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Tebeje TM, Abebe M, Aragaw FM, Seifu BL, Mare KU, Shewarega ES, Sisay G, Seboka BT. A multiscale geographically weighted regression analysis of teenage pregnancy and associated factors among adolescents aged 15 to 19 in Ethiopia using the 2019 mini-demographic and health survey. PLoS One 2024; 19:e0310025. [PMID: 39240994 DOI: 10.1371/journal.pone.0310025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 08/22/2024] [Indexed: 09/08/2024] Open
Abstract
BACKGROUND Teenage pregnancy remains one of the major reproductive health problems, especially in sub-Saharan African countries. It can lead to maternal and neonatal complications and social consequences. The proportion of teenage pregnancy differs across regions of Ethiopia. Thus, this study aimed to determine the spatial variation in determinants of teenage pregnancy among adolescents aged 15-19 years in Ethiopia using the 2019 Demographic and Health Survey (DHS). METHODS This study included a total weighted sample of 2165 teenage girls aged 15 to 19 years. A mixed-effect binary logistic regression model was employed to consider the hierarchical nature of the DHS data using STATA version 17. Adjusted odds ratios with 95% confidence intervals are reported, and a p-value less than 0.05 was used to identify significant predictors. The spatial analysis was conducted with ArcGIS version 10.7 and Python 3. To identify factors associated with the hotspots of teenage pregnancy, a multiscale geographically weighted regression (MGWR) was performed. Spatial regression models were compared using adjusted R2, the corrected Akaike information criterion (AICc), and the residual sum of squares (RSS). RESULTS The prevalence of teenage pregnancy among adolescents aged 15 to 19 years was 12.98% (95% CI: 11.6%, 14.5%). It was spatially clustered throughout the country with a significant Moran's I value. Significant hotspot areas were detected in central and southern Afar; northern, central, and western Gambela; northeastern and southern central Oromia; and the eastern Somali region. The MGWR analysis revealed that the significant predictors of spatial variations in teenage pregnancy were being illiterate and being married. Based on the multivariable multilevel analysis, age 17 (AOR = 3.54; 95% CI: 1.60, 7.81), 18 (AOR = 8.21; 95% CI: 3.96, 17.0), 19 (AOR = 15.0; 95% CI: 6.84, 32.9), being literate (AOR = 0.57; 95% CI: 0.35, 0.92), being married (AOR = 22.8; 95% CI: 14.1, 37.0), age of household head (AOR = 0.98; 95% CI: 0.98, 0.99) and residing in the Gambela region (AOR = 3.27; 95% CI: 1.21, 8.86) were significantly associated with teenage pregnancy among adolescents aged 15 to 19. CONCLUSION Teenage pregnancy is a public health problem in Ethiopia. Policymakers should prioritize addressing early marriage and improving teenage literacy rates, with a focus on the Gambela region and other hotspot areas. It is crucial to implement policies aimed at transforming the traditional practice of early marriage and to take measures to enhance literacy levels and promote awareness about sexual and reproductive health at the family and school levels. This will help ensure that young people have the opportunity to pursue education and make informed decisions about their reproductive health.
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Affiliation(s)
- Tsion Mulat Tebeje
- School of Public Health, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
| | - Mesfin Abebe
- Department of Midwifery, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
| | - Fantu Mamo Aragaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Beminate Lemma Seifu
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Afar, Ethiopia
| | - Kusse Urmale Mare
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Afar, Ethiopia
| | - Ever Siyoum Shewarega
- Department of Reproductive Health, School of Public Health, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
| | - Gizaw Sisay
- School of Public Health, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
| | - Binyam Tariku Seboka
- School of Public Health, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
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Kalulu JJ, Masoambeta J, Stones W. Determinants of teenage pregnancy in Malawi: a community-based case-control study. BMC Womens Health 2024; 24:335. [PMID: 38851734 PMCID: PMC11161912 DOI: 10.1186/s12905-024-03166-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 05/28/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND Teenage pregnancies are a global concern. Malawi is one of the countries with the highest teenage pregnancy rates despite government efforts to reverse the situation and yet studies on determinants of teenage pregnancy are rare with some factors remaining unexplored. Therefore, this study aimed to identify factors associated with teenage pregnancies in Malawi. METHODS This was a community-based case-control study that used secondary data from the 2015-16 Malawi Demographic and Health Survey from all 28 districts of Malawi. The study population comprised women aged 20-24 who participated in the survey. The study ran from September 2021 to October 2022 and used a sample size of 3,435 participants who were all women aged 20-24 in the dataset who met the inclusion criteria. Data were analysed using Stata 16 software. Logistic regression analyses were used to determine factors. Variables with a P value of < 0.1 in the univariable analysis were included in the multivariable analyses, where statistical significance was obtained at a P value < 0. 05. RESULTS Data on 3435 participants were analysed. In multivariable analyses: no teenage marriage (AOR 0.13); secondary education (AOR 0.26); higher education (AOR 0.39); richest category of wealth index (AOR 0.51), use of contraception (AOR 3.08), domestic violence by father or mother (AOR 0.37) were found to be significant factors. CONCLUSION This study identified determinants of teenage pregnancy. The government has to sustain and expand initiatives that increase protection from teenage pregnancy, reinforce the implementation of amended marriage legislation, introduce policies to improve the socioeconomic status of vulnerable girls and increase contraceptive use among adolescent girls before their first pregnancy. Further research is also recommended to resolve inconclusive results.
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Affiliation(s)
- James John Kalulu
- Department of Health Systems and Policy, School of Global and Public Health, Kamuzu University of Health Sciences, Private Bag 360, Blantyre 3, Chichiri, Malawi.
- University of Malawi Medical Scheme, P. O. Box 278, Zomba, Malawi.
| | | | - William Stones
- Department of Health Systems and Policy, School of Global and Public Health, Kamuzu University of Health Sciences, Private Bag 360, Blantyre 3, Chichiri, Malawi
- Department of Public Health and Obstetrics & Gynecology, Centre for Reproductive Health, Kamuzu University of Health Sciences, Private Bag 360, Blantyre 3, Chichiri, Malawi
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Dilli PP, Obeagu E, Tamale A, Ajugwo A, Pius T, Makeri D. Update on the practice of premarital screening for sickle cell traits in Africa: a systematic review and meta-analysis. BMC Public Health 2024; 24:1467. [PMID: 38822327 PMCID: PMC11143629 DOI: 10.1186/s12889-024-19001-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 05/29/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Screening for sickle cell traits before marriage or producing children is one of the outstanding preventive measures for sickle cell disease (SCD).The disease is a collection of inherited blood disorders that impact millions globally, with a predominant 75% occurrence in the sub-Saharan region. With increasing burden of SCD on the continent amidst a cost effective prevention method, no study has systematically reviewed or presented meta-analytic uptake or practice of premarital sickle cell trait screening. METHODS This review systematically explored the uptake or practice of premarital genotype screening in Africa. We searched PubMed and Scopus databases for African studies on premarital screening for sickle cell traits. RESULTS Our results indicate that the pooled uptake of premarital sickle cell trait screening in Africa is 47.82% (95% CI: [46.53-49.11]; I2: 98.95% [98.74-99.13]). Our review observed, a significant relationship between the awareness of sickle cell disease and the uptake of genotype screening; F(1, 13) = 12.04, p = 0.004). The model explained approximately 48.08% of the variation in genotype screening (R² = 0.4808) and predicted a 0.729 increase in the likelihood of genotype screening uptake for every unit rise in sickle cell disease awareness (β = 0.729, p = 0.004). Additionally, Pearson correlation (r = 0.6934) indicated a moderately strong positive correlation between the two variables. CONCLUSION With over 75% of the global burden of sickle cell disease domiciled in Africa, the continent cannot overlook the cost of hemoglobinopathies. The uptake of sickle cell traits screening is suboptimal across the continent. To achieve the mandate of sustainable development goal number (3); to end preventable deaths of newborns and children under 5 years of age by 2030, there is need to intensify campaigns on premarital genetic screening through education and other health promotion tools.
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Affiliation(s)
- Priscilla Peter Dilli
- Department of Public Health, Kampala International University-Western Campus, Ishaka, Uganda
| | - Emmanuel Obeagu
- Department of Medical Laboratory Science, Kampala International University-Western Campus, Ishaka, Uganda
| | - Andrew Tamale
- Department of Public Health, Kampala International University-Western Campus, Ishaka, Uganda
| | - Anselm Ajugwo
- Department of Medical Laboratory Science, Kampala International University-Western Campus, Ishaka, Uganda
| | - Theophilus Pius
- Department of Medical Laboratory Science, Kampala International University-Western Campus, Ishaka, Uganda
| | - Danladi Makeri
- Department of Microbiology and Immunology, Kampala International University-Western Campus, Ishaka, Ishaka, Uganda.
