{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T20:51:56Z","timestamp":1793220716840,"version":"4.5.0"},"reference-count":44,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T00:00:00Z","timestamp":1728345600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T00:00:00Z","timestamp":1728345600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Reprod Health"],"DOI":"10.1186\/s12978-024-01872-4","type":"journal-article","created":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T16:02:11Z","timestamp":1728403331000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The reasons for and influences of unintended teenage pregnancy in Kericho county, Kenya: a qualitative study"],"prefix":"10.1186","volume":"21","author":[{"given":"Rio","family":"Harada","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsuko","family":"Imoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louisa","family":"Ndunyu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Masuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,10,8]]},"reference":[{"key":"1872_CR1","unstructured":"World Health Organization. Adolescent pregnancy. 2019. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/adolescent-pregnancy. Accessed August 26, 2024."},{"key":"1872_CR2","unstructured":"World Health Organization. Adolescent pregnancy. 2019. p. 2. https:\/\/www.who.int\/publications\/i\/item\/WHO-RHR-19.15. Accessed 26 Aug 2024."},{"key":"1872_CR3","unstructured":"United Nations Educational, Scientific and Cultural Organization. Early and unintended pregnancy. 2017. p. 2. https:\/\/www.right-to-education.org\/resource\/early-and-unintended-pregnancy-recommendations-education-sector. Accessed 26 Aug 2024."},{"key":"1872_CR4","unstructured":"Centers for Disease Control and Prevention. Unintended pregnancy. 2023. https:\/\/www.cdc.gov\/reproductive-health\/hcp\/unintended-pregnancy\/index.html. Accessed 26 Aug 2024."},{"key":"1872_CR5","unstructured":"United Nations Children\u2019s Fund. Early childbearing. 2022. https:\/\/data.unicef.org\/topic\/child-health\/adolescent-health\/. Accessed 26 Aug 2024."},{"issue":"1","key":"1872_CR6","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1186\/s12905-022-02048-7","volume":"22","author":"HG Ayalew","year":"2022","unstructured":"Ayalew HG, Liyew AM, Tessema ZT, Worku MG, Tesema GA, Alamneh TS, et al. Prevalence and factors associated with unintended pregnancy among adolescent girls and young women in sub-saharan Africa, a multilevel analysis. BMC Women\u2019s Health. 2022;22(1):464. https:\/\/doi.org\/10.1186\/s12905-022-02048-7.","journal-title":"BMC Women\u2019s Health"},{"issue":"1","key":"1872_CR7","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1186\/s12884-019-2204-z","volume":"19","author":"YD Wado","year":"2019","unstructured":"Wado YD, Sully EA, Mumah JN. Pregnancy and early motherhood among adolescents in five east African countries: a multi-level analysis of risk and protective factors. BMC Pregnancy Childbirth. 2019;19(1):59. https:\/\/doi.org\/10.1186\/s12884-019-2204-z.","journal-title":"BMC Pregnancy Childbirth"},{"key":"1872_CR8","unstructured":"United Nations Population Fund. Adolescent pregnancy: A review of the evidence. 2013. p. 26. https:\/\/www.unfpa.org\/publications\/adolescent-pregnancy. Accessed 26 Aug 2024."},{"key":"1872_CR9","unstructured":"National Council for Population and Development. Draft action plan for addressing adolescent health and teenage pregnancy in Kenya. 2021. https:\/\/healtheducationresources.unesco.org\/library\/documents\/draft-action-plan-addressing-adolescent-health-and-teenage-pregnancy-kenya. Accessed 26 Aug 2024."},{"key":"1872_CR10","unstructured":"Kenya National Bureau of Statistics. Kenya demographic and health survey 2014, Summary of findings. 