Issues in Antenatal Care Services Utilization Among Unmarried Adolescents in Akwa Ibom State, Nigeria

Abstract

This study describes the sociocultural factors that influence the utilization of antenatal care services among unmarried adolescents aged 16 and below in Akwa Ibom State, Nigeria. A cross-sectional survey design was utilized. A self-designed questionnaire was randomly administered to 621 ever-pregnant unmarried adolescents. Thirty-five in-depth interviews were purposively conducted among unmarried adolescents, skilled and unskilled healthcare providers, and caregivers. Twelve focus group discussions and four life histories were also conducted among unmarried adolescents. Quantitative data were analyzed using descriptive and multivariate logistic regression at p ≤ .05; qualitative data were content analyzed. Poor health provider-patient relations, financial constraints, distant health facilities, and fear of the exchange of babies by health workers influenced antenatal care practices among unmarried adolescents. More than half of the respondents (68.3%) received pregnancy care from faith-based and traditional birth attendants. Antenatal care utilization from orthodox (certified medical) healthcare providers was associated with secondary school education (OR = 7.35, 95% CI [5.83-8.94]), wealthiest households (OR = 6.74, 95% CI [4.34-8.35]) and age at last pregnancy 14–16 (OR = 0.17, 95% CI [0.12-0.27]). There is a need for functional and accessible orthodox healthcare facilities and an increased awareness about antenatal care services among adolescents to reduce delays in antenatal visits and maternal-related health risks through effective policies that could lead to attitudinal change among the populace.