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Kigongo E, Tumwesigye R, Anyolitho MK, Musinguzi M, Kwizera G, Achan E, Nabasirye CK, Udho S, Kabunga A, Omech B. Access to family planning services and associated factors among young people in Lira city northern Uganda. BMC Public Health 2024; 24:1146. [PMID: 38658880 PMCID: PMC11044454 DOI: 10.1186/s12889-024-18605-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 04/15/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Access to family planning services among young people is crucial for reproductive health. This study explores the access and associated factors among young people in Lira City, Northern Uganda. METHODS AND MATERIALS A mixed-methods study was conducted in March to April 2022. Quantitative data were collected using a structured questionnaire from 553 participants aged 15-24 years. Qualitative data were obtained through in-depth interviews and focus group discussions. Data analysis included univariate, bivariate, and multivariate analyses for quantitative data, while interpretative phenomenological analysis was used for qualitative data. RESULTS Overall, 31.7% of the respondents had a good perceived access to family planning services, with 64.6% reporting perceived availability of FP methods. Challenges included lack of privacy (57.7%), fear of mistreatment (77.2%), and decision-making difficulties (66.2%). Among females, good perceived access to FP services was less likely among urban residents (AOR: 0.22, 95% CI: 0.09-0.53), Christian respondents (AOR: 0.51, 95% CI: 0.01-0.36), Muslim respondents (AOR: 0.07, 95% CI: 0.01-0.55) and respondents with poor attitude to FP services (AOR: 0.39, 95% CI: 0.24-0.64), but more likely among respondents with a sexual a partner (AOR: 4.48, 95% CI: 2.60-7.75). Among males, good perceived access to FP services was less likely among respondents living with parents (AOR: 0.19, 95% CI: 0.05-0.67) but more likely among respondents with good knowledge of FP services (AOR: 2.28, 95% CI: 1.02-5.32). Qualitative findings showed that three themes emerged; knowledge of family planning methods, beliefs about youth contraception and, friendliness of family planning services. CONCLUSION The study revealed a substantial gap in perceived access to family planning services among young people in Lira City. Barriers include privacy concerns, fear of mistreatment, and decision-making difficulties. Tailored interventions addressing urban access, religious beliefs for females, and knowledge enhancement for males are essential. Positive aspects like diverse FP methods and physical accessibility provide a foundation for targeted interventions. Youth-friendly services, comprehensive sexual education, and further research are emphasized for a nuanced understanding and effective interventions in Northern Uganda.
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Affiliation(s)
- Eustes Kigongo
- Faculty of Public Health, Lira University, Lira City, Northern, P. O Box 1035, Uganda.
| | - Raymond Tumwesigye
- Faculty of Public Health, Lira University, Lira City, Northern, P. O Box 1035, Uganda
| | | | - Marvin Musinguzi
- Faculty of Public Health, Lira University, Lira City, Northern, P. O Box 1035, Uganda
| | - Gad Kwizera
- Faculty of Education, Lira University, Lira, Uganda
| | - Everlyne Achan
- Faculty of Public Health, Lira University, Lira City, Northern, P. O Box 1035, Uganda
| | | | - Samson Udho
- Faculty of Nursing , Mbarara University of Science and Technology, Mbarara, Uganda
| | - Amir Kabunga
- Faculty of Medicine, Lira University, Lira, Uganda
| | - Bernard Omech
- Faculty of Public Health, Lira University, Lira City, Northern, P. O Box 1035, Uganda
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Shukla S, Castro Torres AF, Satish RV, Shenderovich Y, Abejirinde IOO, Steinert JI. Factors associated with adolescent pregnancy in Maharashtra, India: a mixed-methods study. Sex Reprod Health Matters 2023; 31:2249284. [PMID: 37712990 PMCID: PMC10506432 DOI: 10.1080/26410397.2023.2249284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023] Open
Abstract
Reducing the adolescent birth rate is paramount in achieving the health-related Sustainable Development Goals, given that pregnancy and childbirth are the leading cause of mortality among young women aged 15-19. This study aimed to explore predictors of adolescent pregnancy among girls aged 13-18 years in Maharashtra, India, during the COVID-19 pandemic. Using a mixed-methods approach, primary data were gathered from two regions in Maharashtra between February and April 2022. Quantitative data from face-to-face interviews with 3049 adolescent girls assessed various household, social, and behavioural factors, as well as the socioeconomic and health impacts of COVID-19. Qualitative data from seven in-depth interviews were analysed thematically. The findings reveal that girls from low socioeconomic backgrounds face a higher likelihood of adolescent pregnancy. Multivariable analysis identified several factors associated with increased risk, including older age, being married, having more sexual partners, and experiencing COVID-19-related economic vulnerability. On the other hand, rural residence, secondary and higher secondary education of the participants, and higher maternal education were associated with a decreased likelihood of adolescent pregnancy. In the sub-sample of 565 partnered girls, partner's emotional abuse also correlated with higher rates of adolescent pregnancy. Thematic analysis of qualitative data identified four potential pathways leading to adolescent pregnancy: economic hardships and early marriage; personal safety, social norms, and early marriage; social expectations; and lack of knowledge on contraceptives. The findings underscore the significance of social position and behavioural factors and the impact of external shocks like the COVID-19 pandemic in predicting adolescent pregnancy in Maharashtra, India.Plain Language Summary: Adolescent pregnancy is an important health issue for young girls. In South Asia, one out of every five adolescent girls becomes a mother before turning 18, and in India, around 9% of girls aged 15-19 get pregnant yearly. This study focused on understanding the factors associated with adolescent pregnancy in Maharashtra, India, especially after the COVID-19 pandemic. We collected information from both urban and rural areas in Maharashtra. A total of 3049 adolescent girls participated in a survey, and seven girls participated in detailed interviews. Our analysis showed that factors like older age, being married, having multiple sexual partners, and experiencing economic difficulties due to COVID-19 increased the chances of adolescent pregnancy. On the other hand, living in rural areas, higher education for both the girls and their mothers reduced the likelihood of adolescent pregnancy. Qualitative analysis revealed that economic challenges, concerns about safety and societal norms, early marriage, societal expectations, and lack of knowledge about contraceptives could contribute to adolescent pregnancy in Maharashtra.
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Affiliation(s)
- Shruti Shukla
- PhD Candidate and Research Associate, TUM School of Social Sciences and Technology, Technical University of Munich, Munich, Germany
| | | | - Rucha Vasumati Satish
- Field Coordinator and Freelance Researcher based in Pune, Maharashtra, TUM School of Social Sciences and Technology, Technical University of Munich, Munich, Germany
| | - Yulia Shenderovich
- Senior Lecturer, Wolfson Centre for Young People’s Mental Health, Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Ibukun-Oluwa Omolade Abejirinde
- Assistant Professor, Division of Social & Behavioural Health Sciences, University of Toronto, Dalla Lana School of Public Health and Women’s College Hospital Research Institute, Toronto, Canada
| | - Janina Isabel Steinert
- Principal Investigator, TUM School of Social Sciences and Technology, Technical University of Munich, Munich, Germany
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Birungi L, Izudi J. Fertility awareness and teenage pregnancy in rural western Uganda: a community-based cross-sectional study. Afr Health Sci 2023; 23:451-461. [PMID: 38974264 PMCID: PMC11225474 DOI: 10.4314/ahs.v23i4.49] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024] Open
Abstract
Background Teenage pregnancy (pregnancy among girls aged 13-19 years) is prevalent in Uganda but data about the associated factors are limited. Objective To determine the prevalence and factors associated with teenage pregnancy in Buliisa district, western Uganda. We hypothesized that fertility awareness is associated with reduced likelihood of teenage pregnancy. Methods In this cross-sectional study, we included girls aged 15-19 years and collected data using a structured questionnaire. The modified Poisson regression analysis was used to determine the association between fertility awareness and teenage pregnancy, adjusted for confounders, reported using adjusted prevalence risk ratio (aPR) and 95% confidence interval (CI). Results Of 246 teenagers, the prevalence of teenage pregnancy was 41.5% while fertility awareness was 56.7%. The age category 18-19 years (aPR, 3.44; 95% CI, 2.16-5.47), fertility awareness (aPR, 1.80; 95%CI, 1.30-2.51) and Muslim faith (aPR, 1.37; 95%CI, 1.04-1.80) were associated with increased likelihood of teenage pregnancy. Living with a father (aPR, 0.61; 95%CI, 0.48-0.76), mother (aPR, 0.65; 95%CI, 0.524-0.81), or both parents (aPR, 0.57; 95% CI, 0.43-0.76) was associated with a reduced likelihood of teenage pregnancy. Conclusion The prevalence of teenage pregnancy in Bulisa district is high. There is a need to target teenagers with correct fertility information, including the engagement of parents and religious leaders.
