Prevalence and factors associated with adolescent pregnancies in Zambia: a systematic review from 2000–2022

Abstract

Plain English summary Pregnancy increases risk of adverse short- and long-term outcomes for adolescent mothers and their babies. Adolescent pregnancy is significantly high in Zambia. However, the risk factors are varied and in need of further review and research. Using a systematic review process, we identify the trends and factors that influence adolescent pregnancy in Zambia from research articles published since 2000. We found that prevalence of adolescent pregnancy in Zambia was between 29%-48% and that nationally, 29.1% of the country’s adolescents had given birth as of 2018. Factors identified as influencing adolescent pregnancy in Zambia were analysed at four levels: 1) individual factors such as early or child marriage, exposure to media, knowledge about sexual and reproductive health and contraception, contraceptive use, as well as risky sexual behaviours; 2) interpersonal level factors such as peer pressure, educational attainment, household wealth, influence of male or female headed households, and family members; 3) community/environmental factors such as socio-cultural, gender and sexual norms; and 4) an enabling policy/legal environment covering mostly access to SRH information and services. It was emphasized that various stakeholders should deliberately collaborate to address these issues at all four levels using interventions that are socio-culturally suitable and should be supported by strong political will at policy and implementation levels to facilitate better access to education, improve economic empowerment of girls, review of gender and dysfunctional cultural norms and practices, amongst other considerations.

Keywords

• Adolescent pregnancy
• Teenage
• Sexual and reproductive health
• Socio-ecological model
• Zambia