Ang ganda ko. - Philippine Population Association

Adult Life Situations of Filipino Women
Who Experienced Teen Childbearing
A Pseudo-Cohort Analysis
PLENEE GRACE J. CASTILLO
MA Demography, UPPI
2015 Annual Scientific Conference, Seda Abreeza, Davao City
January 29, 2015
OUTLINE OF PRESENTATION
Background of the Study
Data and Methods of Analysis
Results and Discussion
Recommendation
Background of the Study
3
Teen pregnancy rate is declining in most industrialized and
developing countries (Driscoll, 2014; CDC, 2011; Singh, 2000)
However, in the Philippines, the trend is increasing
Proportion of women 15-19 years old who began childbearing more than
doubled from 6.3% in 2002 to 13.6% in 2013 (DRDF & UPPI, 2014)
Live births by teen mothers rose by 65% from 2000 through 2010 (NSO, 2013)
Fertility rate of 15-19 age group has been increasing in the last 15 years
despite declining trend for all other groups (Cruz, 2014)
Teen childbearing rate in the Philippines is one of the highest
in Southeast Asia (UNFPA,2013; Marquez, 2014)
Background of the Study
4
Most countries and societies view teen pregnancy and childbearing
as a major social problem
 Negative outcomes to the teen mother and her baby: Health
risks, lost opportunities for personal advancement, school
underachievement, be underemployed or unemployed, social
stigma (United Nations, 2014; Culp-Ressler, 2012; Singh, 1998; Loignon, 1996 as
quoted in MSSS (n.d); Brunner & Mazel, 1986)


High cost to the state: social programs, public sector health care,
education; lost earnings from increased high school and college
drop outs(Culp-Ressler, 2012; Brunner & Mazel, 1986; Gilchrist&Schinke,1983)
In Britain, teen pregnancy has been labeled alongside
cardiovascular disease, cancer and mental health as a major
public health problem (Dickson, et.al., 1997)
Counter arguments and analysis assert that the negative life
outcomes are not result of early pregnancy per se (Punongbayan,
2014; Whitney, 2012; Stewart, 2003; Rich-Edwards, 2002 )
5
Research Problem
How do Teen mothers compare with Older mothers in their
adult life situations, in terms of their demographic, socioeconomic, and fertility characteristics and child mortality
experiences ?
 Do Teen mothers tend to have poorer socio-economic
life situation in adulthood compared with their
counterparts at any time period, and in any geographic
sub-group?
 Are the adult life situation of Teen mothers from more
recent cohorts better or worse off than those in earlier
cohorts?
Data
6
Individual women dataset of the 5 most recent rounds of
National Demographic Survey/National Demographic and
4.1 NDS/NDHS survey rounds, date of field operations and number of sample
HealthTable
Surveys
households and women respondents
Survey Round
Data Collection
Period
Number of sample
households
Number of sample
women
1993 NDS
April – June 1993
12,995
15,029
1998 NDHS
March – May 1998
12,407
13,983
2003 NDHS
16 June – 3 Sept 2003
12,586
13,633
2008 NDHS
7 Aug – 27 Sept 2008
12,469
13,594
2013 NDHS
12 Aug – 24 Sept 2013
14,804
16,155
7
Analytic sample
Pooled data from the 5 survey rounds
Restricted to women ≥ 25 y/o and with at least 1 live
birth
Created 2 types of groupings for the women
 By five-year birth cohort (based on woman’s year of
birth)
 By woman’s age at first childbirth
• Age < 20
Teen mother
• Age ≥ 20
Older mother
Table 4.3 Distribution of final analytic sample by birth cohort, age at first birth, and NDS/NDHS round
8
Birth Cohort/
Mothers by age at
first birth
Years aged Number Percent to
15-19
of cases total sample
Percent distribution of sample by NDS/NDHS Round
1993
1998
2003
2008
2013
All
1951-1955
1 Teen Mothers
2 Older Mothers
1966-1974
3,404
1,005
2,399
10.2
47.3
48.5
46.8
36.1
35.3
36.4
16.6
16.2
16.8
-
-
100.0
100.0
100.0
1956-1960
1 Teen Mothers
2 Older Mothers
1971-1979
5,401
1,601
3,800
16.2
34.1
36.0
33.3
28.8
30.2
28.2
25.8
22.9
26.9
11.3
10.8
11.5
-
100.0
100.0
100.0
1961-1965
1 Teen Mothers
2 Older Mothers
1976-1984
7,311
2,078
5,233
21.9
26.2
29.5
24.9
24.6
24.4
24.7
21.1
21.9
20.8
18.5
15.9
19.5
9.6
8.3
10.2
100.0
100.0
100.0
1966-1970
1 Teen Mothers
2 Older Mothers
1981-1989
7,495
2,180
5,315
22.4
10.3
13.1
3.3
22.9
24.3
19.8
10.3
13.1
9.1
22.9
24.3
22.4
22.7
22.2
22.9
100.0
100.0
100.0
1971-1975
1 Teen Mothers
2 Older Mothers
1986-1994
5,590
1,636
3,954
16.7
-
11.3
12.9
11.3
29.1
29.5
29.1
27.8
27.6
27.8
31.7
30.0
31.7
100.0
100.0
100.0
1976-1980
1 Teen Mothers
2 Older Mothers
1991-1999
4,226
1,121
3,105
12.6
-
-
17.5
16.3
16.3
38.7
38.1
38.1
43.8
45.5
45.5
100.0
100.0
100.0
33,427
9,621
23,806
100.0
18.4
20.4
17.5
20.7
21.7
20.4
22.6
22.7
22.6
20.0
19.1
20.4
18.2
16.2
19.0
100.0
100.0
100.0
All Cohorts
1 Teen Mothers
2 Older Mothers
9
Distribution of sample
by birth cohort and current age
Teen mothers are similarly distributed as Older mothers!
