Adolescent Fertility Research Articles

Соціально-демографічні аспекти становища жінок в Україні в світлі Конвенції ООН про ліквідацію всіх форм їх дискримінації (CEDAW)

This paper dwells upon the demographic features and some peculiarities of women’s social situation in Ukraine in the context of CEDAW’s requirements. It also reviews the implementation of these requirements in recent years. The study focuses on general issues (changes in the number of women and their age structure as well as the situation with gender statistics), the specifics of the marriage and family situation and health problems. Such trends are highlighted based on the results of the analysis: the fastest reduction rates of the number of women in working and reproductive age against the increase of the older women’s share; reduction of early nuptiality and adolescent fertility; not sustained decline of infant mortality, decrease of venereal morbidity. The latest changes in gynecologic cancer morbidity and mortality are ambiguous in Ukraine. The maternal mortality has begun to rise in recent years; cases of obstetric violence are common; the situation with HIV/AIDS is still unfavourable (and the share of women among AIDS patients increases). Now the improvement of the reproductive health of women in Ukraine is complicated by the absence of state social program on reproductive and sexual health. Due to a more significant share of elderly and other factors women have greater needs for medical care and social support, they are incredibly vulnerable to the current COVID-19 pandemic and its consequences. At the same time, women suffer, mainly due to the low accessibility of high-quality medical care in Ukraine. The paper also deals with gender statistics in Ukraine. The current state of gender statistics is analyzed, and some recommendations for its improvement are proposed in order to form a proper information basis for the development of policies in the field of elimination of discrimination against women in Ukraine.

Inequality in fertility rate among adolescents: evidence from Timor-Leste demographic and health surveys 2009\u20132016

BackgroundDespite a decline in global adolescent birth rate, many countries in South East Asia still experience a slower pace decline in adolescent birth rates. Timor-Leste is one of the countries in the region with the highest adolescent birth rate and huge disparities between socio-economic subgroups. Hence, this study assessed the magnitude and trends in adolescent fertility rates within different socio-demographic subgroups in Timor-Leste.MethodsUsing the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT) software, data from the Timor-Leste Demographic and Health surveys (TLDHS) were analyzed between 2009 and 2016. We approached the inequality analysis in two steps. First, we disaggregated adolescent fertility rates by four equity stratifiers: wealth index, education, residence and region. Second, we measured the inequality through summary measures, namely Difference, Population Attributable Risk, Ratio and Population Attributable Fraction. A 95% confidence interval was constructed for point estimates to measure statistical significance.ResultsWe found large socio-economic and area-based inequalities over the last 7 years. Adolescent girls who were poor (Population Attributable Fraction: -54.87, 95% CI; − 57.73, − 52.02; Population Attributable Risk: -24.25, 95% CI; − 25.51, − 22.99), uneducated (Difference: 58.69, 95% CI; 31.19, 86.18; Population Attributable Fraction: -25.83, 95% CI; − 26.93, − 24.74), from rural areas (Ratio: 2.76, 95% CI; 1.91, 3.60; Population Attributable Risk: -23.10, 95% CI; − 24.12, − 22.09) and from the Oecussi region (Population Attributable Fraction: -53.37, 95% CI; − 56.07, − 50.67; Difference: 60.49, 95% CI; 29.57, 91.41) had higher chance of having more births than those who were rich, educated, urban residents and from the Dili region, respectively.ConclusionsThis study identified disproportionately higher burden of teenage birth among disadvantaged adolescents who are, poor, uneducated, rural residents and those living in regions such as Oecussi, Liquica and Manufahi, respectively. Policymakers should work to prevent child marriage and early fertility to ensure continuous education, reproductive health care and livelihood opportunities for adolescent girls. Specialized interventions should also be drawn to the subpopulation that had disproportionately higher adolescent childbirth.

Case-control study of risk factors for adolescent fertility and premature birth in Bulgaria

Abstract The significant positive correlation between share of Roma population and adolescent live birth in EU member states (r = 0.804, with 2-tailed significance p = 0.000) was found. The highest level of proportion of live births to mothers aged less than 20 years was found in Romania (9.8%) and Bulgaria (9.5%). At the same tame proportion of Roma population in those countries is highest: Bulgaria (4.7%) and Romania (2.5%). The study found that two thirds (66%) of children born to mothers under the age of 19 are born prematurely OR = 2.10 95% CI (1.13-3.91). Among the newborns studied, the proportion of prematurely born children living in rural areas is significantly higher than those living in the city (p = 0.0001; r = 0.26). Later registration (after the first trimester) and monitoring of pregnancy is a significant risk factor and increases more than four times the risk of having a premature baby OR = 4.23 95% CI (1.41-12.69). A holistic approach is needed in which socio-economic development and education of Roma girls leads to further reduction of adolescent childbirth and premature delivery in Bulgaria.

