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. 2025 Nov 10;22(1):223.
doi: 10.1186/s12978-025-02164-1.

"Unintended pregnancy and attitudes towards sexual and reproductive health among young people in Benguela Province, Angola"

Esperanza Esteban  1   2   3 , Olatz Larrea  4 , María Gabriela Irrazabal  5 , Alba Sánchez  6 , Francisca Zacarias  7 , Paula Regina Oliveira  8   9 , Domingos Vita  10   11   12   13 , Jackson Ceita  14 , Carlos Pacatolo  15 , Maria Luisa Aznar #  16   17 , Israel Molina #  16   17
Affiliations

"Unintended pregnancy and attitudes towards sexual and reproductive health among young people in Benguela Province, Angola"

Esperanza Esteban et al. Reprod Health. .

Abstract

Background: Young women (YW) in Angola face multiple, intersecting challenges related to sexual and reproductive health (SRH), including high rates of early and unintended pregnancy, limited access to contraception, gender-based violence (GBV), and unsafe abortion. These issues are shaped by structural inequalities, restrictive laws, stigma, and inadequate youth-friendly services. Despite the urgency, qualitative research exploring youth perspectives on SRH in Angola remains scarce.

Methods: This qualitative study was conducted in May 2023 in Benguela Province, Angola, as part of the formative phase of the [Anonymised] project. Four focus group discussions (FGDs) were held with 27 young people aged 18-25, stratified by sex and setting (urban Lobito, rural Cubal). Participants were purposively selected to ensure diversity of background and recruited through civil society networks. Discussions followed a semi-structured guide and were analysed using thematic content analysis, integrating systems thinking and Bronfenbrenner's ecological model.

Results: Participants identified early pregnancy as the most pressing concern, frequently linked to stigma, misinformation, social pressure, and lack of confidential services. Contraceptive use was limited by fear, myths, and gender dynamics, with abortion often emerging as a stigmatized but common response to unintended pregnancy. Testimonies revealed four "Itineraries of Reality" (IR): [1] abortion as moral crime [2], clandestine abortion as escape [3], forced continuation of pregnancy, and [4] an aspirational path toward safe, legal abortion. These trajectories were embedded in two "Vulnerability Circuits" (VC): unsafe abortion and intergenerational poverty. However, two Exit Strategies (ES)-social activism and legal-health system reform-and one Empowerment Pathway (EP) linked to youth-led associations and community spaces emerged as means of resistance and resilience.

Conclusions: Young people's SRH decisions in Benguela are shaped not only by individual attitudes but by social norms, gender inequality, systemic barriers, and restrictive policies. Early motherhood often reflects constrained agency rather than choice. Addressing these issues requires expanding SRH education and services, decriminalizing abortion, and strengthening youth empowerment mechanisms. Findings support the design of rights-based, context-sensitive interventions rooted in young people's lived realities.

Keywords: Angola; Contraception; Gender norms; Qualitative research.; Sexual and reproductive health; Unintended pregnancies; Unsafe abortion; Vulnerability; Young people.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was designed, implemented, and reported in accordance with the Declaration of Helsinki’s Good Clinical Practice guidelines. The ethics committee of the Ministry of Health of the Republic of Angola (MINSA) (nº14/2021) requested approval. Written informed consent was obtained from all participants to participate and record interviews, and the transcriptions were anonymized. This study adheres to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist to ensure transparency and comprehensiveness in the reporting of qualitative methods, data collection, analysis, and findings. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Main concerns about SRH among adolescents in Benguela. Number (N) of mentions
Fig. 2
Fig. 2
Number of mentions of key factors influencing sexual and reproductive health (SRH)
Fig. 3
Fig. 3
A model of early pregnancy outcomes of young women in Benguela. Relationship between itineraries of reality (IR), vulnerability circuits (VC), exit strategies (ES) and Empowerment Path (EP)
Fig. 4
Fig. 4
Social structures that favour early and unwanted pregnancies in Benguela Province
See this image and copyright information in PMC

References

    1. Instituto Nacional de Estatística de Angola. Inquérito de Indicadores Múltiplos e de Saúde de Angola (IIMS 2023–2024). Luanda: INE, Ministério da Saúde, e UNICEF;2024.
    1. Girlhood N. Motherhood: Preventing Adolescent Pregnancy. New York: UNFPA. 2015. https://www.unfpa.org/publications/girlhood-not-motherhood
    1. World Health Organization. WHO. Global Abortion Policies Database. Geneva: WHO; 2024. https://abortion-policies.srhr.org
    1. Chandra-Mouli V, et al. A never-before opportunity to strengthen investment and action on adolescent contraception, and what we must do to make full use of it. Reprod Health. 2017. 10.1186/s12978-017-0347-9. - PMC - PubMed
    1. UNESCO. International Technical Guidance on Sexuality Education. An Evidence-Informed Approach for Schools, Teachers and Health Educators. Revised Edition. Paris: UNESCO;2018. https://unesdoc.unesco.org

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