Socio-economic Variable of Parents as a Correlate Promoting Teenage Pregnancy Among Medical Students in Delta State University, Abraka

Purpose: The incidence of teenage pregnancy has attracted global concern due to its impact on the teen’s maternal health, the overall wellbeing of the child and the society at large. This study examined socioeconomic variable of parents as a correlate promoting teenage pregnancy among medical students in Delta State University, Abraka Delta State. Methods: The Ex-Post Facto method was chosen as the research design for the study. 294 female medical students were selected from a total of 982 students from the medical college using simple random sampling technique. The instruments used for data collection was a self-structured and well-designed questionnaire containing 25 multiple choice items based on the research questions developed in the study. 278 questionnaires were successful retrieved from the eld and was used for data analysis. Frequency count, percentages, mean score and Pearson product moment correlation were employed as the statistical technique for data analysis. SPSS version 21.0 was utilized for data analysis. Results: Findings from this study revealed that parental income (p=0.003) and occupation (p=0.005) were the viable parents’ socio-economic variable promoting teenage pregnancy among medical students in Delta State University, Abraka when compared to educational background (p=0.343), religion (p=0.307) and marital status (p=0.053) variables that were not signicantly related. Conclusions: It appears that signicant number of adolescent female students who become pregnant has to leave school and this have a long-term implication for them as individual, their family and their community. Therefore, effective parent-daughter relationships and school-based reproductive health education programmes are strongly recommended.


Introduction
Teenage is a time of obvious physical changes. The concept "teenage pregnancy" may vary from one individual to the next relying upon the perspective one ganders at it. Teenage pregnancy is a situation in which a girl in her teenage years (13)(14)(15)(16)(17)(18)(19) becomes a mother as a result of getting pregnant. Pregnancy among many adolescent girls can result to devastating health complications [1,2]. It is a biology process whereby the sperm fertilizes the ovum released by the ovary and the fertilized ovum travels down the fallopian tube were it attaches to the uterus to form the embryo and the placenta [3]. Pregnancy usually occurs by sexual intercourse and/or by Assisted Reproductive Technology [4]. Childbirth around pregnancy typically takes place within 40weeks from the time of last menstrual period (LMP). According to Eunice, [3] pregnancy can be generally classi ed into three periods of trimesters, namely; the rst trimester, second trimester and third trimester respectively.
Pregnancy among teenagers is increasing despite its increasing threat to schooling with several health implications especially among those in tertiary institutions [5,6,7]. World Health Organization (WHO), [8] reported that most adolescent girls between the age of 15 to 19 get pregnant and that globally close to 16 million of these women give birth yearly resulting to about 11% of all births. In Nigeria, teenage pregnancy is seen as a serious problem as an estimated 23% of women between 15-19 years have begun childbearing, out of which 17% have had their rst child and 5% are pregnant with their rst child [9,10,11]. Teenage pregnancy is condition that has often been linked with in negative consequences on the adolescents and their children. Finer and Zolna, [12] maintains that an approximate of 26% of teenage pregnancies end in abortion. The report of UNFPA, [13] have identi ed the following as the underlying cause of teenage pregnancy include; parents' socio-economic status, gender inequality, child marriage, poverty, sexual violence, obstacles to human rights, national policies restricting access to contraception, age, lack of access to education.
Parents' socio-economic status has impact on the rate of teenage pregnancies in different countries of the world [11]. In Nigeria and other developing countries, parent's socio-economic status such as; parental income, education level, parental occupation, family size, income level and family structure of the learner could in uence the rate of teenage pregnancy [14,15]. More often, these girl child drops out of school mostly due to pressures they experience such as; shame, stigmatization and disgrace that is limited with early parenting; they begin con ning from their companions with absence of the vital help from their friends, family, schools and different organizations. At the long run, this could eventually terminate their dreams of achieving higher pursuits. Hence, the need for this study to explore parent's socio-economic variable as a correlate of teenage pregnancy among medical students in Delta State University, Abraka.