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Affiliation(s)
- Lilian Birungi
- Institute of Public Health and Management, Clarke International University, Kampala, Uganda. P.O. Box 7782, Kampala, Uganda
| | - Jonathan Izudi
- Department of Community Health, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda. P.O. BOX 1410, Mbarara, Uganda
- Data Science and Evaluation Unit, African Population and Health Research Center, Nairobi, Kenya
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Okot C, Laker F, Apio PO, Madraa G, Kibone W, Pebalo Pebolo F, Bongomin F. Prevalence of Teenage Pregnancy and Associated Factors in Agago District, Uganda: A Community-Based Survey. Adolesc Health Med Ther 2023; 14:115-124. [PMID: 37577045 PMCID: PMC10417689 DOI: 10.2147/ahmt.s414275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 07/29/2023] [Indexed: 08/15/2023] Open
Abstract
Background Teenage pregnancy remains a common public health and social problem associated with negative health outcomes. We determined the prevalence and factors associated with teenage pregnancy among teenage girls aged 13-17 years in Agago district, Uganda. Methods We conducted a community-based, cross-sectional study between October and November 2020 in Lapono Sub-County, Agago district among teenage girls 13-17 years. Multi-stage sampling technique was used. Parishes, villages, and households were randomly selected (computer generated random numbers were used for household selection). In each household, one participant was randomly selected for interview and pregnancy testing. We collected data on socio-demographic factors using a pre-tested semi-structured questionnaire. All eligible participants were tested for urine human chorionic gonadotropin (hCG). Multivariable logistic regression analysis was done to determine independent predictors of teenage pregnancy, with p<0.05 considered statistically significant. Results A total of 289 eligible participants, with a mean age of 15.1±1.5 years, were enrolled. Most (n=246, 81.5%) participants had attained primary education, 18 (6.2%) were married, 41 (14.2%) used alcohol, 62 (21.5%) had a history of sexual intercourse and 32 (11.1%) were sexually abused. The prevalence of teenage pregnancy was 2.8% (n=8). Factors significantly associated with teenage pregnancy were alcohol consumption (adjusted odds ratio (aOR): 13.2, 95% Confidence Interval (95% CI): 1.7-100.6, p=0.013) and having secondary/tertiary education (aOR: 10.2, 95% CI: 1.5-71.9, p=0.02). Conclusion The study findings suggest that teenage pregnancy is still a public health and social problem in Agago district, Uganda. Interventions discouraging alcohol consumption and promoting education among teenagers are key in addressing the burden of teenage pregnancies in the district.
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Affiliation(s)
- Christopher Okot
- Department of Public Health, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Florence Laker
- Department of Public Health, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Pamela Okwir Apio
- Makerere Lung Institute, School of Medicine, Makerere University, Kampala, Uganda
| | - Grace Madraa
- Department of Rural Development and Agri-Business, Faculty of Agriculture, Gulu University, Gulu, Uganda
| | - Winnie Kibone
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Francis Pebalo Pebolo
- Department of Reproductive Health, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Felix Bongomin
- Department of Medical Microbiology & Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda
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Poudel S, Dobbins T, Razee H, Akombi-Inyang B. Adolescent Pregnancy in South Asia: A Pooled Analysis of Demographic and Health Surveys. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6099. [PMID: 37372686 DOI: 10.3390/ijerph20126099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/04/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023]
Abstract
Adolescent pregnancy has important health and social implications. Despite the availability of nationally representative household survey data, there are limited studies that analyze factors associated with adolescent pregnancy across countries of South Asia. This study aimed to identify factors associated with adolescent pregnancy across South Asia. This study used the most recent Demographic and Health Survey (DHS) data from six countries in South Asia: Afghanistan, Bangladesh, India, the Maldives, Nepal, and Pakistan. Pooled individual record data from 20,828 ever-married women aged 15-19 years were used for the analysis. Multivariable logistic regression analysis, informed by the World Health Organization framework on social determinants of health, was performed to examine factors associated with adolescent pregnancy. Adolescent pregnancy was highest in Afghanistan compared to Bangladesh, Nepal, Pakistan, India, and the Maldives. Multivariable analyses confirmed that being from a poor household or male-headed household, increasing maternal age, having no access to newspapers, and having no knowledge of family planning were significantly associated with adolescent pregnancy. The use or intention to use contraceptives was protective against adolescent pregnancy. To reduce adolescent pregnancy in South Asia, interventions targeting adolescents from poor households with limited access to mass media should be considered, especially those from households with an existing patriarchal structure.
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Affiliation(s)
- Samikshya Poudel
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Timothy Dobbins
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Husna Razee
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia
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Webb L, Kyaddondo D, Ford T, Bergqvist A, Cox N. Psychosocial health in adolescent unmarried motherhood in rural Uganda: Implications for community-based collaborative mental health education, and empowerment strategies in the prevention of depression and suicide. Transcult Psychiatry 2023; 60:537-551. [PMID: 36628461 PMCID: PMC10486171 DOI: 10.1177/13634615221147361] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Teenage pregnancy rates in Uganda are among the highest in sub-Saharan Africa. Child marriage is often the result of unmarried teenage pregnancy and is recognised by Uganda's government as a form of sexual violence and an outcome of inequality. However, unmarried motherhood incurs stigma and shame within traditionally living rural communities. Using co-produced Open Space and ethnographic methods, we examined the psychosocial impact of unmarried motherhood on girls and their communities, and explored problem-solving with key local stakeholders. Findings indicate that girls experience extreme stress, social exclusion and rejection by their families, and experience bereavement from school expulsion and the loss of their career aspirations. Depressive symptoms and suicidal behaviour are reportedly not uncommon among this population group. Community and family efforts to promote marriage for these mothers to avoid social stigma increased the mothers' feelings of depression, whereas mothers who became independent appeared to fare better psychologically. Community members and local stakeholders demonstrated a willingness to act locally to reduce the negative impacts of unmarried motherhood but lacked knowledge and support resources. Our findings indicate that mental health promotion for teenage mothers is likely to be better served through empowerment strategies rather than marriage and, in a context of poor mental health service access, there is a substantial role for community mobilisation and the promotion of self-help strategies to support teenage mothers. This study raises important points regarding different community understandings of depression and indicates collaboration between professionals and communities for a values-based approach.
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Affiliation(s)
- Lucy Webb
- Faculty of Health & Education, Manchester Metropolitan University
| | | | | | - Anna Bergqvist
- Faculty of Health & Education, Manchester Metropolitan University
| | - Nigel Cox
- Faculty of Health & Education, Manchester Metropolitan University
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Kareem YO, Abubakar Z, Adelekan B, Ameyaw EK, Gbagbo FY, Goldson E, Mueller U, Yaya S. Prevalence, Trends, and Factors Associated with Teen Motherhood in Nigeria: An Analysis of the 2008-2018 Nigeria Demographic and Health Surveys. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2023; 35:248-262. [PMID: 38595858 PMCID: PMC10903619 DOI: 10.1080/19317611.2023.2189763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 04/11/2024]
Abstract
Background: Teen pregnancy and childbearing are common in Nigeria, and understanding the complexities, such as sociodemographics and economic factors including sexual and reproductive health knowledge and awareness among adolescents over time can trigger innovative approaches and interventions. This study intends to capture the patterns and associated factors of teen motherhood among sexually active adolescents (15-19 years) between 2008 and 2018. Methods: The study data was extracted from 2008, 2013, and 2018 Nigeria Demographic and Health Surveys. Descriptive analysis was presented using frequencies and percentages; multivariable analysis was conducted using log-binomial logistic regression at a p-value <0.05. All analyses were performed using Stata 15.0, weighted and adjusted for the complex survey design and population size. Results: The prevalence of teen motherhood increased between the three successive survey waves (50.9% vs. 52.4% vs. 55.2%) from 2008, 2013, and 2018. Although, the pooled adjusted analysis revealed no significant change over the 10-year period. Knowledge of modern contraceptive methods, primary education, non-Catholic Christians, residing in the South-South region, and those currently or formerly married were associated with increased risk of teen motherhood. There was an inverse relationship between teen motherhood and wealth status; lower wealth status was associated with high adolescent pregnancy and childbearing. Conclusion: This study revealed an increase in the proportion of teen pregnancy and childbearing in Nigeria. Notably, there exist variations across age groups, geographic location, educational level, religious belief, marital and economic status. Interventions that ensure comprehensive sexuality education, girl child education, and economic empowerment especially for school dropouts are advocated to reduce teen motherhood.
