Socioeconomic inequalities in teenage pregnancy in a fragile and politically unrecognized setting: evidence from the 2020 Somaliland demographic and health survey

Teenage pregnancy remains a major global public health challenge with serious health and socioeconomic consequences for adolescent girls. Although widely studied worldwide, evidence from fragile and politically unrecognized settings remains limited. Somaliland is characterized by high fertility, early marriage, low contraceptive use, and limited policy frameworks addressing reproductive health inequalities. This study examined socioeconomic inequality in teenage pregnancy among adolescents aged 15–19 years using data from the 2020 SLDHS. A sample of 258 adolescents was analysed using the concentration index and Wagstaff decomposition methods. The weighted prevalence of teenage pregnancy was 15.03% (95% CI: 9.80%–20.26%). The concentration index (CI = −0.1844) indicated that teenage pregnancy was disproportionately concentrated among poorer adolescents. Educational attainment (30.49%), age at first marriage (27.44%), current age (19.27%), marital status (18.16%), and household wealth (17.49%) were the main contributors to the observed inequality. Addressing poverty, education, delayed marriage, and reproductive health information is essential.