RESEARCH PROJECT

TOPIC: TO ASSESS THE REPRODUCTIVE HEALTH AWARENESS AND

KNOWLEDGE OF ADOLESCENTS TO THE PREVENTION OF EARLY
PREGNANCY IN KIGABIRO SECTOR.

Author’s names

HASHAKIMANA DANIEL

KOMEZUSENGE LEONTINE

NKURUNZIZA VENANT

UFITESE DELPHINE

BENIMANA VALERIEN

A research project submitted in partial fulfillment of the requirements for BACHELOR

WITH HONORS IN NURSING

In the

Department of General Nursing

SCHOOL OF NURSING AND MIDWIFERY

COLLEGE OF MEDICINE AND HEALTH SCIENCES

UNIVERSITY OF RWANDA

Supervisor: Mr. RUMENGE Nt ALAIN

Rwamagana on 23/03/2023

Declaration

Page 1 of 48
We do hereby declare that this research project submitted in partial fulfillment of the
requirement for the Bachelor’s degree with honors in General Nursing at University of
Rwanda, College of Medicine and Health Sciences, School of Nursing and Midwifery is our
own work and has not previously been submitted elsewhere. Also, we do declare that
complete list of references is provided indicating all resources of information quoted or cited.

Rwamagana on 23/03/2023

HASHAKIMANA DANIEL

KOMEZUSENGE LEONTINE

NKURUNZIZA VENANT

UFITESE DELPHINE

BENIMANA VALERIEN
Authority to Submit Research Project

I, Mr. RUMENGE Nt ALAIN in my capacity as supervisor, I do hereby authorize students

to submit their research project entitled “ASSESS THE REPRODUCTIVE HEALTH
AWARENESS AND KNOWLEDGE OF ADOLESCENTS TO THE PREVENTION
OF EARLY PREGNANCY IN KIGABIRO SECTOR.” to the department for their
defense.

Rwamagana on 23.03.2023

……………………

Mr. RUMENGE Nt ALAIN

Page 2 of 48
Dedication

We, as researchers, dedicate this work to Almighty God for guiding us throughout our
studies. We also dedicate this work to our families for guidance, support and love. Our
teachers for their knowledge given to us as well as guiding in our research and friends for
advices.

Abstract

The rate of adolescent’s pregnancy remains unacceptably high in most developing countries.
In Rwanda, studies show a rapid increase over the past two decades despite the political
achievements of women's empowerment, and efforts to restrict child sexual abuse.
Unfortunately, the current knowledge on reproduction of adolescents in Rwanda is limited, as
recent studies have focused on providing numbers with little analysis of proximate causal
factors or focused on the individual awareness. This study aims to assess reproductive health
knowledge among adolescents from Rwamagana District in Kigabiro sector. A community
based cross-sectional study carried out. A sample of 150 adolescent aged 15-19 participated
in the study. Simple random sampling used to select respondents, and questionnaires for
getting data from respondents.

The study used secondary data from the recent Rwanda Demographic and Health Survey
(RDHS: 2014–2015) to analyze adolescent’s awareness and knowledge on reproduction
associated with adolescent’s pregnancy in Rwamagana district in Kigabiro sector

Page 3 of 48
Acknowledgement

We wish to express our thanks to Almighty God for the life he has given to us and the
guidance we get in all what we do in our daily living. We would like to express thanks to the
Government of Rwanda through Higher Education Council (HEC) for the scholarship
provided in order to complete our studies. We are grateful to the University of
Rwanda/College of Medicine and Health Sciences staff for their contribution in our studies.

Again, we extend our sincere thanks and appreciation to our supervisor Mr. RUMENGE Nt
ALAIN for staying power and precious time being taken to help us in the research project.
Also, let our special thanks also go to our fellow students for their collaboration and advice
they have given us in order to progress through our studies. Finally, we strongly give thanks
to our parents and all relatives for all they have done since our birth up to now.

Page 4 of 48
 Table of Contents
Title page 1

Declaration 2

Dedication 3

Abstract 3

Aknowledgement 4

Table of content 5

List of acronyms and

abbreviations…………………………………………………………………………………7

1 chapter i: introduction……………………………………………………………8

1.1 Introduction of study……………………………………………………8

1.2 Background……………………………………………………………………10
1.3 Problem statement………………………………………………………12
1.4 Significance of the study……………………………………………...13
1.5 Research objectives………………………………………………………14
1.5.1 Aim of the study…………………………………………………14
1.5.2 Specific objectives……………………………………………...14
1.6 Research questions……………………………………………………….15
1.7 Conclusion on chapter one…………………………………………….15
2 Chapter 2: literature review………………………………………………16
2.1 Introduction……………………………………………………………….16
2.2 Theoretical literature………………………………………………16
2.2.1 Definition of key terms………………………………………………16
2.2.2 Etiology……………………………………………………………….17
2.3 Empirical literature……………………………………………………19
2.3.1 Introduction…………………………………………………….19
2.3.2 Epidemiology………………………………………………………….19

Page 5 of 48
2.3.3 Empirical literature review conclusion…………………………........22
3 Chapter 2 methodology……………………………………………………23
3.1 Introduction……………………………………………………………….23
3.2 Research approach…………………………………………………………….23
3.3 Research design…………………………………………………………………23
3.4 Study setting……………………………………………………………………23
3.5 Study population……………………………………………………………....24

3.6 Selective criteria……………………………………………………………….24

3.6.1 Inclusion criteria……………………………………………………24

3.6.2 Exclusion criteria……………………………………………………24

3.7 Sampling strategy ……………………………………………………………….25

3.8 Sample size……………………………………………………………………….25

3.9 Data collection instrument……………………………………………………….26

3.9.1 Validity of the instrument…………………………………………….26

3.10 Data collection procedures……………………………………………………27

3.11 Data analysis……………………………………………………………………27

3.12 Data dissemination…………………………………………………………….28

3.13 Data management………………………………………………………28

3.14 Data management………………………………………………………28

3.15 Problems and limitations of study…………………………………………….29

3.16 Conclusion on methodology………………………………………………….29

3.17 Research results……………………………………………………………….25

3.18 Discussion and recommendation…………………………………………….32

3.19 Ethical clearance …………………………………………………………….33

Page 6 of 48
3.20 Approval of collecting data………………………………………………….34

3.21 Referencing list …………………………………………………………….35

List of Acronyms and Abbreviations

UR: University of Rwanda

CMHS: College of Medicine and Health sciences

Mr.: mister

RDHS: Rwanda Demographic and Health Survey

REB Rwanda Education Board

NISR: National Institute for Statistics and Research

STDs: Sexual Transmitted Diseases

AIDS: Acquired Immune Deficiency Syndrome

HIV: Human Immunodeficiency Virus

STIs: Sexual Transmitted Infections

SRH: Sexual Reproductive Health

MOH: Ministry of Health

UNFPA: United Nations Population Fund

LBW Lower Body Weight

WHO: World Health Organization

UNICEF: United Nations International Children’s Emergency Fund

HCT: HIV counseling and testing

SPSS: Statistical package for the social sciences

Page 7 of 48
Chapter 1

Introduction

1.1 Introduction of study

The World Health Organization defines adolescence as the period between the ages of 10
and 19, even though the end of adolescence is harder to define because it is determined more
by psycho-sociological principles than by somatic, physical or biological changes(World
health organization, 2014). Therefore, it is highly important, when defining adolescence (its
upper limit), to take into account the aspects of psycho-social maturity, personal – economic
independence and freedom, which extend the adolescence period to the age of 25 (Telebak et
al., 2013).

