Summary measures of socioeconomic and area-based inequalities in fertility rates among adolescents: evidence from Ethiopian demographic and health surveys 2000–2016

BMC Public Health

Gebretsadik Shibre¹  Betregiorgis Zegeye²  Dina Idriss-Wheeler³  Sanni Yaya⁴  Edward Kwabena Ameyaw⁵ 

[1] Department of Reproductive Health and Health Services Management, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia;HaSET Maternal and Child Health Research Program, Shewarobit Field Office, Shewarobit, Ethiopia;Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada;School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, Ottawa, Canada;The George Institute for Global Health, Imperial College London, London, UK;School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia;

关键词: Adolescent fertility rate;    Inequality;    Reproductive health;    Global health;    Ethiopia;    DHS;   

DOI  :  10.1186/s12889-021-10729-5

来源: Springer

【 摘 要 】

BackgroundOne of the highest rates of adolescent pregnancies in the world is in sub-Saharan Africa. Most adolescent pregnancies in the region are unintended or unwanted, due to poor access to information and services on sexual and reproductive health for adolescents. Ethiopia has high adolescent fertility rates (AFR) with disparities across socioeconomic subgroups and regions. This study assessed the magnitude and trends of socioeconomic and area-based AFR inequalities in Ethiopia.MethodsThe 2000 and 2016 Ethiopia Demographic and Health surveys (EDHS) was analyzed using the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT) software. Adolescent fertility rates were disaggregated using three equity stratifiers (economic status, education and residence) and analyzed through four summary measures (Difference (D), Population Attributable Risk (PAR), Ratio (R) and Population Attributable Fraction (PAF)) to assess inequality. To measure statistical significance, point estimates were constructed using a 95% Uncertainty Interval (UI).ResultsLarge socio-economic and urban-rural inequalities were observed within the 16-year period. Adolescents in less well-off socio-economic groups (PAF: -62.9 [95% UI; − 64.3, − 61.4], D: 96.4 [95% UI; 47.7, 145.1]), uneducated (R: 8.5 [95% UI; 4.8, 12.2], PAR: -76.4 [95% UI;-77.7, − 75.0]) and those from rural areas (D: 81.2 [95% UI; 67.9, 94.6], PAF: -74.2 [95% UI, − 75.7, − 72.7]) had a higher chance of pregnancy and more births than their counterparts.ConclusionsSocioeconomic (education and economic status) and place of residence determine adolescents’ pregnancy and childbearing. Policies and programs should be directed at preventing child marriage and early fertility so that adolescents continue to access education, sexual and reproductive health care as well as access employment opportunities. More emphasis should be placed on subpopulations with disproportionately higher adolescent pregnancy and childbirth.

【 授权许可】

CC BY