Childbearing, Unintended Pregnancy and Contraceptive Use among South Asian Married Female Adolescents

Author(s) S. M. Mostafa Kamal1, Che Hashim Hassan2,
Affiliation(s) 1Department of Mathematics, Islamic University, Kushtia-7003, Afghanistan, Unit for the Enhancement of Academic Performance, University of Malaya, Kuala Lumpur, Malaysia, 3
Country - ies of focus Bangladesh
Relevant to the conference tracks Social Determinants and Human Rights
Summary This study examined the childbearing status, unintended pregnancy and contraceptive use among married female adolescents of four South Asian countries using the nationally representative survey data. Findings show that, the initiation of childbearing ranges from 57% in Pakistan to 67% in Nepal. The incidence of unintended pregnancy was more frequent in Nepalese adolescents. The use rate of contraceptive methods was highest in Bangladesh and lowest in India. The reproductive behaviour of female adolescents are significantly associated with education, working status, place of residence and standard of living indices, although the associations are not always consistent across countries.
Background Despite global declines in the rate of early childbearing, reproductive behaviour of adolescents remains a persistent challenge in many developing countries.
Objectives This study endeavours to examine childbearing, unintended pregnancy and contraceptive use among married adolescents in four South Asian countries: Bangladesh, India, Nepal and Pakistan.
Methodology Data for this study have drawn from the most recent and nationally representative Demographic and Health Survey (DHS) conducted between 2005 and 2011. The analysis focused on the married female adolescents of age ranging from 15 to 19. The prevalence of initiation of childbearing, intention status of the most recent pregnancy, current use of any contraceptive methods were assessed by simple cross tabulation, while binary logistic regression models were constructed to examine the socioeconomic and country impacts on each of the outcome measures. The sample was made nationally representative by using the weight factor in the survey data. Data were analysed by IBM SPSS v21 (SPSS Inc., Chicago, IL, USA).
Results The mean age at first marriage was significantly lowest among adolescents in Bangladesh (15.1±1.7), followed by India (15.5±1.8), Pakistan (15.7±1.7) and Nepal (15.9±1.5) respectively. In Bangladesh, two-thirds (66.1%) of the adolescents initiated childbearing, of whom 53.4% were already a mother 12.7% were pregnant for the first time. The corresponding figures for India, Nepal and Pakistan were 57.8%, 67.6% and 56.7% respectively. The incidence of unintended pregnancy was more frequent in Nepalese adolescents (32.4%), followed by Bangladesh (25.2%), India (17.3%) and Pakistan (13.1%). The use rate of any and modern contraceptive methods was highest in Bangladesh (47.1% and 42.4%), followed by Nepal (21.0% and 17.1%), India (13.0% and 6.9%) and Pakistan (6.7% and 4.2%). The multivariate binary logistic regression analyses yielded quantitatively important and reliable estimates of the reproductive behaviour of adolescents. The analyses suggest that reproductive behaviours of female adolescents are significantly associated with their level of education, working status, place of residence and standard of living indices, although the associations are not always consistent across countries. Furthermore, the likelihood of initiation of childbearing was significantly higher among female adolescents of Bangladesh than other three South Asian countries. Unintended pregnancy was significantly higher in Nepalese adolescents. Meanwhile, the adolescents of India, Nepal and Pakistan were less likely to use any contraceptive methods than those of Bangladesh.
Conclusion Early initiation of childbearing, unintended pregnancies and lower use rate of any contraceptive methods among married female adolescents are common in the four South Asian countries. Programmes and policy initiatives should focus on the enforcement of the legal age at first marriage and education retention as this may reduce early practices of child marriage in South Asian countries. Providing door-step delivery services of effective family planning methods is important to reduce unintended pregnancy among married female adolescents.

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