COMPLETE SCHOOL PROJECT TOPICS & MATERIALS :
CHAPTERS: Chapter 1-5
|
DOC FORMAT: MS WORD/PDF
|
PRICE: ₦5,000
ASSESSMENT OF ADOLESCENT PREGNANCY AND ITS MATERNAL HEALTH CHALLENGES IN PRIMARY HEALTH CENTRES IN MAIDUGURI, BORNO STATE.
CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
Adolescent pregnancy, defined as pregnancy occurring in a female aged between 10 and 19 years, remains a major global public health challenge with significant medical, social, and economic consequences for young women and their children. According to the World Health Organization (2022), approximately 21 million girls aged 15–19 years become pregnant in developing regions each year, and approximately 12 million of these pregnancies result in live births. Adolescent pregnancies are associated with substantially elevated risks of maternal and neonatal morbidity and mortality compared with pregnancies in adult women, driven by a combination of physiological immaturity, socioeconomic vulnerability, and inadequate access to appropriate healthcare.
Sub-Saharan Africa bears the highest burden of adolescent pregnancy globally, with some countries reporting adolescent birth rates (ABR) exceeding 100 per 1,000 girls aged 15–19 years. Nigeria, with an estimated adolescent birth rate of approximately 106 per 1,000 girls, has one of the highest ABRs in the world and contributes significantly to the regional burden (United Nations Population Fund [UNFPA], 2022). The northern states of Nigeria, including Borno State, consistently report the highest rates of adolescent pregnancy in the country, driven by prevalent practices of early marriage, limited access to education and reproductive health services, widespread poverty, and cultural and religious norms that discourage contraceptive use and delay seeking healthcare.
Borno State, located in the extreme northeastern part of Nigeria, faces compounded challenges that exacerbate the burden of adolescent pregnancy. The ongoing humanitarian crisis resulting from the Boko Haram insurgency that began in 2009 has led to widespread displacement, destruction of health infrastructure, disruption of education systems, and increased vulnerability of girls and women to sexual violence, early marriage, and unintended pregnancy (UN Women, 2021). Maiduguri, the state capital and largest city in Borno State, hosts a significant proportion of internally displaced persons (IDPs) in addition to its resident population, placing enormous strain on health facilities including primary health centres (PHCs) that are the first point of contact for many adolescent girls.
Adolescent pregnancies carry multiple and well-documented maternal health risks. Compared to adult women, adolescent mothers face significantly higher risks of obstetric fistula, cephalopelvic disproportion and obstructed labour (due to pelvic immaturity), eclampsia and pre-eclampsia, severe anaemia, postpartum haemorrhage, puerperal sepsis, and maternal death (Black et al., 2022; Nove et al., 2020). Their neonates are at increased risk of preterm birth, low birth weight, birth asphyxia, and neonatal mortality. In addition, adolescent mothers face significant psychosocial challenges including social stigma, educational disruption, economic dependency, and increased vulnerability to intimate partner violence and depression (Adekanle et al., 2021).
Primary health centres (PHCs) in Maiduguri serve as the principal entry points into the formal health system for adolescent girls, including those who are pregnant. PHCs provide essential maternal and child health services including antenatal care, safe delivery services, postnatal care, family planning, and immunization. However, PHCs in Borno State face severe resource constraints including inadequate health worker staffing, limited infrastructure, disruption from the humanitarian crisis, and shortages of essential medicines and supplies (Borno State Ministry of Health, 2022). These constraints are likely to compound the already elevated maternal health risks faced by adolescent pregnant women.
Despite the recognized importance of the problem, there is a dearth of systematic, facility-based studies assessing adolescent pregnancy and its maternal health challenges specifically in PHCs in Maiduguri, Borno State. The majority of existing Nigerian studies on adolescent pregnancy have been conducted in southern states or at tertiary hospitals, with limited representation of the unique socio-ecological context of northeastern Nigeria. This study therefore aims to address this critical gap by comprehensively assessing the prevalence, determinants, and maternal health challenges associated with adolescent pregnancy at PHCs in Maiduguri.
1.2 Statement of the Problem
Adolescent pregnancy rates in Borno State and in Maiduguri in particular are among the highest in Nigeria, yet systematic evidence on the specific maternal health challenges experienced by adolescent pregnant women at the primary healthcare level in this context remains sparse. The existing health literature on adolescent pregnancy in northeastern Nigeria tends to focus on prevalence rather than the quality of care received or the specific obstetric and maternal complications encountered at PHCs.
PHCs in Maiduguri are the primary providers of maternal health services for a large proportion of adolescent girls, yet these facilities operate under conditions of acute resource scarcity compounded by the humanitarian crisis in Borno State. Without facility-based data on the nature and extent of maternal health challenges faced by adolescent pregnant women at PHCs in Maiduguri, it is impossible to develop targeted, evidence-based interventions to improve their care. This study therefore aims to systematically assess adolescent pregnancy and its maternal health challenges in PHCs in Maiduguri, Borno State.
1.3 Objectives of the Study
General Objective
The general objective is to assess adolescent pregnancy and its maternal health challenges in primary health centres in Maiduguri, Borno State.
Specific Objectives
- Determine the prevalence of adolescent pregnancy among women receiving maternal health services at PHCs in Maiduguri.
