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Teenage pregnancy and social disadvantage: systematic review integrating controlled trials and qualitative studies

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  • Peer review
  • Angela Harden , professor of community and family health 1 ,
  • Ginny Brunton , research officer 2 ,
  • Adam Fletcher , lecturer in young people’s health 3 ,
  • Ann Oakley , professor of sociology and social policy 2
  • 1 Institute of Health and Human Development, University of East London, London, E15 4LZ
  • 2 Social Science Research Unit, Institute of Education, University of London, London WC1H 0NR
  • 3 Department of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, WC1E 7H
  • Correspondence to: A Harden a.harden{at}uel.ac.uk
  • Accepted 12 July 2009

Objectives To determine the impact on teenage pregnancy of interventions that address the social disadvantage associated with early parenthood and to assess the appropriateness of such interventions for young people in the United Kingdom.

Design Systematic review, including a statistical meta-analysis of controlled trials on interventions for early parenthood and a thematic synthesis of qualitative studies that investigated the views on early parenthood of young people living in the UK.

Data sources 12 electronic bibliographic databases, five key journals, reference lists of relevant studies, study authors, and experts in the field.

Review methods Two independent reviewers assessed the methodological quality of studies and abstracted data.

Results Ten controlled trials and five qualitative studies were included. Controlled trials evaluated either early childhood interventions or youth development programmes. The overall pooled effect size showed that teenage pregnancy rates were 39% lower among individuals receiving an intervention than in those receiving standard practice or no intervention (relative risk 0.61; 95% confidence interval 0.48 to 0.77). Three main themes associated with early parenthood emerged from the qualitative studies: dislike of school; poor material circumstances and unhappy childhood; and low expectations for the future. Comparison of these factors related to teenage pregnancy with the content of the programmes used in the controlled trials indicated that both early childhood interventions and youth development programmes are appropriate strategies for reducing unintended teenage pregnancies. The programmes aim to promote engagement with school through learning support, ameliorate unhappy childhood through guidance and social support, and raise aspirations through career development and work experience. However, none of these approaches directly tackles all the societal, community, and family level factors that influence young people’s routes to early parenthood.

Conclusions A small but reliable evidence base supports the effectiveness and appropriateness of early childhood interventions and youth development programmes for reducing unintended teenage pregnancy. Combining the findings from both controlled trials and qualitative studies provides a strong evidence base for informing effective public policy.

Introduction

Countries such as the United Kingdom and the United States have high teenage pregnancy rates relative to other countries. 1 2 3 Although teenage pregnancy can be a positive experience, particularly in the later teenage years, 4 5 it is associated with a wide range of subsequent adverse health and social outcomes. 6 7 These associations remain after adjusting for pre-existing social, economic, and health problems. 8 Despite the establishment of a national teenage pregnancy strategy in 1999, 9 teenage birth rates in the UK are the highest in western Europe 10 and conceptions among girls under 16 years of age in England and Wales have increased since 2006. 11

Recent research evidence shows that traditional approaches to reducing teenage pregnancy rates—such as sex education and better sexual health services—are not effective on their own. 12 13 This evidence has generated increased interest in the effects of interventions that target the social disadvantage associated with early pregnancy and parenthood. 14 15 16 17 18 19 Social disadvantage refers to a range of social and economic difficulties an individual can face—such as unemployment, poverty, and discrimination—and is distributed unequally on the basis of sociodemographic characteristics such as ethnicity, socioeconomic position, educational level, and place of residence. 20 21

The objectives of this study were to determine on the basis of evidence in qualitative and quantitative research the impact on teenage conceptions of interventions that address the social disadvantage associated with early parenthood and to assess the appropriateness of such interventions for young people in the UK.

We undertook a three part systematic review of the research evidence on social disadvantage and pregnancy in young people by using an innovative method we developed previously for integrating qualitative and quantitative research. 22 23 The first part of the review focused on quantitative controlled trials and was designed to assess the impact on teenage conceptions of interventions that address the social determinants of teenage pregnancy. The second part focused on qualitative research and examined intervention need and appropriateness on the basis of the perspectives and experiences of young people. In the third part of the review, we integrated the two sets of findings to assess the extent to which existing evaluated interventions do in fact address the social disadvantage associated with early pregnancy and parenthood as determined by the needs and concerns of young people.

The inclusion of qualitative research in systematic reviews facilitates the incorporation of “real life” experiences into evidence based policy making. 24 An ability to unpack the worldview of participants at a particular time and location has been highlighted as a key strength of qualitative research. 25 26 Although we included trials conducted in any country, we drew only on qualitative studies conducted in the UK to help assess the applicability of interventions to reduce teenage pregnancy within this country in particular.

Search strategy

Our literature searches covered seven major databases and five specialist registers (table 1 ⇓ ). Highly sensitive topic based search strategies were designed for each database. We did not use study type search filters and identified controlled trials and qualitative studies using the same strategy.

Major databases and specialist registers searched

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We included randomised and non-randomised controlled trials that evaluated interventions designed to target social disadvantage and that reported teenage conceptions or births as an outcome measure. The inclusion of trials was not restricted according to language, publication date, or country. We included any qualitative study published between 1994 and 2004 that focused on teenage pregnancy and social disadvantage among young people aged less than 20 years old living in the UK.

Relevant interventions were those that aimed to improve young people’s life opportunities and financial circumstances; for example, through educational or income support. Relevant interventions could be targeted at children, young people, or their families. Controlled trials of sex education or sexual health services and qualitative studies focusing solely on attitudes to and knowledge of sexual health or sex education were excluded.

We hand searched American Journal of Public Health (from January 1999 to January 2004), Journal of Adolescent Health (from January 1999 to February 2004), Journal of Adolescence (from February 1999 to April 2004), and Perspectives on Sexual and Reproductive Health (from issue 1, 1999, to issue 1, 2004). We also reviewed the reference lists of all studies that met our inclusion criteria and contacted experts in the field who suggested further studies to pursue.

Quality assessment

We assessed the extent to which controlled trials had minimised bias and error in their findings by using a set of criteria developed in previous health promotion reviews. 27 28 29 “Sound” trials were those that reported data on each outcome measure indicated in the study aims; used a control or comparison group equivalent to the intervention group on relevant sociodemographic measures (or, in cases with non-equivalent groups, adjusted for differences in the analysis); provided pre-intervention data for all individuals in each group; and provided post-intervention data for all individuals in each group.

The criteria we used to assess the methodological quality of the qualitative studies were built on those suggested in the literature on qualitative research. 26 30 31 32 33 Each study was assessed according to 12 criteria designed to aid judgment on the extent to which study findings were an accurate representation of young people’s perspectives and experiences (box). A final assessment sorted studies into one of three categories on the basis of quality: high quality (those meeting 10 or more criteria), medium quality (those meeting between seven and nine criteria), and low quality (those meeting fewer than seven criteria).

Criteria used to assess the quality of qualitative studies

Quality of reporting.

Were the aims and objectives clearly reported?

Was there an adequate description of the context in which the research was carried out?

Was there an adequate description of the sample and the methods by which the sample was identified and recruited?

Was there an adequate description of the methods used to collect data?

Was there an adequate description of the methods used to analyse data?

Use of strategies to increase reliability and validity

Were there attempts to establish the reliability of the data collection tools (for example, by use of interview topic guides)?

Were there attempts to establish the validity of the data collection tools (for example, with pilot interviews)?

Were there attempts to establish the reliability of the data analysis methods (for example, by use of independent coders)?

Were there attempts to establish the validity of data analysis methods (for example, by searching for negative cases)?

Extent to which study findings reflected young people’s perspectives and experiences

Did the study use appropriate data collection methods for helping young people to express their views?

Did the study use appropriate methods for ensuring the data analysis was grounded in the views of young people?

Did the study actively involve young people in its design and conduct?

Data extraction

We used a standardised tool to extract from “sound” controlled trials information on the development and content of the intervention evaluated, the population involved, and the trial design and methods. 34 Data to calculate effect sizes for pregnancy and birth rates were identified from study reports and via contact with study authors if data were incomplete or not in an appropriate form.

Data on the development, design, methods, and the populations involved were extracted from the qualitative studies in a standardised way by using an established tool designed for a broad range of study types. 35 The findings of the qualitative studies were identified within the “findings” or “results” sections of study reports and exported verbatim into NVivo (version 2; QSR, Victoria, Australia), a qualitative data analysis software package.

Data synthesis

The data synthesis was conducted in three stages according to the model described by Thomas and colleagues. 22 Firstly, we used statistical meta-analysis techniques to assess the effectiveness of the interventions in the controlled trials. Chi square statistical tests were used to test for heterogeneity (“Q statistic”) between controlled trials; when there was no significant heterogeneity, we combined effect sizes in a random effects statistical meta-analysis using Evidence for Policy and Practice Information Centre reviewer software. 36 Relative risk (RR) was used to calculate both individual study and combined effect sizes. Our procedures for meta-analysis followed standard practice in the field 37 38 39 and were similar to those used in previous reviews by the Evidence for Policy and Practice Information Centre. 29 40

Secondly, we conducted a thematic synthesis of the findings from the qualitative studies, 41 42 following established principles developed for the analysis of qualitative data. 25 43 44 Study findings were coded line by line to characterise the content of each line or sentence (for example, “frustration with rules and regulations at school,” “expectations for the future”). Codes were compared and contrasted, refined, and grouped into higher order themes (for example, “dislike of school”). The review team then drew out the implications for appropriate interventions suggested by each theme.

Thirdly, we constructed a methodological and conceptual matrix to integrate the findings of the two syntheses. The potential implications of young people’s views for interventions to prevent teenage pregnancy were laid out alongside the content and findings of the soundly evaluated interventions.

Screening of full reports against inclusion criteria, quality assessment, data extraction, and data synthesis were all carried out by pairs of reviewers working independently at first and then together. Initial screening of titles and abstracts was done by single reviewers after a period of double screening to ensure consistency across reviewers.

Study characteristics and quality

Ten controlled trials w1-w10 and five qualitative studies w11-w15 met our inclusion criteria. Six controlled trials were judged to be of sufficient methodological quality to provide reliable evidence about the impact of interventions on teenage pregnancy rates. w1-w3 w6 w7 w9 All these trials were conducted in the US and targeted disadvantaged groups of children and young people (tables 2 ⇓ and 3 ⇓ ).

 Characteristics of the six “sound” trials

 Characteristics of the interventions in the six “sound” trials

Each of the methodologically sound controlled trials evaluated one of two intervention types: ( a ) an early childhood intervention, or ( b ) a youth development programme. Three studies evaluated early childhood interventions that aimed to promote cognitive and social development through preschool education, parent training, and social skills training. w2 w3 w7 Two of these studies—the Perry Preschool Program w2 and the Abecedarian Project w3 —evaluated the long term effects of preschool education and parenting support interventions; the third—the Seattle Social Development Project—evaluated the long term effects of a school based social skills development intervention for children and their parents. w7

A further three studies evaluated youth development programmes that aimed to promote self esteem, positive aspirations, and a sense of purpose through vocational, educational, volunteering, and life skills work. w1 w6 w10 Two of these studies—Teen Outreach w1 and the Quantum Opportunities Program w6 —evaluated after school programmes based on the principle of “serve and learn,” in which community service is combined with student learning and educational support; the third—the Children’s Aid Society Carrera-Model Program—evaluated a comprehensive academic and social development intervention delivered in youth centres, which included work experience, careers advice, academic support, sex education, arts workshops, sports, and other activities. w10

In each trial, the control group received no intervention or standard education. The four controlled trials that were deemed not to be of sufficient quality also evaluated youth development programmes in the US. w4 w5 w8 w9 All five qualitative studies were judged to be of medium or high quality. w11-w15 These studies included participants from a range of areas throughout the UK and used individual interviews, focus groups, and self completion questionnaires to collect data (table 4 ⇓ ). Four studies focused on, or included, the views of young parents, w11 w12 w14 w15 but only two of these studies included the views of young fathers as well as young mothers. w14 w15

 Characteristics of the four high and medium quality qualitative studies

Quantitative studies of the effects of interventions on teenage pregnancy rates

Of the six controlled trials deemed to be of sufficient methodological quality, four measured pregnancy rates reported by young women, w1 w2 w7 w10 three measured partner pregnancy rates reported by young men, w1 w7 w10 and two measured birth rates reported by young men and young women separately w3 or together. w6 The four controlled trials measuring pregnancy rates reported by young women or young men w1 w2 w7 w10 were included in two random effects meta-analyses: one that assessed the effects of interventions on teenage pregnancies reported by young women and a second that measured the effects of interventions on teenage pregnancies reported by young men. The findings of the two controlled trials that measured birth rates w3 w6 were not subject to meta-analysis, but their findings are summarised after each meta-analysis. Tests revealed no statistical heterogeneity between the studies, suggesting that it would be appropriate to pool the effect sizes. However, effect sizes for youth development interventions and early childhood education interventions were pooled separately in recognition of the differences between these two types of intervention.

