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Nevertheless, a sub-group of pregnant teenagers appeared to be vulnerable, reporting unplanned and unhappy pregnancy; factors that were also associated with first intercourse being reported as not wanted.

Levels of reproductive and contraceptive knowledge were poor among both pregnant teenagers and male partners.

Meanwhile, improved provision of contraceptive information and services is needed to support the delay of second pregnancies for young mothers.

In addition, strategies to identify and protect those girls who are vulnerable to unwanted sexual activity are needed.

In those ten MOH areas that included plantation populations, the target sample size was further stratified across plantation and non-plantation areas in proportion to these population sizes (with one fifth of the samples being drawn from plantation areas).

This method ensured that the sample included proportionate representation of the urban, rural and plantation population.

The area is divided into fifteen medical officer of health (MOH) areas for provision of community health services.

The teen pregnancy rate is 7.2%, a little above the national average, with higher rates among those living on the tea plantations and the indigenous Veddha population [Regional Director of Health Services Badulla: unpublished].Divergent findings and evidence of significant geographical variation, as well as unexamined factors, underscore the need for further exploration of the sociocultural context of teenage pregnancies in Sri Lanka.As well as limited local understanding, there are significant challenges to extrapolating evidence from other settings – such as the USA, UK or even other South and Southeast Asian countries - given the important differences in socio-cultural milieu, marriage and childbearing practices [].Intervention to reduce teenage pregnancy must recognise the normative nature of early childbearing for the majority of girls who currently conceive and their families.Avoiding such pregnancies will require a fundamental shift in life chances such that delaying pregnancy offers significant socioeconomic advantages.

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