Adolescent childbearing trends and sub-national variations in Ethiopia: a pooled analysis of data from six surveys

Abstract

BackgroundEthiopia houses the second largest population of female adolescents in Africa. Adolescent childbearing can have detrimental effect to the health and wellbeing of women and their offspring. This study examined trends, sub-national variations and determinants of early childbearing (i.e. childbearing before age 20) in Ethiopia.MethodsData from the 2000–2011 Ethiopia Demographic and Health Surveys and from the 2014–2016 Performance Monitoring and Accountability surveys were pooled for this analysis. Based on the year the women reached puberty, five different cohorts were reconstructed that date back to the early 1970s. Kaplan-Meier methodology was used to estimate the cumulative probability of early childbearing and a Cox proportional hazard regression model to examine the associated factors.ResultsThe cumulative probability of early childbearing declined by approximately two-fifth in the past four decades, from 57.6 to 35.3%. The occurrence of early childbearing varies substantially by region. In the most recent period, it ranged from 9.6% in Addis Ababa to 59% in Benishangul-Gumuz. Early childbearing risk was reduced by 95% for women who did not marry before the age of 20 years compared to those who married before the age of 18 years. For adolescents who married at the age of 18 and 19 years, early childbearing risk decreased by 60 and 78%, respectively. During the same period, there was a parallel decline in the cumulative probability of early marriage (i.e., before the legal age of 18 years) from 55.3 to 28.7%. Compared with adolescents with no education, those with elementary and secondary or higher education had a 50 and 82% lower risk of early childbearing, respectively.ConclusionsEarly childbearing declined in Ethiopia, largely driven by a parallel reduction in early marriage. However, a large portion of adolescents are still facing early childbearing, and the situation is more dismal in some regions than others. A further reduction in early childbearing is warranted by enforcing the law on the minimum marriage age and expanding secondary and higher education for females. These efforts should give greater emphasis to regions where early childbearing is markedly high.

Spatial distribution and associated factors’ of Early Marriage among Reproductive age women in Ethiopia: A Secondary Data Analysis of Ethiopian Demographic and Health Survey 2016.

“…The possible justi cation of a high proportion of early marriage in Amahara, Afar, and Gambela region might be deep-rooted traditions such as, considering marriage as a success for the girl and her family, ensuring the virginity of the girl when she marries, the concern that the girl will become too old for marriage, and creating a bond with the bridegroom's family (13) This study evidenced that, as the age of mothers increases the likelihood to have an early marriage decreases. This nding is consistent with studies conducted in Ethiopia (28,29). The possible justi cation might be with young women who had married at ages <20, those married before age 20 were less likely to have known about the disadvantage of early marriage because of teenage (30).…”

Time to first birth and its Predictors among reproductive-age women in Ethiopia: inverse Weibull gamma shared frailty model

“…Regarding region of residence Oromia, SNNP, Eastern pastoralist and western semi-pastoralist regions significantly increased the hazard of first birth at an early age compared to most urban regions (Addis Ababa, Dire Dawa, and Harare), controlling for other factors and holding cluster effect the same. This finding was coherent with the study reported in Ethiopia (60) and Ghana (31).This might be due to fewer proportions of educated women, and access to contraceptive and reproductive health issues in rural regions (28). Furthermore, women in rural regions might have less decision making role regarding their reproductive health and timing of first birth.…”

“…Most of the studies revealed that having poor and middle wealth index status was identified as the risk of age at first birth in early age (24,(30)(31)(32)(35)(36)(37)41,44). (5,6,(33)(34)(35)(36)(37)(38)9,14,17,20,21,25,30,31). The majority works of the literature revealed that the use of any contraception delay age at first birth (5,8,9,20,30,31,34,39,40) On the other hand, advanced maternal age (> 30 years) at first birth is associated with an increased risk of fetal loss, chromosomal anomalies, multiple pregnancies, hypertension, diabetes mellitus, preterm birth, low birth weight, breast cancer and maternal mortality (16,22,23).…”

Spatial distribution and associated factors’ of Early Marriage among Reproductive age women in Ethiopia: A Secondary Data Analysis of EDHS 2016.

“…The possible justi cation of a high proportion of early marriage in Amahara, Afar and Gambela region might be deep-rooted traditions such as, considering marriage as a success for the girl and her family, ensuring virginity of the girl when she marries, the concern that the girl will become too old for marriage, and creating a bond with the bridegroom's family (13) This study evidenced that, as the age of mothers increases the likelihood to have an early marriage decreases. This nding is consistent with studies conducted in Ethiopia (27,28). The possible justi cation might be with young women who had married at ages <20, those married before age 20 were less likely to have known about the disadvantage of early marriage because of teenage (29).…”