The pooled effect size from the first meta-analysis showed that early childhood interventions and youth development programmes reduced teenage pregnancy rates among young women (RR 0.61, 95% CI 0.48 to 0.77; fig 1 ⇓ ). The effect of an early childhood intervention on birth rates reported by young women was similar in the study by Campbell and colleagues w3 (0.56, 0.42 to 0.75).

Fig 1 Forest plot showing the effect of youth development programmes and early childhood interventions on pregnancy rates reported by young women

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The effect of these interventions on pregnancies reported by young men is less clear (fig 2 ⇓ ). The pooled effect size from the second meta-analysis showed that young men who had received an early childhood or youth development intervention reported fewer partner pregnancies than those who had not, but this result was not statistically significant (RR 0.59, 95% CI 0.34 to 1.02).

Fig 2 Forest plot showing the effect of youth development programmes and early childhood interventions on pregnancy rates reported by young men

Hahn and colleagues w6 evaluated a youth development programme and measured birth rates reported by both young women and young men. The intervention reduced the birth rate by 36%, although this result was of borderline statistical significance (RR 0.64, 95% CI 0.40 to 1.03).

Qualitative studies of the views and experiences of young people

Three major themes relating to teenage pregnancy emerged from the findings of the five qualitative studies: dislike of school; poor material circumstances and unhappy childhood; and low expectations and aspirations for the future (fig 3 ⇓ ).

Fig 3 Thematic analysis of young people’s views on the role of education; training; employment and careers; and financial circumstances in teenage pregnancy

Dislike of school was a key aspect of young parents’ accounts of their lives before becoming parents and of young people identified as “at risk” of becoming teenage parents (for example, “Still be at school? I’d rather have a baby than that. I just didn’t like school, it was hard, it was horrible” w14 ). The reasons young people gave for disliking school varied (fig 3). Some related to the subject matter taught in school, which was seen as boring or irrelevant, especially for young women who had difficult or unhappy home lives and caring responsibilities (for example, “what on earth is this going to do for me?” w15 ). Other reasons related to insufficient or inappropriate support when falling behind with school work or experiencing bullying by teachers and peers (for example, “I got bullied so I just stopped going” w12 ). Some young people were frustrated with the inflexibility of “institutional life,” with all its rules and regulations (for example, “You can’t sit with your friends, which I found the best way of learning” w11 ).

Young parents reported unhappiness, rather than poverty in itself, as the most significant aspect of their childhood experiences that related to becoming a parent, although unhappiness went hand in hand with adversity and material disadvantage in their accounts. Common experiences included family conflict and breakdown, sometimes caused by violence, which could lead to living in care (fig 3). Young fathers reported violent fathers and a lack of suitable role models. Young parents noted how they had to “grow up faster” in order to survive, and also reported a lack of confidence, low self esteem, and high anxiety levels. w11 Some young women saw having a baby at an early age as a way to change their circumstances and ameliorate the effects of adversity. It is important to note, however, that not all the teenage mothers who participated in these studies had grown up unhappy or experienced personal adversity. Regardless of circumstances, some women had wanted to have a baby when they were young and looked forward to still being young when their children were older.

There were differences in the expectations and aspirations of young people who had, or wanted to have, a baby early in life and young people who had or wanted to have a baby later in life. For example, mothers who had children when they were teenagers wanted to leave school as soon as possible and get a job. In contrast, those who became pregnant later in life expected to go to university and travel. Both young mothers and young fathers believed that few opportunities were open to them apart from poorly paid, temporary work in jobs that they disliked (for example, “There are so many jobs out there that I didn’t even know existed . . . I probably could have done something but I just didn’t even think of these high paid jobs I could have done” w14 ). Young mothers described how having a baby was a more attractive option than entering the workforce, further education, or training. Young men’s lack of ambition was compounded by the low expectations their parents and peers held for them. Young people who wanted children later in life had long term plans and a more positive outlook for the future, and they described how participating in out of school activities such as sports, music, and arts improved their self esteem and motivation.

Do current interventions address the needs and concerns reported by young people?

The themes in our synthesis of qualitative studies suggest areas that should be addressed in preventive interventions, but measures to target these areas have not all been soundly evaluated for their effect on teenage pregnancy rates (table 5 ⇓ ).

 Comparison of themes arising from studies of young people’s views with interventions assessed in “sound” trials

Youth development programmes and early childhood interventions both go some way to addressing young people’s dislike of school. Two of the three youth development programmes in the controlled trials we reviewed included components designed to promote young people’s academic achievement, such as tutoring and homework assistance, w6 w10 whereas the third aimed to improve young people’s interpersonal skills so they could develop good relationships with their peers and others. w1 One early childhood intervention both taught children conflict resolution skills and trained parents to create a home environment supportive of learning. w7 We did not find any research that had tested the impact on teenage pregnancy rates of interventions designed to change the school culture and environment, such as antibullying strategies, teacher training, or involving young people in making decisions about what happens in the school.

All the youth development programmes aimed to prevent teenage pregnancy by broadening young people’s expectations and aspirations for the future. These programmes offered young people work experience in their local communities, careers advice, group work to stimulate active reflection, and discussion of future careers and employment opportunities. Two of the three soundly evaluated youth development programmes also provided out of school sports or arts activities. w6 w10

Summary of principal findings

This review sought to improve our understanding of the link between social disadvantage and teenage pregnancy by integrating evidence from qualitative studies and quantitative trials.

The evidence from the six controlled trials we looked at showed that early childhood interventions and youth development programmes can significantly lower teenage pregnancy rates. Both types of intervention target the social determinants of early parenthood but are very different in content and timing. Preschool education and support appear to exert a long term positive influence on the risk of teenage pregnancy, as well as on other outcomes associated with social and economic disadvantage such as unemployment and criminal behaviour. 45 Programmes of social support, educational support, and skills training delivered to young people have a much more immediate impact.

Our review of five qualitative studies of young people in the UK indicated that happiness, enjoying school, and positive expectations for the future can all help to delay early parenthood. Young people who have grown up unhappy, in poor material circumstances, do not enjoy school, and are despondent about their future may be more likely to take risks when having sex or to choose to have a baby.

The findings of our review are especially important in the light of evidence that sex education and sexual health services are not on their own effective strategies for encouraging teenagers to defer parenthood 12 ; they need to be complemented by early childhood and youth development interventions that tackle social disadvantage. 13 18 46 Early childhood interventions and youth development programmes provide enhanced educational and social support in the early years of life and engage young people in developing career aspirations, respectively, thus addressing some of the key themes identified within our qualitative synthesis. However, important gaps exist in the evidence on how effectively current interventions address these themes (table 5). Structural and systemic issues such as housing, employment opportunities, community networks, bullying, and domestic violence were all important issues in young people’s accounts, but these factors have yet to be addressed in appropriate interventions and evaluated as wider determinants of teenage pregnancy.

Comparison with other studies

Our review adds to a growing body of research identifying factors that may explain the association between social disadvantage and teenage pregnancy. Dislike of school, an unhappy childhood, and a lack of opportunities for jobs and education have all emerged as explanatory factors in large scale national and international epidemiological analyses. 3 9 17 18 47 48 49 Dislike of school appears to have an independent effect on the risk of teenage pregnancy. 49 Our analysis of qualitative research provides additional insight into how factors that increase the risk of teenage pregnancy may operate. For example, a dislike of school was frequently the result of bullying, frustration with rules and regulations, lack of curriculum relevance, boredom, and inadequate support.

As well as developing and testing interventions to modify these antecedents, future research on teenage pregnancy and social disadvantage needs to consider strategies that counter the stigmatisation and discrimination faced by young parents. Some of the social exclusion experienced by young parents is the result of negative societal reaction. However, there is evidence to suggest that teenage parenting can under certain circumstances be a route to social inclusion rather than exclusion. 50

Like many other systematic reviews in health promotion and public health, we found few trials conducted in the UK. 27 29 40 This raises questions about the generalisability of the trial evidence. Our inclusion of qualitative evidence permitted us to examine the appropriateness of interventions evaluated in US trials from the perspective of young people in the UK. The appropriateness of interventions is an important aspect of generalisability to consider. 51 Our inclusion of qualitative evidence does not, however, replace the need for further trials in the UK and elsewhere to address the impact of interventions designed to ameliorate the wider determinants of teenage pregnancy.

A recent study carried out in England evaluated the effects of the Young People’s Development Programme—an intensive, multicomponent youth development intervention based on the Children’s Aid Society Carrera Model Program. w10 52 In contrast to the findings of this review, the quasi-experimental study found that young women in the intervention group were more likely to report pregnancy than those in the comparison group. This finding may be the result of the potentially stigmatising effect of targeting and labelling young people as “high risk” or of introducing participants to other “high risk” young people in alternative educational settings. In comparison with the Young People’s Development Programme, the youth development programmes evaluated by the controlled trials in our review used after school programmes or interventions delivered in community settings rather than the approach of keeping young people out of mainstream schools and working with them in alternative educational settings. This difference in approach may explain the difference in the findings of the two studies and highlights the need to evaluate a revised youth development programme in the UK.

Strengths and limitations of the study

The strengths of our review include the comprehensiveness of our searches, the exclusion of methodologically weak studies, the rigorous synthesis methods used, and the inclusion of qualitative research alongside controlled trials to establish not only “what works” but also appropriate and promising intervention strategies on the basis of young people’s views on the factors associated with teenage pregnancy. Including only studies that evaluated interventions relative to control conditions over the same period of time avoids missing temporal differences between groups. Such changes include the relaxing of abortion laws and the increasing acceptability of abortion over time, which may affect self reported pregnancy rates.

The small numbers of studies we found are a limitation of the available body of research, as is the dominance of controlled trials conducted in the US (although this is a common feature of many health promotion and public health reviews). Our search strategies would have under-represented non-English language studies. As with any systematic review, we cannot be certain that we identified all relevant studies; in particular we may not have identified all unpublished studies, which are more likely to report negative findings than are published studies. We are only aware of one relevant study published since the searches for this review were carried out: the evaluation of the Young People’s Development Programme. 52 Whether this study would meet the quality criteria for our review is unclear, but it should be considered in any update.

Conclusion and policy implications

This review provides a small but reliable evidence base that early childhood interventions and youth development programmes are effective and appropriate strategies for reducing unintended teenage pregnancy rates. Our findings on the effects of early childhood interventions highlight the importance of investing in early care and support in order to reduce the socioeconomic disadvantage associated with teenage pregnancy later in life. 53 Both the early childhood interventions and the youth development programmes combined structural level and individual levels components, which is in line with many current recommendations in health promotion and public health. 54 55 A policy move to invest in youth programmes should complement rather than replace high quality sex education and contraceptive services, and should aim to improve enjoyment of school, raise expectations and ambitions for the future, and provide young people with relevant social support and skills.

What is already known on this topic

Evidence suggests that sex education and better sexual health services do not reduce teenage pregnancy rates

A number of controlled trials have tested the effects of interventions that target the social disadvantage associated with early pregnancy and parenthood, and a number of qualitative studies have considered young people’s views of the factors associated with teenage pregnancy

No systematic review has brought these quantitative trials and qualitative studies together to determine intervention effectiveness and appropriateness

What this study adds

Early childhood interventions and youth development programmes that combine individual level and structural level measures to tackle social disadvantage can lower teenage pregnancy rates

Such interventions are likely to be appropriate for children and young people in the UK because they improve enjoyment of school, raise expectations and ambitions for the future, and ameliorate the effect of an unhappy childhood in poor material circumstances

A policy move to invest in interventions that target social disadvantage should complement rather than replace high quality sex education and contraceptive services

Cite this as: BMJ 2009;339:b4254

Contributors: AH, AO, and GB designed the study and obtained funding. AH, AO, and GB wrote the review protocol. AF, GB, and AH conducted the searches, screened titles and full papers, assessed study quality, extracted data, and undertook the statistical and qualitative syntheses. All authors contributed to the drafting of the paper and approved the final submitted version. AH, AO, and GB are the guarantors. All authors had full access to all the data in the study, including statistical reports and tables, and can take responsibility for the integrity of the data and the accuracy of the data analysis.

Funding: The review was funded by the Department of Health. AH was funded by a senior level research scientist in evidence synthesis award from the Department of Health. The researchers operated independently from the funders and the views expressed in this paper are those of the authors and not necessarily those of the Department of Health.

Competing interests: None declared.

Data sharing: Technical appendix available at http://eppi.ioe.ac.uk/cms/Default.aspx?tabid=674 .

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode .

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research proposal on teenage pregnancy

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Qualitative Research on Adolescent Pregnancy: A Descriptive Review and Analysis

Profile image of Liezyl Blancada

This study examined qualitative research on adolescent pregnancy to determine designs and methods used and to discover emergent themes across studies. Most of the 22 studies reviewed were described as qualitative or phenomenological by design and included samples comprising either African-American and Caucasian participants or African-Americans exclusively. Based on analysis of the collective primary findings of the sample articles, four themes were identified: (a) factors influencing pregnancy; (a) pregnancy resolution; (c) meaning of pregnancy and life transitions; and (d) parenting and motherhood. Overall, the studies revealed that most adolescent females perceive pregnancy as a rite of passage and a challenging yet positive life event. More qualitative studies are needed involving participants from various ethnic backgrounds, on males' perceptions relative to adolescent pregnancy and fatherhood, and about decision-making relevant to pregnancy resolution, intimacy, and peer relationships.

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Joefel Libo-on

Teenage pregnancy is a global problem. It confronted all levels of societal status from low, middle to high-income nations. The current paper provides an exploration of the mothers that come across the stage of teenage pregnancy. This provides narratives of the causes, challenges encountered, and their regrets by mothers that come across teenage pregnancy. A qualitative method of research was used in this study. The narrative - case study design was utilized in this methodology. It includes 10 participants and data were gathered through the use of a semi-structured interview schedule. The following were the study's significant findings: The majority of the participants were at the age of 21 and got pregnant at the age of 16 – 19. Most of them were first-year college students when they got pregnant, unmarried, unemployed, and therefore dependent on their parent's income. Participants’ narratives revealed that they got pregnant at an early age because of the individual willing...

research proposal on teenage pregnancy

Im schoolBOy

The aim of the present study was to investigate the increasing incidence of teenage pregnancy. Specifically, the study sought to determine whether or not pregnant teenagers experience psychological distress during pregnancy, and to explore the nature of such distress. Thirty five (35) pregnant teenagers were conveniently sampled to participate in the study. Their ages ranged from 15 to 20 years, with the gestation period ranging from 4 to 9 months. Data was collected using triangulation of methods, namely quantitative and qualitative methods. For the quantitative data, a 15-item General Health Questionnaire (GHQ-15) which measures such factors as Socio-economic, Social, Ethnic and Religion. For qualitative data, five focus group interviews were conducted with the participants. The results suggested indications of psychological distress during the gestation period. These included experiences of symptoms associated with somatic complaints, anxiety and insomnia, social isolation and severe depression. Furthermore, the study showed themes of distress wherein teenagers react to the minimize on pregnancy with fear and disbelief, and thoughts of termination of pregnancy. Participants gave reports that pregnancy was seen as a stressful event for the teenagers involved. Coping strategies noted included teenagers ‟ resort to avoidance of situations were perceived to be stressful, and also associating with people they perceived as being more supportive. Based on the findings, the following recommendations were made: a) Intervention programs should be put in place so as to help minimize the increasing number pregnant teenagers, and able to identify factors may contribute teenage mother; b) Social support structures should be made available to Pregnant teenagers; and c) Cultural practices should be incorporated in education syllabi that focus on human sexuality and reproduction.

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Teenage pregnancy is both a social and a public health problem in The Gambia and as such it continues to be a concern to families, community leaders, educators, social workers, health care professionals, the government and its partners. Though there are some studies on the topic of teen pregnancy and school dropout, there is a limited material on the perceptions held by teens about teenage pregnancy, contributing factors and childbearing, difficulties encountered by teen parents, needed preventive and curative programmes. The purpose of the study was first to explore and describe the major causes of teenage pregnancy and childbearing despite the fact that contraceptive is widely available and family life education being taught in all schools. Secondly, examine the problems the teenagers encounter after becoming mothers. Thirdly, examine the ways the teen mothers cope and adapt to the situation of becoming mothers. An exploratory, descriptive, contextual and qualitative design was ad...

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  • Published: 26 March 2021

Prevalence and associated factors of adolescent pregnancy (15–19 years) in East Africa: a multilevel analysis

  • Misganaw Gebrie Worku 1 ,
  • Zemenu Tadesse Tessema 2 ,
  • Achamyeleh Birhanu Teshale 2 ,
  • Getayeneh Antehunegn Tesema 2 &
  • Yigizie Yeshaw 2 , 3  

BMC Pregnancy and Childbirth volume  21 , Article number:  253 ( 2021 ) Cite this article

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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.

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.

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.

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.

Peer Review reports

Adolescent pregnancy is a global public health problem that affects both developed and developing countries [ 1 ]. Nearly 25% of adolescent women have got pregnant worldwide [ 1 , 2 , 3 ], and the prevalence of adolescent pregnancy in Africa is 18.8%, of this, 19.3% occurred in Sub-Saharan Africa and 21.5% in eastern Africa [ 2 ]. The prevalence of adolescent pregnancy in eastern Africa ranges from 18 to 29% and around half of these pregnancies are unintended [ 4 ].

Globally an estimated 3.9 million adolescents experience unsafe abortions, which contribute to the highest maternal mortality and morbidity [ 5 , 6 ]. Adolescent pregnancy is considered the leading cause of newborn and maternal mortality in developing countries [ 7 , 8 , 9 ]. Pregnancies among adolescents are associated with several adverse health, educational, social and economic outcomes [ 10 , 11 ]. Adolescent pregnancies typically occur in poor populations, which could be influenced by poverty, lack of education, and work opportunities [ 12 ].

Adolescent pregnancy has significant health, psychological and socioeconomic impacts on the mother. It increases the risk of low birth weight, premature delivery, mortality, preeclampsia, social isolation, delayed or neglected educational goals, and maternal depression [ 8 ]. The social consequence includes stigma, rejection, violence and drops out of school [ 13 , 14 ]. Due to their direct association with adolescent sexual intercourse, several biological factors such as the timing of pubertal development, hormone levels, and genes, are also related to adolescent pregnancy [ 15 ]. In general, adolescent mothers had a low level of education and low level of antenatal care and faces a higher risk of developing pregnancy-induced hypertension (PIH), Preeclampsia toxemia [ 16 ], eclampsia, premature labor onset, and premature delivery with increased risk of neonatal morbidity and mortality [ 3 , 17 , 18 ].

Previous studies showed that being sexually active at an early age, early marriage, older teenage, married women, educational attainment, age at 1st sex, household wealth, family structure, exposure to media, community poverty level, and contraceptive use are significantly associated with adolescent pregnancy [ 3 , 4 , 13 , 19 , 20 ].

Though there are studies conducted on the prevalence and associated factors of adolescent pregnancy in individual east African countries [ 4 , 7 , 8 , 9 , 16 ], there is limited evidence on the pooled prevalence and associated factors of adolescent pregnancy in the region. Therefore, this study aimed to determine the pooled prevalence and associated factors of adolescent pregnancy in East Africa based on the pooled nationally representative Demographic and Health Surveys (DHS). Thus, the findings of this study could help policymakers, and governmental and non-governmental organizations to design programs and interventions towards adolescent pregnancy and pregnancy-related complications.

Data sources, sampling technique, and study population

This study was a secondary data analysis based on the datasets from the most recent Demographic and Health Surveys (DHS) conducted in East African countries (Burundi, Ethiopia, Comoros, Uganda, Rwanda, Tanzania, Mozambique, Madagascar, Zimbabwe, Kenya, Zambia, and Malawi). These datasets were appended to determine the prevalence and associated factors of adolescent pregnancy in east Africa. The DHS is a nationally representative survey that collects data on basic health indicators like mortality, morbidity, family planning service utilization, fertility, maternal and child health. The DHS used two stage stratified sampling technique to select the study participants. Each country’s survey consists of different datasets including men, women, children, birth, and household datasets, and for this study, we used the women’s dataset (individual record (IR) file). In this study, all adolescent girls aged 15–19 years and those who ever had sex (a total weighted sample of 17, 234) were considered for the final analysis. The detailed information on the survey country, the number of adolescents in each country, eligible and actual number of women for each country were provided in Table  1 .

Variables of the study

The outcome variable of this study was “getting pregnant during the age of 15-19 years among adolescents who ever had sex”. A woman was considered as experiencing adolescent/teenage pregnancy if her age was from 15 to 19 and if she had ever been pregnant before or during the survey. We used all girls age 15–19 who had ever experienced sex as our study population. The outcome was derived using the variables; the number of women who have had a birth and the number of women who have not had a birth but are pregnant at the time of interview [ 14 ].

The independent variables considered for this study were both individual and community-level variables. The individual-level factors include; the age of respondent, marital status, age at 1st sex, contraceptive use, educational attainment, household wealth status, sex of household head, relation to household head, and access to mass media. The community-level factors were community women education, community poverty, community contraceptive utilization, residence and country. In DHS, except country and residence, all the other variables were collected at the individual level. Therefore, we generate three community-level variables such as community women’s education, community poverty, and community contraceptive utilization by aggregating the individual-level factors at cluster level and categorized as high and low based on the median value (Table  2 ).

Data management and analysis

Data extraction, recoding and analysis were done using STATA version 14 software. The data were weighted before any statistical analysis to restore the representativeness of the data and to get a reliable estimate and standard error. Descriptive statistics were done using frequencies and percentages. Since the DHS data has a hierarchical structure, this violates the independent assumptions of the standard logistic regression model, a multilevel logistic regression analysis was used. Besides, adolescents in the same cluster are more likely to be similar to each other than adolescents from another cluster. This implies that there is a need to take in to account the between cluster variability by using advanced models such as multilevel analysis. The Interclass Correlation Coefficient (ICC) and Median Odds Ratio (MOR) were checked to assess whether there was clustering or not. In this study, four models were fitted; the null model- a model without explanatory variables, model I- a model with individual-level factors, model II- a model with community-level factors, and model III- a model with both individual and community-level factors, simultaneously. Model comparison was done based on deviance (−2LL) and a model with the lowest deviance was selected as the best-fitted model. Both bivariable and multivariable analysis was done using the best-fitted model. At the bivariable analysis variables with a p -value ≤0.2 were considered for multivariable analysis. Finally, variables with a P -value of ≤0.05 in the multivariable analysis were considered a significant factor associated with adolescent pregnancy.

Socio-demographic characteristics

A total of 17, 234 (weighted) adolescent girls who ever had sex was included for the final analysis. Nearly three-fourths (73.78%) of the respondent were rural dwellers and more than half (59.54%) of the respondents were aged 18 to 19 years. About 57.64% of respondents had attained primary education and 39.48% of respondents were from rich households. The majority (70.43%) of adolescent girls had media exposure and 69.51% of respondents were from male-headed households. More than half (53.54%) of adolescent girls were unmarried and 76.92% of adolescent girls did not use any contraceptive (Table  3 ).

Prevalence of teenage pregnancy in East Africa

The overall prevalence of teenage pregnancy in East Africa was 54.6% (95%CI; 53.85, 55.34%), ranged from 36.15% in Rwanda to 65.29% in Zimbabwe (Fig.  1 ).

figure 1

Prevalence of teenage pregnancy among adolescent girls in eastern Africa countries

Factors associated with adolescent pregnancy in East Africa

Random effect model and model fitness.

The random effect model has been assessed using ICC, MOR, and PCV. The ICC value in the null model was 0.10, which indicates that about 10% of the total variation in adolescent pregnancy was attributable due to the difference between clusters with the remaining 90% of the total variability in adolescent pregnancy was attributable due to the between-individual variability. Besides, the MOR value was 4.7 and this indicates that adolescent pregnancy was significantly different between clusters. Furthermore, PCV was highest in the final model (model III), which indicated that about 86% of the variation in adolescent pregnancy was explained by both individual and community-level factors. Regarding model fitness, the final model (Model III) was the best-fitted model for the data since it had the lowest deviance (Table  4 ).

Fixed effect analysis results

Variables including sex of household head, country and community level of education were excluded from multivariable analysis since their p -value at bivariable analysis was greater than 0.2. In the multivariable multilevel binary logistic regression analysis; age of respondent, marital status, relation to the household head, age at first sex, wealth status, contraceptive use, educational level, exposure to media, working status, and community level of contraceptive use were found statistically significant factors associated with adolescent pregnancy.

