Prevalence and factors associated with adolescent pregnancy in Hoima district, Uganda: A community-based cross-sectional study

Adolescent pregnancy is a global public health problem with serious social and medical implications relating to maternal and child health. In Uganda, particularly Hoima district, limited information about the factors influencing adolescent pregnancy is available. The study estimated the prevalence of adolescent pregnancy and identified factors independently associated with adolescent pregnancy among girls aged 13–19 years in Hoima district. We conducted a community-based cross-sectional study among 543 adolescent girls randomly selected using multistage sampling. Data were collected using a structured, interviewer-administered questionnaire. Bivariate logistic regression was used to assess associations between independent variables and adolescent pregnancy. Variables with p < 0.20 at bivariate analysis were included in a multivariable logistic regression model to identify factors independently associated with adolescent pregnancy. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported, and statistical significance was set at p < 0.05. Findings revealed 29.1% prevalence of adolescent pregnancy. Age (18–19 years) AOR 4.4 (95%CI 1.5–12.8), low parents’ economic status AOR 5.4 (95%CI 2.5–11.8), multiple sexual partners AOR 8.0 (95%CI 4.5–14.2), being out of school AOR 12.0 (95%CI 5.0–29.1), early marriage AOR 37.0 (95%CI 13.4–107.5), having no control over sex AOR 7.4 (95%CI 3.7-16.4), not discussing SRH with parents AOR 8.4 (95%CI 3.3–21.5), witnessed domestic violence AOR 30.0 (95%CI 12.0–77.5), never received counselling AOR 5.7 (95%CI 3.6–9.0), and, rural residence AOR 1.8 (95%CI 1.2–2.9) were significant predictors of adolescent pregnancy. These findings suggest that adolescent pregnancy in Hoima district remains high and is associated with interconnected individual, family, health system, and community-level factors. Interventions should prioritize keeping girls in school, strengthening adolescent-friendly and non-judgmental health services, addressing household poverty, preventing early marriage, and promoting supportive family and community environments to reduce adolescent pregnancy in rural Ugandan settings.