Plain English summary
Background
Methods
Study design and search strategy
Study selection and eligibility criteria
Definition of adolescent pregnancy
Quality assessment and data extraction
Heterogeneity and publication Bias
Statistical methods and analysis
Results
Study selection
Characteristics of included studies
Authors & year | Study area, country | Sub-region | Study design and type | Study population | Range of ages of participants | Sample size | Response rate (%) | Outcome measured | Prevalence of adolescent pregnancy |
---|---|---|---|---|---|---|---|---|---|
Mathewos and Mekuria, 2018 [12] | Arba Minch town, Ethiopia | East Africa | Cross sectional, institution-based | School adolescent students | 15 to 19 | 578 | 100 | Ever pregnant | 7.7 |
Akanbi F et al., 2016 [15] | Naguru Teenage Centre Kampala, Uganda | East Africa | Cross sectional, institution-based | Adolescent girls | 13 to 19 | 384 | 82 | Current pregnant | 39.7 |
Sungwe, 2015 [16] | Zambia, 2007 DHS | East Africa | Cross sectional, community-based | Adolescent girls | 15 to 19 | 1574 | 100 | Ever pregnant | 28.5 |
Kaphagawani and Kalipeni, 2017 [69] | Zomba district, Malawi | East Africa | Cross sectional, institution-based | Women visiting ANC | 10 to 19 | 505 | 100 | Current pregnant | 37.1 |
Agbor et al., 2017 [47] | Health facilities in rural Cameroon | Central Africa | Retrospective study, institution-based | All deliveries during the study period | 10 to 19 | 2343 | 77 | Current pregnant | 20.4 |
Malawi 2015–16 DHS, 2017 [45] | The 2015–16 DHS, Malawi | East Africa | Cross sectional, community-based | Adolescent girls | 15 to 19 | 5263 | 100 | Ever pregnant | 29 |
Ethiopia 2016 DHS, 2017 [29] | The 2016 DHS, Ethiopia | East Africa | Cross sectional, community-based | Adolescent girls | 15 to 19 | 3381 | 100 | Ever pregnant | 13 |
Jonas et al., 2016 [72] | South Africa | Southern Africa | Cross sectional, institution-based | School adolescent students | 11 to 19 | 16,614 | 100 | Ever pregnant | 20.5 |
Garba et al., 2016 [48] | Aminu kano teaching hospital, Nigeria | West Africa | Retrospective study, institution-based | All deliveries during the study period | 15 to 19 | 9312 | 100 | Current pregnant | 5.8 |
Zimbabwe 2015 DHS, 2016 [45] | The 2015 DHS, Zimbabwe | East Africa | Cross sectional, community-based | Adolescent girls | 15 to 19 | 2199 | 100 | Ever pregnant | 21.6 |
Rwanda 2014–15 DHS, 2016 [44] | The 2014–15 DHS, Rwanda | East Africa | Cross sectional, community-based | Adolescent girls | 15 to 19 | 2768 | 100 | Ever pregnant | 7.3 |
Lesotho 2014 DHS, 2016 [43] | The 2014 DHS, Lesotho | Southern Africa | Cross sectional, community-based | Adolescent girls | 15 to 19 | 1440 | 100 | Ever pregnant | 19.1 |
Tanzania 2015–16 DHS, 2016 [42] | The 2015–16 DHS, Tanzania | East Africa | Cross sectional, community-based | Adolescent girls | 15 to 19 | 2904 | 100 | Ever pregnant | 26.7 |
Beyene et al., 2015 [18] | Assosa general Hospital, Benishangul Gumuz region, Ethiopia | East Africa | Cross sectional, institution-based | Teenage females visiting hospital for health care services | 13 to 19 | 783 | 98.3 | Ever pregnant | 20.4 |
Okigbo and Speizer, 2015 [70] | Five urban areas in Kenya, Kenya | East Africa | Cross sectional, community-based | Unmarried young women | 15 to 19 | 750 | 100 | Ever pregnant | 8.1 |
Ngowa et al., 2015 [49] | Yaoundé general hospital, Cameroon | Central Africa | Retrospective study, institution-based | All delieveries during the study period | 10 to 19 | 11,640 | 100 | Current pregnant | 2.84 |
Egbe et al., 2015 [71] | Buea health district, South West Region, Cameroon | Central Africa | Retrospective study, institution-based | Women visiting ANC | 10 to 19 | 6564 | 100 | Current pregnant | 13.3 |
Schipulle, 2015 [50] | Three health centers in the central Gabon | Central Africa | Retrospective study, institution-based | All delieveries during the study period | 12 to 19 | 1972 | 100 | Current pregnant | 23.7 |
Kenya 2014 DHS, 2015 [40] | The 2014 DHS, Kenya | East Africa | Cross sectional, community-based | Adolescent girls | 15 to 19 | 5820 | 100 | Ever pregnant | 18.1 |
Egypt 2014 DHS, 2015 [41] | The 2014 DHS, Egypt | North Africa | Cross sectional, community-based | Adolescent girls | 15 to 19 | 5185 | 100 | Ever pregnant | 10.9 |
Ghana 2014 DHS, 2015 [39] | The 2014 DHS, Ghana | West Africa | Cross sectional, community-based | Adolescent girls | 15 to 19 | 1625 | 100 | Ever pregnant | 14.2 |
Zambia 2013–14 DHS, 2015 [38] | The 2013–14 DHS, Zambia | East Africa | Cross sectional, community-based | Adolescent girls | 15 to 19 | 3625 | 100 | Ever pregnant | 28.5 |
Envuladu et al., 2014 [19] | Rural Community in Jos, Plateau State, Nigeria | West Africa | Cross sectional, community-based | Teenage girls | 13 to 19 | 192 | 100 | Ever pregnant | 25.5 |
Brahmbhatt et al., 2014 [67] | Urban disadvantaged settings, South Africa | Southern Africa | Cross sectional, community-based | Adolescent girls | 15 to 19 | 224 | 100 | Ever pregnant | 28.8 |
Brahmbhatt et al., 2014 [67] | Urban disadvantaged settings, Nigeria | West Africa | Cross sectional, community-based | Adolescent girls | 15 to 19 | 229 | 100 | Ever pregnant | 24.1 |
Gambia 2013 DHS, 2014 [37] | The 2013 DHS, Gambia | West Africa | Cross sectional, community-based | Adolescent girls | 15 to 19 | 2407 | 100 | Ever pregnant | 17.5 |
Sierra Leone 2013 DHS, 2014 [36] | The 2013 DHS, Sierra Leone | West Africa | Cross sectional, community-based | Adolescent girls | 15 to 19 | 3878 | 100 | Ever pregnant | 27.9 |
Liberia 2013 DHS, 2014 [33] | The 2013 DHS, Liberia | West Africa | Cross sectional, community-based | Adolescent girls | 15 to 19 | 2080 | 100 | Ever pregnant | 31.3 |
Namibia 2013 DHS, 2014 [34] | The 2013 DHS, Namibia | Southern Africa | Cross sectional, community-based | Adolescent girls | 15 to 19 | 1906 | 100 | Ever pregnant | 18.6 |
Nigeria 2013 DHS, 2014 [35] | The 2013 DHS, Nigeria | West Africa | Cross sectional, community-based | Adolescent girls | 15 to 19 | 7820 | 100 | Ever pregnant | 22.5 |
Fayemi et al., 2013 [68] | Ekiti state, Nigeria | West Africa | Cross sectional, community-based | Adolescent girls | 13 to 18 | 400 | 100 | Ever pregnant | 25 |
Ugboma et al., 2012 [51] | Ebonyi state university teaching hospital, Nigeria | West Africa | Retrospective study, institution-based | All delieveries during the study period | 13 to 19 | 8297 | 100 | Current pregnant | 5.5 |
Iklaki et al., 2012 [52] | University of Calabar Teaching Hospital, Calabar, Nigeria | West Africa | Retrospective study, institution-based | All delieveries during the study period | 10 to 19 | 9906 | 100 | Current pregnant | 6.5 |
Ezegwui et al., 2012 [53] | Tertiary hospital in Enugu, Nigeria | West Africa | Retrospective study, institution-based | All delieveries during the study period | 11 to 19 | 4422 | 100 | Current pregnant | 1.62 |
Amoran, 2012 [58] | Sagamu local government area, Ogun State, Nigeria | West Africa | Cross sectional, institution-based | All pregnant women attending the primary health care | 10 to 19 | 225 | 100 | Current pregnant | 22.9 |
Nyarko, 2012 [22] | The 2008 DHS, Ghana | West Africa | Cross sectional, community-based | Adolescent girls | 15 to 19 | 1037 | 100 | Ever pregnant | 10.2 |
Mchunu et al., 2012 [73] | South Africa | Southern Africa | Cross sectional, community-based | Youths | 10 to 19 | 3123 | 96.4 | Ever pregnant | 19.3 |
Isa and Gani, 2012 [54] | Niger delta university teaching hospital, Bayelsa state, Nigeria | West Africa | Cross sectional, institution-based | All delieveries during the study period | 13 to 19 | 1341 | 100 | Current pregnant | 6.2 |
Uganda 2011 DHS, 2012 [32] | The 2011 DHS, Uganda | East Africa | Cross sectional, community-based | Adolescent girls | 15 to 19 | 2048 | 100 | Ever pregnant | 23.8 |
Rasheed et al., 2011 [55] | Sohag university hospital, Sohag, Egypt | North Africa | Retrospective study, institution-based | All delieveries during the study period | 10 to 19 | 30,441 | 100 | Current pregnant | 7.5 |
