Magnitude and Determinants of Teenage Pregnancy Among Adolescents in Chikankata District, Zambia
Terrynet Chitanda Konkola and Tinkler Saul Simbeye*
ABSTRACT
Introduction: Teenage pregnancy is a significant global public health problem, affecting millions of girls aged 10 to 19, particularly in Sub-Saharan Africa, which accounts for 35% of unplanned pregnancies. It is characterized by high rates of unintended pregnancies, school dropout, forced and unstable marriages, low birth weight, preterm birth, unsafe abortions, anemia, toxemia, and other associated health risks. This study aimed to determine the magnitude and determinants of teenage pregnancy among adolescents aged 10–19 years in Chikankata District of Southern Province of Zambia.
Methods: Ethical approval for the study was obtained from Texila American University Research Ethics Committee Reference Number 2025/TAU-LTDZA/ 12723. Written informed consent was obtained from the guardians of adolescents aged 10–17 years, and written assent was obtained from the adolescents themselves as well. Written informed consent was also obtained from adolescents aged 18–19 years. All participants were informed that participation in the study was voluntary and that they were free to withdraw from it at any time without coercion.
Results: The study found that most of the respondents (62.2%) reported never having been pregnant. In contrast, one-third of participants (33.1%) indicated that they had experienced pregnancy. Age (p = 0.001), marital status (p < 0.001), religion (p = 0.004), level of education (p = 0.002), and number of children (p < 0.001) were statistically significantly associated with teenage pregnancy among adolescents in Chikankata District, Zambia. The study also revealed that, most of respondents had attained secondary school education (70.3%), with very few progressing to the tertiary level (0.8%). It was also found that most of the respondents were single (98.4%), suggesting that pregnancies occurred outside marriage. It was found that three-quarters of respondents (74.0%) lived with both parents, while smaller proportions stayed with one parent (12.8%) or guardians (13.3%), which may influence the level of supervision and support received. Cohabitation began at ages 18–19 (93.2%), but a notable 6.0% of respondents started living with a partner at 14–17 years, reflecting early exposure to adult roles. Communication on sexual and reproductive health was weak, with only 27.6% reporting frequent discussions with parents/guardians, while half (50.5%) indicated such discussions occurred rarely, pointing to limited parental guidance. Most families described themselves as average in financial status (72.7%), though 18.5% considered themselves poor. A large majority (74.0%) of respondents admitted that poverty or financial need had influenced their sexual decisions. The study also revealed that, a considerable proportion of respondents (40.6%) correctly understood that contraceptives are used to prevent pregnancy, while 30.7% had only a vague awareness, and 18.5% admitted to having no knowledge. Access to reproductive health services was via health facilities (76.6%), with fewer adolescents relying on private pharmacies (16.7%) or school clinics (3.1%). In terms of contraceptive use, only 26.8% reported consistent use, whereas 41.7% used them occasionally, and 19.5% did not use them at all. Almost all adolescents (98.4%) felt comfortable discussing reproductive health with providers. Moreover, the majority (95.6%) of restudy participants agreed that teenage girls should access contraceptives without parental consent. Study further revealed that 54.2% of respondents received comprehensive reproductive health education in schools and 32.0% of respondents acknowledged limited exposure. Attitudes towards contraceptives were positive (60.2%) while 18% of respondents still held negative views. Finally, health facility utilization varied, with 45.3% visiting regularly and 28.1% occasionally, but a significant minority (22.7%) rarely sought services.
Conclusion: In conclusion, teenage pregnancy remains a notable public health challenge in Chikankata District despite most adolescents reporting no prior pregnancy. The study shows that pregnancies largely occurred outside marriage and were influenced by poverty, weak parent–adolescent communication, limited reproductive health knowledge, and inconsistent contraceptive use. Although access to health facilities and positive attitudes toward contraceptives were relatively high, gaps in comprehensive sexuality education and service utilization persist. These findings highlight the need to strengthen parental involvement, improve adolescent reproductive health education, and enhance access to and utilization of youth-friendly reproductive health services to reduce teenage pregnancy among adolescents in the district.
