Prevalence and factors associated with teenage pregnancy in refugee settlements of northern Uganda post-COVID-19 (2020–2023): a cross-sectional study

Background Following the COVID-19 pandemic, there was an increase in teenage pregnancies nationally, however, limited data exists regarding the same among girls living in refugee settlements.Objectives We evaluated the prevalence of teenage pregnancy and associated factors in Palorinya and Bidi Bidi...

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Main Authors: Felix Bongomin, Donald Otika, George Odongo, Ruth Mary Mary Muzaki, Beatrice Oweka Lamwaka, Francis Pebalo Pebolo
Format: Article
Language:English
Published: BMJ Publishing Group 2024-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/12/e089361.full
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author Felix Bongomin
Donald Otika
George Odongo
Ruth Mary Mary Muzaki
Beatrice Oweka Lamwaka
Francis Pebalo Pebolo
author_facet Felix Bongomin
Donald Otika
George Odongo
Ruth Mary Mary Muzaki
Beatrice Oweka Lamwaka
Francis Pebalo Pebolo
author_sort Felix Bongomin
collection DOAJ
description Background Following the COVID-19 pandemic, there was an increase in teenage pregnancies nationally, however, limited data exists regarding the same among girls living in refugee settlements.Objectives We evaluated the prevalence of teenage pregnancy and associated factors in Palorinya and Bidi Bidi refugee settlements in Obongi and Yumbe districts of northern Uganda, in the post-COVID-19 era.Design We conducted a cross-sectional study.Setting Refugee settlements in northern Uganda.Participants We included 385 teenage girls aged 15–19 years.Methods We used convenience sampling techniques between March and May 2023. Prevalence of teenage pregnancy was assessed by self-reported pregnancies between January 2020 and May 2023 among participants. We conducted Pearson’s χ2 and Fisher’s exact tests for bivariate analysis. All variables with a p value<0.2 at bivariate analysis were included in multivariable regression. We applied a modified Poisson regression model at the multivariable level to evaluate independent associations. The level of statistical significance was set at p<0.05.Primary and secondary outcome measures The primary outcome measure was the prevalence of teenage pregnancy, assessed through self-reported pregnancies among participants. Secondary outcome measures included factors associated with teenage pregnancy, such as living with a husband, lack of formal education, peer pressure and history of sexual abuse.Results Overall, the mean age was 17 (IQR: 15–18), and sexual debut was at 16 (IQR: 15–17) years. Lifetime modern contraceptive use was 13.8% (n=53/385) and current use was 7.5% (n=29/385). Teenage pregnancy period prevalence was 34.0% (CI: 29.4% to 38.9%). Factors independently associated with teenage pregnancy were: living with a husband (aPR: 3.8, 95% CI: 2.51 to 5.84, p<0.001), lack of formal education (Adjusted Prevalence Ratios - aPR: 2.3, 95% CI: 1.26 to 4.35, p=0.007), peer pressure (aPR: 2.1, 95% CI: 1.54 to 2.86, p<0.001) and history of sexual abuse (aPR: 1.5, 95% CI: 1.07 to 1.99, p=0.018).Conclusion Our study revealed that around 1 in 3 adolescent girls in northern Uganda’s refugee settlements experienced pregnancy during the COVID-19 pandemic, with only 1 in 13 currently using modern contraceptives. To address this, targeted strategies by relevant authorities are crucial, including legal actions against sexual abuse, promoting girl child education and enhancing access to long-term contraception to reduce teenage pregnancy and associated health risks in these settings.