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Affiliation(s)
| | - Zubaida Abubakar
- United Nations Population Fund, Nigeria Country Office, Abuja, Nigeria
| | | | - Edward Kwabena Ameyaw
- Institute of Policy Studies and School of Graduate Studies, Lingnan University, Hong Kong, China
| | | | - Erika Goldson
- United Nations Population Fund, Nigeria Country Office, Abuja, Nigeria
| | - Ulla Mueller
- United Nations Population Fund, Nigeria Country Office, Abuja, Nigeria
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Canada
- The George Institute for Global Health, Imperial College London, London, UK
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Okalo P, Arach AA, Apili B, Oyat J, Halima N, Kabunga A. Predictors of Unintended Pregnancy Among Adolescent Girls During the Second Wave of COVID-19 Pandemic in Oyam District in Northern Uganda. Open Access J Contracept 2023; 14:15-21. [PMID: 36776919 PMCID: PMC9910206 DOI: 10.2147/oajc.s399973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/02/2023] [Indexed: 02/05/2023] Open
Abstract
Background In Uganda, unintended pregnancies are responsible for one in three births with detrimental consequences, a situation that worsened during COVID-19. Thus, the present examined unplanned pregnancy and its associated risks in Oyam district, northern Uganda during the COVID-19 epidemic. Methods and Methods This study employed a cross-sectional study among adolescent girls aged 15-19 years who had a pregnancy during the second phase of COVID-19 in Oyam district, northern Uganda in November 2022. A consecutive method was employed to recruit the participants attending health facilities. A structured questionnaire was utilized to collect data. For data analysis, both bivariate and multivariable regression methods with adjusted odds ratio and 95% CI were used. A p-value of 0.05 was used to determine the significance level. Results Of the total respondents, 292 (69.5%) were aged between 18 and 19 years of age, 295 (70.2%) lived in rural areas, and 222 (52.9%) had no formal education. The results also show that 293 (69.8%) of the respondents had unintended pregnancies during COVID-19. The results indicate that participants who lacked knowledge of the ovulation period (AOR: 0.242; 95% CI: 0156-0376; P<0.001), sex education during COVID-19 (AOR: 0.563; 95% CI:: 0.365-0.869; P=0.024) and lacked the freedom to discuss family planning-related issues with family members during COVID-19 (AOR: 0.228; 95% CI: 0.138-0.376; P<0.001) were more likely to have an unintended pregnancy compared to their counterparts. Conclusion Our study shows that unwanted pregnancies among adolescent girls remain a public health issue in Oyam district with more than two-thirds of adolescents having unwanted pregnancies during the crisis of COVID-19. The major correlates of unwanted pregnancies among adolescent girls during COVID-19 pandemic were inadequate knowledge of the ovulation period, sex education, and lack of freedom to discuss family planning-related issues with family members. There is a need to prioritize interventions, especially in rural settings. Sex education to improve contraceptive use and delay sexual debut. In light of the possibility that social and cultural norms in the Oyam district prohibit parents and children from discussing sexual subjects, it is crucial to promote sexual health education through the mass media, including newspapers, television, radio, and social media.
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Affiliation(s)
- Ponsiano Okalo
- Department of Psychiatry, Lira University, Lira City, Uganda
| | - Anna Agnes Arach
- Department of Nursing and Midwifery, Lira University, Lira City, Uganda
| | - Brenda Apili
- Department of Psychiatry, Lira University, Lira City, Uganda
| | - Jimmy Oyat
- Department of Psychiatry, Lira University, Lira City, Uganda
| | - Namata Halima
- Department of Mental Health, Makerere University, Kampala City, Uganda
| | - Amir Kabunga
- Department of Psychiatry, Lira University, Lira City, Uganda,Correspondence: Amir Kabunga, Department of Psychiatry, Lira University, P.O BOX, 1035, Lira City, Uganda, Tel +256777929576, Email
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Moshi FV, Tilisho O. The magnitude of teenage pregnancy and its associated factors among teenagers in Dodoma Tanzania: a community-based analytical cross-sectional study. Reprod Health 2023; 20:28. [PMID: 36737763 PMCID: PMC9896796 DOI: 10.1186/s12978-022-01554-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 12/15/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Teenage pregnancies cause serious health, social and economic consequences including death among adolescent girls worldwide. It is estimated that in 2019 about 55% of unintended pregnancies among adolescent girls aged 15-19 years ended up in abortions, which are often unsafe in developing countries. Little was known about the magnitude of teenage pregnancy and its associated factors in Dodoma Tanzania. Therefore, the study aimed at establishing the magnitude and factors associated with teenage pregnancies among adolescents in Dodoma Region Tanzania. METHOD It was a community-based analytical cross-sectional study that included 539 adolescent girls aged 15 to 19 years old. A multistage sampling technique was used to recruit study participants. An interviewer-administered structured questionnaire was used to collect data. Data were analyzed by using SPSS v23. Descriptive statistics were used to describe the distribution of the entire study variable while the inferential statistics helped to establish factors associated with teenage pregnancy among adolescent girls and the level of significance was set at two sides of less than 0.05. RESULTS The magnitude of teenage pregnancy in Dodoma was 29%. After controlling for possible confounders, factors associated with teenage pregnancy were; urban residence [AOR: 3.02, 95%CI: (1.60-5.68), p = 0.001], low mothers' education status [AOR: 3.46, 95%CI: (1.47-8.11), p = 0.004]; Poor knowledge on sexual and reproductive health [AOR: 2.09, 95%CI: (1.2-3.63), p = 0.009]; Low family economic status [AOR: 3.83, 95%CI: (1.77-8.30), p = 0.001]; Peer group [AOR: 2.92, 95%CI: (1.33-6.40), p = 0.007]; Early marriage [AOR: 2.58, 95%CI: (1.57-4.26), p < 0.0001]; and Sexual abuse [AOR: 13.56, 95%CI: (7.98-23.06), p < 0.0001]. CONCLUSION This study found a high magnitude of teenage pregnancy among youth in Dodoma. Teenagers who were more likely to teenage pregnancy were those with limited knowledge about sexual and reproductive health living in urban, from families with low economic status, their mothers had a low level of education, from a culture that encourage early marriages, with the influence of peer and who experienced sexual abuse. An innovative intervention study to come up with a cost-effective strategy to address the challenge of teenage pregnancy in Dodoma is highly recommended.
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Affiliation(s)
- Fabiola V. Moshi
- grid.442459.a0000 0001 1998 2954Department of Nursing Management and Education, School of Nursing and Public Health, The University of Dodoma, P.O. Box 259, Dodoma, Tanzania
| | - Olympia Tilisho
- grid.442459.a0000 0001 1998 2954Department of Clinical Nursing, School of Nursing and Public Health, The University of Dodoma, P.O. Box 259, Dodoma, Tanzania
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Phiri M, Kasonde ME, Moyo N, Sikaluzwe M, Simona S. A multilevel analysis of trends and predictors associated with teenage pregnancy in Zambia (2001-2018). Reprod Health 2023; 20:16. [PMID: 36653839 PMCID: PMC9848028 DOI: 10.1186/s12978-023-01567-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/06/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Teenage pregnancy remains a major social and public health challenge in developing countries especially sub-Saharan Africa (SSA) where prevalence rates are still increasing. Even if considerable effort has been made over the years to study determining factors of teenage pregnancy in SSA, few studies have looked at the trends and associated factors over a longer period. Furthermore, no known study has focussed on both individual and contextual factors influencing teenage pregnancy in Zambia. This study, thus sought to fill this gap in knowledge by simultaneously investigating trends of teenage pregnancy as well as its individual and contextual determining factors. METHODS A total pooled weighted sample of 10,010 teenagers (in the age group 15-19) from four waves of the Zambia Demographic and Health Surveys were extracted. Using bivariate analysis, we investigated the trends of teenage pregnancy between 2001 and 2018. Separate multilevel logistic regression models were fitted on pooled teenage pregnancy data in relation to several individual and contextual level factors. Both fixed and random effects were produced. Bayesian parameter estimates were produced using lme4 package in R statistical programming environment. RESULTS Results of the trends of teenage pregnancy in Zambia have shown an overall decrease of 2% between 2001 and 2018. Almost all the socioeconomic and demographic variables were consistently associated with teenage pregnancy (p < 0.001) in a bivariate analysis across the four survey. In multilevel analysis, the odds of being pregnant were higher for teenagers who were employed (aOR = 1.21, 95% CI: 1.02-1.42), married (aOR = 7.71, 95% CI: 6.31-9.52) and those with knowledge of ovulation period (aOR = 1.58, 95% CI: 1.34-1.90). On the other hand, belonging to households in high wealth quintiles, being literate, exposure to mass-media family planning messages and delayed sexual debut were associated with decreased odds of teenage pregnancy. CONCLUSION The study shows that teenage pregnancy remains a social and public health challenge in Zambia as the country has seen little decrease in the prevalence over the years under consideration. Factors associated with teenage pregnancy include marital status, and employment, knowledge of ovulation period, wealth quintile, sexual debut and exposure to mass-media family planning messaging. Concerted effort must be made to improve literacy levels, reduce poverty and enhance sexual health promotion through the mass media in view of cultural norms, which may prevent parents and children from discussion sexual education topics thus exacerbate the vice.
