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Introduction 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. Methods 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. Results 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. Conclusion 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.
Data were collected among childbearing adolescent females in urban slums in three Nigerian states namely Kaduna in the northwest region, and Lagos and Oyo in the southwest. For this study, we have adopted UN-HABITAT’s definition of a slum as an urban area characterized with lack of durable facilities, poor access to adequate sanitation and poor living conditions. The study documented the slum areas in the study states with high population of adolescent using population counts from the Nigeria’s Geo-Referenced Infrastructure and Demographic Data for Development (GRID3) programme. The survey used a multi-stage sampling design. At the first stage, the 3 states identified in extant literature as accommodating most urban slums in Nigeria- Kaduna, Lagos and Oyo states were selected for the northern and southern region. All the local government areas (LGAs) where the slums areas were located were selected as the second stage. The GRID3 population estimates shows the slum areas with high population of adolescents and young people and those areas were selected as the study clusters in the urban centers. Households with female adolescents were randomly selected using a referral system until the cluster sample size is attained. A female adolescent was randomly selected in households with more than one eligible female respondent to ensure community representativeness. As such, individuals were nested within clusters and clusters within LGAs. The data covered a sample of 1,015, 1,009 and 1,088 childbearing adolescents with at least a child less than 5 years from Kaduna, Lagos, and Oyo states respectively. The data collection was implemented between July and October 2018. The inclusion criteria included being a teenager and having begun childbearing; and having had a child during adolescence with the reference child below 5 years. The upper age limit for those who had a child during adolescence was therefore extended to 24 years to accommodate those who had a child at age 19 years with the current age of the child around 5 years. All women who had their first birth after age 19 years were excluded from the sample. The National Health Research Ethics Committee of Nigeria (NHREC) approved this study and the protocol on May 25, 2018, with IRB number NHREC/01/01/2007. A letter of approval for the publication was granted by Harvard T.H. Chan School of Public Health, IRB18-1385 August 27, 2018. All participants signed written consent form during data collection. In addition, guardians of minors, most especially, the unmarried ones signed assent form.
