Summary measures of socioeconomic and area-based inequalities in fertility rates among adolescents: evidence from Ethiopian demographic and health surveys 2000–2016

Yaya, S; Ameyaw, EK; Idriss-Wheeler, D; Shibre, G; Zegeye, B

Summary measures of socioeconomic and area-based inequalities in fertility rates among adolescents: evidence from Ethiopian demographic and health surveys 2000–2016

Yaya, S Ameyaw, EK Idriss-Wheeler, D Shibre, G Zegeye, B

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Publisher:: BioMed Central
Publication Type:: Journal Article
Citation:: BMC Public Health, 2021, 21, (1), pp. 1-9
Issue Date:: 2021-04-21

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Field	Value	Language
dc.contributor.author	Yaya, S
dc.contributor.author	Ameyaw, EK
dc.contributor.author	Idriss-Wheeler, D
dc.contributor.author	Shibre, G
dc.contributor.author	Zegeye, B
dc.date.accessioned	2022-01-10T00:13:42Z
dc.date.available	2021-03-29
dc.date.available	2022-01-10T00:13:42Z
dc.date.issued	2021-04-21
dc.identifier.citation	BMC Public Health, 2021, 21, (1), pp. 1-9
dc.identifier.issn	1471-2458
dc.identifier.issn	1471-2458
dc.identifier.uri	http://hdl.handle.net/10453/152852
dc.description.abstract	Background One of the highest rates of adolescent pregnancies in the world is in sub-Saharan Africa. Most adolescent pregnancies in the region are unintended or unwanted, due to poor access to information and services on sexual and reproductive health for adolescents. Ethiopia has high adolescent fertility rates (AFR) with disparities across socioeconomic subgroups and regions. This study assessed the magnitude and trends of socioeconomic and area-based AFR inequalities in Ethiopia. Methods The 2000 and 2016 Ethiopia Demographic and Health surveys (EDHS) was analyzed using the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT) software. Adolescent fertility rates were disaggregated using three equity stratifiers (economic status, education and residence) and analyzed through four summary measures (Difference (D), Population Attributable Risk (PAR), Ratio (R) and Population Attributable Fraction (PAF)) to assess inequality. To measure statistical significance, point estimates were constructed using a 95% Uncertainty Interval (UI). Results Large socio-economic and urban-rural inequalities were observed within the 16-year period. Adolescents in less well-off socio-economic groups (PAF: -62.9 [95% UI; − 64.3, − 61.4], D: 96.4 [95% UI; 47.7, 145.1]), uneducated (R: 8.5 [95% UI; 4.8, 12.2], PAR: -76.4 [95% UI;-77.7, − 75.0]) and those from rural areas (D: 81.2 [95% UI; 67.9, 94.6], PAF: -74.2 [95% UI, − 75.7, − 72.7]) had a higher chance of pregnancy and more births than their counterparts. Conclusions Socioeconomic (education and economic status) and place of residence determine adolescents’ pregnancy and childbearing. Policies and programs should be directed at preventing child marriage and early fertility so that adolescents continue to access education, sexual and reproductive health care as well as access employment opportunities. More emphasis should be placed on subpopulations with disproportionately higher adolescent pregnancy and childbirth.
dc.format	Electronic
dc.language	eng
dc.publisher	BioMed Central
dc.relation.ispartof	BMC Public Health
dc.relation.isbasedon	10.1186/s12889-021-10729-5
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1117 Public Health and Health Services
dc.subject.classification	Public Health
dc.subject.mesh	Adolescent
dc.subject.mesh	Birth Rate
dc.subject.mesh	Child
dc.subject.mesh	Educational Status
dc.subject.mesh	Ethiopia
dc.subject.mesh	Female
dc.subject.mesh	Fertility
dc.subject.mesh	Health Surveys
dc.subject.mesh	Humans
dc.subject.mesh	Pregnancy
dc.subject.mesh	Rural Population
dc.subject.mesh	Socioeconomic Factors
dc.subject.mesh	Humans
dc.subject.mesh	Health Surveys
dc.subject.mesh	Birth Rate
dc.subject.mesh	Fertility
dc.subject.mesh	Pregnancy
dc.subject.mesh	Socioeconomic Factors
dc.subject.mesh	Adolescent
dc.subject.mesh	Child
dc.subject.mesh	Rural Population
dc.subject.mesh	Educational Status
dc.subject.mesh	Ethiopia
dc.subject.mesh	Female
dc.title	Summary measures of socioeconomic and area-based inequalities in fertility rates among adolescents: evidence from Ethiopian demographic and health surveys 2000–2016
dc.type	Journal Article
utslib.citation.volume	21
utslib.location.activity	England
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
utslib.copyright.status	open_access	*
pubs.consider-herdc	false
dc.date.updated	2022-01-10T00:13:40Z
pubs.issue	1
pubs.publication-status	Published
pubs.volume	21
utslib.citation.issue	1

Abstract:

Background One of the highest rates of adolescent pregnancies in the world is in sub-Saharan Africa. Most adolescent pregnancies in the region are unintended or unwanted, due to poor access to information and services on sexual and reproductive health for adolescents. Ethiopia has high adolescent fertility rates (AFR) with disparities across socioeconomic subgroups and regions. This study assessed the magnitude and trends of socioeconomic and area-based AFR inequalities in Ethiopia. Methods The 2000 and 2016 Ethiopia Demographic and Health surveys (EDHS) was analyzed using the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT) software. Adolescent fertility rates were disaggregated using three equity stratifiers (economic status, education and residence) and analyzed through four summary measures (Difference (D), Population Attributable Risk (PAR), Ratio (R) and Population Attributable Fraction (PAF)) to assess inequality. To measure statistical significance, point estimates were constructed using a 95% Uncertainty Interval (UI). Results Large socio-economic and urban-rural inequalities were observed within the 16-year period. Adolescents in less well-off socio-economic groups (PAF: -62.9 [95% UI; − 64.3, − 61.4], D: 96.4 [95% UI; 47.7, 145.1]), uneducated (R: 8.5 [95% UI; 4.8, 12.2], PAR: -76.4 [95% UI;-77.7, − 75.0]) and those from rural areas (D: 81.2 [95% UI; 67.9, 94.6], PAF: -74.2 [95% UI, − 75.7, − 72.7]) had a higher chance of pregnancy and more births than their counterparts. Conclusions Socioeconomic (education and economic status) and place of residence determine adolescents’ pregnancy and childbearing. Policies and programs should be directed at preventing child marriage and early fertility so that adolescents continue to access education, sexual and reproductive health care as well as access employment opportunities. More emphasis should be placed on subpopulations with disproportionately higher adolescent pregnancy and childbirth.

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http://hdl.handle.net/10453/152852