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spelling doaj-art-5c3e80a5d5314a9a9a6385028b4f482f2025-01-01T07:05:08ZengBMJ Publishing GroupBMJ Open2044-60552024-12-01141210.1136/bmjopen-2024-089361Prevalence and factors associated with teenage pregnancy in refugee settlements of northern Uganda post-COVID-19 (2020–2023): a cross-sectional studyFelix Bongomin0Donald Otika1George Odongo2Ruth Mary Mary Muzaki3Beatrice Oweka Lamwaka4Francis Pebalo Pebolo5Gulu University, Gulu, UgandaGulu University, Gulu, UgandaNorthern Uganda Regional Cancer Center, Uganda Cancer Institute, Gulu, UgandaGulu University, Gulu, UgandaGulu University, Gulu, UgandaReproductive Health, Gulu University, Gulu, UgandaBackground Following the COVID-19 pandemic, there was an increase in teenage pregnancies nationally, however, limited data exists regarding the same among girls living in refugee settlements.Objectives We evaluated the prevalence of teenage pregnancy and associated factors in Palorinya and Bidi Bidi refugee settlements in Obongi and Yumbe districts of northern Uganda, in the post-COVID-19 era.Design We conducted a cross-sectional study.Setting Refugee settlements in northern Uganda.Participants We included 385 teenage girls aged 15–19 years.Methods We used convenience sampling techniques between March and May 2023. Prevalence of teenage pregnancy was assessed by self-reported pregnancies between January 2020 and May 2023 among participants. We conducted Pearson’s χ2 and Fisher’s exact tests for bivariate analysis. All variables with a p value<0.2 at bivariate analysis were included in multivariable regression. We applied a modified Poisson regression model at the multivariable level to evaluate independent associations. The level of statistical significance was set at p<0.05.Primary and secondary outcome measures The primary outcome measure was the prevalence of teenage pregnancy, assessed through self-reported pregnancies among participants. Secondary outcome measures included factors associated with teenage pregnancy, such as living with a husband, lack of formal education, peer pressure and history of sexual abuse.Results Overall, the mean age was 17 (IQR: 15–18), and sexual debut was at 16 (IQR: 15–17) years. Lifetime modern contraceptive use was 13.8% (n=53/385) and current use was 7.5% (n=29/385). Teenage pregnancy period prevalence was 34.0% (CI: 29.4% to 38.9%). Factors independently associated with teenage pregnancy were: living with a husband (aPR: 3.8, 95% CI: 2.51 to 5.84, p<0.001), lack of formal education (Adjusted Prevalence Ratios - aPR: 2.3, 95% CI: 1.26 to 4.35, p=0.007), peer pressure (aPR: 2.1, 95% CI: 1.54 to 2.86, p<0.001) and history of sexual abuse (aPR: 1.5, 95% CI: 1.07 to 1.99, p=0.018).Conclusion Our study revealed that around 1 in 3 adolescent girls in northern Uganda’s refugee settlements experienced pregnancy during the COVID-19 pandemic, with only 1 in 13 currently using modern contraceptives. To address this, targeted strategies by relevant authorities are crucial, including legal actions against sexual abuse, promoting girl child education and enhancing access to long-term contraception to reduce teenage pregnancy and associated health risks in these settings.https://bmjopen.bmj.com/content/14/12/e089361.full
spellingShingle Felix Bongomin
Donald Otika
George Odongo
Ruth Mary Mary Muzaki
Beatrice Oweka Lamwaka
Francis Pebalo Pebolo
Prevalence and factors associated with teenage pregnancy in refugee settlements of northern Uganda post-COVID-19 (2020–2023): a cross-sectional study
BMJ Open
title Prevalence and factors associated with teenage pregnancy in refugee settlements of northern Uganda post-COVID-19 (2020–2023): a cross-sectional study
title_full Prevalence and factors associated with teenage pregnancy in refugee settlements of northern Uganda post-COVID-19 (2020–2023): a cross-sectional study
title_fullStr Prevalence and factors associated with teenage pregnancy in refugee settlements of northern Uganda post-COVID-19 (2020–2023): a cross-sectional study
title_full_unstemmed Prevalence and factors associated with teenage pregnancy in refugee settlements of northern Uganda post-COVID-19 (2020–2023): a cross-sectional study
title_short Prevalence and factors associated with teenage pregnancy in refugee settlements of northern Uganda post-COVID-19 (2020–2023): a cross-sectional study
title_sort prevalence and factors associated with teenage pregnancy in refugee settlements of northern uganda post covid 19 2020 2023 a cross sectional study
url https://bmjopen.bmj.com/content/14/12/e089361.full
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