Is a woman’s first pregnancy outcome related to her years of schooling? An assessment of women’s adolescent pregnancy outcomes and subsequent educational attainment in Ghana

listen audio

Study Justification:
– Adolescent pregnancy and childbearing have negative impacts on young women’s educational attainment.
– Understanding the relationship between pregnancy outcomes and educational attainment can inform interventions to support young girls in staying in school.
– The study aims to assess the impact of adolescent pregnancy outcomes on subsequent educational outcomes in Ghana.
Highlights:
– The study used the 2007 Ghana Maternal Health Survey dataset, which provides nationally representative information on women’s pregnancy histories.
– The sample included 8,186 women aged 20-49 years, with a focus on their first pregnancies as adolescents.
– Findings showed that women who had induced abortions had the highest years of schooling, while those who experienced live births had the lowest.
– Women with live births as teenagers had significantly fewer years of schooling compared to those who terminated their pregnancies.
– Women with miscarriages and stillbirths had educational levels similar to those who gave birth.
– Controlling for age at first pregnancy resulted in similar years of schooling for women with no teenage births compared to those who gave birth.
– The results varied across age groups, with the 30-39 year olds showing different patterns.
Recommendations:
– Encourage young mothers to continue schooling.
– Focus on preventing and/or delaying adolescent pregnancies to support young girls in staying in school.
Key Role Players:
– Ministry of Education
– Ministry of Health
– Ministry of Women and Gender Affairs
– Non-governmental organizations working on women’s health and education
Cost Items for Planning Recommendations:
– Education programs targeting young mothers
– Awareness campaigns on preventing adolescent pregnancies
– Access to reproductive health services and contraception
– Support for girls’ education, including scholarships and mentorship programs

The strength of evidence for this abstract is 8 out of 10.
The evidence in the abstract is strong because it is based on a nationally representative survey dataset and includes statistical analyses. However, there are some limitations that could be addressed to improve the evidence. First, the information on women’s educational attainment levels is inadequate, as there is no question about their schooling at the time of pregnancy. Including this information would provide a clearer picture of the relationship between pregnancy outcomes and educational attainment. Second, combining stillbirths and miscarriages as one category may limit the ability to differentiate their effects on educational attainment. It would be beneficial to analyze them separately if possible. Third, considering the timing of induced and spontaneous abortions could provide additional insights into their impact on educational attainment. Finally, addressing the under-reporting of induced abortions and adolescent pregnancies would help ensure the accuracy of the findings.

Background: Adolescent pregnancy and childbearing pose challenges to young women’s educational attainment. Studies show that while adolescent childbearing reduces educational attainment, not becoming pregnant and resorting to induced abortion when pregnant increases women’s educational levels. This study examined relationships between adolescents’ resolution of their first pregnancies and subsequent educational outcomes, for all women ages 20-49 years and across three age cohorts: 20-29, 30-39 and 40-49 year olds. Methods: Using the 2007 Ghana Maternal Health Survey (GMHS) dataset, we conducted ANOVA, bivariate and multivariate linear regression analyses on 8186 women ages 20-49 years. Women’s first adolescent pregnancy outcomes were measured as live births, induced abortions, spontaneous abortions or no pregnancy, while educational attainment constituted their years of schooling. Results: Findings showed years of schooling was highest for women who had induced abortions, and lowest for those who experienced live births. Women with live births as teenagers experienced significantly fewer years of schooling compared to their counterparts who terminated their pregnancies. Also, women with miscarriages and stillbirths exhibited levels similar to those who gave birth. Although women with no teenage births had higher educational levels than their childbearing counterparts, controlling for age at first pregnancy resulted in similar years of schooling compared to those who gave birth. Finally, the 30 to 39 year olds were the only age group whose results contradicted those of all women. These findings may be due to the socio-economic and political events that affected women’s educational attainment at the time. Conclusions: Childbearing during adolescence does impact women’s educational attainment levels. Therefore, in addition to encouraging young mothers to continue schooling, all other interventions to help keep young girls in school must focus on preventing and/or delaying their adolescent pregnancies.

