Improving the quality of sexual and reproductive health and rights (SRHR) through pre-service training, research, and evidence-based clinical care delivery in Sub-Saharan Africa

Background: One in three women experience poor person-centered maternity care (PCMC) during childbirth, with adolescents disproportionately affected. However, limited evidence exists on adolescents’ experiences of care during childbirth and how these experiences influence future childbearing intentions, including decisions to give birth again, return to the same facility, or recommend it to others. This study aimed to examine the association between adolescents’ perceptions of PCMC during childbirth and their future childbearing intentions.
Methods: A community-based cross-sectional survey was conducted among 570 adolescents aged 14–19 years who had delivered in public primary health facilities in Lira District, Northern Uganda. Perceptions of PCMC were measured using the validated PCMC scale and categorized as low, moderate, or high. Future childbearing intentions were assessed using the Community Survey tool. Data was analyzed using descriptive statistics and logistic regression. A p-value < 0.05 was considered statistically significant.
Results: The median age of participants was 18 years (IQR: 18–19). More than three-quarters of participants (77.74%) had perceptions of moderate level of overall PCMC during childbirth. Similarly, most participants had perceptions of moderate levels for PCMC sub-scales of dignity and respect (75.09%), communication and autonomy (45.89%), and supportive care (78%). Most adolescents intended to have another child (82%), return to the same facility (83%), and recommend the facility to a sister or friend (85%). Adolescents reporting moderate and high PCMC scores were significantly more likely to intend to return to the same facility (AOR=2.84; 95% CI: 1.61–5.00 and AOR=5.60; 95% CI: 1.19–26.43) and recommend it to others (AOR=4.31; 95% CI: 2.46–7.54).
Conclusion: The study found that adolescents perceived moderate levels of PCMC during childbirth. Adolescents’ perceptions of higher PCMC during childbirth were strongly linked to intentions to return to and recommend the facility, highlighting the importance of respectful, supportive care in shaping maternal health behaviors.
Keywords: Adolescents, Experiences, Childbirth, “Person-Centred Maternity Care”, Childbearing, and Intention.