10
Adult life situation variables
Highest educational attainment
 2 categories: Has gone beyond high school vs.
Has not gone beyond high school
Adult socio-economic status (SES)
 2 categories: Poor vs. Not poor
 Based on wealth index expressed in quintiles
 Poor: 1st (Lowest) and second quintiles
 Not poor: 3rd to 5th (Highest) quintiles
11
Methods of Analysis
Analysis of adult life situations
Binary logistic regression to examine the likelihood of
“having gone beyond high school” and being “not
poor” within and across birth cohorts
Mantel-Haenszel linear by linear association to
examine trend in proportions
Linear regression to examine trend in odds ratios
12
Study Results
13
Incidence of teen childbearing in the country
remained more or less stable at 29% from
middle 1960’s to middle 1990’s
14
Proportion who have gone beyond high school
• Generally increasing trend
in the proportion of both
Teen and Older mothers
who have gone beyond
high school
• Proportions of Teen mothers
far lower compared to
Older mothers’ across
cohorts and types of place
of residence
15
Proportion who have gone beyond HS
by region
• Apparent edge of
NCR over the rest of
the regions
• Trends may have
been influenced
(and disrupted) by
societal events, i.e
history effects
16
Increasing odds over time of having gone beyond
high school for both Teen and older mothers!
Note:
** significant at 1% level of significance
Educational
underachievement
of
Teen
mothers
17
• Teen mothers less likely than
Older mothers to have gone
beyond high school in all
birth cohorts
• However, there is very slight
yet highly significant
improving trend in the odds
of having gone beyond HS
for teen mothers relative to
older mothers
• Across cohorts, teen mothers
are 83% less likely to have
gone beyond high school
than older mothers
Poorer socio-economic status of Teen mothers
18
Poorer socioeconomic
condition of rural mothers vs.
urban mothers
Generally decreasing trend
of ‘not poor’ especially
among rural Teen mothers
Teen mothers who belong to
the 1956-1960 cohort better
off than all the rest of the
cohorts
Poorer socio-economic status of Teen mothers
19
Poorer socioeconomic
condition of Visayas and
Mindanao mothers, esp.
Teen mothers
Older mothers’ situation
relatively more stable,
except in Mindanao
20
Improving education of mothers;
Declining socio-economic condition of households!
Note:
** significant at 1% level of significance
ns - not significant
Poorer socio-economic status of Teen mothers
21
Overall, across cohorts, Teen
mothers are just 7% less likely to
be “not poor” compared with
older mothers
Consideration of more current
factors i.e., number of children
ever born, current age and
work status affect (reduce or
increase the odds of being not
poor in adult life.
22
Summary of Findings
A stable teen childbearing incidence of
29% from middle 1960’s to 1990’s
Much higher risks of educational
underachievement and poorer socioeconomic status for Teen mothers vis-a-vis
Older mothers
23
Summary of Findings: Education
Teen mothers tend to have lower educational
attainment than older mothers across birth cohorts and
across regions.
The former are 83% less likely to have gone beyond HS
compared with the former
Nonetheless, educational attainment of mothers
improve across cohorts
Summary of Findings: SES
24
Teen mothers tend to have poorer socio-economic
condition compared with older mothers across birth
cohorts and across regions.