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Affiliation(s)
- Million Phiri
- grid.12984.360000 0000 8914 5257Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia ,grid.11951.3d0000 0004 1937 1135Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Mwewa E. Kasonde
- grid.12984.360000 0000 8914 5257Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | - Nkuye Moyo
- grid.12984.360000 0000 8914 5257Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | - Milika Sikaluzwe
- grid.12984.360000 0000 8914 5257Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | - Simona Simona
- grid.12984.360000 0000 8914 5257Department of Social Work and Sociology, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
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Predictors of underage pregnancy among women aged 15-19 in highly prevalent regions of Ethiopia: a multilevel analysis based on EDHS, 2016. Sci Rep 2023; 13:857. [PMID: 36646737 PMCID: PMC9842682 DOI: 10.1038/s41598-023-27805-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 01/09/2023] [Indexed: 01/17/2023] Open
Abstract
Under age (teenage) pregnancy is a pregnancy that occurs under the age of 20 years old. Its magnitude is increasing globally. It is much higher in low-income countries compared to high-income countries. Teenage pregnancy exposed teenagers to various obstetric and perinatal complications. However, its predictors are not well investigated in highly prevalent regions of Ethiopia. Therefore, this study assessed individual and community-level predictors of teenage pregnancy using a multi-level logistic regression model. An in-depth secondary data analysis was performed using the fourth Ethiopian Demographic and Health Survey (EDHS) 2016 data set. A weighted sample of 2397 teenagers was included in the final analysis. Multi co linearity and chi-square tests were checked and variables which did not fulfill the assumptions were excluded from the analysis. Four models were fitted. Variables with p value ≤ 0.2 in the bi-variable multilevel logistic regression were included in the multivariable multilevel logistic regression. The adjusted odds ratio (AOR) with a 95% confidence interval (95% CI) was computed. Variables with a p value of less than 0.05 in the multi-variable multilevel logistic regression were declared as statistically significant predictors. A total of 2397 weighted participants aged from 15 to 19 were involved. About 15% of teenagers were pregnant. Age [17 (AOR = 9.41: 95% CI 4.62, 19.13), 18 (AOR = 11.7: 95% CI 5.96, 23.16), 19 (AOR = 24.75: 95% CI 11.82, 51.82)], primary education (AOR = 2.09: 95% CI 1.16, 3.76), being illiterate (AOR = 1.80: 95% CI 1.19, 2.73), religion [being Muslims (AOR: 2.98:95% CI 1.80, 4.94), being Protestants (AOR = 2.02: 95% CI 1.20, 3.41)], contraceptive non use (AOR = 0.18: 95% CI 0.11, 0.31), a high proportion of family planning demand (AOR = 3.52: 95% CI 1.91, 6.49), and a high proportion of marriage (AOR = 4.30: 95% CI 2.25, 8.21) were predictors of teenage pregnancy. Age, educational status, religion, contraceptive non-use, literacy proportion of marriage and proportion of demand for family planning were the most significant predictors of teenage pregnancy. The ministry of education shall focus on universal access to education to improve female education. The government should work in collaboration with religious fathers to address reproductive and sexual issues to decrease early marriage and sexual initiation. Especial attention should be given to teenagers living in a community with a high proportion of marriage.
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Musinguzi M, Kumakech E, Auma AG, Akello RA, Kigongo E, Tumwesigye R, Opio B, Kabunga A, Omech B. Prevalence and correlates of teenage pregnancy among in-school teenagers during the COVID-19 pandemic in Hoima district western Uganda-A cross sectional community-based study. PLoS One 2022; 17:e0278772. [PMID: 36525426 PMCID: PMC9757589 DOI: 10.1371/journal.pone.0278772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/23/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic related restrictions and lockdown measures had compromised the routine delivery and access of sexual and reproductive health and rights services to the population including the teenage girls. However, the teenage pregnancy rates during COVID-19 pandemic period were poorly documented. This study aimed at determining the prevalence and the factors associated with teenage pregnancy among in-school teenage girls during the COVID-19 pandemic period in Hoima District Uganda. METHODS This was a descriptive cross-sectional study that employed quantitative research methods. A total of 314 in-school teenage girls aged 13-19 years were selected using a multi-stage sampling techniques. Interviewer-administered questionnaires were used to collect the data from the participant's homes during the period December 2021-January 2022. Data analysis was done using univariate, bi-variate, and multivariate. RESULTS The prevalence of teenage pregnancy among the in-school teenage girls in Hoima district Uganda was 30.6% [96/314]. Higher teenage pregnancy rates were prevalent among the unmarried teenage girls [aOR: 9.6; 95%CI: 4.64-19.87; p = 0.000], teenage girls studying from boarding schools [aOR 2.83, 95%CI 1.36-5.86, p = 0.005], contraceptive non-users [aOR: 2.54; 95%CI: 1.12-5.4; p = 0.015] and teenage girls involved in sex trade [aOR 3.16, 95%CI 1.5-6.7, p = 0.003]. The factors associated with the reduced likelihood for teenage pregnancy included being an adult teenage girl aged 18-19 years [aOR: 0.15; 95%CI: 0.07-0.32; p = 0.000] and not receiving sex education during the period [aOR 0.36, 95%CI 0.13-0.62, p = 0.024]. CONCLUSION The results indicated that 3 out of 10 in-school teenage girls from Hoima district Uganda got pregnant during the COVID-19 pandemic period of 2021. Teenage pregnancy was prevalent among teenage girls who don't use modern contraceptive methods and those involved in sex trade. Teenage pregnancy was however, less prevalent among adult teenage girls aged 18-19 years. The findings point to the need for health stakeholders to innovate creative policies, contingency plans and programmes aimed at delaying age for sexual activities, increasing contraceptive use and minimizing pregnancy risk from sex trade among in-school teenage girls during COVID-19 pandemics.
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Affiliation(s)
| | - Edward Kumakech
- Department of Nursing and Midwifery, Lira University, Lira, Uganda
- * E-mail:
| | - Anne Grace Auma
- Department of Nursing and Midwifery, Lira University, Lira, Uganda
| | | | - Eustes Kigongo
- Department of Public Health, Lira University, Lira, Uganda
| | | | - Bosco Opio
- Department of Public Health, Lira University, Lira, Uganda
| | - Amir Kabunga
- Department of Psychiatry, Lira University, Lira, Uganda
| | - Bernard Omech
- Department of Public Health, Lira University, Lira, Uganda
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Muacevic A, Adler JR, Sharma DK, Wasnik P, Wanjari MB. Unwanted Teenage Pregnancy and Its Complications: A Narrative Review. Cureus 2022; 14:e32662. [PMID: 36686124 PMCID: PMC9848684 DOI: 10.7759/cureus.32662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/18/2022] [Indexed: 12/23/2022] Open
Abstract
Teenage pregnancy may have a huge negative social and medical influence on mothers' and children's health globally. Compared to adult primigravida, young women experience more harmful perinatal problems, such as premature births, neonatal fatalities and stillbirths, and the delivery of children with low birth weight. With negative perinatal outcomes, in India, teenage pregnancy is still a widespread and important public health issue that needs urgent attention. One of the main causes of mortality for females between the ages of 15 and 19 is pregnancy and delivery problems. The health of young women in India is, therefore, seriously threatened by adolescent pregnancies. Neonatal and maternal difficulties are more common when a teen gets pregnant. To bring about change, avert problems, and lower the risk of maternal death, specialized antenatal care (ANC) and health education are crucial. In India, teenage pregnancy is very high. To prevent this, there is a need to focus on teenage education regarding safe sexual practices and pregnancy complications.