La fécondité précoce dans les camps d’hébergement de l’Aire Métropolitaine de Port-au-Prince dans un contexte post-catastrophe naturelle

Le tremblement de terre qui s’est produit le 12 janvier 2010 a Haiti a eu des impacts sur le comportement sexuel des adolescentes, plus particulierement sur celles residant dans les camps d’hebergement de l’Aire Metropolitaine de Port-au-Prince (AMPAP). En effet, selon l’EDS (2012), le taux de fecondite a augmente de facon considerable du cote des femmes âgees de 15 a 19 ans (66‰ en 2012 contre 44,35‰ en 2009). Par ailleurs, en comparaison avec les autres communes ou zones du pays, la situation etait beaucoup plus preoccupante dans les camps d’hebergement de l’AMPAP, avec un taux allant jusqu’a representer 107‰. D’ou l’objectif de cet article : identifier les differents facteurs socio-economiques qui influencent la fecondite des adolescentes vivant dans les camps d’hebergement de l’AMPAP.Les donnees utilisees dans le cadre de ce travail de recherche proviennent de la cinquieme Enquete demographique et sante (Haiti, 2012). A travers l’estimation d’un modele logit, il ressort que la «presence d’un enfant âge de 5 ans et moins dans le menage», l’» âge au premier rapport sexuel », le « statut matrimonial » et le « niveau d’education » sont les facteurs cles dans l’explication du phenomene de la maternite precoce observe dans les camps d’hebergement de l’AMPAP.

Uneven decline in fertility rates in adolescents in 32 countries of the Region of the Americas, 1960-2019Diminuição desigual nas taxas de fecundidade de adolescentes em 32 países da Região das Américas, 1960-2019

RESUMENObjetivo.Conocer la evolución temporal de las tasas de fecundidad en adolescentes (TFA) de los países de la Región de las Américas, categorizándolas para evaluar su movilidad, sus diferencias y generar una predicción para 2023.Métodos.Estudio ecológico y descriptivo de una serie temporal de la TFA de 32 países, de 1960 a 2019, basado en información del Banco Mundial y de la OPS. Se estimaron tendencias de la TFA con un modelo de regresión lineal (método de Prais-Winsten), se evaluaron diferencias entre 2 subperíodos (1960-1989 y 1990-2019) y entre 4 categorías de la TFA de 2019 mediante pruebas de muestras relacionadas y ANOVA, respectivamente, y se hizo una predicción de la TFA para 2023 con modelos ARIMA.Resultados.La serie temporal de la TFA de la muestra fue no estacionaria, la tendencia media anual fue decreciente (coeficiente = -1,173; p < 0,001; R2 ajustada = 0,968) y disminuyó de 124 por 1 000 en 1960 a 56,1 por 1 000 en 2019. Los países con mayor y menor tendencia anual fueron San Vicente y las Granadinas (-2,783) y Argentina (0,017). Entre subperíodos (1960-1989 frente a 1990-2019) no hubo diferencias estadísticamente significativas entre las TFA en Uruguay y Argentina; sí las hubo entre las cuatro categorías de la TFA de 2019. La TFA media muestral mantendría una disminución para 2023, pero en 8 países podría aumentar.Conclusiones.La serie temporal es mayoritariamente no estacionaria, con tendencia decreciente para 2023. Hay disminución desigual de las TFA, con diferencias significativas entre los cuatro grupos de países categorizados con la TFA de 2019. Las menores TFA corresponden a 2 países de Norteamérica, a 5 del Caribe no latino y a 1 sudamericano, y las mayores, a países del Caribe latino y de Centro y Sudamérica.

