Determinants of Reproductive Health Behavior among Adolescents and Women of Childbearing Age:

Abstract

Background: Unhealthy reproductive health behavior remains a serious problem in many developing countries, including Indonesia. Various studies have identified determinant factors, but few literature reviews have comprehensively mapped these factors within a multi-level framework. Method: This study is a literature review using a thematic narrative approach. Literature searches were conducted in PubMed, Scopus, Web of Science, CINAHL, and Google Scholar from January 2022 to March 2026. Inclusion criteria included original studies and review articles reporting determinants of reproductive health behavior among adolescents (10-19 years) and women of childbearing age (15-49 years). Twenty studies were analyzed narratively based on an expanded socio-ecological model. Results: Determinants of reproductive health behavior were grouped into five levels: (1) individual (knowledge, attitudes, self-efficacy, mental health), (2) interpersonal (parental support: OR/PR=2.64-4.86; peer influence: AOR=3.80), (3) environmental (service access: AOR=2.11-2.76; social norms), (4) digital (parental guidance in digital use: AOR=3.65), and (5) macro (impact of COVID-19 pandemic, contraceptive policies). Implications: These findings emphasize the need for integrated interventions involving individuals, families, schools, and digital platforms. Health workers should involve parents in counseling, provide adolescent-friendly services, and improve digital literacy among adolescents and parents. Novelty: This literature review presents a recent synthesis of determinants of reproductive health behavior among adolescents and WCA using a socio-ecological framework that includes digital and macro levels, which has rarely been discussed in an integrated manner in previous studies.