School of Public Health, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia.
Department of Midwifery, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia.
PLoS One. 2024 Sep 6;19(9):e0310025. doi: 10.1371/journal.pone.0310025. eCollection 2024.
Teenage pregnancy remains one of the major reproductive health problems, especially in sub-Saharan African countries. It can lead to maternal and neonatal complications and social consequences. The proportion of teenage pregnancy differs across regions of Ethiopia. Thus, this study aimed to determine the spatial variation in determinants of teenage pregnancy among adolescents aged 15-19 years in Ethiopia using the 2019 Demographic and Health Survey (DHS).
This study included a total weighted sample of 2165 teenage girls aged 15 to 19 years. A mixed-effect binary logistic regression model was employed to consider the hierarchical nature of the DHS data using STATA version 17. Adjusted odds ratios with 95% confidence intervals are reported, and a p-value less than 0.05 was used to identify significant predictors. The spatial analysis was conducted with ArcGIS version 10.7 and Python 3. To identify factors associated with the hotspots of teenage pregnancy, a multiscale geographically weighted regression (MGWR) was performed. Spatial regression models were compared using adjusted R2, the corrected Akaike information criterion (AICc), and the residual sum of squares (RSS).
The prevalence of teenage pregnancy among adolescents aged 15 to 19 years was 12.98% (95% CI: 11.6%, 14.5%). It was spatially clustered throughout the country with a significant Moran's I value. Significant hotspot areas were detected in central and southern Afar; northern, central, and western Gambela; northeastern and southern central Oromia; and the eastern Somali region. The MGWR analysis revealed that the significant predictors of spatial variations in teenage pregnancy were being illiterate and being married. Based on the multivariable multilevel analysis, age 17 (AOR = 3.54; 95% CI: 1.60, 7.81), 18 (AOR = 8.21; 95% CI: 3.96, 17.0), 19 (AOR = 15.0; 95% CI: 6.84, 32.9), being literate (AOR = 0.57; 95% CI: 0.35, 0.92), being married (AOR = 22.8; 95% CI: 14.1, 37.0), age of household head (AOR = 0.98; 95% CI: 0.98, 0.99) and residing in the Gambela region (AOR = 3.27; 95% CI: 1.21, 8.86) were significantly associated with teenage pregnancy among adolescents aged 15 to 19.
Teenage pregnancy is a public health problem in Ethiopia. Policymakers should prioritize addressing early marriage and improving teenage literacy rates, with a focus on the Gambela region and other hotspot areas. It is crucial to implement policies aimed at transforming the traditional practice of early marriage and to take measures to enhance literacy levels and promote awareness about sexual and reproductive health at the family and school levels. This will help ensure that young people have the opportunity to pursue education and make informed decisions about their reproductive health.
青少年怀孕仍然是撒哈拉以南非洲国家主要的生殖健康问题之一。它可能导致母婴和新生儿并发症以及社会后果。青少年怀孕的比例在埃塞俄比亚的不同地区有所不同。因此，本研究旨在使用 2019 年人口与健康调查 (DHS) 来确定埃塞俄比亚 15-19 岁青少年怀孕的决定因素的空间变化。
本研究包括总共 2165 名 15 至 19 岁的少女的加权总样本。采用混合效应二元逻辑回归模型，使用 STATA 版本 17 考虑 DHS 数据的层次性质。报告调整后的优势比和 95%置信区间，p 值小于 0.05 用于确定显著预测因素。使用 ArcGIS 版本 10.7 和 Python 3 进行空间分析。为了确定与青少年怀孕热点相关的因素，进行了多尺度地理加权回归 (MGWR)。使用调整后的 R2、校正的 Akaike 信息标准 (AICc) 和残差平方和 (RSS) 比较空间回归模型。
15-19 岁青少年怀孕的患病率为 12.98%（95%CI：11.6%，14.5%）。它在全国范围内呈空间聚类分布，具有显著的 Moran's I 值。在阿法尔中部和南部、北部、中部和西部甘贝拉、奥罗米亚中北部和南部以及索马里东部地区检测到显著的热点区域。MGWR 分析显示，空间变化青少年怀孕的显著预测因素是文盲和已婚。基于多变量多水平分析，17 岁（AOR = 3.54；95%CI：1.60，7.81）、18 岁（AOR = 8.21；95%CI：3.96，17.0）、19 岁（AOR = 15.0；95%CI：6.84，32.9）、识字（AOR = 0.57；95%CI：0.35，0.92）、已婚（AOR = 22.8；95%CI：14.1，37.0）、户主年龄（AOR = 0.98；95%CI：0.98，0.99）和居住在甘贝拉地区（AOR = 3.27；95%CI：1.21，8.86）与 15-19 岁青少年怀孕显著相关。
青少年怀孕是埃塞俄比亚的一个公共卫生问题。决策者应优先解决早婚问题和提高青少年识字率，重点是甘贝拉地区和其他热点地区。实施旨在改变早婚传统的政策并采取措施提高家庭和学校层面的性健康和生殖健康意识至关重要。这将有助于确保年轻人有机会接受教育并就其生殖健康做出明智的决定。
