Skip to main content
Top
Published in: Reproductive Health 1/2019

Open Access 01-12-2019 | Research

“It is a thing that depends on God”: barriers to delaying first birth and pursuing alternative futures among newly married adolescent girls in Niger

Authors: Ghazaleh Samandari, Carolyn Grant, Lily Brent, Sara Gullo

Published in: Reproductive Health | Issue 1/2019

Login to get access

Abstract

Background

Pregnancy 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.

Methodology

In 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.

Results

Participants 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.

Conclusions

Findings 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.
Footnotes
1
Dedoose is cross-platform online application designed for analyzing a variety of medium for qualitative and mixed methods research. It can be found online at: https://​www.​dedoose.​com/​
 
Literature
1.
go back to reference World Health Organization, UNICEF. Trends in maternal mortality: 1990 to 2010: WHO, UNICEF, UNFPA and The World Bank estimates. Geneva: World Health Organization; 2012. World Health Organization, UNICEF. Trends in maternal mortality: 1990 to 2010: WHO, UNICEF, UNFPA and The World Bank estimates. Geneva: World Health Organization; 2012.
2.
go back to reference Institut National de la Statistique (INS) et ICF International, Enquête Démographique et de Santé et à Indicateurs Multiples du Niger 2012. Calverton: INS et ICF International; 2013. Institut National de la Statistique (INS) et ICF International, Enquête Démographique et de Santé et à Indicateurs Multiples du Niger 2012. Calverton: INS et ICF International; 2013.
3.
go back to reference United Nations. Department of Economics. The Millennium Development Goals Report 2011. Geneva: United Nations Publications; 2011. United Nations. Department of Economics. The Millennium Development Goals Report 2011. Geneva: United Nations Publications; 2011.
4.
go back to reference Neal S, Matthews Z, Frost M, Fogstad H, Camacho AV, Laski L. Childbearing in adolescents aged 12–15 years in low resource countries: a neglected issue. New estimates from demographic and household surveys in 42 countries. Acta Obstet Gynecol Scand. 2012;91(9):1114–8.CrossRef Neal S, Matthews Z, Frost M, Fogstad H, Camacho AV, Laski L. Childbearing in adolescents aged 12–15 years in low resource countries: a neglected issue. New estimates from demographic and household surveys in 42 countries. Acta Obstet Gynecol Scand. 2012;91(9):1114–8.CrossRef
5.
go back to reference Castle S. Factors influencing young Malians’ reluctance to use hormonal contraceptives. Stud Fam Plan. 2003;34(3):186–99.CrossRef Castle S. Factors influencing young Malians’ reluctance to use hormonal contraceptives. Stud Fam Plan. 2003;34(3):186–99.CrossRef
6.
go back to reference Hindin MJ, Fatusi AO. Adolescent sexual and reproductive health in developing countries: an overview of trends and interventions. Int Perspect Sex Reprod Health. 2009;35(2):58–62.CrossRef Hindin MJ, Fatusi AO. Adolescent sexual and reproductive health in developing countries: an overview of trends and interventions. Int Perspect Sex Reprod Health. 2009;35(2):58–62.CrossRef
7.
go back to reference Williamson LM, Parkes A, Wight D, Petticrew M, Hart GJ. Limits to modern contraceptive use among young women in developing countries: a systematic review of qualitative research. Reprod Health. 2009;6(1):3.CrossRef Williamson LM, Parkes A, Wight D, Petticrew M, Hart GJ. Limits to modern contraceptive use among young women in developing countries: a systematic review of qualitative research. Reprod Health. 2009;6(1):3.CrossRef
8.
go back to reference DeRose LF, Ezeh AC. Decision-making patterns and contraceptive use: evidence from Uganda. Popul Res Policy Rev. 2010s;29(3):423–39.CrossRef DeRose LF, Ezeh AC. Decision-making patterns and contraceptive use: evidence from Uganda. Popul Res Policy Rev. 2010s;29(3):423–39.CrossRef
9.
go back to reference Cau BM. Community influences on contraceptive use in Mozambique. Health Place. 2015;31:10–6.CrossRef Cau BM. Community influences on contraceptive use in Mozambique. Health Place. 2015;31:10–6.CrossRef
10.
