Factors Associated with Teen Pregnancy in sub-Saharan Africa: A Multi-Country Cross-Sectional Study

Clifford Odimegwu, Sibusiso Mkwananzi

Abstract

This study aimed to assess the contextual factors associated with teenage pregnancy in sub-Saharan Africa. Using DHS data we modelled females aged 15-19 with multilevel logistic regression to establish the independent influence of social disadvantage on teenage pregnancy in West, East and Southern Africa with aid of the MLwiN programme. Results showed teenage pregnancy decreased in East Africa, plateaued in West Africa and increased slightly in Southern Africa between 1992 and 2011. Multilevel multivariate regression revealed teenage pregnancy was associated with family disruption (0.39; 0.40: P<0.05), community-levels of female unemployment (1.01; 0.99: P<0.05) and community poverty (1.01; 1.02: P<0.05) in Southern and East Africa, while only community poverty (1.01; P<0.05) independently predicted the outcome in West Africa. Our findings emphasise the necessity of creating regional-specific interventions and prevention campaigns to address multilevel factors such as family disruption as well as the need for governments to address issues of unemployment, poverty and inequality. (Afr J Reprod Health 2016 (Special Edition);20[3]: 94-107).

Full Text:

PDF

References

United Nations Population Fund. Motherhood in Childhood: Facing the challenge of adolescent pregnancy. New York: UNFPA, 2013. 2. World Health Organization. Adolescent Pregnancy. Secondary Adolescent Pregnancy 2014. http://www .who.int/maternal_child_adolescent/topics /maternal/adolescent_pregnancy/en/. 3. Clifton D, Hervish A. The World's Youth 2013 Data Sheet. Washington DC: Population Reference Bureau 2013. 4. Loaiza E, Liang M. Adolescent Pregnancy: A Review of Evidence. New York: United Nations Population Fund,, 2013. 5. Macleod CI, Tracey T. A decade later: follow-up review of South African research on the consequences of and contributory factors in teen-aged pregnancy. South African Journal of Psychology 2010; 40(1):18-31. 6. Mangiaterra V, Pendose R, McClure K, et al. Adolescent Pregnancy. In: Heine M, ed. Making Pregnancy Safer Notes. Geneva: World Health Organisation, 2008:4. 7. Tsui A, Creanga A, Ahmed S. The role of delayed childbearing in the prevention of obstetric fistulas. International Journal of Gynecology & Obstetrics 2007;99:S98-S107. 8. Lee D. The early socioeconomic effects of teenage childbearing: A propensity score matching approach. Demographic Research 2010;23(25):697736. 9. Chen X-K, Wen SW, Fleming N, et al. Teenage pregnancy and adverse birth outcomes: a large population based retrospective cohort study. International Journal of Epidemiology 2007; 36(2):368-73. 10. Hoque M, Hoque E, Anwar M, et al. Assessment and Comparison of Obstetric Characteristics and Perinatal Outcomes of Rural Population of South

