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Navigating the Triple Burden: Understanding Pregnancy, HIV, and Mental Well-Being Among Adolescent Girls and Young Women in Zambia
Navigating the Triple Burden: Understanding Pregnancy, HIV, and Mental Well-Being Among Adolescent Girls and Young Women in Zambia
상세정보
- 자료유형
- 학위논문 서양
- 최종처리일시
- 20260202103118
- ISBN
- 9798315705079
- DDC
- 614
- 서명/저자
- Navigating the Triple Burden: Understanding Pregnancy, HIV, and Mental Well-Being Among Adolescent Girls and Young Women in Zambia
- 발행사항
- [Sl] : The University of North Carolina at Chapel Hill, 2025
- 발행사항
- Ann Arbor : ProQuest Dissertations & Theses, 2025
- 형태사항
- 150 p
- 주기사항
- Source: Dissertations Abstracts International, Volume: 86-11, Section: B.
- 주기사항
- Advisor: Speizer, llene S.
- 학위논문주기
- Thesis (Ph.D.)--The University of North Carolina at Chapel Hill, 2025.
- 초록/해제
- 요약Introduction: Adolescent girls and young women (AGYW) in Zambia face a triple burden of mental health challenges, pregnancy, and the complexities of living with or being at risk for HIV. High rates of anxiety and depression are compounded by stigma, socio-economic hardship, and limited mental health services. AGYW who become mothers often encounter health system constraints, financial insecurity, and competing responsibilities that hinder postnatal care (PNC) engagement. While social support and self-efficacy are recognized protective factors, their influence across age and HIV status remains underexplored. This dissertation examines the intersection of social support, self-efficacy, mental health, and maternal service engagement among AGYW in Zambia, focusing on mental health outcomes and experiences with facility-based delivery, breastfeeding, and PNC.Methods: This cross-sectional mixed-methods study draws on two datasets. Quantitative baseline data (N=1123) from the SHIELD/IWC trial were analyzed using logistic regression to assess associations between social support, self-efficacy, and mental health (anxiety and depression), stratified by HIV status and age group (10-15, 16-20, 21-25). Additionally, in a nested mixed-methods study, survey data on postnatal distress, PNC, and breastfeeding were collected from 40 AGYW. Qualitative data included in-depth interviews with these same 40 postpartum AGYW and focus group discussions with healthcare providers and caregivers.Results: Family support was associated with reduced anxiety, especially among AGYW aged 16-20, while friend support was linked to increased anxiety, particularly among AGYW living with HIV and those aged 21-25. Self-efficacy was not significantly associated with mental health overall but predicted higher depression among AGYW aged 10-15 and those living without HIV. Postnatal distress was common, shaped by concerns over newborn care, finances, and personal health. Despite all AGYW attending at least one PNC visit, barriers such as long waits, vaccine shortages, and stigma discouraged continued care. Social support aided PNC attendance and breastfeeding, though food insecurity and transportation challenges disrupted both.Conclusion: Findings highlight the interconnected burdens of mental health, maternal health, and HIV among AGYW. Addressing stigma, socio-economic disparities, and health system barriers is vital for improving outcomes. Future research should explore longitudinal trends and interventions to enhance resilience and youth-friendly care.
- 일반주제명
- Public health
- 일반주제명
- Social research
- 일반주제명
- Mental health
- 일반주제명
- Womens studies
- 키워드
- Perinatal care
- 키워드
- Self-efficacy
- 키워드
- Social support
- 기타저자
- The University of North Carolina at Chapel Hill Maternal and Child Health
- 기본자료저록
- Dissertations Abstracts International. 86-11B.
- 전자적 위치 및 접속
- 로그인 후 원문을 볼 수 있습니다.
MARC
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■020 ▼a9798315705079
■035 ▼a(MiAaPQ)AAI31937680
■040 ▼aMiAaPQ▼cMiAaPQ
■0820 ▼a614
■1001 ▼aNyamaizi, Alinda Mildred.
■24510▼aNavigating the Triple Burden: Understanding Pregnancy, HIV, and Mental Well-Being Among Adolescent Girls and Young Women in Zambia
■260 ▼a[Sl]▼bThe University of North Carolina at Chapel Hill▼c2025
■260 1▼aAnn Arbor▼bProQuest Dissertations & Theses▼c2025
■300 ▼a150 p
■500 ▼aSource: Dissertations Abstracts International, Volume: 86-11, Section: B.
■500 ▼aAdvisor: Speizer, llene S.
■5021 ▼aThesis (Ph.D.)--The University of North Carolina at Chapel Hill, 2025.
■520 ▼aIntroduction: Adolescent girls and young women (AGYW) in Zambia face a triple burden of mental health challenges, pregnancy, and the complexities of living with or being at risk for HIV. High rates of anxiety and depression are compounded by stigma, socio-economic hardship, and limited mental health services. AGYW who become mothers often encounter health system constraints, financial insecurity, and competing responsibilities that hinder postnatal care (PNC) engagement. While social support and self-efficacy are recognized protective factors, their influence across age and HIV status remains underexplored. This dissertation examines the intersection of social support, self-efficacy, mental health, and maternal service engagement among AGYW in Zambia, focusing on mental health outcomes and experiences with facility-based delivery, breastfeeding, and PNC.Methods: This cross-sectional mixed-methods study draws on two datasets. Quantitative baseline data (N=1123) from the SHIELD/IWC trial were analyzed using logistic regression to assess associations between social support, self-efficacy, and mental health (anxiety and depression), stratified by HIV status and age group (10-15, 16-20, 21-25). Additionally, in a nested mixed-methods study, survey data on postnatal distress, PNC, and breastfeeding were collected from 40 AGYW. Qualitative data included in-depth interviews with these same 40 postpartum AGYW and focus group discussions with healthcare providers and caregivers.Results: Family support was associated with reduced anxiety, especially among AGYW aged 16-20, while friend support was linked to increased anxiety, particularly among AGYW living with HIV and those aged 21-25. Self-efficacy was not significantly associated with mental health overall but predicted higher depression among AGYW aged 10-15 and those living without HIV. Postnatal distress was common, shaped by concerns over newborn care, finances, and personal health. Despite all AGYW attending at least one PNC visit, barriers such as long waits, vaccine shortages, and stigma discouraged continued care. Social support aided PNC attendance and breastfeeding, though food insecurity and transportation challenges disrupted both.Conclusion: Findings highlight the interconnected burdens of mental health, maternal health, and HIV among AGYW. Addressing stigma, socio-economic disparities, and health system barriers is vital for improving outcomes. Future research should explore longitudinal trends and interventions to enhance resilience and youth-friendly care.
■590 ▼aSchool code: 0153.
■650 4▼aPublic health
■650 4▼aSocial research
■650 4▼aSub Saharan Africa studies
■650 4▼aMental health
■650 4▼aWomens studies
■653 ▼aAdolescent girls and young women
■653 ▼aPerinatal care
■653 ▼aSelf-efficacy
■653 ▼aSocial support
■653 ▼aMental well-being
■690 ▼a0573
■690 ▼a0344
■690 ▼a0639
■690 ▼a0453
■690 ▼a0347
■71020▼aThe University of North Carolina at Chapel Hill▼bMaternal and Child Health.
■7730 ▼tDissertations Abstracts International▼g86-11B.
■790 ▼a0153
■791 ▼aPh.D.
■792 ▼a2025
■793 ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17357024▼nKERIS▼z이 자료의 원문은 한국교육학술정보원에서 제공합니다.
