Determinants of teenage pregnancy in Degua Tembien District, Tigray, Northern Ethiopia: A community-based case-control study

BACKGROUND: Approximately 16 million teenagers aged 15–19 years and 2 million teenagers under the age of 15 years give birth annually, with 95% of these births occurring in developing countries. Ethiopia has one of the highest teenage fertility rates in Sub-Saharan Africa; however determinants of teenage pregnancy are not well studied. Therefore, this study aimed to identify determinants of teenage pregnancy among female teenagers in Degua Tembien district, Tigray, Northern Ethiopia, in 2015. METHODS: A community-based case-control study was conducted in Degua' Tembien district from February 01, 2015 to March 15, 2015 with a randomly selected total sample size of 414 females (with a ratio of 1:2 case to control, 138 and 276 respectively). Data were entered in to Epi-Info and analyzed using SPSS software. Multivariable logistic regression was used to assess predictors of the outcome variable; variables with a p-value <0.25 in bivariable analysis were included in the model. Statistically significance was considered at a p-value ≤0.05 in both bivariable and multivariable logistic regression analyses. RESULT: The mean ages (plus or minus standard deviation (±SD)) of cases and controls were 18.47 (0.72) and 17.09 (1.2) years, respectively. After adjustment for other variables, predictors of teenage pregnancy included: lower monthly income below ~$25 and ~$25–50 (adjusted odds ratio (AOR) = 23.96; 95% confidence interval (95%CI) 4.89–117.29 and AOR = 4.91; 95%CI 1.64–14.66, respectively); aged 18–19 years (AOR = 16.75; 95%CI 6.45–43.47); being married (AOR = 15.91; 95%CI 7.43–34.04); not communicating with parents on reproductive health issues (AOR = 6.52; 95%CI 3.12–13.64) and having a history of maternal teenage pregnancy (AOR = 4.14; 95%CI 1.84–9.33). CONCLUSION: The factors associated with teenage pregnancy in our study were lower family monthly income, being married, being in the 18–19 year age group, not communicating with parents on reproductive health issues and having a maternal history of teenage pregnancy. Programs that encourage parent-teenage communication of reproductive health issues, starting from early adolescence, in order to build skills to prevent pregnancy in the late teenage years, are very important. In addition, multi-pronged activities across sectors that encourage delayed marriage and improve health service utilizations for girls are essential.