Maduforo and Oluwatoyin, 2011 [59] | General hospital Ganye, Nigeria | West Africa | Cross sectional, institution-based | Women visiting ANC | 10 to 19 | 106 | 100 | Current pregnant | 50.9 |
Alemayehu et al., 2010 [23] | The 2005 DHS, Ethiopia | East Africa | Cross sectional, community-based | Adolescent girls | 15 to 19 | 3266 | 100 | Ever pregnant | 13.6 |
Tebeu et al., 2010 [56] | Referral maternity units in Cameroon | Central Africa | Retrospective study, institution-based | All delieveries during the study period | 10 to 19 | 57,787 | 99.7 | Current pregnant | 14.23 |
Swaziland 2006–07 DHS, 2008 [31] | The 2006–07 DHS, Swaziland | Southern Africa | Cross sectional, community-based | Adolescent girls | 15 to 19 | 1274 | 100 | Ever pregnant | 22.6 |
Iloki et al., 2004 [57] | Brazzaville university hospital, Congo | Central Africa | Cross sectional, institution-based | All delieveries during the study period | < 18 | 5204 | 100 | Current pregnant | 5.3 |
Fathi, 2003 [25] | The 1998 DHS, Cameroon | Central Africa | Cross sectional, community-based | Adolescent girls | 15 to 19 | 1282 | 100 | Ever pregnant | 31.2 |
Eritrea 2002 DHS, 2003 [30] | The 2002 DHS, Eritrea | East Africa | Cross sectional, community-based | Adolescent girls | 15 to 19 | 1129 | 100 | Ever pregnant | 23 |
Ayele et al., 2018 [13] | Deguwa Tembien district, Tigry, Ethiopia | East Africa | Case control, community-based | Adolescent girls | 13 to 19 | 414 | 100 | Current pregnancy | – |
Izugbara, 2015 [17] | 2008 DHS, Nigeria | West Africa | Cross sectional, community-based | Adolescent girls | 13 to 19 | 6592 | 100 | Current pregnancy | – |
Philemon, 2007 [24] | Kinondoni Municipality, Dar-Es-Salaam, Tanzania | East Africa | Cross sectional | Adolescent girls | 10 to 19 | 246 | 83 | Current pregnancy | – |
Kupoluyi et al., 2013 [20] | 2003 DHS, Nigeria | West Africa | Cross sectional, community-based | Adolescent girls | 10 to 19 | 7819 | 100 | Ever pregnant | – |
Gideon, 2013 [21] | 2011 DHS, Uganda | East Africa | Cross sectional, community-based | Adolescent girls | 15 to 19 | 2026 | 100 | Ever pregnant | – |
Variables | Coefficient |
P-value
|
---|---|---|
Publication year | 0.24 | 0.653 |
Sample size | - < 0.001 | 0.672 |
East Africa | 4.31 | 0.572 |
Southern Africa | 12 | 0.266 |
West Africa | −3.88 | 0.560 |
Central Africa | −3.53 | 0.612 |
Unpublished studies | 19.22 | 0.319 |
Prevalence of adolescent pregnancy in Africa
Subgroup | Number of studies | Total Sample | Prevalence (95%CI) | Heterogeneity | |
---|---|---|---|---|---|
I
2
|
p-value
| ||||
By Sub-region | |||||
East Africa | 16 | 36,977 | 21.5 (17.3, 25.7) | 99.1 | < 0.001 |
Southern Africa | 6 | 24,581 | 20.4(18.9, 21.7) | 73.7 | 0.002 |
West Africa | 16 | 53,277 | 17.7 (14.1, 21.4) | 99.6 | < 0.001 |
Central Africa | 7 | 86,792 | 15.8 (10.3, 21.3) | 99.8 | < 0.001 |
Northern Africa | 2 | 35,626 | 09.2 (05.8, 12.5) | 98.2 | < 0.001 |
Sub Saharan African countries | 45 | 201,627 | 19.3 (16.9, 21.6) | 99.7 | < 0.001 |
By study design | |||||
Cross-sectional (including survey studies) | 37 | 94,569 | 21.3 (18.6, 24) | 99.2 | < 0.001 |
Retrospective study | 10 | 142,684 | 10.1 (06.9, 13.2) | 99.8 | < 0.001 |
By study type | |||||
Community-based | 28 | 68,829 | 20.9 (18.2, 23.7) | 98.9 | < 0.001 |
Institution-based | 18 | 168,424 | 15.2 (12.5, 17.9) | 99.7 | < 0.001 |
By type of the document | |||||
DHS final report | 18 | 56,752 | 20.9 (17.4, 24.3) | 99.1 | < 0.001 |
Research article | 29 | 180,501 | 17.2 (14.9, 19.5) | 99.7 | < 0.001 |
By publication status | |||||
Unpublished studies | 3 | 4828 | 27.7 (23.3, 32.2) | 91.7 | < 0.001 |
Published studies | 44 | 232,425 | 18.2 (16, 20.3) | 99.7 | < 0.001 |
By publication year | |||||
Before 2015 (during MDG period) | 35 | 189,562 | 18.2 (15.9, 20.5) | 99.7 | < 0.001 |
2016 to 2018 (post MDG) | 12 | 47,691 | 20.5 (15.1, 25.9) | 99.6 | < 0.001 |
By quality score | |||||
Low score | 22 | 164,964 | 16.3 (13.6, 18.9) | 99.7 | < 0.001 |
High score | 25 | 72,289 | 20.8 (17.3, 24.4) | 99.4 | < 0.001 |
Total | 47 | 237,253 | 18.8 (16.7, 20.9) | 99.7 | < 0.001 |