The odds of adolescent pregnancy among adolescent girls aged 18–19 years were 3.06 (AOR = 3.06, 95% CI: 2.83, 3.31) times higher than adolescent girls aged 15–17 years. Unmarried adolescent girls had 75% (AOR = 0.25; 95% CI: 0.23, 0.28) lower odds of being pregnant at the age of 15–19 years as compared with married adolescent girls. Adolescent girls who used contraceptives had 1.41 [AOR = 1.41; 95% CI: 1.28, 1.55] times higher odds of becoming pregnant during the adolescent period as compared to their counterparts. Besides, adolescents in the rich household had 36% (AOR = 0.64; 95% CI: 0.58, 0.71) lower odds of adolescent pregnancy as compared to adolescents from a poor household. The odds of adolescent pregnancy among adolescent girls who started sexual intercourse at the age of 15–17 years, and 18–19 years were 0.69 (AOR = 0.69; 95% CI: 0.63, 3.75), and 0.31 (AOR = 0.31; 95% CI: 0.27, 0.35) times lower as compared to those who started intercourse at the age of 5–14 years, respectively. The odds of being pregnant during the adolescent period was 1.11 times (AOR = 1.11; 95% CI: 1.03, 1.19) higher among employed girls compared to their counterparts. The odds of teenage pregnancy among adolescent girls who were spouse/head with in the family were also higher compared to being a daughter [AOR = 1.62; 95% CI: 1.45, 1.82]. Looking at media exposure, adolescent girls who had exposure to media had 0.85 times (AOR = 0.85; 95%CI: 0.78, 0.92) lower odds of being pregnant during the adolescent period compared to their counterparts. Adolescent girls with secondary and higher education had lower odds of being pregnant during adolescence compared with uneducated adolescent girls (AOR = 0.78; 95%CI: 0.68, 0.91). Regarding community-level contraceptive utilization, adolescent girls from the community with a higher level of contraceptive use had 1.10 times (AOR = 1.10; 95%CI: 1.02, 1.19) higher odds of being pregnant compared with their counterparts (Table  5 ).

This study aimed to assess the pooled prevalence and associated factors of adolescent pregnancy in east Africa using the pooled DHS data. The pooled prevalence of teenage pregnancy in this study was 54.6% (95%CI: 53.85, 55.34%), ranging from 36.15% in Rwanda to 65.29% in Zimbabwe. It is higher than the report of previous studies [ 2 , 4 , 9 ]. This might be due to the difference in the study population since we have incorporated any form of pregnancy such as terminated pregnancy as teenage pregnancy, unlike other studies. The other possible explanation might be because of the large sample size and we included participants from different countries with a wide variety of socioeconomic status and cultural norms [ 19 ].

In this study; respondent age, contraceptive utilization, marital status, media exposure, respondent working status, household wealth status, community-level contraceptive utilization, age at first sex, educational level and relation to the household head were significantly associated with adolescent pregnancy. The odds of adolescent pregnancy were higher among older teenagers and this is supported by a study done in Africa [ 11 ]. This might be due to the fact that as age increases, teenagers will have more exposure to sex and their chance of getting married will also increase to procreate children [ 15 ]. Besides, older teenagers had the chance to separate from their parents and started to live independently which may lead them to have risky sexual behavior.

Surprisingly, in our study, adolescent girls who used contraceptives were at higher risk of teenage pregnancy which is in contrast to different studies [ 3 , 19 ]. This may be correlated with even though there is increased use of contraception in developing countries, still a contraceptive failure, due to inadequate contraceptive counseling, awareness, and utilization skills, is common and this results in unplanned and unwanted pregnancy [ 17 ]. The higher rate of teenage pregnancy among contraceptive users also indicates that contraceptive needs may still be unmet, including intermittent use of contraceptives and supply interruption [ 18 ].

Adolescent girls from rich households had a lower risk of teenage pregnancy compared with adolescent girls from poor economic classes. This is widely accepted and in agreement with a study in Africa [ 19 ]. This may be because adolescent girls from poor households may be exposed to early marriage and sexual initiation and can’t afford the cost of reproductive health services and contraceptives [ 19 ]. Also, adolescents from families of low socioeconomic status are at greater risk of early and unintended pregnancies largely due to poverty and lower expectations of future economic success [ 4 ]. This may also be justified as young people from higher poverty levels may be involved in transactional sex as an economic survival strategy and this leads to pregnancy at a younger age [ 9 ]. In this study, early sexual initiation is a risk factor for teenage pregnancy, which is in agreement with another study done in Ethiopia [ 19 ]. This may be because women with early sexual initiation had less information, knowledge, attitude, and practice about safe sex and modern contraceptive utilization [ 18 , 19 ].

The study at hand also revealed that adolescents of being spouse/head are at increased risk of teenage pregnancy, which is in line with studies in eastern Africa [ 4 , 20 ]. This might be due to adolescent girls who didn’t live with both of their biological parents’ lack their parental support and guidance which exposes them to early sexual initiation, pregnancy and early motherhood [ 4 ].

Married adolescent girls had higher odds of being pregnant, which is in agreement with a study in Ethiopia [ 11 ]. Similarly, an employed adolescent girls had higher odds of teenage pregnancy compared with unemployed girls which is supported by a study done in sub-Saharan Africa [ 9 ]. This may be because adolescent girls are exposed to different risky sexual behaviors at their workplace and this sexual assault leads to pregnancy [ 21 ]. Interestingly, adolescent girls who had exposure to media had lower odds of being pregnant. This may be justified by exposure to various mass media can encourage adolescents to utilize maternal health services such as youth reproductive services and family planning services [ 22 ]. Mass media exposure also offers improved awareness and understanding, as well as improvements in attitudes, social expectations and behaviors that can contribute to beneficial effects for public health [ 16 ]. Adolescent girls who had secondary and higher education had a lower chance of being pregnant early, which is supported by a study conducted in sub-Saharan Africa [ 9 ]. This may be explained because education increases autonomy and decision-making power and increases economic independence, leading to the postponement of marriage, and reduction of fertility [ 23 ].

Strength and limitation of the study

The study has many strengths, first, the study was based on weighted nationally representative data from 12 eastern African countries with large sample size. Second, the multilevel analysis was used to accommodate the hierarchical nature of the DHS data to get reliable standard error and estimate. Moreover, since it is based on the national survey data the study has the potential to give insight for policy-makers and program planners to design appropriate intervention strategies both at national and regional levels. However, this study had limitations in that the DHS survey was based on respondents’ self-report, this might have the possibility of recall bias. Besides, since this study was based on survey data, we are unable to show the temporal relationship between adolescent pregnancy and independent variables. Also, the independent variables for adolescent girls who gave childbirth (pregnant before) were measured at the time of the survey date.

In this study, the pooled prevalence of teenage pregnancy was higher, indicating that teenage pregnancy is still the major public health problem in east Africa. Respondent’s age, contraceptive utilization, marital status, respondent working status, household wealth status, community poverty level, initiation of sex at an earlier age, residence, and relation to the household head had a significant association with teenage pregnancy. So, emphasis should be given to the reduction and prevention of pregnancy in adolescent girls to prevent adverse maternal, neonatal, educational and economic outcomes. Besides, African countries should have an integrated approach for the improvement of sexual health promotion and early pregnancy prevention among adolescent girls and women with poor socioeconomic status.

Availability of data and materials

All result-based data are within the manuscript and the data set is available online and anyone can access it from www.measuredhs.com .

Abbreviations

Confidence Interval

Central Statistical Agency

Demographic Health Survey

Enumeration Area

Intraclass correlation

Likelihood Ratio

World Health Organization

Pregnancy-induced hypertension

Preeclampsia toxemia

Median odds ratio

Proportional Change in Variance

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Acknowledgments

We greatly acknowledge MEASURE DHS for granting access to the Demographic and Health Surveys data.

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Department of Human Anatomy, College of Medicine and Health Science, School of Medicine, University of Gondar, Gondar, Ethiopia

Misganaw Gebrie Worku

Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia

Zemenu Tadesse Tessema, Achamyeleh Birhanu Teshale, Getayeneh Antehunegn Tesema & Yigizie Yeshaw

Department of Human Physiology, College of Medicine and Health Science, School of Medicine, University of Gondar, Gondar, Ethiopia

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GAT, MGW, ABT, YY, and ZTT conceived the study. GAT, MGW, ABT, YY, and ZTT analyzed the data. GAT, MGW, ABT, YY, and ZTT drafted the manuscript and reviewed the article. All authors read and approved the final manuscript.

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Worku, M.G., Tessema, Z.T., Teshale, A.B. et al. Prevalence and associated factors of adolescent pregnancy (15–19 years) in East Africa: a multilevel analysis. BMC Pregnancy Childbirth 21 , 253 (2021). https://doi.org/10.1186/s12884-021-03713-9

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research proposal on teenage pregnancy

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Sample Research Proposal on Teenage Pregnancy

Sample Research Proposal on Teenage Pregnancy

Introduction.

This research proposal implies on teenage pregnancy and its effect on academic progression. There will be association between teenage pregnancy and academic progression places evidence that education should put weight on reality adhering to teenage pregnancy. Understanding teenage pregnancy within UK context is adamant to the purpose of study. Thus, the expectation that teenage pregnancy will be reduced by proper academic programs, school based prevention ways towards teenage pregnancy . The need to find out basis if such teenage pregnancy has positive effect on academic progression, meaning towards a positive behavior of teenagers while having their academic life.

Another would be negative effect of teenage pregnancy on academic progression. Indeed, research on the decision to continue or terminate teenage pregnancy is sparse. Research study will seek to address certain gap in research literature through analysing the educational dimensions of decision to continue teenage pregnancy by means of using data collection in case study survey approach. Research will review qualitative methodology, its strengths, application, and potential weaknesses. Presence of comprehensive range of qualitative techniques are to be reviewed, issues will be highlighted for framing the area of investigation, the epistemological issues of causality, induction, case selection, as well level of explanation regarding teenage pregnancy and academic progress.

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Research questions

Research questions are essential part of the research process, as this will imply a solid connection towards secondary knowledge composed of peer reviewed studies such as from academic centered journals and articles, also from documented information and facts from books having contents about leadership and change. The research questions serve as the initial organization flow of the study’s review of the literature which leads to the creation of research methods and techniques and the questions were the following: What is teenage pregnancy? How does teenage pregnancy affect academic lifestyle of teenagers? How teenage pregnancy be prevented given the fact that education plays a crucial factor for disseminating imperative information? Explain What is meant by academic progression?

How does it relate to teenage pregnancy? What are positive effects of teenage pregnancy on academic progression of college students? Provide cases/ examples What are negative effects of teenage pregnancy on academic progression of college students? Provide cases/ examples What are several options to prevent teenage pregnancy? (School based prevention, approaches are to be applied) How education and resolution is being realized in accordance to teenage pregnancy? Cite literature support base

Aims and objectives

Research aims to recognize teenage pregnancy among college students particularly first year and second year college students in the UK and be able to find out positive and negative effects of teenage pregnancy towards academic progression, academic life of teenagers. Literature studies of teenage pregnancy and its outcomes will be reviewed; state of current knowledge will be assessed. The effectiveness of academic oriented programs for pregnant teenagers is to be examined accordingly. The research will be aiming to explore the timing of pregnancy in relation to leaving or finishing college. The main objective will be the examination of academic factors and decision to terminate or continue teenage pregnancy while undergoing college education. Thus, complete level, school marks and subject preference are included as it may discriminate those who continued and those who terminated the truth of pregnancies. The need to find out if teenagers who have strong attachment to school will be more likely to terminate than continue pregnancy, particularly for college students in rural and regional UK.

Methodology (qualitative)

The application of case study analysis, case study survey approach using college students (first year and second year female students) serving as research participants, within the criteria that they are pregnant and are continuing their pregnancies from the time of this research administration and they comprise of ages 18 to 22 years old. The participants will come from institutions/ universities located in the United Kingdom. Furthermore, case study approach will determine effects in relationship between teenage pregnancy and educational/ academic progression of 50 college students, pregnant teenagers may have lower rates of participation in tertiary education and training than their nonpregnant peers.

Subsequent analyses showed that the links between teenage pregnancy and educational participation can be noncausal and reflected the earlier academic ability, behavior, family circumstances of college students who became pregnant. In contrast, antecedent child and family factors only partially explained associations between teenage pregnancy and academic school participation and achievement (Fergusson and Woodward, 2000). Research findings may suggest that rates of teenage pregnancy might be elevated among teenagers who leave school early, rather than rates of early school leaving being elevated among teenagers who become pregnant during their teenage years.

Qualitative method is designed to help researchers understand people, social and cultural contexts as Kaplan and Maxwell (1994) argue that the goal of understanding phenomenon from viewpoints of participants and its particular social and institutional context is lost when textual date are to be quantified. The need to examine case analysis and case analysis method, research implies to qualitative methods such as open-ended questions, to request respondents to rank their views as one measure in research (Marshall and Rossman, 1999) toward statements ranging from 1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree and 5 = strongly agree. Data will be collected and analyzed through using qualitative techniques such as pointing towards document analysis, interviews and questionnaire survey. The primary data is to be collected from the respondents in case situations, secondary data is to comprise of reference concerning research subject. The using of existing information on such levels into the study to be realized upon.

