Secular Trends and Determinants Of Adolescent Childbearing In Ghana: A Review Of Demographic And Health Survey Data (1988-2003)

Abstract

Introduction Adolescent childbearing has adverse effects on both mother and child. High fertility and rapid population growth are direct consequences of early childbearing. For intervention targeting, it is crucial to know trends and determinants of adolescent childbearing. Objectives The objectives of this study were to: (1) describe the trends in adolescent pregnancy and childbearing in Ghana (2) determine the factors associated with adolescent childbearing and (3) describe the birth outcome characteristics of adolescent pregnancy. Methods Using four Ghana Demographic and Health Survey data collected from 1988 to 2003, the proportions of pregnancies and childbearing among adolescents were calculated using frequencies and cross-tabulations. The proportion of deliveries in a health facility, assisted deliveries and low birth weight (LBW) infants was also determined using frequencies and cross-tabulations. Employing a nested case-control study design, preliminary bivariate analyses were done to identify various factors associated with adolescent childbearing. Multiple logistic and linear regression models were used to examine the independent effect of key predictors on adolescent childbearing. Results The rate of adolescent childbearing declined from 35% in 1988 to 23% in 2003. The proportion of adolescents that were currently pregnant with their first child decreased from 8% in 1988 to 4% in 2003. From 1993 to 2003, about 41 % of adolescent deliveries occurred in a health facility. Over the same period, a slightly higher proportion (1.2%) of LBW infants was born to adolescents than adult women. Secondary education had the strongest effect on delaying first birth during adolescence. Age at marriage had a strong association with age at first birth. A one year increase in the age at first marriage delays the age at adolescent first birth by at least 5 months. Conclusion From 1988 to 2003 the rate of adolescent childbearing declined in Ghana. Age at marriage and secondary education are key predictors of adolescent childbearing. This has policy implications for promoting girls education to at least secondary level and delaying age at first marriage. Majority of adolescents did not deliver in a health facility. This has policy implications for making delivery in health facilities more attractive to adolescents.