Partner's characteristics and adolescent motherhood among married adolescent girls in 48 low-income and middle-income countries: a population-based study

OBJECTIVES

The objective of this study was to examine the prevalence of adolescent motherhood among married adolescent girls and its associations with their partners' characteristics in low-income and middle-income countries (LMICs).

DESIGN

Population-based study.

PARTICIPANTS

54 285 ever married (or lived with a partner) adolescent girls (15-19 years old) were including in prevalence analysis. However, partner characteristics were assessed in a subsample of 24 433 adolescent girls who were married (or living with a partner) at the time of interview.

SETTINGS

Data from the latest available Demographic and Health Survey round during 2010-2018 in 48 LMICs across different geographic regions.

RESULTS

The overall prevalence of adolescent motherhood was 73.98% (95% CI 70.96 to 78.10) among married adolescent girls in this study. In the pooled analysis, statistically significant and positive associations were observed between adolescent motherhood and partners' desire for more children (adjusted marginal effect (AME): 2.34, 95% CI 1.21 to 3.47) and spousal age gap (AME: 1.67, 95% CI 0.30 to 3.04 for three plus age gap). However, no statistically significant association was observed between adolescent motherhood and partners' education (AME: -0.36, 95% CI -1.77 to 1.05 for primary education) and partners' agricultural occupation (AME: 1.07, 95% CI -0.17 to 2.32). Overall, there was significant variation in the associations across countries; however, the positive associations persisted between adolescent motherhood and partners' desire for more children and spousal age gap in most of the studied countries.

CONCLUSIONS

Our findings may inform policymakers about the importance of incorporating partners of married adolescent girls into the existing birth control programmes to delay age at first birth among married adolescents in LMICs. More attention should be given to the married adolescent girls who have older partners, and efforts to discourage marriages with much older partners may have a secondary benefit of reducing adolescent motherhood in LMICs.

Family planning perspectives and practices of married adolescent girls in rural Upper Egypt

OBJECTIVES

The aims of the study were to explore the contraceptive practices of married adolescent girls in rural Upper Egypt and identify the determinants of their ever use of modern contraception.

METHODS

The study was a household survey of 729 married adolescent girls in 23 villages of two governorates in Upper Egypt. Listing and enumeration of all households in the selected villages were performed prior to data collection, to recruit married adolescent girls below 20 years of age. The girls were interviewed using a structured questionnaire.

RESULTS

Only 6% of married adolescent girls were using a modern contraceptive method; 10.6% had ever used a modern contraceptive method, mostly a short-acting method. Considerable proportions of participants believed that using contraception would reduce a woman's fertility and that women should not delay their first pregnancy (34% and 54.3%, respectively); only 50.2% believed that contraception could be used for birth spacing. Predictors of the ever use of a modern method of contraception among married adolescent girls were: accepting that contraception could be used for birth spacing (B = 1.82, p < .001), older age (B = 0.42, p < .01), better reproductive health knowledge (B = 0.23, p < .05) and sharing in contraceptive decision making (B = 0.55, p < .05).

CONCLUSION

Married adolescent girls' current use and ever use of modern contraception were very low in rural Upper Egypt. Changing the social norms to create the desire to delay first childbirth, improving adolescent girls' reproductive health knowledge, correcting myths about contraception and building girls' agency to use contraception may increase their contraceptive use.

The Effect of a Club in Making Differences in Knowledge, Attitude, and Practices on Family Planning Among Married Adolescent Girls in Urban Slums in Bangladesh

Early marriage and childbearing have led to Bangladesh having the highest adolescent fertility rate in the Asia Pacific region. Adolescent pregnancy is correlated with pregnancy-related complications, preterm delivery, delivery of low-birth weight babies, and spousal violence. A quasi-experimental study was conducted in four urban slums (two intervention and two control areas) of Dhaka from July 2014 to August 2016 to assess the effectiveness of a married adolescent girls club (MAG club) in reducing the unmet need for family planning (FP) among married girls between the ages of 14 and 19 (n = 1601, 799 in intervention and 802 in control areas). The percentages of the targeted population using any modern method of contraception were significantly higher among respondents in the intervention areas than those in the control areas (72.6% versus 63.5%). The unmet need for FP was significantly lower among respondents in the intervention areas than that of the control areas (16.2% versus 20.7%). The MAG club was a well-received strategy to provide comprehensive information on FP, which in turn helped improve contraceptive method practices and reduced the unmet need for FP among married adolescent girls in urban slums in Bangladesh. The government could leverage its existing resources to expand the MAG Club model in rural parts of the country to achieve the targets outlined in its Adolescent Reproductive Health Strategy.