2014. p. xxi. https:\/\/dhsprogram.com\/pubs\/pdf\/fr308\/fr308.pdf. Accessed 26 Aug 2024."},{"key":"1872_CR11","unstructured":"Kenya National Bureau of Statistics. Kenya demographic and health survey key indicators report 2022. 2022. p. 15. https:\/\/dhsprogram.com\/pubs\/pdf\/PR143\/PR143.pdf. Accessed 26 Aug 2024."},{"key":"1872_CR12","unstructured":"Partridge-Hicks. Rise in teenage pregnancies in Kenya linked to COVID-19 lockdown. Global Citizen. 2020. https:\/\/www.globalcitizen.org\/en\/content\/rise-in-teenage-pregnancies-during-kenya-lockdown\/. Accessed 26 Aug 2024."},{"key":"1872_CR13","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2021-007666","author":"G Zulaika","year":"2022","unstructured":"Zulaika G, Bulbarelli M, Nyothach E, van Eijk A, Mason L, Fwaya E, et al. Impact of COVID-19 lockdowns on adolescent pregnancy and school dropout among secondary schoolgirls in Kenya. BMJ Global Health. 2022. https:\/\/doi.org\/10.1136\/bmjgh-2021-007666.","journal-title":"BMJ Global Health"},{"key":"1872_CR14","unstructured":"Kenya National Bureau of Statistics. Kenya Demographic and Health Survey Key Indicators Report 2022. p.15. https:\/\/dhsprogram.com\/pubs\/pdf\/PR143\/PR143.pdf. Accessed 26 Aug 2024."},{"key":"1872_CR15","unstructured":"Ministry of Health. National Adolescent Sexual and Reproductive Health Policy. p.18. https:\/\/knowledgecommons.popcouncil.org\/departments_sbsr-rh\/260\/. Accessed 26 Aug 2024."},{"key":"1872_CR16","unstructured":"Ministry of Education. National Guidelines for School Re-Entry in Early Learning and Basic Education. p.14, 19\u201320. https:\/\/knowledgecommons.popcouncil.org\/departments_sbsr-rh\/1323\/. Accessed 26 Aug 2024."},{"issue":"4","key":"1872_CR17","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1111\/sifp.12178","volume":"52","author":"LE Miller","year":"2021","unstructured":"Miller LE, Zamudio-Haas S, Otieno B, Amboka S, Odeny D, Agot I, et al. We don\u2019t fear HIV. We just fear walking around Pregnant.: a qualitative analysis of adolescent sexuality and pregnancy stigma in Informal settlements in Kisumu, Kenya. Stud Fam Plann. 2021;52(4):557\u201370. https:\/\/doi.org\/10.1111\/sifp.12178.","journal-title":"Stud Fam Plann"},{"key":"1872_CR18","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0255954","author":"EK Harrington","year":"2021","unstructured":"Harrington EK, Casmir E, Kithao P, Kinuthia J, John-Stewart G, Drake AL, et al. Spoiled girls: understanding social influences on adolescent contraceptive decision-making in Kenya. PLoS ONE. 2021. https:\/\/doi.org\/10.1371\/journal.pone.0255954.","journal-title":"PLoS ONE"},{"issue":"1","key":"1872_CR19","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1186\/s12978-021-01107-w","volume":"18","author":"J Mwaisaka","year":"2021","unstructured":"Mwaisaka J, Wado YD, Ouedraogo R, Oduor C, Habib H, Njagi J, et al. Those are things for married people: exploring parents\u2019\/adults\u2019 and adolescents\u2019 perspectives on contraceptives in Narok and Homa Bay Counties, Kenya. BMC Reproductive Health. 2021;18(1):48. https:\/\/doi.org\/10.1186\/s12978-021-01107-w.","journal-title":"BMC Reproductive Health"},{"issue":"1","key":"1872_CR20","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1186\/s12889-015-1483-1","volume":"15","author":"R Ochako","year":"2015","unstructured":"Ochako R, Mbondo M, Aloo S, Kaimenyi S, Thompson R, Temmerman M, et al. Barriers to modern contraceptive methods uptake among young women in Kenya: a qualitative study. BMC Public Health. 