Teenage pregnancy is considered a documented problem with approximately 890,000 teenage pregnancies (Hoyt and Broom, 2002) although teen pregnancy rates have declined rates remain higher than the middle of 1970s and are fourfold such as those of European countries like UK. Substantial morbidity and social problems result from these pregnancies, affecting the mother, her children, other family members, and society. Multiple educational approaches have been used, with few demonstrating significant reductions in teen pregnancy. School-based programs have been diverse and multifaceted.

Recently, programs with comprehensive approach have shown potential for success. For this research, characteristics and elements of school based programs will be identified and discussed. Literature studies may indicate that certain incidence of teenage pregnancy are quite high and is continually increasing. Program and policy implications will place important matters such as, sex education should be introduced at an earlier grade level, small discussion group teaching techniques should be used, parenting techniques should be taught in sex education programs, the funding of preventive an academic driven intervention programs must be increased.

  • Fergusson, D. and Woodward, L. (2000). Teenage Pregnancy and Female Educational Underachievement: A Prospective Study of a New Zealand Birth Cohort. Journal of Marriage and Family, Vol. 62, No. 1 (Feb., 2000), pp. 147-161. National Council on Family Relations
  • Hoyt, H. and Broom, B. (2002). School-Based Teen Pregnancy Prevention Programs: A Review of the Literature. Journal of School Nursing, v18 n1 p11-17
  • Kaplan B & Maxwell, J.A (1994): Qualitative Research Methods for Evaluation Computer Information Systems. In Anderson J G, C E Aydin and S J Jay (eds) (1994): Evaluating Health Care Information System: Methods and Applications. Sage. Thousand Oaks, CA, pp 45-68

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Teenage pregnancy has become a major issue in communities globally because of the negative effects it is associated with. Majority of teenage mothers and their children are likely to face challenges in their living. This paper will address some challenges that children born from teenage mothers undergo and also give insight to the many complications

Teenage Pregnancy Sample

First I would wish to thank the Almighty God for giving me the counsel. wellness and strength in finishing this undertaking and doing it a success.Second. I would wish to demo gratitude to my Social Studies teach. Mr. Burke. for giving me the chance and holding forbearance with me to make this undertaking.Third. I would

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[Adolescent pregnancy. A proposal for intervention]

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  • 1 E.U. de Trabajo Social, Salamanca.
  • PMID: 9385187

Adolescent pregnancy constitutes an important problem, not so much in infant mortality (which is low), but in the diseases which can accompany it. Pregnancies at this age have an elevated social and emotional cost. The principle consequences of adolescent pregnancy are: abortions, forced marriages, undesired motherhood, adoptions and emotional problems that can lead to depression and suicide. Clearly, the impact of these pregnancies can have many lasting repercussions. But one fact persists adolescent pregnancy can and should be prevented. Nurses are in the ideal situation to assume the role as leaders in the fight to prevent teenage pregnancy, whether it be in the local medical clinics or in the schools; our position in the community enables us to know the needs and socioeconomic characteristics of our patients. Nursing training has prepared us to investigate risk factors that are present as well as ways to design programs and educational strategies to inform our young. We must also be prepared, along with other health professionals (doctors, social workers, etc.), to deal with the inevitable unwanted pregnancy. Our job demands that we be able to evaluate the options available to these young people in an atmosphere of support and understanding.

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Socio-economic factors associated with adolescent pregnancy and motherhood: Analysis of the 2017 Ghana maternal health survey

Ephraim kumi senkyire.

1 Ga West Municipal Hospital, Ghana Health Service, Amasaman-Accra, Ghana

Dennis Boateng

2 Global Statistical Consult, Accra, Ghana

Felix Oppong Boakye

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3 Research and Development Division, Ghana Health Service, Accra, Ghana

Magdalena Ohaja

4 University of Galway, Galway, Ireland

Associated Data

Complete data are not publicly available but can be requested from the DHS program on reasonable request. The IRB-approval procedures for DHS public-use datasets do not allow in anyway the respondents, households or sample communities to be identified. To have access to the data, a registered request of a research project must be submitted and approved with the DHS. The instruction for requesting for the Demographic and Health Survey (DHS) data can be found on their website ( https://dhsprogram.com/data/Access-Instructions.cfm ). The DHS Program will normally review all data requests within 24 – 48 hours (Monday - Friday), and provide notification if access has been granted or additional project information is needed, before access can be granted. The authors confirm that others would be able to access these data in the same manner as themselves. The authors also confirm that they did not have any special access privileges.

Adolescent pregnancy and motherhood have been linked to several factors stemming from social, cultural and to a large extent economic issues. This study examined the socio-economic factors associated with adolescent pregnancy and motherhood in Ghana.

This was a secondary analysis of the 2017 Ghana Maternal Health Survey, which was a nationally representative cross-sectional survey. Data from 4785 adolescents aged between 15–19 years were included in the analysis. Adolescent pregnancy was defined as adolescents who have ever been pregnant, whiles adolescent motherhood was defined as adolescents who have ever given birth. Weighted logistic regression was used to assess the association between the socio-economic variables and adolescent pregnancy and motherhood.

Of the 25062 women aged between 15 and 49 years included in the 2017 maternal health survey, 4785 (19.1%) were adolescents between 15–19 years. Adolescent pregnancy was reported in 14.6% (CI:13.2% -16.1%) of the respondents, whereas 11.8% (CI: 10.5% -13.1%) of the respondents had ever given birth. In the multivariate regression analysis, zone (p<0.001), wealth index (p<0.001), age (p<0.001), marital status (p<0.001) and level of education (p<0.001) were all significantly associated with adolescent pregnancy and motherhood. The odds of pregnancy and motherhood were significantly higher in the Middle and Coastal zones (p<0.001), and among older adolescents (p<0.001). However, the odds of pregnancy and motherhood was significantly lower among adolescents from households with the highest wealth index (p<0.001), among those who were never married (p<0.001) and among adolescents who had secondary/higher education (p<0.001).

Several socio-economic variables including education, household wealth, marital status and zone of residence were significantly associated with adolescent pregnancy and adolescent motherhood. Sexual and reproductive health education should be intensified among these populations. Adolescent friendly corners should be made available and accessible to all adolescents in Ghana irrespective of where they live or their age.

Introduction

The United Nations Children’s Fund (UNICEF) defines adolescent pregnancy as “an adolescent girl, usually between the ages of 13 and 19 becoming pregnant” [ 1 ]. Adolescent pregnancy is a global menace that occurs in both high income and Low- and Middle-Income Countries (LMICs) [ 2 , 3 ]. However, it is more prevalent in poorly privileged communities [ 2 ]. Approximately 21 million girls aged 15–19 years become pregnant annually, and more than half of these girls give birth. It is also worth noting that approximately 777,000 of these births are among adolescent girls below 15 years of age living in LMICs [ 2 ].

Adolescent pregnancy is a known contributing factor to the global maternal mortality rate owing to the high incidence of unsafe abortion practices among these age groups [ 2 , 4 ]. Adolescent motherhood is a vital concern in maternal and child health [ 5 ]. The dearth of care among adolescent mothers has advanced to a surged peril of poor maternal and neonatal health sequelae [ 6 ]. This predisposes adolescent mothers to a greater risk of eclampsia, prolonged labour, puerperal endometritis, STIs and systemic infections [ 2 , 4 , 7 , 8 ]. Consequently, the infants of adolescent mothers face greater risks of low birth weight, preterm delivery and severe neonatal conditions [ 2 , 4 , 5 , 7 , 8 ]. Evidence exists that children born to adolescent mothers are likely to become adolescent mothers in the future [ 5 ].

Adolescent pregnancy and motherhood have been linked to social, cultural and economic factors that affect sexual and reproductive experiences [ 7 ]. The social sequelae of adolescent motherhood include isolation by parents and friends, stigma, poverty, unemployment, school disruption and intimate partner violence [ 2 , 5 , 6 , 9 , 51 ].

The adolescent-specific fertility rate has reduced by 11.6% over the last two decades with large variations across countries: approximately 2% in China to about 18% in Latin America and the Caribbean, and more than 50% in Sub-Saharan Africa [ 2 ]. Nevertheless, in LMICs, adolescent birth is still on the rise [ 2 ].

The narrative is not different in Ghana where among all births registered in 2014, 30% were from adolescent mothers, with the highest prevalence in the rural setting [ 3 , 10 , 15 ]. Furthermore, in 2017 alone, close to 14% of adolescents aged between 15 and 19 years had already started childbearing [ 11 ]. Collectively, adolescent pregnancy contributes to about 9% of maternal mortality in Ghana [ 12 ]. It is important to note that relatively little research has been conducted on the socio-economic consequences of adolescent pregnancy and motherhood in Ghana. Although there are several studies on adolescent pregnancy in Ghana, few studies have examined the association of socio-economic factors on adolescent pregnancy and motherhood using data from nationally representative surveys [ 13 , 14 ].

These studies mostly used data from the past Ghana demographic and health surveys with a focus on adolescent fertility rates. Therefore, this study sought to assess the association of socio-economic factors with adolescent pregnancy and motherhood in Ghana. Understanding both the social and economic influences of these variables are vital for effective policy formulations [ 15 ].

The data used for this study were obtained from the 2017 Ghana Maternal Health Survey (GHMS) [ 11 ] which was implemented by the Ghana Statistical Service. The data collected in the survey include individual and household level data. The design and methods used make it possible to obtain representative estimates across the whole country for maternal mortality. The sampling frame utilised in the 2017 GMHS was established from the 2010 Population and Housing Census (PHC) in Ghana [ 11 ]. The survey sampling technique consisted of a two-stage stratification procedure. In the interstratification stage, each of the 10 regions of Ghana was separated into rural and urban areas to generate a total of 20 sampling strata.

An independent selection in each stratum occurred in two stages, first with the sorted strata generated from administrative regions and levels using implicit stratification and proportional allocation before sample selection. Initially, a proportional probability sampling technique was used to select a total of 900 enumeration areas consisting of all regions. A cluster size of 466 was produced from urban areas and 434 from rural areas. In the second stage, 30 households were randomly sampled from each of the 900 clusters to produce a total sample size of 27000 households. From these households 20277 (80.9%) women were aged 20 years and above whiles, 4785 (19.1%) were adolescents aged between 15–19 years. Of 4785 adolescents aged between 15–19 years, 701 (14.6%) had ever been pregnant and 566 (11.8%) had ever had a live birth. Further details on the data description are presented in Fig 1 . Only adolescents aged 15–19 years were included in this secondary data analysis.

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Object name is pone.0272131.g001.jpg

Respondents included in this secondary analysis are highlighted.

Study variables

A detailed description of the variables included in this secondary analysis are listed in Table 1 . The variable definitions and how they were utilised in the data analysis are presented.

VariableDefinitionUtilised in Model/Type
Adolescent motherhoodAdolescents who have ever given birth.Dependent/Binary
Adolescent pregnancyAdolescents who have ever been pregnant.Dependent/Binary
Place of residenceLocation of household (Urban; Rural)Independent/Binary
Region of residenceFormulated regional locations with 10 administrative regions (Western; Central; Greater Accra; Volta; Eastern; Ashanti; Brong Ahafo; Northern; Upper East; Upper West)Independent/Categorical
ZoneThe location from three major geographic regions in Ghana, i.e.
: Western, Central, Greater Accra, and Volta regions.
: Eastern, Ashanti, and Brong Ahafo regions
: Northern, Upper East, and Upper West regions.
Independent/Categorical
Wealth indexThe wealth status of households is grouped as Lowest, Second, Middle, Fourth and Highest.Independent/Categorical
AgeAge of women grouped into <15 years, 16 years, 17 years, 18 years, and 19 years.Independent/Categorical
Marital statusGrouped as Never Married; Married; Living together with a man; Divorced/Separated.Independent/Categorical
Media exposureWomen’s access to media including the internet, print, television and radio at least once a week are grouped as Yes; No.Binary
Level of educationWomen’s highest level of education (No education; Primary education; Middle/Junior Secondary/High School (JSS/JHS); Secondary
/Higher education)
Independent/Categorical

Statistical analysis

Data analysis was performed using SAS (Statistical Analysis Software 9.4, SAS Institute Inc, Cary, North Carolina, USA). Sampling weights were used to obtain a national/regional representation of the survey results. Weights were calculated separately for each sampling stage and each cluster using probability sampling. The proportion of women aged 15–19 years who have ever been pregnant (adolescent pregnancy) and those who have ever given birth (adolescent motherhood) were presented by the different demographic variables (place/region/zone of residence, wealth index, age of woman, marital status, media exposure and level of education of woman). Chi-square tests were used to assess the association of demographic variables with adolescent pregnancy and adolescent motherhood.

The dependent variables, adolescent pregnancy and adolescent motherhood were defined for women aged 15–19 years. Independent variables included in the analysis were a place of residence, zone, wealth index, age, marital status, media exposure and educational level. Both dependent variables were coded as binary variables and fitted in a weighted logistic regression analysis. Univariate and multivariate techniques were used to assess the association of socio-economic variables with adolescent pregnancy and adolescent motherhood.

