Trends and factors associated with pregnancies among adolescent women in Nepal: Pooled analysis of Nepal Demographic and Health Surveys (2006, 2011 and 2016)

INTRODUCTION: Adolescent pregnancy is a significant cost to mother, newborn, and their family and society. Despite the enormous health and social impact of adolescent pregnancy, there is a dearth of nationally representative studies on factors associated with adolescent pregnancies in Nepal. Therefore, this study aimed to examine trends and factors associated with adolescent pregnancies in Nepal, using pooled data of three nationally representative demographic surveys. METHODS: Data for this study was derived from the recent three consecutive (2006, 2011 and 2016) Nepal Demographic and Health Surveys (NDHS). A total of 7,788 adolescent women aged 15–19 years included in the analysis. Trends and multivariable logistic regression analysis was performed to examine the factors associated with adolescent pregnancy. RESULTS: Over the study period (2006–2016), the rate of adolescent pregnancy was 173 [95% Confidence Interval (CI): 159, 188] per 1000 women aged 15–19 years. Adolescent pregnancy was significantly higher among woman with middle household wealth index [adjusted Odds Ratio (aOR) 2.19, 95% confidence interval CI 1.65, 2.91] or poor household wealth index (aOR 2.37, 95% CI 1.76, 3.21). Similarly, Dalit (aOR 1.87, 95% CI 1.50, 2.34) or Madhesi (aOR 1.67, 95% CI 1.32, 2.11); and unemployed (aOR 1.28, 95% CI 1.09, 1.50) women had higher odds of adolescent pregnancies. In contrast, adolescent pregnancy was significantly lower among educated women (aOR 0.60, 95% CI 0.48, 0.74), and women with access to media exposure to public health issues (aOR 0.75, 95% CI 0.64, 0.88). CONCLUSIONS: Access to the media exposure on public health issues can be the effective efforts to reduce adolescent pregnancy. Women who have low maternal education, low wealth index, unemployed, and ethnic groups such as Dalits, and Madeshi needs to be targeted while designing and implementing policies and programs.