CHAPTER ONE

1.1       Background of the Study

Adolescent childbearing remains a challenge requiring urgent resolution worldwide (UNPFA,  2013). The 2014 World Health Statistics reported 16 million births to mothers aged 15–19 years representing 11% of all births that were due to women aged 15-19 years. The average global birth rate among 15 to 19 year olds is 49 per 1000 girls. Country rates range from 1 to 299 births per 1000 girls with the highest rates in sub-Saharan Africa (WHO, 2014). Studies of adolescent childbearing in developed countries showed differences in levels, as well as wide variation in trends, the adolescent birth rate in the United States was among the highest; it was lowest in Japan and was quite low in several European countries the Netherlands, Switzerland, Sweden, Denmark and Finland. Compared with other developed countries, the United States had an especially high birth rate for adolescents under 18 years old (Westoff, Calot & Foster, 1985). In developed countries, adolescent fertility rates range from 4.6 in Japan to 30.1 in the United Kingdom of Great Britain and Northern Ireland and 48.7 in the United States of America (UN, 2002).

 Sub-Saharan Africa has the highest prevalence rate of adolescence pregnancies in the world (WHO, 2014). Approximately 95% of adolescent pregnancies occur in developing countries with 36.4 million women becoming mothers before age 18 (UNPFA, 2013).  Births to teenage mothers account for more than half of all the births in this region, with an estimated 101 births per 1000 women aged 15 to 19 (UNPFA, 2013). The majority of countries with adolescent pregnancy levels above 30% occur in sub-Saharan Africa (Loaiza & Liang, 2013). More than half the women in sub-Saharan Africa and about one third in Latin America and the Caribbean give birth before the age of 20 (Alan Guttmacher Institute, 1998). The regional average rate of births, per 1000 women aged 15–19 years, is 115 in Africa, 75 in Latin America and the Caribbean, and 39 in Asia, compared to the world average adolescent fertility rate of 54 births per 1000 women aged 15 – 19 years (UN, 2002).          The World Population Report on adolescent fertility shows that the number of births to adolescent in this region is projected to increase over the next few decades, exceeding a total of 4.8 million births to girls age 15-19 over the period 1995 to2020.  In part, this increase reflects a growth in the size of the cohort of teens in this region relative to levels in other parts of developing world (McDevitt, 1996). The proportional contribution of adolescents’ fertility (among women age15-19) to the overall fertility rate among women age15-49 has been increasing over time. Though there has been observed decline by 27 percent in the birth rate among women age 15-19 between 1980 and 2003, 46 percent of women nationally and about 70 percent of those in some geo-political zones still give birth before their 20th birthday (Alan Guttmacher Institute, 2004)

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