Date of Award

2018

Document Type

Open Access Thesis

Degree Name

MS in Physician Assistant Studies (PA)

Department

Physician Assistant Studies

First Advisor

Stephanie Elko

Abstract

Adolescent pregnancy is one of the main healthcare issues facing Nicaragua. Prevention strategies are needed to avoid the maternal and fetal outcomes associated with young pregnancies. Extensive literature analysis and face-to-face discussions in Nicaragua were conducted to determine the current incidence of adolescent pregnancy and contraception use, barriers to reproductive health for adolescents, maternal outcomes of adolescent pregnancy, and if intrauterine devices have the potential to be a culturally effective method of contraception. Specific barriers to reproductive health for adolescents were identified to be machismo, societal criticism, lack of reproductive education, fear of infection from IUDs, and underutilization of healthcare facilities. Intrauterine devices are more effective and have a lower discontinuation rate compared to other contraceptives. Intrauterine devices also provide an option for a less extensive treatment regimen following implantation compared to daily or monthly dosing with other contraceptives. However, current attitudes regarding IUDs for contraception remain skeptical, which explains why they are the least favored contraceptive method in Nicaragua. Solely educating clinicians and patients about the effectiveness of IUDs does not increase their use nor change patient and provider attitudes. Instead, a multifactorial approach to IUD implementation has shown increased uptake of IUDs as contraception and has given hope for adolescent pregnancy prevention.

Identifier

SC11.PASA.2018.Johnson.H

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