All variables were included in both univariate and multivariate analysis except for the region of residence that was excluded due to the many levels and aggregated into the zone for ease and clarity of interpretation. Also, given the interest in the a priori selected variables, they were all included in the adjusted analysis without considering their level of significance in the unadjusted analysis. Unadjusted/adjusted odds ratios with 95% confidence intervals were computed, and variables with p-value <0.05 in the univariate/multivariate analyses were considered statistically significant.

Ethical consideration

The study protocol was reviewed and approved by the ICF institutional review board [ 11 ]. Informed written and signed consent was provided by all study respondents for their participation in the survey. The structured data collection tool administered by trained data enumerators was translated where necessary from the English language to a local dialect to obtain responses. Further details on the survey design and methodology can be found in the survey report [ 11 ].

Characteristics of study participants

Out of the 25062 women included in the 2017 maternal health survey, 4785 were adolescents aged 15–19 years. The mean age of the 4758 respondents included in this analysis was 17 (Standard Deviation = 1.40) years. More than half (54.2%) of the study participants had middle/JSS/JHS education. Compared to the other regions, most of the study participants were from the Ashanti region (19.6%). A significant majority (90.9%) of the respondents were never married, with (0.6%) being divorced or separated. A similar percentage (91.0%) of the adolescent respondents were exposed to at least one form of media. See Table 2 .

VariableUnweighted frequencyWeighted frequencyWeighted percentage
    Urban2240241150.4
    Rural2648237449.6
    Western46365013.6
    Central2904138.6
    Greater Accra40574815.6
    Volta2863968.3
    Eastern42149010.2
    Ashanti60693619.6
    Brong Ahafo47949010.2
    Northern8173517.3
    Upper east5561763.7
    Upper west5651362.8
    Northern193866313.9
    Middle1506191640.0
    Coastal1444220646.1
    Lowest150386918.2
    Second1011102721.5
    Middle878105122.0
    Fourth82395320.0
    Highest67388618.5
    15 years1203104621.9
    16 years92793619.6
    17 years1047109823.0
    18 years95997420.4
    19 years75273115.3
    Never Married4403435090.9
    Married176871.8
    Living together with a man2793176.6
    Divorced/separated30310.6
    Yes4183435491.0
    No7054309.0
    No education2711643.4
    Primary94883517.5
    Middle/JSS/JHS2609259554.2
    Secondary/ Higher1060119124.8

Characteristics of study participants by pregnancy and birth history

At the time of the survey, 123/4785 respondents (2.6%, 95% CI: 2.2% - 2.9%) were pregnant. As presented in Table 3 , 14.6% (95% CI: 13.2% - 16.1%) of the study respondents had ever been pregnant, whereas 11.8% (95% CI: 10.5% - 13.1%) had ever given birth. Adolescent pregnancy was higher in rural areas compared to urban areas (17.6% vs. 11.7%) and differed by region of residence (p<0.001), with the highest prevalence in the Brong Ahafo Region (18.6% 95% CI:14.9% - 22.4%) and the lowest prevalence in the Greater Accra region (8.1% 95% CI: 6.1% - 10.2%). Respondents from households with the highest wealth index had the lowest prevalence. Adolescent pregnancy increased with age, with prevalence lower among younger adolescents and higher among older adolescents, whereas those from a household with the lowest and second-lowest wealth index had a high prevalence of adolescent pregnancy (p<0.001). Similarly, adolescent pregnancy was significantly lower among respondents with secondary/higher education (p<0.001).

VariableTotal number of women aged 15–19 yearsAdolescents aged 15–19 years who have ever been pregnantAdolescents aged 15–19 years who have had a live birth
NN% (95% CI)p-valueN% (95% CI)p-value
Overall478570114.6 (13.2–16.1)-56611.8 (10.5–13.1)-
    Urban241128311.7 (9.8–13.7)0.0012229.2 (7.5–11.0)0.009
    Rural237441817.6 (15.1–20.1)34414.5 (12.1–16.9)
    Western65012018.5 (12.5–24.3)<0.00110215.7 (10.3–21.0)<0.001
    Central4137117.2 (10.0–24.5)5613.6 (6.8–20.3)
    Greater Accra748618.1 (6.1–10.2)516.8 (4.9–8.6)
    Volta3966115.4 (7.3–23.5)5413.6 (5.8–21.7)
    Eastern4906713.7 (10.6–16.5)5411.0 (8.6–13.7)
    Ashanti93614715.7 (11.5–20.0)11412.2 (8.4–16.0)
    Brong Ahafo4909118.6 (14.9–22.4)6513.3 (10.0–16.5)
    Northern3514813.7 (11.4–16.2)4111.7 (9.4–13.7)
    Upper east1762614.8 (11.4–17.6)2212.5 (10.2–15.3)
    Upper west136107.4 (5.1–8.8)64.4 (2.9–6.6)
    Northern6638410.6 (9.0–12.0)<0.0017010.6 (9.0–12.0)<0.001
    Middle191630512.2 (10.1–14.4)23412.2 (10.1–14.4)
    Coastal220631212.0 (9.7–14.1)26312.0 (9.7–14.1)
    Lowest86916719.2 (14.7–24.1)<0.00114616.8 (12.4–21.2)<0.001
    Second102721821.2 (17.0–25.5)19018.5 (14.5–22.4)
    Middle105118017.1 (13.4–20.8)13913.2 (9.8–16.6)
    Fourth95310310.8 (8.1–13.5)707.3 (5.2–9.5)
    Highest886333.7 (2.1–5.2)222.5 (1.2–3.7)
    15 years1046343.2 (1.8–4.7)<0.001292.8 (1.4–4.0)<0.001
    16 years936505.3 (3.6–7.1)404.3 (2.7–5.8)
    17 years109814413.1 (10.1–16.1)1079.7 (7.0–12.4)
    18 years97422523.1 (19.0–27.2)17317.8 (14.4–21.0)
    19 years73124833.9 (28.6–39.3)21829.8 (24.6–35.0)
    Never Married43503768.6 (7.5–9.7)<0.0012736.3 (5.2–7.3)<0.001
    Married875967.8 (49.4–49.4)5259.7 (42.5–77.1)
    Living together with a man31724176.0 (59.3–92.7)21668.1 (52.7–83.9)
    Divorced/separated312684.0 (41.9–122.6)2580.6 (38.7–119.4)
    Yes435462014.2 (12.8–15.7)<0.00149911.5 (10.1–12.8)<0.001
    No4308219.1 (19.1–24.2)6715.6 (10.7–20.2)
    No education1645131.1 (21.3–40.9)<0.0014527.4 (17.7–36.6)<0.001
    Primary83519122.9 (18.6–27.7)16619.9 (15.4–24.3)
    Middle/JSS/JHS259539115.1 (13.3–16.8)31912.3 (10.6–14.0)
    Secondary/Higher1191685.9 (4.1–7.7)363.0 (1.7–4.5)

Similar results were reported for the respondents who have had a live birth–higher in rural areas, higher among respondents from a household with the lowest and second-lowest wealth index, higher among older adolescents and higher among adolescents with no education. Also, adolescent motherhood was higher among older adolescents than younger adolescents (p<0.001).

Association of socio-economic factors with adolescent pregnancy

In univariate analysis, place of residence (p<0.001), wealth index (p<0.001), age (p<0.001), marital status (p<0.001), mass media exposure (p = 0.022) and level of education (p<0.001) were significantly associated with adolescent pregnancy. In multivariate analysis, zone (p<0.001), wealth index (p<0.001), age (p<0.001), marital status (p<0.001) and level of education (p<0.001) were significantly associated with adolescent pregnancy. The odds of pregnancy were significantly higher in the middle zone (AOR = 2.96, 95% CI: 1.95–4.52) and coastal zone (AOR = 3.71, 95% CI: 2.37–5.80) compared to the northern zone. With regards to the wealth index, the odds of pregnancy were significantly lower among adolescents from households with the highest wealth index compared to adolescents from households with the lowest wealth index (AOR = 0.28, 95% 0.14–0.55). The odds of pregnancy increased with age: AOR = 1.92, 5.08, 10.50 and 20.27 for adolescents aged 16 years, 17 years, 18 years and 19 years respectively compared to those aged 15 years. Married adolescents (AOR = 16.48, 95% CI:7.96–34.10), those living together with a man (AOR = 17.24, 95% CI:11.80–25.19) and those divorced/separated (AOR = 14.30, 95% CI: 4.62–44.27) had significantly higher odds of pregnancy compared those who were never married. Adolescents who had secondary/higher education had significantly lower odds of pregnancy compared to those with no formal education (AOR = 0.29, 95% CI: 0.13–0.64). See Table 4 .

VariableUnivariate analysisMultivariate analysis
Odd ratio95% CIp-valueAdjusted Odd ratio95% CIp-value
    Rural1<0.00110.884
    Urban0.620.48–0.811.030.74–1.43
    Northern10.0931<0.001
    Middle1.321.03–1.682.961.95–4.52
    Coastal1.140.88–1.483.712.37–5.80
    Lowest1<0.0011<0.001
    Second1.130.82–1.561.030.68–1.56
    Middle0.870.62–1.210.930.55–1.59
    Fourth0.510.36–0.730.760.45–1.27
    Highest0.160.10–0.260.280.14–0.55
    15 years1<0.0011<0.001
    16 years1.680.98–2.881.921.12–3.30
    17 years4.482.72–7.405.083.07–8.42
    18 years8.905.53–14.3210.506.34–17.39
    19 years15.249.47–24.5220.2711.94–34.42
    Never Married1<0.0011<0.001
    Married21.9013.84–34.6316.487.96–34.10
    Living together with a man33.5123.01–48.7917.2411.80–25.19
    Divorced/separated52.0517.41–155.6514.304.62–44.27
    Yes10.02210.632
    No1.411.05–1.901.110.74–1.66
    No education1<0.0011<0.001
    Primary0.670.44–1.002.041.02–4.06
    Middle/JSS/JHS0.400.27–0.601.010.51–1.99
    Secondary/Higher0.140.08–0.230.290.13–0.64

Association of socio-economic factors with adolescent motherhood

In univariate analysis, place of residence (p<0.001), wealth index (p<0.001), age (p<0.001), marital status (p<0.001), mass media exposure (p = 0.013) and level of education (p<0.001) were significantly associated with adolescent motherhood. In multivariate analysis, zone (p<0.001), wealth index (p<0.001), age (p<0.001), marital status (p<0.001) and level of education (p<0.001) were significantly associated with adolescent motherhood.

The odds of adolescent motherhood were significantly higher in the middle zone (AOR = 2.79, 95% CI: 1.75–4.46) and coastal zone (AOR = 4.44, 95% CI: 2.71–7.26) compared to the Northern zone. With regards to the wealth index, the odds of motherhood were significantly lower among adolescents from households with the highest wealth index compared to adolescents from households with the lowest wealth index (AOR = 0.23, 95% 0.11–0.47). The odds of motherhood increased with age: AOR = 1.78, 4.01, 8.07 and 19.50 for adolescents aged 16 years, 17 years, 18 years and 19 years respectively compared to those aged 15 years. Married adolescents (AOR = 16.48, 95% CI:7.63–34.55), those living together with a man (AOR = 17.24, 95% CI:11.15–23.85) and those divorced/separated (AOR = 14.30, 95% CI: 6.48–53.51) had significantly higher odds of motherhood compared those who were never married. Adolescents who had secondary/higher education had significantly lower odds of motherhood compared to those with no formal education (AOR = 0.21, 95% CI: 0.09–0.50). See Table 5 .

