Abstract
Intervention by community health workers (CHWs) is believed to prevent repeated childbearing
among teenagers. This review investigated the effectiveness of CHWs in reducing repeated
pregnancies and births among adolescents aged <20 years, 2 years after the delivery
of their first child. Through electronic database and hand searching, experimental
and/or observational studies were screened with their results undergoing systematic
review and meta-analyses. Subgroup analyses were performed to further assess how study
characteristics affected the pooled estimates and heterogeneity. A total of 11 eligible
articles, from January 1980 to May 2015, were included. Seven studies evaluated repeated
births and eight measured repeated pregnancies. Studies showed relevant disparities
in terms of selected methodological aspects and program characteristics. Although
most studies (n = 9) were either of “strong” or of “moderate” quality, only two of
five finding a significant reduction exhibited a high level of quality as the other
three failed to adjust results for confounders. Random effects modeling revealed an
overall 30% decrease in repeated adolescent births (odds ratio = .70, confidence interval =
.49–.99) among CHW-visited areas relative to nonvisited sites. On the other hand,
no significant association was detected in terms of repeated pregnancies (odds ratio =
.96, confidence interval = .70–1.28).
Keywords
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Article info
Publication history
Published online: July 27, 2016
Accepted:
May 13,
2016
Received:
October 8,
2015
Footnotes
Conflicts of Interest: The authors have no conflict of interest and no financial relationships relevant to this article to disclose.
Systematic review registration: PROSPERO CRD42015020854.
Identification
Copyright
© 2016 Society for Adolescent Health and Medicine. All rights reserved.
