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

Sanni  YAYA; Edward Kwabena AMEYAW; Dina IDRISS-WHEELER; Gebretsadik SHIBRE; Betregiorgis ZEGEYE

doi:10.1186/s12889-021-10729-5

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

Sanni YAYA^*, Edward Kwabena AMEYAW, Dina IDRISS-WHEELER, Gebretsadik SHIBRE, Betregiorgis ZEGEYE

^*Corresponding author for this work

Research output: Journal Publications › Journal Article (refereed) › peer-review

7 Citations (Scopus)

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.

Original language	English
Article number	763
Number of pages	9
Journal	BMC International Health and Human Rights
Volume	21
DOIs	https://doi.org/10.1186/s12889-021-10729-5
Publication status	E-pub ahead of print - 21 Apr 2021
Externally published	Yes

Funding

We acknowledge the WHO for making the software available to the public domain for free.

Keywords

Adolescent fertility rate
DHS
Ethiopia
Global health
Inequality
Reproductive health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1186/s12889-021-10729-5Licence: CC BY

Cite this

YAYA, S., AMEYAW, E. K., IDRISS-WHEELER, D., SHIBRE, G., & ZEGEYE, B. (2021). Summary measures of socioeconomic and area-based inequalities in fertility rates among adolescents: evidence from Ethiopian demographic and health surveys 2000–2016. BMC International Health and Human Rights, 21, Article 763. Advance online publication. https://doi.org/10.1186/s12889-021-10729-5

@article{177a53292532411bb3c77e6b855ca893,

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

abstract = "BackgroundOne 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.MethodsThe 2000 and 2016 Ethiopia Demographic and Health surveys (EDHS) was analyzed using the World Health Organization{\textquoteright}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).ResultsLarge 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.ConclusionsSocioeconomic (education and economic status) and place of residence determine adolescents{\textquoteright} 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.",

keywords = "Adolescent fertility rate, DHS, Ethiopia, Global health, Inequality, Reproductive health",

author = "Sanni YAYA and AMEYAW, {Edward Kwabena} and Dina IDRISS-WHEELER and Gebretsadik SHIBRE and Betregiorgis ZEGEYE",

year = "2021",

month = apr,

day = "21",

doi = "10.1186/s12889-021-10729-5",

language = "English",

volume = "21",

journal = "BMC International Health and Human Rights",

issn = "1471-2458",

publisher = "BioMed Central Ltd.",

}

Summary measures of socioeconomic and area-based inequalities in fertility rates among adolescents: evidence from Ethiopian demographic and health surveys 2000–2016. / YAYA, Sanni; AMEYAW, Edward Kwabena; IDRISS-WHEELER, Dina et al.
In: BMC International Health and Human Rights, Vol. 21, 763, 21.04.2021.

Research output: Journal Publications › Journal Article (refereed) › peer-review

TY - JOUR

T1 - Summary measures of socioeconomic and area-based inequalities in fertility rates among adolescents: evidence from Ethiopian demographic and health surveys 2000–2016

AU - YAYA, Sanni

AU - AMEYAW, Edward Kwabena

AU - IDRISS-WHEELER, Dina

AU - SHIBRE, Gebretsadik

AU - ZEGEYE, Betregiorgis

PY - 2021/4/21

Y1 - 2021/4/21

N2 - BackgroundOne 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.MethodsThe 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).ResultsLarge 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.ConclusionsSocioeconomic (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.

AB - BackgroundOne 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.MethodsThe 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).ResultsLarge 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.ConclusionsSocioeconomic (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.

KW - Adolescent fertility rate

KW - DHS

KW - Ethiopia

KW - Global health

KW - Inequality

KW - Reproductive health

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U2 - 10.1186/s12889-021-10729-5

DO - 10.1186/s12889-021-10729-5

M3 - Journal Article (refereed)

C2 - 33882875

AN - SCOPUS:85104574011

SN - 1471-2458

SN - 1472-698X

VL - 21

JO - BMC International Health and Human Rights

JF - BMC International Health and Human Rights

M1 - 763

ER -

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

Abstract

Funding

Keywords

UN SDGs

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