Skip to main content

Advertisement

SpringerLink
Log in

Individual Characteristics and Use of Maternal and Child Health Services by Adolescent Mothers in Niger

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

Despite high rates of early childbearing, maternal mortality, and under-five mortality, little is known about factors that affect access of teenage mothers to maternal and child health (MCH) services in Niger. This paper explores potential factors associated with the utilization of MCH care services by adolescent mothers. Using the third wave of the Niger demographic and health survey (NDHS) 2006, we estimate three multivariate logistic regression models to assess individual characteristics associated with the utilization of antenatal care (ANC) and safe delivery care services among adolescent women, as well as full immunization received by children born to adolescent mothers. The analytical sample includes 934 adolescent mothers out of 1,835 respondents aged 15–19, and within this group, 493 mother–child dyads for children aged 12–59 months. Possessing any level of education was found associated with the increased use of all three selected MCH services, while urban residence and higher income were associated with the increased use of two of three MCH services studied. Higher birth order plus a birth interval more than 2 years for the most recent birth appeared associated with the lower probability of antenatal care visits and safe delivery care. This study finds that women who attended at least four ANC visits were more likely to experience safe delivery care, and the children whose mothers had safe delivery care were more likely to receive full immunization. Therefore, an effective program should be designed to promote a continuum of MCH care with special attention to adolescent women who are uneducated, poor and residing in rural areas.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. WHO. (2012). Trends in maternal mortality, 1990 to 2010: WHO, UNICEF. UNFPA and The World Bank Estimates: World Health Organization Press, Geneva, Switzerland.

    Google Scholar 

  2. UNICEF. (2012). Levels and trends in child mortality, report 2012: Estimates developed by the UN inter-agency group for child mortality estimation. New York: USA.

    Google Scholar 

  3. WHO. (2008). Adolescent pregnancy. Geneva: Switzerland.

    Google Scholar 

  4. UNICEF. (2011). Adolescence: an age of opportunity. New York: USA.

    Google Scholar 

  5. UN. (2011). The millennium development goals report, 2011. USA: United Nations Department of Economic and Social Affairs New York.

    Google Scholar 

  6. Hampton, T. (2010). Child marriage threatens girls’ health. JAMA, the Journal of the American Medical Association, 304, 509–510.

    Article  CAS  Google Scholar 

  7. Save the Children. (2011). Champion for children: State of the world’s mothers 2011. USA: Connecticut.

    Google Scholar 

  8. Potts, M., Gidi, V., Campbell, M., & Zureick, S. (2011). Niger: Too little, too late. International Perspective on Sexual and Reproductive Health, 27, 95–101.

    Article  Google Scholar 

  9. Babatunde, O. (2011). Population and development. Science, 333, 499.

    Article  Google Scholar 

  10. Institut National de la Statistique (INS) et Macro International Inc. (2007). Enquête Démographique et de Santé et à Indicateurs Multiples du Niger 2006. Calverton, Maryland, USA: INS et Macro International Inc.

    Google Scholar 

  11. WHO. (2013). Niger. Retrieved from http://www.who.int/countries/ner/en/. Accessed April 14, 2013.

  12. Thaddeus, S., & Maine, D. (1994). Too far to walk: Maternal mortality in context. Social Science and Medicine, 38, 1091–1110.

    Article  CAS  PubMed  Google Scholar 

  13. Mosley, W. H., & Chen, L. C. (1984). An analytical framework for the study of child survival in developing countries. Population and Development Review, 10, 25–45.

    Article  Google Scholar 

  14. Aday, L. A., & Andersen, R. M. (1974). A framework for the study of access to medical care. Health Services Research, 9, 208–220.

    CAS  PubMed Central  PubMed  Google Scholar 

  15. LeGrand, T. K., & Mbacke, C. S. M. (1993). Teenage pregnancy and child health in urban Sahel. Studies in Family Planning, 24, 137–149.

    Article  CAS  PubMed  Google Scholar 

  16. Filippi, V., Ronsmans, C., Campbell, O. M., Graham, W. J., Mills, A., Borghi, J., et al. (2006). Maternal health in poor countries: The broader context and a call for action. Lancet, 368, 1535–1541.

    Article  PubMed  Google Scholar 

  17. Pitt, C., Greco, G., Powell-Jackson, T., & Mills, A. (2010). Countdown to 2015: Assessment of official development assistance to maternal, newborn, and child health, 2003–08. Lancet, 376, 1485–1496.

    Article  PubMed  Google Scholar 

  18. Paxton, A., & Wardlaw, T. (2011). Are we making progress in maternal mortality? New England Journal of Medicine, 364, 1990–1993.

    Article  CAS  PubMed  Google Scholar 

  19. Boerma, J. T., Sommerfelt, A. E., Rutstein, S. O., & Rojas, G. (1990). Immunization: Levels, trends and differentials. Columbia, MD, USA: Institute for Resource Development/Macro Systems.

