An evolution of socioeconomic related inequality in teenage pregnancy and childbearing in Malawi

BackgroundTeenage pregnancies and childbearing are important health concerns in low-and middleincome countries (LMICs) including Malawi. Addressing these challenges requires, among other things, an understanding of the socioeconomic determinants of and contributors to the inequalities relating to these outcomes. This study investigated the trends of the inequalities and decomposed the underlying key socioeconomic factors which accounted for the inequalities in teenage pregnancy and childbearing in Malawi.MethodsThe study used the 2004, 2010 and 2015–16 series of nationally representative Malawi Demographic Health Survey covering 12,719 women. We used concentration curves to examine the existence of inequalities, and then quantified the extent of inequalities in teenage pregnancies and childbearing using the Erreygers concentration index. Finally, we decomposed concentration index to find out the contribution of the determinants to socioeconomic inequality in teenage pregnancy and childbearing.Results The teenage pregnancy and childbearing rate averaged 29% (

A Multilevel Analysis of Risk and Protective Factors for Adolescent Childbearing in Malawi

Although teenage pregnancy and childbearing has declined throughout sub-Saharan Africa, the recent increase in teenage pregnancy in countries such as Malawi has prompted interest from social researchers. Using Malawi Demographic and Health Survey (MDHS) data from 2004 to 2015, this study employs multilevel logistic regression to examine the magnitude of change over time in risk and protective factors for teenage childbearing. During this period, teenage childbearing declined from 36.1% (C.I.: 31.5–36.7) in 2004 to 25.6% (C.I.: 24.0–27.3) in 2010 before increasing to 29.0% (C.I.: 27.4–30.7) in 2015. Age and being married (compared to never married) were consistently significantly associated with increased odds of teenage childbearing. However, delaying sexual debut, attaining secondary education, belonging to the richest quintile and rural residence offered protective effects against early motherhood, while Muslim affiliation (compared to Christian denominations) was associated with increased likelihood of teenage childbearing among adolescents. Teenage childbearing remains high in the country, largely influenced by adolescents’ early sexual debut and child marriage—risk factors that have hardly changed over time. While individual socioeconomic predictors are useful in explaining the apparent high risk of adolescent fertility among specific subgroups in Malawi, sustained declines in teenage childbearing were not evident at district level

The impact of young maternal age at birth on neonatal mortality; Evidence from 45 low and middle income countries

Objectives: This study explores the impact of early motherhood on neonatal mortality, and how this differs between countries and regions. It assesses whether the risk of neonatal mortality is greater for younger adolescent mothers compared with mothers in later adolescence, and explores if differences reflect confounding socio-economic and health care utilisation factors. It also examines how the risks differ for first or subsequent pregnancies. Methods:The analysis uses 64 Demographic and Health Surveys collected between 2005 and 2015 from 45 countries to explore the relationship between adolescent motherhood (disaggregated as <16 years, 16/17 years and 18/19 years) and neonatal mortality. Both unadjusted bivariate association and logistic regression are used. Regional level multivariate models that adjust for a range of socio-economic, demographic and health service utilisation variables are estimated. Further stratified models are created to examine the excess risk for first and subsequent births separately.Findings: The risk of neonatal mortality in all regions was markedly greater for infants with mothers under 16 years old, although there was marked heterogeneity in patterns between regions. Adjusting for socio-economic, demographic and health service utilisation variables did not markedly change the odds ratios associated with age. The increased risks associated with adolescent motherhood are lowest for first births.Conclusion: Our findings particularly highlight the importance of reducing adolescent births among the youngest age group as a strategy for addressing the problem of neonatal mortality, as well ensuring pregnant adolescents have access to quality maternal health services to protect the health of both themselves and their infants. The regional differences in increased risk are a novel finding which requires more exploration

A Multilevel Analysis of Risk and Protective Factors for Adolescent Childbearing in Malawi

Although teenage pregnancy and childbearing has declined throughout sub-Saharan Africa,the recent increase in teenage pregnancy in countries such as Malawi has prompted interest fromsocial researchers. Using Malawi Demographic and Health Survey (MDHS) data from 2004 to 2015,this study employs multilevel logistic regression to examine the magnitude of change over timein risk and protective factors for teenage childbearing. During this period, teenage childbearingdeclined from 36.1% (C.I.: 31.5–36.7) in 2004 to 25.6% (C.I.: 24.0–27.3) in 2010 before increasing to29.0% (C.I.: 27.4–30.7) in 2015. Age and being married (compared to never married) were consistentlysignificantly associated with increased odds of teenage childbearing. However, delaying sexual debut,attaining secondary education, belonging to the richest quintile and rural residence offered protectiveeffects against early motherhood, while Muslim affiliation (compared to Christian denominations)was associated with increased likelihood of teenage childbearing among adolescents. Teenagechildbearing remains high in the country, largely influenced by adolescents’ early sexual debut andchild marriage—risk factors that have hardly changed over time. While individual socioeconomicpredictors are useful in explaining the apparent high risk of adolescent fertility among specificsubgroups in Malawi, sustained declines in teenage childbearing were not evident at district level

Unadjusted O.R. for neonatal deaths by mother's age at birth of child in individual years and by regions.

<p>Unadjusted O.R. for neonatal deaths by mother's age at birth of child in individual years and by regions.</p

Number of births and neonatal deaths to mothers in each age group by region, and percentage of births ending in neonatal death (unweighted data).

<p>Number of births and neonatal deaths to mothers in each age group by region, and percentage of births ending in neonatal death (unweighted data).</p

Unadjusted ORs for maternal age groups by region with neonatal mortality, early neonatal mortality and late neonatal mortality as outcome variable.

<p>Unadjusted ORs for maternal age groups by region with neonatal mortality, early neonatal mortality and late neonatal mortality as outcome variable.</p