

 What is your perception or belief regarding to your situation as

pregnant teenager?
 What are the programs that are known that are offered by the rural
health unit for pregnant teenagers?

Having this situation, what is you belief or perception towards the services and
programs offered by the rural health for pregnant teenagers?
 38

APPENDIX D
RESPONSES OF PARTICIPANTS
Table 1 - Shame
Questions Study participants Theme
Verbal Non-
Verbal
Do you feel R1. No, I’m proud of having Smiling Communications
ashamed in my child because it’s a gift and experiences
going to health from God.
centers? Why? R2. No, beause it is
needed for the health of the
baby.
Answers
R3. Yes, I’m afraid to be the
judge by other people. questions
R4. Yes, “mahadlok ko na confidently.
malain ang pag tan.aw sa
ubang tao nako kay
nabuntis ko ug sayo.” Hesitates
R5. Yes, “mahadlok ko e to make
judge sa makakita.” eye
R6. Yes, “mauwaw ko sa contact.
unsay maingon sa laing tao
nko.”
R7. No, “dawat man nako
ug ge supportahan ko sa
amahan sa akong anak.”
R8. Yes, because of
judgement.
R9. Yes, because as an
achiever I disappointed my
family because I didn’t met
their expectation.
R10. Yes, “kay daghan ug
chismosa aning among
dapit.”

2. In your R3. I have to think the Overcoming fear

opinion how can welfare of my child.
you cope up R4. “Wala nako seryosoha
shame? ug unsay ilang gipang
ingon nga dautan bahin
nako.”
R5. “Dawaton na laman
 39

ang nahitabo.”
R6. “Dili mo gawas sa
balay.”
R8. I never listened to their
assumptions.
R9. I just accepted it as a
consequence of my action.
R10. “Dawaton kay Grasya
man ni sa Ginoo.

Table 2 – Confidentiality Issues

3. Do you trust R1. Yes, because it is part Trust Issues
that the health of their job to keep my
care providers personal information.
won’t tell anyone R2. Yes, because they can
about your be trusted.
personal R3. Yes, because I trust
information? them.
Why? R4. No, “mahadlok ko
basin e tabi sa uban.”
R5. No, “ kay chismosa
man sila”
R6. No, “ tao raman masulti
ra gyapon na nila.”
R7. No, “ dili kalikayan na
mag chismis.”
R8. Yes, because I trusted
them.
R9. Yes, they handle their
work professionally.
R10. No, “ dili malikayan na
masulti sa uban labina sa
ilang mga kauban.”

Table 3 – Knowledge Deficit

4. Are you aware R1. No, I’ not familiar of Majority of the Awareness
that there are any programs. respondents
programs of the R2. Yes, my mother shook their
government accompanied to the health head.
intended for center for prenatal care.
teenage mothers? R3. Yes, I only know about
prenatal care.
R4. No, wala gyud koy
nahibaw.an
R5. No
 40

R6. No
R7. No
R8. No
R9. No
R10. No
If yes: R2.
 What  Prenatal care
program/s  Yes, to monitor
do you about my
know? pregnancy.
 Do you find  It is important to
it have a prenatal
significant? check - up to
 What are monitor my
you pregnancy.
learnings? R3.
 Prenatal care.
 Yes, to ensure the
health of the unborn
baby.
 “Importante gyud
ang pag prenatal
para matan.aw ug
ni dako ba ug
tarong ang bata
sulod sa tiyan.”

Table 4 – Financial Support

4. Who R1. Parents and they Some of the Support System
supported you provided my daily respondents
financially and needs. became teary
have they R2. Partner and eyed when they
provided all your parents, they answered this
needs during provided my needs. questions.
your pregnancy? R3. Parents, yes they
provide.
R4. “Ginikanan, ge
hatag nila ang tanan.”
R5. “Sila mama ug
papa, o nahatag nila
akong
panginahanglan.”
R6.” Ginikanan, ge
supotahan nila akong
 41

pag buntis.”
R7. “Giniknan, ge
dawat ug ge
suportahan nila
akong pag buntis.
R8. Parents, yes they
supported my
pregnancy.
R9. Parents, they
provide my needs.
R10. Sila tatay ug
nanay, gihatag man
nila akong gipangayu
labina sa
panginahanglan sa
bata.

Table 5 – Belief and traditions

5. What are your R7. “Dili pwede Cultural beliefs
belief/s? In your mo gawas ug
opinion, does it Lunar eclipse. Dili
help you? mo gawas kay
mamatay ang
bata.”
R8. Dili mo gawas
ug gabie kay nay
wak-wak. Wala
man poy mawala
ug mu tuo.”
R10. “Magpalina
sa dili pa
panganak. Para
daw dili mag lisod
ug panganak.”
 42

CURRICULUM VITAE

PROFILE
Name: Charlyn P. Cagampang
Nickname: Dai-dai
Age: 21
Birthdate: November 23, 1997
Place of Birth: Candijay, Bohol
Address (City): Gumamela St. Lindaville Phase II, Tagbilaran City, Bohol
(Hometown): Pagahat, Candijay, Bohol
EDUCATIONAL BACKGROUND
Elementary: Anoling Elementary School
High School: Holy Name University
College: Holy Name University

CURRICULUM VITAE

PROFILE
Name: Ma. Vina C. Galorio
Nickname: Vinskiey
Age: 22
Birthdate: December 3, 1996
Place of Birth: Jagna, Bohol
Address (City): Upper Calceta St. Cogon Dist., Tagbilaran City, Bohol
(Hometown):Tejero, Jagna, Bohol
EDUCATIONAL BACKGROUND
Elementary: Jagna Central Elementary School
High School: Holy Name University
College: Holy Name University
 43

CURRICULUM VITAE

PROFILE
Name: Leene Lorraine E. Gamayon
Nickname: Lhang-lhang
Age: 22
Birthdate: June 22, 1997
Place of Birth: GCGMH Tagbilaran City, Bohol
Address (City): Poincitia St. Lindaville Phase II, Tagbilaran City, Bohol
(Hometown):Purok I Limokon Ilaud, Dimiao, Bohol
EDUCATIONAL BACKGROUND
Elementary: Limokon Elementary School
High School: Dimiao National High School
College: Holy Name University

CURRICULUM VITAE

PROFILE
Name: Mia Danica D. Goder
Nickname: Mia
Age: 24
Birthdate: September 5, 1995
Place of Birth: Tagbilaran City, Bohol
Address (City): Dampas Dist., Tagbilaran City, Bohol
(Hometown): Calangahan ,Sagbayan, Bohol
EDUCATIONAL BACKGROUND
Elementary: Calangahan Elementary School
High School: Holy Name University
College: Holy Name University
44