The influence of adolescent age at first union on physical intimate partner violence and fertility in Uganda: a path analysis

Background. Uganda has a high fertility rate, high levels of intimate partner violence (IPV) and also very young ages at first union. Experiencing IPV has previously been shown to increase fertility rates. Entering marriage at a later age has been shown to decrease fertility rates in some countries. Given that a large proportion of Ugandan women are married by the end of adolescence, marital age may be a key proximate determinant of fertility in Uganda. Objective. To examine the effect of age at first union on fertility, via the intermediate effect of physical IPV, among Ugandan women of reproductive age. Methods. Data from the 2011 Ugandan Demographic and Health Survey were used to create an integrated path model to investigate the effects of age at first union on fertility. Known factors that influence fertility were included in the model. The interaction with age at first union in increasing fertility differentials, via the intermediate effect of physical IPV, was assessed. Results. Results show that women who are preadolescent or adolescent at first union have a higher likelihood of experiencing IPV, indicated by both direct and indirect pathways that work via known intermediate and proximate factors. Furthermore, age at first union increases fertility, expressed as the number of children born to a woman, via a direct interaction. Conclusion. Most Ugandan women enter their first union during adolescence (<19 years), which exposes them to a higher risk of IPV and a longer period of childbearing, thereby increasing fertility rates

Disease prevalence and grade repetition among adolescents in South Africa: is there any relationship?

Background. A universal goal of public health is to ensure that adolescents have a healthy transition to adulthood. In developing countries, a host of social, economic and political factors inhibit this from happening. The results of these challenges include an increasing disease prevalence among an age group (10 - 19-year-olds) that should be healthy. Objectives. The purpose of this study is to identify the most prevalent diseases and assess the relationship between disease and grade repetition among adolescents in South Africa (SA), and to assess the impact of disease on grade repetition. Methods. Data from the SA General Household Surveys (2009 - 2016) were analysed, and both adolescent (10 - 19 years) sexes from all geographical and racial groups were included. Frequencies, percentages and rates of infectious, non-communicable diseases (NCDs) and mental health outcomes were estimated. The relationship between disease and grade repetition was determined using logistic regression. Results. Infectious diseases, NCDs and mental illnesses are increasing in adolescents over time. In urban areas, rates of NCDs are higher than those of infectious diseases, while in rural areas a high burden of infectious disease persists. Among adolescents who repeated a grade, 7.07% had an infectious disease. In addition, infectious disease (odds ratio (OR) 1.17, p<0.05), younger adolescents, 15 - 19-year-olds (OR 1.52, p<0.05) and urban residence (OR 1.12, p<0.05) are associated with increased likelihood of grade repetition. Conclusion. Policies and programmes in SA which address the health of adolescents need to be more aware of the disease prevalence among school pupils in the country. Prolonged disease occurrences are contributing to the slow school progression and eventual matriculation of pupils