Factors associated with agreeing to early childbearing among Adolescent girls in selected rural districts of Zambia.

Abstract

In Zambia, approximately 7.2% of sexually active girls, aged 15-19, reported having had a sexual partner. The National Health Strategic Plan 2017-2021 highlighted the high adolescent birth rate which was at 141 per 1000 live births between the year’s 2013 and 2014. According to the laws of Zambia, an adolescent girl can consent for sex at the age of 16 and above; early childbearing is any pregnancy before the age of 16 which is the focus for this study. This study was investigating factors that influence early childbearing among adolescent girls in some selected rural districts of Zambia at baseline of the RISE cluster randomised trial. The investigated factors included; cultural beliefs, social economic factors, knowledge and access to reproductive health information and peer pressure. The study was a nested quantitative cross-sectional design embedded in a Cluster Randomised Trial of the Research Initiative to Support the Empowerment (RISE) of girls. Participants were girls attending grade seven at various schools in 2016. Information on factors that could influence the participants’ view on childbearing were collected at baseline. A complete enumeration of approximately 4900 girls recruited in 12 rural districts of Central and Southern provinces was analysed. Descriptive statistics are presented as frequencies and percentages in tables. To check for the association between the outcome variable which was categorical in nature and the independent variables, Chi-squared test was used or Fisher’s exact test for frequencies which were less than five. Univariate and Multiple Logistic regression analysis was used to test the association between independent factors and early childbearing. Clustering in the study was accounted for using robust standard errors. Results: The findings showed that more than two-thirds 3189 (73.7%) of the participants had no knowledge regarding adolescent sexual and reproductive health information on family planning use, only 1137( 26%) had knowledge. A number of adolescents with mobile phones 235(77.6%) agreed to engaging into early childbearing practices as opposed to those who had none. Majority of adolescent girls 227 (69%) who agreed to early childbearing were aged 10 to 15 years, whilst the least number of adolescents who agreed to early childbearing were 99(30.3%) in the age ranges of 16 to 20 years. In addition, results reviled that one-year increase in age of an adolescent girl increases early childbearing by 30% (OR=1.30, 95% CI (1.01, 1.67), p- value=0.03). Overall, very few factors (mobile phone and age) at baseline were found to be associated with child bearing. In conclusion, Only mobile phone use and age were associated with early childbearing at baseline. Cultural norms and socio-economic factors were not associated with early childbearing in this study. Given that this information was at baseline of the original cluster randomised trial, the information suggests that there was no evidence of a difference in factors that may affect early childbearing. Hence, in the original study, it appears like randomisation worked as there is no evidence of difference on a number of possible factors that may affect early childbearing. Key Words: Early Child bearing Knowledge, Adolescent, Reproductive health.