Impact of COVID-19 lockdowns on adolescent pregnancy and school dropout among secondary schoolgirls in Kenya

Abstract

IntroductionSecondary school closures aimed at limiting the number of infections and deaths due to COVID-19 may have amplified the negative sexual and reproductive health (SRH) and schooling outcomes of vulnerable adolescent girls. This study aimed to measure pandemic-related effects on adolescent pregnancy and school dropout among school-going girls in Kenya.MethodsWe report longitudinal findings of 910 girls in their last 2 years of secondary school. The study took place in 12 secondary day schools in rural western Kenya between 2018 and 2021. Using a causal-comparative design, we compared SRH and schooling outcomes among 403 girls who graduated after completion of their final school examinations in November 2019 pre-pandemic with 507 girls who experienced disrupted schooling due to COVID-19 and sat examinations in March 2021. Unadjusted and adjusted generalised linear mixed models were used to investigate the effect of COVID-19-related school closures and restrictions on all outcomes of interest and on incident pregnancy.ResultsAt study initiation, the mean age of participants was 17.2 (IQR: 16.4–17.9) for girls in the pre-COVID-19 cohort and 17.5 (IQR: 16.5–18.4) for girls in the COVID-19 cohort. Girls experiencing COVID-19 containment measures had twice the risk of falling pregnant prior to completing secondary school after adjustment for age, household wealth and orphanhood status (adjusted risk ratio (aRR)=2.11; 95% CI:1.13 to 3.95, p=0.019); three times the risk of school dropout (aRR=3.03; 95% CI: 1.55 to 5.95, p=0.001) and 3.4 times the risk of school transfer prior to examinations (aRR=3.39; 95% CI: 1.70 to 6.77, p=0.001) relative to pre-COVID-19 learners. Girls in the COVID-19 cohort were more likely to be sexually active (aRR=1.28; 95% CI: 1.09 to 1.51, p=0.002) and less likely to report their first sex as desired (aRR=0.49; 95% CI: 0.37 to 0.65, p<0.001). These girls reported increased hours of non-school-related work (3.32 hours per day vs 2.63 hours per day in the pre-COVID-19 cohort, aRR=1.92; 95% CI: 1.92 to 2.99, p=0.004). In the COVID-19 cohort, 80.5% reported worsening household economic status and COVID-19-related stress was common.ConclusionThe COVID-19 pandemic deleteriously affected the SRH of girls and amplified school transfer and dropout. Appropriate programmes and interventions that help buffer the effects of population-level emergencies on school-going adolescents are warranted.Trial registration numberNCT03051789.

Returning to school after COVID-19 closures: Who is missing in Malawi?

“…Moreover, a Nigerian study found that dropout increased with age, and noted stronger effects for girls in a region with higher child marriage rates ( Dessy et al, 2021 ). Similarly, the Kenyan study that documented increased pregnancy and dropout focused on female students in their last two years of secondary school ( Zulaika et al, 2022 ).…”

“…A longitudinal study compared girls who were expected to complete secondary school just before the pandemic (2019) to those expected to complete schooling just after the pandemic (2021). They found that Kenyan girls who experienced COVID-19 closures were twice as likely to report a pregnancy and three times as likely to dropout ( Zulaika et al, 2022 ).…”

Adolescent well-being during the COVID-19 pandemic in India

“…21 Across low and middle income countries, including India, there has been a growing number of programs and interventions targeting these perceptions and attitudes in an effort to improve health and educational outcomes during and after adolescence. 10,12,16,20 Investing in building positive and equitable gender attitudes, and growing voice, agency, self-efficacy and locus of control are key mechanisms to ensuring that adolescents eventually become educated, healthy, and prosperous adults. 9,23,24 The findings of this study are especially useful as the world moves out of the peak and deadliest phase of the COVID-19 pandemic.…”

“…15 In a recent study conducted by Zulaika et al adolescent girls in Kenya who remained out of school for longer than six months due to the COVID-19 outbreak, twice as likely to become pregnant and three times as likely to drop out of school than those girls that graduated prior to 2020. 16 While it may take many years, and many studies to fully understand the sequelae of the COVID-19 pandemic in India (and around the world), prior research shows a consistent link to the pandemic and inequalities when it comes to girls and women. It is evident that experiences from pandemics and large-scale crises often affect men and women differently.…”

Nowcasting the Impact of Covid-19 on Education, Intergenerational Mobility and Earnings Inequality in Sub-Saharan Africa

“…In Malawi, for instance, an 11% increase in teenage pregnancies was recorded from January to August 2020 compared to the same period in 2019 (UNFPA, 2021). Scientific studies document a dramatic rise in the risk of young girls becoming pregnant, for instance, in Kenya (Zulaika et al, 2022), Nigeria (Musa et al, 2021) and other African countries (see the review by Willie, 2021).…”