Two Level Logistic Regression Model of Factors Influencing in Early Childbearing and its Consequences on Nutritional Status of Bangladeshi Mothers: Nationally Representative Data

Background: Early marriage and early pregnancy is a social as well as a medical problem in developing countries, which may have an impact on the health and nutritional status of teenage mothers. Therefore, the objective of this study was to determine the influencing factors of early childbearing (ECB) and its consequences on the nutritional status of Bangladeshi mothers. Methods: Data was extracted from Bangladesh Demographic and Health Survey (BDHS-2014). Women who delivered their first baby before the age of 20 years are considered ECB mothers. Nutritional status was measured by body mass index (BMI). Chi-square test and both univariable and multivariable logistic regressions, and z-proportional test were used in this study. Results: The prevalence of ECB among currently non-pregnant mothers in Bangladesh was 83%. The logistic regression model provided the following six risk factors of ECB: (i) living location (division) (p<0.01), (ii) respondents’ education (p<0.05), (iii) husbands’ education (p<0.05), (iv) household wealth quintiles (p<0.01), (v) respondents’ age at first marriage (p<0.05), and (vi) number of family members (p<0.05). Still, 17.6% of mothers were undernourished in Bangladesh; among them, 18.5% and 13.4% were ECB and non- ECB mothers respectively. ECB mothers had a greater risk to be undernourished than non-ECB mothers [COR=1.26, 95% CI: 1.11-1.43; p<0.01]. Conclusions: In this study, some modifiable factors were found as predictors of ECB in Bangladesh. ECB mothers were more prone to become under-nourished. These findings can be considered to reduce the number of ECB mothers in Bangladesh consequently improve their nutritional status.

Associations of early marriage and early childbearing with anemia among adolescent girls in Ethiopia: a multilevel analysis of nationwide survey

Background Early marriage and early childbearing are common practices in Ethiopia. Girls who get married and give birth at a very young age are more likely to experience several health problems including anemia among others. However, the effects of early marriage and early childbearing on anemia status of adolescent girls have not been quantified in previous studies. In this study, we assessed whether early marriage and early childbearing measured at both individual and community levels are associated with adolescent anemia. Methods We analyzed data from the 2016 demographic and health survey of Ethiopia. Our study focused on 3172 late female adolescents (15–19 years). We used the chi-squared test and spearman correlation coefficients for bivariate analysis. The relationship between early marriage and childbearing with anemia was evaluated using multilevel binary logistic regression models while controlling other determinants. Results Overall prevalence of anemia among female adolescents was 23.8% (95% CI; 22.3–25.2). Our multivariable multilevel analysis showed that individual-level marital status (AOR = 1.53, 95% CI = 1.06–2.02) and community-level childbearing status (AOR = 2.80, 95% CI 1.25–6.29) were positively associated with anemia among female adolescents. Conclusion Our findings show the presence of significant association between early marriage & early childbearing with adolescent anemia. Therefore, there is a need for effective policies and programs to end the practice of early child marriage and the consequent adolescent pregnancy in Ethiopia. This will help to improve nutritional status of adolescent girls as well as nutritional outcomes of their children.

Mechanisms linking teenage mothers’ educational attainment with self-reported health at age 50

Background Early childbearing is associated with adverse health and well-being throughout the life course for women in the United States. As education continues to be a modifiable social determinant of health after a young woman gives birth, the association of increased educational attainment with long-term health for women who begin childbearing as teenagers is worthy of investigation. Methods Data are from 301 mothers in the National Longitudinal Survey of Youth 1979 who gave birth prior to age 19. We estimated path models to assess women’s incomes, partner characteristics, and health behaviors at age 40 as mediators of the relationship between their educational attainment and self-rated general health at age 50. Results After accounting for observed background factors that select women into early childbearing and lower educational attainment, higher levels of education (high school diploma and GED attainment vs. no degree) were indirectly associated with higher self-rated health at age 50 via higher participant income at age 40. Conclusions As education is a social determinant of health that is amenable to intervention after a teen gives birth, our results are supportive of higher educational attainment as a potential pathway to improving long-term health outcomes of women who begin childbearing early.

