Abstract
BackgroundAdolescent pregnancy in rural areas is a persistent health problem that has still not properly been understood. Studies with qualitative perspectives that address this phenomenon as a complex social process, which involves the recognition of the voices of the actors involved and the analysis of the specific context in which it takes place, are limited.ObjectiveThis research explored the perceptions of young people and other social actors (municipalities of Palmira and El Cerrito in Colombia) of the social forces and dimensions of the social determination of adolescent pregnancy in the Amaime river basin. These geographic areas have been scenes of armed violence with various groups in combat within the context of a long-standing political conflict in Colombia. After the 2016 Havana agreements were signed, peacebuilding has been underway in its territories.MethodsA qualitative study that implemented focus groups and semi-structured interviews was conducted. The theoretical approach of social determination of health proposed by Breilh was used to study the social process entailed in adolescent pregnancy. Perceptions about social conditions, specific ways of life, and lifestyles were addressed. Galtung and Fischer’s theoretical approach on violence and peacebuilding was also incorporated to enrich the understanding of the Colombian context. The analysis was conducted with approaches from phenomenology.ResultsLiving conditions with strong social stigma and demand for social, political, and cultural opportunities were found. Regarding ways of life, little communication and information about sex education was perceived. As for lifestyles, there are youthful behaviors infused by sociocultural traditions that affect life projects and sexual behavior. Gender relations are precarious, and there are various types of violence that limit effective peacebuilding.ConclusionsThis study contributes to a priority issue in sexual and reproductive health, with an approach that generates analytical elements to comprehensively expand the social and health interventions required.
Highlights
Adolescent pregnancy in rural areas is a persistent health problem that has still not properly been understood
As for lifestyles, there are youthful behaviors infused by sociocultural traditions that affect life projects and sexual behavior
Results the research results were presented according to the various domains proposed by Jaime Breilh on the theoretical approach to social determination [16], while the findings of the scene of violence are presented in a category considered transversal, as it pervades the social environment where adolescent pregnancy is experienced by the study participants
Summary
Adolescent pregnancy in rural areas is a persistent health problem that has still not properly been understood. The Colombian municipalities of Palmira, where 3562 adolescent pregnancies were recorded in 2016, and El Cerrito, which recorded 543 pregnancies [4], stand out These municipalities are part of the Amaime river basin, featuring an extensive rural area. These geographical areas used to be scenes of armed violence within the framework of a long-standing political conflict in the country. This took place with high intensity in the time period preceding the Havana Peace Agreement (signed on September 26, 2016) and is currently seeking peacebuilding in the nation [5]. The population experienced armed violence due to the confrontation of different groups in combat, such as the guerrillas with a political leaning toward the Marxist–Leninist left called the Revolutionary Armed Forces of Colombia—People’s Army (FARC-EP), the far-right political armed forces called the United Self-Defense Forces of Colombia (AUC), and the military forces of the national government [5]
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