Trends and determinants of adolescent childbirth in Uganda- analysis of rural and urban women using six demographic and health surveys, 1988–2016

Amongin, Dinah; Beňová, Lenka; Nakimuli, Annettee; Nakafeero, Mary; Kaharuza, Frank; Atuyambe, Lynn; Hanson, Claudia

doi:10.1186/s12978-020-00925-8

Cited by 15 publications

(21 citation statements)

References 50 publications

(64 reference statements)

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“…In Uganda, where adolescents constitute 34.8% of the total population, the Ministry of Health prioritises adolescents’ health by improving access to contraceptives, professional care during childbirth, and postnatal care; however, uptake remains low [ 9 ]. The 2020 Uganda Demographic and Health Survey [ 10 ] reported that 24.8% of girls aged 15–19 had begun bearing children. Over 30.4% of 15–19-year-old girls who require contraceptives are unable to access such services, while 17.2% of adolescent girls die because of childbirth-related complications [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Barriers and strategies needed to improve maternal health services among pregnant adolescents in Uganda: a qualitative study

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Atuhaire

Namuli

et al. 2022

Global Health Action

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Background In Uganda, the uptake of maternal health services is very low, with only 41.1% of pregnant adolescent girls attending the eight antenatal visits that are recommended by the World Health Organisation. Uptake of maternal health services is essential in reducing the current level of adolescent pregnancies as well as its adverse effects on adolescent mothers and their babies, such as preterm deliveries, prolonged labour, death during pregnancy, and childbirth. No previous study has described pregnant adolescents’ experiences with maternal health services in Uganda. Objective This study aimed to describe the barriers and strategies needed to improve maternal health services among pregnant adolescents in Uganda. Methods Data were collected in the Naguru Teenage Information and Health Centre in Uganda through individual interviews involving 31 pregnant adolescents. The transcribed interviews were inductively analysed through content analysis. Results The pregnant adolescents described difficulty in reaching, as well as lack of financial support to visit, the Naguru Teenage Information and Health Centre, which is a clinic providing youth friendly services. Feelings of being discriminated against and disrespected by health workers, and lack of privacy when receiving health services was major barriers that hindered their access to maternal health services. Pregnant adolescents’ access to these services can be enhanced by improving health workers’ working conditions, accelerating community and health worker awareness on ways to mitigate these barriers, and developing policies that encourage men’s involvement in maternal health services. Conclusion Adolescents in Uganda face considerable barriers to accessing improved and quality maternal health services. To mitigate these barriers, according to the adolescents, considerable efforts are required to tackle health workers’ working conditions and sensitise the community on the importance of, as well as securing the availability of, maternal health services for pregnant adolescents. Future research should focus on pregnant adolescents who receive family support.

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Section: Introductionmentioning

confidence: 99%

Barriers and strategies needed to improve maternal health services among pregnant adolescents in Uganda: a qualitative study

Cumber

Atuhaire

Namuli

et al. 2022

Global Health Action

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“… 3 Tackling the unmet need for FP among adolescents is critical especially in LMICs because it has significant implications on their reproductive health and well-being. 5 Adolescent childbearing has been associated with multiple adverse health outcomes, 6 7 and the literature also shows several challenges of the motherhood transition period for adolescents, which leave them disempowered with feelings of shame and embarrassment. 8–10 Specifically, concern has been raised about the unmet need for FP among postpartum women.…”

Section: Introductionmentioning

confidence: 99%

“… 25 Unmet need for child spacing among women with adolescent births or repeat adolescent births have also been reported. 6 25 Lack of knowledge and access to general health services and youth-friendly FP care, in particular, are some of the key challenges affecting adolescent health in Uganda. 26 Evidence on the use of LAM in adolescents in LMICs are still scarce.…”

Section: Introductionmentioning

confidence: 99%

Knowledge and use of lactational amenorrhoea as a family planning method among adolescent mothers in Uganda: a secondary analysis of Demographic and Health Surveys between 2006 and 2016

et al. 2022

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ObjectiveTo assess the level of knowledge and use of the lactational amenorrhoea method (LAM) among adolescents in Uganda between 2006 and 2016 using nationally representative data from Demographic and Health Surveys (DHS).DesignCross-sectional design involving analysis of three DHS (2006, 2011, and 2016) in Uganda.SettingThe data collection took place in Uganda. The DHS are nationally representative surveys on a wide range of indicators including contraception knowledge and use.ParticipantsA total of 1948 (2006), 2026 (2011) and 4276 (2016) adolescents (15–19 years) and 1662 (2006), 1666 (2011) and 3782 (2016) young women (20–24 years) were included.Primary outcome measureUse of LAM among adolescents and young women with a live birth within 6 months before each survey.ResultsIn 2016, less than 1.0% (95% CI: 0.2% to 3.5%) of eligible adolescents correctly used LAM, and 56.3% (95% CI: 48.8% to 63.6%) were passively benefitting from LAM. The median duration of postpartum amenorrhoea (PPA) among adolescents in 2016 was 6.9 months, declining from 8.3 months in 2006. Compared with adolescents (56.7%), eligible young women had higher knowledge of LAM (64.1%) and higher median PPA duration (8.0 months) in 2016. The percentage of eligible adolescents who met the LAM criteria irrespective of whether they reported LAM use (were protected by LAM) decreased from 76.4% (95% CI: 66.5% to 84.0%) in 2006 to 57.2% (95% CI: 49.5% to 64.6%) in 2016. More than 50.0% (95% CI: 49.2% to 63.8%) of eligible adolescents were aware of LAM in 2016, increasing from 6.0% (95% CI: 2.5% to 13.8) in 2006.ConclusionDespite increasing awareness of LAM, reported and correct use of LAM was low among adolescents who could benefit from this method in Uganda, and declining over time. Support for adolescents to harness the benefits of correct LAM use should be increased. Additional research is needed to better understand the dynamics of LAM use in adolescents, including the transition to use of other modern contraceptive methods.

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“…Tackling the unmet need for FP among adolescents is critical especially in LMICs because it has significant implications on their reproductive health and wellbeing (Figaroa et al, 2020). Adolescent childbearing has been associated with multiple adverse health outcomes (Amongin et al, 2020a, Burke et al, 2018, and the literature also shows several challenges of the motherhood transition period for adolescents, which leave them disempowered with feelings of shame and embarrassment (Erfina et al, 2019, Mangeli et al, 2017, Watts et al, 2015. Specifically, concern has been raised about the unmet need for FP among postpartum women (Abraha et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

“…Evidence shows that over 40% of pregnancies among Ugandan adolescents are unintended (Nalwadda et al, 2019) and there is an increasing occurrence of repeat adolescent births (<20 years) estimated at 56%, with a prevalence of short-birth intervals of 5.4% (Amongin et al, 2020b). Unmet need for child spacing among women with adolescent births or repeat adolescent births has also been reported (Amongin et al, 2020a, Amongin et al, 2020b. Lack of knowledge and access to general health services and youth-friendly FP care, in particular, are some of the key challenges affecting adolescent health in Uganda (Atuyambe et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Knowledge and use of lactational amenorrhea as a family planning method among adolescent mothers in Uganda: a secondary analysis of Demographic and Health Surveys between 2006 and 2016

Birabwa

Bakkabulindi

et al. 2021

Preprint

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Objective: To assess the level of knowledge and use of lactational amenorrhea method (LAM) among adolescents in Uganda between 2006 and 2016 using nationally representative data from Demographic and Health Surveys (DHS). Design: Cross-sectional design involving analysis of three DHS (2006, 2011, and 2016) in Uganda. Setting: The data was collected in Uganda. The DHS are nationally representative surveys on a wide range of indicators including contraception knowledge and use. Participants: A total of 8,250 adolescents (15-19 years) and 7,110 young women (20-24 years) were included. Primary outcome measure: Use of LAM among adolescents and young women with a livebirth within six months before each survey. Results: In 2016, less than 1% of eligible adolescents correctly used LAM and 56% were passively benefitting from LAM. The median duration of postpartum amenorrhea (PPA) among adolescents in 2016 was 6.9 months, declining from 8.3 months in 2006. Compared to adolescents, eligible young women had higher knowledge of LAM and higher medianPPA duration in 2016. The percentage of eligible adolescents who met the LAM criteria irrespective of whether they reported LAM use (protected by LAM) decreased from 76% in 2006 to 57% in 2016. More than 50% of eligible adolescents were aware of LAM in 2016, increasing from 6% in 2006, potentially in part due to change in survey question. Conclusion: Despite increasing awareness of LAM, reported and correct use of LAM was low among adolescents who could benefit from this method in Uganda, and declining over time. Support for adolescents to harness the benefits of correct LAM use should be increased. Additional research is needed to better understand the dynamics of LAM use in adolescents, including the transition to use of other modern contraceptive methods.

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Trends and determinants of adolescent childbirth in Uganda- analysis of rural and urban women using six demographic and health surveys, 1988–2016

Cited by 15 publications

References 50 publications

Barriers and strategies needed to improve maternal health services among pregnant adolescents in Uganda: a qualitative study

Barriers and strategies needed to improve maternal health services among pregnant adolescents in Uganda: a qualitative study

Knowledge and use of lactational amenorrhoea as a family planning method among adolescent mothers in Uganda: a secondary analysis of Demographic and Health Surveys between 2006 and 2016

Knowledge and use of lactational amenorrhea as a family planning method among adolescent mothers in Uganda: a secondary analysis of Demographic and Health Surveys between 2006 and 2016

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