Exploration of adolescent sexuality and pregnancy in Sri Lanka : A quantitative approach.

Rigorous research into the patterns and determinants of adolescent pregnancy in Sri Lanka is scarce. Compared to many Western populations and other South Asian countries, levels of adolescent pregnancy are low in Sri Lanka. Nevertheless, anecdotal evidence indicates that pregnancies outside of marriage are stigmatized among large sections of the population and that unwanted adolescent pregnancies, illegal abortions and suicides linked to adolescent pregnancy are a concern. Evidence shows low levels of knowledge and restricted access to contraception for adolescents in Sri Lanka. There is a need for more reliable data on adolescent sexuality and pregnancy encompassing a wider range of views in order to shape a culturally appropriate policy and practice response to meeting the reproductive health needs of Sri Lankan adolescents. To understand the context and patterns of adolescent pregnancy and sexual behaviour in a district in Sri Lanka. Population based questionnaire surveys of random samples of pregnant adolescents (n=450, interviewer-administered), their partners (n=150, interviewer-administered) and school going adolescents (n=2,020, self-completion). Descriptive and multivariate analyses were performed for each sample separately, followed by an integration of the data across the three data sources. Out of the 450 pregnant adolescents, 409 (91%) were in their first pregnancy. From this 409; 121(30%) were 18 years old. 263 (64%) pregnant adolescents reported that they had planned their pregnancies and 146 (36%) had not planned. Among the 150 partners, 100 (67%) reported they had planned the pregnancy and 50 (33%) had not planned the pregnancy. Among the 2,020 school adolescents (521 boys and 1,499 girls), just 1.5% of the girls and 8.8% of the boys reported experience of a sexual relationship, and only 0.3% of girls and 5.7% of boys had experienced an intimate sexual relationship.Adolescent pregnancies, whether planned or unplanned, were found to be largely welcomed, and adolescent pregnant girls were living within stable and supportive family environments. Pregnant adolescents parents' low education level, parents having married earlier than 18 years, and pregnant adolescents' siblings having children were more apparent compared to the school adolescent girls hinting that pregnant adolescents are from a subculture within which early childbearing is the norm. Findings confirm that pre-marital adolescent sexual activity was not generally condoned and remains rare. Relationships are predominantly monogamous. Gender difference in sexual activity exists. Reproductive health knowledge was very low across the samples and requires attention. Although the majority of pregnancies were planned and welcomed, given the inter-generational consequences of early childbearing, policy makers must find ways to tackle the structural and cultural factors that hamper a shift towards later childbearing among certain sections of the population. A proper collaboration between the education, health and community action can harness a long-term sustainable adolescent risk reduction and adolescent development. The difference of the age of consent (16 years) and the legal age of marriage (18 years) require policy debate.