Research Design
The Ex-Post Facto was utilized as the research design for the study. The choice of the design is because it attempts to investigate parents' socio-economic variables such as; income, education level, occupation religion and marital status as a correlate promoting teenage pregnancy among medical students in Delta State University, Abraka. According to Igwebuike, [16] using Ex-Post Facto research design allows the researcher not to manipulate or control the variables and perhaps, the cause-effect relationship established are tentative in nature.

Sample size and Sampling
Data used in the present study were obtained from a total of 982 female medical students aged 15-25years. 294 female students were sampled from four Departments from the College of Health Sciences. A simple random sampling through balloting was used for selecting three (3) Departments from the Faculty of Basic Medical Science in the university.

Research Instruments
The instrument used for data collection was s well-structured questionnaire titled 'Parents Socioeconomic Variables and Teenage Pregnancy Survey (PSVTPS)' developed by the researcher after extensive review of literature. The questionnaire method according to Mugenda and Mugenda,[17] was chosen because it was considered easy to manage and could help the researcher to concurrently gather elicit information from the participants therefore saving time. Orodho, [18] opined that a questionnaire allows dimension for or beside a particular viewpoint and that questionnaire has the capability to gather a great amount of information in a reasonably short time. The instrument employed the 4-Likert scale points ranging from strongly agree (SA)-4, agree (A)-3, disagree (D)-2 to strongly disagree (SD)-1.

Ethical Clearance
Prior to the study, ethical clearance was obtained from the Bioethics Committee on Research of the Faculty of Basic Medical Sciences, Delta State University, Abraka. Oral and written permissions from the Dean of the Faculty and the respective study subjects were equally obtained before the time of data collection.

Method of Data Collection
Before visiting the identi ed sampled respondents, the researcher sorted permission from the relevant authorities within the Medical College. The researcher thereafter administered the questionnaire personally to the participants to enhance large returns. 278 questionnaires were successfully lled and retrieved from the students. Their responses were scored and the data generated were collated for statistical analysis.

Statistically Analysis
The completed questionnaires were collated, coded and analyzed using both descriptive and inferential statistics. For the descriptive statistics, frequency counts, percentages, bar and pie charts were used to illustrate the section. The average mean for the research items generated with a score of 2.50 and above indicating agreement benchmark while scores below 2.50 were not considered. For the inferential statistics, Pearson Product Moment Correlation (PPMC) coe cient was employed. Statistical Package for Social Sciences (SPSS) version 22.0 was utilized for data analysis.

