Factors associated with early child bearing in eastern Uganda. A case study of Uganda demographic and health survey, 2022.

Abstract

The study aimed to determine the factors associated with early child bearing in Eastern Uganda using the 2022 Uganda Demographic and Health Survey (UDHS). Early child bearing, defined as a first birth before the age of 18 years, is associated with poor maternal and child health outcomes, interrupted education and reduced economic opportunities for women. Its burden remains high in Uganda, and the Eastern region has repeatedly been reported among the regions most affected. A quantitative cross-sectional analysis of secondary UDHS 2022 data was conducted on 3,192 women in Eastern Uganda who had ever given birth. The outcome was age at first birth (before 18 years versus 18 years or older). The explanatory variables were household wealth status, education level, place of residence, employment status, religion, age at first cohabitation and knowledge of contraceptive use. Data were analysed in Stata using descriptive statistics, the Pearson chi-square test and binary logistic regression, and associations were considered significant at p < 0.05. Overall, 1,398 women (43.8%) had their first birth before the age of 18 years. In the bivariate analysis, education level (p < 0.001) and household wealth status (p = 0.002) were significantly associated with early child bearing, while place of residence, employment status, religion and knowledge of contraceptive use were not. In the multivariable analysis, compared with women with no education, those with secondary education (AOR = 2.53; 95% CI: 1.69–3.79) and higher education (AOR = 5.79; 95% CI: 2.59–12.94) had higher odds of a first birth at 18 years or older, while primary education showed no significant difference. Each additional year of age at first cohabitation increased the odds of a first birth at 18 years or older by about 49% (AOR = 1.49; 95% CI: 1.43–1.54). Household wealth was no longer significant after adjustment, and knowledge of contraceptives was almost universal. Early child bearing is common in Eastern Uganda, and education and age at first cohabitation are the main factors associated with it. Interventions should focus on keeping girls in school through the secondary level, supporting the return to school of adolescent mothers, delaying the formation of first unions, and improving access to, rather than awareness of, contraceptive services.