Correlates of teenage pregnancy in Western Uganda

Abstract

Teenage pregnancy remains a major public health and socio-economic challenge in Uganda, where approximately one in four adolescent girls becomes pregnant before the age of 19. The burden is particularly high in the western sub-regions of Tooro, Bunyoro, Ankole, and Kigezi. Guided by Bronfenbrenner’s Ecological Systems Theory, this study examined the socio-demographic, economic, and reproductive health correlates of teenage pregnancy among adolescent girls aged 15–19 years in Western Uganda. The study used the women's dataset of the 2016 Uganda Demographic and Health Survey (UDHS), analyzed a weighted sample of 1,017 adolescent girls, using descriptive statistics, chi-square tests, and binary logistic regression to identify factors associated with teenage pregnancy. The findings reveal that 24% of teenage girls in western Uganda had experienced a teenage pregnancy. Older teenagers aged 18-19 exhibited a significantly higher prevalence of 47% compared to 12% among younger girls (15-17). Multivariate analysis showed that older teenagers (18-19) were nearly two times more likely to experience a teenage pregnancy (AOR = 1.82, 95% CI:0.95-2.68) compared to those younger than 18 years. Married teenagers were two times (AOR = 2.13, 95% CI:0.95-3.32) more likely to experience teenage pregnancy compared to unmarried peers. Those who had received family planning information from a health facility also showed increased odds (AOR = 1.67; 95% CI: 0.71-2.63). Early sexual debut (ages 8-15) significantly increased the likelihood of teenage pregnancy (AOR = 5.77; 95% CI:2.91–8.63). The study concludes that teenage pregnancy in Western Uganda is influenced by factors operating across multiple ecological levels: individual (age, early sexual initiation), relational (marital status), and institutional (health system engagement). Addressing teenage pregnancy, therefore, requires an integrated, multi-level approach that strengthens comprehensive sexuality education, delays marriage and sexual debut, and ensures accessible, youth-friendly reproductive health services. It is recommended that the Ministries of Health and Education, together with local governments and development partners, implement coordinated programs that provide accurate sexual and reproductive health information in schools and communities, enhance adolescent-friendly service delivery, and address socio-cultural norms that perpetuate early marriage and limited contraceptive use. Subject keywords; Teenage pregnancy, western Uganda