Multilevel Determinants of Teenage Pregnancies Among Girls Aged 13-19 Years in Rural Uganda: Community Based Cross-Sectional Study

Background: Teenage pregnancy is a global public health problem with serious social and medical implications relating to maternal and child health. In Uganda, particularly Hoima district, limited information about the factors influencing teenage pregnancy is available. This study estimated the prevalence of teenage pregnancy and associated factors among teenage girls aged 13-19 years to guide design the interventions to mitigate this problem. Methods: This was a community-based cross-sectional study that utilized multi-stage random sampling approach to select 543 study respondents. Data were collected using a pre-tested interviewer-administered structured questionnaire and analyzed using SPSS V26. Multivariable logistic regression analysis was conducted to determine independent predictors of teenage pregnancy among girls 13-19 years. Results: The prevalence of teenage pregnancy was 29%. Age (18-19 years) (AOR 4.4, 95%CI 1.52–12.78), low parents’ economic status (AOR 5.4, 95%CI 2.47–11.78), multiple sexual partners (AOR 8.0, 95%CI 4.51–14.18), being out of school (AOR 12, 95%CI 5.02–29.06), early marriage (AOR 37, 95%CI 13.35–107.54), having no control over sex (AOR 47, 95%CI 13.7-163.8), not discussing SRH with parents (AOR 8.4, 95%CI 3.31–21.51), witnessed domestic violence (AOR 30, 95%CI 11.97–77.53), never received counselling (AOR 5.7, 95%CI 3.56–9.01), and, rural residence (AOR 1.8, 95%CI 1.15–2.94) were significant predictors of teenage pregnancy. Conclusion: Teenage pregnancy is highly prevalent suggesting that teenage pregnancy is still a public health and social problem in Hoima district, Uganda. It is imperative for the Ministry of Health (MOH) and implementing partners to scale up and expand teenage friendly health services, consolidate efforts towards keeping girls in school, strengthen the policy of delaying early/child marriage, improve on the economic welfare of households through job creation and skill the youth for self-employment.