abstract: 'Objective Understanding the determinants of adolescent pregnancy and how

  they have changed over time is essential for measuring progress and

  developing strategies to improve adolescent reproductive health. This

  study examined changes over time in the prevalence and determinants of

  adolescent pregnancy in Ghana.

  Methods A total of 11 nationally representative surveys from the Ghana

  Demographic and Health Survey (1988, 1993, 1998, 2003, 2008, 2014),

  Multiple Indicator Cluster Survey (2006, 2011, 2017-2018) and Malaria

  Indicator Survey (2016 and 2019) provided data on 14556 adolescent girls

  aged 15-19 for this analysis. A random-effect meta-analysis, time trends

  and multivariable logistic regression models were used to track the

  prevalence and determinants of adolescent pregnancy.

  Results The pooled prevalence of adolescent pregnancy in Ghana was

  15.4\% (95\% CI=13.49\% to 17.30\%). Rural areas (19.5\%) had a higher

  prevalence of adolescent pregnancy than urban areas (10.6\%). In the

  overall sample, middle adolescents (15-17 years) (aOR=0.30, 95\% CI=0.23

  to 0.39), adolescents in urban areas (aOR=0.56, 95\% CI=0.43 to 0.74),

  large households (aOR=0.62, 95\% CI=0.49 to 0.78), not working

  (aOR=0.62, 95\% CI=0.43 to 0.90) and those unaware of contraceptive

  methods (aOR=0.49, 95\% CI=0.27 to 0.90) were less likely to become

  pregnant. Adolescents from middle-income (aOR=0.91, 95\% CI=0.67 to

  1.24) or high-income (aOR=0.59, 95\%CI=0.36 to 0.94) households, those

  who were semiliterate (aOR=0.56, 95\%CI=0.39 to 0.82) or literate

  (aOR=0.28, 95\%CI=0.21 to 0.37) and those with fewer previous sex

  partners were less likely to become pregnant. Not all determinants in

  the overall sample were consistently associated with adolescent

  pregnancy in the last three decades. Between 1988 and 1998, determinants

  of adolescent pregnancy were age, literacy, employment, household size

  and whether the mother was alive. Between 2003 and 2008, age, literacy,

  household size, income, age of last sexual partner, number of previous

  partners and contraception knowledge determined adolescent pregnancy.

  From 2011 to 2019, age, residence, literacy and menstrual cycle

  knowledge were determinants of adolescent pregnancy.

  Conclusion Interventions and policies to prevent adolescent pregnancy

  should prioritise adolescents from disadvantaged backgrounds.'
affiliation: 'Mohammed, S (Corresponding Author), London Sch Hyg \& Trop Med, Dept
  Noncommunicable Dis Epidemiol, London, England.

  Mohammed, Shamsudeen, London Sch Hyg \& Trop Med, Dept Noncommunicable Dis Epidemiol,
  London, England.'
article-number: e068117
author: Mohammed, Shamsudeen
author-email: Shamsudeen.Mohammed1@lshtm.ac.uk
author_list:
- family: Mohammed
  given: Shamsudeen
da: '2023-09-28'
doi: 10.1136/bmjopen-2022-068117
files: []
issn: 2044-6055
journal: BMJ OPEN
keywords: Epidemiology; Public health; REPRODUCTIVE MEDICINE
language: English
month: FEB
number: '3'
number-of-cited-references: '30'
papis_id: 20b9d4bdb6ebd30b66ada8d35ce7f322
ref: Mohammed2023analysisnational
times-cited: '0'
title: Analysis of national and subnational prevalence of adolescent pregnancy and
  changes in the associated sexual behaviours and sociodemographic determinants across
  three decades in Ghana, 1988-2019
type: Article
unique-id: WOS:000991974800067
usage-count-last-180-days: '0'
usage-count-since-2013: '0'
volume: '13'
web-of-science-categories: Medicine, General \& Internal
year: '2023'