Abstract

Adolescent fertility remains a public health concern in Indonesia, with substantial variations across provinces. However, the evidence explaining provincial disparities using population-level indicators remains limited. This study aimed to examine provincial disparities in adolescent fertility and assess the association of child marriage, median age at first marriage among women, and the Family Development Index called iBangga with adolescent fertility across Indonesia. This ecological, cross-sectional study used aggregated data from 34 Indonesian provinces. Descriptive statistics, spatial visualization, Pearson’s correlation, and multiple linear regression analyses were performed. The mean adolescent fertility rate was 25.0 births per 1,000 female adolescents aged 15–19 years, ranging from 7.8 to 47.0 across provinces, demonstrating substantial geographical disparities. Higher adolescent fertility was predominantly concentrated in eastern Indonesia, whereas lower rates were observed in Java and several western provinces. Child marriage showed a positive correlation with adolescent fertility and remained associated after adjustment for provincial-level indicators. Although the median age at first marriage among women and the Family Development Index were associated with adolescent fertility in the bivariate analysis, these associations were not retained in the adjusted model. Overall, child marriage was the primary province-level factor associated with provincial disparities in adolescent fertility.

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