Sexuality has biological-physiological and psychological basis that even the youngest
children have to know thoroughly about. Children must have the knowledge about why there
is a need to use protection, self-protection and partner protection. Sexual Education is the
transfer of knowledge, and as such should be the primary goal of the education system. In
order to form proper attitudes in the fields of family planning and taking responsibility for
one’s sexual behavior, one of the important conditions is the knowledge about the possible
consequences of irresponsible sexual behavior, unwanted pregnancy and sexually transmitted
diseases (Santelli & Beilenson, 1992).

Santelli & Beilenson, (1992) noted that adolescence is the period during which biological
maturity is gained, personality is formed, individual’s own attitudes and principles are
developed, moral and ethical values are built and attained, emotional independence and
socially responsible behavior are attained, more mature relationships with peers, as well as
preparation for economic independence, marriage and parenthood. Taking all these factors
into consideration, we can conclude that the process of growing up is in no way easy. In
order for adolescents to ask for a doctor’s advice or help, they need to have a sense of

Page 8 of 48
 security and trust. Apart from that, this period in life, due to specificities of health issues,
requires specially educated experts.

The same source indicate that it is considered that the young between the ages of 15 and 19
are at greatest risk with regard to promiscuous behavior and sexual contacts with a larger
number of partners. It is also known that protection is least used at the beginning of sexual
activity, while every fifth pregnancy begins in the first month of sexual activity, and about a
half of all premarital pregnancies begin in the first six months of sexual activity.

In another hand, (NISR, 2019) add that adolescents are not quite capable of understanding
complex concepts, the relationship between behaviors and consequences, the extent of
control they have and can have over health decisions making including that related to sexual
and reproductive behavior. This makes them vulnerable to sexual exploitation and high-risk
sexual behaviors and reproductive health problems. Poverty is a major driver of adolescent
pregnancy – 11.1% of adolescents (aged 15–19) from the poorest households are reported to
have begun childbearing, compared to 5.8% from the wealthiest households.

It constrains adolescents’ access to education, health services and their power over decision-
making(Hakizimana et al., 2019). Girls from low-income households may have fewer options
to avoid taking sexual risks to get economic support, including having sex with older men in
transactional sexual relationships to pay for school or buy material goods (WHO,2020). This
study demonstrated that the age at marriage for adolescents living in rural areas is quite low
compared to their counterpart in urban area.(Alemu & Assefa, 2014).

The changing moral & social values and shift in the standard of societal behavior from
conservatism to liberal interaction between both sexes is attributed largely to exposure to the
media like internet, social media, televisions and movies. Adolescents find themselves
sandwiched between a glamorous western influence and a stern conservatism at home, which
strictly forbids discussion on sex.

1.2 Background

Early and unprotected sexual activity and misconceptions about HIV+ and AIDs are
prevalent among rural adolescents. It was previously reported that adolescent knowledge
about sexual reproductive health affects the reproductive health services utilization

Page 9 of 48
(Alemayehu, Fantahun, 2006). (W.H.O, 2016) estimates that in Africa, 60% of all new HIV-
infection occur in adolescents who are 15-19 years old, in developing countries, there are
about 12.8 million births by adolescents aged between 15-19.

Adolescent’s sexual and reproductive health knowledge include knowledge about the female
menstrual cycle and conception, ways to avoid pregnancy, methods of contraception, correct
use of condoms and oral contraceptives, sexually transmitted infections and HIV, means of
STIs transmission, ways to avoid STIs and symptoms of STIs. Those are the indicator that
used to measure knowledge about SRH (W.H.O, 2014).

Data from Rwanda’s Ministry of Health (2017) indicate that adolescents and young adults
comprise the majority of Rwanda’s population. The report showed that adolescents remain
neglected group, in the country’s health care model this group is neglected because they are
considered comparatively healthy with a low disease burden. Yet the choices adolescent
makes today affect their health and the health of their families in future, especially the
choices related to family planning and STDs. (MoH ,2017) reported that “Rwandan
adolescent lack the ability to negotiate safer sex or to seek the health of family planning
services.

Adolescent mothers (ages 10-19 years) face higher risks of eclampsia, puerperal
endometritis, and systemic infections than women aged 24 to 24 years, and babies of
adolescent mothers face higher risk of lower body weight [LBW], preterm delivery and
severe neonatal conditions (WHO, 2016).

So, the adolescent pregnancies must be addressed globally especially in developing region in
order everyone to be accountable of the problem solving and to give their share in prevention
and eradicate the unwanted pregnancies in adolescents. Thus, we preferred to conduct this
research of assessing the awareness of reproduction in adolescents in order to address more
the problem of unwanted pregnancies in adolescents.

1.3 Problem Statement

The problem that this study addresses is the “gap in knowledge and awareness of adolescents
for their reproductive health”.

Page 10 of 48
Being unaware and less knowledge of adolescents for their reproduction, brings about many
negative effects on adolescent’s life, families and even a country. Some of those negative
effects are like the case in kigabiro sector in Rwamagana district where an adolescent of 16
years old got pregnancy, due to not knowing the time, that she has big chances to get
pregnancy and no/less chances to get pregnancy, other negative effects are school dropout
because of ++pregnancy, getting STIs and poverty in the family, all above are abundant in
Kigabiro sector in Rwamagana district. Those are the consequences of not removing the gap
in adolescent’s knowledge and awareness on their reproductive health, that may continue if
nothing done it.

Our contribution for reducing this gap was assessing the knowledge and attitudes level of
adolescents towards reproduction and adolescent pregnancies prevention in KIGABIRO
sector, for addressing more the root of the problem.

1.4 Significance of The Study

Teenage pregnancy has been described as a major challenge to Rwanda whose numbers are
increasing, especially in the rural areas (NISR, 2019). Poor rural girls with limited or no
access to sexual reproductive health education are at higher risk of becoming pregnant or
falling victims to sexually transmitted diseases. On other hand, a report from UNICEF (20
17) showed that young people in Rwanda remain at risk of getting unwanted pregnant this is
because a large number of young people in Rwanda, are unaware of the reproductive health.

This research has helped us to know the knowledge and attitudes of adolescents in fighting
against unwanted pregnancies in adolescents, and also it has to help health sectors, local
governments and stakeholders to reduce mortality and morbidity rate of adolescent mothers
during giving birth. In addition, after getting the result of our study, as well as the health care
providers and even multisector in community. we encourage to increase the effort in
providing health education to different individual, families, groups and community about
reproduction, unwanted pregnancies prevention in adolescents and how to prevent it.
Furthermore, our research was not only focus on the statement mentioned above but also
focused on challenges encountered by adolescents in fighting against unwanted pregnancy in
adolescents during their routine practices.