Knowledge and misconceptions surrounding family planning among Young Maasai women in Kenya

ABSTRACT Adolescent fertility rates are high in Kenya and increase the likelihood of maternal and infant morbidity and mortality. Our objective was to explore the knowledge, perceptions, and barriers surrounding the use of family planning services among young Maasai women in Laikipia County, Central Kenya. Individual interviews with 50 participants were conducted in Laikipia County, Kenya during June and July of 2019. Qualitative data was visualised using JMP software and coded using the framework method for content analysis. Several overarching themes were identified. First, we identified a high rate of unintended pregnancy and a low rate of family planning use. Second, we found that many young Maasai women believe that only women that are married and have finished childbearing should utilise family planning services. Finally, we document highly prevalent myths among young women in the Maasai community that the use of family planning will lead to negative health consequences, such as infertility and cancer. We conclude that the Maasai community of Laikipia County, Kenya needs comprehensive family planning education that will improve knowledge and dispel myths in order to empower young Maasai women to make informed decisions surrounding family planning.

An Intervention Delivered by Mobile Phone Instant Messaging to Increase Acceptability and Use of Effective Contraception Among Young Women in Bolivia: Randomized Controlled Trial.

BackgroundAlthough the most effective methods of contraception are available in Bolivia, unmet need for contraception among women aged 15 to 19 years is estimated to be 38% (2008), and the adolescent fertility rate is 71 per 1000 women (2016). Mobile phones are a popular mode to deliver health behavior support. We developed a contraceptive behavioral intervention for young Bolivian women delivered by mobile phone and guided by behavioral science. The intervention consists of short instant messages sent through an app over 4 months.ObjectiveThis trial aimed to evaluate the effect of the intervention on young Bolivian women’s use of and attitudes toward the effective contraceptive methods available in Bolivia.MethodsThis was a parallel group, individually randomized superiority trial with a 1:1 allocation ratio. Women were eligible if they were aged 16 to 24 years, owned a personal Android mobile phone, lived in La Paz or El Alto, reported an unmet need for contraception, and could read Spanish. The target sample size was 1310 participants. Participants allocated to the intervention had access to an app with standard family planning information and intervention messages. Participants allocated to the control group had access to the same app and control messages. Coprimary outcomes were use of effective contraception and acceptability of at least one method of effective contraception at 4 months. Secondary outcomes were use of effective contraception during the study, acceptability of the individual methods, service uptake, unintended pregnancy, and abortion. Process outcomes included knowledge, perceived norms, personal agency, and intention. Outcomes were analyzed using logistic and linear regression. We also asked participants about physical violence.ResultsA total of 640 participants were enrolled, and 67.0% (429) of them contributed follow-up data for the coprimary outcome, the use of effective contraception. There was no evidence that use differed between the groups (33% control vs 37% intervention; adjusted odds ratio [OR] 1.19, 95% CI 0.80 to 1.77; P=.40). There was a borderline significant effect regarding acceptability (63% control vs 72% intervention; adjusted OR 1.49, 95% CI 0.98 to 2.28; P=.06). There were no statistically significant differences in any of the secondary or process outcomes. The intervention dose received was low. In the control group, 2.8% (6/207) reported experiencing physical violence compared with 1.9% (4/202) in the intervention group (Fisher exact test P=.75).ConclusionsThis trial was unable to provide definitive conclusions regarding the effect of the intervention on use and acceptability of effective contraception because of under recruitment. Although we cannot strongly recommend implementation, the results suggest that it would be safe and may increase the acceptability of effective contraception if the intervention messages were offered alongside the download of the app.Trial RegistrationClinicalTrials.gov NCT02905526; https://clinicaltrials.gov/ct2/show/NCT02905526

Subnational inequalities of early marriage and fertility among Chinese females from 1990 to 2010

