Socio-demographic determinants of pregnancy termination among adolescent girls and young women in selected high fertility countries in sub-Saharan Africa

Abstract

Background Most of the unintended pregnancies that occur among adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA) end up in pregnancy termination. In this study, the socio-demographic determinants of pregnancy termination among AGYW (aged 15–24) in selected countries with high fertility rates in SSA were examined. Methods This was a cross-sectional analysis of data from the most recent Demographic and Health Surveys of nine countries in SSA. The countries included are Angola, Burkina Faso, Burundi, Chad, Gambia, Mali, Niger, Nigeria, and Uganda. A total of 62,747 AGYW constituted the sample size for the study. Fixed and random effects models were used to examine the determinants of pregnancy termination with statistical significance at p < 0.05. Results Higher odds of pregnancy termination were found among AGYW aged 20–24, those who were cohabiting and married, those who listened to radio and watched television at least once a week and those who lived in communities with high literacy level. Conversely, the odds of pregnancy termination were lower among AGYW with three or more births and those with secondary/higher education. Conclusion The socio-demographic determinants of pregnancy termination among AGYW in this study were age, level of education, marital status, exposure to radio and television, parity, and community literacy level. The findings provide the needed information for designing health interventions to reduce unwanted pregnancies and unsafe abortions in countries with high fertility rates in SSA. It is recommended that governments and non-governmental organisations in these countries should enhance sexuality education and regular sensitization of adolescent sexual and reproductive health programmes targeted at AGYW who are at risk of pregnancy termination.

Pooled prevalence and associated factors of pregnancy termination among youth aged 15–24 year women in East Africa: Multilevel level analysis

“…Ethiopia 5.26% [95% CI: 4.39, 6.16].The finding was significantly greater than previous studies in Ethiopia (2.5%) [24], Nigeria (5.8%) [27], Sub-Saharan Africa (5%) [28]. This finding was lower than studies in Democratic Republic of Congo [29], Gabon (34%) [30], and Cote D'lvoire (16.1%) [30].…”

“…The objective of this study was to examine the pooled prevalence and factors that affect pregnancy termination in 12 East African countries from 2008 to 2018 using data from recent Demographic and Health Surveys. The pooled prevalence of pregnancy termination in East African countries was 7.79% [95% CI: 7.54, 8.04] with the highest pregnancy termination in Uganda 12.51% [95% CI: 11.56, 13.41] and the lowest pregnancy termination was observed in Ethiopia 5.26% [95% CI: 4.39, 6.16].The finding was significantly greater than previous studies in Ethiopia (2.5%) [ 24 ], Nigeria (5.8%) [ 27 ], Sub-Saharan Africa (5%) [ 28 ]. This finding was lower than studies in Democratic Republic of Congo [ 29 ], Gabon (34%) [ 30 ], and Cote D’lvoire (16.1%) [ 30 ].…”

“…This is consistent with studies in China [ 39 ], Burkina Faso [ 40 ], and Nepal [ 16 ]. The possible explanations might be women with a higher level of education are more likely to use contraception to prevent unwanted pregnancies that are more common and can lead to pregnancy termination [ 28 , 41 ].…”

Factors associated with pregnancy termination in women of childbearing age in 36 low-and middle-income countries

“…Eligible survey-respondent women were asked whether they had pregnancy termination, which was measured using self-reported questionnaires such as: "have you ever had a pregnancy terminated?" The binary response of pregnancy termination (yes/no) was used as our dependent variable in a manner similar to previous publications using DHS data [9,12].…”

“…Such knowledge will guide the prioritization of intervention strategies to the most at-risk countries in LMICs and assist healthcare professionals and stakeholders to adequately identify potential reasons for the high prevalence of pregnancy termination. However, these estimates are lacking because most previous studies that have examined pregnancy termination in LMICs have either focused mainly on an individual country such as Ghana [10] and Ethiopia [11] or selected countries in sub-Saharan Africa (SSA) [9,12] and yield inconsistent results using Demographic and Health Surveys data (DHS). To the best of our knowledge, there is currently no study that has examined the prevalence and factors associated with pregnancy termination in combined LMICs (SSA, North Africa, and South and Southeast Asia) and how these estimates vary across regions and countries.…”