VariableUnivariate analysisMultivariate analysis
Odd ratio95% CIp-valueAdjusted Odd ratio95% CIp-value
    Rural1<0.00110.919
    Urban0.600.45–0.800.980.68–1.42
    Northern10.4861<0.001
    Middle1.190.89–1.582.791.75–4.46
    Coastal1.160.87–1.544.442.71–7.26
    Lowest1<0.0011<0.001
    Second1.130.80–1.580.970.63–1.50
    Middle0.750.52–1.100.720.40–1.30
    Fourth0.400.27–0.590.540.30–0.96
    Highest0.130.07–0.230.230.11–0.47
    15 years1<0.0011<0.001
    16 years1.590.85–2.971.780.96–3.32
    17 years3.852.18–6.804.012.25–7.14
    18 years7.684.57–12.908.074.62–14.12
    19 years15.188.94–25.7819.5010.67–35.64
    Never Married1<0.0011<0.001
    Married22.1913.98–35.2316.247.63–34.55
    Living together with a man32.3422.47–46.5616.3111.15–23.85
    Divorced/separated61.0521.97–169.6418.636.48–53.51
    Yes10.01310.878
    No1.421.03–1.950.970.62–1.50
    No education1<0.0011<0.001
    Primary0.700.44–1.032.051.03–4.11
    Middle/JSS/JHS0.380.25–0.581.020.52–2.02
    Secondary/Higher0.080.05–0.160.210.09–0.50

Adolescent pregnancy and motherhood are major challenges facing low resourced countries in Sub-Saharan Africa (SSA) including Ghana [ 3 ]. Pregnant adolescents and mothers face diverse challenges including physical, psychological, mental and social obstacles and pregnancy-related challenges [ 16 – 30 ]. This paper explored the association of socioeconomic factors with adolescent pregnancy and motherhood. The prevalence of adolescent pregnancy was 14.6%, while the prevalence of adolescent motherhood was 11.8%. The former was inconsequential compared to 14% in 2014 [ 31 ]. Adolescent pregnancy is lower in Ghana compared to other African countries. A prevalence of 18% has been reported in Kenya [ 32 ], 19% in Nigeria [ 33 ] and 36% in Mali [ 34 ]. Again the prevalence of AP in Ghana is lower compared to the overall 18.8% prevalence in Africa and the 19.3% prevalence in SSA [ 35 ]. The disparities could be a consequence of the existence of several cultural, sociodemographic, and individual adolescent features.

Significant regional variations were found in the prevalence of adolescent pregnancy and adolescent motherhood in Ghana, with a high AP and AM prevalence in the Brong-Ahafo, Western and Central regions. Likewise, the 2014 GDHS indicated that adolescent girls residing in the Brong Ahafo, Central and Volta regions start childbearing earlier than adolescents in other regions [ 35 ]. These differences have been attributed to poverty and employment satus [ 36 ], transactional sex [ 30 , 37 , 38 ], decline in menarche [ 39 , 40 ], child marriage [ 41 ], early sexual debut [ 42 – 45 ], lack of contraceptive knowledge [ 46 , 47 ] and inadequate sexual and reproductive health education [ 48 ].

From our analysis, it is evident that socio-economic factors are significantly associated with adolescent pregnancy and adolescent motherhood. Several studies in Ghana have also reported the association of socio-economic factors with adolescent pregnancy and adolescent motherhood [ 6 , 14 , 48 – 55 ]. In Asare et al. [ 56 ], adolescents from low economic backgrounds were about 4 times more likely to be pregnant compared to those from high-income households. This was consistent with the results of our study where adolescent pregnancy and adolescent motherhood was found to be significantly higher among adolescents from low-income households. Other studies in Sub-Saharan Africa associated the high prevalence of adolescent pregnancies with low socio-economic status [ 57 – 59 ].

Further, AP and AM were noted to be associated with increasing age, with prevalence lower among younger adolescents and higher among older adolescents. This was also revealed in studies done by Uwizeye et al. [ 60 ] and Habitu et al. [ 61 ] where age was significantly associated with AP and AM and age at first sexual debut increased AP and AM [ 62 , 63 ]. This could be attributed to older adolescents having access to “virulent” digital information [ 60 ], peer influence and increasing sexual drive as age increases [ 61 ].

Although in the multivariate analysis, there was no significant association between place of residence and media and adolescent pregnancy/adolescent motherhood, other studies reported that residence [ 43 , 61 , 64 , 65 ] and media [ 53 , 66 ] were associated with adolescent pregnancy/adolescent motherhood. In contrast, a study in Ethiopia indicated that early sexual debut is more prevalent among urban residents [ 67 ]. Likewise, adolescents in rural West Africa had lower odds of first pregnancy [ 68 ].

In multivariate analysis, zone and marital status were significantly associated with adolescent pregnancy and motherhood. The odds of pregnancy and motherhood were significantly higher in the middle zone and coastal zone compared to the northern zone. This was similar in the 2014 GDHS report where the Brong Ahafo, Central, and Volta regions were among the regions with the highest adolescent pregnancy [ 31 ]. Conversely, shreds of evidence showed that adolescent pregnancy is higher in the northern region due high prevalence of adolescent marriage [ 69 ]. Nevertheless, in the Ghanaian culture, marriage is associated with childbirth because extra-marital sex and early childbearing are scowled and unethical, ergo early marriage is emboldened [ 70 ]. Parallelly, the convention by which young women are anticipated to begin child-bearing shortly following marriage is a contributing factor leading adolescent mothers to become pregnant [ 69 ]. As found in our study, reports from several studies have shown a significant association between marital status and adolescent pregnancy [ 61 , 68 , 71 ]. The consequences of adolescent marriage are multi-faceted including increased risk for sexually transmitted diseases, cervical cancer, death during childbirth, obstetric fistulas, child mortality and low agency, deprivation of education, violence, abuse and forced sexual relations [ 69 , 72 – 78 ].

From both the univariate and multivariate analysis, higher levels of education were associated with reduced odds of adolescent pregnancy and adolescent motherhood. In parallel, Okine and Dako-Gyeke [ 50 ], indicated that a low level of education was among the factors contributing to adolescent pregnancy in Ghana. Accordingly, an extra year of schooling was reported to reduce the likelihood of marriage and childbirth before age 18 [ 79 ]. Attaining higher education prevents adolescent pregnancy in low-income countries [ 80 ]. Huang [ 81 ] echoed those girls who have higher education are five times less likely to become pregnant, similar to Mamboreo [ 64 ] who reported that level of education influences AM. Adolescents who report a pregnancy in a South African study were less educated [ 82 ]. Hence, adolescents with the slightest secondary education had a lower risk of childbirth [ 61 ]. Again nulliparous adolescent girls are more likely to receive pregnancy prevention information from school [ 83 ]. Yet, mothers were able to complete their education despite being adolescent mothers in another study in South Africa [ 84 ]. It is well documented that educated women use maternal care services regularly to prevent both neonatal and maternal mortality. Thus advancing access to basic education among girls is a constructive plan to decrease adolescent pregnancy and adolescent motherhood and their related side effects [ 8 , 79 ].

Our analysis revealed that education, age, household wealth, marital status and zone of residence are associated with adolescent pregnancy and adolescent motherhood in Ghana. Given that adolescent pregnancy and motherhood were significantly higher in the Middle and Coastal zones, and among older adolescents, sexual and reproductive health education should be intensified among these populations. Also, adolescent-friendly corners should be made available and accessible to all adolescents in Ghana irrespective of where they live or their age.

Supporting information

Acknowledgments.

The authors are grateful to the DHS program for providing them access to the 2017 Ghana Maternal Health Survey database. We are also grateful to the survey participants.

Funding Statement

The author(s) received no specific funding for this work

Data Availability

  • PLoS One. 2022; 17(12): e0272131.

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PONE-D-21-40893Socio-economic factors associated with adolescent pregnancy and motherhood: analysis of the 2017 Ghana maternal health surveyPLOS ONE

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Reviewer #1: The authors introduced an abbreviation in the abstract; AP and AM. I recommend, the words are written fully. Also, the recommendation is not based on the conclusions of the manuscript, therefore, recommendation should be focused on health promotion tenets such increased education, accessibility to contraceptives at adolescent friendly corners and policies to promote adolescents reproductive health. Again, the authors introduced abbreviation of AP and AM in the introduction but the words still being used in the manuscripts. The authors should make corrections on these mishaps especially in the results session.

Reviewer #2: Socio-economic factors associated with adolescent pregnancy and motherhood: analysis of the 2017 Ghana maternal health survey

Thank you for the opportunity to review this manuscript. I think it has merit for publishing but I have a number of comments that need to be addressed before it can be accepted for publication. These comments are below:

I recommend a critical read to correct grammatical errors/omissions/repetitions/ and omissions. e.g.

a. …was significantly higher in the Middle and Coastal zones (p<0.001), among older adolescents (p<0.001).

b. The design and methods used makes it…

c. … that aff ect sexual…

d. …first with the the sorted…

e. …with the the sorted…

Design: The authors should clarify the sample for the study, thus what age frame was the caveat? Motherhood as conceptualised for the study should be defined in this section.

Results: In the first statement, i.e. “Of the 25062 women included in the survey, 4785 were adolescents between 15-19 years.” Does this mean that the study included participants outside adolescence, considering the word “women”. This need to be clarified and if only females in adolescence, then authors should change “women” to “adolescents”. Also, the percentage of 4785 should be captured in the statement.

Conclusion: Write these in full “AP and AM.” From the focus of the study and your findings, it is expected that you make specific recommendation that address your “socio-economic” findings, however, not even a single recommendation was made in this regard. The recommendations provided must therefore be reconsidered.

INTRODUCTION

Page 9: Change from “The Social sequelae…” to “The social sequelae…”

Page 10: Remove the misplaced “s” from “…births are s still on the rise…”

Page 10: Authors should reconstruct this statement for clarity “It is important to note that relatively little research has been conducted on the socio-economic consequences of adolescent mothers and their children in Ghana.”

“GMHS” should be written in full at first use.

The last paragraph under the “METHODS” section should be removed and be placed under a subheading “Ethical Consideration”, possibly right after the statistical analysis.

Change from “RESULT” to “RESULTS”

Instead of “adolescents”, some sections of the results mention “women” and this must be revised.

Characteristics of study participants.

Authors should report the standard deviation in addition to the mean age.

“…with the highest prevalence in the Brong Ahafo Region and the lowest

prevalence in the Greater Accra region.” Please quote the percentages and CIs.

Association of socio-economic factors with adolescent pregnancy (AP)/ Association of socio-economic factors with adolescent motherhood (AM)

Authors reported some adjusted findings in these sections yet the odds ratios are quoted as though they are results from unadjusted models. This should be rectified for clarity.

Great discussion. The findings are well discussed and situated in the body of knowledge.

The conclusions are great, however, the recommendations do not align with findings of the study and the prime focus of the study. Recommendations are to be made regarding the socio-economic factors studied.

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Reviewer #1:  Yes:  Thomas Hormenu, PhD. University of Cape Coast, Ghana

Reviewer #2:  Yes:  Edward Kwabena Ameyaw

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Author response to Decision Letter 0

14 Apr 2022

Ga West Municipal Hospital

Ghana Health Service,

Amasaman-Accra, Ghana

The Managing Editor

Dear Editor,

ACTIONS AND/OR RESPONSES TO REVIEWER COMMENTS

Thank you so much for giving us an opportunity to submit a revised draft of our manuscript entitled “Socio-economic factors associated with adolescent pregnancy and motherhood: analysis of the 2017 Ghana maternal health survey”. We appreciate the time and effort that you and the reviewers dedicated to providing feedback on our manuscript. We are very grateful for the insightful comments and valuable improvements to our paper. We have incorporated all the suggestions and comments made by the handling editor and the reviewers. We have cautiously revised the article as shown in the detailed point-by-point actions, responses or explanations to all the reviewer comments and suggestions as presented herein. Changes within the main document are highlighted in colour.

Reviewer # 1 Responses Line numbers/Page Numbers

1 Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at

https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and

The current manuscript now meets PLOS ONE style requirements.

throughout the manuscript

3 In your Data Availability statement, you have not specified where the minimal data set underlying the results described in your manuscript can be found. PLOS defines a study's minimal data set as the underlying data used to reach the conclusions drawn in the manuscript and any additional data required to replicate the reported study findings in their entirety. All PLOS journals require that the minimal data set be made fully available. For more information about our data policy, please see http://journals.plos.org/plosone/s/data-availability .

The Data Available Statement has been included in the manuscript 308-330

4 . Please amend either the abstract on the online submission form (via Edit Submission) or the abstract in the manuscript so that they are identical.

The abstract in both the online submission form and within the manuscript have been amended and are now identical.

23-47 in the manuscript and updated online

Reviewer #1:

1 1. The authors introduced an abbreviation in the abstract; AP and AM. I recommend, the words are written fully.

AP and AM have been written in full as adolescent pregnancy and adolescent motherhood respectively.

Throughout the manuscript

2 Also, the recommendation is not based on the conclusions of the manuscript, therefore, recommendation should be focused on health promotion tenets such increased education, accessibility to contraceptives at adolescent friendly corners and policies to promote adolescents’ reproductive health.

The reviewers’ suggestions have been incorporated into the recommendation.

3 Again, the authors introduced abbreviation of AP and AM in the introduction but the words still being used in the manuscripts. The authors should make corrections on these mishaps especially in the results session.

The abbreviations AP and AM are now written in full throughout the manuscript.

Entire manuscript

Reviewer #2:

a I recommend a critical read to correct grammatical errors/omissions/repetitions/ and omissions. e.g.

