Prevalence and determinants of unintended pregnancy in sub-Saharan Africa: A multi-country analysis of demographic and health surveys.

Edward Kwabena Ameyaw,Francis Appiah,Francis Sambah,Eugene Budu,Abdul-Aziz Seidu,Linus Baatiema,Bright Opoku Ahinkorah,Russell Kabir

doi:10.1371/journal.pone.0220970

Edward Kwabena Ameyaw, Francis Appiah + Show 6 more

Open Access

https://doi.org/10.1371/journal.pone.0220970

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Abstract

IntroductionApproximately 14 million unintended pregnancies are recorded annually in sub-Saharan Africa (SSA). We sought to investigate the prevalence and determinants of unintended pregnancies among women in sub-Saharan Africa.Materials and methodsThe study pooled data from current Demographic and Health Surveys (DHS) conducted from January 1, 2010 to December 31, 2016 from 29 countries in SSA. Logistic regression analysis was used to examine the factors that influence unintended pregnancies in SSA. Results were presented using odds ratios (OR).ResultsWe found overall unintended pregnancy prevalence rate of 29%, ranging from 10.8% in Nigeria to 54.5% in Namibia. As compared to women aged 15–19 years, women of all other age categories had higher odds of unintended pregnancies. Married women were 6 times more probable to report unintended pregnancy as compared to women who had never married (OR = 6.29, CI = 5.65–7.01). The phenomenon had higher odds among rural residents as compared to urban residents (OR = 1.08, CI = 1.01–1.16). Women with primary (OR = 0.74, CI = 0.69–0.80) and secondary (OR = 0.71, CI = 0.65–0.77) levels of education had less chances of unintended pregnancies, compared to those with no education. Again, women in all other wealth categories had less probability of unintended pregnancy, as compared to women with poorest wealth status.ConclusionOur study contributes substantially towards the discourse of maternal wellbeing by unveiling the prevalence and determinants of unintended pregnancy across the SSA region. There is the need for SSA countries with high prevalence of unintended pregnancies to consider past and present successful interventions of other countries within the region such as health education, counselling, skills-building, comprehensive sex education and access to contraception. Much of these efforts rest with the governments of SSA countries.

Highlights

14 million unintended pregnancies are recorded annually in sub-Saharan Africa (SSA)
Unintended pregnancy accounted for 44% of all global pregnancies between 2010 and 2014 [1] and this makes up 62 unintended pregnancies per 1,000 women aged 15–44 years
There has been a decline in unintended pregnancy but this has been uneven between the highincome countries, compared with low- and middle-income countries, where 65 unintended pregnancies per 1,000 women aged 15–44 (30%) and 45 per 1,000 women (16%) decline respectively occurred between 2010 and 2014 [1]