We used the 2007 GMHS dataset to assess the relationships between young Ghanaian women’s pregnancy outcomes and their educational attainment. To the best of our knowledge the GMHS is the only survey that enables us to access nationally representative information on women’s pregnancy histories as it provides detailed accounts of their pregnancy outcomes. Despite being a dated source, its findings have implications that are still relevant for women’s health at this time. Ethical clearance for the survey was provided by the ICF Macro Institutional Review Board, Maryland, USA. The surveyed women were sampled using a multi-stage cluster sampling approach. A total of 420 enumeration areas (EAs) were randomly selected across the nation and households in these EAs were then systematically selected. Eligible women, that is, those in the reproductive ages of 15 to 49, were selected from the households to partake in the study. The participation rate was quite high as 98.7% of sampled women were interviewed for the study. In total, 10,370 women were interviewed; however, this study focuses on two groups of women. The first group consists of all women between ages 20 and 49 years. After adjusting for missing cases for some of the variables, the final sample of women in this group was 8186. Less than 2 % of the sample was removed at this stage. The second group consists of 7208 women ages 20 to 49 years who had ever been pregnant. The outcome of women’s first pregnancies as adolescents (pregnancies below age 20) was the predictor variable. Women were asked about the outcomes of each of their pregnancies, whether they ended in a live birth, stillbirth, miscarriage or abortion. We selected women’s first pregnancies that occurred when they were below age 20 (and for some these were their only pregnancies) and re-categorized the outcomes. We combined the responses of women who had miscarriages and stillbirths, and also included women who had not been pregnant as adolescents. Combining miscarriages and stillbirths was necessary, primarily for statistical reasons, which are further discussed as part of the data limitations of the study. Thus, the variable consisted of the following categories: live birth, spontaneous abortion (miscarriage/stillbirth), induced abortion, and no pregnancy. Once again, these refer to outcomes for women whose initial pregnancies occurred when they were teenagers. A woman’s current educational attainment was measured using ‘number of years of schooling’ at the time of the survey. This was computed using three variables in the dataset, ‘ever been to school’, ‘highest educational level’ and ‘highest grade attained at that level’. Using cross tabulation results from the education variables, we were able to generate the years of schooling variable for women. One key variable in the study was age group. Women were divided into three age cohorts: 20–29 years, 30–39 years, and 40–49 years. Socio-cultural variables included religion and ethnicity. Religion was categorized as follows: Catholics, Protestants, Pentecostals/Charismatics, Other Christians, Muslims and ‘Others’. Ethnicity included the four major groups of Akan, Ga-Dangme, Ewe, Mole-Dagbani and also ‘Others’. Socio-economic proxy measures were ‘place of residence’, measured as urban and rural settings, and ‘household wealth’ which was split into five quintiles ranging from poorest to richest. The number of pregnancies a woman has had and her age at first pregnancy were continuous measures, while the number of abortions a woman she has had was re-coded into 4 categories: 0, 1, 2, and 3+. Age at first pregnancy was measured as a continuous variable comprising of the ages at which all women that had ever been pregnant had their first pregnancies. Bivariate and multivariate linear regression models were conducted to assess relationships between women’s first adolescent pregnancy outcomes and their years of schooling. The mean years of schooling of women across the four pregnancy outcome categories and by age group was also computed and graphed. The linear regression models were run with pregnancy outcome and years of schooling to assess the bivariate relationships between the main independent and dependent variables. Models were run for all women and women who had ever been pregnant, as well as across the three age cohorts. Additionally, multiple linear regression models were conducted to examine the association between pregnancy outcome and years of schooling while controlling for all covariates, with an exception. Only the models conducted with ever been pregnant women included the age at first pregnancy variable. The statistical software package, STATA version 12, was used for the analyses. There were a few data limitations to this study. First, the information available on women’s educational attainment levels was inadequate as no question was asked on their schooling at the time of the pregnancy. Thus, there was no evidence to indicate whether pregnancies occurred before respondents ended their education or vice versa; in addition, there was no information to indicate whether the respondent was in school at the time of the survey. The absence of such information does not enable us to make definitive conclusions about the women’s education since some may not have ended their education at the time of the survey. However, we specifically chose women starting from age 20 where we presume they should have finished their secondary education by age 18. Cross tabulation results show that the 20 to 29 year old women have more education than their older counterparts and it is highly likely that some of the younger ones may still be in school. Second, although stillbirths and miscarriages represent different durations at which women experience pregnancy loss, for example, a fetus may die at delivery and in this case the stillbirth will be almost akin to a live birth, and a miscarriage may take place as early as in the first few weeks of conception, the frequencies of women who had miscarriages (n = 181) and stillbirths (n = 60) were far too small to leave them as separate categories. Despite this limitation, we argue that ideally both forms of pregnancy loss were unexpected spontaneous and involuntary occurrences, and although duration and timing of the pregnancy loss varied, women were expecting to keep those pregnancies that were ultimately terminated. Third, it would have been ideal to factor in the timing of the induced and spontaneous abortions which could provide an opportunity to observe its effect on their educational attainment. However, there are many complexities associated with including this variable and this was also beyond the scope of this paper. Finally, the under-reporting of induced abortions or misreporting them as spontaneous abortions is always a major concern in abortion studies as social desirability and fear of stigma may result in women denying their abortions or reducing the number of repeated abortions they report [34, 35]. In the same manner, there may be under-reporting of adolescent pregnancies, where women refuse to acknowledge their teenage pregnancies due to the shame and stigma that is generally associated with premarital and adolescent pregnancy [33]. Also, women may have reported their pregnancies but misreported the ages at which they had them and this could pose another limitation to us concluding on a true effect of an adolescent pregnancy on women’s educational attainment levels.

