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Mapping adolescent first births within three east African countries using data from Demographic and Health Surveys: exploring geospatial methods to inform policy

Mapping adolescent first births within three east African countries using data from Demographic and Health Surveys: exploring geospatial methods to inform policy
Mapping adolescent first births within three east African countries using data from Demographic and Health Surveys: exploring geospatial methods to inform policy
Background: Early adolescent pregnancy presents a major barrier to the health and wellbeing of young women and their children. Previous studies suggest geographic heterogeneity in adolescent births, with clear “hot spots” experiencing very high prevalence of teenage pregnancy. As the reduction of adolescent pregnancy is a priority in many countries, further detailed information of the geographical areas where they most commonly occur is of value to national and district level policy makers. The aim of this study is to develop a comprehensive assessment of the geographical distribution of adolescent first births in Uganda, Kenya and Tanzania using Demographic and Household (DHS) data using descriptive, spatial analysis and spatial modelling methods.

Methods: The most recent Demographic and Health Surveys (DHS) among women aged 20 to 29 in Tanzania, Kenya, and Uganda were utilised. Analyses were carried out on first births occurring before the age of 20 years, but were disaggregated in to three age groups: <16, 16/17 and 18/19 years. In addition to basic descriptive choropleths, prevalence maps were created from the GPS-located cluster data utilising adaptive bandwidth kernel density estimates. To map adolescent first birth at district level with estimates of uncertainty, a Bayesian hierarchical regression modelling approach was used, employing the Integrated Nested Laplace Approximation (INLA) technique.

Results: The findings show marked geographic heterogeneity among adolescent first births, particularly among those under 16 years. Disparities are greater in Kenya and Uganda than Tanzania. The INLA analysis which produces estimates from smaller areas suggest “pockets” of high prevalence of first births, with marked differences between neighbouring districts. Many of these high prevalence areas can be linked with underlying poverty.


Conclusions: There is marked geographic heterogeneity in the prevalence of adolescent first births in East Africa, particularly in the youngest age groups. Geospatial techniques can identify these inequalities and provide policy-makers with the information needed to target areas of high prevalence and focus scarce resources where they are most needed.
1742-4755
1-29
Neal, Sarah
2b63ebf7-1cf9-423d-80a2-bd99a759f784
Ruktanonchai, Corrine
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Chandra-Mouli, Venkatraman
35234274-1c30-4a20-8a1b-edb3363321ac
Matthews, Zoe
ebaee878-8cb8-415f-8aa1-3af2c3856f55
Tatem, Andrew
6c6de104-a5f9-46e0-bb93-a1a7c980513e
Neal, Sarah
2b63ebf7-1cf9-423d-80a2-bd99a759f784
Ruktanonchai, Corrine
a576fb11-a475-4d48-885a-85938b60a7a8
Chandra-Mouli, Venkatraman
35234274-1c30-4a20-8a1b-edb3363321ac
Matthews, Zoe
ebaee878-8cb8-415f-8aa1-3af2c3856f55
Tatem, Andrew
6c6de104-a5f9-46e0-bb93-a1a7c980513e

Neal, Sarah, Ruktanonchai, Corrine, Chandra-Mouli, Venkatraman, Matthews, Zoe and Tatem, Andrew (2016) Mapping adolescent first births within three east African countries using data from Demographic and Health Surveys: exploring geospatial methods to inform policy. Reproductive Health, 13, 1-29, [98]. (doi:10.1186/s12978-016-0205-1).

Record type: Article

Abstract

Background: Early adolescent pregnancy presents a major barrier to the health and wellbeing of young women and their children. Previous studies suggest geographic heterogeneity in adolescent births, with clear “hot spots” experiencing very high prevalence of teenage pregnancy. As the reduction of adolescent pregnancy is a priority in many countries, further detailed information of the geographical areas where they most commonly occur is of value to national and district level policy makers. The aim of this study is to develop a comprehensive assessment of the geographical distribution of adolescent first births in Uganda, Kenya and Tanzania using Demographic and Household (DHS) data using descriptive, spatial analysis and spatial modelling methods.

Methods: The most recent Demographic and Health Surveys (DHS) among women aged 20 to 29 in Tanzania, Kenya, and Uganda were utilised. Analyses were carried out on first births occurring before the age of 20 years, but were disaggregated in to three age groups: <16, 16/17 and 18/19 years. In addition to basic descriptive choropleths, prevalence maps were created from the GPS-located cluster data utilising adaptive bandwidth kernel density estimates. To map adolescent first birth at district level with estimates of uncertainty, a Bayesian hierarchical regression modelling approach was used, employing the Integrated Nested Laplace Approximation (INLA) technique.

Results: The findings show marked geographic heterogeneity among adolescent first births, particularly among those under 16 years. Disparities are greater in Kenya and Uganda than Tanzania. The INLA analysis which produces estimates from smaller areas suggest “pockets” of high prevalence of first births, with marked differences between neighbouring districts. Many of these high prevalence areas can be linked with underlying poverty.


Conclusions: There is marked geographic heterogeneity in the prevalence of adolescent first births in East Africa, particularly in the youngest age groups. Geospatial techniques can identify these inequalities and provide policy-makers with the information needed to target areas of high prevalence and focus scarce resources where they are most needed.

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Accepted/In Press date: 28 July 2016
e-pub ahead of print date: 23 August 2016
Published date: 23 August 2016
Organisations: Social Statistics & Demography, WorldPop

Identifiers

Local EPrints ID: 399703
URI: http://eprints.soton.ac.uk/id/eprint/399703
ISSN: 1742-4755
PURE UUID: 84a4d809-b260-4a38-911e-5e9fe32d41b0
ORCID for Sarah Neal: ORCID iD orcid.org/0000-0003-1812-7221
ORCID for Zoe Matthews: ORCID iD orcid.org/0000-0003-1533-6618
ORCID for Andrew Tatem: ORCID iD orcid.org/0000-0002-7270-941X

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Date deposited: 24 Aug 2016 11:37
Last modified: 15 Mar 2024 03:43

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Contributors

Author: Sarah Neal ORCID iD
Author: Corrine Ruktanonchai
Author: Venkatraman Chandra-Mouli
Author: Zoe Matthews ORCID iD
Author: Andrew Tatem ORCID iD

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