Evidence in Focus: A Review of Socio-Demographic and Clinical Profiles, and Pregnancy Outcomes of Adolescents in Eastern and Southern Zambia

Background Zambia remains one of the countries with a significantly high prevalence of teenage pregnancy among SSA countries with a stagnant rate only declining slightly from 31.6% in 1992 to 28% in 2024. Most studies have not explored the intrinsic characteristics of pregnant adolescents at different stages of adolescence. In order to inform health system response, we aimed to investigate the profile of pregnant adolescents as well as their pregnancy outcomes in Zambia focusing on Eastern and Southern provinces Methods We conducted a retrospective review of routinely collected health data from the Health Management Information System (HMIS) of the Ministry of Health (MoH). Data was extracted from Antenatal Care (ANC) registers as well as Labour and Delivery (L&D) registers in the health facilities from 2021 to 2022. Multistage sampling was utilized and a total of 118 facilities across the two provinces were sampled. All available records were extracted for 2021 and 2022. Results Our study shows a growing concern that the middle-aged adolescents (14–17 years) accounted for 51% of all adolescent pregnancies slightly higher than their late adolescents (18–19 years) counterparts at 49%. We also found that marriage rates increased significantly with age. Among late adolescents, 70.4% were married, compared to 50.3% of middle adolescents and 45.1% of early adolescents. We found that among the early adolescents, 25% booked for ANC in the first trimester compared to only 15% and 20% of the middle and late adolescents, respectively. We also found that facility location, number of ANC visits, type of delivery and term of birth were associated with adolescents having live births. Conclusion and implications This raises concerns for implementation of interventions particularly among this age group in light of the Zambian Children’s Code Act, 2022 that requires parental consent for provision of health services to for adolescents below 18 years. Efforts to reduce the age of consent to access Sexual Reproductive Health (SRH) services should be hastened. We also recommend intensified efforts to improve ANC services to improve pregnancy outcomes for the adolescents as well as improved quality of care provided at hospital to improve newborn outcomes.