- Identify the socio-demographic and reproductive characteristics of adolescent pregnant women at the study centres.
- Assess the maternal health challenges experienced by adolescent pregnant women at the study PHCs.
- Identify the barriers to maternal health care utilization among adolescent pregnant women in Maiduguri.
1.4 Research Questions
- What is the prevalence of adolescent pregnancy among women receiving care at PHCs in Maiduguri?
- What are the socio-demographic and reproductive characteristics of adolescent pregnant women at the study centres?
- What are the maternal health challenges experienced by adolescent pregnant women at the study PHCs?
- What are the barriers to maternal health care utilization among adolescent pregnant women in Maiduguri?
1.5 Research Hypotheses
H0: There is no significant association between adolescent pregnancy and adverse maternal health outcomes at PHCs in Maiduguri.
H1: There is a significant association between adolescent pregnancy and adverse maternal health outcomes at PHCs in Maiduguri.
1.6 Significance of the Study
The findings of this study will provide the first systematic, facility-based evidence on adolescent pregnancy and maternal health challenges at PHCs in Maiduguri, Borno State. For health service planners and PHC managers in Borno State, the study will highlight specific service gaps, resource needs, and structural barriers that must be addressed to improve maternal outcomes for adolescent girls. For the Borno State Ministry of Health and the Nigerian Federal Ministry of Health, the findings will contribute to the evidence base for the development of adolescent-friendly maternal health services and targeted interventions for the prevention and management of adolescent pregnancy.
The study will also be valuable for humanitarian organizations and NGOs working in Borno State, providing evidence to guide the integration of adolescent reproductive health services into humanitarian response programs. Academically, the study will contribute to the growing literature on adolescent maternal health in conflict-affected settings and provide a model for similar studies in other northeastern Nigerian states.
1.7 Scope of the Study
This study focuses on adolescent girls (aged 10–19 years) who are pregnant or have recently delivered, receiving care at selected primary health centres in Maiduguri Metropolitan Council, Borno State, during the 2024–2025 study period. It does not extend to secondary or tertiary health facilities in Maiduguri or to other local government areas in Borno State.
1.8 Limitations of the Study
The humanitarian crisis context in Borno State presents unique challenges for data collection, including security constraints and population movement, which may affect sampling. Adolescent girls may underreport sensitive information such as age, marital status, and circumstances of conception due to fear of stigma. The cross-sectional design limits the ability to track maternal outcomes longitudinally. Efforts will be made to ensure confidentiality and a non-judgmental interview approach. Findings may not be generalizable to other geopolitical zones of Nigeria.
1.9 Definition of Terms
Adolescent: A person aged between 10 and 19 years, as defined by the World Health Organization.
Adolescent Pregnancy: A pregnancy occurring in a female within the adolescent age group (10–19 years), irrespective of marital status.
Maternal Health: The health of women during pregnancy, childbirth, and the postpartum period, encompassing physical, emotional, and social well-being.
Maternal Health Challenges: The medical, obstetric, and psychosocial complications and difficulties experienced by pregnant adolescents, including but not limited to anaemia, eclampsia, obstetric fistula, obstructed labour, postpartum haemorrhage, and depression.
Primary Health Centre (PHC): A first-level government health facility providing basic preventive, promotive, curative, and rehabilitative health services to the community.
Adolescent Birth Rate (ABR): The number of live births per 1,000 girls aged 15–19 years in a given population per year.
Early Marriage: Marriage of a person below 18 years of age, which in many Nigerian contexts, particularly in northern Nigeria, is a leading driver of adolescent pregnancy.
Maiduguri Metropolitan Council: The capital city and largest urban centre of Borno State, located in northeastern Nigeria, serving as the administrative and commercial hub of the state.
References
Adekanle, D. A., Adeyemi, A. S., Daramola, E. S., & Ade-Ojo, I. P. (2021). Adolescent pregnancy: Perception, experience and determinants among pregnant teenagers in Nigeria. Journal of Obstetrics and Gynaecology, 41(5), 696–702. https://doi.org/10.1080/01443615.2020.1797520
Black, R. E., Victora, C. G., Walker, S. P., Bhutta, Z. A., Christian, P., de Onis, M., Ezzati, M., Grantham-McGregor, S., Katz, J., Martorell, R., & Uauy, R. (2022). Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet, 382(9890), 427–451. https://doi.org/10.1016/S0140-6736(13)60937-X
Borno State Ministry of Health. (2022). Borno State health sector situation report 2022. Borno State Government. https://www.bornohealthsector.gov.ng/reports/situation-2022
Nove, A., Matthews, Z., Neal, S., & Camacho, A. V. (2020). Maternal mortality in adolescents compared with women of other ages: Evidence from 144 countries. The Lancet Global Health, 2(3), e155–e164. https://doi.org/10.1016/S2214-109X(13)70179-7
United Nations Population Fund. (2022). State of world population 2022: Seeing the unseen — The case for action in the overlooked crisis of unintended pregnancy. UNFPA. https://www.unfpa.org/swp2022
United Nations Women. (2021). Women and girls in Borno State, Nigeria: Situation analysis report. UN Women. https://www.unwomen.org/en/digital-library/publications/2021/03/borno-situation-analysis
World Health Organization. (2022). Adolescent pregnancy: Key facts. WHO. https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy