| 摘要: | Abstract
Title of Thesis: Trends of teenage pregnancy and its associated factors in the Kingdom of Eswatini
Institution: Master Program, School of Nursing, Taipei Medical University
Author: Sihle Agrippa Dlamini
Thesis Advisor: Shu-Yu Kuo, Professor, Taipei Medical University
Introduction: Teenage pregnancy is a serious public health issue and links with adverse maternal and infant health outcomes. Little is known regarding the changes of teenage pregnancy over time and the associated factors in the Kingdom of Eswatini. This study aimed to: (1) investigate the trends in the prevalence of teenage pregnancy in Eswatini between 2010 and 2014; (2) examine the individual- and community-level factors associated with teenage pregnancy in 2010 and 2014.
Methods: We conducted a secondary data analysis of 2010 and 2014 using Eswatini Multiple Indicator Cluster Surveys (MICS), a population-based household study. A total of 1098 and 1037 women aged 15-19 years old were included for 2010 and 2014 surveys, respectively. Data was collected using a standardized survey questionnaire through face-to-face interviews among nationally representative samples of households. The outcome variable was teenage pregnancy, defined as a woman aged 15-19 years who have had a live birth or who have not had a live birth but a pregnant with their first child. Individual-level and community-level factors were included. We used two-level mixed-effect logistic regression models to assess the association between individual- and community-level factors with teenage pregnancy.
Results: A total of 2135 adolescents (level 1) living in 365 communities (level 2) were included in the years 2010 and 2014 in this study. The prevalence of teenage pregnancy was 16.8% in the year 2010 and 17.4% in 2014. The trend of teenage pregnancy remained stable between 2010 and 2014. Most teenage pregnancy participants were 18-19 years old (62.4% in 2010; 66.8% in 2014). Majority were not married (81.0% in 2010; 83.6% in 2014), had secondary and above education (55.6% in 2010; 60.4% %), and resided in the rural areas (84.2% in 2010; 78.0% in 2014).
In 2010, At individual level, adolescents aged 18-19 years (Adjusted Odds Ratio, aOR = 2.59, 95% Confidence Interval, CI: 1.78, 3.78; p < .001), already married (aOR = 6.48, 95% CI: 3.12, 13.49; p < .001), had secondary education and above (aOR = 1.80, 95% CI: 1.20, 2.69; p = .004), and used contraception (aOR = 6.75, 95% CI: 4.29, 10.63; p < .001) were more likely to be pregnant during teenager period. At community level, adolescents from the rural areas (aOR = 0.81, 95% CI: 0.46, 1.64; p = .482), and communities with high wealth concentration (aOR = 0.67, 95% CI: 0.42, 1.07; p = .091) were less likely to become pregnant. Adolescents who came from communities with high contraception use were more likely (aOR = 1.14, 95% CI: 0.74, 1.76; p = .562) to become pregnant during teenager period.
At individual level, in 2014, women aged 18-19 years (aOR = 5.79, 95% CI: 2.95, 11.39; p < .001), married (aOR = 5.79, 95% CI: 1.77, 18.91; p = .004), had education of secondary and above (aOR = 0.38, 95% CI: 0.16, 0.88; p = .023), with richest family income (aOR = 0.18, 95% CI: 0.06, 0.54; p = .002), had exposure to media (aOR = 0.49, 95% CI: 0.26, 0.93; p = .030) was found to be significantly associated with teenage pregnancy. At community level, participants resided at the rural areas (aOR = 0.29, 95% CI: 0.12, 0.74; p = .009), high concentration of internet use (aOR = 2.79, 95% CI: 1.18, 6.57; p = .019) were found to be significantly associated with teenage pregnancy.
Conclusion: The prevalence of teenage pregnancy was high and remains stable between the years 2010 and 2014. Both individual and community-levels factor significantly influence the adolescent pregnancy in Eswatini. Effective interventions integrating individual and community strategies tailored to teenage women are required to improve reproductive health in Eswatini. |
