Individual and Contextual Factors Associated with Teenage Pregnancy in Colombia: A Multilevel Analysis
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Individual and Contextual Factors Associated with Teenage Pregnancy in Colombia: A Multilevel Analysis Karen Aguía‑Rojas1 · Andrés Daniel Gallego‑Ardila1 · Maryi Viviana Estrada Bonilla1 · Juan Nicolás Rodríguez‑Niño1,2
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Objective To analyze municipal- and individual-level factors related to the prevalence of teenage pregnancy in Colombia during 2015. Methods We analyzed 660,767 births registers, of which 21.5% recorded adolescent women. At an individual level, marital status, educational level, area of residence, and access to health services were included in the analysis. At the contextual level, Colombian municipal socioeconomic characteristics and proxies of violence and poverty were analyzed. A multilevel logistic regression model was generated with a Markov Chain Monte Carlo estimation method using 100,000 simulations in MLwiN 2.32 software. Results Multilevel modeling revealed an increased risk of teenage pregnancy in municipalities with the highest numbers of people expelled by forced displacement (OR 1.21; CI 95%, 1.13–1.29) and with unsatisfied basic needs (OR 1.09; CI 95%, 1.02–1.17). At an individual level, the majority of the teenage women were unmarried and/or had an unstable partnership, a low level of educational, a subsidized health regimen, and resided in the municipal seat. Conclusions Municipal contextual variables related to poverty, violence, and social inequity contribute to an increase in teenage pregnancy in Colombia. At the individual level, marital status, educational level, and area of residence is associated with teenage pregnancy. It is therefore imperative to include municipal contextual characteristics in the design of the national political agenda. Keywords Pregnancy in adolescence (teenage pregnancy) · Factors (individual factors, contextual factors) · Multilevel analysis · Colombia
Significance Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10995-020-02997-1) contains supplementary material, which is available to authorized users. * Karen Aguía‑Rojas [email protected] Andrés Daniel Gallego‑Ardila [email protected] Maryi Viviana Estrada Bonilla [email protected] Juan Nicolás Rodríguez‑Niño [email protected] 1
Universidad del Rosario, Carrera 24 # 63c – 69, Bogotá, Colombia
Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
2
Latin America and the Caribbean have the second largest rate of teenage pregnancy in the world: 66.5 births for every 1000 women aged 15–19 years (World Health Organization 2020). National, regional, and sub-regional policies have contributed to a gradual decline in this figure, with noticeable inequities within countries (Pan American Health Organization et al. 2016, p. 33). The rate of teenage pregnancy in Colombia has decreased due to the implementation of health programs directed at adolescents and young adults nevertheless, information is lacking i
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