Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
National Population Council, Ministry of Finance, Planning and Economic Development, Statistics House, Plot 9, Colville Street, P.O. Box 2666, Kampala, Uganda.
BMC Public Health. 2021 Oct 18;21(1):1875. doi: 10.1186/s12889-021-11403-6.
Adolescent pregnancy in Uganda declined from 31% in 2000-01 to 25% in 2006 but thereafter stalled at 25% from 2006 to 2016. This paper investigates the factors associated with the recent stall in the rate of decline of adolescent pregnancy in Uganda.
We used logistic regression models for 4 years (2000-01, 2006, 2011 and 2016) of data from the Uganda Demographic Health Survey to explore proximate and distal factors of adolescent pregnancy in Uganda. We carried out Blinder-Oaxaca decomposition models to explore the contributions of different factors in explaining the observed decline in adolescent pregnancy between 2001 and 2006, and the subsequent stall between 2006 and 2016.
We found that marriage among women aged 15-19 years, and early sexual debut, were strongly associated with adolescent pregnancy. These declined substantially between 2000 and 01 and 2006, leading to a decline in adolescent pregnancy. Their decline was in turn associated with rising levels of female education and household wealth. After 2006, education levels and household wealth gains stalled, with associated stalls in the decline of marriage among women aged 15-19 years and sexual debut, and a stall in the decline of adolescent pregnancy.
The stall in the decline of adolescent pregnancies in Uganda was linked to a stall in the reduction of adolescent marriage, which in turn was associated with limited progress in female educational attainment between 2006 and 2016. We emphasize the need for a renewed focus on girl's education and poverty reduction to reduce adolescent pregnancy in Uganda and subsequently improve health outcomes for adolescent girls.
乌干达青少年怀孕率从 2000-01 年的 31%下降到 2006 年的 25%，但此后在 2006 年至 2016 年期间停滞在 25%。本文研究了导致乌干达青少年怀孕率下降近期停滞的相关因素。
我们使用来自乌干达人口与健康调查的 4 年（2000-01 年、2006 年、2011 年和 2016 年）数据，采用逻辑回归模型探讨乌干达青少年怀孕的近期和远期因素。我们进行了 Blinder-Oaxaca 分解模型，以探讨不同因素对 2001 年至 2006 年期间青少年怀孕率下降和 2006 年至 2016 年期间下降停滞的解释作用。
我们发现，15-19 岁女性的婚姻和早期性行为与青少年怀孕密切相关。这些情况在 2000 年至 2001 年和 2006 年之间大幅下降，导致青少年怀孕率下降。这些下降与女性教育水平和家庭财富的提高有关。2006 年以后，教育水平和家庭财富的提高停滞不前，与 15-19 岁女性的婚姻和性行为初现的下降停滞以及青少年怀孕率下降的停滞相关。
乌干达青少年怀孕率下降的停滞与青少年结婚率下降的停滞有关，而后者又与 2006 年至 2016 年期间女性教育程度提高有限有关。我们强调需要重新关注女孩教育和减贫，以减少乌干达青少年怀孕，从而改善青少年女孩的健康状况。
