Determinants of change in the inequality and associated predictors of teenage pregnancy in Uganda for the period 2006-2016: analysis of the Uganda Demographic and Health Surveys

Awareness of cervical cancer risk factors and preventive approaches, and perceived causes of cervical cancer among secondary school girls: a cross-sectional study in Northern Uganda

BACKGROUND

The majority of women in low- and middle-income countries have low awareness of cervical cancer. This study sought to establish awareness of cervical cancer risk factors and preventive approaches, as well as sources of information and perceived causes of cervical cancer among secondary school girls in northern Uganda.

METHODS

This was a cross-sectional study conducted in rural northern Uganda. We collected data using an investigator administered pre-tested questionnaire. Analysis was done with STATA version 14.0. Multivariate analyses with logistic regressions models were used to determine magnitudes of association between independent and outcome variables. Odds ratios and accompanying 95% confidence intervals are reported. Statistical significance was considered if the two sided p-value <.05.

RESULTS

Most participants (97%; n = 624) had heard of cervical cancer before this study. The most common source of information about cervical cancer was friends (31.1%; n = 194). More than half of the participants (59%; n = 380) had heard about a vaccine that prevents cervical cancer, but only a third (33%; n = 124) had ever received a dose of the vaccine. The majority of participants (89%; n = 550) reported that cervical cancer could be prevented; however only half (52%; n = 290) knew that vaccination of girls aged 9-13 years could prevent cervical cancer. The majority of participants did not recognize the risk factors for cervical cancer; for example, only 15% (n = 98), 7% (n = 45), and 1.4% (n = 9) recognized early onset of sexual intercourse, infection by the human papillomavirus (HPV), and smoking respectively. On adjusting for age, students' class, and religion, students in schools with school health programs were twice (aOR = 2.24: 95%CI; 1.24-4.06) more likely to know that cervical cancer is preventable.

CONCLUSION

Secondary school girls need information on cervical cancer risk factors and approaches to prevention so that they may avoid exposures to the risk factors and promptly seek and undertake preventive approaches including HPV vaccinations.

Trends and factors associated with teenage pregnancy in Ethiopia: multivariate decomposition analysis

Teenage is a time of transition from childhood to adulthood. This stage is a time of change and needs particular care and ongoing support. Adolescent pregnancy remains a common health care problem in low- and middle-income countries, and it is associated with higher maternal and neonatal complications. Thus, this study aimed to determine the trends and factors associated with them that either positively or negatively contributed to the change in teenage pregnancy in Ethiopia. Ethiopian Demographic and Health Survey data from 2005 to 2016 were used for this study. A total weighted sample of 10,655 (3265 in 2005, 4009 in 2011, and 3381 in 2016) teenagers was included. Trends and the proportion of teenage pregnancies for each factor over time were explored. Then, a logit-based multivariate decomposition analysis for a non-linear response model was fitted to identify the factors that contributed to the change in teenage pregnancy. Statistical significance was declared at p-value < 0.05 and the analysis was carried out on weighted data. Teenage pregnancy declined significantly from 16.6% (95% CI: 15.4, 17.9) to 12.5% (95% CI: 11.4, 13.6) in the study period, with an annual reduction rate of 2.5%. About 49.8% of the decrease in teenage pregnancy was attributed to the change in the effect of the characteristics. The compositional change in primary educational status (41.8%), secondary or above educational status (24.55%), being from households with a rich wealth index (1.41%) were factors positively contributed to the decline in teenage pregnancy, whereas being from a Muslim religion (-12.5%) was the factor that negatively contributed to the reduction in teenage pregnancy. This study has shown that teenage pregnancy declined significantly; however, it is still unacceptably high. The changes in compositional factors of teenagers were responsible for the observed reduction in the prevalence of teen pregnancy rates in Ethiopia. Educational status, religion, and wealth index were found to be significant factors that contributed to the reduction in teenage pregnancy. Therefore, intervention programs targeting adolescents should address the socio-economic inequalities of these influential factors to reduce teenage pregnancy and related complications.

Socioeconomic inequality in teenage pregnancy in Papua New Guinea: a decomposition analysis

BACKGROUND

Teenage pregnancy is a global public health issue, and it poses a serious threat to the health and socioeconomic status of mothers and their newborn children. Although Papua New Guinea has recorded one of the highest teenage pregnancy rates among Asia-Pacific countries, few studies have conducted research on the related inequality in the country. Therefore, this study aimed to assess socioeconomic inequality in teenage pregnancy and its contributing factors in Papua New Guinea.

METHODS

Data for this cross-sectional study were obtained from the 2016-2018 Papua New Guinea Demographic and Health Survey. The analytical sample consisted of 2,864 girls aged 15-19 years. We employed Erreygers normalized concentration index (ECI) and concentration curves to measure and depict socioeconomic inequality in teenage pregnancy. Decomposition analysis was likewise performed to identify the contributions of determinants to the observed inequality.

RESULTS

Weighted ECI for teenage pregnancy was - 0.0582 (P < 0.001), thereby indicating that teenage pregnancy in Papua New Guinea is disproportionately concentrated among poor girls. Decomposition analysis suggested that education level (65.2%), wealth index (55.2%), early sexual debut (25.1%), region (8.5%), and sex of household head (4.1%) are the main determinants explaining the pro-poor socioeconomic inequality in teenage pregnancy.

CONCLUSIONS

A pro-poor socioeconomic inequality of teenage pregnancy was present in Papua New Guinea. This inequality may be alleviated by such interventions as ensuring that teenage girls receive education; implementing poverty alleviation projects, eliminating child, early, and forced marriages; strengthening promotion for household head to support teenagers in accessing sexual and reproductive health education; improving geographical accessibility to health facilities on contraceptive services, and taking necessary precautions and responses to sexual misconduct.

Magnitude and Factors Associated with Teenage Pregnancy in Somaliland: Evidence from Somaliland Health and Demographic Survey, 2020

Purpose

Teenage pregnancy is estimated to be common in Somaliland. It is linked with adverse perinatal outcomes. However, no study has been conducted in the country on this subject. Therefore, this study intended to assess the magnitude and factors associated with teenage pregnancy in Somaliland.

Patients and Methods

Data from the 2020 Somaliland Health and Demographic Survey (SLHDS); were used in the current analysis. A total sample of 3,786 women in reproductive age groups were involved as participants. The survey used a two-level cluster sampling design, which included initial selection of enumeration areas followed by selection of households. To identify associated factors, binary logistic regression analysis was applied.

Results

The magnitude of teenage pregnancy was 47.2% (95%CI: 45.5-48.9%). Being a nomadic resident (AOR: 1.26; 95%CI: 1.12-1.71), being in the lowest wealth quintiles (AOR: 1.34; 95%CI: 1.01-1.77), being in the Sanaag region (AOR: 1.95;95%CI: 1.54-2.46) and having lower educational attainment (AOR: 2.29; 95%CI: 1.08-4.83) were significantly associated with teenage pregnancy.

Conclusion

Teenage pregnancy is highly prevalent in Somaliland and associated with a lower educational level, lower wealth quintiles and nomadic residence. Hence, governmental and non-governmental organizations should work on educating and financially empowering women by giving particular focus to nomadic people.