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Poudel S, Razee H, Dobbins T, Akombi-Inyang B. Adolescent Pregnancy in South Asia: A Systematic Review of Observational Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15004. [PMID: 36429723 PMCID: PMC9690629 DOI: 10.3390/ijerph192215004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 11/12/2022] [Accepted: 11/12/2022] [Indexed: 06/16/2023]
Abstract
Adolescent pregnancy is a major health and social concern in South Asia. The aim of this study is to systematically review evidence on the factors associated with adolescent pregnancy in South Asia. This study was conducted using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines. Four electronic databases: EMBASE, PubMed, CINAHL, and Scopus were searched for relevant studies on factors associated with adolescent pregnancy in South Asia published in English between January 2000 and July 2022. The quality of the included studies was assessed using 12 criteria from The National Institute of Health (NIH) Study Quality Assessment Tools for observational studies. Of the 166 articles retrieved, only 15 studies met the eligibility criteria and were included in the final analysis. Consistent factors associated with adolescent pregnancy in South Asia were low maternal education, low socioeconomic status, rural residency, and ethnic minorities. To prevent adolescent pregnancy in South Asia, concerted effort towards promoting health equity by addressing the predisposing factors associated with adolescent pregnancy is essential. This systematic review was registered with PROSPERO [CRD42022340344].
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Eyeberu A, Getachew T, Sertsu A, Sisay M, Baye Y, Debella A, Alemu A. Teenage pregnancy and its predictors in Africa: A systematic review and meta-analysis. Int J Health Sci (Qassim) 2022; 16:47-60. [PMID: 36475034 PMCID: PMC9682880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Abstract
Objective Although teenage pregnancy has declined in the last decade, it remains a major public health issue in Africa. Maternal mortality is common among teenagers due to their increased risk of obstetric and medical complications. In Africa, there is a lack of robust and comprehensive data on the prevalence and predictors of teenage pregnancy. As a result, this systematic review and meta-analysis were carried out to summarize evidence that will assist concerned entities in identifying existing gaps and proposing strategies to reduce teenage pregnancy in Africa. Methods The review is registered by the international prospective register of systematic reviews (CRD42021275013). This search included all published and unpublished observational studies written in English between August 23, 2016, and August 23, 2021. The articles were searched using databases (PubMed, CINHAL [EBSCO], EMBASE, POPLINE, Google Scholar, DOAJ, Web of Sciences, MEDLINE, Cochrane Library, and SCOPUS). Data synthesis and statistical analysis were conducted using STATA version 14 software. Forest plots were used to present the pooled prevalence and odds ratio (OR) with a 95% confidence interval (CI) of meta-analysis using the random effect model. Results A total of 43,758 teenagers (aged 13-19) were included in 23 studies. In Africa, the overall pooled prevalence of teenage pregnancy was 30% (95% CI: 17-43). Western Africa had the highest prevalence of teenage pregnancy 33% (95% CI: 10-55). Age (18-19) (OR = 2.99 [95% CI = 1.124-7.927]), wealth index (OR = 1.84 [95% CI = 1.384-2.433]), and marital status (OR = 6.02 [95% CI = 2.348-15.43]) were predictors of teenage pregnancy in Africa. Conclusion In Africa, nearly one-third of teenagers become pregnant. Teenage pregnancy was predicted by age (18-19), wealth index, and marital status. Strengthening interventions aimed at increasing teenagers' economic independence, reducing child marriage, and increasing contraceptive use among married teenagers can help to prevent teenage pregnancy.
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Affiliation(s)
- Addis Eyeberu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tamirat Getachew
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addisu Sertsu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mekonnen Sisay
- School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yohannes Baye
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Adera Debella
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addisu Alemu
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Aldrete-Cortez V, Rendón-Macías ME, Azcorra H, Salvador-Ginez O. Differential fetal growth rates mediated by sociodemographic factors in Yucatan, Mexico: an epidemiological study. J Matern Fetal Neonatal Med 2022; 35:9884-9892. [PMID: 35450517 DOI: 10.1080/14767058.2022.2066992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Fetal growth restriction (FGR) may be related to ethnicity. Additionally, ethnic groups experience adverse socioeconomic circumstances that increase FGR risk. However, the dearth of evidence of the interaction between socioeconomic factors and FGR highlights the need for additional research. OBJECTIVE To analyze the association between socioeconomic factors and FGR in Maya and non-Maya populations in Yucatan, Mexico. METHODS A total of 21,320 singleton births in 2017 in Yucatan were analyzed. The student's t-test and the chi-square test were used to compare the means and proportions of maternal and perinatal variables between the FGR group and the birthweight appropriate for gestational age (AGA) group. Path analysis was performed to identify the direct and indirect effects of socioeconomic factors on FGR and mediators between predictors and FGR. RESULTS The prevalence of FGR at birth was 9.06%; this rate was higher in the Maya population (12.4, 95% CI 11.3-13.5), without differences between socioeconomic levels. Path analysis revealed sociostructural variables (ethnicity and poverty) are reliable predictors of FGR at birth mediated by maternal education (β = -.152, p < .001) and teenage pregnancy (β = .065, p = .037). The proposal path model had a good fit index CFI = .968, TLI = .920, RMSEA = .046. CONCLUSION The prevalence of FGR was higher among Maya women than non-Maya women The socioeconomic conditions associated with FGR at birth were ethnicity, poverty, maternal education, and teenage pregnancy. Maternal education and teenage pregnancy act as mediators between sociostructural variables and FGR at birth.
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Affiliation(s)
- Vania Aldrete-Cortez
- Laboratory of Neuroscience and Cognitive Development, School of Psychology, Universidad Panamericana, Mexico City, Mexico
| | | | - Hugo Azcorra
- Centro de Investigaciones Silvio Zavala, Universidad Modelo, Mérida, Mexico
| | - Octavio Salvador-Ginez
- Environmental Psychology Department, School of Psychology, National University of Mexico (UNAM), Mexico City, Mexico
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Do Community-based Livelihood Interventions Affect Sexual and Reproductive Health and Rights of Young People in Slum Areas of Uganda: a Difference-in-difference with Kernel Propensity Score Matching Analysis. J Urban Health 2022; 99:164-189. [PMID: 35034278 PMCID: PMC8866584 DOI: 10.1007/s11524-021-00596-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/19/2021] [Indexed: 02/03/2023]
Abstract
Slum dwellers across Africa have been targeted in interventions whose impacts remain unclear. We evaluated the impact of a livelihood intervention on the sexual and reproductive health and rights (SRHR) of young people in the slum areas of Kampala, Uganda. We carried out a repeated cross-sectional survey in 2014 and 2017 to examine the impact of community-based livelihood interventions on the SRHR of young people in the slum areas of Kampala, Uganda. Impacts were observed such as reduced sexual activity, reduction in aspects of gender-based violence attitudes and beliefs, increased access to and decision-making about contraceptive and family-planning services, increased availability and affordability of SRHR services, reduced need to seek further knowledge on SRHR, reduced barriers to HIV testing, and increased knowledge of health responsibilities. Unexpected results included: increased proportion of young people who had ever had sex, decreased mean age of sexual debut, unaffordability of contraceptives, and increased culturally shaped attitudes and social norms related to gender-based violence. We observed no impact on condom use, consensual sex and sexual assault, the number of sexual partners, knowledge about HIV/AIDS, stigma and discrimination against people living with HIV/AIDS, affordability of male and female condoms, and uptake of HIV testing services. Rights-based interventions are crucial to how we understand the SRHR of young people in complex sociocultural environments. While the livelihood interventions made significant impacts on the SRHR of young people, there are questions about how such interventions address deeply rooted sociocultural practices to maximise outcomes.
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Asiimwe R, Tseng C, Murray SM, Ojuka JC, Arima EG, Familiar‐Lopez I. Association of pregnancy‐related stigma and intimate partner violence with anxiety and depression among adolescents. J Adolesc 2022; 94:270-275. [DOI: 10.1002/jad.12008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 12/24/2021] [Indexed: 11/10/2022]
Affiliation(s)
- Ronald Asiimwe
- Department of Human Development and Family Studies Michigan State University East Lansing Michigan USA
| | - Chi‐Fang Tseng
- Department of Human Development and Family Studies Michigan State University East Lansing Michigan USA
| | - Sarah M. Murray
- Department of Mental Health Johns Hopkins School of Public Health Baltimore Maryland USA
| | | | - Ethan G. Arima
- Makerere University Johns Hopkins University Research Collaboration Kampala Uganda
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Qurniyawati E, Martini S, Syahrul F, Sari Dewi M, Lubis R, Mohamed Gomaa Nasr N. Risk Factors for Adolescent Pregnancy in the New Normal Era of the Covid-19 Pandemic: A Case-Control Study. BIO WEB OF CONFERENCES 2022. [DOI: 10.1051/bioconf/20225400007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Cases of early marriage are reported to have increased during the pandemic due to stressed teenagers with the pressure of online learning. The increase in this number plays a role in increasing the risk of teenage pregnancy. This study aimed to analyse the risk factors for adolescent pregnancies during the new normal era of the COVID-19 pandemic. A case-control design using a simple random sampling technique involved 40 pregnant adolescents aged 15-19 years and 80 non-pregnant adolescents during the online learning period (July 2021 to January 2022) in Ngawi Regency, Indonesia. Data obtained from interviews were analysed to find Odds Ratio (OR) with a 95% Confidence Interval (CI). Results showed factors associated with adolescent pregnancies were underpaid parental income (OR 4.00, 95%CI 1.64–9.74), authoritarian and permissive parenting (OR 12.75, 95%CI 4.71–34.46), lack of exposure to media about reproductive health (OR 7.91, 95%CI 3.32–18.84), risky dating behaviour (OR 37.09, 95%CI 4.86–283.25), and smoking habit (OR 5.57, 95%CI 1.03–30.12). Preventing adolescent pregnancies could be done through public health education focusing on adolescent communities, parent-child discussion on reproductive health, as well as exposure to educative media related to reproductive health and the impacts of juvenile delinquency.
