Institute for Social Science Research, University of Queensland, Brisbane, QLD, Australia; ARC Centre of Excellence for Children and Families over the Life Course, University of Queensland, Brisbane, QLD, Australia.
Institute for Social Science Research, University of Queensland, Brisbane, QLD, Australia; ARC Centre of Excellence for Children and Families over the Life Course, University of Queensland, Brisbane, QLD, Australia.
Lancet Child Adolesc Health. 2021 Jan;5(1):26-36. doi: 10.1016/S2352-4642(20)30311-4. Epub 2020 Nov 24.
Documenting trends and inequalities in the prevalence of adolescent motherhood across low-income and middle-income countries (LMICs) is important to support the adolescent sexual and reproductive health target in the UN Sustainable Development Goals (SDGs). We aimed to examine time trends and sociodemographic inequalities in the prevalence of adolescent motherhood in LMICs.
We analysed data from 747 137 young women (aged 15-19 years) from 74 LMICs, using 254 nationally representative Demographic and Health Surveys done between 1990 and 2018. We estimated the population-weighted prevalence of adolescent motherhood among women aged aged 15-19 years (defined as having had a livebirth or being pregnant at the time of the survey). Trends in the prevalence were calculated at the national level using the average annual rate of change (AARC) in a subset of 61 countries with at least two surveys from different timepoints during the study period. Sociodemographic inequalities (eg, wealth quintile, level of education, and rural or urban residence) in adolescent motherhood were described using the normalised concentration index.
The highest prevalence of adolescent motherhood was observed in sub-Saharan African countries, for example it was 36·00% (95% CI 33·98-38·08) in Mali (which had recent survey data; 2018). Examining AARC, countries such as Nigeria (AARC -1·35%; 1990-2018) and India (-4·62%; 1992-2015) experienced a steady decline in the prevalence of adolescent motherhood during the study period. However, several high-burden countries experienced little change in prevalence over time (-0·60%; Bangladesh, 1993-2014), and 16 countries, such as Cambodia (2·42%; 2000-14) and Philippines (1·59%; 1993-2017), had an increase in the prevalence of adolescent motherhood over time. Sociodemographic inequalities in the prevalence of adolescent motherhood persist in most countries in this study.
Many of the countries in this study experienced either a slow rate of reduction or an increase in the prevalence of adolescent motherhood during the study period, and sociodemographic inequalities within countries persist. These results indicate that efforts to reduce adolescent motherhood and the associated health burden need to be improved within many LMICs. These findings can assist policy makers to target the rollout of interventions on the basis of observed geographic and sociodemographic inequalities to reduce adolescent motherhood among the disadvantaged, and accelerate progress towards adolescent sexual and reproductive health targets in the UN SDGs.
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记录低收入和中等收入国家（LMICs）青少年母亲比例的趋势和不平等情况，对于支持联合国可持续发展目标（SDGs）中的青少年性健康和生殖健康目标至关重要。我们旨在研究 LMICs 中青少年母亲比例的时间趋势和社会人口学不平等情况。
我们分析了来自 74 个 LMIC 的 747137 名 15-19 岁年轻女性的数据，这些数据来自于 1990 年至 2018 年期间进行的 254 次全国代表性人口与健康调查。我们估计了年龄在 15-19 岁的女性中青少年母亲的人口加权比例（定义为在调查时生育过活产儿或怀孕）。使用 61 个国家的亚组数据，这些国家在研究期间至少有两次来自不同时间点的调查，我们在国家层面上使用平均年变化率（AARC）来计算青少年母亲比例的变化趋势。使用标准化集中指数描述了青少年母亲在社会人口学方面的不平等情况（例如，财富五分位数、教育水平以及农村或城市居住）。
在撒哈拉以南非洲国家，青少年母亲的比例最高，例如在马里（2018 年的数据），这一比例为 36.00%（95%CI 33.98-38.08）。在 AARC 方面，尼日利亚（AARC-1.35%；1990-2018 年）和印度（-4.62%；1992-2015 年）等国家在研究期间经历了青少年母亲比例的稳定下降。然而，一些高负担国家的比例变化不大（0.60%；孟加拉国，1993-2014 年），而柬埔寨（2.42%；2000-14 年）和菲律宾（1.59%；1993-2017 年）等 16 个国家的青少年母亲比例则呈上升趋势。在本研究的大多数国家，青少年母亲比例的社会人口学不平等仍然存在。
在研究期间，许多国家的青少年母亲比例要么增长缓慢，要么增长，而且国家内部的社会人口学不平等仍然存在。这些结果表明，许多 LMIC 需要改进减少青少年母亲比例和相关健康负担的工作。这些发现可以帮助决策者根据观察到的地理和社会人口学不平等情况，有针对性地推出干预措施，以减少弱势群体中的青少年母亲比例，并加速实现联合国可持续发展目标中的青少年性健康和生殖健康目标。
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