Age and Economic Asymmetries in the Sexual Relationships of Adolescent Girls in Sub-Saharan Africa

Abstract Background The use of modern contraception has increased in much of sub-Saharan Africa (SSA). However, the extent to which changes have occurred across the wealth spectrum among adolescents is not well known. We examine poor-rich gaps in demand for family planning satisfied by modern methods (DFPSm) among sexually active adolescent girls and young women (AGYW) using data from national household surveys. Methods We used recent Demographic and Health Surveys and Multiple Indicator Cluster Surveys to describe levels of wealth-related inequalities in DFPSm among sexually active AGYW using an asset index as an indicator of wealth. Further, we used data from countries with more than one survey conducted from 2000 to assess DFPSm trends. We fitted linear models to estimate annual average rate of change (AARC) by country. We fitted random effects regression models to estimate regional AARC in DFPSm. All analysis were stratified by marital status. Results Overall, there was significant wealth-related disparities in DFPSm in West Africa only (17.8 percentage points (pp)) among married AGYW. The disparities were significant in 5 out of 10 countries in Eastern, 2 out of 6 in Central, and 7 out of 12 in West among married AGYW and in 2 out of 6 in Central and 2 out of 9 in West Africa among unmarried AGYW. Overall, DFPSm among married AGYW increased over time in both poorest (AARC = 1.6%, p < 0.001) and richest (AARC = 1.4%, p < 0.001) households and among unmarried AGYW from poorest households (AARC = 0.8%, p = 0.045). DPFSm increased over time among married and unmarried AGYW from poorest households in Eastern (AARC = 2.4%, p < 0.001) and Southern sub-regions (AARC = 2.1%, p = 0.030) respectively. Rwanda and Liberia had the largest increases in DPFSm among married AGYW from poorest (AARC = 5.2%, p < 0.001) and richest (AARC = 5.3%, p < 0.001) households respectively. There were decreasing DFPSm trends among both married (AARC = − 1.7%, p < 0.001) and unmarried (AARC = − 4.7%, p < 0.001) AGYW from poorest households in Mozambique. Conclusion Despite rapid improvements in DFPSm among married AGYW from the poorest households in many SSA countries there have been only modest reductions in wealth-related inequalities. Significant inequalities remain, especially among married AGYW. DFPSm stalled in most sub-regions among unmarried AGYW.

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How to reduce HIV risk among adolescent girls and young women in sub-Saharan Africa? Implementation science around the DREAMS Initiative

10.31899/hiv7.1009 ◽

2016 ◽

Author(s):

Keyword(s):

Implementation Science ◽

Adolescent Girls ◽

Young Women ◽

Hiv Risk ◽

Sub Saharan Africa ◽

Sub Saharan

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Attitudes towards early marriage and related factors among adolescent girls in Ethiopia

10.21203/rs.2.11060/v1 ◽

2019 ◽

Author(s):

Hanna Gulema ◽

Ayah Hamdan ◽

Jessica Gingles ◽

Lauren E. Friedman ◽

Bizu Gelaye ◽

...

Keyword(s):

Adolescent Girls ◽

Cross Sectional Study ◽

Sub Saharan Africa ◽

Early Marriage ◽

Final Decision ◽

Related Factors ◽

Cross Sectional ◽

Decision Making Processes ◽

Sub Saharan ◽

Structured Questionnaire

Abstract Background Early marriage, although it remains a common practice in sub-Saharan Africa, has detrimental effects on women’s sexual and reproductive health, social networks, and educational attainment. We sought to investigate the association between attitudes towards early marriage and marital status among adolescent girls in Ethiopia. Methods A cross-sectional study was conducted among 3,013 adolescent girls aged 13-17 years of age, living in four districts of the Oromia region of Ethiopia. Sociodemographic characteristics and were participants’ attitudes towards early marriage were measured using a pre-tested structured questionnaire. Results The prevalence of early marriage among adolescent girls was 8.3% and approximately 87.0% of girls had an overall positive attitude towards early marriage. Compared to adolescent girls who were unmarried, those who were married or living with a partner were less likely to believe they should have a say whether they want to marry or not (OR=0.32; 95%CI: 0.18-0.57), believe they should get to decide when to marry (OR=0.52; 0.31-0.88), and believe they should have the final decision over the decision to marry (OR=0.48; 0.32-0.73). Conclusions Interventions to prevent early marriage should strengthen women decision-making processes and promote women’s agency.

