Uganda has the highest adolescent fertility rate in East Africa, while Burundi and Rwanda have the lowest, a new report shows.

The report also highlights the policy headache the region faces in pushing strong pregnancy-prevention messages aimed at teens.
The adolescent birth rate measures the annual number of births per 1,000 women aged 15 to 19.

In the newly launched African Reproductive and Sexual Health Scorecard report, Uganda is among the top 10 African countries with the highest adolescent fertility rate at position eight, with an adolescent fertility rate of 159 births per 1,000 young women aged 15 – 19 years.

The report says Tanzania follows at position two in the region and ranks 23rd in Africa, with an adolescent fertility rate of 116 births per 1,000 young women of the same age.

Kenya takes third position in the region and ranks 29th in Africa with an adolescent fertility rate of 106 births per 1,000 young women.

Burundi which ranks 48th in Africa has the lowest adolescent fertility rates in East Africa with only 30 births per 1,000 young women followed by Rwanda that has 43 births per 1,000 young women.

The rise in teenage pregnancies poses a huge healthcare challenge to African governments, medical experts say, citing risks the young mother and her unborn baby are exposed to.

“Young pregnant women have a higher risk of developing complications such as preeclampsia (hypertension during pregnancy), while their babies are likely to face fetal growth restriction,” said Gathari Ndirangu, an obstetrics gynaecologist and reproductive health advisor in Kenya’s Ministry of Public Health.

The report notes that higher adolescent fertility is also a pointer for early sexual debut and unprotected sexual activity among girls — including forced sex through child marriage.

Studies have shown that keeping girls in school improves their sexual and reproductive health.

A recently released report by Save the Children shows that the higher a mother’s level of education, the lower the children’s under-five mortality rate.

Uganda has the highest adolescent population which stands at 24 per cent of the general population. Tanzania, Burundi and Kenya follow closely with 23 per cent of each of their general population being adolescents, while Rwanda’s stands at 22 per cent.

However, the lifetime risk of maternal deaths is still highest in Burundi and low in Tanzania and Uganda. Burundi has a high maternal risk of 42 (1 in 31) followed by Kenya at 30 (1 in 55) and Rwanda with 27 (1 in 54).

Tanzania and Uganda have low maternal death risks in East Africa of 17 (1 in 38) and 18 (1 in 24) respectively.

The female life expectancy in the region is high with Kenya leading at 62, followed closely by Rwanda that has a female life expectancy of 60.

Tanzania is third followed by Uganda with a female life expectancy of 58 and 57 respectively, while Burundi has the lowest life expectancy in the region of 51.

According to the report, the general African adolescent fertility rate is between 123 per 1,000 births, and 199 per 1,000 births among young girls aged 15-19 years — with Niger, Chad, Mali, Mozambique and Liberia as top five most affected African countries.

Globally, the countries with the 5th joint lowest adolescent fertility rates are Democratic Peoples Republic of Korea and San Marino at 1 per 1,000; Republic of Korea at 2 per 1,000; Algeria, Libya, Lichtenstein and Switzerland at 4 per 1,000; Japan and Netherlands at 5 per 1,000; and China and Tunisia at 6 per 1,000.

They also have significantly lower though mixed levels of maternal death risk compared with countries with the highest adolescent fertility.

Across Africa, percentage prevalence and absolute numbers of women living with Aids/HIV is mostly higher than that of men.

In the East African region, the percentage of Aids related maternal deaths is high in Uganda and Kenya but lowest in Rwanda. Between 1990 -2010, 25 per cent of maternal deaths in Uganda were due to Aids, and 20 per cent in Kenya.