Factors associated with teenage pregnancies during the Covid-19 period in Pakwach district, Northern Uganda: a case-control study
Date
2023-09-14
Journal Title
Journal ISSN
Volume Title
Publisher
medRxiv preprint
Abstract
Teenage pregnancy rates have globally decreased over the years, but remain high,
especially in low- and middle-income countries (LMICs). Among girls aged 15-19, teenage
pregnancy remains the leading cause of death and a significant barrier to education and
productivity. Its prevalence underscores concern about the sexual and reproductive health of
youth. However, limited data exist regarding factors contributing to its rise during the COVID19 pandemic in Uganda. This study explores the factors associated with teenage pregnancy in
Pakwach district during this period.
We conducted a matched case-control study, enrolling 362 teenage girls aged 10-19
years, divided into two groups: 181 pregnant teenagers and 181 not pregnant teenagers. We
collected exposure data from both groups using questionnaires to evaluate factors associated with
teenage pregnancy. The study period covered March 2020 to January 2021, coinciding with
lockdown measures.
During the COVID-19 lockdown, teenage pregnancies were only associated with
having exclusively female peers (AOR 3.0, 95% CI: 0.1-104.4). Conversely, having a Radio/TV
at home (AOR 0.2, 95% CI: 0.1-0.6), age at first sexual encounter (AOR 0.1, 95% CI: 0.03-0.9),
considering teenage pregnancy as sexual abuse (AOR 0.1, 95% CI: 0.02-0.4), feeling
comfortable asking questions during consultations (AOR 0.5, 95% CI: 0.2-1.3), and ensuring
sufficient privacy during consultations were protective against teenage pregnancy.
The factors contributing to increased teenage pregnancies during the COVID-19
pandemic were consistent with long-standing contextual factors associated with teenage
pregnancy. The lockdown environment may have slightly exacerbated these factors, but no direct
association was observed. Only having female peers was linked to teenage pregnancy during the
lockdown. Conversely, having access to a radio/TV at home and other healthcare system-related
factors offered protection. Therefore, interventions should prioritize providing comprehensive
information on the risks of teenage pregnancy during any lockdown scenario.
Description
Keywords
Case-control study, Healthcare providers, COVID-19, Teenage pregnancy, Outcomes.