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Investigating exchange in sexual relationships in sub-Saharan Africa using survey data

Sex Without Consent ◽

10.5040/9781350222519.ch-007 ◽

2005 ◽

Author(s):

Nancy Luke

Keyword(s):

Survey Data ◽

Sexual Relationships ◽

Sub Saharan Africa ◽

Sub Saharan

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Trends and inequalities in the nutritional status of adolescent girls and adult women in sub-Saharan Africa since 2000: a cross-sectional series study

BMJ Global Health ◽

10.1136/bmjgh-2020-002948 ◽

2020 ◽

Vol 5 (10) ◽

pp. e002948

Author(s):

Safia S Jiwani ◽

Giovanna Gatica-Domínguez ◽

Inacio Crochemore-Silva ◽

Abdoulaye Maïga ◽

Shelley Walton ◽

...

Keyword(s):

Nutritional Status ◽

Adolescent Girls ◽

Overweight And Obesity ◽

Rate Of Change ◽

Capital City ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Adult Women ◽

Cross Sectional ◽

Sub Saharan

IntroductionEvidence on the rate at which the double burden of malnutrition unfolds is limited. We quantified trends and inequalities in the nutritional status of adolescent girls and adult women in sub-Saharan Africa.MethodsWe analysed 102 Demographic and Health Surveys between 1993 and 2017 from 35 countries. We assessed regional trends through cross-sectional series analyses and ran multilevel linear regression models to estimate the average annual rate of change (AARC) in the prevalence of underweight, anaemia, anaemia during pregnancy, overweight and obesity among women by their age, residence, wealth and education levels. We quantified current absolute inequalities in these indicators and wealth-inequality trends.ResultsThere was a modest decline in underweight prevalence (AARC=−0.14 percentage points (pp), 95% CI −0.17 to -0.11). Anaemia declined fastest among adult women and the richest pregnant women with an AARC of −0.67 pp (95% CI −1.06 to -0.28) and −0.97 pp (95% CI −1.60 to -0.34), respectively, although it affects all women with no marked disparities. Overweight is increasing rapidly among adult women and women with no education. Capital city residents had a threefold more rapid rise in obesity (AARC=0.47 pp, 95% CI 0.39, 0.55), compared with their rural counterparts. Absolute inequalities suggest that Ethiopia and South Africa have the largest gap in underweight (15.4 pp) and obesity (28.5 pp) respectively, between adult and adolescent women. Regional wealth inequalities in obesity are widening by 0.34 pp annually.ConclusionUnderweight persists, while overweight and obesity are rising among adult women, the rich and capital city residents. Adolescent girls do not present adverse nutritional outcomes except anaemia, remaining high among all women. Multifaceted responses with an equity lens are needed to ensure no woman is left behind.

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Coerced First Sex among Adolescent Girls in Sub-Saharan Africa: Prevalence and Context

African Journal of Reproductive Health ◽

10.2307/25549732 ◽

2007 ◽

Vol 11 (3) ◽

pp. 62 ◽

Cited By ~ 75

Author(s):

Ann M. Moore ◽

Kofi Awusabo-Asare ◽

Nyovani Madise ◽

Johannes John-Langba ◽

Akwasi Kumi-Kyereme

Keyword(s):

Adolescent Girls ◽

Sub Saharan Africa ◽

First Sex ◽

Sub Saharan

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Hearing from men in Eswatini: Shifts in HIV risk and service uptake—Findings from DREAMS implementation science research

10.31899/hiv16.1000 ◽

2021 ◽

Author(s):

Keyword(s):

Implementation Science ◽

Adolescent Girls ◽

Young Women ◽

Hiv Risk ◽

Large Scale ◽

Hiv Infections ◽

Science Research ◽

Sub Saharan Africa ◽

Engaging Men ◽

Sub Saharan

HIV prevention efforts across sub-Saharan Africa are increasingly focused on engaging men, for their own health and that of their partners and families. We examined whether and how HIV risk and protective factors are changing among men in Eswatini (formerly Swaziland)—a country with a substantial HIV burden. The study is part of the Population Council’s implementation science research portfolio on the DREAMS Partnership1, a large-scale initiative to reduce new HIV infections among adolescent girls and young women (AGYW) and their partners.

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