Beyond national fertility rates: unmasking territorial differences in adolescent pregnancy in Ecuador
Journal
Frontiers in Reproductive Health
Date Issued
2026-07-22
Author(s)
Izurieta-Guevara, Lorena
Abstract
Introduction
Teenage pregnancy is a significant public health challenge that may contribute to cycles of poverty in the context of social inequality. In Latin America and the Caribbean, Ecuador ranks third in terms of fertility rates. The objective of this study is to describe temporal trends and territorial patterns of adolescent fertility in Ecuador between 2015 and 2024, differentiating early adolescents (10–14 years) and late adolescents (15–19 years), and identifying priority territories for public health monitoring.
Method
A descriptive observational study was conducted using anonymized databases from the National Institute of Statistics and Census (INEC). Fertility rates were calculated for two groups: early adolescents (10–14 years) and late adolescents (15–19 years). Data were analyzed by province, area of residence, and social variables. Monotonic temporal trends were assessed using the non-parametric Mann–Kendall test.
Results
The national fertility rate declined steadily, from 40.75 per 1,000 (95% CI: 40.44–41.08) in 2015 to 20.53 in 2024 (95% CI: 20.30–20.75). Despite this overall progress, geographic heterogeneity in fertility rates was observed, with the highest rates and slowest declines concentrated in Amazonian and Coastal provinces. Fertility rates remained consistently elevated among adolescents in early unions, those with lower educational attainment, and within Indigenous and Mestizo populations. Mann–Kendall analyses identified priority provinces with non-significant downward trends, particularly among early adolescents.
Conclusion
The study identified declining adolescent fertility rates alongside persistent territorial disparities across Ecuador. Differences observed by province, age group, ethnicity, educational attainment, and early unions underscore the importance of complementing national indicators with disaggregated analyses. This perspective may contribute to a more nuanced understanding of adolescent fertility patterns and may guide territorial surveillance and public health planning.
Teenage pregnancy is a significant public health challenge that may contribute to cycles of poverty in the context of social inequality. In Latin America and the Caribbean, Ecuador ranks third in terms of fertility rates. The objective of this study is to describe temporal trends and territorial patterns of adolescent fertility in Ecuador between 2015 and 2024, differentiating early adolescents (10–14 years) and late adolescents (15–19 years), and identifying priority territories for public health monitoring.
Method
A descriptive observational study was conducted using anonymized databases from the National Institute of Statistics and Census (INEC). Fertility rates were calculated for two groups: early adolescents (10–14 years) and late adolescents (15–19 years). Data were analyzed by province, area of residence, and social variables. Monotonic temporal trends were assessed using the non-parametric Mann–Kendall test.
Results
The national fertility rate declined steadily, from 40.75 per 1,000 (95% CI: 40.44–41.08) in 2015 to 20.53 in 2024 (95% CI: 20.30–20.75). Despite this overall progress, geographic heterogeneity in fertility rates was observed, with the highest rates and slowest declines concentrated in Amazonian and Coastal provinces. Fertility rates remained consistently elevated among adolescents in early unions, those with lower educational attainment, and within Indigenous and Mestizo populations. Mann–Kendall analyses identified priority provinces with non-significant downward trends, particularly among early adolescents.
Conclusion
The study identified declining adolescent fertility rates alongside persistent territorial disparities across Ecuador. Differences observed by province, age group, ethnicity, educational attainment, and early unions underscore the importance of complementing national indicators with disaggregated analyses. This perspective may contribute to a more nuanced understanding of adolescent fertility patterns and may guide territorial surveillance and public health planning.