2015;15(1):118. https:\/\/doi.org\/10.1186\/s12889-015-1483-1.","journal-title":"BMC Public Health"},{"key":"1872_CR21","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0248836","author":"M Kumar","year":"2021","unstructured":"Kumar M, Huang KY. Impact of being an adolescent mother on subsequent maternal health, parenting, and child development in Kenyan low-income and high adversity informal settlement context. PLoS ONE. 2021. https:\/\/doi.org\/10.1371\/journal.pone.0248836.","journal-title":"PLoS ONE"},{"issue":"1","key":"1872_CR22","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1186\/s12905-018-0521-4","volume":"18","author":"BA Ushie","year":"2018","unstructured":"Ushie BA, Izugbara CO, Mutua MM, Kabiru CW. Timing of abortion among adolescent and young women presenting for post-abortion care in Kenya: a cross-sectional analysis of nationally representative data. BMC Women\u2019s Health. 2018;18(1):184. https:\/\/doi.org\/10.1186\/s12905-018-0521-4.","journal-title":"BMC Women\u2019s Health"},{"issue":"1","key":"1872_CR23","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1186\/s12978-021-01078-y","volume":"18","author":"AI Ajayi","year":"2021","unstructured":"Ajayi AI, Odunga SA, Oduor C, Ouedraogo R, Ushie BA, Wado YD. I was tricked: understanding reasons for unintended pregnancy among sexually active adolescent girls. BMC Reproductive Health. 2021;18(1):19. https:\/\/doi.org\/10.1186\/s12978-021-01078-y.","journal-title":"BMC Reproductive Health"},{"issue":"1","key":"1872_CR24","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1007\/s40609-017-0102-8","volume":"5","author":"M Kumar","year":"2018","unstructured":"Kumar M, Huang KY, Othieno C, Wamalwa D, Madeghe B, Osok J, et al. Adolescent pregnancy and challenges in Kenyan context: perspectives from multiple community stakeholders. Global Social Welf. 2018;5(1):11\u201327. https:\/\/doi.org\/10.1007\/s40609-017-0102-8.","journal-title":"Global Social Welf"},{"key":"1872_CR25","unstructured":"Kenya National Bureau of Statistics. 2019 Kenya Population and Housing Census Volume II: Distribution of Population by Administrative Units. 2019. p.11, 12, 184. https:\/\/www.knbs.or.ke\/2019-kenya-population-and-housing-census-reports\/. Accessed 26 Aug 2024."},{"key":"1872_CR26","unstructured":"Kenya National Bureau of Statistics. 2019 Kenya Population and Housing Census Volume III: Distribution of Population by Age, Sex and Administrative Units. 2019. p.298. https:\/\/www.knbs.or.ke\/2019-kenya-population-and-housing-census-reports\/. Accessed 26 Aug 2024."},{"key":"1872_CR27","unstructured":"Kenya National Bureau of Statistics. 2019 Kenya Population and Housing Census Volume IV: Distribution of Population by Socio-Economic Characteristics. 2019. p.155, 354. https:\/\/www.knbs.or.ke\/2019-kenya-population-and-housing-census-reports\/. Accessed 26 Aug 2024."},{"key":"1872_CR28","unstructured":"Ministry of Medical Services, Ministry of Public Health & Sanitation. Health Sector Strategic and Investment Plan (KHSSP) July 2013-June 2017. 2013. p.74. https:\/\/publications.universalhealth2030.org\/ref\/f80da7c0096095c3b80512bcd83f93ec. Accessed 26 Aug 2024."},{"key":"1872_CR29","unstructured":"Ministry of Health. Kenya Community Health Strategy 2020\u20132025. 2020. Definition of Terms p. vi. http:\/\/guidelines.health.go.ke\/#\/category\/12\/447\/meta. Accessed 26 Aug 2024."},{"key":"1872_CR30","unstructured":"Sidze EM, Stillman M, Keogh S, Mulupi S, Egesa CP, Leong E et al. From paper to practice: sexuality education policies and their implementation in Kenya. 2017. p. 18, 19, 55. https:\/\/www.guttmacher.org\/report\/sexuality-education-kenya. Accessed 26 Aug 2024."},{"key":"1872_CR31","unstructured":"World Health Organization. Unmet need for family planning (%). 2023. https:\/\/www.who.int\/data\/gho\/indicator-metadata-registry\/imr-details\/3414. Accessed 26 Aug 2024."