{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T00:19:30Z","timestamp":1789863570718,"version":"4.0.1"},"reference-count":22,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2024,12,28]],"date-time":"2024-12-28T00:00:00Z","timestamp":1735344000000},"content-version":"unspecified","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007270","name":"University of Michigan","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/100007270","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Center for International Reproductive Health Training","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,11,29]]},"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Following the COVID-19 pandemic, there was an increase in teenage pregnancies nationally, however, limited data exists regarding the same among girls living in refugee settlements.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>We evaluated the prevalence of teenage pregnancy and associated factors in Palorinya and Bidi Bidi refugee settlements in Obongi and Yumbe districts of northern Uganda, in the post-COVID-19 era.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>We conducted a cross-sectional study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Refugee settlements in northern Uganda.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>We included 385 teenage girls aged 15\u201319 years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used convenience sampling techniques between March and May 2023. Prevalence of teenage pregnancy was assessed by self-reported pregnancies between January 2020 and May 2023 among participants. We conducted Pearson\u2019s \u03c7<jats:sup>2<\/jats:sup> and Fisher\u2019s exact tests for bivariate analysis. All variables with a p value&lt;0.2 at bivariate analysis were included in multivariable regression. We applied a modified Poisson regression model at the multivariable level to evaluate independent associations. The level of statistical significance was set at p&lt;0.05.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Primary and secondary outcome measures<\/jats:title>\n                  <jats:p>The primary outcome measure was the prevalence of teenage pregnancy, assessed through self-reported pregnancies among participants. Secondary outcome measures included factors associated with teenage pregnancy, such as living with a husband, lack of formal education, peer pressure and history of sexual abuse.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall, the mean age was 17 (IQR: 15\u201318), and sexual debut was at 16 (IQR: 15\u201317) years. Lifetime modern contraceptive use was 13.8% (n=53\/385) and current use was 7.5% (n=29\/385). Teenage pregnancy period prevalence was 34.0% (CI: 29.4% to 38.9%). Factors independently associated with teenage pregnancy were: living with a husband (aPR: 3.8, 95%\u2009CI: 2.51 to 5.84, p&lt;0.001), lack of formal education (Adjusted Prevalence Ratios - aPR: 2.3, 95%\u2009CI: 1.26 to 4.35, p=0.007), peer pressure (aPR: 2.1, 95%\u2009CI: 1.54 to 2.86, p&lt;0.001) and history of sexual abuse (aPR: 1.5, 95%\u2009CI: 1.07 to 1.99, p=0.018).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Our study revealed that around 1 in 3 adolescent girls in northern Uganda\u2019s refugee settlements experienced pregnancy during the COVID-19 pandemic, with only 1 in 13 currently using modern contraceptives. To address this, targeted strategies by relevant authorities are crucial, including legal actions against sexual abuse, promoting girl child education and enhancing access to long-term contraception to reduce teenage pregnancy and associated health risks in these settings.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-089361","type":"journal-article","created":{"date-parts":[[2024,12,28]],"date-time":"2024-12-28T07:30:12Z","timestamp":1735371012000},"page":"e089361","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Prevalence and factors associated with teenage pregnancy in refugee settlements of northern Uganda post-COVID-19 (2020\u20132023): a cross-sectional study"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7779-4222","authenticated-orcid":false,"given":"Donald","family":"Otika","sequence":"first","affiliation":[{"name":"Gulu University, Gulu, Uganda"},{"name":"Northern Uganda Regional Cancer Center, Uganda Cancer Institute, Gulu, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Odongo","sequence":"additional","affiliation":[{"name":"Northern Uganda Regional Cancer Center, Uganda Cancer Institute, Gulu, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth Mary Mary","family":"Muzaki","sequence":"additional","affiliation":[{"name":"Gulu University, Gulu, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice Oweka","family":"Lamwaka","sequence":"additional","affiliation":[{"name":"Gulu University, Gulu, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Bongomin","sequence":"additional","affiliation":[{"name":"Gulu University, Gulu, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1205-1150","authenticated-orcid":false,"given":"Francis Pebalo","family":"Pebolo","sequence":"additional","affiliation":[{"name":"Reproductive Health, Gulu University, Gulu, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,12,28]]},"reference":[{"key":"2025101815022775000_14.12.e089361.1","unstructured":"WHO . 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