Africa. Tropical Journal of Obstetrics and Gynaecology 2013;26(1):60-67. 11. Reynolds HW, Wong EL, Tucker H. Adolescents' use of maternal and child health services in developing countries. International family planning perspectives 2006;32(1). 12. Organization WH. WHO guidelines on preventing early pregnancy and poor reproductive health outcomes among adolescents in developing countries. 2011. 13. Duflo E, Dupas P, Kremer M. Education, HIV, and early fertility: Experimental evidence from Kenya: National Bureau of Economic Research, 2014. 14. Tombros A. Integrating efforts to prevent HIV other STIs and pregnancy among teens in developing countries: three case studies. 2005. 15. Neal SE, Chandra-Mouli V, Chou D. Adolescent first births in East Africa: disaggregating characteristics, trends and determinants. Reproductive health 2015;12(1):13. 16. Amoran OE. A comparative analysis of predictors of teenage pregnancy and its prevention in a rural town in Western Nigeria. International journal for equity in health 2012;11(1):1-7. 17. Demissie T. Levels, trends and differentials of adolescent motherhood in Ethiopia. Addis Ababa University, 2008. 18. Francis GF. The effect of household characteristics on adolescent childbearing in Lesotho. University of the Witwatersrand, 2008. 19. Isa AI, Gani IOO. Socio-demographic determinants of teenage pregnancy in the Niger Delta of Nigeria. Open Journal of Obstetrics and Gynecology 2012;2:239. 20. Kaphagawani N. Risk factors for unwanted/ unplanned teenage pregnancy in Zomba District, Malawi. University of the Witwatersrand, 2006. 21. Kyokwijuka MBG. Risk Factors of Adolescent Pregnancy in Kabale District-Uganda. Makere University, 2009. 22. Molosiwa S, Moswela B. Girl-pupil dropout in secondary schools in Botswana: Influencing factors, prevalence and consequences. International Journal of Business and Social Science 2012;3(7):265-71. 23. Nwogwugwu NC. Socio-demographic determinants of adolscent fertility in Zambia. University of the Witwatersrand, 2013. 24. Nyakubega P. Factors associated with adolescent pregnancies among secondary school students. a study from Tanga-Tanzania. Dar Es Salaam Medical Students' Journal 2010;16(1):31-34. 25. Ogunlesi T, Ayeni V, Jagun E, et al. Socio-clinical factors related to the perinatal outcome of teenage pregnancies in a Nigerian teaching hospital. Nigerian Journal of Paediatrics 2013;40(3):290-94. 26. Palermo T, Peterman A. Are Female Orphans at Risk for Early Marriage, Early Sexual Debut, and Teen Pregnancy? Evidence from Sub‐Saharan Africa. Studies in Family Planning 2009;40(2):101-12. 27. Runsewe-Abiodun TI, Bondi SF. Teenage pregnancy and

Odimegwu & Mkwananzi Factors Associated with teenage Pregnancy in sub-Sharan African

African Journal of Reproductive Health September 2016 (Special Edition); 20(3): 106

implications on child survival amongst mothers attending a clinic in the East-End, Freetown, Sierra Leone. Open Journal of Pediatrics 2013;3:294. 28. Were M. Determinants of teenage pregnancies: The case of Busia District in Kenya. Economics & Human Biology 2007;5(2):322-39. 29. Jelili M, Akindele O, Akintayo O. Teenage Pregnancy and Home Environment Factors in Ogbomoso, Nigeria. Research on Humanities and Social Sciences 2013;3(18):69-77. 30. Magadi MA, Agwanda AO. Determinants of transitions to first sexual intercourse, marriage and pregnancy among female adolescents: Evidence from South Nyanza, Kenya. Journal of Biological Sciences 2009(41):409-27. 31. Oyefara JL. Determinants of adolescent fertility in contemporary Yoruba society: a multivariate analysis. Gender and Behaviour 2011;9(2):39794004. 32. Ugoji F. Parental marital status and peer influence as corelates of teenage pregnancy among female teens in south-South Nigeria. Gender and Behaviour 2011;9(2):4125-38. 33. Jewkes R, Morrell R, Christofides N. Empowering teenagers to prevent pregnancy: lessons from South Africa. Culture, Health & Sexuality 2009;11 (7): 675-88. 34. Mkhwanazi N. Understanding teenage pregnancy in a post-apartheid South African township. Culture, Health & Sexuality 2010;12(4):347-58. 35. Panday S, UNICEF. Teenage Pregnancy in South Africa: With a Specific Focus on School-going Learners: Executive Summary: Department of Basic Education, 2009. 36. Chohan Z, Langa M. Teenage mothers talk about their experience of teenage motherhood. Agenda 2011;25(3):87-95. 37. Mkhwanazi N. Developing and expanding our ideas about teenage desire and fertility. Agenda 2011;25(3):2-8. 38. Eyakuze A, Salim A. The state of East Africa 2012: Deepening integration, intensifying challenges: Society for International Development, Regional Office for Eastern Africa, 2012. 39. Open Society Initiative for Southern Africa. Inequality in Southern Africa:Options for Redress. South Africa: OSISA, 2011. 40. StatsCompiler. SatsCompiler Computations. In: Survey DaH, ed., 2015. 41. Kubrin C. Social Disorganization Theory: Then, Now and in the Future. In: Krohn, ed. Handbook on Crime and Deviance: Springer Scince and Business Media, 2009. 42. Shaw CR, McKay HD. Juvenile delinquency and urban areas: A study of rates of delinquents in relation to differential characteristics of local communities in American cities: University of Chicago Press Chicago, 1942. 43. Bowen NK, Bowen GL, Ware WB. Neighborhood Social