go back to reference Chandra-Mouli V, McCarraher DR, Phillips SJ, Williamson NE, Hainsworth G. Contraception for adolescents in low and middle income countries: needs, barriers, and access. Reprod Health. 2014;11(1):1.CrossRef Chandra-Mouli V, McCarraher DR, Phillips SJ, Williamson NE, Hainsworth G. Contraception for adolescents in low and middle income countries: needs, barriers, and access. Reprod Health. 2014;11(1):1.CrossRef
11.
go back to reference Mmari KN, Magnani RJ. Does making clinic-based reproductive health services more youth-friendly increase service use by adolescents? Evidence from Lusaka, Zambia. J Adolesc Health. 2003;33(4):259–70.CrossRef Mmari KN, Magnani RJ. Does making clinic-based reproductive health services more youth-friendly increase service use by adolescents? Evidence from Lusaka, Zambia. J Adolesc Health. 2003;33(4):259–70.CrossRef
12.
go back to reference Biddlecom AE, Singh S, Munthali A. Adolescents’ views of and preferences for sexual and reproductive health services in Burkina Faso, Ghana, Malawi and Uganda. Afr J Reprod Health. 2007;11(3):99–110.CrossRef Biddlecom AE, Singh S, Munthali A. Adolescents’ views of and preferences for sexual and reproductive health services in Burkina Faso, Ghana, Malawi and Uganda. Afr J Reprod Health. 2007;11(3):99–110.CrossRef
13.
go back to reference Ahanonu EL. Attitudes of healthcare providers towards providing contraceptives for unmarried adolescents in Ibadan, Nigeria. J Family Reprod Health. 2014;8(1):33.PubMedPubMedCentral Ahanonu EL. Attitudes of healthcare providers towards providing contraceptives for unmarried adolescents in Ibadan, Nigeria. J Family Reprod Health. 2014;8(1):33.PubMedPubMedCentral
16.
go back to reference Shattuck D, Kerner B, Gilles K, Hartmann M, Ng'ombe T, Guest G. Encouraging contraceptive uptake by motivating men to communicate about family planning: the Malawi male motivator project. Am J Public Health. 2011;101(6):1089–95.CrossRef Shattuck D, Kerner B, Gilles K, Hartmann M, Ng'ombe T, Guest G. Encouraging contraceptive uptake by motivating men to communicate about family planning: the Malawi male motivator project. Am J Public Health. 2011;101(6):1089–95.CrossRef
17.
go back to reference Mosha I, Ruben R, Kakoko D. Family planning decisions, perceptions and gender dynamics among couples in Mwanza, Tanzania: a qualitative study. BMC Public Health. 2013;13(1):523.CrossRef Mosha I, Ruben R, Kakoko D. Family planning decisions, perceptions and gender dynamics among couples in Mwanza, Tanzania: a qualitative study. BMC Public Health. 2013;13(1):523.CrossRef
18.
go back to reference Hamid S, Stephenson R, Rubenson B. Marriage decision making, spousal communication, and reproductive health among married youth in Pakistan. Glob Health Action. 2011;4(1):5079.CrossRef Hamid S, Stephenson R, Rubenson B. Marriage decision making, spousal communication, and reproductive health among married youth in Pakistan. Glob Health Action. 2011;4(1):5079.CrossRef
19.
go back to reference Dehlendorf C, Levy K, Ruskin R, Steinauer J. Health care providers' knowledge about contraceptive evidence: a barrier to quality family planning care? Contraception. 2010;81(4):292–8.CrossRef Dehlendorf C, Levy K, Ruskin R, Steinauer J. Health care providers' knowledge about contraceptive evidence: a barrier to quality family planning care? Contraception. 2010;81(4):292–8.CrossRef
20.
go back to reference Bankole A, Malarcher S. Removing barriers to adolescents’ access to contraceptive information and services. Stud Fam Plan. 2010;41(2):117–24.CrossRef Bankole A, Malarcher S. Removing barriers to adolescents’ access to contraceptive information and services. Stud Fam Plan. 2010;41(2):117–24.CrossRef
21.
go back to reference Nouhou AM. Liberté reproductive et recours à la contraception: les influences religieuse et sociale au Niger. Afr Popul Stud. 2016;30(2):1–29. Nouhou AM. Liberté reproductive et recours à la contraception: les influences religieuse et sociale au Niger. Afr Popul Stud. 2016;30(2):1–29.
Metadata
Title
“It is a thing that depends on God”: barriers to delaying first birth and pursuing alternative futures among newly married adolescent girls in Niger
Authors
Ghazaleh Samandari
Carolyn Grant
Lily Brent
Sara Gullo
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Reproductive Health / Issue 1/2019
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/s12978-019-0757-y

Other articles of this Issue 1/2019

Reproductive Health 1/2019 Go to the issue