TEENAGE PREGNANCY AND ITS SOCIOECONOMIC DETERMINANTS: EVIDENCE FROM FEDERAL MEDICAL CENTRE YENAGOA

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Teenage pregnancy (defined as pregnancy in a woman aged 10-19 years) is a significant public health and socio-economic problem with severe impact on the health, education and economic opportunities of adolescent girls and their children. It is estimated that every year, an estimated 21 million girls aged 15-19 years in developing countries get pregnant, and around 12 million of those give birth (WHO 2022). Sub-Saharan Africa is home to the world's highest rates of adolescent pregnancy. Teenage pregnancy is linked to a much higher chance of obstetric problems such as obstructed labour, obstetric fistula, maternal death, and obstetric complications in the infant such as low birth weight, preterm birth, and neonatal death.

Nigeria is one of the world nations with the most incidence of teenage pregnancy. NDHS 2018 revealed that about 17% of girls aged between 15 and 19 have already had children, and there was a slight improvement in some indicators after decades of intervention, according to NDHS 2023-2024 data (NDHS, 2024). There is no uniform distribution of adolescent pregnancy in Nigeria, it is significantly linked to a complex set of social, economic factors such as poverty, low educational levels, early marriage, insufficient access to sexual and reproductive health information and services, exposure to gender-based violence, regional variations in socio-economic indicators (Okara et al., 2024). Bayelsa State is located in the South-South geopolitical area, where there are high incidences of teenage pregnancies, partly due to economic marginalisation, environmental degradation caused by crude oil extraction in the area, and poor educational provision by the government.

Federal Medical Centre Yenagoa is the main tertiary health institution of the state with significant referral responsibilities for obstetric and gynecological cases from other hospitals in the state and neighbouring states particularly teenage pregnancies. Lots of teenage pregnant women are accommodated in the obstetric wards of the facility and the antenatal clinics give the facility a good empirical background for the study of the socioeconomic determinants of adolescent pregnancy in the Niger Delta region. Other studies have pointed to poverty, early marriage, and lack of education as factors contributing to teenage pregnancy in the Niger Delta, but further recent facility-specific studies are only available in FMC Yenagoa.

Okoli et al (2022) conducted a systematic analysis of the socioeconomic inequalities of teenage pregnancy using pooled NDHS data and found that marital status, wealth index, exposure to media and information and communication technology (ICT) and religion are the most important socioeconomic predictors of teenage pregnancy concentration in Nigeria. The findings are also nationally representative, but may not fully reflect the particular socioeconomic context at the state and facility level in the Niger Delta region, especially since there are unique political economy traits in this region that interact with reproductive health behaviour, including those of the parental generation, and that could not be fully captured. This study is useful for adding to the existing body of evidence on the socioeconomic determinants of teenage pregnancy that is qualitative and context based in the context of FMC Yenagoa.

1.2 Statement of the Problem

The prevalence of adolescent pregnancy in Bayelsa state and the Niger Delta is far from being insignificant despite the many policies and programmes at the national and State levels aimed at addressing adolescent sexual and reproductive health and rights. Teenage pregnancy is still common in FMC Yenagoa and several socioeconomic factors are responsible for this situation, which include low family income, dropping out of school early, high levels of early marriage, lack of access to contraceptive services and overall cultural attitudes towards early marriage and pregnancy in some of these communities. But, there is little documented in the published literature to support the case with empirical evidence that will document the specific socioeconomic profile of adolescent pregnant women attending FMC Yenagoa and the most critical factors in this context.

This lack of facility-based evidence represents a huge gap in the information available to FMC Yenagoa, the Bayelsa State Ministry of Health and the civil society organisations in the Niger Delta with adolescent reproductive health programmes. The lack of understanding on the socio-economic factors driving adolescent pregnancy in this specific context makes it challenging to design interventions and target the actions for this, to allocate resources efficiently and to monitor the impact of the programmes. This study fills in this gap by exploring socioeconomic factors that contribute to teenage pregnancy among patients visiting FMC Yenagoa, providing evidence that can be easily applied to facility-level and state-level reproductive health programming.

1.3 Research Questions

This study is guided by the following research questions:

1. What is the prevalence and trend of teenage pregnancy among patients attending FMC Yenagoa?
2. What are the socioeconomic characteristics of teenage pregnant women attending FMC Yenagoa?
3. What are the key socioeconomic determinants of teenage pregnancy among adolescents in Bayelsa State as assessed from FMC Yenagoa?
4. What is the relationship between educational level, marital status, and household wealth and the occurrence of teenage pregnancy among adolescents at FMC Yenagoa?
5. What are the obstetric and neonatal outcomes associated with teenage pregnancies managed at FMC Yenagoa?

1.4 Objectives of the Study

1.4.1 General Objective

The general objective of this study is to examine the socioeconomic determinants of teenage pregnancy among adolescents attending Federal Medical Centre Yenagoa, Bayelsa State.

1.4.2 Specific Objectives

The specific objectives are to:

1. Determine the prevalence and trend of teenage pregnancy at FMC Yenagoa over the study period.
2. Describe the socioeconomic profile of teenage pregnant women attending FMC Yenagoa.
3. Identify the key socioeconomic determinants of teenage pregnancy among adolescents at FMC Yenagoa.
4. Assess the association between educational attainment, marital status, and household economic status with teenage pregnancy at FMC Yenagoa.
5. Document the obstetric and neonatal outcomes of teenage pregnancies managed at FMC Yenagoa.

