Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Reproductive Health
Published in: Reproductive Health 1/2018

Open Access 01-12-2018 | Review

Determinants of adolescent pregnancy in sub-Saharan Africa: a systematic review

Authors: Ibrahim Yakubu, Waliu Jawula Salisu

Published in: Reproductive Health | Issue 1/2018

Login to get access

Abstract

Background

Adolescent pregnancy has been persistently high in sub-Saharan Africa. The objective of this review is to identify factors influencing adolescent pregnancies in sub-Saharan Africa in order to design appropriate intervention program.

Methods

A search in MEDLINE, Scopus, Web of science, and Google Scholar databases with the following keywords: determinants, factors, reasons, sociocultural factors, adolescent pregnancy, unintended pregnancies, and sub- Saharan Africa. Qualitative and cross-sectional studies intended to assess factors influencing adolescent pregnancies as the primary outcome variable in sub- Saharan Africa were included. Our search was limited to, articles published from the year 2000 to 2017 in English. Twenty-four (24) original articles met the inclusion criteria.

Results

The study identified Sociocultural, environmental and Economic factors (Peer influence, unwanted sexual advances from adult males, coercive sexual relations, unequal gender power relations, poverty, religion, early marriage, lack of parental counseling and guidance, parental neglect, absence of affordable or free education, lack of comprehensive sexuality education, non-use of contraceptives, male’s responsibility to buy condoms, early sexual debut and inappropriate forms of recreation). Individual factors (excessive use of alcohol, substance abuse, educational status, low self-esteem, and inability to resist sexual temptation, curiosity, and cell phone usage). Health service-related factors (cost of contraceptives, Inadequate and unskilled health workers, long waiting time and lack of privacy at clinics, lack of comprehensive sexuality education, misconceptions about contraceptives, and non-friendly adolescent reproductive services,) as influencing adolescent pregnancies in Sub-Saharan Africa

