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Open Access Research article

Qualitative evaluation of the Teenage Mothers Project in Uganda: a community-based empowerment intervention for unmarried teenage mothers

Joanne N Leerlooijer12*, Arjan ER Bos4, Robert AC Ruiter2, Miranda AJ van Reeuwijk3, Liesbeth E Rijsdijk25, Nathan Nshakira6 and Gerjo Kok2

Author Affiliations

1 Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands

2 Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands

3 Rutgers WPF, Utrecht, The Netherlands

4 School of Psychology, Open University, Heerlen, The Netherlands

5 Windesheim University of Applied Sciences, Windesheim Honours College, Zwolle, The Netherlands

6 Uganda Christian University, Mukono, Kampala, Uganda

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BMC Public Health 2013, 13:816  doi:10.1186/1471-2458-13-816

Published: 8 September 2013

Abstract

Background

A large proportion of unmarried teenage mothers in Uganda face physical, psychological, and social problems after pregnancy and childbirth, such as obstetric complications, lack of education, and stigmatisation in their communities. The Teenage Mothers Project (TMP) in Eastern Uganda empowers unmarried teenage mothers to cope with the consequences of early pregnancy and motherhood. Since 2000, 1036 unmarried teenage mothers, their parents, and community leaders participated in economic and social empowerment interventions. The present study explored the changes resulting from the TMP as well as factors that either enabled or inhibited these changes.

Methods

Semi-structured interviews (N = 23) were conducted with former teenage mothers , community leaders, and project implementers, and lifeline histories were obtained from former teenage mothers (N = 9). Quantitative monitoring data regarding demographic and social characteristics of teenage mother participants (N = 1036) were analysed.

Results

The findings suggest that, overall, the TMP seems to have contributed to the well-being of unmarried teenage mothers and to a supportive social environment. It appears that the project contributed to supportive community norms towards teenage mothers’ position and future opportunities, increased agency, improved coping with early motherhood and stigma, continued education, and increased income generation by teenage mothers. The study findings also suggest limited change in disapproving community norms regarding out-of-wedlock sex and pregnancy, late active enrolment of teenage mothers in the project (i.e., ten months after delivery of the child), and differences in the extent to which parents provided support.

Conclusions

It is concluded that strengths of the community-based TMP seem to be its socio-ecological approach, the participatory planning with community leaders and other stakeholders, counselling of parents and unmarried teenage mothers, and the emphasis on education and income generation. The project can improve by earlier active participation of unmarried pregnant adolescents and increased support for parents.

Keywords:
Empowerment; Stigma; Teenage pregnancy; Qualitative evaluation; Agency; Community; Social change