Department of Social Statistics and Demography, University of Southampton, Southampton, UK.
Department of Sexual and Reproductive Health and Research, World Health Organisation, Geneva, Switzerland.
Int J Equity Health. 2020 Sep 4;19(1):151. doi: 10.1186/s12939-020-01251-y.
Single aggregate figures for adolescent pregnancy may fail to demonstrate particular population groups where rates are very high, or where progress has been slow. In addition, most indicators fail to separate younger from older adolescents. As there is some evidence that the disadvantages faced by adolescent mothers are greatest for those at the younger end of the spectrum, this is an important omission. This paper provides information on levels and trends of adolescent first births in 22 countries (at national and regional level) disaggregated by age (< 16 years, 16/17 years and 18/19 years), socio-economic status and place of residence. It highlights differences and similarities between countries in the characteristics of women who experience first birth during adolescence, as well as providing information on trends to identify groups where progress in reducing adolescent first births is poor.
In this descriptive and trend analysis study we used data from 22 low- and middle-income countries from sub-Saharan Africa that have at least three Demographic and Health Surveys (DHS) since 1990, with the most recent carried out after 2005. Adolescent first births from the most recent survey are analysed by age, wealth, and residence by country and region for women aged 20-24 years at time of survey. We also calculated annual percentage rates of change (using both short- and longer-term data) for adolescent first births disaggregated by age, family wealth and residence and examined changes in concentration indices (CI).
Overall percentages of adolescent first births vary considerably between countries for all disaggregated age groups. The burden of first birth among adolescents is significant, including in the youngest age group: in some countries over 20% of women gave birth before 16 years of age (e.g. Mali and Niger). Adolescent first births are more common among women who are poorer, and live in rural areas; early adolescent first births before 16 years of age are particularly concentrated in these disadvantaged groups. Progress in reducing adolescent first births has also been particularly poor amongst these vulnerable groups, leading to increasing inequity.
Findings from this study show that adolescent births are concentrated among vulnerable groups where progress is often poorest. Strategies and programmes need to be developed to reduce adolescent pregnancies in marginalised young women in low- and middle-income countries.
青少年怀孕的单一总体数据可能无法显示某些特定人群中非常高的比率，或者显示进展缓慢的情况。此外，大多数指标都无法区分年轻和年长的青少年。由于有一些证据表明，青少年母亲所面临的劣势在频谱的年轻端最大，这是一个重要的遗漏。本文提供了 22 个国家（国家和地区层面）青少年初次生育水平和趋势的信息，按年龄（<16 岁、16/17 岁和 18/19 岁）、社会经济地位和居住地进行了细分。它突出了各国在青少年怀孕特征方面的差异和相似之处，以及提供了有关趋势的信息，以确定在减少青少年初次生育方面进展不佳的群体。
在这项描述性和趋势分析研究中，我们使用了来自撒哈拉以南非洲的 22 个低收入和中等收入国家的数据，这些国家自 1990 年以来至少进行了三次人口与健康调查（DHS），其中最近一次是在 2005 年之后进行的。对最近一次调查中 20-24 岁的女性，按国家和地区按年龄、财富和居住地对青少年初次生育进行分析。我们还计算了按年龄、家庭财富和居住地细分的青少年初次生育的年百分比变化率（使用短期和长期数据），并检查了集中指数（CI）的变化。
所有按年龄细分的组别的国家之间，青少年初次生育的总体百分比差异很大。青少年初次生育的负担很大，包括在最年轻的年龄组：在一些国家，超过 20%的女性在 16 岁之前生育（例如马里和尼日尔）。青少年初次生育在较贫穷和生活在农村地区的妇女中更为常见；16 岁以下的青少年初次生育尤其集中在这些弱势群体中。在这些弱势群体中，减少青少年初次生育的进展也特别差，导致不平等加剧。
本研究结果表明，青少年生育集中在弱势群体中，而这些群体的进展往往最差。需要制定战略和方案，以减少低收入和中等收入国家中边缘化年轻妇女的青少年怀孕。