Results
Demographic Data of Respondents Figure 1 below revealed that a total of 88(31.6%) of the participants for the study were medical students in Physiology Department, 80(28.8%) were students from Anatomy Department, 65(23.38%) were students in Nursing science and the remaining 45(16.19%) were students in medicine and surgery. Based on the academic levels of the students, 121(43.53%) were in 200level, 102(36.69%) were in 300level and the remaining 55(19.8%) were 400level students respectively. This showed that a very high percentage of the responses were gathered from college students in 200level.  Table 1 below depicts a picture of the responses on relationship between parental income and teenage pregnancy. Out of the 5 items tested, it was revealed that all were accepted. Hence, items 1, 2, 3, 4 and 5 respectively had a mean score above the bench mark of 2.50 and were adopted. This implies that teenage pregnancy is common among students whose parents earn low incomes or from poorer homes. Consequently, teenage pregnancy certainly affects students whose parents are struggling to support their medical education. In addition, consequences of teenage pregnancies are enormous among students whose parents have no employment and this often results to dropout of students from medical school. Based on hypothesis I formulated, it was observed that the parental income variable had a higher mean score of 110.3 with a standard deviation of 32.6 when compared to the teenage pregnancy variable that had a mean score of 28.8 with a standard deviation of 27.8. Hence, the result indicates that the rcalculated value of 0.828 is greater than the r-critical value of 0.440 at p < 0.05 levels of signi cance. Hence, the null hypothesis I is rejected. Therefore, we conclude that there is signi cant relationship between parental income and teenage pregnancy among medical students in College of Health Sciences, Delta State University, Abraka. The data analyzed in Table 2 below represents the relationship between education level of parents and teenage pregnancy among medical students. Five (5) items were used to analyze the statement, whereas, the result obtained clearly revealed that all the items tested were accepted. Hence, item 6-10 respectively had a mean score above 2.50, thus, were adopted. This implies that parents' educational achievements has less impact on the incidence of teenage pregnancy, uneducated parents do not readily advice their children of the risk factor of teenage pregnancy; hence, teenage pregnancy is common among parents with no formal education. Meanwhile parents with formal education help teenagers to execute and coordinate their experience as well as helps students to be conscious of the risk associated with teenage pregnancy. It was equally observed that the r-cal value of 0   Table 3 below shows the responses on relationship between parental occupation and teenage pregnancy among medical students. It was gathered that 3 items out of the 5 generated statements were accepted, which implies that item 11, 12 and 13 respectively had a mean score above the bench mark of 2.50 and were adopted, while item 14 and 15 had a mean score below 2.50 and was rejected. This implies that occupation of parents determines the incidence of teenage pregnancy and this affects student's attitude towards teenage pregnancy, also, parents' occupation status in uences the knowledge of students towards consequences of teenage pregnancy. Result obtained with regards to Hypothesis III revealed that parental occupation variable had a higher mean score of 89.6 with a standard deviation of 55.9 when compared to the teenage pregnancy variable that had a mean score of 49.4 with a standard deviation of 23.9. Considering that the r-calculated value of 0.805 was greater than the r-critical value of 0.440 at p < 0.05 levels of signi cance, therefore, we conclude that there is signi cant relationship between parental − \ v a r v e c x occupation and teenage pregnancy among medical students in College of Health Sciences, Delta State University, Abraka.  Table 4 below represents the statement on the relationship between parents' religion and teenage pregnancy among medical students. It was obtained from the analysis that all the items generated, that is, 16, 17, 18, 19 and 20 respectively had a mean score above 2.50 and were accepted. Hence, this implies that students whose parents has value for religion are not victims of teenage pregnancy, religion is a powerful social force and provides a moral framework for socialization, in addition, students whose parents often conduct morning devotions are less likely to experience teenage pregnancy, also, students whose parents fails to have their marriage blessed in the church are likely to experience teenage pregnancy and students whose parents had mixed marriage are likely to experience teenage pregnancy. Considering Hypothesis IV; it was revealed that the r-cal value of 0.360 is less than the r-crit value of 0.440 at P > 0.05 levels of signi cance. Result obtained shows that parent's religion variable had a higher mean score of 115.20 with a standard deviation of 31.5 when compared to the teenage pregnancy variable that had a mean score of 23.80 with a standard deviation of 21.3. Hence, the null hypothesis of is accepted. Therefore we conclude that there is no signi cant relationship between parents' religion and teenage pregnancy among medical students in College of Health Sciences, Delta State University, Abraka.  Table 5 below represents statements on the relationship between parents' marital status and teenage pregnancy among medical students. Out of the 5 items generated, 3 of the items, that is, 21, 22 and 25 had a mean score above the bench mark of 2.50 and were accepted while the remaining 2 items; 23 and 24 respectively had a mean score below 2.50 and were rejected. This implies that students from broken homes and polygamous family are likely to engage in teenage pregnancy. Thus, poor parental supervision as a result of broken homes promotes likelihood of teenage pregnancy. The r-cal value of 0.626 for the Pearson Product Moment Correlation analysis for Hypothesis V was less than the r-crit value of 0.440 at p < 0.05 levels of signi cance. Meanwhile, the parent's marital status variable had a higher mean score of 77.20 with a standard deviation of 50.9 greater than the teenage pregnancy variable that had a mean score of 61.8 with a standard deviation of 41.2. Since, the r-calculated value was greater than the r-critical value, hence, the null hypothesis V formulated is accepted. This implies that there is no signi cant relationship between parent's marital status and teenage pregnancy among medical students in College of Health Sciences, Delta State University, Abraka.

