Trends and Factors Associated with Pregnancy Termination Among Sexually Active Female Youth in Tanzania (2004/05–2022): Evidence from Demographic and Health Surveys

Pregnancy termination is a significant public health challenge in Tanzania, contributing to reproductive, emotional, and psychosocial difficulties among sexually active female youth. This study analyzed a pooled weighted sample of 13,182 sexually active female youth using data from four Tanzania Demographic and Health Surveys conducted between 2004/05 and 2022. The overall prevalence of pregnancy termination was 9.0%, with rates remaining relatively stable over time: 9.5% in 2004/05, 9.3% in 2010, 8.2% in 2015/16, and 9.1% in 2022. Adjusted analysis revealed that female youth aged 20-24 and those residing in the Eastern region and Zanzibar had higher odds of pregnancy termination. Conversely, secondary or higher education, late sexual initiation, current abstinence, and contraceptive use were associated with decreased odds of pregnancy termination. These findings highlight persistent pregnancy termination rates influenced by age, education level, timing of sexual debut, and geographic location. To reduce this prevalence, comprehensive sexual education that encourages delayed sexual debut, expanded youth-friendly contraceptive services, enhanced educational support for pregnant young women, and policy reforms aimed at improving healthcare access are essential. Implementing these strategies may effectively address the complex determinants and improve reproductive health outcomes among Tanzanian female youth.