To analyze the inequality of early marriage and adolescent fertility with respect to local economic development among Chinese females aged 15-19 years from 1990 to 2010. Aggregated data were extracted from the Chinese National Census from 1990 to 2010. We calculated the ever-married rate and fertility rate of female adolescents aged 15-19 years. Using gross domestic product (GDP) per capita as an indicator for socio-economic status of a province, we calculated the slope index of inequality (SII) and the concentration index (CI) to analyze the subnational inequalities of early marriage and adolescent fertility. Weighted linear regression models were also established to assess the associations between GDP per capita and the ever-married rate/fertility rate. The ever-married rate for Chinese female adolescents aged 15-19 years decreased from 4.7% in 1990 to 1.2% in 2000, and rebounded to 2.1% in 2010. From 1990 to 2000, the fertility rate decreased from 22.0 per 1 000 to 6.0 per 1 000, and further decreased to 5.9 per 1 000 in 2010. In 1990, the socio-economic inequalities of the ever-married rate and fertility rate for female adolescents aged 15-19 years were not statistically significant (P for SII or CI>0.05). The values of SII revealed that, in 2000 and 2010, female adolescents with the lowest GDP per capita had an ever-married rate 2.4% (95%CI: 0.4-4.4) and 2.3% (95%CI: 0.3-4.2) higher than those with the highest GDP per capita, respectively. In the meantime, in 2000 and 2010, female adolescents with the lowest GDP per capita had a fertility rate 12.9 per 1 000 (95%CI: 5.4-20.5) and 9.3 per 1 000 (95%CI: 4.6-14.0) higher than those with the highest, respectively. In 2000 and 2010, the CIs for marriage were -0.32 (P=0.02) and -0.17 (P=0.03), respectively, and the CIs for childbirth were -0.37 (P<0.01) and -0.26 (P<0.01), respectively. In 2000, the ever-married rate and the fertility rate were estimated to increase by 1.4% (95%CI: 0.1-2.7) and 7.9 per 1 000 (95%CI: 2.9-12.8) with 100% increase in GDP per capita, respectively; in 2010, the numbers were 1.5% (95%CI: 0.1-2.9) and 6.7 per 1 000 (95%CI: 3.2-10.1), respectively. Subnational socio-economic inequality of early marriage and adolescent fertility existed in 2000 and 2010. Female adolescents residing in less-developed areas were more likely to engage in early marriage and childbirth. Reducing income inequality and increasing education investment for poverty-stricken areas seem to be effective measures to reduce this inequality.

Trends and social determinants of adolescent marriage and fertility in China

Trends and social determinants of adolescent marriage and fertility in China

Chinese trends in adolescent marriage and fertility between 1990 and 2015: a systematic synthesis of national and subnational population data

Early marriage and fertility are major social determinants of health and wellbeing. Rapid shifts in the past three decades, including a rise in sexual activity in unmarried adolescents, a large population of young migrant workers, and a high proportion of males relative to females, have the potential to alter patterns of reproductive health in Chinese adolescents and young women. We aimed to establish long-term trends of marriage and fertility for girls and women aged 15-24 years in China. We did a longitudinal study in which we extracted aggregated data for marriage and childbearing status for Chinese girls and women aged 15-24 years from the Chinese National Population Census (in 1990, 2000, and 2010) and the Chinese 1% National Population Sample Survey (in 1995, 2005, and 2015). The census included all individuals with Chinese nationality who resided in China when the survey was done. For the 1% sample survey, communities or villages were randomly selected and all residents with Chinese nationality in the selected communities or villages were included. In all censuses and sample surveys, forms that included information on basic demographic characteristics, education, marriage, and fertility were completed and verified by the census enumerators at the household residence, based on responses provided by the householder or another adult in the household. We calculated the ever-married rate and age-specific fertility rate (ASFR) for all included individuals. We built multivariate random-effects generalised least squares regression models on panel data to test whether marriage or fertility rate was associated with education level, sex ratio, and the proportion of the population who are an ethnic minority in a province. The ever-married rate for those aged 15-19 years decreased from 4·7% in 1990 to 1·2% (95% CI 1·2-1·3) in 2000, but rebounded to 2·4% (2·4-2·5) in 2015. The ASFR for this age group decreased from 22·0 births per 1000 individuals in 1990 to 6·0 (5·9-6·0) births per 1000 in 2000, and rebounded to 9·2 (8·9-9·4) births per 1000 in 2015. The rebound was found in most provinces. In women aged 20-24 years, the ever-married rate generally declined from 58·6% in 1990 to 25·5% (95% CI 25·4-25·6) in 2015, and the ASFR decreased from 198·8 births per 1000 in 1990 to 55·0 (54·5-55·5) births per 1000 in 2015. In 2015, the ever-married rate and ASFR for girls and women in rural areas aged 15-19 years were three-times higher than those of their urban counterparts (3·8% [95% CI 3·7-3·9] vs 1·1% [1·1-1·1] for the ever-married rate and 15·4 [14·9-15·9] vs 4·1 [3·9-4·3] births per 1000 for the ASFR). There were large disparities in ever-married rate across individuals of different education levels, with increases in the ever-married rate of 15-19-year-olds not attending senior high school between 2000 and 2010. Those aged 15-19 years were more likely to be married or give birth in the western provinces. Education held a protective association against adolescent childbearing, whereas a high ratio of males to females and a high proportion of ethnic minorities were associated with greater risk. Although China's total fertility rate remains far less than replacement, after a period of steady decline, there has been a rebound in adolescent marriage and childbearing in the past decade. A range of adolescent-targeted strategies will be needed across provinces, including scaling up comprehensive sex education, ensuring that girls continue in school, and providing adequate reproductive health services, which specifically meet the needs for modern contraception in sexually active unmarried girls. Humanities and Social Sciences Planning Fund Project, Sports and Health Special Project of Education and Scientific Research, and China Scholarship Council.

