Predictors of Teenage Pregnancy in Zambia Between 2007-2018
Abstract Background: In Zambia, 29% of adolescents aged 10-19 have begun childbearing. Early childbearing has been shown to have detrimental social and medical outcomes. As far as we are aware, there has been no study in Zambia that has investigated the drivers of teenage pregnancies over a 10-year period. Using DHS data, we sought to determine predictors of teenage pregnancies among teenagers in Zambia between the years of 2007 and 2018. Methods: We analyzed survey data of 11,194 adolescents from the 2007, 2014 and 2018 Demographic and Health Surveys (DHS), which are nationally representative. Analyses were conducted with Stata/SE software and we examined rates of teenage pregnancy based on multiple predictors of interest. Chi-square tests and multivariable logistic regression models were employed for statistical comparison using a p-value of 0.05 to indicate statistical significance. Results:After exclusions, 11,194 adolescents under the age of 19 were included in our analysis, with a 29% prevalence of teenage pregnancy. Teenagers were more likely to become pregnant if they were married, had younger sexual debut, had less education, were illiterate, lived in rural areas, or were of the poorest wealth index than if they were not. Among adolescents with teenage pregnancies, utilization of sexual and reproductive health services among teen mothers significantly increased between 2007 and 2018. On multivariate analysis, teenage pregnancy was found to be significantly different given predictors when compared to the reference group, with significant effect modification due to marital status. Conclusion: Our study identified significant demographic, intrapersonal, and socioeconomic factors that have impacted rates of teenage pregnancy in Zambia over the past 10 years. Understanding these drivers can inform programmatic interventions targeting reduction of teenage pregnancies.