},{"key":"1872_CR32","unstructured":"Kirby DEA. 2007: Research Findings on Programs to Reduce Teen Pregnancy and Sexually Transmitted Diseases. 2007. p.154. https:\/\/eric.ed.gov\/?id=ED456171. Accessed 26 Aug 2024."},{"key":"1872_CR33","unstructured":"United Nations Educational, Scientific and Cultural Organization. International technical guidance on sexuality education: an evidence-informed approach. 2018. p.16, 17, 28. https:\/\/unesdoc.unesco.org\/ark:\/48223\/pf0000260770. Accessed 26 Aug 2024."},{"issue":"1","key":"1872_CR34","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1186\/s13012-020-01074-z","volume":"16","author":"J Webster","year":"2021","unstructured":"Webster J, Krishnaratne S, Hoyt J, Demissie SD, Spilotros N, Landegger J, et al. Context-acceptability theories: example of family planning interventions in five African countries. Implement Sci. 2021;16(1):12. https:\/\/doi.org\/10.1186\/s13012-020-01074-z.","journal-title":"Implement Sci"},{"issue":"4","key":"1872_CR35","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1111\/sifp.12043","volume":"48","author":"MON Kunnuji","year":"2017","unstructured":"Kunnuji MON, Robinson RS, Shawar YR, Shiffman J. Variable implementation of sexuality education in three Nigerian states. Stud Fam Plann. 2017;48(4):359\u201376. https:\/\/doi.org\/10.1111\/sifp.12043.","journal-title":"Stud Fam Plann"},{"key":"1872_CR36","unstructured":"Joint United Nations Programme on HIV and AIDS. Transactional sex and HIV risk: from analysis to action. 2018. https:\/\/www.unaids.org\/en\/resources\/documents\/2018\/transactional-sex-and-hiv-risk. Accessed 26 Aug 2024."},{"key":"1872_CR37","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0286850","author":"GN Mihretie","year":"2023","unstructured":"Mihretie GN, Kassa BG, Ayele AD, Liyeh TM, Belay HG, Miskr AD, et al. Transactional sex among women in Sub-saharan Africa: a systematic review and meta-analysis. PLoS ONE. 2023. https:\/\/doi.org\/10.1371\/journal.pone.0286850.","journal-title":"PLoS ONE"},{"key":"1872_CR38","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0144321","author":"K Oruko","year":"2015","unstructured":"Oruko K, Nyothach E, Zielinski-Gutierrez E, Mason L, Alexander K, Vulule J, et al. He is the one who is providing you with everything so whatever he says is what you do\u2019: a qualitative study on factors affecting secondary school girls\u2019 dropout in rural Western Kenya. PLoS ONE. 2015. https:\/\/doi.org\/10.1371\/journal.pone.0144321.","journal-title":"PLoS ONE"},{"issue":"41","key":"1872_CR39","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1016\/S0968-8080(13)41682-8","volume":"21","author":"J McCleary-Sills","year":"2013","unstructured":"McCleary-Sills J, Douglas Z, Rwehumbiza A, Hamisi A, Mabala R. Gendered norms, sexual exploitation and adolescent pregnancy in rural Tanzania. Reprod Health Matters. 2013;21(41):97\u2013105. https:\/\/doi.org\/10.1016\/S0968-8080(13)41682-8.","journal-title":"Reprod Health Matters"},{"issue":"1","key":"1872_CR40","doi-asserted-by":"publisher","first-page":"666","DOI":"10.1186\/s12889-017-4636-6","volume":"17","author":"M Ranganathan","year":"2017","unstructured":"Ranganathan M, Macphail C, Pettifor A, Kahn K, Khoza N, Twine R, et al. Young women\u2019s perceptions of transactional sex and sexual agency: a qualitative study in the context of rural South Africa. BMC Public Health. 2017;17(1):666. https:\/\/doi.org\/10.1186\/s12889-017-4636-6.","journal-title":"BMC Public Health"},{"issue":"3","key":"1872_CR41","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1111\/sifp.12100","volume":"50","author":"K Austrian","year":"2019","unstructured":"Austrian K, Soler-Hampejsek E, Duby Z, Hewett PC. When he asks for sex, you will never refuse: transactional sex and adolescent pregnancy in Zambia. Stud Fam Plann. 