Teenage mothers report poor health and economic functioning in Western Kenya: A call to action.

Teenage pregnancy remains a critical issue in Kenya, with 15% of girls aged 15-19 having been pregnant. Counties in western Kenya experience high teenage pregnancy rates (22-30%) along with high HIV prevalence and widespread poverty. Long-term consequences of teenage pregnancy have been documented in high-income countries, but evidence from the Global South is lacking. Here, we examined the association between teenage pregnancy and adult socio-economic functioning in western Kenya using cross-sectional survey data from Migori County, Kenya. We categorized women into three groups: adult mothers (first child ≥20 years), teenage mothers to 1 child (had 1 child before age 20), and teenage mothers to 2 + children (had 2 or more children before age 20). We then compared adult socioeconomic and health outcomes of these groups. We found that among 6,089 mothers, 45.2% had their first child during adolescence. Compared to adult mothers, teenage mothers were significantly less likely to complete primary education: a 12.2 percentage point (pp) reduction (95% CI: -14.9, -9.4) among teenage mothers to 1 child and 27.6 pp reduction (95% CI: -31.4, -23.8) among teenage mothers to 2 + children. Teenage mothers were also more likely to have loans and experience food insecurity. The risk of experiencing the death of a child increased from 3.4% among adult mothers to 15.3% among teenage mothers to 2 + children, a 4.5-fold increase (p < 0.001). Teenage mothers also reported short birth spacing and poor mental health. Our study highlights that teenage motherhood is associated with worse health and economic functioning that persists into adulthood. Urgent policy action is needed to address teenage pregnancy in Kenya to support the economic development of youth and reduce the risk of HIV infection.