Determinants of maternal health service utilisation among pregnant teenagers in Delta State, Nigeria

Abstract

Introduction: the prevailing high maternal mortality and morbidity rate among pregnant adolescents in Nigeria underscores all efforts said to have been made to tackle maternal deaths among this population. Not much research has been done to ascertain the reasons associated with the poor utilisation of Maternal Health Services (MHS) by pregnant teenagers. This study, therefore, explored the extent and determinants of MHS utilisation among pregnant teenagers in Delta State.

Methods: this study made use of a mixed cross-sectional study design. Multi-stage sampling technique was adopted in selecting eight communities while snowballing was used in identifying pregnant teenagers. A structured interviewer-administered questionnaire was used for the data collection from 212 pregnant teenagers and an interview guide was further used to interview 16 pregnant teenagers randomly selected from the communities. Descriptive and inferential data analyses were done using SPSS version 22. Hypotheses were tested using Chi-square test at P≤0.05 level of significance.

Results: seventy per cent of the participants stated that they utilised MHS by visiting an antenatal care centre (ANC) centre at least once during their pregnancy but only 28.3% had ANC attendance that was appropriate with their gestational age. A grand mean ± SD of 3.4714 showed that there is a high level of perception of stigmatisation among pregnant teenagers. Also, married teenagers [86%] were found to utilise MHS more than their single counterparts [67.1%]. A statistically significant association (Chi-square) was found between utilisation of MHS and maternal education [P=0.024], utilisation of MHS and availability/accessibility of MHS facilities [P=0.002], utilisation of MHS and cost of MHS [P=0.001] and utilisation of MHS and coercion/violence from partner [P=0.000].

Conclusion: the level of utilisation of MHS by pregnant teenagers is low with main determinants of use being stigmatisation of pregnant teenagers, availability of health personnel, accessibility to MHS facilities, permission from significant others and cost of MHS.