Page 11 of 48
 This research was also having to help the local health facilities, different stakeholders and
multisector to know the gap in awareness and knowledge of reproduction and prevention of
unwanted pregnancies in adolescent community. Also knowing where to put efforts for better
awareness of adolescent’s community. This study has also to help the health facilities which
the adolescent’s community localized to work together for searching the solutions and
training to the whole community about unwanted adolescent’s pregnancies.

1.5 Research Objectives

1.5.1 Aim of The Study

To explore the awareness, knowledge and attitudes of adolescent on their reproductive health
in regard of preventing unwanted pregnancy in KIGABIRO SECTOR.

1.5.2 Specific Objectives

To assess the knowledge level of adolescents towards reproduction and adolescent

pregnancies prevention in KIGABIRO sector.

To assess the attitudes level of adolescents towards reproduction and adolescent pregnancies
prevention in KIGABIRO sector.

To evaluate the practice level of adolescents towards reproduction and adolescent

pregnancies prevention in KIGABIRO sector.

To estimate the correlation between reproductive knowledge, attitudes and practices of

adolescents in prevention of unwanted pregnancies in adolescents in KIGABIRO sector.

1.6 Research Questions

What is the knowledge of adolescents towards reproduction and adolescent’s pregnancies

prevention in KIGABIRO SECTOR?

What are the attitudes of adolescents towards reproduction and adolescent’s pregnancies
prevention in KIGABIRO SECTOR?

What are the practices of adolescents towards reproduction and adolescent’s pregnancies
prevention in KIGABIRO SECTOR?

Page 12 of 48
 What are the challenges faced by adolescents towards unwanted adolescent’s pregnancies
prevention in KIGABIRO SECTOR?

1.7 Conclusion of Chapter One

This study assessed the awareness, knowledge, attitudes and practices about reproduction by
adolescents towards unwanted adolescent’s pregnancies prevention and it is conducted
because adolescent’s pregnancy is serious burden to the population and to the whole country
even globally.

Page 13 of 48
 Chapter 2
Literature Review

2.1 Introduction

As the primary purpose of literature review is to summarize evidence on research topic and
to sum up what is known and what is not known our literature review was obtained from
different articles, journals, Hinari, PubMed, WHO, google scholars, and other different
resources. This chapter reviews the literature related to the reproductive awareness and
knowledge of adolescents to the prevention of early pregnancy

2.2 Theoretical Literature

2.2.1. Definition of Key terms

1) Reproduction health

Reproductive health is a state of complete physical, mental and social well-being and not
merely the absence of disease or infirmity, in all matters relating to the reproductive system
and to its functions and processes. Reproductive health implies that people are able to have a
satisfying and safe sex life and that they have the capability to reproduce and the freedom to
decide if, when and how often to do so (W.H.O, 2013).

The term ‘reproductive health’ is coined by Peters and Wolper (1995) that explains it as
complete attainment of well-being in terms of mental, physical, and social conditions. Scarce
knowledge or lack of awareness in reproductive health enhances the chance of vulnerability
for adolescents to engage in unintended pregnancies, STD’s, STI’s, and HIV(Mustapa et al.,
2015).

2) Adolescents
Page 14 of 48
Adolescence is a transitional phase of growth and development between childhood and
adulthood. The World Health Organization (WHO, 2016) defines an adolescent as any
person between ages 10 and 19. This age range falls within WHO’s definition of young
people, which refers to individuals between ages 10 and 24.

In many societies, however, adolescence is narrowly equated with puberty and the cycle of
physical changes culminating in reproductive maturity. In other societies adolescence is
understood in broader terms that encompass psychological, social, and moral terrain as well
as the strictly physical aspects of maturation. In these societies the term adolescence typically
refers to the period between ages 12 and 20 and is roughly equivalent to the word teens.

[https://www.britannica.com/science/childhood]

2.2.2. Etiology

Several factors contribute to adolescent births. In many societies, girls may be under pressure
to marry and bear children early (W.H.O, 2014). they may have limited educational and
employment prospects. In low- and middle-income countries, over 39% of girls marry before
they are 18 years of age; around 14% before the age of 15 (World Bank, 2017). Education,
on the other hand, is a major protective factor for early pregnancy: the more years of
schooling, the fewer early pregnancies (NISR, 2019). Birth rates among women with low
education are higher than for those with secondary or tertiary education. Some adolescents do
not know how to avoid becoming pregnant, or are unable to obtain contraceptives. However,
even where contraceptives are widely available, sexually active adolescents are less likely to
use contraceptives than adults. (Hakizimana et al., 2019)

In Latin America, Europe and Asia only 42–68% of adolescents who are married or in
partnerships use contraceptives. In Africa the rate ranges from 3–49%. There is a lack of
sexuality education in many countries. A global coverage measure related to sexuality
education estimates that only 36% of young men and 24% of young women aged 15–24 in
low and middle-income countries have comprehensive and correct knowledge of how to
prevent unwanted pregnancies. In some situations, adolescent girls may be unable to refuse
sex. Sexual violence is widespread and particularly affects adolescent girls. More than one

Page 15 of 48
third of girls in some countries report that their first sexual encounter was coerced (W.H.O,
2014).

Adolescent pregnancies are a global problem occurring in high-, middle-, and low-income
countries. Around the world, however, adolescent pregnancies are more likely to occur in
marginalized communities, commonly driven by poverty and lack of education and
employment opportunities. several factors contribute to adolescent pregnancies and births. In
many societies, girls are under pressure to marry and bear children early.11,12,13 In least
developed countries, at least 39% of girls marry before they are 18 years of age and 12%
before the age of 15.14 In many places girls choose to become pregnant because they have
limited educational and employment prospects. Often, in such societies, motherhood is
valued and marriage or union and childbearing may be the best of the limited options
available. (WHO, UNICEF, UNFPA, 2015). Adolescents who may want to avoid
pregnancies may not be able to do so due to knowledge gaps and misconceptions on where to
obtain contraceptive methods and how to use them (W.H.O, 2011).

Adolescents face barriers to accessing contraception including restrictive laws and policies
regarding provision of contraceptive based on age or marital status, health worker bias and/or
lack of willingness to acknowledge adolescents’ sexual health needs, and adolescents’ own
inability to access contraceptives because of knowledge, transportation, and financial
constraints. Additionally, adolescents may lack the agency or autonomy to ensure the correct
and consistent use of a contraceptive method. At least 10 million unintended pregnancies
occur each year among adolescent girls aged 15-19 years in developing regions (Darroch J,
2016).

An additional cause of unintended pregnancy is sexual violence, which is widespread with

more than a third of girls in some countries reporting that their first sexual encounter was
coerced (Gomez, 2011).

Page 16 of 48
 2.3 Empirical Literature
2.3.1 Introduction

In this part of literature review we have seen different literature that studied on knowledge
and awareness of adolescents to reproductive health towards preventions of early pregnancy.

Awareness and knowledge of adolescents to ward reproductive health.

Firstly, the word ‘awareness’ refers to knowledge that something exists or understanding of a
situation or subject at the present time based on information or experience.