“was” has been changed to “were”, and an “and” conjunction introduced before among…

b The design and methods used makes it…

This has been corrected to read “The design and methods used to make it …” 92

c . … that affect sexual…

that aff ect sexual… has been corrected, and now reads “that affect sexual…”

d. …first with the the sorted… The repetition has been corrected and now reads “first with the sorted strata generated from administrative regions ….”

e . …with the the sorted… changed to “the first step ensures a sorted…” The repetition has been corrected and now reads “first with the sorted strata generated from administrative regions ….” 98

f. kenya. kenya has been corrected to Kenya

2 Design: The authors should clarify the sample for the study, thus what age frame was the caveat?

From a total of 25 062 women respondents, 20 277 (80.9%) women were aged 20 years and above whiles 4785 (19.1%) were adolescents aged between 15-19 years. Thus data from these 4785 adolescents aged between 15-19 years were used for this secondary data analysis.

3 Motherhood as conceptualised for the study should be defined in this section.

Both adolescent pregnancy and motherhood have been defined in this section. It reads “Adolescent pregnancy was defined as adolescents who have ever been pregnant, whiles adolescent motherhood was defined as adolescents who have ever given birth”

4 Results: In the first statement, i.e. “Of the 25062 women included in the survey, 4785 were adolescents between 15-19 years.” Does this mean that the study included participants outside adolescence, considering the word “women”. This need to be clarified and if only females in adolescence, then authors should change “women” to “adolescents”. Also, the percentage of 4785 should be captured in the statement.

The maternal health survey includes all women of reproductive age (i.e. 15-49 years).

In the main survey, a total of 25062 women were enrolled, of which 20277 (80.9%) women were aged 20 years and above whiles 4785 (19.1%) were adolescents aged between 15-19 years. Only adolescents aged 15-19 years were included in this secondary data analysis for the purpose of our research objectives. This has been clarified in the design section. We have also included a flow diagram that highlights the respondents of this secondary analysis. 32-33,104-108

5 Conclusion: Write these in full “AP and AM.”

AP and AM have been written in full as adolescent pregnancy and adolescent motherhood.

43-47, 301-306

6 From the focus of the study and your findings, it is expected that you make specific recommendations that address your “socio-economic” findings, however, not even a single recommendation was made in this regard. The recommendations provided must therefore be reconsidered. The recommendations have been revised to reflect the objectives and results of our study.

45-47, 301-306

7 Page 9: Change from “The Social sequelae…” to “The social sequelae…”

This has been amended

8 Page 10: Remove the misplaced “s” from “…births are s still on the rise…”

The misplaced “s” has been removed

9 Page 10: Authors should reconstruct this statement for clarity “It is important to note that relatively little research has been conducted on the socio-economic consequences of adolescent mothers and their children in Ghana.” This sentence has been clarified. It now reads “Although there are several studies on adolescent pregnancy in Ghana, few studies have examined the association of socio-economic factors on adolescent pregnancy and motherhood using data from nationally representative surveys.”

10 GMHS” should be written in full at first use. Ghana Maternal Health Survey (GMHS) has been written in full at first use

11 The last paragraph under the “METHODS” section should be removed and be placed under a subheading “Ethical Consideration”, possibly right after the statistical analysis.

The last paragraph of the methods section has been removed and placed under the subheading “Ethical Consideration”

12 1. Change from “RESULT” to “RESULTS” This change has been effected

13 Instead of “adolescents”, some sections of the results mention “women” and this must be revised. Sections with “women” changed to “adolescents”

14 Authors should report the standard deviation in addition to the mean age.

The standard deviation has been reported together with the mean age. The sentence now reads “The mean age of the 4758 respondents included in this analysis was 17 (Standard Deviation (SD) =1.40) years”. 152-153

15 Characteristics of study participants by pregnancy and birth history

The percentages and CIs have been quoted. The sentence now reads “… with the highest prevalence in the Brong Ahafo Region (18.6% CI:14.9% - 22.4%) and the lowest prevalence in the Greater Accra region (8.1% CI: 6.1% - 10.2%)”

16 Association of socio-economic factors with adolescent pregnancy (AP)/ Association of socio-economic factors with adolescent motherhood (AM)

Authors reported some adjusted findings in these sections, yet the odds ratios are quoted as though they are results from unadjusted models. This should be rectified for clarity.

The results from the adjusted odds ratios have been clarified.

The conclusions are great; however, the recommendations do not align with findings of the study and the prime focus of the study. Recommendations are to be made regarding the socio-economic factors studied. The recommendation modified to read as “Our analysis revealed that education, age, household wealth, marital status and zone of residence are associated with adolescent pregnancy and adolescent motherhood in Ghana. Given that adolescent pregnancy and motherhood were significantly higher in the Middle and Coastal zones, and among older adolescents, sexual and reproductive health education should be intensified among these populations. Also, adolescent-friendly corners should be made available and accessible to all adolescents in Ghana irrespective of where they live or their age”.

Submitted filename: Response to reviewers.docx

Decision Letter 1

13 Jul 2022

Socio-economic factors associated with adolescent pregnancy and motherhood: analysis of the 2017 Ghana maternal health survey

PONE-D-21-40893R1

Dear Dr. Senkyire,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Additional Editor Comments (optional):

There are still a few minor English typos (e.g., "adolescet"). Please ensure a thorough read and correction of typos in the final typeset version.

Acceptance letter

Dear Dr. Senkyire:

I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department.

If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact gro.solp@sserpeno .

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on behalf of

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  1. Adolescent Pregnancy Outcomes and Risk Factors

    Teenage pregnancy is the pregnancy of 10- to 19-year-old girls [ 1 ]. Adolescents are further divided into early (10-14 years old), middle (15-17 years old), and late adolescents (over 17 years old) [ 2 ]. According to the World Health Organization, adolescent pregnancies are a global problem for both developed and developing countries.

  2. PDF CHAPTER 1: INTRODUCTION 1.1 PROBLEM STATEMENT

    1.1 PROBLEM STATEMENT. Adolescent pregnancy has long been a worldwide social and educational concern for the developed, developing and underdeveloped countries. Many countries continue to experience high incidence of teenage pregnancy despite the intervention strategies that have been put in place. In 1990 approximately 530,000 teenagers in the ...

  3. Prevalence and Associated Factors of Teenage Pregnancy in Sub-Saharan

    Teenage pregnancy is defined as a teenage girl becoming pregnant before 20 years of age (Alauddin et al., 1999).Teenage pregnancy occurs in all societies but varies in magnitude across countries (Mann et al., 2020).According to World Fertility 2019 report, teenage fertility was still relatively high in 2015 to 2020 with 80 to 140 births per thousand teenage girls aged 15 to 19 years (World ...

  4. (PDF) Teenage Pregnancy

    Abstract. Teen preg nanc y is a social problem not resolved in developing and some developed countries. Adolescent fecundity has become the most exact bio-demographic and health indicator of ...

  5. Maternal and Neonatal Outcomes of Adolescent Pregnancy: A Narrative

    Introduction and background. Adolescent pregnancy, by definition, is pregnancy in girls between the ages of 10 and 19, where the majority are unintended pregnancies [].Approximately 15% of women below 18 years gave birth globally in 2015- 2020, and 90% or more of such deliveries occur in countries with low and middle income [1,2].One in every five adolescent girls has given birth globally, and ...

  6. Teenage pregnancy and social disadvantage: systematic review ...

    Methods. We undertook a three part systematic review of the research evidence on social disadvantage and pregnancy in young people by using an innovative method we developed previously for integrating qualitative and quantitative research.22 23 The first part of the review focused on quantitative controlled trials and was designed to assess the impact on teenage conceptions of interventions ...

  7. Basic Research Proposal and paper on Impact of adolescent pregnancy on

    Basic Research Proposal and paper on Impact of adolescent pregnancy on maternal morbidity. ... Pregnancy during teenage can adversely affect the health of both the mother and the foetus as the adolescent female concerned is yet to attain her full growth potential. Adolescent pregnancy is a global phenomenon with serious health, social and ...

  8. Teenage Pregnancy and Its Associated Factors among School Adolescents

    Teenage pregnancy is the biggest killer of young girls worldwide; 1, 000, 000 teenage girls die or suffer serious injury, infection or disease due to pregnancy or childbirth every year . Adolescent girls aged 15 to 19 years are twice as likely to die from complications in pregnancy as are women in their twenties.

  9. (PDF) Qualitative Research on Adolescent Pregnancy: A Descriptive

    This study examined qualitative research on adolescent pregnancy to determine designs and methods used and to discover emergent themes across studies. Most of the 22 studies reviewed were described as qualitative or phenomenological by design and ... Teenage pregnancy is a global problem. It confronted all levels of societal status from low ...

  10. PDF The Scope of Teen Pregnancy

    The Scope of Teen Pregnancy: A Prevention Project. The Scope of Teen Pregnancy is a project designed for the middle school aged teens, thirteen to fifteen years of age. This is a twelve-session project that meets once a week. Each session lasts for an hour and fifteen minutes. The group size should be ten to twelve.

  11. Prevalence and associated factors of adolescent pregnancy (15-19 years

    Adolescent pregnancy is a global public health problem that affects both developed and developing countries [].Nearly 25% of adolescent women have got pregnant worldwide [1,2,3], and the prevalence of adolescent pregnancy in Africa is 18.8%, of this, 19.3% occurred in Sub-Saharan Africa and 21.5% in eastern Africa [].The prevalence of adolescent pregnancy in eastern Africa ranges from 18 to 29 ...

  12. PDF The Impact of Teenage Pregnancies on Secondary School Students: a Case

    pact of teenage pregnancies to secondary school girls in Magu district, Mwanza region, Tanzania". This study is being don. y Witgal Mgomera, a student from The Open University of Tanzania pursuing Masters of Social Work. The purpose of this research is to co. duct a thoroughly investigation to the im.

  13. Teenage pregnancy and its associated factors among teenage females in

    1st pregnancy, planned pregnancy, perception on teenage pregnancy. Operational definition Teenage pregnancy: pregnancy in teenagers aged 10-19 years confirmed by a healthcare provider13. Sample size determination Single population proportion formula was used to determine the sample size. A 95% confidence interval (CI), a margin

  14. Sample Research Proposal on Teenage Pregnancy

    This research proposal implies on teenage pregnancy and its effect on academic progression. There will be association between teenage pregnancy and academic progression places evidence that education should put weight on reality adhering to teenage pregnancy. Understanding teenage pregnancy within UK context is adamant to the purpose of study.

  15. The Effects of Pregnancy: A Systematic Review of Adolescent Pregnancy

    Teenage pregnancy and experience of physical violence among women aged 15-19 years in five African countries: analysis of complex survey data: ... This study was approved by the Human Research Ethics Committee of Thammasat University (Science), Thailand (HREC-TUSc) (COE No. 020/2564). Informed Consent Statement. Not applicable.

  16. PDF Understanding Teenage Pregnancy in Kenya: the Magnitude and Policy

    hat adolescent or teenage pregnancy and childbearing h. become common in Kenya. Kenya's adolescent birth rate is 96 per 1,000 women. According to the Kenya Demographic and Health Survey (2014), 18% of (i.e. nearly 1 in 5) girls age 15-19 have already begun child bearing with the proportions increasin.

  17. PDF Effects of Teenage Pregnancy on The Academic Performance Of

    investigate the impact of teenage pregnancy in the Ukwala ward in Siaya County. A total sample of 50 respondents was used for the study. Questionnaire; observation and interview were used to collect data for the research. Looking at the effects of teenage pregnancy, it is clear that the girls face stigmatization, ridicule, and

  18. Teen Pregnancy Prevention: Implementation of a Multicomponent

    Although the teen birth rate declined 64% between 1991 and 2015 from 61.8 to 22.3 per 1,000 female adolescents aged 15-19 years [], the United States continues to have one of the highest teen pregnancy rates among developed nations [], and racial/ethnic and geographic disparities in teen birth rates persist [3,4].Because of the high rates and persistent disparities in teen births, teen ...

  19. (PDF) IMPACT OF TEENAGE PREGNANCY ON GIRLS' ACADEMIC ...

    PDF | On Jan 1, 2023, Salome Aluoch Owuonda and others published IMPACT OF TEENAGE PREGNANCY ON GIRLS' ACADEMIC PROGRESSION BASED ON THEIR EXPERIENCES IN NYATIKE SUB-COUNTY, MIGORI COUNTY -KENYA ...

  20. [Adolescent pregnancy. A proposal for intervention]

    The principle consequences of adolescent pregnancy are: abortions, forced marriages, undesired motherhood, adoptions and emotional problems that can lead to depression and suicide. Clearly, the impact of these pregnancies can have many lasting repercussions. But one fact persists adolescent pregnancy can and should be prevented.

  21. Socio-economic factors associated with adolescent pregnancy and

    It is important to note that relatively little research has been conducted on the socio-economic consequences of adolescent pregnancy and motherhood in Ghana. ... C and Obrist B. Socio-cultural and economic factors influencing adolescents' resilience against the threat of teenage pregnancy: a cross-sectional survey in Accra, Ghana.