Factors Associated with Repeat Teenage Pregnancy in Refugee Settlements in Uganda

Repeat teenage pregnancy is a global issue affecting low-, middle-, and high-income countries, with significant risks for both the mother and child. Despite the high prevalence of repeat teenage pregnancy in refugee or internally displaced persons camps, there are limited data on the phenomenon, particularly among teenage mothers residing in refugee settlements. We determined the prevalence and factors associated with repeat teenage pregnancies among teenage mothers in refugee settlements in Northern Uganda.

We performed a secondary analysis on data from a cross-sectional descriptive study conducted on conveniently sampled adolescent girls aged 15-19 years, from Bidi Bidi and Palorinya refugee settlement camps in Northern Uganda. Cluster sampling techniques, where each settlement represented one cluster was used. The prevalence of repeat teenage pregnancies was assessed by self-reported number of pregnancies of more than one. We performed multivariable logistic regression on all variables with p<0.2 to assess for factors independently associated with repeat teenage pregnancy.

We included 131 participants with a median age of 18 (IQR: 18 to 19) years, the median age of sex debut was 16 (Range: 13-18), years, and 60.3% (n=79) were married. The prevalence of repeat teenage pregnancy was 24.4% (n=32). No factor was seen to be independently significant at the multivariable level.

The study reveals a 24.4% rate of repeat teenage pregnancies among girls in northern Uganda's refugee settlements. This prevalence shows a significant public health challenge, particularly in humanitarian contexts where access to reproductive health services is limited. While no specific independent risk factors were identified, bivariate analysis linked male-headed households and cohabitation with increased risk. These findings suggest that male-headed households and cohabitation may influence reproductive decision-making or access to contraception, potentially due to power dynamics or socio-cultural norms.