2.3.2 Epidemiology

Globally

In the latest international study worldwide (UNFPA, 2020), it estimates that “there are more
than 60 million women aged 20-24 years were married before the age of 18 years and about
16 million women 15-19 years old give birth each year, representing 11.0% of all births
worldwide. Teenagers pregnancy is dangerous for the mother, child and the community.
Although teens aged 10-19 years’ account for 11.0% of all births worldwide, they account for
23.0% of the overall burden of disease due to pregnancy and childbirth”.

On behalf of Rwanda

Method used on the previous study (Published May 23, 2022 by Patricie Mukandagano, et al)
was community cross-sectional study with quantitative approach which was carried out in
Rwamagana district. A cross-sectional research design was chosen because this help
researcher to collect quick information and make analysis that respondent to study objectives.

Page 17 of 48
study was conducted in rural sectors of Rwamagana District. According to fourth population
and housing census, the population of Rwamagana is mostly young where 65 % of the
resident population of Rwamagana is under 25 years old. Adolescent aged 15-19 years are
31852; of them 20890 are from rural sectors.

due to the nature of the study, the study was conducted in rural sectors as the aim of the study
is to assess the reproductive health knowledge among adolescents from different areas of
Rwamagana District

Rwanda has seen an increase in adolescent pregnancy where it was reported from 4.1% in
2005 to 7.5%2 in 2015 (Hakizimana et al., 2019) where in Rwanda unwanted pregnancy
remains a major concern for adolescent girls in Rwanda (Walker et al., 2014).

Disparities in education levels also shows that girls vulnerabilities to pregnancy increase
where it is reported that 6.9% of adolescents (aged 15–19) with primary education have had a
live birth, compared to 3.2% with secondary or higher education (NISR, 2019). School-based
education can potentially delay marriage and pregnancy as it equips girls with information
about ASRHR (Hakizimana et al., 2019).

The increase in teenage pregnancy rates in Rwanda in recent years is worrisome. The data
from NISR (Table 1) indicate that in 2007/2008 to 2014/2015 teenage pregnancy increased
from 5.7% to 7.2% of the teen girls countrywide, and from 14% to nearly 21% among young
girls aged 19 (NISR, 2009; 2012; 2015).

Table 1: Statistics of how adolescents’ pregnancy increased 2007/2008-2014/2015

Characteristi 2007 2010 2014/2015

cs of teen Percen Numb Percen Numb Percen Numb
girls t er of t er of t er of
pregna wome pregna wome pregna wome
nt n nt n nt n
Age
15 0.0 265 0.0 677 1.0 676
16 2.6 274 0.8 655 2.0 559
17 2.4 267 3.3 530 4.3 518

Page 18 of 48
 18 8.6 293 9.7 605 11.5 557
19 14.1 288 20.3 478 20.8 469
Family residence
Urban 5.3 275 5.4 447 7.9 575
Rural 5.8 1112 6.2 2499 7.1 2204
Province
City of 9.1 155 6.6 332 10.2 359
Kigali
South 5.6 371 4.9 642 5.6 668
West 5.2 320 5.4 762 5.8 597
North 6.0 234 5.7 503 4.9 526
East 4.5 308 7.9 707 10.7 629
Educational level
No 5.1 104 24.9 87 12.7 41
education
Primary 6.3 1076 6.1 2132 9.2 1632
Secondary 2.3 207 3.6 727 4.3 1106
and Higher
Source: (NISR, 2009; 2015; 2019)

Kigali city and the Eastern province present the highest increase of teenage pregnancy in
recent years from nearly 7% to 10% and from 8% to nearly 11% in 2010 and 2015 survey
respectively(NISR, 2015).

2.3.3 Empirical literature review conclusion.

Adolescents are great potential resources for the future, with fresh energy, ideas and hopes.
They are resilient, energetic, and eager to learn. To reach this potential, they need to acquire
skills and knowledge. Reproductive health of adolescents includes understanding and coping
with reproductive health risks and consequences. Young age is a crucial make or break age
for girls around the world. What a girl experiences during her teenage year’s paves way for
the direction of her life and that of her family. In many countries, the mere onset of puberty

Page 19 of 48
that occurs during adolescence marks a time of heightened vulnerability to leaving school,
child marriage, early pregnancy, HIV, sexual exploitation, coercion and violence. It is
predicted that adolescents are at greater risk of dying in childbirth than women in their 20s
continued. Hence spreading awareness about the reproductive health could help in the better
development of the nation (Alemu & Assefa, 2014).

Chapter 3

Methodology

3.1. Introduction

In our project this chapter include research approach and design to achieve study objectives.
In addition, it also includes study setting, study population, sample size and sampling
strategy, inclusion and exclusion criteria, data collection instrument and data collection
procedure, ethical considerations, data analysis, data management, data dissemination, and
limitations and challenges to the study.

3.2. Research Design and Approach

In our study, a descriptive cross-sectional design was used. To answer our research questions,
the quantitative research approach was used. This is because results of our study might be
presented as numbers and have statistical description instead of being presented as narrated
experiences, personal opinions and feelings.

3.3. Study Setting

In our study, setting was Kigabiro sector in Rwamagana district. Kigabiro sector is the
mostly populated sector in Rwamagana district with area of 37.74 km² and over 30, 000
residents accounting for 10.4% of the total population of the district (NISR, 2019). The
adolescents account 21.8% in all population. This sector is divided into 5 cells which are
Bwiza , Cyanya , Nyagasenyi, Sibagire and Sovu which we took as our study setting.

Page 20 of 48
3.5. Study Population

In this study, the target population were all adolescents in Kigabiro sector. We have selected
adolescents because they are the ones who are on frontline of preventing unwanted
pregnancy in them, thus, they need to be aware of their reproductive health status. Kigabiro
sector has a total of 2600 adolescents (10-19) from 38 villages (NISR, 2019). This means that
our accessible population were from those 2600 adolescents who were available on days of
data collection and fulfilling our inclusion criteria.

3.6. Selection criteria

3.6.1. Inclusion criteria

In our study, the inclusion criteria were: (1) residence of selected sector for at least 6 months,
(2) being in range of year of 15-19, (3) being in selected sector during data collection period,
(4) received a consent form from parents, caretaker and, teacher, (5) able to communicate
with researcher

3.6.2. Exclusion criteria

In our study, those who were not included in our population are adolescents who were not
available at time of data collection and those who didn’t sign informed consent, under the
age, and who have disability for communication.

3.7. Sampling strategy

In our study, we selected adolescents who were participated in our research by using simple
random sampling to select all study participants. Our sampling frame was the list of
adolescents from Kigabiro sector in alphabetical order who was provided by local
governments.

We decided to use simple random sampling because all adolescents had equal chance to be
selected, and the results are representative of the population.

Page 21 of 48
3.8. Sample size

According to Wayne W and Chad L (2013), when proportion is to be estimated and

population size is known, sample size can be estimated by using Yamanee formula.

n=N /¿1+e2N), Where n is desired sample,

N target population,

e is the marginal error (5%)

n=2600/ (1+((0.05)2*2600)

n= 2600/17.35

n=149.74≈150

3.9 Data collection instrument

In our study, questionnaires were used to collect data about level of knowledge, attitudes, and
practice of adolescents toward their reproductive health. questionnaires prepared by
reviewing previous studies on the problem of interest.

