Determinants of Adolescent Pregnancy in Luuka District, Eastern Uganda: A Mixed Methods Study
Abstract:
Adolescent pregnancy is a serious public health and social
problem. Over 95% of adolescent pregnancy cases occur in developing countries. Understanding
and addressing the determinants of adolescent pregnancy is crucial to ending the
vice. This study aimed to explore factors associated with adolescent pregnancy in
Luuka District, in Uganda. An embedded mixed methods study design was used. Primary
data was collected from 336 adolescent girls, aged 10–19 years, selected through
simple random sampling, using a case-control survey, with a structured questionnaire.
In addition, qualitative data was collected through 20 in-depth interviews and 16
focus group discussions. Quantitative and qualitative analyses were done using SPSS
for descriptive, bivariate (i.e., Chi-square tests), multivariable analyses (i.e.,
logistics regression) used for determining independent associations and content
analysis respectively. Findings revealed multiple factors influencing adolescent
pregnancy including behavioral factors: such as having multiple sexual partners,
frequent sex, lack of self-control over sex and irregular contraceptive use; familial
factors: peer pressure, being an orphan living with mother, sexual abuse, and socioeconomic
factors such as poverty. In conclusion: behavioral, demographic, familial and socioeconomic
factors are major determinants of adolescent pregnancy in Luuka District. We recommend
interventions focusing on providing information on sexual and reproductive health,
including improving access to contraceptives for adolescent girls. Improving socio-economic
status of families, legal punishment of sexual offenders, as well as keeping girls
in school to mitigate effects of adolescent pregnancy in the low-income settings.
References:
[1] WHO
Coming of age: Adolescent health. 2020.
[2] WHO,
Adolescent pregnancy. Key facts. 2020.
[3] WHO,
Adolescent pregnancy: Issues in adolescent health and development. 2004. p. 86.
[4] WHO,
Adressing adolescent health challenges in Uganda. 2014.
[5] T
Ganchimeg, et al., Pregnancy and childbirth outcomes among adolescent mothers:
a World Health Organization multicountry study. BJOG 2014. 121(Suppl.1): p.
40-48.
[6] Nathali
Gunawardena, Arone Wondwossen Fantaye, and S. Yaya, Predictors of pregnancy
among young people in sub-Saharan Africa: a systematic review and narrative
synthesis. BMJ Global Health 2019;4:e001499., 2019.
[7] Elizabeth
Sully, et al., Adding It Up: Investing in Sexual and Reproductive Health 2019.
2020.
[8] C
Bonell, et al., The effect of dislike of school on risk of teenage pregnancy:
Testing of hypotheses using longitudinal data from a randomised trial of sex
education. Journal of Epidemiology and Community Health 2005: p. 223-30.
[9] Nour,
N., M, Health Consequences of Child Marriage in Africa. . Emerging Infectious
Diseases, 2006. 12(11): p. 1644-1649.
[10] K, E.,
Sexual behaviour and early coitarche in a national sample of 17-year-old
Swedish boys. Acta Paediatr, 2002. 91(9): p.:985-91.
[11] Statistics,
U.B.O., Uganda Demographic and health survey 2016. 2016, Uganda Bureau of
statistics.
[12] Yu, X.
and D. Khazanchi, Using Embedded Mixed Methods in Studying IS Phenomena: Risks
and Practical Remedies with an Illustration, in. Information Systems and
Quantitative Analysis Faculty Publications. 2017, University of Nebraska at
Omaha.
[13] Mukasa,
V., Busoga region has the highest rate of teenage pregnancies. 2014.
[14] UDHS,
Uganda demographic and health survey (UDHS). 2016.
[15] Suresh,
K., G. Suresh, and S.V. Thomas, Design and data analysis 1 study. Review:
Systematic (Statistically Speaking), 2012. 15(2): p. 76-80.
[16] UBOS,
Nationalpopulation and housing census 2014 area spesifc profiles Luuka
District. 2017. p. 66.
[17] Kugonza,
H., Early pregnancies escalate during COVID-19 lockdown, in New Vision. 2020.
[18] Mugabi,
D., Govt launches programme to reduce teenage pregnancy, in PML Daily. 2018.
[19] Nabugoomu,
J., G.K. Seruwagi, and R. Hanning, What can be done to reduce the prevalence of
teen pregnancy in rural Eastern Uganda?: multi-stakeholder perceptions.
Reproductive Health, 2020. 17(1): p. 134.
[20] Joanne
N. Leerlooijer, et al., Applying intervention mapping to develop a
community-based intervention aimed at improved psychological and social
well-being of unmarried teenage mothers in Uganda. Health Educ Research, 2014.
[21] Ochen,
A.M., P.C. Chi, and S. Lawoko, Predictors of teenage pregnancy among girls aged
13–19 years in Uganda: a community based case-control study. BMC Pregnancy
and Childbirth, 2019. 19(1): p. 211.
[22] Joseph
Byonanebye, et al., Geographic variation and risk factors for teenage pregnancy
in Uganda. African Health Sciences 2020 20(4): p. 1898-907.
[23] Magashi
J Ntegwa, Magashi J Ntegwa, and A. Miho, Trends and Causes of Socio-economic
Inequality In Teenage Pregnancy and Childbearing in Tanzania. Journal of
Humanities and Social Sciences, 2021, 2021.
[24] Seblewongel
Tigabu, Alemneh Mekuriaw Liyew, and B.M. Geremew, Modeling spatial determinates
of teenage pregnancy in Ethiopia; geographically weighted regression. BMC
Women’s Health 2021. 21(254).
[25] Kassa,
G.M., Arowojolu A.O.Odukogbe, A.A. etal, Prevalence and determinants of
adolescent pregnancy in Africa a systematic review and meta-analysis.
Reproductive Health, 2018. 15(195).
[26] Government
of Uganda, The Constitution of the Republic of Uganda, 1995. 1995: Kampala. p.
192.
[27] Government
of Uganda and UNICEF, The national strategy to end child marriage and teenage
pregnancy; 2014/2015-2019/2020 .A society free of child marriage and teenage
pregnancy. 2015.
[28] Ministry
of Health, U., Adolescent Health Policy Guidelines and Service Standards,
D.o.C.H. The Reproductive Health Division, Editor. 2012.
[29] Ministry of Health, The national adolescent health-strategy. 2011. p. 61.
[30] Government
of Uganda, Ministry of education and sports nationa strategy for girls’
education in Uganda 2015-2019, M.o. Education, Editor. 2013: Kampala. p. 34.