Understanding the Experiences of Pregnant and Parenting Adolescents in Blantyre, Southern Malawi

Close to one in three adolescent girls in Malawi begin childbearing before their 19th birthday. Early childbearing has significant negative implications for girls' health and wellness. It starts a cycle of social exclusion that often begins with their expulsion or voluntary withdrawal from school with dire socio-economic consequences. Children born to adolescent girls are also vulnerable, and excluded from full societal benefits because of their parents' poor socioeconomic status. While a constellation of actors—government, advocacy, research, and development partners—have focused on reducing teenage pregnancy, there is less attention on the wellness of the millions of pregnant and parenting adolescents (PPAs) in Sub-Saharan Africa (SSA). Very little is known about their lived experiences, including how they perceive their roles as parents, the challenges they experience, and the support they need to improve their life chances. However, robust evidence on the lived realities of PPAs can support the design and implementation of policies and programs to improve not only their wellness but also that of their children. The Centre for Social Research (CSR), University of Malawi, and the African Population and Health Research Center (APHRC) implemented a mixed-methods study in Blantyre, Malawi, to understand how early and unintended pregnancy culminates in the social exclusion of adolescent mothers. We also explored interventions that could ensure their education and economic empowerment. Methods We conducted a concurrent, equal status mixed-methods cross-sectional study comprising a quantitative survey (n = 669 pregnant or parenting girls) and qualitative interviews (n = 57 multiple category participants) in urban and rural Blantyre. Survey participants were selected using two-stage cluster sampling after we conducted a household listing. Overall, we conducted 44 in-depth interviews: 18 among pregnant and parenting adolescent girls, 10 among parenting boys and 16 among parents/guardians. In addition, we conducted 13 key informant interviews, four with teachers, three with policymakers, and six with community leaders and non-governmental organization (NGO) representatives. We also held two validation/dissemination workshops—one among pregnant and parenting girls in Blantyre and the other in Lilongwe—among key stakeholders, including two representatives for pregnant and parenting girls. During both meetings, key findings of the study were presented, and stakeholders not only shared their experiences but also made recommendations on ways to address challenges facing PPAs.