N/A

Based on the information provided, here are some potential innovations that could be used to improve access to maternal health:

1. Mobile Health (mHealth) Applications: Develop mobile applications that provide information and resources related to maternal health, including pregnancy outcomes, prenatal care, and educational opportunities. These apps can be easily accessible to women in Ghana, even in remote areas, and can provide personalized support and guidance.

2. Community Health Workers: Train and deploy community health workers who can provide education and support to pregnant women and new mothers. These workers can visit women in their homes, provide information on pregnancy outcomes, and connect them with resources and services in their communities.

3. Telemedicine: Implement telemedicine programs that allow pregnant women to consult with healthcare providers remotely. This can help overcome barriers to accessing healthcare, particularly in rural areas where there may be a shortage of healthcare professionals.

4. School-based Health Education: Integrate comprehensive sexual and reproductive health education into school curricula. This can help young girls make informed decisions about their reproductive health and prevent unintended pregnancies.

5. Financial Incentives: Provide financial incentives, such as scholarships or grants, to encourage young girls to stay in school and complete their education. This can help delay pregnancies and improve educational attainment.

6. Access to Contraception: Improve access to contraception and family planning services to prevent unintended pregnancies among adolescents. This can include increasing the availability of contraceptives, providing education on contraceptive methods, and reducing barriers to accessing these services.

7. Maternal Health Clinics: Establish dedicated maternal health clinics that provide comprehensive care for pregnant women, including prenatal care, childbirth services, and postnatal care. These clinics can ensure that women receive the necessary support and medical attention throughout their pregnancy journey.

8. Public Awareness Campaigns: Launch public awareness campaigns to educate the community about the importance of maternal health and the impact of adolescent pregnancies on educational attainment. These campaigns can help reduce stigma and promote supportive environments for young mothers.

9. Partnerships and Collaboration: Foster partnerships and collaboration between government agencies, healthcare providers, non-profit organizations, and community leaders to collectively address the barriers to accessing maternal health services and improve outcomes for women in Ghana.

10. Research and Data Collection: Conduct further research and data collection to better understand the factors influencing adolescent pregnancies and educational attainment. This can help inform the development of targeted interventions and policies to improve access to maternal health services.
AI Innovations Description
The study mentioned in the description focuses on the relationship between adolescent pregnancy outcomes and subsequent educational attainment in Ghana. The findings indicate that adolescent childbearing reduces educational attainment, while avoiding pregnancy and resorting to induced abortion increases women’s educational levels. The study suggests that interventions to improve access to maternal health should focus on preventing and/or delaying adolescent pregnancies.