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Association between Teenage Pregnancy and Family Factors: An Analysis of the Philippine National Demographic and Health Survey 2017. Healthcare (Basel) 2021; 9:healthcare9121720. [PMID: 34946450 PMCID: PMC8701314 DOI: 10.3390/healthcare9121720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/09/2021] [Accepted: 12/11/2021] [Indexed: 11/17/2022] Open
Abstract
Adolescence is a key developmental period in one’s life course; health-related behaviors of adolescents can be linked to lifelong consequences, which affect their future health. Previous studies highlight the role of family and its significant association with adolescents’ health. In East Asia and the Pacific, the Philippines is the only country that is showing an upward trend of teenage pregnancy while other countries in the region have declining teenage pregnancy rates. Against this backdrop, this study investigated the association between teenage pregnancy and family factors, specifically parent structure. Data for the study were extracted from the Philippine National Demographic and Health Survey 2017. All adolescent women aged 15–19 years old (n = 5120) were included in the analyses. The dependent variable was teenage pregnancy, while parent structure, defined as a presence or absence of parents in the domicile, was the exposure variable. Multivariable logistic regression was utilized in assessing the association of teenage pregnancy and family factors after adjusting for several potential confounders. Adolescent women were more likely to become pregnant as a teenager when they lived with neither parent (aOR = 4.57, 95% CI = 2.56–8.15), were closer to 19 years of age (aOR = 2.17, 95% CI = 1.91–2.46), had knowledge of contraception (aOR = 1.27, 95% CI = 1.22–1.32) and lived in a big family (aOR = 1.14, 95% CI = 1.09, 1.20). Furthermore, adolescent women who lived with neither parent and belonged to the poorest wealth quintile were more likely to become pregnant as a teenager (aOR = 3.55, 95% CI = 1.67–7.55). Conversely, educational attainment higher than secondary education (aOR = 0.08, 95% CI = 0.01–0.49) and those who belonged to the richest wealth quintile (aOR = 0.40, 95% CI = 0.18–0.92) exhibited a statistically inverse association with teenage pregnancy compared with those with no education and from the middle wealth quintile, respectively. Living with neither parent was found as a risk factor for teenage pregnancy. Furthermore, we found that several sociodemographic factors exhibited a non-uniform increment and reduction in the risk of teenage pregnancy.
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Mejia JR, Quincho-Estares ÁJ, Flores-Rondon AJ, Reyes-Beltran G, Arias-Sulca IL, Palomino-Hilario E, Barrientos-Cochachi JE, Toro-Huamanchumo CJ. Determinants of adolescent pregnancy in indigenous communities from the Peruvian central jungle: a case-control study. Reprod Health 2021; 18:203. [PMID: 34641910 PMCID: PMC8507392 DOI: 10.1186/s12978-021-01247-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 09/22/2021] [Indexed: 06/21/2024] Open
Abstract
Background Adolescent pregnancy carries a high risk of severe health issues for both the mother and the newborn. Worldwide, 21 million adolescents give birth every year, with high percentages in Latin America. Most of the risk factors are met in indigenous communities, which is an underrepresented and poorly studied population. We aimed to assess the determinants of adolescent pregnancy in indigenous communities from the Peruvian central jungle. Methods Through a case–control study, female adolescents aged 13 to 19 years old from seven indigenous communities of the Peruvian central jungle were interviewed. Adolescents with (cases) and with no (controls) pregnancy history, such as current pregnancy, children and abortion, fulfilled our eligible criteria. Our instrument explored: sociodemographic, adolescent and family characteristics, as well as perceptions of adolescent pregnancy. We performed a penalized maximum likelihood logistic regression analysis to obtain Odds Ratios (OR) and their 95% confidence intervals (95% CI). Results We enrolled 34 cases and 107 controls. Overall, 53.9% were 15 to 19 years old. We found a significant association of being 15–19 years old (OR = 6.88, 95% CI 2.38–19.86, p < 0.0001) and an elementary school level of instruction (OR = 5.59, 95% CI 1.95–16.06, p = 0.001) with the risk of adolescent pregnancy. A marginal statistical significance between having five to six siblings and adolescent pregnancy was also reported (OR = 2.70, 95% CI 0.85–8.61, p = 0.094). Furthermore, adolescents with sexual and reproductive health communication with parents had a lower risk of adolescent pregnancy (OR = 0.17, 95% CI 0.06–0.47, p = 0.001). Conclusion Our results suggest that public health and educational efforts should be age-specific focused within indigenous communities of the Peruvian central jungle, encouraging parents to talk about sexual and reproductive health topics with adolescents. Supplementary Information The online version contains supplementary material available at 10.1186/s12978-021-01247-z. Worldwide, 21 million adolescents give birth every year, with high percentages in Latin America and rural areas. Indigenous communities are mainly located in rural areas and are exposed to multiple risk factors of adolescent pregnancy. We aimed to find the factors that have an influence on adolescent pregnancy in indigenous communities from the Peruvian central jungle. We conducted a case–control study identifying female indigenous adolescents from the Peruvian central jungle with or without pregnancy history. Our survey explored sociodemographic, adolescent and family characteristics, as well as perceptions of adolescent pregnancy. Being 15 to 19 years old, having an elementary educational level, and five to six siblings increased the risk of adolescent pregnancy. On the other hand, adolescents with sexual and reproductive health communication with parents had a lower risk of adolescent pregnancy. Furthermore, eight out of ten adolescents opposed to sexual intercourse at an early age. Public health and educational efforts should be age-specific focused within indigenous communities of the Peruvian central jungle, encouraging parents to talk about sexual and reproductive health with adolescents.
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Affiliation(s)
- Jhonatan R Mejia
- Universidad Nacional del Centro del Perú, Sociedad Científica de Estudiantes de Medicina del Centro, Huancayo, Peru.
| | - Ángel J Quincho-Estares
- Universidad Nacional del Centro del Perú, Sociedad Científica de Estudiantes de Medicina del Centro, Huancayo, Peru
| | - Asstrid J Flores-Rondon
- Universidad Nacional del Centro del Perú, Sociedad Científica de Estudiantes de Medicina del Centro, Huancayo, Peru
| | - Giancarlo Reyes-Beltran
- Universidad Nacional del Centro del Perú, Sociedad Científica de Estudiantes de Medicina del Centro, Huancayo, Peru
| | - Irene L Arias-Sulca
- Universidad Nacional del Centro del Perú, Sociedad Científica de Estudiantes de Medicina del Centro, Huancayo, Peru
| | - Estephanie Palomino-Hilario
- Universidad Nacional del Centro del Perú, Sociedad Científica de Estudiantes de Medicina del Centro, Huancayo, Peru
| | | | - Carlos J Toro-Huamanchumo
- Universidad San Ignacio de Loyola, Unidad de Investigación Para la Generación y Síntesis de Evidencias en Salud, Lima, Peru
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Modeling spatial determinates of teenage pregnancy in Ethiopia; geographically weighted regression. BMC WOMENS HEALTH 2021; 21:254. [PMID: 34167542 PMCID: PMC8223368 DOI: 10.1186/s12905-021-01400-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 06/16/2021] [Indexed: 11/25/2022]
Abstract
Background In developing countries, 20,000 under 18 children give birth every day. In Ethiopia, teenage pregnancy is high with Afar and Somalia regions having the largest share. Even though teenage pregnancy has bad maternal and child health consequences, to date there is limited evidence on its spatial distribution and driving factors. Therefore, this study is aimed to assess the spatial distribution and spatial determinates of teenage pregnancy in Ethiopia.
Methods A secondary data analysis was conducted using 2016 EDHS data. A total weighted sample of 3381 teenagers was included. The spatial clustering of teenage pregnancy was priorly explored by using hotspot analysis and spatial scanning statistics to indicate geographical risk areas of teenage pregnancy. Besides spatial modeling was conducted by applying Ordinary least squares regression and geographically weighted regression to determine factors explaining the geographic variation of teenage pregnancy.
