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Teenage pregnancy is an enormous challenge in Swaziland. The Nkalashane clinic (Lubombo region) observed a growing number of teenage pregnancies. In 2014 alone, 49% of pregnancies were among women who had their first child before their 19th birthday. The objective of this study was to investigate risk factors of teenage pregnancy among teenage mothers (TM), teenage fathers (TF), and services needed by the at-risk youth (ARY) to prevent teenage pregnancy. Participants were identified from the clinic’s registers, snowball sampling, and the 3 schools in the area. Participants completed questionnaires and focus group discussions (FGDs). Data was summarized using descriptive statistics. 43 TM, 8 TF and 73 ARY participated. TM had a family history of teenage pregnancy (42%), had guardians with only a primary education (63%), and had older partners (mean age difference 5.2 years). Only 44% of TM and 38% of TF reported using contraception at the time of first pregnancy. Reasons for not using contraception included: lack of knowledge on pregnancy (47%) and contraception (38%). TM reported engaging in transactional sex due to peer pressure or lack of money. In FGDs, lack of knowledge, peer pressure, difficult access to contraception, and lack of parental guidance were discussed as risk factors. The main risk factors were: lack of knowledge; peer pressure; intergenerational sex; and difficult access to contraceptives. Recommendations include: offering comprehensive sexual education to both youth and adults; strengthening the relationship between schools, communities, and clinics; training clinic staff on youth-friendly services.

Risk Factors for Teenage Pregnancy and Youth Health Needs in Nkalashane, Swaziland