The questionnaire explores the demographic, social and economic characteristics; knowledge
of RH-related topics (fertility, contraception, STIs/HIV/AIDS, HIV counseling and testing
(HCT)) and patterns of RH services utilization. Data were collected by students from
university of Rwanda. We as students we have trained/learned on the study objective,
questionnaire content and how to ensure privacy and confidentiality. The collected data
checked for incompleteness and inconsistency and cleaned by researcher. All questionnaires
and entered data kept secure by the researcher. Access is restricted. Name and addresses of
participants were not required in the study.

3.9.1. Validity of the instrument

Page 22 of 48
 The instrument that we used has been previously used by Patricie Mukandagano, et al. in the
study conducted in Rwamagana district to assess reproductive Health Knowledge and
Services Utilization among Rural Adolescents. and we have received permission via email to
use the questionnaire and to adapt it according to our context. We have examined validity of
our instrument in terms of face validity, content validity.

3.9.2. Reliability of instrument

Reliability is concerned with a measure’s accuracy, and it is aimed at minimizing measurement

error. In this study we have conducted a pilot study with 1/10 of our calculated sample size.
Therefore, we used 15 adolescents from kigabiro sector in order to determine clarity of
questions, effectiveness of instructions, completeness of response sets, time required to complete
the questionnaire, and success of data collection techniques.

3.10 Data Collection Procedures

The process of data collection started after obtaining permission from (IRB) at UR-CMHS
Research Center administration and after the consent form from administration of
Rwamagana district. After receiving the permission from IRB, we went to Rwamagana
district and present ourselves to the staff members as well as school head teachers who gave
us permission to meet with participants who meet with inclusion criteria stated above, after
that we explained to participants the purpose of the study. In addition, we have explained to
them the benefits of study, brief on data collection process and how the provided information
was disseminated and managed with confidentiality followed by signing consent form.
Finally, participants have given questionnaires and given enough time to read, to understand
and to ask for some clarifications where it is not understandable, and to answer asked
questions. Thus, during data collection self-administered questionnaire were used.

3.11 Data Analysis

Data have been checked for completeness, cleaned, coded and entered into excel sheet, and
then exported to SPSS version for further analysis. Frequencies and percentage used to
summarize descriptive statistics. Percentages used to assess the level of RH knowledge and
awareness in adolescents. A total of 25 questions were used to assess knowledge of

Page 23 of 48
adolescents about reproductive health. The right answer scored 1 and wrong answer scored 0,
total scores were 25. The respondents classified as good knowledge with scores >20
equivalent to 75% and middle knowledge with scores of [20-15] and lower knowledge scored
<15. Data were presented using tables and graphs accordingly.

3.12. Data dissemination

Our research project book might be available in library of University of Rwanda Rwamagana
campus, Rwamagana district, Rwamagana health center, school data bases and even the local
government administrators. So, individuals who were participated in our study and our fellow
academicians can be able to access them easily.

3.13. Data Management

In order to keep safely the collected information, our research questionnaires must be kept in
the shelf for 5 years. The soft data saved on the computer with password to avoid external
accesses. And also, we saved them on our Email addresses, the results of a study
disseminated to the institutions that have participated for the accomplishment of the research
and among the respondents of the research.

Therefore, participants ensured that no names would be provided on the questionnaires to

ensure their anonymity as well as motivating them to participate in the research study. Again,
the participants ensured that the information that could be provided could be confidential to
be used. In addition to that, to protect the right of our study participants, we ensured that
potential subjects make informed consent which were shown by voluntary signing on the
consent form before taking part in our study. Lastly, participant withdrawal from the research
study during data collection were agreed without further complication.

3.15 Problems and limitations of study

While carrying out our study, we have certain challenges and limitations. Among them there
is use of cross-sectional design which does not explore about causality between variables of
interest. The last one but not the least, there is state of being scattered among members of our
Page 24 of 48
 research project team due to clinical placements, as were not in the same place, most of the
time. So, it was difficult to combine and analyse our findings and to have general
understanding.

3.16. Conclusion on Methodology

To sum up, we conducted a cross-sectional study to explore awareness and knowledge of

adolescents on reproduction toward unwanted adolescents’ pregnancy in 3 selected cells of
Kigabiro sector in Rwamagana district. Our sample size was 150 adolescents, and these were
selected using simple random sampling. In addition, subjects that recruited were all
adolescents (15-19 year) and Questionnaire were used to collect data. Also, limitations and
challenges include the use of cross-sectional design, and financial resources limitations.
Furthermore, to ensure that ethical principles are applied, potential subjects were first read
the consent form and then sign on it in order to take part in the research. Moreover, we also
emphasized on data to be collected to be confidential and to be used only for the purpose of
the study. Finally, the above information clearly shows how our research project has put in
action to answer research questions mentioned in Chapter one.

Results
Socio-Demographic Characteristics of Respondents

A total of 150 adolescents aged 15-19 participated in the study. Participants were from kigabiro
sector of Rwamagana District.

Socio-demographic characteristics of adolescents from Rwamagana District in Kigabiro sector

presented in table 1 shows that 99(66%) of them were female, half of them 51(50.5) were aged
15-17 years old. Of 150 adolescents all (100%) were single, 52(34.7%) were affiliated to catholic
religion, 36(24%) to protestant, 15(10%) to Muslim, 47(31.3%) affiliated to other religion.
150(100%) were currently at school. regarding the socio-demographic of their families, the
majority 52.7% had mothers aged 40-49 years old, the majority 48(32.0%) reported that their

Page 25 of 48
mother had primary education, 92(61.3%) were in ubudehe category 3, 82(54.7%) reported that
they live with their parents, of those who do not live the parent 33(22.0%) were living with their
only one parent.

Reproductive Health Knowledge among Adolescents in Rwamagana District

Individual knowledge about reproductive health aspects were assessed by 25 questions. Overall
knowledge was also estimated.

Findings presented in table 3 shows that regarding individual knowledge on the reproductive
health aspects a total of 138(92.0%) reported that first menstruation(menarche) is a sign of a girl
who can pregnant, 126(84.0%) ovarian cycle can be regular (28 days) or irregular (more or less
than 28 days) 134(89.3%) a girl could become pregnancy at the first sexual intercourse,
114(76.0%) agreed that a girl could become pregnancy during puberty, 121(80.7%) agreed that a
girl could become pregnancy after puberty.

Concerning the maturity of male to pregnant a girl, 24(16.0%) reported that male could be
physically mature to get a girl pregnant, 111(74.0%) reported that male get a girl pregnant during
puberty. The majority of respondents 133(88.7%) agreed that breast development for a girl as a
sign of maturity, 132(88.0%) said that appearance of pubic hair for both girls and boys is a sign
of maturation, 133(88.7%) of respondents knew appearance of facial hair development for boys
is a sign of maturity.

It was observed that the majority of adolescents in Rwamagana District Kigabiro sector knew the
sign of maturity where 138(92.0%), knew that appearance of menstruation for a girl as a sign of
maturity, 136(90.7%) knew that male voice changes as a sign of maturity.

