Knowledge about danger signs in pregnancy and its determinants among pregnant teenagers attending antenatal care at public health facilities in Rubirizi District, Southwestern Uganda

Abstract Introduction : Pregnancy complications pose significant risks to teenagers and their unborn babies. Despite the high prevalence of these complications, there remains a substantial knowledge gap regarding danger signs in pregnancy among this vulnerable group. This study assessed the level of knowledge about pregnancy danger signs and its determinants among pregnant teenagers attending antenatal care (ANC) in public health facilities of Rubirizi District, Uganda Methods : A mixed-methods approach was utilized, combining quantitative data from a survey of 237 pregnant teenagers with qualitative insights on facility factors from key informant interviews (KIIs) with 10 healthcare providers. The survey evaluated knowledge about danger signs and determined individual, social, and facility-related factors. Quantitative data were collected using a Kobo-designed questionnaire and analyzed in STATA, while qualitative data were analyzed thematically. Results: Only 11.0% (26/237) of pregnant teenagers had good knowledge of danger signs in pregnancy. Awareness was highest for vaginal bleeding (23.6%) and excessive vomiting (21.1%), but was low for severe headaches (5.5%) and convulsions (2.5%). Factors significantly associated with good knowledge included having been pregnant more than once (AOR = 3.3, 95% CI: 1.05–10.55), access to a telephone (AOR = 5.4, 95% CI: 1.01–28.72), living in a community where teenage pregnancy was considered taboo (AOR = 3.5, 95% CI: 1.29–9.69), receiving follow-up during the current pregnancy (AOR = 3.8, 95% CI: 1.23–11.69), and being divorced (AOR = 20.5, 95% CI: 2.79–151.13). Participants whose husbands were casual labourers had lower odds of good knowledge compared with those whose husbands were civil servants (AOR = 0.1, 95% CI: 0.01–0.44). Qualitative findings indicated that health workers’ attitudes and skills, availability of educational resources, and follow-up by health workers were perceived as important factors related to knowledge of danger signs in pregnancy . Conclusion: The study identified a significant knowledge gap on pregnancy danger signs among pregnant teenagers in Rubirizi District. To enhance knowledge, health workers should adopt a friendly and supportive approach, organize special antenatal care clinics, and engage experienced teenage mothers as peer educators to share knowledge and experience