Gunawardena Nathali, Fantaye Arone Wondwossen, Yaya Sanni
Faculty of Science, University of Ottawa, Ottawa, Ontario, Canada.
Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
BMJ Glob Health. 2019 Jun 5;4(3):e001499. doi: 10.1136/bmjgh-2019-001499. eCollection 2019.
Sub-Saharan Africa has among the highest prevalence of teenage pregnancy in the world. Teenage mothers and their children are at risk to a host of medical, social and economic challenges. Adolescent pregnancy is a significant cost to the mother and newborn child, and also to their family and the wider society. Despite measures taken by some sub-Saharan nations to tackle the issue of adolescent pregnancy, the phenomenon remains a public health concern that is widespread throughout the region. Currently, there are few studies that examine the predictors of teenage pregnancy in the sub-Saharan region. The objective of the present study was to systematically review predictors of pregnancy among young people in sub-Saharan Africa.
A literature search was conducted using Medline, CINAHL and EMBASE electronic databases. Following duplicate removal, abstract and full-text screening, 15 studies were ultimately included in the final review. Narrative synthesis was used to synthesise the qualitative and quantitative findings. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses.
Twenty-seven predictors of teenage pregnancy were identified and grouped into six themes (Partner and peer-related predictors; Sexual health knowledge, attitude and behaviour-related predictors; Parenting and family-related predictors; Economic, environmental and cultural predictors; Personal predictors; and Quality of healthcare services predictors). The most obvious predictors included sexual coercion and pressure from male partners, low or incorrect use of contraceptives, and poor parenting or low parental communication and support.
This review emphasises that the large prevalence of adolescent pregnancy in sub-Saharan Africa is attributable to multiple predictors that our study was able to group into six themes. Policy changes and programmes must be implemented in sub-Saharan Africa to address these determinants in order to reduce adolescent pregnancy within the region.
撒哈拉以南非洲地区是世界上青少年怀孕率最高的地区之一。青少年母亲及其子女面临一系列医疗、社会和经济挑战。青少年怀孕对母亲和新生儿以及他们的家庭和更广泛的社会来说成本高昂。尽管撒哈拉以南一些国家已采取措施应对青少年怀孕问题，但这一现象仍是该地区普遍存在的公共卫生问题。目前，很少有研究探讨撒哈拉以南地区青少年怀孕的预测因素。本研究的目的是系统回顾撒哈拉以南非洲地区年轻人怀孕的预测因素。
使用Medline、CINAHL和EMBASE电子数据库进行文献检索。在去除重复项、进行摘要和全文筛选后，最终有15项研究纳入最终综述。采用叙述性综合方法来综合定性和定量研究结果。本综述遵循系统评价和Meta分析的首选报告项目。
确定了27个青少年怀孕的预测因素，并将其分为六个主题（与伴侣和同伴相关的预测因素；性健康知识、态度和行为相关的预测因素；育儿和家庭相关的预测因素；经济、环境和文化预测因素；个人预测因素；以及医疗服务质量预测因素）。最明显的预测因素包括来自男性伴侣的性胁迫和压力、避孕措施使用不足或不当、育儿方式差或父母沟通及支持不足。
本综述强调，撒哈拉以南非洲地区青少年怀孕率高归因于多个预测因素，本研究能够将这些因素归为六个主题。撒哈拉以南非洲地区必须实施政策变革和项目来解决这些决定因素，以降低该地区的青少年怀孕率。
