The prevalence of pregnancy among adolescent girls and young women across the Southern African development community economic hub: A systematic review and meta-analysis

Yah, Clarence S.; Ndlovu, Sithembiso; Kutywayo, Alison; Naidoo, Nicolette; Mahuma, Tshepo; Mullick, Saiqa

doi:10.34172/hpp.2020.51

Cited by 24 publications

(22 citation statements)

References 62 publications

(153 reference statements)

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“…Utilising data from a large prospective cohort study of adolescents living with HIV and a comparison group of adolescents not living with HIV within South Africa, this study explores the prevalence of probable common mental disorder according to experience of motherhood and, the syndemic of adolescent motherhood and HIV. The prevalence of adolescent motherhood was 15.2% (a figure in line with current national estimates) [21] and, over a tenth (10.9%) were classified as reporting probable common mental disorder (either depression, anxiety, posttraumatic stress, or suicidality symptomology). These prevalence data indicate a need for attention to both adolescent mental health and particularly within the context of adolescent motherhood.…”

Section: Discussionsupporting

confidence: 80%

“…South Africa has one of the highest rates of adolescent pregnancy (10–19 years) in the world—recent estimates suggest that 19% (95% confidence interval: 16–22%) of female adolescents have experienced pregnancy [ 21 ]. In addition to navigating a broad development period, denoted by substantial psychological, social and, biological changes, pregnant and parenting adolescents (both adolescent mothers and fathers) must also traverse pregnancy, parenting, and childrearing.…”

Section: Introductionmentioning

confidence: 99%

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Adolescent Motherhood and HIV in South Africa: Examining Prevalence of Common Mental Disorder

et al. 2021

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The mental health of adolescents (10–19 years) remains an overlooked global health issue, particularly within the context of syndemic conditions such as HIV and pregnancy. Rates of pregnancy and HIV among adolescents within South Africa are some of the highest in the world. Experiencing pregnancy and living with HIV during adolescence have both been found to be associated with poor mental health within separate explorations. Yet, examinations of mental health among adolescents living with HIV who have experienced pregnancy/parenthood remain absent from the literature. As such, there exists no evidence-based policy or programming relating to mental health for this group. These analyses aim to identify the prevalence of probable common mental disorder among adolescent mothers and, among adolescents experiencing the syndemic of motherhood and HIV. Analyses utilise data from interviews undertaken with 723 female adolescents drawn from a prospective longitudinal cohort study of adolescents living with HIV (n = 1059) and a comparison group of adolescents without HIV (n = 467) undertaken within the Eastern Cape Province, South Africa. Detailed study questionnaires included validated and study specific measures relating to HIV, adolescent motherhood, and mental health. Four self-reported measures of mental health (depressive, anxiety, posttraumatic stress, and suicidality symptomology) were used to explore the concept of likely common mental disorder and mental health comorbidities (experiencing two or more common mental disorders concurrently). Chi-square tests (Fisher’s exact test, where appropriate) and Kruskal Wallis tests were used to assess differences in sample characteristics (inclusive of mental health status) according to HIV status and motherhood status. Logistic regression models were used to explore the cross-sectional associations between combined motherhood and HIV status and, likely common mental disorder/mental health comorbidities. 70.5% of participants were living with HIV and 15.2% were mothers. 8.4% were mothers living with HIV. A tenth (10.9%) of the sample were classified as reporting a probable common mental disorder and 2.8% as experiencing likely mental health comorbidities. Three core findings emerge: (1) poor mental health was elevated among adolescent mothers compared to never pregnant adolescents (measures of likely common mental disorder, mental health comorbidities, depressive, anxiety and suicidality symptoms), (2) prevalence of probable common mental disorder was highest among mothers living with HIV (23.0%) compared to other groups (Range:8.5–12.8%; Χ2 = 12.54, p = 0.006) and, (3) prevalence of probable mental health comorbidities was higher among mothers, regardless of HIV status (HIV & motherhood = 8.2%, No HIV & motherhood = 8.2%, Χ2 = 14.5, p = 0.002). Results identify higher mental health burden among adolescent mothers compared to never-pregnant adolescents, an increased prevalence of mental health burden among adolescent mothers living with HIV compared to other groups, and an elevated prevalence of mental health comorbidities among adolescent mothers irrespective of HIV status. These findings address a critical evidence gap, highlighting the commonality of mental health burden within the context of adolescent motherhood and HIV within South Africa as well as the urgent need for support and further research to ensure effective evidence-based programming is made available for this group. Existing antenatal, postnatal, and HIV care may provide an opportunity for mental health screening, monitoring, and referral.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Adolescent Motherhood and HIV in South Africa: Examining Prevalence of Common Mental Disorder

et al. 2021

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“…It should be guided with appropriate education, especially as it also represents a key factor in the attainment of sustainable developmental goals. It is estimated that over 21 million adolescents aged 15–19 years get pregnant annually in low economies [ 1 – 3 ]. At the same time, over 50% of them give birth, excluding additional 777,000 adolescents that are less than 15 years who give birth in developing countries [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Exposure to Sex Education and Its Effects on Adolescent Sexual Behavior in Nigeria

Osadolor

Amoo

Azuh

et al. 2022

Journal of Environmental and Public Health

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Sexual behavior during adolescence fundamentally steers the future life of both girls and boys, and it should be guided with appropriate education, especially as it also represents a key factor to be considered in attainment of sustainable developmental goals. The study assessed the effect of exposure to sex education on adolescents’ sexual behavior. The primary and cross-sectional survey data used for this study were analyzed using basic descriptive statistics and binary logistic regression analytical technique. The results, among others, highlighted that the most common sources of first sex education among the respondents are school (54.6%), family (21.6%), social media (9.5%), and others like television (7.6%) and books or magazines (4.9%). Frequency of discussion on sexual matters is positively associated with the use of protection such as condom (β = 0.261; p ≤ 0.01 ). The study gave support to the increasing pursuit of sexuality education. However, since adolescents’ needs could vary by demographics, streamlining sex education need by age and sex characteristics could enhance its effectiveness.

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“…Within South Africa, almost a fifth of female adolescents have experienced pregnancy (19%; 95% confidence intervals 16%-22%)–one of the highest prevalence rates of adolescent pregnancy in the world [ 12 ]. This high rate of adolescent pregnancy is set against a backdrop of the world’s largest HIV epidemic in which approximately a fifth of the population (15+ years) within South Africa are living with HIV [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Adolescent mothers and their children affected by HIV—An exploration of maternal mental health, and child cognitive development

Roberts

Smith²,

Cluver³

et al. 2022

PLoS ONE

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Background Some children born to adolescent mothers may have developmental challenges, while others do not. Research focusing on which children of adolescent mothers are at the highest risk for cognitive delay is still required. Both maternal HIV status and maternal mental health may affect child development. An examination of maternal mental health, especially in the presence of maternal HIV infection may be timely. This study explores the relationship between the mental health of adolescent mothers (comparing those living with and not living with HIV) and the cognitive development performance scores of their children. Additional possible risk and protective factors for poor child development are explored to identify those children born to adolescent mothers who may be at the greatest risk of poor cognitive development. Methods Cross-sectional data utilised within the analyses was drawn from a large cohort of adolescent mothers and their children residing in South Africa. Detailed study questionnaires were completed by adolescent mothers relating to their self and their child and, standardised cognitive assessments were completed by trained researchers for all children using in the Mullen Scales of Early Learning. Chi-square, t-tests (Kruskal Wallis tests, where appropriate), and ANOVA were used to explore sample characteristics and child cognitive development scores by maternal mental health status (operationalised as likely common mental disorder) and combined maternal mental health and HIV status. Multivariable linear regression models were used to explore the relationship between possible risk factors (including poor maternal mental health and HIV) and, child cognitive development scores. Results The study included 954 adolescent mothers; 24.1% (230/954) were living with HIV, 12.6% (120/954) were classified as experiencing likely common mental disorder. After adjusting for covariates, maternal HIV was found to be associated with reduced child gross motor scores (B = -2.90 [95%CI: -5.35, -0.44], p = 0.02), however, no other associations were identified between maternal likely common mental disorder, or maternal HIV status (including interaction terms), and child cognitive development scores. Sensitivity analyses exploring individual maternal mental health scales identified higher posttraumatic stress symptomology scores as being associated with lower child cognitive development scores. Sensitivity analyses exploring potential risk and protective factors for child cognitive development also identified increased maternal educational attainment as being protective of child development scores, and increased child age as a risk factor for lower development scores. Conclusions This study addresses a critical evidence gap relating to the understanding of possible risk factors for the cognitive development of children born to adolescent mothers affected by HIV. This group of mothers experience a complex combination of risk factors, including HIV, likely common mental disorder, and structural challenges such as educational interruption. Targeting interventions to support the cognitive development of children of adolescent mothers most at risk may be of benefit. Clearly a basket of interventions needs to be considered, such as the integration of mental health provision within existing services, identifying multiple syndemics of risk, and addressing educational and structural challenges, all of which may boost positive outcomes for both the mother and the child.

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The prevalence of pregnancy among adolescent girls and young women across the Southern African development community economic hub: A systematic review and meta-analysis

Cited by 24 publications

References 62 publications

Adolescent Motherhood and HIV in South Africa: Examining Prevalence of Common Mental Disorder

Adolescent Motherhood and HIV in South Africa: Examining Prevalence of Common Mental Disorder

Exposure to Sex Education and Its Effects on Adolescent Sexual Behavior in Nigeria

Adolescent mothers and their children affected by HIV—An exploration of maternal mental health, and child cognitive development

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