The prevalence of pregnancy among adolescent girls and young women across the Southern African development community economic hub: A systematic review and meta-analysis.

Clarence S Yah,Alison Kutywayo,Nicolette Naidoo,Saiqa Mullick,Sithembiso Ndlovu,Tshepo Mahuma

doi:10.34172/hpp.2020.51

Abstract

Background: Despite the high rate of HIV infections, there is still high rate of early unprotected sex, unintended pregnancy, and unsafe abortions especially among unmarried adolescent girls and young women (AGYW) 10-24 years of age in sub Saharan Africa. AGYW face challenges in accessing health care, contraception needs, and power to negotiate safer sex. This study aimed to estimate the rate of pregnancy among AGYW aged 10-24, 10-19 and 15-19 years in the Southern African Development Community (SADC) economic region. Methods: A systematic review and meta-analysis was used to describe the prevalence of pregnancy among AGYW in 15 SADC member countries between January 2007 and December2017. The articles were extracted from PubMed/MEDLINE, African Index Medicus, and other reports. They were screened and reviewed according to PRISMA methodology to fulfil study eligibility criteria. Results: The overall regional weighted pregnancy prevalence among AGYW 10-24 years of age was 25% (95% CI: 21% to 29%). Furthermore, sub-population 10-19 years was 22% (95% CI:19% to 26%) while 15-19 years was 24% (18% to 30%). There was a significant heterogeneity detected between the studies (I=99.78%, P < 0.001), even within individual countries. Conclusion: The findings revealed a high pregnancy rate among AGYW in the SADC region. This prompts the need to explore innovative research and programs expanding and improving sexual and reproductive health communication to reduce risk and exposure of adolescents to early planned, unplanned and unwanted pregnancies, SRHR challenges, access to care, HIV/STIs, as well as other risk strategies.

Highlights

Despite the high rate of HIV infections among adolescent girls and young women (AGYW) aged 10-24 in subSaharan Africa (SSA), early and/or unintended pregnancy, unsafe abortion and unprotected sex remains high in this age group.[1,2,3,4,5,6,7,8,9,10,11,12,13]
The study objectives were framed to assess the rate of pregnancy among AGYW in the 15 Southern African Development Community (SADC) countries: Angola, Botswana, Democratic Republic of Congo (DRC), Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Namibia, Seychelles, South Africa, Swaziland, United Republic of Tanzania, Zambia and Zimbabwe
The type of studies included in this systematic review were cross sectional, baseline data from cohort or randomized controlled trial (RCT) study designs, and from national Demographic and Health Survey (DHS) studies published as full papers, conference proceedings/ abstracts, policy or reports

Summary

Introduction

Despite the high rate of HIV infections among adolescent girls and young women (AGYW) aged 10-24 in subSaharan Africa (SSA), early and/or unintended pregnancy, unsafe abortion and unprotected sex remains high in this age group.[1,2,3,4,5,6,7,8,9,10,11,12,13] There are several factors associated with AGYW pregnancy in Southern Africa[14,15]; the pregnancy itself but the sexual and reproductive health rights (SRHR) risks and associated exposures.[12,16,17,18,19] In addition, AGYW in sub Saharan Africa rarely access SRH care services.[2,7,9,11] The region has high unmet contraception needs, harmful gender inequalities, high rates of sexual and gender-based violence (SGBV) and drug and alcohol abuse.[3,7,10,12,13]Globally, over 16 million young women, aged 15 to 19 give birth each year, with more than 50% in SSA.[4,5] The birth rate of young mothers aged 15 to 19 in SSA in 2013 was estimated at 101 births per 1000 young women.[1]. Conclusion: The findings revealed a high pregnancy rate among AGYW in the SADC region This prompts the need to explore innovative research and programs expanding and improving sexual and reproductive health communication to reduce risk and exposure of adolescents to early planned, unplanned and unwanted pregnancies, SRHR challenges, access to care, HIV/ STIs, as well as other risk strategies

Objectives

Methods

Results

Discussion

Conclusion