Adolescent motherhood in Mozambique. Consequences for pregnant women and newborns.

IntroductionIn sub-Saharan Mozambique, high adolescent fertility rates are a significant public health problem. Understanding the consequences of teenage pregnancies facilitates effective strategies for improving the quality of care of both mother and the newborn.AimsTo identify the factors associated with adolescent motherhood in Tete (Mozambique).MethodsThis was a cross-sectional study including 821 pregnant women (255 teenagers) admitted to the general maternity ward of the Provincial Hospital between March and October 2016. The survey included clinical data of the mother and newborn.ResultsThe overall prevalence of adolescent deliveries was 31.8% (95% CI 27.9% - 34.2%). Multivariate analysis showed that independent factors associated with teenage motherhood were: number of pregnancies (OR 0.066; 95% CI 0.040–0.110), pregnancy follow-up (OR 0.29; CI 0.173–0.488) and previous abortions (OR 4.419; 95% CI 1.931–10.112). When the age of the mother was analysed as a continuous variable, positively associated factors were body mass index, arterial hypertension, HIV infection, previous abortions, pregnancy follow-up, and the weight of the newborn. Negatively associated factors were episiotomy and respiratory distress in the newborn.ConclusionTeenage motherhood is a serious public health problem in Mozambique. Intensive sexual and reproductive health planning for adolescents is needed.

Adolescent Fertility Is Lower than Expected in Rural Areas: Results from 10 African HDSS.

The adolescent birth rate (ABR) is an important indicator of maternal health, adolescent sexual health, and gender equity; it remains high in sub-Saharan Africa. While Demographic and Health Surveys (DHS) are the main source of ABR estimates, Health and Demographic Surveillance Systems (HDSS) also produce ABRs. Studies are lacking, however, to assess the ease of access and accuracy of HDSS ABR measures. In this paper, we use birth and exposure data from 10 HDSS in six African countries to compute local ABRs and compare these rates to DHS regional rates where the HDSS sites are located, standardizing by education and place of residence. In rural HDSS sites, the ABR measure is on average 44 percent lower than the DHS measure, after controlling for education and place of residence. Strong temporary migration of childless young women out of rural areas and different capacities in capturing temporarily absent women in the DHS and HDSS could explain this discrepancy. Further comparisons based on more strictly similar populations and measures seem warranted.

FERTILITAS REMAJA DI INDONESIA: HUBUNGAN ANTARA MELAHIRKAN PADA USIA REMAJA DAN CAPAIAN PENDIDIKAN WANITA

Adolescent fertility has become concerns at both national and international levels. The government of Indonesia views pregnancy and teenage childbearing as a problem that must be overcome. Giving birth in adolescence can lead to low levels of education. The aim of this study is to examine the relationship between adolescent fertility which is teenage childbearing and women’s educational attainment in Indonesia. The data source used is the Indonesia Demographic and Health Survey (IDHS) 2017. Based on IDHS 2017, among women who have given birth. Around 31.5% of women gave birth for the first time before the age of 20. Of those, 3.8% gave birth out of wedlock, and 9.8% gave birth after postconception marriage. By using the instrumental variable (IV) method, the results of the study show that there is a negative association between giving birth in adolescent and women’s educational attainment. After controlling for individual and community/environmental characteristics, women who experienced first birth during their adolescence have 3.5 years of education lower than women who give birth for the first time at the age of 20 years and above.

