Department of Global Health & Population, Harvard School of Public Health, Boston, Massachusetts, United States of America.
Department of Demography and Social Statistics, Obafemi Awolowo University, Ile Ife, Nigeria.
PLoS One. 2021 Nov 29;16(11):e0260588. doi: 10.1371/journal.pone.0260588. eCollection 2021.
Adolescent pregnancy contributes significantly to the high maternal mortality in Nigeria. Research evidence from developing countries consistently underscores Antenatal Care (ANC) among childbearing adolescents as important to reducing high maternal mortality. However, more than half of pregnant adolescents in Nigeria do not attend ANC. A major gap in literature is on the influence of family context in pregnant adolescent patronage of ANC services.
The study utilized a cross-sectional survey with data collected among adolescent mothers in urban slums in three Nigerian states namely, Kaduna, Lagos, and Oyo. The survey used a multi-stage sampling design. The survey covered a sample of 1,015, 1,009 and 1,088 childbearing adolescents from each of Kaduna, Lagos, and Oyo states respectively. Data were analyzed at the three levels: univariate, bivariate and multivariate.
Overall, about 70 percent of female adolescents in our sample compared with 75 percent in the Demographic and Health Survey (DHS) had any antenatal care (ANC) visit. About 62 percent in our sample compared with 70 percent in the DHS had at least 4 ANC visits, and, about 55 percent in our sample compared with 41 percent of the DHS that had 4 ANC visits in a health facility with skilled attendant (4ANC+). Those who have both parents alive and the mother with post-primary education have higher odds of attending 4ANC+ visits. The odds of attending 4ANC+ for those who have lost both parents is almost 60% less than those whose parents are alive, and, about 40% less than those whose mothers are alive. The influence of mother's education on 4ANC+ attendance is more significant with large disparity when both parents are dead.
The study concludes that identifying the role of parents and community in expanding access to ANC services among adolescent mothers is important in improving maternal health in developing countries.
少女怀孕是导致尼日利亚高产妇死亡率的主要原因之一。来自发展中国家的研究证据一致强调，为减少高产妇死亡率，为生育青少年提供产前护理 (ANC) 非常重要。然而，尼日利亚超过一半的怀孕青少年没有接受 ANC。文献中的一个主要空白是家庭背景对怀孕青少年接受 ANC 服务的影响。
本研究采用横断面调查，数据来自尼日利亚三个州的城市贫民窟中的青少年母亲，这三个州分别是卡杜纳州、拉各斯州和奥约州。该调查采用多阶段抽样设计。调查涵盖了每个州的 1015、1009 和 1088 名生育青少年的样本。数据在三个层面进行分析：单变量、双变量和多变量。
总体而言，我们样本中的大约 70%的少女与人口与健康调查 (DHS) 中的 75%相比，有过任何产前护理 (ANC) 就诊。我们样本中大约 62%的人比 DHS 中的 70%至少有 4 次 ANC 就诊，而我们样本中大约 55%的人比 DHS 中在有熟练助产士的卫生机构中进行了 4 次 ANC 就诊的 41%（4ANC+）。那些父母双全且母亲受过中学后教育的人更有可能接受 4ANC+就诊。那些失去双亲的人接受 4ANC+就诊的几率比父母健在的人低近 60%，比母亲健在的人低约 40%。母亲教育对 4ANC+就诊的影响更为显著，而当父母双方都去世时，差距更大。
该研究得出结论，确定父母和社区在扩大青少年母亲获得 ANC 服务方面的作用，对于改善发展中国家的产妇健康非常重要。
