Catching them young to protect the future of maternal health

It is vital to stress the importance of timing to decision and policy makers, intervening organizations, and any technical-managerial elite. It is also important to consider risk communication timing in the aspect of defining moments for the message making. Relaying important maternal health messages could begin from secondary school sex educations, right before these young adolescent girls get pregnant.

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These messages could include the importance of early registration pre-birth and potential negative outcomes of poor reproductive health choices. The school system could be employed as an important, timely risk communication engine. Worldwide, 16-19 years old were reported to have accounted for 16 million births, and 95% of them occurred in low and middle income countries (Lloyd, 2005; Chandra-Mouli et al., 2013). Therefore, to tackle adolescent pregnancy and its consequences, the WHO developed guidelines addressing six areas which includes: preventing early pregnancy through sexuality education, increasing education opportunities and economic and social support programs; use of contraception; preventing early marriage; increasing use of prenatal care childbirth and post partum care; preventing unsafe abortion and reducing coerced sex (WHO, 2011; Chandra-Mouli et al., 2013).

The salient point here is the importance of implementing these messages at the defining points where future patterns of adult health are established, to avert future negative implications (Orji & Esimai, 2003). Interestingly, some countries have initiated programs along these lines, for example: in 2002, Nigeria pledged to carry out a national school-based comprehensive sexuality education (CSE), although efforts have been made, the pledge is being plagued by some weaknesses. The decision makers are further encouraged to continue on this path of CSE, despite the limitations, as a sustainable long-term strategy to curbing maternal mortality.

Finally, it is also worthwhile to note that teenage pregnancies mainly occur in rural areas where early marriages are commonly practiced (Achema et al., 2015). Going directly to the grassroots may hold the key to achieving the Sustainable Development Goals. 

Please checkout this informative article here for more about rallying the younger generation in the public health fight for a better and safer world. 

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Risk perception and risk attitude towards health decisions

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Individual choices are affected by the perception of the risk, disease or threat, and these opinions are formed by personal reasoning, common sense, and social communication (Sjoberg et al., 2003; Larson et al., 2012). Several factors can modify the individual’s perception including physical, social factors and their perceived susceptibility and seriousness of the threat (Sjoberg et al., 2003; Larson et al., 2012). However the risk perception of an individual is inherently subjective, with people having varying risk attitudes (see Figure 1) (Hillson & Murray-Webster, 2007, p39).

A study in which perceptions of 129 African American women were measured about breast cancer screening and their intention to be screened, revealed some psychological influences on risk perception. 41% of participants were underestimators, 23% overestimators and 37% were extreme overestimators of their personal risks for breast cancer, and this affected their need to attend breast-screening sessions (Bowen et al., 2014). Several psychological variables were seen to influence the women’s decision to undergo breast screening, such as ethnic identity, attitudes towards the physician, emotional distress and risk estimation.

Understanding the perception of stakeholders of maternal health or any other health sector is essential to an improvement of health services and acceptability of intervention programmes. In summary, the psychological and sociological perspectives on risk suggest that lay citizens interpret a particular risk and make decisions towards that risk using several different thought processes.

One of the ways to address different perspectives is via communication. Igboanugo & Martin (2011) recommended that providing critical information to women on how to identify risk factors during pregnancy was important. Also, health ministers in charge of maternity service provision should be required to hear the voices of the people they represent. Communication plays a vital role in addressing the individual/ community perception and world-views.