Disorganization, Families, and the Educational Behavior of Adolescents. Journal of Adolescent Research 2002;17(5):468-90. 44. McNulty TL, Bellair PE. Explaining Racial And Ethnic Differences In Serious Adolescent Violent Behavior*. Criminology 2003;41(3):709-47. 45. Tolan PH, Gorman-Smith D, Henry DB. The developmental ecology of urban males' youth violence. Developmental psychology 2003; 39(2):274. 46. Yahaya I, Uthman O, Soares J, et al. Social Disorganization and history of child sexual abuse against girls in sub-Saharan Africa: a multilevel analysis. BMC International Health and Human Rights 2013;13(33):8. 47. Kawachi I, Subramanian SV. Neighbourhood influences on health. Journal of Epidemiology and Community Health 2007;61(1):3-4. 48. Merlo J. Multilevel analytical approaches in social epidemiology: measures of health variation compared with traditional measures of association. Journal of epidemiology and community health 2003;57(8):550-52. 49. Subramanian S. The relevance of multilevel statistical methods for identifying causal neighborhood effects. Social science & medicine 2004;58 (10):1961-67. 50. United Nations. Fertility Levels and Trends as Assessed in the 2012 Revision of the World Population Prospects. New York: United Nations, 2013. 51. Walker J-A. Early Marriage in Africa–Trends, Harmful Effects and Interventions. African journal of reproductive health 2012;16(2):231-40. 52. Blum R, John Hopkins Bloomberg School of Public Health. A Global Look at Adolescent Pregnancy Prevention: Strategies for Success. In: Office of Adolescent Health, ed. Webcast. Washington, DC: US Department of Health and Human Services,, 2013. 53. Meade CS, Kershaw TS, Ickovics JR. The intergenerational cycle of teenage motherhood: an ecological approach. Health Psychology 2008;27 (4):419. 54. Walker J-A. Why Ending Child Marriage Needs to Be an Education Goal. Improving Learning Opportunities and Outcomes for Girls in Africa 2013:6. 55. Harwood-Lejeune A. Rising age at marriage and fertility in Southern and Eastern Africa. European Journal of Population/Revue Européenne de Démographie 2001;17(3):261-80. 56. Nalenga GZ. Causes of unintended pregnancy among adolescents in Addis Abeba, Ethiopia. 2012. 57. Kirby D. Antecedents of adolescent initiation of sex, contraceptive use, and pregnancy. American Journal of Health Behavior 2002;26(6):473-85. 58. Miller BC. Family influences on adolescent sexual and contraceptive behavior. Journal of Sex Research 2002;39(1):22-26. 59. Leclerc-Madlala S. Transactional sex and the pursuit of

Odimegwu & Mkwananzi Factors Associated with teenage Pregnancy in sub-Sharan African

African Journal of Reproductive Health September 2016 (Special Edition); 20(3): 107

modernity. Social dynamics 2003;29(2):213-33. 60. Palamuleni M, Adebowale A. Patterns of premarital childbearing among unmarried female youths in sub-Saharan Africa: Evidence from demographic health survey. Scientific Research and Essays 2014;9(10):421-30. 61. Tawiah E. Adolescent fertility and reproductive health in four sub-Saharan African countries. 2002. 62. Spjeldnæs IO. Family values of young people in Limpopo, South Africa: A sociocultural psychological study on perceptions and experiences

of reproduction and parenthood. 2013. 63. Hutchinson MK, Jemmott JB, Jemmott LS, et al. The role of mother–daughter sexual risk communication in reducing sexual risk behaviors among urban adolescent females: a prospective study. Journal of adolescent health 2003;33(2):98-107. 64. Fasula AM, Miller KS. African-American and Hispanic adolescents’ intentions to delay first intercourse: Parental communication as a buffer for sexually active peers. Journal of Adolescent Health 2006;38(3):193-200.

Refbacks

  • There are currently no refbacks.