In terms of knowledge about the ways of preventing unwanted pregnancy, the majority of
respondents 132(88.0%) knew that consistent and proper use of condom, 136(90.7%) knew that
use of oral contraceptive pills, 129(86.0%) knew that use of injectable contraceptive should be
used to prevent unwanted pregnancy.

For HIV transmission route, the majority 132(88.0%) knew that HIV can be transmitted during
unprotected sex, 139(92.7%) knew that HIV can be transmitted through the sharing sharps,
138(92.0%) knew that HIV can be affect through transfusion of infected blood, 139(92.7%)

Page 26 of 48
sharing sharps also can be the route of HIV, 135(90.0%) knew that HIV can affect during child
birth, 127(84.7%) knew that during child birth is another route of HIV.

Adolescents were aware about HIV prevention measures where 135(90.0%) agreed that sexual
abstinence during adolescents should prevent adolescent to get HIV, 139(92.7%) knew that
consistent and proper use of condom can prevent HIV.

The findings presented in figure 1 shows that the majority of adolescents 87.6% had good
knowledge about reproductive health

Table 1. Socio-Demographic Characteristics of Adolescents

Variables Frequency Percentage

Gender
Male 51 34.0
Female 99 66.0
Age group
15-17 46 30.7
18-19 104 69.3
Marital status
Single 148 98.7
Cohabitating 2 1.3
Religion
Catholic 52 34.7
Muslim 15 10.0
Protestant 36 24.0
Other 47 31.3
Occupation
Student 150 100.0
Educational level
Secondary 150 100.0
Current schooling
In school 150 100.0

Page 27 of 48
 Out of school 0 0.0
Age of mother
30-39 18 12.0
40-49 79 52.7
50-59 41 27.3
60+ 12 8.0
Mother education
No formal education 19 12.7
Primary 48 32.0
Secondary 73 48.6
University 10 6.7
Social-class
Category 1 6 4.0
Category 2 52 34.7
Category 3 92 61.3
Living status
With parents 82 54.7
With no parents 8 5.3
One parent 33 22.0
Family member 21 14.0
Other(partners) 6 4.0

Table 2. Reproductive health knowledge among the adolescents in Kigabiro sector in

Rwamagana district

Variables Frequency Percentage

First menstruation(menarche) is a sign of a girl who can pregnant
Yes 139 92.6
No 11 7.4
Ovarian cycle can be regular (28 days)or irregular(more or less
than 28 days)

Page 28 of 48
Yes 126 84.0
No 24 16.0
A girl could become pregnancy at first sexual intercourse
Yes 134 89.3
No---------------------------------------------------------------------------- 16 10.7
--------------------------------------------------------
A girl could become pregnancy during puberty
Yes 114 76.0
No 36 24.0
A girl could become pregnancy after puberty
Yes 122 81.2
No 28 18.8
Males could be physically mature to get a girl pregnant
Yes 24 16.0
No 126 84.0
Males get a girl pregnant during puberty
Yes 111 74.0
No 39 26
Breast development for a girl is a sign of maturity
Yes 133 88.7
No 17 11.3
Appearance of public hair for both girls and boys is a sign of
maturation
Yes 132 88.0
No 18 12.0
Appearance of facial hair development for boys is a sign of
maturation
Yes 133 88.7
No 17 11.3
Appearance of menstruation for a girl is a sign of maturity
Yes 139 92.6
Page 29 of 48
No 11 7.4
Male voice changes is a sign of maturity
Yes 136 90.7
No 14 9.3
Ways of preventing unwanted pregnancy
Consistent and proper use of condom
Yes 134 89.8
No 16 10.2
use of oral contraceptive pills
Yes 136 91.7
No 14 8.3
use of Injectable contraceptives
Yes 130 86.6
No 20 13.4
use of long-lasting contraceptives
Yes 130 86.6
No 20 13.4
Route of HIV transmission
Unprotected sexual intercourse
Yes 132 89.2
No 18 10.8
HIV can be got during the first unprotected sexual experience
Yes 140 93.3
No 10 6.7
Transfusion of infected blood
Yes 140 93.3
No 10 6.7
Sharing sharps
Yes 140 93.3

Page 30 of 48
No 10 6.7
During child birth
Yes 135 91.8
No 15 8.2
During breastfeeding
Yes 127 85.8
No 23 14.2
Prevention of HIV
Sexual abstinence
Yes 135 91.2
No 15 8.8
Consistent and proper use of condom
Yes 139 93.3
No 11 6.7

Figure 1. Overall Reproductive health

Knowledge
100

90

80 87.6

70

60

50

40

30

20

10 12.4

0
Good knowledge Poor knowledge

Page 31 of 48
Discussion and recommendations

Adolescent’s reproductive health knowledge are affected by different controversies including

says that adolescents are not ready for sensitive sexual information, comprehensive sexual
education promote early sex, reproductive health education makes young people promiscuous,
reproductive health education does not fit with our culture or religion, adolescent should not use
contraceptive methods and adolescent should abstain from sex until marriage(Hakizimana et al.,
2019).

Access and use of reproductive health services by adolescents, adolescents’ level of knowledge
in RH is paramount. Increasing adolescent’s awareness about SRH and advocating for them is a
crucial to the adolescent’s reproductive health effort. Reproductive health awareness of the
young is insufficient, on the one hand, because these topics are not sufficiently covered by the
National
Curriculum, and on the other, because of the insufficient role of the parents in transferring
sexuality-related knowledge. hence, this study assesses the SHR knowledge among adolescents
in Kigabiro sector Rwamagana District.

CONCLUSION

Health improvement, in the broadest sense of the word, is defined as a mutual concept which
means enabling people and communities to increase control over their health and improve it
(W.H.O, 2016). This is achieved by timely educating primarily young people through health
education and by developing necessary skills and habits (Cucić V et al, 2000). Besides the
aforementioned, the reproductive health promotion also represents an extended social care with
the purpose of establishing the appropriate public health policy (Lazes P et al, 2012). Realizing
reproductive health necessarily includes the right of men and women to be informed, and to have
a free choice and access to reliable, acceptable and available methods of family planning, as well
as the right to use adequate services that would enable women to safely go through pregnancy
and childbirth.

Page 32 of 48
Page 33 of 48
Page 34 of 48
Appendices

APPENDIX 1: CONSENT FORM

APPENDIX 1A:

University of Rwanda

College of medicine and health sciences

School of nursing and midwifery

General nursing department

Year of study: Year 4, Academic Year 2021/2022

Tel: +2507807896898/+250780666354/+250786040073/+250786942114/+250780806968.

Deputy Chairperson :0783 340 040

Chairperson of the CMHS IRB: 0788 490 522

Emails:
danielhashak.hd@gmail.com,komezaleontine@gmail.com,vennkurunziza@gmail.com,delphineu
fitese@gmail.com,valerienben002@gmail.com

We, HASHAKIMANA DANIEL, KOMEZUSENGE LEONTINE, NKURUNZIZA

VENANT, UFITESE DELPHINE, BENIMANA VALERIEN, year four students at
University of Rwanda, College of Medicine and Health Sciences, School of Nursing and
Midwifery, General Nursing Department at Rwamagana campus, under supervision of Mr
RUMENGE Nt ALAIN lecturer at UR-CMHS in School of Nursing and Midwifery, we are
conducting a study on assess the reproductive health awareness and knowledge of adolescents to
the prevention of early pregnancy in kigabiro sector.

