Determinants of teenage pregnancies: The case of Busia District in Kenya

Abstract

Sub-Saharan Africa has one of the highest levels of teenage pregnancies in the world. In spite of that, there is paucity of empirical research on causes of teenage pregnancies in African countries. This paper investigates the determinants of teenage pregnancies based on a case study of Busia District in Kenya. The data are from a household survey conducted in 1998/1999. Empirical results indicate that girls’ education level has significant influence on the probability of teenage birth, with non-schooling adolescents and those with primary school level education being more vulnerable. Among the variables used as proxies for access to sex education, availability of church forums that educate adolescents about sex and family life issues reduce probability of teenage pregnancy. Age is positively related to teenage pregnancies, with older adolescents being more predisposed to pregnancies. Though use of contraceptives is found to have a positive effect, only a small proportion of adolescents were using modern contraceptives and, supply side factors such as quality and availability were not accounted for. Other key factors as outlined by the adolescents themselves include peer pressure and social environment-related factors like inappropriate forms of recreation, which act as rendezvous for pre-marital sex, as well as lack of parental guidance and counselling. Overall, lack of access to education opportunities, sex education and information regarding contraceptives, as well the widespread poverty predispose girls to teenage pregnancies. The problem of teenage pregnancies should be viewed within the broader socio-economic and socio-cultural environment in which the adolescents operate. For instance, lack of parental guidance on issues of sexuality and sex education was reinforced by cultural taboos that inhibit such discussions. Adolescents should be equipped with the relevant knowledge to enable them make informed choices regarding sexual relationships. This should be complemented with broader programmes aimed at promoting girl education and poverty alleviation.

Introduction

Reproductive health concerns of adolescents have received increasing international attention in recent years. Early childbearing is linked to a number of undesirable health outcomes such as risk of death, pregnancy-related illnesses, abortion, infertility and exposure to sexually transmitted diseases including the dreaded human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) (World Health Organisation, 1997, Fathalla, 1997). Female adolescents, compared to their male counterparts, face disproportionate health concerns due to teenage pregnancies.¹ Although sexual activity among the adolescents is widespread around the world, the determinants and consequences are likely to vary from one region to another. Early pregnancies are more pronounced and detrimental in Sub-Saharan African (SSA) countries, most of which experience high levels of poverty. However, most of the empirical literature on teenage pregnancies is based on the developed countries. There is paucity of empirical studies on causes of teenage pregnancies in African countries. This paper makes a contribution towards closing the gap by focusing on a particular case of Kenya. Given the differences in socio-economic as well as cultural backgrounds, the results from a developing country like Kenya are likely to differ from those based on experiences of the richer, industrialised nations. For instance, given limited resources in rural areas, girls are forced to drop out of school or get married at an early age. Additionally, inability to meet basic, personal material needs makes teenage girls susceptible to pre-marital sex in exchange for trifles. Such factors are likely to predispose them to unwanted pregnancies.

In Kenya, teenage pregnancy is not only as a reproductive health issue, but one that affects the current and future socio-economic well-being of women. Early childbearing deny girls the opportunity to complete education and acquire human capital skills critical for gainful employment in the labour market and decision-making on key issues of development. Given the absence of welfare benefits and child support, teenage pregnancies lead to increased dependency, and are likely to perpetuate poverty and low status of women.² Given the relatively high levels of poverty,³ and with the HIV/AIDS pandemic taking its toll among the Kenyan youth, teenage pregnancies pose a serious policy problem. Unfortunately, interest in fertility studies and policies has largely focused on adults, with much less attention being paid to adolescents.

Although teenage pregnancies are decried as one of the major hindrances to girl's education in Kenya, there has been little effort in critically evaluating the underlying determinants, particularly in the rural areas where they are prevalent. The study seeks to investigate the socio-economic and other factors that perpetuate teenage pregnancies, based on a case study of three divisions in Busia District, located in Western Province of Kenya. The paper uses data from a household survey conducted in the district by the author in 1998/1999. Busia District is one of the poorest districts in Kenya,⁴ characterised by relatively high school dropout, low completion and high illiteracy rates particularly for girls (Republic of Kenya, 1997). It also ranges among the districts with the highest incidence of HIV/AIDS and rampant early pregnancies. There being no major cash crop,⁵ the main source of livelihood is peasant farming. Given the fairly similar lifestyles and culture across the district, the three divisions are by and large representative of the district. The district is typical of rural livelihoods in Kenya and thus the results have wide applicability.