title: Multilevel Analysis of Childbearing in Childhood in Tanzania's Rufiji District.
abstract: OBJECTIVE
  To examine levels, trends and correlates of childbearing in childhood (CiC) in the Rufiji district of Tanzania from 2002 to 2010.
  
  
  METHODS
  Using longitudinal data collected in, and by, the Rufiji health and demographic surveillance system in Tanzania from 2002 to 2010, all women who initiated childbearing in this period (n = 5491) were selected for analysis. CiC was defined as childbearing initiation before age 18. Data analysis involved one-way tabulations of each variable-most of which were socio-demographic-to obtain frequency distributions, cross-tabulations of CiC and each of the independent variables with a Chi square test for associations, and multivariate analysis using multilevel logistic regression to examine covariates of CiC.
  
  
  RESULTS
  CiC was 44 % and remained constant over the 2002-2010 period (P = 0.623). The relative odds of CiC was significantly reduced by 83 percent among women with secondary or higher educational attainment relative to CiC among uneducated women (OR = 0.17, CI 0.12-0.23). Moreover, the odds of CiC significantly declines monotonically as relative household wealth increases by quintile (OR = 0.70, CI 0.57-0.86). CiC also declines significantly with employment and marital status of the respondent.
  
  
  CONCLUSIONS
  CiC represents a challenging social and health problem. Forty-four percent of first time mothers in Rufiji district of Tanzania are of childhood age, and this has not changed over the past 9 years since 2002. Prioritizing girls' formal education-especially up to secondary level or higher-as well as devising some economic empowerment modalities, may be worthwhile measures towards curbing CiC in the study area.
authors.affiliation: Ifakara Health Institute, P.O. Box 78373, Dar es Salaam, Tanzania. aexavery@ihi.or.tz.
authors.forename: Amon
authors.initials: A
authors.lastname: Exavery
authors.affiliation: Ifakara Health Institute, P.O. Box 78373, Dar es Salaam, Tanzania. amk2213@columbia.edu.|Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, USA. amk2213@columbia.edu.|Swiss Tropical and Public Health Institute, University of Basel, Socinstrasse 57, 4002, Basel, Switzerland. amk2213@columbia.edu.
authors.forename: Almamy Malick
authors.initials: AM
authors.lastname: Kanté
authors.affiliation: Ifakara Health Institute, P.O. Box 78373, Dar es Salaam, Tanzania. smrema@ihi.or.tz.
authors.forename: Sigilbert
authors.initials: S
authors.lastname: Mrema
authors.affiliation: Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, USA. jfp2113@columbia.edu.
authors.forename: James F
authors.initials: JF
authors.lastname: Phillips
authors.affiliation: Ifakara Health Institute, P.O. Box 78373, Dar es Salaam, Tanzania. hmasanja@ihi.or.tz.
authors.forename: Honorati
authors.initials: H
authors.lastname: Masanja
mesh_terms: D000293:Adolescent; D005191:Family Characteristics; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D017533:Marital Status; D055361:Multilevel Analysis; D015999:Multivariate Analysis; D036801:Parturition; D011159:Population Surveillance; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000208:ethnology* / Q000523:psychology / Q000706:statistics & numerical data; D043762:Reproductive Behavior; D012111:Residence Characteristics; D011795:Surveys and Questionnaires; D013636:Tanzania / Q000453:epidemiology
keywords: Adolescent fertility trends; Childhood childbearing; Childhood fertility; Correlates; Rufiji; Tanzania