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Numbers of repeat adolescent births among teenagers in Uganda worrying, says new study

Many teenage girls are forced to abandon their education once they become mothers hence second pregnancy (PHOTO /File)

KAMPALA — The rate of repeat pregnancies among teenagers remains at whopping 55 percent, with researchers now warning of a regression in girls’ well-being, rights to education and health.

Dr. Dinah Amongin, a THRiVE PhD scholar and a lead investigator told Ugstandard.com
that while the government has managed to reduce teenage pregnancy rates from 40% in the last 15 years to 24% now, repeat adolescent births remain very high — reasoning that this is a pointer that teenagers haven’t been guided on protection against second or another unwanted pregnancy.

The study whose report was launched in Thursday September 16 shows that 55.6% of the mothers that got their first baby at the age of between 15 and 19 years got a second baby before celebrating their 20th birthday.

Government has only been able to reduce the figure by less than 3% from 58.9% in the last 30 years.

Research shows that Eastern Uganda especially Soroti and Katakwi districts are the most affected.

Dr. Amongin’s study ‘Understanding trends and trajectories of repeat adolescent birth in Uganda’ sought to quantify the challenge, explore factors associated with repeat adolescent births; socio-economic and reproductive outcomes among women in Uganda toward the end of their reproductive life-course (40-49 years) and the motivators and circumstances for repeat adolescent birth in Soroti and Katakwi districts of Uganda.

Following an analysis of the Uganda Demographic and Health Surveys (UDHS) of 1988/89, 1995, 2000/01, 2006, 2011 and 2016, Dr. Amongin found that among women aged 20–24 years for whom the first birth occurred before age 18 years, the percentage reporting a repeat birth before 20 years has registered slight decline over the 30 years (58.9% in 1988/1989, 55.6% in 2016).

When examined at age 40-49 years, women who had first birth before 18 years were poorer, less educated, had spouses of older age and low socio-economic status compared to those who did not give birth before 18 years.

This was worse among those who had repeat adolescent births. Furthermore, women who had repeat adolescent births had a total of seven live births compared to five among those with no birth before 18 years of age.

“Girls who have had a repeat adolescent birth have on average seven children in life compared to 5 children among those who did not have a live birth before age 18 years,” says Dr. Amongin.

Motivators for repeat births

Extreme household poverty characterized by peasantry, alcohol abuse and large families was an overarching reason for the decisions that resulted in the first (under age birth) and subsequently, repeat adolescent birth.

Poverty led to inadequate provision of basic needs resulting into girls engaging in unprotected sexual activity in a bid to secure financial support. Largely, girls were in school at first pregnancy and immediately dropped out once the pregnancy was confirmed. Teen mothers are more likely to have a repeat birth if they drop out of school.

“Repeat adolescent birth in Uganda is premised around attempts to address the economic distress precipitated by first birth. Many women want to delay that repeat birth but financial challenges rob them of their reproductive autonomy,” the research partly reads.

Other contributing factors cited in the research are:
vulnerability characterized by marital entrapment, partner coercion, and domestic violence.

Enduring consequences

Compared to a teen mother with one child, results show that girls who have a second birth before 20 years are at a greater risk of school discontinuation, greater likelihood of poverty and impaired health for the baby.

“Many adolescents with repeat adolescent birth are taken out of school entirely and this underscores the need to prevent early marriage in a country where marriage/union before 18 years remains common,” says Dr. Amongin.

Moreover, premature births and low birth weight are a major problem affecting children of adolescent mothers. These factors put the newborns at greater risk of poor survival and other opportunities in life.

Additionally, the second or more children are more likely to put more strain onto the mother and the consequences get multiplied.

Covid-19 aftershocks on global scale

The COVID-19 pandemic has wreaked unprecedented havoc on children, families and communities around the globe, disrupting vital services and putting millions of lives at risk.

Since March 2020, attempts to avert the global health crisis have seen nationwide school closures in 194 countries, affecting nearly 1.6 billion learners — over 90 per cent of the world’s school-going population.

For the most vulnerable children, especially girls, accessing education and staying in school is hard enough. The pandemic has caused additional, unanticipated disruption, and the likelihood of vulnerable children being able to continue their education has plummeted.

A recent UNFPA report also spotlights one particular vulnerability that is known to be exacerbated by school closures in times of crisis and risks the continued education of vulnerable children: teenage pregnancy.

School closures during crises can result in girls spending more time with men and boys than they would were they to be in school, leading to greater likelihood of engagement in risky sexual behaviour and increased risk of sexual violence and exploitation.

Teenage pregnancy is further linked to lack of sexual and reproductive health education and services, child marriage, health and well-being risks, and increased poverty and insecurity.

Sub-Saharan Africa is home to more out-of-school children than any other region in the world.

It also has the highest teenage pregnancy rates globally, making the region uniquely confronted by how to address and accommodate pregnancies and young mothers in school.

Policies range across the region — from outright expulsion of pregnant girls to strategies that support the continued education of adolescent mothers — yet social norms, practices and other barriers still typically result in pregnancy being the end to one’s education.

With school closures related to COVID-19 threatening to lead to an increase in repeat teenage pregnancy, sub-Saharan Africa is poised for a further crisis in girls’ education unless governments and partners act now.

Preventing repeat teen births

Repeat adolescent births can be prevented. In her study, Dr. Amongin gives a number of recommendations that government, healthcare providers and communities can adopt in order to nip repeat adolescent births in the bud.

These are: helping mothers gain information about and use of effective types of birth control; alleviating household poverty and domestic violence; implementation of a school continuation policy or providing alternative forms of education for adolescent mothers and strengthening legislation against early marriage.

“Beyond focusing on preventing index adolescent pregnancy, programs need to specifically place emphasis on preventing repeat adolescent pregnancy,” she advises.

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