Social factors affecting adolescent pregnancy in “middle-human development” countries: A case study of Dominican Republic, Egypt and China

Background/Purpose: A decline in the rates of adolescent pregnancy has been seen in many countries. Urbanization, education, income parity and access to healthcare are factors associated with decreased adolescent pregnancy. However, approximately 16 million 15 to19 year old adolescents give birth each year. About 2.5 million of these adolescent pregnancies end in unsafe abortions. Our study focuses on analyzing the situation beyond statistics. The purpose of this study is to provide a more context and culture-specific analysis of pregnancy among adolescents.

Approach:

We analyzed socio-cultural determinants affecting adolescent pregnancy and the possible health implications among three middle – human development countries according to the World Bank's Human Development Index: the Dominican Republic, Egypt and China. We have considered possible limitations in the data and how both the concept of “adolescence” and the meaning of early pregnancy vary across cultures.

Findings:

Paradoxically, though the Dominican Republic has higher levels of urbanization, employed women, education of girls, and healthcare expenditure, the adolescent pregnancy rate is over twice as high as it is in Egypt, and nearly ten times that in China. Our analysis shows how forces as globalization, government policy, cultural practices and family interaction affect the adolescent pregnancy rate differently depending on the local context.

Recommendations:

Our recommendations for research and policy emphasize the importance of consistent data collection, refining age categories to include young teens, recognizing that a multitude of socio-cultural factors determine the meaning of adolescent pregnancy and that developing policy that is responsive to the local socio-cultural context.