Maternal Mortality In Nigeria Research Articles

Contraceptive methods continuation and its determinants among acceptors on repeat visits to a Nigerian University Teaching Hospital: a 10-year review

Background: Family planning is a known reproductive health modality for reducing the high maternal mortality in Nigeria. Contraceptive use and continuation is thus necessary to achieve its benefits. The study aimed to determine the contraceptive options and the factors associated with the continuation of contraceptive choices among women on repeat visits. Methods: This was a 10-year retrospective study of the family planning clinic register of all clients who presented for a repeat visit for contraceptive method continuation at the University of Uyo Teaching Hospital. Results: There were 6939 contraceptive acceptors on repeat visits aged between 14 and 50 years (mean 31.6 years, SD 5.4). The majority were 26 to 30 years (32.9%), had secondary education (54.6%), were multiparous (90.9%) and chose the subdermal implant (34.9%) and the intrauterine contraceptive devices (27.7%) for continuation. There was a significant association between the women`s age (Df=3, F=10.81, p<0.0001), their educational status (Df=6, Χ2=38.5583, p<0.0001), their parity (Df= 15, Χ2 =76.8644, p<0.0001) and the contraceptive method continued. Conclusions: An interest in long-acting reversible contraceptives for continuation was found, and this is significantly associated with their sociodemographic and obstetric characteristics; however, we recommend cross-sectional and focus-group inquiries among clients in the different contraceptive-specific categories for further information on the reasons for their choices at subsequent visits.

The Role of Tranexamic Acid in Preventing Primary Post-Partum Haemorrhage During Caesarean Section: A Randomized Control Trial

Background: Primary postpartum haemorrhage (PPH) is a leading cause of maternal mortality in Ni-geria. Caesarean section (CS), though a life-saving alternative to vaginal delivery in several maternity units globally, is a risk factor for PPH. Its rate has increased globally with wide variability amongst various countries. Although tranexamic acid (TXA) is an affordable medication that has been widely investigated for the treatment of PPH, its role as prophylaxis against PPH during Caesarean section has not been well characterized in our environment. Methods: A randomized, double-blind, two-center study of 130 consenting pregnant women who were scheduled for either elective or emergency LSCS at the Institute of Maternal and Child Health, Lagos State University Teaching Hospital (LASUTH) and Federal Medical Center, Ebute-Metta (FMCEB) Lagos. Data was imported into Stata version 17 (StataCorp, USA) software for analysis. Results: The mean age of the participants was 30.8 ± 4.76 years. The prevalence of PPH among the placebo group was four times that of the Tranexamic acid group. (P-value < 0.0001). There was a sta-tistically significant lower estimated blood loss in the intervention compared to the placebo arm of the study (P-value < 0.0001) Conclusion: Prophylactic use of intravenous Tranexamic acid as an adjunct to uterotonic at caesarean section is efficacious in reducing blood loss and preventing post-partum haemorrhage.

The prospects of litigation to secure maternal health in Nigeria: Does SERAP v Attorney-General Lagos have any value?

Blood transfusions play a crucial role in addressing obstetric complications such as post-partum haemorrhage and anaemia that contribute to maternal deaths. The right to health guaranteed by numerous international human rights instruments, national constitutions and legislation obligates governments to ensure that women have access to interventions to prevent maternal mortality. In 2020 a health policy in Lagos State, Nigeria, providing that, in the event that patients are likely to need a blood transfusion, such as pregnant women, spouses and relatives are required to donate blood as a condition for accessing maternity and health services in government-run health facilities, was the subject of a High Court ruling. The judgment declared the policy to be a breach of some human rights guaranteed by the Nigerian Constitution, legislation and international instruments that the country had ratified. Additionally, the judge noted that the policy contributed to maternal deaths. Consequent to the above, this article explores the contribution of human rights litigation and the ensuing verdicts to the protection of maternal health globally, and in light of these evaluates the value of the judgment in particular. A few national and international cases involving other countries that depict the strides that have been made in the use of human rights litigation to protect maternal health are presented to enable an appreciation of the extent to which human rights litigation has been used to support maternal mortality reduction efforts. A critical appraisal of the Lagos State court's decision with a view to determining its potential to contribute to maternal mortality reduction efforts in Nigeria and elsewhere is then embarked upon. The finding is that despite certain flaws identified in the judgment, it makes a valuable contribution to the protection of maternal health and, by extension, the reduction of maternal mortality in Nigeria.