Page 35 of 48
Purpose of the research : The present research will help the unwanted pregnancy prevention in
adolescents program to better understand informational needs of the adolescents on adolescents
pregnancy issues.

Procedure : If you agree with the purpose of the research we will question you about your
knowledge and awareness in relation to reproduction. You will answer asked questions in not
more than thirty minutes.

Benefits: There are no direct benefits for you being part of this research. However, your
contributions will help the unwanted pregnancy Control in adolescents Programme and the
Department of Health to design and develop appropriate information resources to help
adolescents effectively recognize and fully aware of their reproductive health and to take
appropriate action in different difficult time related to their reproductive health. Your name will
not appear in any oral or written report of this study. Your participation is voluntary and You
have right to agree or disagree to participate in this study and to withdraw any time. Furthermore,
your opinions are very important, there are no wrong or right answers and the study will be
approved by university of Rwanda.

If you accept to participate in this research, please only sign in the space bellow.

Signature of Participant ……………. Date ….../……/2023

Thank you for your cooperation.

APPENDIX 1B: IN KINYARWANDA

KAMINUZA Y’URWANDA
ISHAMI RY’UBUVUZI
ISHURI RY’ABAFOROMO N’ABABYAZA
ISHAMI RYA RWAMAGANA

UBWUMVIKANE BWA BURI MUNTU MU KWITABIRA UBUSHAKASHATSI

Twebwe, HASHAKIMANA DANIEL, KOMEZUSENGE LEONTINE, NKURUNZIZA
VENANT, UFITESE DELPHINE, BENIMANA VALERIEN, abanyeshuri biga mu mwaka

Page 36 of 48
wa kane mu ishuri ry’abaforomo n’ababyaza muri kaminuza y’URwanda ishami rya Rwamagana
tukaba turi gukora ubushakashatsi busoza amasomo yacu ku bajyanama b’ubuzima ku
“ubumenyi, imyitwarire ndetse n’imikorere by’abana babangavu bari hagati y’imyaka 15-19 ku
buzima bw’imyororkere yabo hagamijwe kwirinda no kurwanya inda zitateguwemu mu murenge
wa Kigabiro”. tuyobowe na RUMENGE Nt ALAIN umwarimu muri kaminuza y’urwanda.

Impamvu y, ubushakashatsi: Ubu bushakashatsi buzafasha porogamu Yo kurinda no kurwanya

inda zitateguwe mubangavu mu kumva neza amakuru asanzwe afitwe ndetse nakenewe
n’abangavu kumyororokere ndetse no kwirinda inda zitateguwe. Uko ubushakashatsi
buzakorwa: Niba wemeye Impamvu y’ubu bushakashatsi tugiye kukubaza ibibazo bitandukanye
byanditse kurupapuro bijyanye nubumenyi ndetse n’imyitwarire kubuzima bw’imyororokere,
bisubizwa mugihe cy’iminota 30.
INYUNGU UFITE MURI UBUBUSHAKASHATSI: Nta nyungu ufite yahafi mukuboneka
muri ububushakashatsi. Ureretse ko bizafasha porogaramu yo kurinda inda zitateguwe mu
kongerera ubumenyi nuko abangavu bitwara mubihe bitandukanye bijyanye nubuzima
bw’imyororokere yabo n’ibindi byose nkenerwa mu kwirinda inda zitateguwe.
Turabasaba ubwitabire bwanyu murubu bushakashatsi, ibitekerezo byanyu n’ingenzi, Kwitabira
kwanyu ni ubushake kandi tubijeje ko amakuru muduha azagirwa ibanga kandi ntazina ryanyu
rizagaragara muri raporo y’ibyavuye muri ubu bushakashatsi. Ikindi kandi, wemerewe
gusobanuza aho tumva neza no guhagarika gukomeza igihe icyo ari cyo cyose kandi nta
nkurikizi zizabaho kandi ntagarukambi zo gutanga amakuru.

Maze gusoma no gusobanukirwa neza impamvu n’inyungu by ’ubu bushakashatsi, ndemera

kwitabira ubu bushakashatsi k’ubushake mu gutanga amakuru akenewe kuko nzi neza ko
umutekano wanjye n’amakuru ntanga bizagirwa ibanga kandi ntangaruk mbi bizangiraho.

Amazina: …………………………………………….

Italiki ……………………
MURAKOZE!!!

Page 37 of 48
APPENDIX 2A

QUESTIONNAIRE ABOUT TO ASSESS THE REPRODUCTIVE HEALTH

AWARENESS AND KNOWLEDGE OF ADOLESCENTS TO THE PREVENTION
OF EARLY PREGNANCY IN KIGABIRO SECTOR.

Section A: Socio-Demographic Characteristics of Adolescents

Valuables Attributes
Gender Male
Female
Age group 15-17
18-19
Marital Status Single
Cohabiting
Religion Catholic
Protestant
Muslim
Occupation Student
Merchant
Farmer
Unemployed
Housewife
Educational level Primary
Secondary
Current schooling In school
Out of school
Age of mother 30-39
40-49
50-59
60+

Page 38 of 48
 Mother education No formal education
Primary
Secondary o-level
A-level
University
Social class Category 1
Category 2
Category 3
Living status With parents
With no parents
One parent
Family member
Others(partner)

Section B: Reproductive health knowledge and awareness among the adolescents in

Kigabiro sector of Rwamagana District

Variables Yes No
First
menstruation(menarche)
is a sign of a girl can
pregnant
Ovarian cycle can be
regular (28 days)or
irregular(more or less
than 28 days)
A girl could become
pregnancy at first sexual
intercourse
A girl could become
pregnancy during puberty

Page 39 of 48
A girl could become
pregnancy after puberty
Males could be physically
mature to get a girl
pregnant
Males get a girl pregnant
during puberty
Breast development for a
girl is a sign of maturity
Appearance of public hair
for both girls and boys is
a sign of maturation
Appearance of facial hair
development for boys is a
sign of maturation
Appearance of
menstruation for a girl is a
sign of maturity
Male voice changes is a
sign of maturity
Ways of preventing unwanted pregnancy
Consistent and proper use
of condom
use of oral contraceptive
pills
use of Injectable
contraceptives
use of long-lasting
contraceptives
Route of HIV transmission
Unprotected sexual

Page 40 of 48
 intercourse
HIV can be got during the
first unprotected sexual
experience
Transfusion of infected
blood
Sharing sharps
During child birth
During breastfeeding
Prevention of HIV
Sexual abstinence
Consistent and proper use
of condom
Avoid transfusion with
infected blood

APPENDIX 2B

Page 41 of 48
QUESTIONAIRE IN KINYARWANDA
URUPAPURO RW’IBIBAZO RUGENEWE
UMWANGAVU K’UBUMENYI, IMYITWARIRE N’IMIKORERE
KUMYOROROKERE YE BIJYANYE NO MUKWIRINDA NO MUKURWANYA INDA
ZITERWA ABANGAVU