    Google Scholar 

  20. Singh, P. K., Rai, R. K., Alagarajan, M., & Singh, L. (2012). Determinants of maternity care services utilization among married adolescents in rural India. PLoS ONE, 7, e31666.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  21. Rai, R. K., Singh, P. K., & Singh, L. (2012). Utilization of maternal health care services among married adolescent women: Insights from the Nigeria demographic and health survey, 2008. Women’s Health Issues, 22, e407–e414.

    Article  PubMed  Google Scholar 

  22. Singh, P. K., Singh, L., Kumar, C., & Rai, R. K. (2013). Correlates of maternal healthcare service utilization among adolescent women in Mali: Analysis of a nationally representative cross-sectional survey, 2006. Journal of Public Health, 21, 15–27.

    Article  Google Scholar 

  23. Rai, R. K., Singh, P. K., Kumar, C., & Singh, L. (2013). Factors associated with the utilization of maternal health care services among adolescent women in Malawi. Home Health Care Services Quarterly. doi:10.1080/01621424.2013.779354.

    PubMed  Google Scholar 

  24. Rai, R. K., Ramadhan, A. A., & Tulchinsky, T. H. (2011). Prioritizing maternal and child health in independent South Sudan. Maternal and Child Health Journal. doi:10.1007/s10995-011-0886-6.

    Google Scholar 

  25. WHO. (2006). Provision of effective antenatal care: Integrated management of pregnancy and child birth (IMPAC). Geneva, Switzerland: Standards for maternal and neonatal care (1.6), Department of Making Pregnancy Safer.

    Google Scholar 

  26. WHO. (1998). Postpartum care of the mother and newborn: A practical guide. Geneva, Switzerland: Maternal and Newborn Health/Safe Motherhood Unit, Division of Reproductive Health (Technical Support).

    Google Scholar 

  27. Antai, D. (2011). Inequalities in under-5 mortality in Nigeria: do ethnicity and socioeconomic position matter? Journal of Epidemiology, 21, 13–20.

    Article  PubMed Central  PubMed  Google Scholar 

  28. Statacorp. (2007). Stata statistical software: Release 10. College Station, Texas, USA: Statacorp LP.

    Google Scholar 

  29. Fatusi, A. O., & Hindin, M. J. (2010). Adolescents and youth in developing countries: health and development issues in context. Journal of Adolescence, 33, 499–508.

    Article  PubMed  Google Scholar 

  30. Fotso, J. C. (2007). Urban-rural differentials in child malnutrition: Trends and socioeconomic correlates in sub-Saharan Africa. Health and Place, 13, 205–217.

    Article  PubMed  Google Scholar 

  31. Tran, T. K., Nguyen, C. T., Nguyen, H. D., Eriksson, B., Bondjers, G., Gottvall, K., et al. (2011). Urban- rural disparities in antenatal care utilization: A study of two cohorts of pregnant women in Vietnam. BMC Health Services Research, 11, 120.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Firestone, R., Punpuing, S., Peterson, K. E., Acevedo-Garcia, D., & Gortmaker, S. L. (2011). Child overweight and undernutrition in Thailand: Is there an urban effect? Social Science and Medicine, 72, 1420–1428.

    Article  PubMed  Google Scholar 

  33. Ronsmans, C., Chowdhury, M. E., Koblinsky, M., & Ahmed, A. (2010). Care seeking at time of childbirth, and maternal and perinatal mortality in Matlab, Bangladesh. Bulletin of the World Health Organization, 88, 289–296.

    Article  PubMed Central  PubMed  Google Scholar 

  34. Fotso, J. C. (2006). Child health inequities in developing countries: Differences across urban and rural areas. International Journal of Equity in Health, 11, 5–9.

    Google Scholar 

  35. Mekonnen, Y., & Mekonnen, A. (2002). Utilization of maternal health care services in ethiopia. Calverton, MD: ORC Macro.

    Google Scholar 

  36. Ezeonwu, M. C. (2011). Maternal birth outcomes: Processes and challenges in Anambra State, Nigeria. Health Care Women International, 32, 492–514.

    Article  Google Scholar 

  37. Koblinsky, M., Matthews, Z., Hussein, J., Mavalankar, D., Mridha, M. K., Anwar, I., et al. (2006). Going to scale with professional skilled care. Lancet, 368, 1377–1386.

    Article  PubMed  Google Scholar 

  38. Magadi, M. A., Agwanda, A. O., & Obare, F. A. (2007). A comparative analysis of the use of maternal health services between teenagers and older mothers in sub-Saharan Africa: Evidence from demographic and health surveys (DHS). Social Science and Medicine, 64, 1311–1325.

    Article  PubMed  Google Scholar 

  39. Lloyd, C. B., & Mensch, B. S. (2006). Marriage and childbirth as factors in school exit: An analysis of DHS data from sub-Saharan Africa. Policy Research Division Working Paper No. 219. Population Council, New York.

  40. Raj, A., Saggurti, N., Winter, M., Labonte, A., Decker, M. R., Balaiah, D., et al. (2010). The effect of maternal child marriage on morbidity and mortality of children under 5 in India: Cross sectional study of a nationally representative sample. BMJ, 21, b4258.

    Article  Google Scholar 

  41. Furuta, M., & Salway, S. (2006). Women’s position within the household as a determinant of maternal health care use in Nepal. International Family Planning Perspectives, 32, 17–27.

