Inequalities in early marriage, childbearing and sexual debut among adolescents in sub-Saharan Africa

Abstract Background Adolescent sexual and reproductive health (ASRH) is a major public concern in sub-Saharan Africa (SSA). However, inequalities ASRH have received less attention than many other priority areas, part due to limited data. In this study, we examine key indicators. Methods We analyzed national household surveys from 37 countries SSA, conducted during 1990–2018, trends adolescent behaviors related early marriage, childbearing debut among adolescents using data respondents 15–24 years. Survival analyses were on each survey obtain estimates for the Multilevel linear regression modelling was used 2000 2015 four subregions of SSA all indicators, disaggregated by sex, age, wealth, urban–rural residence educational status (primary or versus secondary higher education). Results 2015, 28% girls married before age 18, declined at an average annual rate 1.5% 2000–2015, while 47% gave birth 20, declining 0.6% per year. Child marriage rare boys (2.5%). About 54% 43% boys, respectively, had their 18. The declines greater indicators adolescence (10–14 years). Large differences observed between rural urban areas poorest richest households, with much West Central where prevalence highest. wealth-related remained stagnant widened as decline relatively slower compared girls. did not increase either education categories. Conclusion Early but levels still high, especially Africa, persisted became larger. particular, rural, educated continued face risks vulnerabilities. Greater disparities needed better targeting interventions monitoring progress.