IGICE CYA MBERE : IBIBAZO KU IRANGAMIMERERE

Valuables Attributes
Igitsina Gabo
Gore
imyaka 15-17
18-19
Irangamimerere Ingaragu
Narashatse
Idini Aba gaturika
Aba poroso
Abayisiramu
Icyo nkora Umunyeshuri
Umucuruzi
Umuhinzi
Ntakazi mfite
Umugore murugo
Amashuli Abanza
Ayisumbuye
Niba arimo kwiga ubu Ndi mwishuri
Siniga
Imyaka ya mama 30-39
40-49

Page 42 of 48
 50-59
60+
Amashuri ya mama Ntabwo yize
Abanza
Ayisumbuye Atatu yisumbuye
Atandatu yisumbuye
Kaminuza
Icyiciro cy’ubudehe 1
2
3
Uburyo mbayeho Mbana n’ababyeyi
Simbana n’ababyeyi
Mbana n’umubyeyi umwe
Mbana nuwo
mumuryango
Abandi bandera

IGICE CYA KABIRI: UBUMENYI BW’ABANGAVU KU BYEREKERANYE

N,IMYOROROKERE YABO NO KWIRINDA INDA ZITATEGANIJWE

Variables Yego Oya

Kubona imihango
bwambere bigaragaza ko
ushobora gutwita
Ukwezi k’umugore cg
umukobwa gushobora
kudahinduka(iminsi 28)
cg kugahinduka(iminsi
myinshi cg mike kuri 28)
Umukobwa ashobora

Page 43 of 48
gutwita akoze imibonano
mpuzabitsina bwambere
Umukobwa yatwika
mukubyiruka
Umukobwa yatwita
nyuma yo kubyiruka
Umusore cg umugabo
agomba kuba afite
ibigango kugira atere inda
Umuhungu atera inda iyo
ari mukubyiruka
gukura kw’amabere
kumukobwa nikimenyetso
cy’ubukure
Gukura kw’imisatsi
kumyanya y’ibanga
nikimenyetso cy’ubukure
Kugaragara cg se gukura
ku bwanwa kubagabo
nikimenyetso cyubukure
kujya mumihango
kubakobwa nikimenyetso
cyubukure
Guhinduka kwijwi
kubahungunikimenyetsi
cy’ubukure
Uburyo bwo kwirinda inda zitateganijwe
Gukoresha kenshi kandi
neza agakingirizo
Gukoresha imiti yo
kunywa yo kuboneza

Page 44 of 48
urubyaro
use of Injectable
contraceptives
gukoresha imiti batera
mumubiri yo kuboneza
urubyaro
Gukoresha imiti yigihe
kirekire yo kuboneza
urubyaro
Inzira ubwandu bwa virus itera sida yanduramo
Imibonano mpuzabitsina
idakingiye
Ushobora kwandura virus
itera sida kumibonano
yambere idakingiye
Amaraso yanduye
Gusangira ibikoresho
bityaye
Umwana avuka
Mukotsa umwana
Uburyo bwo kwirinda agakoko gatera sida
Kwifata
Gukoresha agakingirizo
kandi neza
Kwirinda guhabwa
amaraso yanduye

APPENDIX 3

Page 45 of 48
 UNIVERSITY OF RWANDA

CMHS-RWAMAGANA CAMPUS

SCHOOL OF NURSING AND MIDWIFERY

RESEARCH BUDGET
NUMBE ITEMS QUANTIT COST PER TOTAL
R Y UNITY(FRW COST(FRW
) )
1 Transport fees 5 20,000 100,000
2 Communicatio 5 10,000 50,000
n means
3 Lunch 10 5,000 50,000
4 Printing 400 50 20,000
questionnaire,
and consent
5 Note books 5 2000 10,000
6 Pens 10 200 2,000
7 Drinking Water 20 600 12,000
8 TOTAL 452 38,300 244,000

PREPARED HASHAKIMANA DANIEL

KOMEZUSENGE LEONTINE

NKURUNZIZA VENANT

UFITESE DELPHINE

Page 46 of 48
 BENIMANA VALERIEN

Supervised by Mr. RUMENGE Nt ALAIN

Reference List:

Adolescent-pregnancy-and-sexual-reproductive-health-and-rights-in-Rwanda. (n.d.).

Alemu, A. A., & Assefa, S. (2014). Reproductive health knowledge and services utilization
among rural adolescents in east Gojjam zone , Ethiopia : a community-based cross-sectional
study. BMC Health Services Research, 14(138), 1–11.

Coley, R. L., & Chase-Lansdale, P. L. (1998). Adolescent Pregnancy and Parenthood: Recent
Evidence and Future Directions. American Psychologist, 53(2), 152–166.
https://doi.org/10.1037/0003-066X.53.2.152

F.Polit, D., & Beck, cheryl tatano. (2018). essential of nursing research (M. L.brittain (Ed.); 9th
ed.). wolters kluwer.

Gomez, A. M. (2011). Sexual violence as a predictor of unintended pregnancy, contraceptive use,

and unmet need among female youth in Colombia. Journal of Women’s Health, 20(9), 1349–
1356. https://doi.org/10.1089/jwh.2010.2518

Gray, J. R., Grove, S. K., & Sutherland, S. (2017). Burns and Grove’s The Practice of Nursing

Page 47 of 48
 Research: Appraisal, Synthesis, and Generation of Evidence (8th ed.). Elsevier Inc.

Hakizimana, D., Logan, J., & Wong, R. (2019). Risk Factors for Pregnancies Among Females
Age 15 to 19 in Rwanda: A Secondary Data Analysis of the 2014/2015 Rwanda
Demographic and Health Survey (RDHS). Journal of Management and Strategy, 10(2), 49.
https://doi.org/10.5430/jms.v10n2p49

Maggio, L. A., Sewell, J. L., & Artino, A. R. (2016). The Literature Review: A Foundation for
High-Quality Medical Education Research. https://doi.org/10.4300/JGME-D-16-00175.1

Mustapa, M. C., Ismail, K. H., Mohamad, M. S., & Ibrahim, F. (2015). Knowledge on Sexuality
and Reproductive Health of Malaysian Adolescents – A Short Review. Procedia - Social and
Behavioral Sciences, 211(September), 221–225. https://doi.org/10.1016/j.sbspro.2015.11.088

NISR. (2019). Population and Housing Census, Rwanda: Rwamagana District. 20–58.

Santelli, J. S., & Beilenson, P. (1992). Risk Factors for Adolescent Sexual Behavior, Fertility, and
Sexually Transmitted Diseases. Journal of School Health, 62(7), 271–279.
https://doi.org/10.1111/j.1746-1561.1992.tb01243.x

teens pregnancy in rwamagana.pdf. (n.d.).

Telebak, D., Perazić, O., Babić, N., Paleksić, V., & Marković, M. (2013). AWARENESS AND
ATTITUDES REGARDING ADOLESCENT REPRODUCTIVE HEALTH IN THE
REPUBLIC OF SRPSKA. Acta Medica Medianae, 9–15.
https://doi.org/10.5633/amm.2013.0102

W.H.O. (2014). Adolescent pregnancy fact sheet. Adolescent Pregnancy Fact Sheet, 1.
https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy

Page 48 of 48