Socioeconomic inequality in teenage pregnancy among adolescent girls in Ethiopia: evidence from the 2019 Mini EDHS

Teenage pregnancy remains a major public health and development challenge in Ethiopia and disproportionately affects adolescents from socioeconomically disadvantaged households. Adolescence is a period marked by increased vulnerability to adverse sexual and reproductive health outcomes, including teenage pregnancy. In Ethiopia, there is limited evidence on socioeconomic inequality in teenage pregnancy and the factors contributing to this disparity. Therefore, this study assessed socioeconomic inequality in teenage pregnancy and quantified the contribution of explanatory factors among adolescent girls aged 15–19 years in Ethiopia. Data for this study were extracted from the nationally representative 2019 Ethiopian Mini Demographic and Health Survey. A total of 2,100 adolescent girls aged 15–19 years were included in the analysis. Survey weights were applied in the estimation to account for the unequal probability of selection and produce nationally representative estimates. The Erreygers normalized concentration index and its concentration curve were applied to assess socioeconomic-inequalities in teenage pregnancy. Decomposition analysis was conducted to identify factors contributing to socioeconomic related inequality. The weighted Erreygers normalized concentration index for teenage pregnancy was − 0.091 [95% CI: − 0.150%, − 0.032%] with Standard error = 0.0303 (P value < 0.01), indicating that teenage pregnancy was disproportionately concentrated among adolescents from poorer households. The decomposition analysis revealed that marital status (24.17%), wealth index (17.96%), and educational status (11.12%) were major positive contributors, while media exposure contributed − 13.56% in the opposite direction to the observed pro-poor socioeconomic inequality in teenage pregnancy. This study revealed a statistically significant pro-poor socioeconomic inequality in teenage pregnancy in Ethiopia. Marital status, wealth index, and educational attainment were the major contributors to the observed socioeconomic inequality in teenage pregnancy. Since marital status was the largest contributor to inequality, strengthening interventions to prevent child marriage and enforce the legal minimum age of marriage is essential. Given the substantial contribution of educational attainment, priority should be given to policies that improve school retention and completion among adolescent girls. Furthermore, because wealth-related disadvantage was an important factors to inequality, efforts to expand access to adolescent-friendly sexual and reproductive health services and social protection programs for economically disadvantaged households should be strengthened.