Abstract
Although teenage pregnancy and childbearing has declined throughout sub-Saharan Africa, the recent increase in teenage pregnancy in countries such as Malawi has prompted interest from social researchers. Using Malawi Demographic and Health Survey (MDHS) data from 2004 to 2015, this study employs multilevel logistic regression to examine the magnitude of change over time in risk and protective factors for teenage childbearing. During this period, teenage childbearing declined from 36.1% (C.I.: 31.5–36.7) in 2004 to 25.6% (C.I.: 24.0–27.3) in 2010 before increasing to 29.0% (C.I.: 27.4–30.7) in 2015. Age and being married (compared to never married) were consistently significantly associated with increased odds of teenage childbearing. However, delaying sexual debut, attaining secondary education, belonging to the richest quintile and rural residence offered protective effects against early motherhood, while Muslim affiliation (compared to Christian denominations) was associated with increased likelihood of teenage childbearing among adolescents. Teenage childbearing remains high in the country, largely influenced by adolescents’ early sexual debut and child marriage—risk factors that have hardly changed over time. While individual socioeconomic predictors are useful in explaining the apparent high risk of adolescent fertility among specific subgroups in Malawi, sustained declines in teenage childbearing were not evident at district level.
Highlights
The present study aims to fill this gap by: (i) examining the pattern of change in individual and contextual risk factors of teenage pregnancy leading to the disruption of declining trend; and (ii) acknowledging that individuals within districts may have some degree of correlation due to unobserved common characteristics, which may result in incorrect conclusions on the effects of associated factors (Hox et al 2018; Rabe-Hesketh and Skrondal 2012)
The results show that three demographic variables were significant in at least one of the years, which merits our approach for adjusting demographic and socioeconomic factors that influence teenage childbearing
Age of an adolescent and age at sexual debut have important implications on the sensitisation messages of girls abstaining from sex that could help reduce teenage childbearing, as well as the age at which adolescents receive appropriate messages that are embedded in the comprehensive sexuality education curricula in Malawi schools
Summary
Global trends estimate that 12 million adolescents between the ages of 15 and 19 give birth every year, and more than 90% of these live births occur in low- and middle-incomecountries (WHO 2020). The global adolescent birth rate declined from 65 births per 1000 women in 1990 to 44 births per 1000 women in 2018 (SDGS n.d.), sub-Saharan. Africa (SSA) still has the highest teenage fertility rates in the world with an estimated births per 1000 women aged 15–19—more than double that of developed countries (UNFPA 2013). About 3 million girls aged 15–19 years have unsafe abortions, resulting in an estimated 2500 adolescent deaths (Temmerman 2017); an estimated. Characteristics Age (years) Sexual debut Median (years) a Early sex debut Marital status. Employment status Unemployed Employed Percent (C.I.) n 3.20 (1.80–5.60) 11.5 (8.80–15.0)
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