Consideration of more current factors i.e., number of
children ever born, current age and work status can
either reduce or increase theodds of being not poor in
adult life.
Overall teen mothers are 7% less likely to be not poor
in their adulthood compared with older mothers
Socio-economic condition of mothers worsened across
cohorts
25
Maraming pong salamat!
26
General Objective of the Study
To examine the linkages between teenage
childbearing with certain adult life situations of
birth cohorts of women from 1993 NDS to 2013
NDHS
Specific Objectives
27
1.
To describe the adult life situations of women who experienced
teenage childbearing vis-à-vis women who had first childbearing
in older ages, with respect to selected demographic, socioeconomic, and fertility characteristics, and child mortality
experience;
2.
To examine within each birth cohort the variation in educational
attainment and socio-economic status in adulthood of the two
groups of women by region and by urban-rural type of
residence; and
3.
To compare across birth cohorts the educational attainment and
socio-economic status in adulthood of the two groups of women
28
Demographic characteristics
Teen mothers vs. Older mothers
Marital status
• 13 % less likely to be married
• 33% more likely to be living-in with a partner
• 46% more likely be widowed
Lower proportion residing in NCR (8.0% vs. 13.0%) and in Luzon
(37.3% vs. 39.8% ); higher in Mindanao (34.7% vs. 27.6% );
almost same in Visayas (19.9% vs. 19.7%)
60.3% of teen mothers are rural residents while 50:50 urbanrural distribution for Older mothers
29
Socio-economic characteristics
Teen mothers vs. Older mothers
Fewer have gone beyond high school (8.4% vs. 35.6%)
Majority are poor (55.5% vs. 38.1%)
Husbands/partners likewise have lower educational
attainment. Lower proportion who have gone beyond
high school (12.8% vs. 32.9%)
Husbands/partners are mostly engaged in agricultural
occupation (45.9% vs. 29.2%)
30
Fertility characteristics and experience of
mortality among young children
Teen mothers vs. Older mothers
Earlier age at menarche(13.4 vs. 13.7 yrs)
Earlier age at first marriage/union (16.8 vs. 22.8 yrs)
2x more likely to be married/in union more than once
Higher number of children ever born (5.1vs. 3.3 children)
2x more likely to have children who died before reaching
age1
3x more likely to have children who died between exact
ages 1 and 5
31
Study Hypotheses
Women who experienced teenage childbearing are more likely
to face adverse social and economic adult life situations than
women who had their first childbearing in older years.
1. Teen mothers (of any birth cohort and region and
place of residence) are more likely to have lower
educational attainment and lower SES than Older
mothers
2. Across birth cohorts, the educational attainment of
both Teen and Older mothers improve while their
adult SES worsen
32
Methods of Analysis
Profile of Teen and Older mothers
Descriptive statistics (proportion, mean and
standard error, and median)
Binary logistic regression and Linear regression to
examine the association of profile
characteristics with being Teen or Older mother
33
Limitations of the Study
Limited choice of variables to use as covariate of
highest educational attainment and adult socioeconomic status
Cannot establish causality with use of data from
cross-sectional surveys
Program and Policy Recommendations
34
Reduce and prevent teen pregnancy
 Age-appropriate sexuality education among
elementary and high school students
 Strengthening of adolescent counselling in
elementary and high schools (Gastardo-Conaco,
et al, 2003)
 Through the strength of the RH Law, contraception
to be taught and be made available openly to
young people
35
Program and Policy Recommendations
For teens already entrapped in teen motherhood:
 Revisit and strengthen alternatives modes of formal
education (e.g., Open High School program (OHSP),
distance education (iDEP)that cater to teen
mothers)
 For mothers with low educational background in the
more rural areas of the country: well-designed
programmes of non-formal education to bring
specific “messages” information, skills, attitudes,
etc.(Castillo, 1976) to empower them to rise above
their situations and become better mothers
36
Program and Policy Recommendations
Development by DSWD of specific programs
directed to teen mothers (e.g., a branch-out of
the CCT)
To reduce infant and child mortality, further
strengthening of DOH’s information campaign on
maternal and infant health benefits of
vaccination targeting young mothers
37
Research Recommendations
Use of longitudinal surveys for a more comprehensive
study of the consequences of teen childbearing
A study on health risks of teen childbearing on the mother
and her baby, and long term outcomes to children born
to teen mothers.
 Explore how the next rounds of NDHS and YAFS could
provide data support for such study
Use of pooled data from several rounds of surveys to
examine rare events