Discussion
Teenage pregnancy is one of the most usually unplanned and unfavourable outcomes of adolescents' sexual activity which constitutes a public health problem to teenagers, families and the society at large. Findings from this present study have revealed that teenage pregnancy is common among students from low parental income and/or poorer homes, and thus, certainly affect students whose parents are struggling to support their medical education and parents that have no employment thus resulting to frequent dropouts. The outcome of this study corroborates the ndings of Bello, [19] who found that children from high socio economic background have a better chance of succeeding in school than their low socio economic status counterparts; however, this determines the attitude of the student to teenage pregnancy. Also, it agrees with the opinion of Odukwe, [20] who con rmed that children from high − \ v a r v e c x economic background are able to enroll in lesson, buy necessary text books and stationary when compared to those students from poorer homes.
Parental education was not found to have signi cant relationship with teenage pregnancy among medical students, as such; parent's educational achievement has less impact to play on the incidence of teenage pregnancy. Although, uneducated parents do not readily advice their children of the risk factor of teenage pregnancy; hence, making teenage pregnancy a common phenomenon among parents with no formal education when compared to parents with formal education who are readily knowledgeable on strategies to help teenagers to execute and coordinate their experience as well as helps students to be conscious of the risk associated with teenage pregnancy. This nding is consistent with studies conducted by [21,22,23] who did not nd any signi cant association between family educational characteristics and the experience of teenage pregnancy while on the contrary the study conducted by Naziru, [24] and Philemon, [25] found signi cant association.
Occupation of parents was found to determine the incidence of teenage pregnancy and this affects student's attitude towards teenage pregnancy. Furthermore, the study revealed that parents' occupation in uences the knowledge of students towards consequences of teenage pregnancy. This con rmed the submission of Muraina and Ajayi, [26] that parental employment is expected to have signi cant effect on the welfare of their children. The author further pointed out that as far as academic performance of children is concerned, parental occupation might have both positive and negative impact on their children sexuality behavours. Similarly, Jessica and Diana, [27] in their studies reported that parental occupation can affect how parents bring their children into a culture of learning.
Religion of parents was not found to be related to teenage pregnancy. Students whose parents has value for religion are not victims of teenage pregnancy, in addition, it was believed that religion is a powerful social force which provides a moral framework for socialization, hence, parents that often conduct morning devotion are less likely to experience teenage pregnancy while, parents that fails to have their marriage blessed in the church are likely to experience teenage pregnancy as well as parents who encounter mixed marriage are likely to experience teenage pregnancy. These ndings support those of Assimeng, [28] who stated that religion is a powerful social force and provides a moral framework for socialization. The ndings of this study is also in line with Nalenga, [29] submission that religion is a factor linked to teenage pregnancy since religion plays a signi cant role in moderating sexual behaviour of adolescents, preventing prostitution and abnormal sexual practice among teen such as; homosexuality, premarital extramarital sexual intercourse and indiscriminate use of condom.
Marital status of parents was not found to be related to teenage pregnancy, although, students from broken homes and polygamous family are likely to engage in teenage pregnancy. Hence, poor parental supervision as a result of broken homes promotes likelihood of teenage pregnancy. These ndings corroborate those of Meddinus and Johnson, [30] who identi ed poor parental supervision as a result of broken homes and inadequate or absence of contraceptives responsible for the occurrence of teenage pregnancy. On the contrary, studies by Mathewos and Mekuria, [21]; Ayele et al, [22]; Envuladu et al, [23]; Gideon, [31] and Alemayehu et al, [32] found signi cant association between marital status and teenage pregnancy.

Conclusion
Teenage pregnancy is a common a social problem which occurs globally. This study shows that there are gaps in socio-economic variable as a correlate that promotes teenage pregnancy among medical students. Several parents' socioeconomic factors have been discovered to be associated with teenage pregnancy. Result obtained from this study has shown that parental income and occupation are signi cantly related to occurrence of teenage pregnancy among medical students in the study area while educational background, religion and marital status are not. Therefore, it is recommended that government, religious leaders, parents and schools must as a matter urgency strengthen and reappraise their obligations towards curbing the menace of teenage pregnancies among students.   Bar chart showing the frequency distribution of the respondents by Religion