Abstract
BackgroundPregnancy among adolescent girls in Niger contributes to 34% of all deaths among females ages 15–19, but there is a dearth of research as to the specific contextual causes. In Zinder region, an area that is especially impoverished and where girls are at heightened risk, there is very little information on the main obstacles to improving adolescents’ health and well-being. This qualitative study examines the underlying social, individual and structural factors influencing married girls’ early first birth and participation in alternative opportunities (such as education or economic pursuits) in Niger.MethodologyIn July of 2017, researchers conducted in-depth interviews with a non-probability sample of community members in three communes of Zinder Region, Niger. Participants (n = 107) included adolescent girls, husbands of adolescent girls, influential adults, community leaders, health providers, and positive deviants. All interviews were transcribed, coded and analyzed using Dedoose software.ResultsParticipants recognize the health benefits of delaying first birth, but stigma around infertility and contraceptive use, desire for children, and belief that childbirth is “God’s will” interfere with a girl’s ability to delay. Girls’ social isolation, lack of mobility or autonomy, and inability to envision alternatives to early motherhood compound the issue. Participants favor adolescents’ pursuit of increased economic opportunities or education, but would not support delaying birth to do so.ConclusionsFindings indicate the need for a holistic approach to delaying early birth and stimulating girls’ participation in economic and educational pursuits. Potential interventions include mitigating barriers to reproductive health care; training adolescent girls on viable economic activities; and providing educational opportunities for girls. Effective programs should also include or target immediate members of the girls’ families (husbands, parents, in-laws), influential local leaders and members of the community at large.
Highlights
Niger has among the poorest sexual and reproductive health outcomes of any country in the world, including the highest fertility rate (7.6 children per woman) and a maternal mortality rate of 590 deaths per 100,000 births [1, 2]
Findings indicate the need for a holistic approach to delaying early birth and stimulating girls’ participation in economic and educational pursuits
Plain English summary Rapid pregnancy among newly married adolescents in Niger is a major cause of death among young girls in the country
Summary
Niger has among the poorest sexual and reproductive health outcomes of any country in the world, including the highest fertility rate (7.6 children per woman) and a maternal mortality rate of 590 deaths per 100,000 births [1, 2] Adolescent girls in this context are at significant risk; the average age of first marriage is 15.7 years and over 70% of adolescents are married by the age of 19. In Zinder region, an area that is especially impoverished and where girls are at heightened risk, there is very little information on the main obstacles to improving adolescents’ health and well-being This qualitative study examines the underlying social, individual and structural factors influencing married girls’ early first birth and participation in alternative opportunities (such as education or economic pursuits) in Niger
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