Adolescent Fertility and Sexual Health in Nigeria
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World Bank, Washington, DC
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This study examines the determinants of
adolescent sexual behavior and fertility in Nigeria, with a
special focus on knowledge, attitudes and behaviors of
adolescents aged 10-19 years old in Karu Local Government
Authority (LGA), a peri-urban area near the capital city of
Abuja. Using the last three waves of Demographic and Health
Surveys (2003, 2008, 2013), focus group discussions,
stakeholder interviews, and a specialized survey of 643
girls and boys aged 10-19 years old in Karu LGA, the study
narrows in on key challenges to and opportunities for
improving adolescent sexual and reproductive health
outcomes. The national median age at sexual debut for
adolescent girls and boys is between 15 and 16 years of age.
This is closely emulated in Karu LGA with a median age of
14.8 years for girls and 15.3 years for boys. While data on
pregnancies was limited in the Karu sample, DHS data show
that for girls, sexual debut is closely associated with
marriage or cohabitation, which in turn is a strong
predictor of adolescent fertility. Poverty is another strong
predictor, with the odds of becoming pregnant being twice as
high for adolescents in the lower wealth quintiles compared
to their counterparts in the richest quintile in the
country. While adolescents’ knowledge of contraception has
increased from under 10 percent to over 30 percent, use of
health services among adolescents for SRH (and
contraception) is limited due to factors such as fear of
stigma, embarrassment, and poor access to services,
something also emphasized in focus group discussions.
Challenges for improving adolescent SRH outcomes relate to:
(i) the paucity of data, especially on the 10-14 year olds;
(ii) availability and access to youth-friendly services and
the Family Life and HIV Education (FLHE); (iii) reaching
out-of-school adolescents with SRH information; and (iv)
addressing ambiguities and gaps in Federal law and customs
on age at marriage, and generating support for the legal age
at marriage of at least 18 years old. Addressing these
barriers at the State and sub-regional levels is going to be
critical in improving adolescent well-being.
Palabras clave
USE OF CONTRACEPTION, SEX EDUCATION, RELIGIOUS DIFFERENCES, CHILD HEALTH, RISKS, SOCIAL NORMS, REPRODUCTIVE HEALTH, CONTRACEPTION, PEER EDUCATION, PEOPLE, VACCINATION, MIDWIFERY, SCHOOL ENROLMENT, ANTENATAL CARE, FAMILY SUPPORT, PREVENTION, SEXUAL BEHAVIOUR, YOUTH-FRIENDLY SERVICES, MORBIDITY, SEXUALLY TRANSMITTED DISEASES, HEALTH EDUCATION, SEXUAL HEALTH, COMMUNITY HEALTH, SOCIAL WORK, ETHNIC GROUPS, REPRODUCTIVE HEALTH POLICY, HEALTH CARE, INFERTILITY, SCHOOL HEALTH, SEXUALLY TRANSMITTED INFECTIONS, LEGAL STATUS, FOCUS GROUP DISCUSSIONS, PUBERTY, HEALTH, CAPACITY BUILDING, HOLISTIC APPROACH, EMERGENCY CONTRACEPTION, NUMBER OF PEOPLE, INFORMATION SYSTEMS, SOCIAL STUDIES, PUBLIC HEALTH, LIFE EXPECTANCY, KNOWLEDGE, PREGNANCIES, PATIENT, SMOKING, INTERVENTION, POPULATION GROWTH, SECONDARY SCHOOLS, HEALTH INDICATORS, FAMILY HEALTH, SEXUALITY, RAPE, SECONDARY SCHOOL, NURSES, STIS, VIOLENCE, GENDER NORMS, CHILD ABUSE, DISSEMINATION, SERVICE PROVIDER, SERVICE PROVISION, MARRIAGE, SEXUAL INTERCOURSE, BASIC HUMAN RIGHTS, GYNECOLOGY, ADOLESCENT FERTILITY, SERVICE DELIVERY, QUALITY IMPROVEMENT, SOCIAL DEVELOPMENT, INTERVIEW, SECONDARY SCHOOL ENROLMENT, AGE AT MARRIAGE, MORTALITY, SEXUAL PRACTICES, HEALTH CARE SYSTEM, RISK GROUPS, RISKY SEXUAL BEHAVIOR, UNIONS, UNEMPLOYMENT, HUMAN CAPITAL, TEENAGE PREGNANCY, SEXUAL ABUSE, MIGRANT, OLDER PEOPLE, YOUNG ADULTS, WORKERS, IUDS, POLICIES, AGED, POPULATION STUDIES, ADOLESCENT GIRLS, HIV, HEALTH POLICY, MINISTRY OF EDUCATION, HEALTH OUTCOMES, UNIVERSAL ACCESS, SEXUAL ACTIVITY, FAMILY FORMATION, URBAN AREAS, FAMILY PLANNING, UNWANTED PREGNANCY, DECISION MAKING, POPULATION COUNCIL, NUTRITION, WORKSHOPS, ADOLESCENTS, QUALITY CONTROL, POLICY, QUALITY OF LIFE, PRIMARY HEALTH CARE, HEALTH POLICIES, CONTRACEPTIVE USE, INTERNET, RISK FACTORS, SEXUAL BEHAVIOR, GOVERNMENT POLICIES, LEGAL AGE AT MARRIAGE, WEIGHT, COMMUNICABLE DISEASES, HUMAN RIGHTS, PREGNANT WOMEN, ECONOMIC OPPORTUNITIES, POPULOUS COUNTRY, SEXUAL HARASSMENT, CHILDREN, CLINICS, WORKING CONDITIONS, LACK OF KNOWLEDGE, YOUTH- FRIENDLY SERVICES, YOUNG WOMEN, SINGLE PARENTS, POLICY IMPLICATIONS, YOUNG PEOPLE, NATIONAL POLICY, POPULATION, INEQUITABLE GENDER NORMS, UNFPA, STRATEGY, FERTILITY, SIBLINGS, FAMILIES, CHILD HEALTH SERVICES, WOMEN, SEXUAL VIOLENCE, ADOLESCENT HEALTH, HOSPITALS, SOCIAL ISSUES, HEALTH INTERVENTIONS, AIDS, EARLY MARRIAGE, BIRTH ATTENDANT, HEALTH SERVICES, IMPLEMENTATION, ALCOHOL CONSUMPTION, ABORTION, PREGNANCY, CONDOMS, POLITICAL INSTABILITY, PARENTAL CONSENT, SERVICE PROVIDERS, ALCOHOLISM