Result Based on the findings of exploratory analysis the high-risk areas of teenage pregnancy were observed in the Somali, Afar, Oromia, and Hareri regions. Women with primary education, being in the household with a poorer wealth quintile using none of the contraceptive methods and using traditional contraceptive methods were significant spatial determinates of the spatial variation of teenage pregnancy in Ethiopia. Conclusion geographic areas where a high proportion of women didn’t use any type of contraceptive methods, use traditional contraceptive methods, and from households with poor wealth quintile had increased risk of teenage pregnancy. Whereas, those areas with a higher proportion of women with secondary education had a decreased risk of teenage pregnancy. The detailed maps of hotspots of teenage pregnancy and its predictors had supreme importance to policymakers for the design and implementation of adolescent targeted programs.
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Worku MG, Tessema ZT, Teshale AB, Tesema GA, Yeshaw Y. Prevalence and associated factors of adolescent pregnancy (15-19 years) in East Africa: a multilevel analysis. BMC Pregnancy Childbirth 2021; 21:253. [PMID: 33771106 PMCID: PMC7995759 DOI: 10.1186/s12884-021-03713-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 03/15/2021] [Indexed: 12/01/2022] Open
Abstract
Background Adolescent pregnancy is a major public health problem both in developed and developing countries with huge consequences to maternal health and pregnancy outcomes. However, there is limited evidence on the prevalence and associated factors of adolescent pregnancy in East Africa. Therefore, this study aimed to investigate the prevalence and associated factors of adolescent pregnancy in Eastern Africa. Method The most recent Demographic and Health Survey (DHS) datasets of the 12 East African countries were used. A total weighted sample of 17, 234 adolescent girls who ever had sex was included. A multilevel binary logistic regression analysis was fitted to identify the significantly associated factors of adolescent pregnancy. Finally, the Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were reported to declare the factors that are significantly associated with adolescent pregnancy. Results The overall prevalence of adolescent pregnancy in East Africa was 54.6% (95%CI: 53.85, 55.34%). In the multivariable multilevel analysis; being age 18–19 years [AOR = 3.06; 95%CI: 2.83, 3.31], using contraceptive [AOR = 1.41; 95%CI: 1.28, 1.55], being employed girls [AOR = 1.11; 95%CI: 1.03, 1.19], being spouse/head within the family [AOR = 1.62; 95% CI: 1.45, 1.82], and being from higher community level contraceptive utilization [AOR = 1.10; 95%CI:1.02, 1.19] were associated with higher odds of adolescent pregnancy. While adolescent girls attained secondary education and higher [AOR = 0.78; 95%CI: 0.68, 0.91], initiation of sex at age of 15 to 14 years [AOR = 0.69; 95%CI: 0.63, 0.75] and 18 to 19 years [AOR = 0.31; 95%CI: 0.27, 0.35], being unmarried [AOR = 0.25; 95%CI: 0.23, 0.28], having media exposure [AOR = 0.85; 95%CI: 0.78, 0.92], and being girls from rich household [AOR = 0.64; 95%CI: 0.58, 0.71] were associated with lower odds of adolescent pregnancy. Conclusion This study found that adolescent pregnancy remains a common health care problem in East Africa. Age, contraceptive utilization, marital status, working status, household wealth status, community-level contraceptive utilization, age at initiation of sex, media exposure, educational level and relation to the household head were associated with adolescent pregnancy. Therefore, designing public health interventions targeting higher risk adolescent girls such as those from the poorest household through enhancing maternal education and empowerment is vital to reduce adolescent pregnancy and its complications.
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Affiliation(s)
- Misganaw Gebrie Worku
- Department of Human Anatomy, College of Medicine and Health Science, School of Medicine, University of Gondar, Gondar, Ethiopia.
| | - Zemenu Tadesse Tessema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yigizie Yeshaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.,Department of Human Physiology, College of Medicine and Health Science, School of Medicine, University of Gondar, Gondar, Ethiopia
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Byonanebye J, Brazauskas R, Tumwesigye N, Young S, May T, Cassidy L. Geographic variation and risk factors for teenage pregnancy in Uganda. Afr Health Sci 2020; 20:1898-1907. [PMID: 34394256 PMCID: PMC8351868 DOI: 10.4314/ahs.v20i4.48] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Teenage pregnancy is a global health issue with high rates in sub-Saharan Africa. In Uganda, teenage pregnancy is a public and community health issue. OBJECTIVES This study hypothesized that there would be regional variations in rates, risk factors and trends of teenage pregnancy in Uganda. METHODS Data were analyzed from the Uganda Demographic and Health Surveys (UDHS) in 2006 and 2011. The outcome of interest was current pregnancy for females 15 to 19 years of age at the time of the survey. Bivariate analysis was performed for each year to examine the rate and trends of pregnancy by various demographic characteristics. Logistic regression was conducted to assess the association between teenage pregnancy and sociodemographic variables. RESULTS Uganda's rate of teenage pregnancy increased from 7.3/1000 in 2006 to 8.1/1000 in 2011. The East Central region consistently had the highest rates than other regions. In 2006, teenage pregnancy was significantly associated with being married, living with a partner or separated, as compared to those who were single. Marital and wealth status were also significant predictors of teenage pregnancy based on the 2011 survey. CONCLUSION The rate of teenage pregnancy in Uganda is high and the trend demonstrated regional variation. Future interventions could focus on regions with high poverty and low education.
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Affiliation(s)
| | - Ruta Brazauskas
- Medical College of Wisconsin, Institute of Health and Equity
| | | | - Staci Young
- Medical College of Wisconsin, Department of Family and Community Medicine
| | - Thomas May
- Washington State University, Elson S. Floyd College of Medicine
| | - Laura Cassidy
- Medical College of Wisconsin, Institute of Health and Equity
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Chemutai V, Nteziyaremye J, Wandabwa GJ. Live Experiences of Adolescent Mothers Attending Mbale Regional Referral Hospital: A Phenomenological Study. Obstet Gynecol Int 2020; 2020:8897709. [PMID: 33335551 PMCID: PMC7723483 DOI: 10.1155/2020/8897709] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 09/24/2020] [Accepted: 11/03/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Adolescence is a period of transition from childhood to adulthood, and is a critical stage in ones' development. It is characterized by immense opportunities and risks. By 2016, 16% of the world's population was of adolescents, with 82% residing in developing countries. About 12 million births were in 15-19 year olds. Sub-Saharan Africa, particularly East Africa, has high adolescent pregnancy rates, as high as 35.8% in eastern Uganda. Maternal mortality ratio (MMR) attributable to 15-19 years olds is significant with 17.1% of Uganda's MMR 336/100.000 live births being in this age group. Whereas research is awash with contributing factors to such pregnancies, little is known about lived experiences during early motherhood. This study reports the lived experiences of adolescent mothers attending Mbale Hospital. MATERIALS AND METHODS A phenomenological study design was used in which adolescent mothers that were attending Young Child Clinic were identified from the register and simple random sampling was used to select participants. We called these mothers by way of phone numbers and asked them to come for focus group discussions that were limited to 9 mothers per group and lasting about 45 minutes-1 hour. Ethical approval was sought and informed written consent obtained from participants. At every focus group discussion, the data which had largely been taken in local languages was transcribed and translated verbatim into English. RESULTS The research revealed that adolescent mothers go through hard times especially with the changes of pregnancy and fear of unknown during intrapartum and immediate postpartum period and are largely treated negatively by family and other community members in addition to experiencing extreme hardships during parenting. However, these early mothers' stress is alleviated by the joy of seeing their own babies. CONCLUSION Adolescent motherhood presents a high risk group and efforts to support them during antenatal care with special adolescent ANC clinics and continuous counseling together with their household should be emphasized to optimize outcome not only during pregnancy but also thereafter. Involving these mothers in technical courses to equip them with skills that can foster self-employment and providing support to enable them pursue further education should be explored.
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Affiliation(s)
- Violet Chemutai
- Department of Obstetrics and Gynaecology, Busitema University Faculty of Health Sciences, Box 1460, Mbale, Uganda
- Department of Community and Public Health, Faculty of Health Sciences Busitema University, Mbale Regional Referral and Teaching Hospital, Mbale, Uganda
| | - Julius Nteziyaremye
- Department of Community and Public Health, Faculty of Health Sciences Busitema University, Mbale Regional Referral and Teaching Hospital, Mbale, Uganda
- Department of Obstetrics and Gynaecology, Faculty of Health Sciences, Busitema University, Mbale Town, Uganda
| | - Gabriel Julius Wandabwa
- Department of Obstetrics and Gynaecology, Faculty of Health Sciences, Busitema University, Mbale Town, Uganda
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