Conclusion

High levels of adolescent pregnancies in Sub-Saharan Africa is attributable to multiple factors. Our study, however, categorized these factors into three major themes; sociocultural and economic, individual, and health service related factors as influencing adolescent pregnancies. Community sensitization, comprehensive sexuality education and ensuring girls enroll and stay in schools could reduce adolescent pregnancy rates. Also, provision of adolescent-friendly health services in schools and healthcare centers and initiating adolescent empowerment programs could have a positive impact.
Literature
1.
Browne AW, Barrett HR. Female education in sub-Saharan Africa: the key to development? Comp Educ. 1991;27(3):275–85.CrossRef
2.
3.
Phillips SJ, Mbizvo MT. Empowering adolescent girls in sub-Saharan Africa to prevent unintended pregnancy and HIV: a critical research gap. Int J Gynaecol Obstet. 2016;132(1):1–3.PubMedCrossRef
4.
5.
Ganchimeg T, Ota E, Morisaki N, Laopaiboon M, Lumbiganon P, Zhang J, et al. Pregnancy and childbirth outcomes among adolescent mothers: a World Health Organization multi-country study. BJOG. 2014;121(Suppl 1):40–8.PubMedCrossRef
6.
Chandra-Mouli V, Camacho AV, Michaud P-A. WHO guidelines on preventing early pregnancy and poor reproductive outcomes among adolescents in developing countries. J Adolesc Health. 2013;52(5):517–22.PubMedCrossRef
7.
Horgan RP, Kenny LC. Management of teenage pregnancy. Obstet Gynaecol. 2007;9(3):153–8.
8.
Officials NAoCCH. Meeting the needs of pregnant and parenting teens. Washington: Local Health Department Programs and Services; 2009.
9.
Hodgkinson S, Beers L, Southammakosane C, Lewin A. Addressing the mental health needs of pregnant and parenting adolescents. Pediatrics. 2014;133(1):114–22.PubMedPubMedCentralCrossRef
10.
Atuyambe L, Mirembe F, Johansson A, Kirumira EK, Faxelid E. Experiences of pregnant adolescents--voices from Wakiso district, Uganda. Afr Health Sci. 2005;5(4):304–9.PubMedPubMedCentral
11.
Aransiola JO, Asa S, Obinjuwa P, Olarewaju O, Ojo OO, Fatusi AO. Teachers' perspectives on sexual and reproductive health interventions for in-school adolescents in Nigeria. Afr J Reprod Health. 2013;17(4):84–92.PubMed
12.
Warenius L, Pettersson KO, Nissen E, Höjer B, Chishimba P, Faxelid E. Vulnerability and sexual and reproductive health among Zambian secondary school students. Cult Health Sex. 2007;9(5):533–44.PubMedCrossRef
13.
Ahorlu CK, Pfeiffer C, Obrist B. Socio-cultural and economic factors influencing adolescents' resilience against the threat of teenage pregnancy: a cross-sectional survey in Accra, Ghana. Reprod Health. 2015;12:117.PubMedPubMedCentralCrossRef
14.
Kumi-Kyereme A, Awusabo-Asare K, Darteh EK. Attitudes of gatekeepers towards adolescent sexual and reproductive health in Ghana. Afr J Reprod Health. 2014;18(3):142–53.PubMed
15.
Mushwana L, Monareng L, Richter S, Muller H. Factors influencing the adolescent pregnancy rate in the Greater Giyani municipality, Limpopo Province - South Africa. Int J Afr Nurs Sci. 2015;2:10–8.
16.
A Yidana, SD Ziblim, TB Azongo, Abass YI. Socio-cultural determinants of contraceptives use among adolescents in northern Ghana. Public Health Res. 2015;5(4):83–89.
17.
Adinma JI, Agbai AO, Okeke AO, Okaro JM. Contraception in teenage Nigerian school girls. Adv Contracept. 1999;15(4):283–91.PubMedCrossRef
18.
Ahlberg BM, Jylkas E, Krantz I. Gendered construction of sexual risks: implications for safer sex among young people in Kenya and Sweden. Reprod Health Matters. 2001;9(17):26–36.PubMedCrossRef
19.
Atuyambe LM, Kibira SP, Bukenya J, Muhumuza C, Apolot RR, Mulogo E. Understanding sexual and reproductive health needs of adolescents: evidence from a formative evaluation in Wakiso district, Uganda. Reprod Health. 2015;12:35.PubMedPubMedCentralCrossRef
20.
Atuyambe L, Mirembe F, Annika J, Kirumira EK, Faxelid E. Seeking safety and empathy: adolescent health seeking behavior during pregnancy and early motherhood in central Uganda. J Adolesc. 2009;32(4):781–96.PubMedCrossRef
21.
Adekunle AO, Arowojolu AO, Adedimeji AA, Roberts OA. Adolescent contraception: survey of attitudes and practice of health professionals. Afr J Med Med Sci. 2000;29(3-4):247–52.PubMed
22.
Abdul-Rahman L, Marrone G, Johansson A. Trends in contraceptive use among female adolescents in Ghana. Afr J Reprod Health. 2011;15(2):45–55.PubMed
23.
Krugu JK, Mevissen FE, Prinsen A, Ruiter RA. Who's that girl? A qualitative analysis of adolescent girls' views on factors associated with teenage pregnancies in Bolgatanga, Ghana. Reprod Health. 2016;13:39.PubMedPubMedCentralCrossRef
24.
The Joanna Briggs Institute. Joanna Briggs institute reviewers’ manual. 2011.
25.
Sedgh G, Finer LB, Bankole A, Eilers MA, Singh S. Adolescent pregnancy, birth, and abortion rates across countries: levels and recent trends. J Adolesc Health. 2015;56(2):223–30.PubMedPubMedCentralCrossRef
26.
Gyan C. The effects of teenage pregnancy on the educational attainment of girls at Chorkor, a suburb of Accra. J Educ Soc Res. 2013;3(3):53.
27.
Hokororo A, Kihunrwa AF, Kalluvya S, Changalucha J, Fitzgerald DW, Downs JA. Barriers to access reproductive health care for pregnant adolescent girls: a qualitative study in Tanzania. Acta Paediatrica (Oslo, Norway: 1992). 2015;104(12):1291–7.CrossRef
28.
McCleary-Sills J, Douglas Z, Rwehumbiza A, Hamisi A, Mabala R. Gendered norms, sexual exploitation and adolescent pregnancy in rural Tanzania. Reprod Health Matters. 2013;21(41):97–105.PubMedCrossRef
29.
