Prevalence and associated factors of Somali teenage pregnancy: a multilevel analysis using the evidence from the demographic and health survey.

Background: Teenage pregnancy is a major public health concern that contributes to maternal and neonatal morbidity and mortality, particularly in low-income countries. In Somalia, evidence on the prevalence and determinants of teenage pregnancy is limited to a few studies. This study aimed to assess the prevalence of teenage pregnancy among teenagers aged 15-19 years and the factors associated with it. Methods: A secondary analysis of the 2020 Somali Demographic and Health Survey (SDHS) was conducted, including 6,608 teenage pregnancies. Descriptive statistics were used to summarise the participant characteristics. Bivariate analyses were used to identify candidate variables ( Results: The prevalence of teenage pregnancy was 49.49%. In the full multilevel model, individual-level factors significantly In the full multilevel mixed-effects logistic regression model (Model 3), primary education was associated with higher odds of teenage pregnancy (aOR = 1.27, Conclusion: Teenage pregnancy in Somalia is very high (49.49%). It is influenced by education, wealth, contraceptive intentions, and regional differences. Primary education increases risk, while higher education and greater wealth reduce it. Regional disparities are significant, and only the lack of intention to use contraceptives shows a meaningful effect.