Julien Pouplard. Credit: Unsplash

The high rate of adolescent motherhood across developing countries isn't shifting, with reductions either modest or absent in some regions and rising in others, according to University of Queensland-led research.

The study found an urgent need for effective interventions such as sexual education, teenage health services, and national policies that promote and decrease income inequality in these countries.

M. Mamun Huda from UQ's Institute for Social Science Research said data from more than 700,000 girls aged 15-19 years across 74 low-income and middle-income countries (LMICs) over 28 years was analysed.

"Young women living in the most disadvantageous conditions, those who are poorest, have no education and live in rural locations, have the highest rates of adolescent motherhood," Mr Huda said.

"Not only do these groups have the highest prevalence, but they also have elevated risk of poor maternal and child health outcomes as well as wider social and economic burdens on family, community and country."

Adolescent health and well-being is a key target in the United Nations Sustainable Development Goals which include the aim of assisting with sexual and reproductive health to delay motherhood.

The World Health Organization estimates 21 million girls aged 15-19 in LMICs become pregnant every year and about 12 million give birth.

Pregnancy and childbirth complications are a leading cause of death in adolescent girls in LMICs, and children of adolescent mothers are at increased risk of infant and child mortality.

Adolescent mothers also have high levels of school dropout and lack of decent work opportunities due to the 'double burden' of household duties and child rearing.

The study showed the highest prevalence of adolescent motherhood was in Sub-Saharan Africa, Niger had the with 40.4 percent of 15-19 year-old girls reported to be pregnant or have had a child.

In South and South East Asia, Bangladesh had the highest prevalence of adolescent motherhood at 30.77 percent; and in Latin America and the Caribbean, Honduras had the highest observed rate at 24 percent.

Over time, the change in the rate of adolescent motherhood is slow, according to the study.

In some high-burden countries such as Nigeria and India there has been a decline in the average annual change, but countries such as Bangladesh had only a slight change.

Cambodia (+2.42%), Honduras (+1.88%), and the Philippines (+1.59%) had rising rates of adolescent motherhood over time.

Associate Professor Abdullah Mamun said providing a more detailed understanding helped to better target interventions. "Several countries not only have widespread poverty, lack of economic opportunity and high rates of school dropout, but also have high rates of sexual violence, unmet need for contraception, and legal restrictions on emergency contraception and abortion."

Strategic interventions, such as school-based and adolescent-friendly services, could help reduce motherhood in LMICs, the study concluded.

National-level policies that promote economic growth, increase expenditure on education, decrease income inequality and improve gender equality also have an important role to play.

The study is published in The Lancet Child & Adolescent Health.

More information: M Mamun Huda et al. Time trends and sociodemographic inequalities in the prevalence of adolescent motherhood in 74 low-income and middle-income countries: a population-based study, The Lancet Child & Adolescent Health (2020). DOI: 10.1016/S2352-4642(20)30311-4