Factors Associated with Utilization of Sexual and Reproductive Health Services among Married Adolescent Girls in Kano, Northern Nigeria

Abstract

Background and Objective Married adolescents face significant obstacles in making informed reproductive health decisions and accessing sexual and reproductive health (SRH) services. It is important to identify barriers hindering these adolescents from accessing SRH services. The aim of this study was to identify factors associated with the utilization of SRH services among married adolescent girls in northern Nigeria. Methods We used a cross-sectional study design. The study population comprised of married female adolescents aged 14–19 years who were residents in the study areas for at least six months. The outcome measure was SRH service utilization, defined as the use of any of the conventional SRH services (ante/postnatal care, human immunodeficiency virus (HIV) testing and counseling, sexually transmitted infections (STI) treatment, family planning, and post-abortion care). Predictor variables included the sociodemographic, obstetric, and gynecological characteristics of the respondents. An adapted, pretested, interviewer-administered, and semi-structured questionnaire was employed for data collection. Multivariable logistic regression was used to explore the independent association between selected variables and utilization of SRH services. Results A total of 200 respondents were surveyed (100 each from an urban and a rural community in Kano, Nigeria), survey response rate: 94.5%. The age of respondents ranged from 14 to 19 years, with mean age (± standard deviation) of 18.5 (±1.1) years and 17.5 (±1.3) years for urban and rural respondents, respectively. All respondents were aware of the available SRH facilities and preferred public facilities (92.6% urban respondents and 67.0% rural respondents). Ever-use of SRH services was higher among urban than rural respondents (86% vs. 56%, respectively). Geographic proximity was a key factor for urban respondents (64.2%), while affordability was considered important by rural respondents (47.9%). Respondent’s age and partner’s occupation were independently associated with utilization of SRH services. Urban respondents whose husbands were businessmen were seven times more likely to use SRH services than those whose partners were civil servants (adjusted odds ratio [aOR] = 6.80, 95% confidence interval [CI]: 1.29–35.84, P = 0.02). Rural respondents 18 years of age and older were approximately six times more likely to utilize SRH services than those <18 years (aOR = 5.71, 95% CI: 1.56–12.78, P = 0.01). Conclusion and Global Health Implications Awareness of available SRH services was high in the study population, and service utilization was influenced by the respondent’s age and partner’s occupation. Findings from this study can help inform the development of age-appropriate and accessible SRH services tailored to married adolescents in similar settings.

Exploring factors influencing sexual and reproductive health knowledge among in-school adolescents in Nigeria

“…Consistent with past research, grade level emerges as a significant predictor, with senior secondary students demonstrating higher odds of SRH knowledge compared to junior secondary students (OR = 2.482, p < 0.001) (Agu et al, 2024;Fubam et al, 2022). Additionally, urban residence is associated with higher odds of SRH knowledge (OR = 1.172, p < 0.001), corroborating previous findings that urban adolescents tend to have better access to SRH information and services compared to their rural counterparts (Ismail et al, 2024). Furthermore, the pivotal role of information sources, such as healthcare providers and teachers/school staff, in shaping adolescents' SRH knowledge echoes findings from prior studies emphasizing the importance of school-based and healthcarebased SRH interventions (Brunelli et al, 2022;Embleton et al, 2023).…”