2019;50(3):243\u201356. https:\/\/doi.org\/10.1111\/sifp.12100.","journal-title":"Stud Fam Plann"},{"key":"1872_CR42","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0113621","author":"MS Dunbar","year":"2014","unstructured":"Dunbar MS, Kang Dufour M-S, Lambdin B, Mudekunye-Mahaka I, Nhamo D, Padian NS. The SHAZ! Project: results from a pilot randomized trial of a structural intervention to prevent HIV among adolescent women in Zimbabwe. PLoS ONE. 2014. https:\/\/doi.org\/10.1371\/journal.pone.0113621.","journal-title":"PLoS ONE"},{"issue":"1","key":"1872_CR43","doi-asserted-by":"publisher","first-page":"901","DOI":"10.1186\/s12889-022-13318-2","volume":"22","author":"AM Kotoh","year":"2022","unstructured":"Kotoh AM, Sena Amekudzie B, Opoku-Mensah K, Baku EA, Glozah FN. Pregnant adolescents\u2019 lived experiences and coping strategies in a peri-urban district in Southern Ghana. BMC Public Health. 2022;22(1):901. https:\/\/doi.org\/10.1186\/s12889-022-13318-2.","journal-title":"BMC Public Health"},{"issue":"1","key":"1872_CR44","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1186\/1471-2458-13-816","volume":"13","author":"JN Leerlooijer","year":"2013","unstructured":"Leerlooijer JN, Bos AE, Ruiter RA, Van Reeuwijk MA, Rijsdijk LE, Nshakira N, et al. Qualitative evaluation of the teenage Mothers Project in Uganda: a community-based empowerment intervention for unmarried teenage mothers. BMC Public Health. 2013;13(1):816. https:\/\/doi.org\/10.1186\/1471-2458-13-816.","journal-title":"BMC Public Health"}],"container-title":["Reproductive Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12978-024-01872-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12978-024-01872-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12978-024-01872-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T16:09:52Z","timestamp":1728403792000},"score":1,"resource":{"primary":{"URL":"https:\/\/reproductive-health-journal.biomedcentral.com\/articles\/10.1186\/s12978-024-01872-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,8]]},"references-count":44,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["1872"],"URL":"https:\/\/doi.org\/10.1186\/s12978-024-01872-4","relation":{},"ISSN":["1742-4755"],"issn-type":[{"value":"1742-4755","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,8]]},"assertion":[{"value":"9 June 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 August 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 October 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Ethical approvals were obtained from the Ethical Committee of the Graduate School of Tropical Medicine and Global Health, Nagasaki University (Approval No.: NU_TMGH_2022_233_1), and the Maseno University Scientific and Ethics Review Committee (MUSERC) (Reference No.: MSU\/DRPI\/MUSERC\/01183\/22). A research license was also obtained from the National Commission for Science, Technology and Innovation (NACOSTI) (License NO.: NACOSTI\/P\/23\/24181). Additional approvals were obtained from the Ministry of Interior and National Administration, Ministry of Education (MOE), and Ministry of Health (MOH) at Kericho County. Before starting each discussion or interview, the study objectives, methods, and volunteerism were explained in English, Kiswahili, or Kipsigis, which is the local language at the study site, according to participant\u2019 preference. After that, informed consent or assent was obtained. For those under 18 years of age, the CHV, village chief, or nurse in charge obtained agreement from the parents or guardians and authorization to sign the informed consent form on their behalf owing to the geographic accessibility of each household.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"143"}}