Adolescent pregnancy remains a significant public health and social challenge in sub-Saharan Africa, including Tanzania. The study aimed to explore contextual reasons and determinants of adolescent pregnancy among girls using a mixed-methods approach.

A convergent mixed-methods study integrating a community-based cross-sectional survey with qualitative in-depth interviews and focus group discussions. Quantitative and qualitative data were analysed separately and integrated during interpretation using triangulation and comparative joint analysis.

Community-based study conducted in Korogwe District, Tanga Region, northeastern Tanzania.

A total of 418 adolescent girls aged 15–19 years were selected through multistage sampling for the quantitative survey. The qualitative component purposively recruited pregnant and parenting adolescents, parents/guardians and community stakeholders.

The primary outcome was adolescent pregnancy, defined as ever having been pregnant, including current pregnancy. Secondary variables included sociodemographic, educational, economic, relational and contraceptive factors associated with adolescent pregnancy.

The prevalence of adolescent pregnancy in Korogwe District was 16%. In multivariable analysis, older age (18–19 years), school discontinuation, marital union and economic vulnerability were independently associated with adolescent pregnancy. Current contraceptive use was more commonly reported among adolescents who had experienced pregnancy, a finding likely reflecting post pregnancy uptake rather than a protective effect, given the cross-sectional design. Qualitative findings revealed that poverty, transactional relationships, early unions, gendered power imbalances and misconceptions about contraception constrained adolescents’ reproductive autonomy. Integrated analysis demonstrated convergence between statistical associations and lived experiences, showing that economic precarity and educational limitations operated as structural pathways influencing early union formation and limiting contraceptive decision making.

Adolescent pregnancy among girls aged 15–19 years in Korogwe District is shaped by interrelated socioeconomic, educational and gendered factors. The identified factors and contextual reasons suggest that adolescent pregnancy is a socially patterned outcome rather than solely an individual behavioural issue. Multisectoral interventions addressing school retention, economic insecurity and gender power relations are essential to reduce vulnerability.

Teenage pregnancy is a major public health problem with huge consequences for maternal health and pregnancy outcomes. This calls for a concerted effort from different stakeholders involved in issues of teenagers’ sexual reproductive health to achieve the SDG target of 2030 on the reduction of maternal mortality. The objective of this systematic review was to estimate the prevalence of teenage pregnancy and its associated factors in Uganda.

We conducted a systematic review and random-effects meta-analysis according to Preferred Reporting Items for Systematic Review and Meta-analysis standards.

After prospective registration (PROSPERO CRD42023486460), a literature search was conducted in PubMed, African Journals Online and Google Scholar in December 2023.

Observational studies that reported the prevalence of teenage pregnancy among teenagers were included.

Articles were screened for relevance at the title, abstract and full-text levels by multiple reviewers. The quality of studies was independently appraised using the Joanna Briggs Institute Critical Appraisal Checklist and Newcastle-Ottawa Scale. Any discrepancies were resolved by reaching a consensus. The process of extracting data included study information, geographical categorisation, type of studies, population, sample size, results/outcomes and prevalence of teenage pregnancy. The risk of bias was determined by Egger’s test. The results were pooled using random-effects models to calculate the prevalence of teenage pregnancy with a CI of 95% and I² statistic.

Of 918 records screened, 10 studies (4143 participants) were included. The pooled prevalence of teenage pregnancy was 25.5% (95% CI 13.7% to 39.5%; I²=98.9%), with individual study estimates ranging widely from 3.0% to 56.4%, reflecting substantial heterogeneity across study settings, populations and periods of data collection. Higher estimates were observed in the Central–Eastern region (31.7%, 95% CI 19.5% to 45.1%). The overall certainty of evidence was rated as very low using the Grading of Recommendations, Assessment, Development and Evaluation framework, primarily due to very serious inconsistency across included studies (I²=98.9%).

Pooling studies of mixed quality revealed a slightly higher prevalence of teenage pregnancy in Uganda. This review provides valuable insight for policymakers and healthcare providers in developing interventions and policies to reduce the burden of teenage pregnancy from disadvantaged backgrounds.

CRD42023486460.