Associations of Early Marriage and Early Childbearing with Anemia Among Adolescent Girls in Ethiopia: A Multilevel Analysis of Nationwide Survey

Background: Early marriage and early childbearing are common practices in Ethiopia. Girls who got married and give birth at a very young age are more likely to experience several health problems including anemia among others. However, the effects of early marriage and early childbearing on anemia status of adolescent girls have not been quantified in previous studies. In this study, we assessed whether early marriage and early childbearing measured at both individual and community levels are associated with adolescent anemia. Methods: We analyzed data from the 2016 demographic and health survey of Ethiopia. Our study concentrated on 3,172 late female adolescents (15-19 years). For bivariate analysis, we used the chi-squared test and spearman correlation coefficients. The relationship between early marriage and childbearing with anemia was evaluated using multilevel binary logistic regression models while controlling other determinants.Results: Overall prevalence of anemia among female adolescents was 23.8 (95% CI; 22.3-25.2). Our multivariable multilevel analysis showed that individual-level marital status (AOR=1.53, 95% CI=1.06-2.02) and community-level childbearing status (AOR=2.80, 95% CI 1.25-6.29) were positively associated with anemia among female adolescents.Conclusion: Our findings show that the consequences of early marriage and early childbearing on adolescent anemia are significant. There is a need to avoid early marriage and childbearing in Ethiopia to improve the health status of adolescent girls.

“I have to provide for another life emotionally, physically and financially”: understanding pregnancy, motherhood and the future aspirations of adolescent mothers in KwaZulu-Natal South, Africa

Background Adolescent pregnancy and motherhood has been a controversial and much disputed subject within the field of public health. Early childbearing is not only characterized as a physical body experience but also embodies the experiences and perceptions of the social norms, discourses, conflict and moral judgement. There is an increasing concern that the psychosocial challenges facing adolescent mothers remains in the background since research in this field has mainly focused on the medical and physical complications of early childbearing. The aim of this qualitative study was to explore adolescent pregnancy and motherhood in order to understand this phenomenon from the perspective of adolescent mothers and to gain insight into their future aspirations. Methods This descriptive qualitative study was based on data from four focus group discussions with adolescent mothers utilising healthcare services at a district hospital in Ugu district, KwaZulu Natal, South Africa. The data were audio-recorded and transcribed verbatim, then analysed using thematic analysis. Results Some adolescent mothers’ partners were in denial and rejected them and the child while others’ partners were happy and supported them during their pregnancy. Families’ reactions to the pregnancies ranged between anger and disappointment to abandonment, the silent treatment, and acceptance and forgiveness. The psychological issues experienced by some of the adolescent mothers included suicidal ideation, guilt, loneliness, anxiety, and stress. They also experienced financial constraints, difficulty in returning to school, and stigmatisation in society. The participants envisioned completing their education, focusing on their dream careers, and contributing positively to society. Conclusion Experiences of adolescent pregnancy and parenting are multifaceted and the healthcare needs of pregnant and parenting adolescents extend beyond information and knowledge. A multidisciplinary approach is required in the care of adolescent mothers. A key policy priority should encompass the collaboration of different professionals from various healthcare sectors to assist adolescent mothers in achieving better health and psychosocial and socio-economic outcomes as steps to securing a better future for them.

Vanilla bisquits and lobola bridewealth: parallel discourses on early pregnancy and schooling in rural Zambia

Background Adolescent pregnancy is a complex socio-economic phenomenon ranking high on the global health policy agenda. Early childbearing is associated with early marriage and school drop-out, and is defined as a problem to the health and development of girls. This paper reports from formative research. The formative research aimed to explore socio-cultural and structural dynamics at work behind early pregnancy and school drop out in rural Zambia. The study findings have been used to inform a school based intervention to reduce early pregnancy (RISE: ‘Research Initiative to Support the Empowerment of Girls’). Theoretically the study is informed by social constructionism. Methods A qualitative approach was employed. Semi-structured qualitative interviews (61) and focus group discussions (7) were carried out with girls (in and out of school), boys, parents, teachers, health workers and community- and district leaders in 2014–15. Systematic text condensation was drawn upon in the analysis of the material. Results The study findings indicate that the official Zambian discourse that presents early pregnancy as a serious challenge and schooling as the prime way to confront the problem enjoy substantial support at community levels. However, a parallel discourse on fertility, early marriage and childbearing as social and economic security surfaced and was articulated by the same study participants. The latter contrasting discourse questioned schooling as the only solution to secure a girl’s future arguing that there are many reasons why early pregnancy may emerge as rational. Conclusions Grasping the complexity of local discourse is vital in planning health interventions. The present study revealed that although delayed child bearing and schooling among girls enjoyed high status and legitimacy in the study area, the social and economic context worked to reward early marriage. Interventions to reduce early pregnancies in rural Zambian communities need to fundamentally address the material constraints that condition and reinforce a culture of early childbearing.