Abstract
BackgroundDespite the numerous policy interventions targeted at preventing early age at first childbirth globally, the prevalence of adolescent childbirth remains high. Meanwhile, skilled birth attendance is considered essential in preventing childbirth-related complications and deaths among adolescent mothers. Therefore, we estimated the prevalence of early age at first childbirth and skilled birth attendance among young women in sub-Saharan Africa and investigated the association between them.MethodsDemographic and Health Survey data of 29 sub-Saharan African countries was utilized. Skilled birth attendance and age at first birth were the outcome and the key explanatory variables in this study respectively. Overall, a total of 52,875 young women aged 20-24 years were included in our study. A multilevel binary logistic regression analysis was performed and the results presented as crude and adjusted odds ratios at 95% confidence interval.ResultsApproximately 73% of young women had their first birth when they were less than 20 years with Chad having the highest proportion (85.7%) and Rwanda recording the lowest (43.3%). The average proportion of those who had skilled assistance during delivery in the 29 sub-Saharan African countries was 75.3% and this ranged from 38.4% in Chad to 93.7% in Rwanda. Young women who had their first birth at the age of 20-24 were more likely to have skilled birth attendance during delivery (aOR = 2.4, CI = 2.24-2.53) than those who had their first birth before 20 years.ConclusionEarly age at first childbirth has been found to be associated with low skilled assistance during delivery. These findings re-emphasize the need for sub-Saharan African countries to implement programs that will sensitize and encourage the patronage of skilled birth attendance among young women in order to reduce complications and maternal mortalities. The lower likelihood of skilled birth attendance among young women who had their first birth when they were adolescents could mean that this cohort of young women face some barriers in accessing maternal healthcare services.
Highlights
Despite the numerous policy interventions targeted at preventing early age at first childbirth glob‐ ally, the prevalence of adolescent childbirth remains high
Rwanda (43.3%) recorded the lowest proportion of young women whose first birth occurred during adolescence, with Chad having the highest proportion (85.7%)
We investigated the relationship between early age at first birth and skilled birth attendance (SBA) among young women in sub-Saharan Africa (SSA)
Summary
Despite the numerous policy interventions targeted at preventing early age at first childbirth glob‐ ally, the prevalence of adolescent childbirth remains high. We estimated the prevalence of early age at first childbirth and skilled birth attendance among young women in sub-Saharan Africa and investigated the association between them. Despite the numerous policy interventions aimed at preventing adolescent childbearing in many countries across the world, the prevalence of adolescent pregnancy and childbirth remains high [1,2,3]. In 2015, for example, approximately 19.4 million adolescent girls aged 10-19 years, gave birth, and 580,000 of them were aged 10-14 [4] Most of these adolescent births occur in less developed countries, especially in sub-Saharan Africa (SSA) [5, 6]. Grønvik and FossgardSandøy [8] reported that adolescent girls in SSA have a higher risk for prenatal and maternal mortality, low birth weight, eclampsia and preterm delivery. Other complications associated with adolescent childbearing include haemorrhage [4], systemic infections, puerperal endometritis, and increased risk for caesarean sections [7, 9]
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