Adolescent Mother Behaviors in Malawi, A Five-Year Comparison Público

Ferrey, Seth (Spring 2018)

Permanent URL: https://etd.library.emory.edu/concern/etds/cn69m414t?locale=es
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Abstract

The transition from the Millennium Development Goals (MDGs) to the Sustainable Development Goals (SDGs) set by the United Nations has marked significant improvement in maternal and child health in developing nations. Demonstrated through Demographic Health Surveys (DHS) administered through USAID, Malawi has improved considerably in child and infant mortality in just the last five years. However, rapid population growth and high rates of adolescent pregnancy create persistent concerns. The 2015-2016 DHS survey shows adolescent birth rates in Malawi at an all-time high, while also showing disproportionate improvement in child mortality compared to other age ranges of mothers. This study seeks to understand this paradox by examining whether there have been secular trends in behavioral risk factors for infant and child mortality among adolescent mothers in Malawi between 2010 and 2015-2016. Multivariate logistic regression was used with the statistical software SAS 9.4. The behaviors considered include antenatal birth utilization, HIV status known or not, birth location, breastfeeding, and marriage status at birth. Covariates considered were location (urban or rural and region), electricity availability, water source, and education attainment. Adolescent mothers in 2015-2016 were twenty percent more likely to have adequate antenatal care (OR 1.2, 95% CI: 1.0, 1.4), four times more likely to have a facility birth compared to home birth (OR 4.03, 95% CI: 2.95, 5.49), and two times more likely to be unmarried (OR 2.03, 95% CI: 1.55, 2.67). The results varied slightly by location. Although there was an increase in adequate antenatal care, respondents from 2015-2016 were less likely to have any care (OR 0.29, 95% CI: 0.12, 0.72) when compared to 2010 respondents. Overall, however, adolescent pregnancy behaviors in the last five years have improved significantly. These changes may have influenced the decrease in overall child mortality seen in Malawi.

Table of Contents

Table of Contents

CHAPTER I: Background/Literature Review…………………………………….1

A. Maternal Outcomes…………………………………………………………………1

B. Maternal and Child Outcomes……………………………………………………2

C. Antenatal Care and Area Specific Concerns………………………………..4

D. Malawi……………………………………………………………………………………….5

CHAPTER II: Manuscript…………………………………………………………………7

A. Title, Author(s), Abstract…………………………………………………………….8

B. Introduction………………………………………………………………………………..9

C. Methods……………………………………………………………………………………10

D. Results……………………………………………………………………………………….11

Antenatal Visits………………………………………………………………………………11

Tested for HIV…………………………………………………………………………………12

Facility Birth……………………………………………………………………………………12

Breastfeeding………………………………………………………………………………..12

Marriage………………………………………………………………………………………..12

E. Discussion………………………………………………………………………………….13

F. References………………………………………………………………………………..15

G. Tables………………………………………………………………………………………19

H. Appendix…………………………………………………………………………………….22

Chapter III:  Summary, Public Health Implications, Possible Future Directions……..25

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