Determinants of Adolescent Pregnancy in Luuka District, Eastern Uganda: A Mixed Methods Study

Abstract

Adolescent pregnancy is a serious public health and social problem. Over 95% of adolescent pregnancy cases occur in developing countries. Understanding and addressing the determinants of adolescent pregnancy is crucial to ending the vice. This study aimed to explore factors associated with adolescent pregnancy in Luuka District, in Uganda. An embedded mixed methods study design was used. Primary data was collected from 336 adolescent girls, aged 10–19 years, selected through simple random sampling, using a case-control survey, with a structured questionnaire. In addition, qualitative data was collected through 20 in-depth interviews and 16 focus group discussions. Quantitative and qualitative analyses were done using SPSS for descriptive, bivariate (i.e., Chi-square tests), multivariable analyses (i.e., logistics regression) used for determining independent associations and content analysis respectively. Findings revealed multiple factors influencing adolescent pregnancy including behavioral factors: such as having multiple sexual partners, frequent sex, lack of self-control over sex and irregular contraceptive use; familial factors: peer pressure, being an orphan living with mother, sexual abuse, and socioeconomic factors such as poverty. In conclusion: behavioral, demographic, familial and socioeconomic factors are major determinants of adolescent pregnancy in Luuka District. We recommend interventions focusing on providing information on sexual and reproductive health, including improving access to contraceptives for adolescent girls. Improving socio-economic status of families, legal punishment of sexual offenders, as well as keeping girls in school to mitigate effects of adolescent pregnancy in the low-income settings.