Adolescent pregnancy prevention programs in Latin America from an intersectional approach. Systematic review
DOI:
https://doi.org/10.29166/rfcmq.v49i3.6730Keywords:
teenage pregnancy, Latin America, intersectional framework, sexual behaviourAbstract
Introduction: intersectionality in health offers a fundamental analytical framework for understanding social inequities. This approach is essential for inclusion in adolescent pregnancy prevention programs in Latin America. Objective: To conduct a systematic review of adolescent pregnancy prevention programs in Latin America from an intersectional approach. Material and methods: PRISMA guidelines and the Cochrane Handbook for systematic reviews of interventions were followed. The search encompassed randomized controlled trials in English, Spanish, and Portuguese in databases such as PubMed, Cochrane, BIREME, BVS, LILACS, ERIC, PsycINFO, SCOPUS and Google Scholar. Case-control, cohort, and quasi-experimental studies were excluded. Risk of bias was assessed using the Cochrane RoB2 tool. Data were analyzed using descriptive statistics and measures of effect. The protocol was registered in PROSPERO (CRD42024540325). Results: Seven studies with 16 873 participants were reviewed. One of them highlighted the intersectional importance in the prevention of adolescent pregnancy by addressing sexual and gender diversity. The other studies showed that educational and self-efficacy interventions can increase condom use, improve sexual assertiveness, reduce pregnancy and sexual initiation rates, and improve contraceptive knowledge. Discussion: There is a gap in the consideration of intersectionality. There is limited evidence of effectiveness of interventions to prevent adolescent pregnancy, lacking robust evidence in intersectional strategies. Conclusions: The review underscores the importance of inclusive and integrative approaches to effectively address inequalities in adolescent pregnancy prevention.
Downloads
Metrics
References
Granados-Martínez A. Interseccionalidad en salud, pobreza y vulnerabilidad. Papeles Poblac [Internet]. 2022 Sept [cited 2024 Ag 16];28(111):137-61. Available from: https://rppoblacion.uaemex.mx/article/view/15796
Rodríguez C. Adolescent pregnancy, public policies, and targeted programs in Latin America and the Caribbean: a systematic review. Rev Panam Salud Publica [Internet]. 2021 Dec [cited 2023 Oct 15];45:1-9.Available from: http://dx.doi.org/10.26633/rpsp.2021.144
Organización Mundial de la Salud. Embarazo en la adolescencia [Internet]. 2024 Abr [cited 2023 Oct 15].Available from: https://www.who.int/es/news-room/fact-sheets/detail/adolescent-pregnancy#:~:text=En%20Am%C3%A9rica%20Latina%20y%20el,cada%201000%20adolescentes%20(4)
Consejo Nacional de Evaluación de la Política de Desarrollo Social (CONEVAL). El embarazo en la adolescencia y el acceso a educación y servicios de salud sexual y reproductiva: un estudio exploratorio [Internet]. 2022 Nov [cited 2023 Oct 15]. Available from:
Comisión Económica para América Latina y el Caribe (CEPAL). Primer informe regional sobre la implementación del Consenso de Montevideo sobre Población y Desarrollo [Internet]. 2019 Feb [cited 2023 Oct 15]. Available from:
Observatorio de Igualdad de Género de América Latina y el Caribe. Autonomía física: maternidad en adolescentes [Internet].2020[cited 2023 Nov 12]. Available from: https://oig.cepal.org/es/indicadores/maternidad-adolescentes
Estrada F, Atienzo EE, Cruz-Jiménez L, Campero L. A rapid review of interventions to prevent first pregnancy among adolescents and its applicability to Latin America. J Pediatr Adolesc Gynecol [Internet]. 2021 Aug [cited 2023 Oct 15];34(4):491-503. Available from:
https://doi.org/10.1016/j.jpag.2021.01.022
Organización Panamericana de la Salud y el Fondo de Población de las Naciones Unidas. Reseña técnica: El embarazo en la adolescencia en América Latina y el Caribe [Internet]. 2020 Ag [cited 2023 Oct 15]. Available from: https://iris.paho.org/handle/10665.2/53134
Fondo de Población de las Naciones Unidas. Consecuencias socioeconómicas del embarazo en la adolescencia en seis países de América Latina: iImplementación de la Metodología Milena en Argentina, Colombia, Ecuador, Guatemala, México y Paraguay [Internet]. 2020 [cited 2023 Nov 12]. Available from:
https://lac.unfpa.org/sites/default/files/pub-pdf/unfpa_consecuencias_en_6_paises_espanol_1.pdf
Organización para la Cooperación y el Desarrollo Económico(OECD Family Database) [Internet]. Organisation for Economic Co-operation and Development. 2024 Jun [cited 2023 Nov 12]. Available from: https://web-archive.oecd.org/temp/2024-06-21/69263-database.htm
Instituto Nacional de las Mujeres. Estrategia Nacional para la Prevención del Embarazo Adolescente: informe 2020 [Internet]. 2020 [cited 2023 Nov 12]. Available from:
https://www.gob.mx/cms/uploads/attachment/file/661025/Informe_Ejecutivo_GIPEA_2020_.pdf
World population prospects 2019 Database [Internet]. United Nations: Department of Economic and Social Affairs. 2024 [cited 2023 Oct 15]. Available from: https://population.un.org/wpp/
Rodríguez J. Fecundidad no deseada entre las adolescentes latinoamericanas: un aumento que desafía la salud sexual y reproductiva y el ejercicio de derechos [Internet]. Naciones Unidas, Santiago; 2017 [cited 2023 Oct 15]. Available from:
Holman D, Salway S, Bell A, Beach B, Adebajo A, Ali N, et al. Can intersectionality help with understanding and tackling health inequalities? Perspectives of professional stakeholders. Health Res Policy Sys [Internet]. 2021 Jun [cited 2023 Nov 12]; 19(1):1-15. Available from: http://dx.doi.org/10.1186/s12961-021-00742-w
Hess LE. Intersectionality: A Systematic Review and Application to Explore the Complexity of Teen Pregnancy Involvement [master´s tesis]. Columbia University; 2012. 126 p. [cited 2023 Nov 12]. Available from: https://doi.org/10.7916/D8CV4FTQ
Cho HL. Can intersectionality help lead to more accurate diagnosis. Am J Bioeth [Internet]. 2019 Feb [cited 2023 Nov 12];19(2):37-9. Available from: http://dx.doi.org/10.1080/15265161.2018.1557279
Azevedo JP, Favara M, Haddock SE, Lopez-Calva LF, Müller M, Perova E. Teenage Pregnancy and Opportunities in Latin America and the Caribbean On Early Child Bearing, Poverty and Economic Achievement [Internet]. Washington; 2012 [cited 2023 Nov 12]. Available from: https://documents.worldbank.org/curated/en/742021468225584924/pdf/831670v10REVIS00Box385190B00PUBLIC0.pdf
Román AA, Fujimori E, Duarte LS, Vilela AL. Prevalence and correlates of early sexual initiation among Brazilian adolescents. PLoS One [Internet]. 2021 Dec [cited 2023 Nov 12]; 16(12):e0260815. Available from: https://doi.org/10.1371/journal.pone.0260815
Agénor M. Future Directions for Incorporating Intersectionality Into Quantitative Population Health Research. Am J Public Health [Internet]. 2020 May [cited 2023 Nov 12]; 110(6):803-6. Available from: http://dx.doi.org/10.2105/ajph.2020.305610
Swain LT, Malouff JM, Meynadier J, Schutte NS. Psychological interventions Decrease unintended pregnancies: a meta‐analysis of randomized controlled trials. Br J Health Psychol [Internet]. 2023 May [cited 2023 Nov 12]; 28(2):567-85. Available from: https://doi.org/10.1111/bjhp.12641
Marseille E, Mirzazadeh A, Biggs MA, Miller AP, Horváth H, Lightfoot M, et al. Effectiveness of School-Based Teen Pregnancy Prevention Programs in the USA: A Systematic Review and Meta-Analysis. Prev Sci [Internet]. 2018 Jan [cited 2023 Nov 23]; 19:468-89. Available from: https://doi.org/10.1007/s11121-017-0861-6
Alegría M, Cheng M. Intersectional approaches are essential to identify the multiple sources of oppression. J Psychopathol Clin Sci [Internet]. 2023 [cited 2023 Nov 23]; 132(5):590-3. Available from:
http://dx.doi.org/10.1037/abn0000842
Gross C, Goldan L. Modelling intersectionality within quantitative research. Sozialpolitik.ch [Internet]. 2023 Aug [cited 2023 Dec 16]; 1:1-25. Available from: http://dx.doi.org/10.18753/2297-8224-4025
Girls Not Brides: The Global Partnership to End Child Marriage. Un enfoque interseccional en materia de matrimonios y uniones Infantiles, Tempranas y forzadas (MUITF) [Internet]. 2022 Feb [cited 2023 Dic 16]. Disponible en: https://www.girlsnotbrides.es/documents/1696/Un_enfoque_interseccional_en_materia_de_MUITF.pdf
Rodríguez CR. Adolescent pregnancy, public policies, and targeted programs in Latin America and the Caribbean: a systematic review. Rev Panam Salud Pública [Internet]. 2021 [cited 2023 Dec 16]; 45:e144. Available from: https://doi.org/10.26633/RPSP.2021.144
Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.4 (updated 2023 Dec 20). Cochrane, 2023. Available from: www.training.cochrane.org/handbook.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. Declaración PRISMA 2020: una guía actualizada para la publicación de revisiones sistemáticas. Rev Esp Cardiol [Internet]. 2021 Sept [cited 2023 Dic 20]; 74(9):790-9.updated: http://dx.doi.org/10.1016/j.recesp.2021.06.016
Shanaa A. Rayyan – intelligent systematic review [Internet]. Rayyan. Rayyan Systems; 2021 [cited 2024 Jan 5]. Available from: https://www.rayyan.ai/
Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ [Internet]. 2019 Aug [cited 2024 Jan 5]; 366:l4898. Available from: http://dx.doi.org/10.1136/bmj.l4898
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ [Internet]. 2021 March [cited 2024 Jan 5]; 372(71). Available from: https://doi.org/10.1136/bmj.n71
Morales A, Garcia-Montaño E, Barrios-Ortega C, Niebles-Charris J, Garcia-Roncallo P, Abello-Luque D, et al. Adaptation of an effective school-based sexual health promotion program for youth in Colombia. Soc Sci Med [Internet]. 2019 Feb [cited 2024 Jan 5]; 222:207-15. Available from: http://dx.doi.org/10.1016/j.socscimed.2019.01.011
Gómez-Lugo M, Morales A, Saavedra-Roa A, Niebles-Charris J, Abello-Luque D, Marchal-Bertrand L, et al. Effects of a sexual risk-reduction intervention for teenagers: A cluster-randomized control trial. AIDS Behav [Internet]. 2022 Jan [cited 2024 Apr 5]; 26(7):2446-58. Available from:
http://dx.doi.org/10.1007/s10461-022-03574-z
Álvarez JT, Blanco A, Torres M, Guilarte OT, Asprón A. Programa educativo sobre el embarazo no deseado dirigido a las adolescentes. ccm [Internet]. 2018 Dic [cited 2024 Abr 5]; 22(4):559-70. Available from: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1560-43812018000400003&lng=es
Vigil P, Riquelme R, Rivadeneira R, Aranda W. TeenSTAR: una opción de madurez y libertad: Programa de educación integral de la sexualidad, orientado a adolescentes. Rev Med Chil [Internet]. 2005 Oct [cited 2024 Abr 13]; 133(10):1173-82. Available from:
http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005001000006&lng=es.
McCarthy OL, Aliaga C, Torrico ME, López J, Huaynoca S, Leurent B, et al. An intervention delivered by mobile phone instant messaging to increase acceptability and use of effective contraception among young women in Bolivia: Randomized controlled trial. J Med Internet Res [Internet]. 2021 March [cited 2024 Apr 15]; 22(6): e14073. Available from: http://dx.doi.org/10.2196/14073
Torres P, Walker DM, Gutiérrez JP, Bertozzi SM. Estrategias novedosas de prevención de embarazo e ITS/VIH/sida entre adolescentes escolarizados mexicanos. Salud Publica Mex [Internet]. 2006 Ag [cited 2024 Abr 25]; 48(4):308-16. Available from:
http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0036-36342006000400005&lng=es.
Cabezón C, Vigil P, Rojas I, Leiva ME, Riquelme R, Aranda W, et al. Adolescent pregnancy prevention: An abstinence-centered randomized controlled intervention in a Chilean public high school. J Adolesc Health [Internet]. 2005 Jan [cited 2024 Apr 15]; 36(1):64-9. Available from: http://dx.doi.org/10.1016/j.jadohealth.2003.10.011
McFarlane MD, Alaybek B, Schatz A, Painter JE, Olsen GP, Hogan KM, et al. Interactive, artistic, fun, and weird: Exploring facilitators and challenges to youth engagement across in-person, virtual, and hybrid pregnancy prevention programs. Am J Sex Educ [Internet]. 2022 Nov [cited 2024 Apr 25]; 18(4):594-617. Available from: http://dx.doi.org/10.1080/15546128.2022.2139034
dos Santos AB, Martin C, Pereira F, de Moraes AC, Souza L, Dias M, et al. Sex education to prevent teenage pregnancy in the context of school health: an integrative analysis. Res Soc Dev [Internet]. 2021 Mar [cited 2024 Apr 25]; 10(3):e28210312967. Available from: http://dx.doi.org/10.33448/rsd-v10i3.12967
Kan ML, Ramirez DD. Preventing subsequent teenage pregnancy: A multisite analysis of goal orientation and social supports. Child Sch [Internet]. 2020 Oct [cited 2024 May 2]; 42(4):225-35. Available from: http://dx.doi.org/10.1093/cs/cdaa023
Rodríguez C. Adolescent pregnancy, public policies, and targeted programs in Latin America and the Caribbean: a systematic review. Rev Panam Salud Publica [Internet]. 2021 [cited 2024 May 2]; 45: e144. Available from: https://doi.org/10.26633/RPSP.2021.144
Baird S, Camfield L, Ghimire A, Hamad BA, Jones N, Pincock K, et al. Intersectionality as a framework for understanding adolescent vulnerabilities in low and middle income countries: Expanding our commitment to leave no one behind. Eur J Dev Res [Internet]. 2021 Sep [cited 2024 May 2]; 33: 1143-62. Available from: http://dx.doi.org/10.1057/s41287-021-00440-x
Golman M, Ricks N, Gallegos ID, Weaver J. Utilizing the Socio-Ecologic Model as a Framework for the Prevention of Teen Pregnancy. Socio-Cultural Influences on Teenage Pregnancy and Contemporary Prevention Measures [Internet]. 2019 [cited 2024 May 2]:208-33. Available from: https://doi.org/10.4018/978-1-5225-6108-8.ch012
Tebb KP, Brindis CD. Understanding the psychological impacts of teenage pregnancy through a Socio-ecological framework and life course approach. Semin Reprod Med [Internet]. 2022 Jan [cited 2024 May 2]; 40(01/02):107-15. Available from: http://dx.doi.org/10.1055/s-0041-1741518
Chambers BD, Erausquin JT. The promise of intersectional stigma to understand the complexities of adolescent pregnancy and motherhood. J Child Adolesc Behav [Internet]. 2015 Oct [cited 2024 May 2]; 03(05):249. Available from: https://doi.org/10.4172/2375-4494.1000249.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Natanael Librado-González, Juliana Cristina dos Santos-Monteiro , Alan Josué Ramírez-Calderón , Maritza Nicolas-Santiago
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