Associations of reproductive coercion and intimate partner violence with overt and covert family planning use among married adolescent girls in Niger

BackgroundIn Niger the prevalence of girl child marriage and low female control over family planning (FP) has resulted in the world's highest adolescent fertility. Male control of FP is associated with intimate partner violence (IPV) and reproductive coercion (RC). We assessed associations of IPV and RC with FP use among married adolescent girls (ages 13–19 years) in Dosso, Niger (N = 1072). MethodsMultivariable, cross-sectional regression models assessed associations between physical IPV, sexual IPV, and RC and any FP use, FP use with husband knowledge (overt use), and FP use without husband knowledge (covert use). FindingsOne in four married adolescent girls using FP reported doing so without husband's knowledge. Unadjusted and adjusted models indicated that physical IPV and RC were associated with covert FP use (vs. no use and vs. overt use), but not with overt use vs. no use. Only physical IPV remained significantly associated with covert use in models including all three forms of violence (AOR: 1.94 vs. any use; AOR: 3.63 vs. overt use). InterpretationMarried adolescents experiencing physical IPV or RC were more likely that others to use FP without their husbands’ knowledge. No form of GBV affected odds of FP use with husbands’ knowledge. Current results suggest caution regarding promoting engagement of men in decisions to use FP in this context, as this may undermine the reproductive autonomy of girls and women who will choose to use FP without the knowledge of their male partners.

Developing Reproductive Health Communication in Early Marriage

Adolescent fertility is an important health and social problem because it is related to the level of morbidity and mortality of mothers and children. The results of the 2017 IDHS show that 7% of women aged 15-19 are already mothers, 5% have given birth, and 2% are pregnant with their first child. The data shows that adolescents are already sexually active, but still have an understanding of low reproductive health. The purpose of this study was to determine the effectiveness of community-based health communication models that developed to improve access to information and public knowledge related to contraceptive methods in young married couples in Rembang Regency in 2019. This research used Research and Development design with a quasi-experimental data collection method. The population in this study were adolescents who married at a young age in Rembang District, while the sample was adolescents who married young in Sedan and Kragan villages (intervention group), Menoro and Ngasinan (control group). Quantitative data analysis uses univariate, bivariate, and multivariate, while for qualitative data use grounded theory. The effectiveness test showed significant data for knowledge (p = 0,000), attitudes (p = 0.003), access to information (0.012), preferences (p = 0.001), and access to contraception (p = 0,000). It can be concluded that the community-based health communication model can improve knowledge, attitudes, access to information, preferences, and access related to contraception in early married couples

Impact of a community contraceptive counselling intervention on adolescent fertility rates: a quasi-experimental study

BackgroundFrom 2000 to 2008, in urban areas in Spain, adolescent fertility and abortion rates underwent unprecedented increases, consecutive to intensive immigration from developing countries. To address unmet needs for contraception information and services, a community-based, gender-sensitive and culturally adapted brief counselling intervention (SIRIAN program) was launched in some deprived neighbourhoods with a high proportion of immigrants in Barcelona. Once a randomized controlled trial demonstrated its effectiveness in increasing the use of contraceptives, we aim to examine its population impact on adolescent fertility rates.MethodsQuasi-experimental study with comparison group, using population data from 2005 to 2016. Five neighbourhoods in the lowest tercile of Disposable Household Income were intervened in 2011–13. The comparison group included the three neighbourhoods which were in the same municipal district and in the lowest Disposable Household Income tercile, and displayed the highest adolescent fertility rates. Generalized linear models were fitted to assess absolute adolescent fertility rates and adjusted by immigrant population between pre-intervention (2005–10) and post-intervention periods (2011–16); Difference in Differences and relative pre-post changes analysis were performed.ResultsIn 2005–10 the intervention group adolescent fertility rate was 27.90 (per 1000 women 15–19) and 21.84 in the comparison group. In 2011–16 intervention areas experienced great declines (adolescent fertility rate change: − 12.30 (− 12.45 to − 12.21); p < 0.001), while comparison neighbourhoods remained unchanged (adolescent fertility rate change: 1.91 (− 2.25 to 6.07); p = 0.368). A reduction of − 10.97 points (− 13.91 to − 8.03); p < 0.001) is associated to the intervention.ConclusionAdolescent fertility rate significantly declined in the intervention group but remained stable in the comparison group. This quasi-experimental study provide evidence that, in a country with universal health coverage, a community counselling intervention that increases access to contraception, knowledge and sexual health care in hard-to-reach segments of the population can contribute to substantially reduce adolescent fertility rates. Reducing adolescent fertility rates could become a feasible goal in cities with similar conditions.

