Trends and differentials in adolescent reproductive behavior in sub-Saharan Africa

Much of the high fertility can be attributed to young age at first sex, first union, and first birth. At the same time, there is wide variation in early initiation of reproductive behavior across countries and between subgroups in the same country. This paper examines the trends and differentials in age at first sex, first union, and first birth in the adolescent populations in selected sub-Saharan countries. The study draws on data from Demographic and Health Surveys carried out in eight countries -- Burkina Faso, Ivory Coast, Ghana, Kenya, Mali, Senegal, Tanzania, and Zimbabwe. These countries had at least two surveys conducted approximately 5 years apart, with questionnaires for women and men of reproductive age. The main analytical tool used to carry out the study is a multivariate logistic model that uses a generalized estimating equation to consider the probability of a young woman having a birth, sex, or union before age 18. The study also considers the probability of a young man engaging in first sex or union before age 20. Results suggest that certain sociodemographic characteristics of adolescents, particularly education, have a strong influence on early reproductive outcomes. However, the direction of the relationship is not always the same for young women as for young men. The effects of community characteristics are inconclusive. While these results may be useful for identifying target groups for reproductive health services and outreach programs, further research is needed to find more appropriate community-level measures for assessing adolescent reproductive behavior. (Author abstract)