Determinants of Adolescent Pregnancy in the Municipality of Malanje, Angola: A Case-Control Study

Abstract

Introduction: Adolescent pregnancy is a global public health problem, with some of the highest rates observed in Sub-Saharan Africa. This phenomenon contributes to maternal and neonatal mortality and may result in diverse economic and psychological consequences. Knowledge of its determinants can help decision-makers to design local policies of sexual and reproductive health. Therefore, the aim of this study was to analyze the determinant factors of adolescent pregnancy in the municipality of Malanje, Angola.
Methods: A case-control study was conducted from August to October, 2022. A sample of 411 adolescent women (137 pregnant and 274 non-pregnant) was compared in terms of socio-demographic, behavioral, family, and extra-family factors. Descriptive statistics, binary univariate and multivariate logistic analysis were applied, with p-values ≤ 0.05 indicating statistical significance. Adjusted odds ratio (AOR) and the respective 95% confidence interval (95% CI) were obtained.
Results: The multivariable analysis showed that a higher risk of adolescent pregnancy was associated with living in a de facto union or being married (AOR = 10.37; 95% CI = 1.05 - 102.83), having 0 - 4 (AOR = 7.40; 95% CI = 1.25 - 43.77) or 5 - 8 years of schooling (AOR = 5.21; 95% CI = 1.25 - 21.77), and a lower risk was related with having a family history of adolescent pregnancy (AOR = 0.30; 95% CI = 0.11 - 0.80) for women aged 15 - 17. For those aged 18 - 19, a higher risk of pregnancy was associated with early sex initiation (AOR = 3.75; 95% CI = 1.05 - 13.43), having multiple sexual partners (AOR = 3.02; 95% CI = 1.23 - 7.44), while a lower risk was related with peer pressure (AOR = 0.35; 95% CI = 0.15 - 0.82). In both groups, the likelihood of pregnancy was significantly increased for irregular or non-use of contraceptive methods.
Conclusion: In Malanje, adolescent pregnancy is a multifactorial phenomenon, and preventive strategies must consider the adolescents’ age. Among adolescents aged 15 - 17, early marriages, should be reduced, through the promotion of education and the creation of specific laws. For older adolescents, preventive strategies should be focused on avoiding risky behaviors such as early initiation of sexual activity and multiple sexual partners. Comprehensive sexual education, including knowledge about contraceptive methods should be promoted.