Determinants of Under-Five Mortality in Southern Asia

Under-five mortality is one of the important indicators for measuring the overall child health status of a country or region. One of the sub-goals of the Sustainable Development Goals (SDGs-2015) is reduction of under-five mortality rate to at least as low as 25 deaths per 1,000 live births by 2030. The present study aims at investigating the determinants of under-five mortality in Southern Asia. The results of the GLS Random Effects regression found adolescent fertility rate, measles immunization, basic drinking water services, prevalence of anemia among children and current health expenditure to be significant determinants of under-five mortality.

A geographically weighted regression approach to examine the dynamics of fertility differentials across Africa

Studies have shown that fertility rate in Africa is still among the highest in the world. However, there are few spatial investigations into the variation of fertility rate and its determinant in Africa. This study aimed to examine the spatial distribution of fertility rate as well as highlight its significant determinants. Ordinary Least Squares (OLS) regression was carried out on dataset for 53 African countries on Total Fertility Rate (TFR) and eleven determinant factors to obtain a best model, which was then used for Geographically Weighted Regression (GWR). The study showed that TFR was significantly influenced by adolescent fertility rates, contraceptive prevalence rates and gross domestic product per capita. GWR model diagnostics of Akaike Information Criterion and adjusted R-squared showed that GWR fitted TFR in Africa better than OLS model. Also, countries around Middle to Western Africa comprising Burundi, Democratic Republic of the Congo, Central African Republic, Chad, Nigeria, Niger, Benin, Burkina Faso and Mali, were regions with high TFRs that impacted Africa’s positive TFR spatial autocorrelation. More intense works could therefore be carried out in these countries to manage the identified significant factors affecting TFR to address the negative consequences of high TFR in Africa.

A Study into the Demographics Having the Greatest Carbon Footprint

Our aim was to determine factors predicting greenhouse gas emissions per capita and to identify the demographics having the greatest carbon footprint. The relationship between socioeconomic trends and greenhouse gas emissions is controversial, given that many past studies evaluated only a single factor. We analyzed the relationship between global greenhouse gas emissions per capita and literacy rate, GDP per capita, urban population percentage, adolescent fertility rate, unemployment percentage, percent of agricultural land, research and development expenditure, renewable energy consumption, food production, population growth, mobile cellular subscriptions, air transport freight, and forest area. We gathered data from 217 countries spanning a period of 20 years; 1993 to 2012. We analyzed the data using multiple regression models. We concluded food production, renewable energy consumption, air transport, mobile cellular subscriptions, literacy rate, and population growth have the greatest impact on predicting greenhouse gas (GHG) emissions in our model, suggesting the demographic with the greatest carbon footprint are wealthy, educated people living in urban centers.

Roma origin as a factor for high level of adolescent fertility and abortion rate in European Union

Abstract Background Adolescence is a vulnerable phase in human development. Adolescent girls from Roma origin, especially younger girls, are particularly vulnerable because they face the risks of premature pregnancy and childbirth. The study aims to evaluate the association between Roma origin of mothers and prevalence of adolescent fertility and abortion rate in EU member states. Methods A correlational study was conducted and data on prevalence of adolescent fertility and abortion among adolescent girls (per 1000 live births) were extracted from European database “Health for all”. The means of variables in different countries were compared and Pearson’s correlation coefficients with share of Roma population were calculated. Data processing was performed by SPSS v.24. Results Increasing trend in premature childbirth has been observed in parallel with the increase of share of Roma population within countries, significantly more expressed in South-East member states. The mean adolescent live birth rate in the countries with highest proportion of Roma population was 5.6 times higher as compared to the mean for those with lowest proportion of Roma population. The highest level of proportion of live births to mothers aged less than 20 years was found in Romania (9.8%) and Bulgaria (9.5%). At the same tame proportion of Roma population in those countries is highest: Bulgaria (4.7%) and Romania (2.5%). The relation of adolescent fertility rate with share of Roma population shows significant positive correlation (r = 0.804, with 2-tailed significance p = 0.000). As far as the correlation of abortion among adolescent girls with the Roma origin is concerned, it is inverse and not significant. Conclusions Our results indicate significant correlation between share of Roma population and adolescent live birth in EU member states. A holistic approach is needed in which socio-economic development and education of Roma girls leads to further reduction of adolescent childbirth and abortions in EU. Key messages Adolescent girls from Roma origin in EU face the risks of premature pregnancy and childbirth more expressed in South-East member states and significant positive correlation for it was found. Bulgaria is the country with highest share of Roma population (4.7%) and in the second place according proportion of live births to mothers aged less than 20 years (9.5%) in the EU in 2015.