Trends in teenage motherhood in Ecuador: challenges and inequalities
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ORIGINAL ARTICLE
Trends in teenage motherhood in Ecuador: challenges and inequalities Vero´nica Espinel-Flores1,2 • Merce` Gotsens2,4 • Vanessa Puig-Barrachina2 • Brenda Biaani Leo´n-Go´mez1,2 Andre´s Peralta1,2,5,6 • Glo`ria Pe´rez1,2,3,4
•
Received: 6 July 2019 / Revised: 4 October 2020 / Accepted: 20 October 2020 Swiss School of Public Health (SSPH+) 2020
Abstract Objectives To describe trends in teenage motherhood (TM), based on the socioeconomic groups teenagers belong to, and factors related to their first experience of heterosexual intercourse (FEHI). We took into consideration women aged 20–24 years, comparing three surveys from 1999, 2004, and 2012. Methods We obtained data from the Ecuadorian Demographic and Health Surveys about 4,696 women aged 20–24 years who had given birth as teenagers. Prevalence ratios and their confidence intervals (95% CI) were calculated to estimate changes in socioeconomic inequalities and factors related to the FEHI. Results The prevalence of TM increased from 48% in 1999 to 60% in 2012 among women with complete primary education. The social gradient among socioeconomic groups were sustained. We detected no changes in the socioeconomic inequalities characterizing TM, and in the factors related to the FEHI across the three studies in Ecuador. Conclusions Socioeconomic inequalities in TM and disadvantageous circumstances at FEHI remained unchanged for 14 years. Some factors are vital for reducing teenage motherhood in Ecuador: gender-equitable economic development, access to comprehensive-sexual education, contraception, health services, and safe abortion. Keywords Inequalities Socioeconomic factors Sexual behaviour Trends Teenage pregnancy Ecuador
Introduction
& Vero´nica Espinel-Flores [email protected] 1
Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
2
Age`ncia de Salut Pu´blica de Barcelona, Pl. Lesseps 1, 08023 Barcelona, Catalonia, Spain
3
CIBER Epidemiologı´a y Salud Pu´blica (CIBERESP), Madrid, Spain
4
Institut d’Investigacio´ Biome`dica (IIB-Sant Pau), Barcelona, Spain
5
Universitat Pompeu Fabra. Department of Political and Social Sciences, Health Inequalities Research Health Inequalities Research Group, Employment Conditions Knowledge Network (GREDS-EMCONET), Barcelona, Spain
6
Johns Hopkins University - Pompeu Fabra University Public Policy Centre, Barcelona, Spain
Since 1994, when the International Conference on Population and Development, ICPD was held, reducing adolescent childbearing has been a global priority. More than two decades later, reducing TM remains an aim of political and societal activity worldwide (UN 2019), as a global indicator of Sustainable Development (SDG3). Another important global indicator of Sustainable Development (SDG5) is women’s access to the means to prevent TM. TM is associated with a variety of adverse outcomes for both women (Tabet et al. 2016) and children. These outcomes involve high risk of neonatal m
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