PUBLIC HEALTH EXPENDITURE AND MATERNAL MORTALITY IN NIGERIA

This study examined the effect of public health expenditure on maternal mortality in Nigeria from 2002 to 2021. To achieve this objective, the study utilized data on maternal death, total government expenditure on health, and migration of doctors and nurses trained in Nigeria - doctors and nurses trained in Nigeria but working in other countries from OECD Health Statistics, 2021, WHO, UNICEF, UNFPA, World Bank Group, the United Nations Population Division, and Central Bank of Nigeria Statistical Bulletin. The study employed an Autoregressive Distributed Lag (ARDL) Bounds testing technique for data analyses. The result revealed that in the long run, total government expenditure on health has a negative and significant relationship with maternal mortality in Nigeria. Meanwhile, the migration of doctors and nurses trained in Nigeria - doctors and nurses trained in Nigeria but working in other countries have a positive and significant relationship with maternal mortality in Nigeria. In the short run, total government expenditure on health has a positive and significant relationship with maternal mortality in Nigeria. At the same time, the migration of doctors and nurses trained in Nigeria - doctors and nurses trained in Nigeria but working in other countries has a negative and significant relationship with maternal mortality in Nigeria. Based on the findings of this study, it is recommended here that the government should step up investment in all components of health infrastructure to cope with the explosive population growth requiring medical services in Nigeria. Put differently, a crucial effort should be made by the government to channel more funds to the health sector in order to improve health standards, reduce the mortality rate and hence the life expectancy of the citizens since a healthy population and workforce is a major ingredient for rapid and sustainable productivity and growth.<p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0004/a.php" alt="Hit counter" /></p>

Malaria Transmission and Home-based Preventive Practices Amongst Women of Reproductive Age in South-South Nigeria

Malaria infection accounts for over 60% of outpatient visits to healthcare facilities, 30% of child fatalities, 25% of infant deaths, and 11% of maternal mortality in Nigeria. Notably, in Nigeria, children under five years of age and pregnant women are especially vulnerable to malaria-related illnesses and death. The study, therefore, seeks to assess the knowledge of malaria disease, transmission, and use of home-based prevention strategies amongst women of reproductive age group. A cross-sectional study design was employed to assess the knowledge of malaria transmission and home-based preventive practices amongst a multistage sample of 379 women of reproductive age seeking healthcare services at the public PHC facilities in South-South, Nigeria. Data was collected using an interviewer-administered semi-structured questionnaire. Descriptive and inferential analyses of data collected were carried out using the IBM SPSS version 20 software. The mean age of the respondents surveyed in this study was 32.2 (SD ± 6.9) years. Most respondents [88.4% (n = 335)] had good knowledge of malaria transmission and prevention; however, the majority were not knowledgeable about the period mosquitoes commonly enter the house (71.5%) and the peak mosquito biting period (63.1%). There were varied degrees of practice of the various malaria home-based prevention strategies. In conclusion, a significant proportion of the surveyed reproductive-age women had some grasp on the fundamental issues of malaria transmission and prevention with some identified gaps, and they used different home-based malaria prevention measures at varied degrees. Keywords: Home-based malaria preventive practices, Knowledge, Malaria transmission and prevention, Primary healthcare, Reproductive age women, South-South Nigeria.

Influence of households' socio-economic factors on maternal and under-five survival in Nigeria: Implication for the sustainable development goal 3.

The objective of this study was to examine the influence of household socio-economic factors on maternal mortality and under-five survival in Nigeria. Consequently, data from 2005 to 2021 were collected from the World Development Indicators, and fully modified least squares and canonical cointegrating regression were utilised to implement the study. The results showed that for every 100,000 live births, at least 1097 mothers die in Nigeria. GDP per capita showed a positive but insignificant impact on maternal mortality, while adjusted net national income had a significant negative relationship with maternal mortality. Broad money supply reduced under-five survival in Nigeria, while social inclusion causes a reduction in under-5 mortality with 32 deaths per 1,000 live births in Nigeria. Hence, to reduce the high rate of maternal mortality in Nigeria, policy and programmes that will be socially inclusive for women and children should be implemented in the country.

Subnational estimates of maternal mortality in Nigeria: Secondary Data Analysis of female siblings' survivorship histories.

High Maternal Mortality (MM) in Nigeria is complicated by the absence of reliable estimates at subnational levels. Obtaining accurate data at the state and geopolitical region levels is crucial for effective policy-making and targeted interventions. This study employs novel small area estimation techniques to derive plausible estimates of Maternal Mortality rates and ratios for Nigerian states and geopolitical regions. Data from 293,769 female siblings, provided by 114,154 women in the Nigeria Demographic and Health Surveys of 2008, 2013, and 2018, are used. Empirical Bayesian technique and the James-Stein estimator are applied to estimate MM Rates and Ratios, respectively. Maternal Mortality Ratio is highest in rural areas, Northern Nigeria states, and regions. While the South West exhibits lower MMRatio, the Northern regions, particularly the North-East, show consistently higher ratios. Mortality trends have decreased in the North West and South East regions but increased in the South West from 2008 to 2018. Addressing these disparities is essential for achieving sustainable development goals and improving maternal health in Nigeria.

Temie Giwa-Tubosun of LifeBank: creating the future of health-care supply chain in Africa powered by technology

Social implications LifeBank is primarily focused on tackling the challenge of maternal mortality in Nigeria and other African countries by providing women access to blood, thereby tackling the challenge of gender inequality. The company employed both men and women at its workplace providing equal opportunities for men and women. Learning outcomes Discuss how women entrepreneurs are solving social problems in developing countries using technology and innovation. Analyze the challenges faced by women entrepreneurs in getting the right human capital, raising funds and managing growth for their social business. Case overview/synopsis The case discusses how social entrepreneur Temie Giwa-Tubosun (Temie) founded LifeBank, a medical distribution company, to provide access to blood, medical oxygen and vaccines to hospitals in Nigeria. The company used technology to provide information to health providers about which blood bank stored the blood type they needed and delivered it quickly and safely to help save lives. Supplementary materials Teaching notes are available for educators only. Subject code CSS 3: Entrepreneurship.

Outcomes of a multifaceted intervention to prevent eclampsia and eclampsia-related deaths in Nigerian referral facilities.

Eclampsia causes maternal mortality in Nigeria. This study presents the effectiveness of multifaceted interventions that addressed institutional barriers in reducing the incidence and case fatality rates associated with eclampsia. The design was quasi-experimental and the activities implemented at intervention hospitals included a new strategic plan, retraining health providers on eclampsia management protocols, clinical reviews of delivery care and educating pregnant women and their partners. Prospective data were collected monthly on eclampsia and related indicators from study sites over 2y. The results were analysed by univariate, bivariate and multivariable logistic regression. The results show a higher eclampsia rate (5.88% vs 2.45%) and a lower use of partograph and antenatal care (ANC; 17.99% vs 23.42%) in control compared with intervention hospitals, but similar case fatality rates of <1%. Overall, adjusted analysis shows a 63% decrease in the odds of eclampsia at intervention compared with control hospitals. Factors associated with eclampsia were ANC, referral for care from other facilities and older maternal age. We conclude that multifaceted interventions that address challenges associated with managing pre-eclampsia and eclampsia in health facilities can reduce eclampsia occurrence in referral facilities in Nigeria and potential eclampsia death in resource-poor African countries.

Clinical characteristics and treatment patterns of pregnant women with hypertension in primary care in the Federal Capital Territory of Nigeria: cross-sectional results from the hypertension treatment in Nigeria Program

BackgroundHypertensive disorders of pregnancy, including hypertension, are a leading cause of maternal mortality in Nigeria. However, there is a paucity of data on pregnant women with hypertension who receive care in primary health care facilities. This study presents the results from a cross-sectional analysis of pregnant women enrolled in the Hypertension Treatment in Nigeria Program which is aimed at integrating and strengthening hypertension care in primary health care centres.MethodsA descriptive analysis of the baseline results from the Hypertension Treatment in Nigeria Program was performed. Baseline blood pressures, treatment and control rates of pregnant women were analysed and compared to other adult women of reproductive age. A complete case analysis was performed, and a two-sided p value < 0.05 was considered statistically significant.ResultsBetween January 2020 to October 2022, 5972 women of reproductive age were enrolled in the 60 primary healthcare centres participating in the Hypertension Treatment in Nigeria Program and 112 (2%) were pregnant. Overall mean age (SD) was 39.6 years (6.3). Co-morbidities were rare in both groups, and blood pressures were similar amongst pregnant and non-pregnant women (overall mean (SD) first systolic and diastolic blood pressures were 157.4 (20.6)/100.7 (13.6) mm Hg and overall mean (SD) second systolic and diastolic blood pressures were 151.7 (20.1)/98.4 (13.5) mm Hg). However, compared to non-pregnant women, pregnant women had a higher rate of newly diagnosed hypertension (65.2% versus 54.4% p = 0.02) and lower baseline walk-in treatment (32.1% versus 42.1%, p = 0.03). The control rate was numerically lower among pregnant patients (6.3% versus 10.2%, p = 0.17), but was not statistically significant. Some pregnant patients (8.3%) were on medications contraindicated in pregnancy, and none of the pregnant women were on aspirin for primary prevention of preeclampsia.ConclusionsThese findings indicate significant gaps in care and important areas for future studies to improve the quality of care and outcomes for pregnant women with hypertension in Nigeria, a country with the highest burden of maternal mortality globally.

A Statistical Comparative Analysis of Changes in Selected Determinants of Maternal Mortality in Bangladesh: A Road Map for Nigeria

Nigeria failed to achieve the Millennium Development Goal (MDG) 5 and is currently on track to miss the Sustainable Development Goal (SDG) 3 of reducing the maternal mortality rate in the country to under 70 death per 100,000 live births. This study aims to examine trends of maternal mortality in Nigeria and Bangladesh and analyse the impact of changes in selected determinants on maternal mortality in both countries between 1985 and 2020. Pearson correlation and linear regression tests were used to identify the strength and impact of the association between these determinants and maternal mortality. The results from this study reveal that Bangladesh witnessed a significant rise in female literacy rates and female secondary school enrolment which were strongly negatively associated with maternal mortality. The increase in female literacy and female secondary school enrolment was approximately twice that experience in Nigeria, in the same period. In Bangladesh, every unit decline in adolescent fertility rate averted 7.16 deaths per 100,000 live births. The percentage of government total expenditure on health in Nigeria shows a moderate negative Pearson correlation when compared to the maternal mortality ratio. The opposite was however the case in Bangladesh. This may suggest that health expenditure alone is incapable of reducing maternal mortality. From the empirical result of this study, policymakers in Nigeria will need to pay close attention to the sociocultural determinants of maternal mortality in a multi-sectoral approach.

Preconception Care: An Untapped Route towards Reducing Infant and Maternal Mortality in Nigeria

The aim of preconception care is to reduce parental risk factors before pregnancy through health promotion and intervention which reduces maternal and infant morbidity and mortality. Healthcare providers play important roles in providing this care to women and men of childbearing age. In Nigeria however, the implementation of preconception care by healthcare providers remains low. In this review, an overview of preconception care in Nigeria and the barriers that affects its delivery will be explored. Peer reviewed articles were searched using key words related to preconception care and implementation of the care by healthcare providers. Publications were deemed eligible if they reported on preconception care and barriers influencing the provision of preconception care. A careful analysis of existing literatures on the topic shows that, there is a low understanding of preconception care among women of reproductive age in Nigeria. Furthermore, preconception care is not yet widely practiced in the Nigeria as part of health care due to unplanned and recurrent pregnancies, high parity, poor health care seeking behavior and low level of maternal health care. In view of the aforementioned challenges, there is a need to develop and implement preconception policies and guidelines to be applied in the existing health care system. Considering the importance of this care in improving pregnancy and neonatal outcomes, there is a need to educate and engage members of the society as well as health care providers in its importance and delivery.

Predictors of Willingness to Use Modern Contraceptives among female undergraduate students in a tertiary institution in Nigeria: The Health Belief Approach

Background: More than half of unintended pregnancies in Nigeria end in induced abortion. Unsafe abortion from unintended pregnancies contributes significantly to maternal mortality in Nigeria. Modern contraceptives have proven useful in preventing unintended pregnancy. The health belief model is a comprehensive tool that can be used to predict contraceptive behaviour. It provides a theoretical framework that gives better understanding of how individual beliefs affect contraceptive behaviour. This study determined the predictors of willingness to use modern contraceptives among female undergraduates of Obafemi Awolowo University Ile-Ife from the perspective of the health belief model.&#x0D; Methods: This descriptive cross-sectional study was conducted among 422 female undergraduates selected by multistage sampling technique. Data were collected using pretested self-administered questionnaire and analysed using IBM SPSS Version 25. Chi square test was used for association while logistic regression was used to determine the predictors. A p-value of &lt;0.05 was considered statistically significant.&#x0D; Results: The mean age of respondents was 21.4±2.4 years. The prevalence of modern contraceptive use was 9.2%. Majority of the respondents 268 (79.3%) were willing to use contraceptives. The most commonly used modern contraceptive was oral pills 289 (68.5%). Perceived benefit (AOR=0.32, 95%CI=0.17-0.63, p=0.001), perceived severity (AOR=0.48, 95%CI=0.44-0.89, p=0.004) and perceived self-efficacy (AOR=0.41, 95%CI=0.22-0.78, p=0.006) were predictors of willingness to contraceptive use.&#x0D; Conclusion: Although willingness to use modern contraceptives was high, the actual use of contraceptives was low. Health education programs and improvement of access to different contraceptive methods can improve un-met need for contraception among respondents.

Impact assessment of particulate pollution on maternal mortality in Nigeria

Recently, the World Health Organization reported that 20% of all global maternal deaths happened in Nigeria between 2005 and 2015. In developing countries, these maternal deaths are mainly from air pollution. Due to poor facilities and documentation, the extent of danger is not known. This research seeks to estimate the available pollutants and its direct and indirect impact on maternal mortality. Ten (10) years (2010–2019) datasets of black carbon, sulfur dioxide, dust, carbon monoxide, organic carbon particulates, sea-salts, and sulphate particulates were obtained from the second modern-era retrospective analysis for research and applications (MERRA-2). The dataset was obtained for the six geopolitical zones of Nigeria and analyzed using statistical tool, models, spatial interpolation, and risk analysis. The volumetric and radioecological risk was also analyzed. It was observed the dust content had minute volume of heavy metal and/or radionuclide particles that may be unharmful in the short term but lethal in the long term. The risk quotient and total dose rate per organism are given as 0.00000396 and 0.0000396 µGy h−1. The result in this manuscript corroborates existing data on maternal mortality in Nigeria. It is recommended that the safety of pregnant woman depends on significant efforts of authorities to enact and enforce environmental laws to mitigate air pollution.

A critical analysis of the extent to which social determinant of health explains health inequalities regarding maternal mortality in Nigeria

This article critically analyzes and quantified the extent to which social determinants of health explains health inequalities regarding maternal mortality in Nigeria. Evidence suggests that maternal mortality is predominant in developing countries. This formed the rationale in using Nigeria as a case study for critical analysis. This study showed the relationship between social status/determinants, health inequalities and maternal mortality outcomes in Nigeria. Using a critical analytical approach, this study shows that access to a good health care by maternal patients depends on a number of social determinants (such as education/awareness, income level/unemployment, cultural beliefs, insecurity, environmental conditions and healthcare decline/lackadaisical attitude displayed by some health workers in some parts of Nigeria) which can be linked to explain health inequalities that results in maternal mortality in Nigeria. To tackle inequalities, this study recommends targeted social policy reforms and maternal program/education for affected populace in Nigeria.

A critical analysis of the extent to which social determinant of health explains health inequalities regarding maternal mortality in Nigeria

A critical analysis of the extent to which social determinant of health explains health inequalities regarding maternal mortality in Nigeria

Levels, Trends, and Causes of Adolescent and Young Adult Maternal Mortality in Nigeria During 1990–2017: Analysis of the 2017 Global Burden of Disease Study Database

Background: Despite the global progress made in reducing maternal mortality in the past two decades, the health of adolescents and young adult women (10-24 years) has been neglected based on the wrong assumption that they are healthy, especially in a developing country like Nigeria; this is despite the fact that adolescents and young adults (AYA) constitute over 16% of Nigeria’s population. Thus, this study aimed to determine the levels, trends, and causes of maternal mortality among AYA women aged 10-24 years in Nigeria. Methods: This was a cross-sectional study that utilized secondary data sets running from 1990 to 2017 from the Global Burden of Disease Study’s (GBD) online interactive tool downloaded from the Global Health Data Exchange (GHDx) platform. From the database, we extracted the numbers of maternal deaths (10-49 years), adolescent and young adults’ maternal deaths (10-24 years), the proportion of maternal deaths (10-24 years), and both maternal mortality ratio and rate for 15-49 years old and 10-24 years old in the form of Comma separated values (CSV) and converted into XLS file in Microsoft (MS) Excel format for the analysis. Frequencies, proportions, and charts were generated using MS Excel. Result: A total of 122,107 maternal deaths occurred among adolescents and young adults (AYA), which is 26% of all deaths occurring among 10-49 years old. Year-to-year changes in the absolute numbers of maternal deaths among AYA showed that it ranged from 3,866 (1990) to 4,451 (2017), showing a slight upward increase over the period; however, both AYA maternal mortality ratio and rate show consistent declines over the period. AYA maternal mortality ratio (MMR) for adolescents aged 15-19 years was 17% higher than for young adults aged 20-24 years. Sepsis was the leading cause of adolescent maternal death (MMR of 168), followed by maternal hypertensive disorder, obstructed labor, maternal hemorrhage, ectopic pregnancy, and abortion. A total of 460,155 maternal deaths occurred in women aged 10-49 years during the study period. Maternal deaths in the age group 10-24 years ranged from 3,866 (29.8%) in 1990 to 4,451 (25.1%) in 2017. The maternal mortality ratio in women aged 10-49 years declined by about 30% for the 1990 – 2017 period. Conclusion and Implications for Translation: The study showed that adolescents and young adults are at increased risk of maternal deaths in Nigeria. Therefore, multi-faceted maternal health programs in the country need to target this age group to prevent maternal deaths. Copyright © 2022 Dahiru et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.

Caesarean section a better pathway to safe motherhood: perception of adults in Ekiti state, South Western Nigeria

Background: Caesarean section also known as C-section (CS), is a surgical procedure in which incisions are made through a mother’s abdomen (laparotomy) and uterus (hysterotomy) to deliver one or more babies. In developing countries such as Nigeria, the incidence of CS is below the World Health Organization (WHO) recommended rate of 10-15%. This has been attributed to several factors impeding the acceptance and attitude of adults to CS, subsequently leading to increasing rates of maternal mortality in Nigeria. The aim of this study is to assess the acceptance and attitude of CS among adults in Ekiti state, South western, Nigeria.Methods: This is a cross-sectional study design. Data were collected using a pre-tested, semi structured, interviewer administered questionnaire and analyzed using the statistical package for social sciences (SPSS), version 25.Results: About half of the respondents, (50.3%) had a positive attitude towards CS while 49.7% had a negative attitude towards CS, 69% were willing to accept CS if necessary while about 31% wouldn’t accept CS no matter the indication.Conclusions: This study showed that though a good number of respondents had positive attitude towards CS, however, a few numbers of respondents were unyielding to accept CS no matter the circumstances.

Effects of multifaceted interventions to prevent and manage primary postpartum haemorrhage in referral hospitals: a quasi-experimental study in Nigeria

IntroductionPrimary postpartum haemorrhage (PPH) is the leading cause of Nigeria’s high maternal mortality rate. This study investigated the effectiveness of a set of multifaceted interventions to manage and reduce PPH...

Family context and individual characteristics in antenatal care utilization among adolescent childbearing mothers in urban slums in Nigeria.

Adolescent pregnancy contributes significantly to the high maternal mortality in Nigeria. Research evidence from developing countries consistently underscores Antenatal Care (ANC) among childbearing adolescents as important to reducing high maternal mortality. However, more than half of pregnant adolescents in Nigeria do not attend ANC. A major gap in literature is on the influence of family context in pregnant adolescent patronage of ANC services. The study utilized a cross-sectional survey with data collected among adolescent mothers in urban slums in three Nigerian states namely, Kaduna, Lagos, and Oyo. The survey used a multi-stage sampling design. The survey covered a sample of 1,015, 1,009 and 1,088 childbearing adolescents from each of Kaduna, Lagos, and Oyo states respectively. Data were analyzed at the three levels: univariate, bivariate and multivariate. Overall, about 70 percent of female adolescents in our sample compared with 75 percent in the Demographic and Health Survey (DHS) had any antenatal care (ANC) visit. About 62 percent in our sample compared with 70 percent in the DHS had at least 4 ANC visits, and, about 55 percent in our sample compared with 41 percent of the DHS that had 4 ANC visits in a health facility with skilled attendant (4ANC+). Those who have both parents alive and the mother with post-primary education have higher odds of attending 4ANC+ visits. The odds of attending 4ANC+ for those who have lost both parents is almost 60% less than those whose parents are alive, and, about 40% less than those whose mothers are alive. The influence of mother's education on 4ANC+ attendance is more significant with large disparity when both parents are dead. The study concludes that identifying the role of parents and community in expanding access to ANC services among adolescent mothers is important in improving maternal health in developing countries.