1.5 Significance of the Study

This study has significant implications for public health policy and practice at facility, state, and national levels. For FMC Yenagoa and the Bayelsa State Ministry of Health, the study provides evidence-based insights into the socioeconomic risk factors most predictive of teenage pregnancy in the local context, enabling targeted preventive programming such as school-based reproductive health education, poverty alleviation linkages, and community sensitisation campaigns. The obstetric and neonatal outcome data will also contribute to clinical quality improvement at the facility by benchmarking the health consequences of teenage pregnancy in the Niger Delta against national and global standards.

At the national level, the study adds Bayelsa State-specific evidence to the growing body of literature on the regional socioeconomic determinants of teenage pregnancy in Nigeria, complementing existing national analyses (Okoli et al., 2022; Kareem et al., 2023; Akombi-Inyang et al., 2022). For international bodies such as UNFPA, UNICEF, and WHO, the study provides Niger Delta-contextualised data that may inform regional programming strategies. Academically, the study addresses a literature gap on the socioeconomic determinants of teenage pregnancy in the South-South geopolitical zone of Nigeria, an area that has received limited attention in the published health literature relative to its public health burden.

1.6 Scope of the Study

The study is geographically confined to Federal Medical Centre Yenagoa, Bayelsa State, Nigeria. The study population comprises teenage pregnant women (aged 10–19 years) attending antenatal, labour ward, and postnatal services at FMC Yenagoa during the study period of January 2021 to December 2024. Thematically, the study covers the prevalence and trend of teenage pregnancy, the socioeconomic profile of teenage mothers, socioeconomic determinants of teenage pregnancy, and associated obstetric and neonatal outcomes. Adult women aged 20 years and above are excluded from the study.

1.7 Limitations of the Study

The facility-based design limits the study to pregnant teenagers who accessed care at FMC Yenagoa, excluding those who delivered at home, at private facilities, or at lower-level health institutions. This may lead to selection bias towards teenagers with higher levels of obstetric risk who are referred to the tertiary facility. Retrospective review of hospital records may be constrained by incomplete documentation, illegible entries, or missing data in medical charts. Socioeconomic data obtained through interviews with teenage mothers may be subject to proxy reporting where the patient is too young or unwell to self-report. These limitations will be addressed through careful data triangulation, standardised data extraction protocols, and sensitive interviewer training.

1.8 Definition of Terms

Teenage Pregnancy: A pregnancy occurring in a female aged 10–19 years, regardless of the circumstances of conception, marital status, or pregnancy outcome.

Socioeconomic Determinants: The social and economic conditions that influence the health behaviours and outcomes of individuals and populations, including educational attainment, household income, occupation, marital status, and geographic residence.

Adolescent: An individual aged 10–19 years according to the World Health Organization classification, encompassing early adolescence (10–14 years) and late adolescence (15–19 years).

Obstetric Outcome: A measurable clinical result of pregnancy and childbirth, including mode of delivery, gestational age at delivery, maternal morbidity, and maternal mortality.

Neonatal Outcome: A measurable clinical result relating to the health of the newborn, including birth weight, Apgar score, admission to the special care baby unit (SCBU), and neonatal mortality.

Household Wealth Index: A composite measure of household economic status constructed from data on household assets, housing characteristics, and access to utilities, commonly used in demographic and health surveys as a proxy for income.

Niger Delta: The delta of the Niger River in Nigeria, comprising nine states including Bayelsa, characterised by oil extraction, environmental degradation, and significant socioeconomic challenges.

REFERENCES

Akombi-Inyang, B. J., Woolley, E., Iheanacho, C. O., Bayaraa, K., & Ghimire, P. R. (2022). Regional trends and socioeconomic predictors of adolescent pregnancy in Nigeria: A nationwide study. International Journal of Environmental Research and Public Health, 19(13), 8222. https://doi.org/10.3390/ijerph19138222

Kareem, Y. O., Aliyu, A. A., & Airede, L. (2023). Prevalence, trends, and factors associated with teen motherhood in Nigeria: An analysis of the 2008–2018 Nigeria Demographic and Health Surveys. International Journal of Sexual Health, 35(2), 248–262. https://doi.org/10.1080/19317611.2023.2189763

National Population Commission (NPC) & ICF. (2024). Nigeria Demographic and Health Survey 2023–2024. NPC and ICF.

Okara, A. T., Ogbonna, B. O., Okpalanma, N. N., Nnamani, M. N., Adenola, U. A., & Umeh, I. B. (2024). Teenage pregnancy in Nigeria from 1970 to 2023: Burden, issues, and prospects. Global Journal of Medical and Clinical Case Reports, 11(4), 047–051. https://doi.org/10.17352/2455-5282.000187

Okorie, C. O., Toluhi, O., & Achara, A. (2012). Socio-demographic determinants of teenage pregnancy in the Niger Delta of Nigeria. Open Journal of Obstetrics and Gynecology, 2(3), 305–310. https://doi.org/10.4236/ojog.2012.23061

Okoli, C. I., Hajizadeh, M., Rahman, M. M., Velayutham, E., & Khanam, R. (2022). Socioeconomic inequalities in teenage pregnancy in Nigeria: Evidence from Demographic Health Survey. BMC Public Health, 22(1), 1729. https://doi.org/10.1186/s12889-022-14146-0

World Health Organization (WHO). (2022). Adolescent pregnancy. WHO Fact Sheet. https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy