Adolescent pregnancy in Papua New Guinea

In Papua New Guinea (PNG) and the Asia-Pacific region, adolescent pregnancy is a major public health concern. Adolescent pregnancy leads to adverse health and socio-economic outcomes. This severely impacts young people now, into the future and across generations. Although national and global health strategies have prioritised adolescent pregnancy, there’s little information about young people’s perceptions and experiences of pregnancy. This lack of awareness hinders the development of effective policies, services and health programs.

Using qualitative methods, this project involved married and unmarried Papua New Guineans aged 15 to 24 years. It aimed to:

• document young women’s and men’s perceptions and experiences of pregnancy
• examine young people’s socio-sexual behaviours
• examine the social, religious, cultural and service-based contexts that influence the risk of adolescent pregnancy and adverse health outcomes
• analyse the strategies young people use to prevent or mitigate the impact of pregnancy
• identify successes and gaps in government and community responses to adolescent pregnancy.

Building new evidence

Our youth-centred research helped establish a new evidence base on young people’s sexual and reproductive health (SRH) in PNG. Among other findings, it revealed: 

• social and institutional contexts that stigmatise premarital pregnancy and constrain engagement with health care providers for pregnancy prevention
• a limited understanding of the contraceptive products available in PNG, and how this works to prevent pregnancy.

Other findings included how young people have limited access to, and use of, modern contraceptives until after the birth of their first child. Particular gaps include:

• no use of any modern methods at first sex or during early sexual experiences before marriage
• inconsistent and incorrect use of withdrawal and calendar approaches
• lack of access to broad range of on-demand or long-acting contraceptives
• difficulties accessing contraception from health service providers.

Other findings:

• clear abortion trajectories that result from unplanned pregnancy, often undertaken unsafely, with limited support from formal care providers
• limited engagement with health services for pregnancy prevention, antenatal care and childbirth.

Building new policies and services

This evidence is being used to inform the development of policies, health services and outreach programmes that pay honest and respectful attention to young people’s lived experiences of pregnancy. 

Working with provincial, national and regional partners, next steps include:

• research to inform innovation in access to contraception and adolescent-responsive services
• exploring the possibilities associated with SRH self-care
• furthering our commitment to youth-led research through our Youth Labs.