    Article  PubMed  Google Scholar 

  42. Kruk, M. E., Prescott, M. R., de Pinho, H., & Galea, S. (2011). Equity and the child health Millennium development goal: The role of pro-poor health policies. Journal of Epidemiology and Community Health, 65, 327–333.

    Article  PubMed  Google Scholar 

  43. Parkhurst, J. O., & Ssengooba, F. (2009). Assessing access barriers to maternal health care: Measuring bypassing to identify health centre needs in rural Uganda. Health Policy and Planning, 24, 377–384.

    Article  PubMed  Google Scholar 

  44. World Bank. (2012). Key development data and statistics; country profile: Niger, 2010. Washington, DC.

  45. Hirsch, A. (2012). Struggling to afford to eat in Niger. BBC News, 2010, Retrieved from http://www.news.bbc.co.uk/2/hi/programmes/from_our_own_correspondent/8929517.stm. Accessed April 14, 2013.

  46. WFP. (2012). Niger country profile, 2010. Retrieved from http://www.wfp.org/countries/niger. Accessed April 14, 2013.

  47. Kwast, B. E., & Liff, J. M. (1988). Factors associated with maternal mortality in Addis Ababa, Ethiopia. International Journal of Epidemiology, 17, 115–121.

    Article  CAS  PubMed  Google Scholar 

  48. Bloom, S. S., Lipperveld, T., & Wypig, D. (1999). Does antenatal care makes a difference to safe delivery? A study in urban Uttar Pradesh, India. Health Policy and Planning, 14, 38–48.

    Article  CAS  PubMed  Google Scholar 

  49. Prual, A., Toure, A., Huguet, D., & Laurent, Y. (2000). The quality of risk factor screening during antenatal consultations in Niger. Health Policy and Planning, 15, 11–16.

    Article  CAS  PubMed  Google Scholar 

  50. Ghuman, S. J., Lee, H. J., & Smith, H. L. (2006). Measurement of women’s autonomy according to women and their husbands: results from five Asian countries. Social Science Research, 35, 1–28.

    Article  Google Scholar 

  51. Kritz, M. M., & Adebusoye, P. M. (1999). Determinants of women’s decision-making authority in Nigeria: The ethnic dimension. Sociological Forum, 14, 399–424.

    Article  Google Scholar 

  52. Rai, R. K., Kumar, C., & Singh, P. K. (2012). Coverage gap in maternal, newborn and child health care services in India. Journal of Epidemiology and Global Health, 2, 221–224.

    Article  PubMed  Google Scholar 

  53. Bisin, S. (2008). UNICEF supports maternal and newborn health in Niger. Retrieved from http://www.unicef.org/health/niger_46254.html. Accessed April 14, 2013.

  54. World Bank. (2005). Niger: Providing all nigeriens with food, education and health care, a demographic perspective. Washington, DC: World Bank.

    Google Scholar 

  55. UN. (2011). World fertility report 2009. Department of Economic and Social Affairs: Population Division, United Nations publication.

    Google Scholar 

  56. Coen, B. (2012). UNICEF helps to begin changing attitudes towards early marriage in Niger. Retrieved from http://www.unicef.org/infobycountry/niger_57296.html. Accessed April 14, 2013.

  57. United Nations interagency task force on adolescent girls (2010). Accelerating efforts to advance the rights of adolescent girls: A UN joint statement. Retrieved from http://www.unfpa.org/webdav/site/global/shared/documents/publications/2010/agtf_jointstatement_en.pdf. Accessed April 14, 2013.

  58. Rai, R. K., Singh, P. K., Kumar, C., & Parasuraman, S. (2013). Teenage childbearing- a growing public health concern in need of urgent policy and program action. Journal of Public Health. doi:10.1007/s10389-012-0551-6.

    PubMed  Google Scholar 

Download references

Acknowledgments

The authors are indebted to four anonymous reviewers for their valuable comments, which helped immensely to improve the paper. The authors are also grateful to Measure Demographic and Health Survey (ORC Macro), Calverton, USA for availing the data used in this study.

Conflict of interest

None declared.

Author information

Authors and Affiliations

  1. Tata Institute of Social Sciences, V N Purav Marg, Deonar, Mumbai, 400 088, India

    Rajesh Kumar Rai

  2. International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai, 400 088, India

    Prashant Kumar Singh

  3. School of Health System Studies, Tata Institute of Social Sciences, V N Purav Marg, Deonar, Mumbai, 400 088, India

    Lucky Singh

  4. Department of Humanities and Social Sciences, Indian Institute of Technology Roorkee, Roorkee, 247 667, Uttarakhand, India

    Chandan Kumar

Authors
  1. Rajesh Kumar Rai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Prashant Kumar Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lucky Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chandan Kumar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rajesh Kumar Rai.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rai, R.K., Singh, P.K., Singh, L. et al. Individual Characteristics and Use of Maternal and Child Health Services by Adolescent Mothers in Niger. Matern Child Health J 18, 592–603 (2014). https://doi.org/10.1007/s10995-013-1276-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-013-1276-z

Keywords

Search

Navigation