Silberschmidt M, Rasch V. Adolescent girls, illegal abortions and "sugar-daddies" in Dar es salaam: vulnerable victims and active social agents. Soc Sci Med. 2001;52(12):1815–26.PubMedCrossRef
30.
Wood K, Jewkes R. Blood blockages and scolding nurses: barriers to adolescent contraceptive use in South Africa. Reprod Health Matters. 2006;14(27):109–18.PubMedCrossRef
31.
Wood L, Hendricks F. A participatory action research approach to developing youth-friendly strategies for the prevention of teenage pregnancy. Educ Action Res. 2017;25(1):103–18.CrossRef
32.
Yidana A, Ziblim SD, Azongo TB, Abass YI. Socio-cultural determinants of contraceptives use among adolescents in northern Ghana. Public Health Res. 2015;5(4):83–9.
33.
Adzitey SP, Adzitey F, Suuk L. Teenage pregnancy in the Builsa District: a focus study in Fumbisi. 2011.
34.
Alhassan E. Early pregnancy of junior high school girls: causes and implications on academic progression in the Talensi District of the upper east region of Ghana. UDS Int J Dev. 2015;2(2):47–59.
35.
Jewkes R, Vundule C, Maforah F, Jordaan E. Relationship dynamics and teenage pregnancy in South Africa. Soc Sci Med. 2001;52(5):733–44.PubMedCrossRef
36.
Lambani MN. Poverty the cause of teenage pregnancy in Thulamela municipality. 2015.
37.
Marston M, Beguy D, Kabiru C, Cleland J. Predictors of sexual debut among young adolescents in Nairobi's informal settlements. Int Perspect Sex Reprod Health. 2013;39(1):22–31.PubMedPubMedCentralCrossRef
38.
McHunu G, Peltzer K, Tutshana B, Seutlwadi L. Adolescent pregnancy and associated factors in south African youth. Afr Health Sci. 2012;12(4):426–34.PubMedPubMedCentral
39.
Ogori AF, Ajeya SHiTU fatima, Yunusa AR. The cause and effect of teenage pregnancy: case of Kontagora local government area in Niger state, northern part of Nigeria. J Educ Res 2013;Vol. 1,( No. 7): 01-15.
40.
Okigbo CC, Speizer IS. Determinants of sexual activity and pregnancy among unmarried young women in urban Kenya: a cross-sectional study. PLoS One. 2015;10(6):e0129286.PubMedPubMedCentralCrossRef
41.
42.
Taffa N, Omollo D, Matthews Z. Teenage pregnancy experiences in rural Kenya. Int J Adolesc Med Health. 2003;15(4):331–40.PubMed
43.
Tilahun M, Mengistie B, Egata G, Reda AA. Health workers' attitudes toward sexual and reproductive health services for unmarried adolescents in Ethiopia. Reprod Health. 2012;9:19.PubMedPubMedCentralCrossRef
44.
Warenius LU, Faxelid EA, Chishimba PN, Musandu JO, Ong'any AA, Nissen EB. Nurse-midwives' attitudes towards adolescent sexual and reproductive health needs in Kenya and Zambia. Reprod Health Matters. 2006;14(27):119–28.PubMedCrossRef
45.
Were M. Determinants of teenage pregnancies: the case of Busia District in Kenya. Econ Hum Biol. 2007;5(2):322–39.PubMedCrossRef
46.
Mngadi PT, Zwane IT, Ahlberg BM, Ransjo-Arvidson AB. Family and community support to adolescent mothers in Swaziland. J Adv Nurs. 2003;43(2):137–44.PubMedCrossRef
47.
worldatlas. Highest Teen Pregnancy Rates Worldwide. In: Dillinger J, editor. 2017.
48.
Fearon E, Wiggins RD, Pettifor AE, Hargreaves JR. Is the sexual behaviour of young people in sub-Saharan Africa influenced by their peers? A systematic review. Soc Sci Med. 2015;146:62–74.PubMedCrossRef
49.
Silk J, Romero D. The role of parents and families in teen pregnancy prevention. J Fam Issues. 2014;35(10):1339–62.CrossRef
50.
Cavazos-Rehg PA, Krauss MJ, Spitznagel EL, Schootman M, Bucholz KK, Peipert JF, et al. Age of sexual debut among US adolescents. Contraception. 2009;80(2):158–62.PubMedPubMedCentralCrossRef
51.
Lohman BJ, Billings A. Protective and risk factors associated with adolescent boys’ early sexual debut and risky sexual behaviors. J Youth Adolesc. 2008;37(6):723.CrossRef
52.
Mott FL, Fondell MM, Hu PN, Kowaleski-Jones L, Menaghan EG. The determinants of first sex by age 14 in a high-risk adolescent population. Fam Plan Perspect. 1996;28(1):13–8.CrossRef
53.
Parsons J, Edmeades J, Kes A, Petroni S, Sexton M, Wodon Q. Economic impacts of child marriage: a review of the literature. Review Faith Int Affairs. 2015;13(3):12–22.CrossRef
54.
Ebeigbe PN, Gharoro EP. Obstetric complications, intervention rates and maternofetal outcome in teenage nullipara in Benin City, Nigeria. Trop Dr. 2007;37(2):79–83.
55.
Leclerc-Madlala S. Age-disparate and intergenerational sex in southern Africa: the dynamics of hypervulnerability. AIDS. 2008;22:S17–25.PubMedCrossRef
56.
Homma Y, Wang N, Saewyc E, Kishor N. The relationship between sexual abuse and risky sexual behavior among adolescent boys: a meta-analysis. J Adolesc Health. 2012;51(1):18–24.PubMedPubMedCentralCrossRef
Metadata
Title
Determinants of adolescent pregnancy in sub-Saharan Africa: a systematic review
Authors
Ibrahim Yakubu
Waliu Jawula Salisu
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Reproductive Health / Issue 1/2018
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/s12978-018-0460-4

Other articles of this Issue 1/2018

Reproductive Health 1/2018 Go to the issue

Research

Female genital mutilation: current awareness, believes and future intention in rural Egypt

Review

Obstetric ultrasound use in low and middle income countries: a narrative review

Study protocol

The global maternal sepsis study and awareness campaign (GLOSS): study protocol

Research

The context of emergency contraception use among young unmarried women in Accra, Ghana: a qualitative study

Research

Weighted log-linear models for service delivery points in Ethiopia: a case of modern contraceptive users at health facilities

Research

Warning about drinking during pregnancy: lessons from the French experience