To develop this recommendation into an innovation to improve access to maternal health, the following steps can be taken:

1. Comprehensive sex education: Implement comprehensive sex education programs in schools and communities to provide young people with accurate information about reproductive health, contraception, and pregnancy prevention. This can help empower young women to make informed decisions about their sexual and reproductive health.

2. Access to contraception: Ensure that affordable and accessible contraception methods are available to all women, including adolescents. This can include providing information about different contraceptive methods, offering contraceptive services in schools and healthcare facilities, and removing barriers to access such as cost and stigma.

3. Youth-friendly healthcare services: Establish youth-friendly healthcare services that are specifically designed to meet the unique needs of young people. These services should provide confidential and non-judgmental care, including access to contraception, pregnancy testing, and counseling.

4. Community engagement: Engage communities in discussions and awareness campaigns about the importance of delaying adolescent pregnancies and supporting young mothers to continue their education. This can involve working with community leaders, parents, and religious organizations to promote positive attitudes towards adolescent sexual and reproductive health.

5. Empowerment and support for young mothers: Provide support and resources for young mothers to continue their education, such as flexible schooling options, childcare services, and mentorship programs. This can help young mothers overcome the challenges they may face in balancing motherhood and education.

6. Strengthening healthcare systems: Invest in strengthening healthcare systems to ensure that quality maternal healthcare services are available and accessible to all women, including adolescents. This can involve training healthcare providers, improving infrastructure and equipment, and ensuring the availability of essential maternal health services.

By implementing these recommendations, it is possible to improve access to maternal health and support young women in achieving their educational goals.
AI Innovations Methodology
Based on the provided description, the study aims to assess the relationship between adolescent pregnancy outcomes and subsequent educational attainment in Ghana. The methodology used involves analyzing data from the 2007 Ghana Maternal Health Survey (GMHS) dataset. Here is a brief summary of the methodology:

1. Dataset: The study utilizes the 2007 GMHS dataset, which provides nationally representative information on women’s pregnancy histories and outcomes. The dataset was obtained through a multi-stage cluster sampling approach, with a high participation rate of 98.7%.

2. Sample: The study focuses on two groups of women. The first group includes all women aged 20-49 years, resulting in a final sample size of 8,186 after adjusting for missing cases. The second group consists of 7,208 women aged 20-49 years who had ever been pregnant.

3. Variables: The predictor variable is the outcome of women’s first pregnancies as adolescents (below age 20), categorized as live births, spontaneous abortions (miscarriage/stillbirth), induced abortions, or no pregnancy. The outcome variable is the number of years of schooling, computed using information on women’s educational level and grade attained.

4. Analysis: The study employs ANOVA, bivariate, and multivariate linear regression analyses to assess the relationships between pregnancy outcomes and years of schooling. The analysis is conducted for all women and women who had ever been pregnant, as well as across three age cohorts (20-29, 30-39, and 40-49 years).

5. Covariates: The analysis includes socio-cultural variables such as religion and ethnicity, socio-economic variables such as place of residence (urban/rural) and household wealth, and continuous measures like the number of pregnancies and age at first pregnancy.

6. Statistical software: The statistical software package STATA version 12 is used for the analysis.

7. Limitations: The study acknowledges several limitations, including inadequate information on women’s educational attainment levels, the small sample size for stillbirths and miscarriages, the absence of timing information for induced and spontaneous abortions, and potential under-reporting or misreporting of pregnancies and abortions due to social desirability and stigma.

In conclusion, the study utilizes the 2007 GMHS dataset to examine the relationship between adolescent pregnancy outcomes and subsequent educational attainment in Ghana. The methodology involves analyzing the data using ANOVA, bivariate, and multivariate linear regression models, while considering various socio-cultural and socio-economic variables.

Partilhar isto:
Facebook
Twitter
LinkedIn
WhatsApp
Email