Factors associated with the knowledge of obstetric danger signs, and perceptions of the need for obstetric care amongst married young women in northern Nigeria

BACKGROUND: Married adolescents contribute to poor maternal health indicators in many low-and middle-income countries, where restrictive social norms hinder access to, and utilisation of maternal health services. Addressing these barriers is key to improving health outcomes of young mothers and their children. AIM: This study assessed married young women’s knowledge of obstetric danger signs and perceptions of the need to attend obstetric services. METHODS: A cross sectional descriptive design, interviewing 1624 randomly selected married young women aged 12–25 years. Data were collected in early 2017 using an interviewer-administered questionnaire on mobile phones, and exported into a statistical software for analysis. RESULTS: We found low levels of knowledge of danger signs, especially those pertaining to the post-partum period. Respondents’ age, literacy and household wealth were significantly associated with knowledge of danger signs across the continuum of care. Awareness of danger signs during delivery, was strongly associated with perceptions of need for antenatal care (odds ratio[OR]= 2.269; p < 0.05), and delivery in a health facility (OR = 1.883; P < 0.05). Most respondents believed they must wait for their husband’s approval to attend a health facility when in labour. CONCLUSION: Our findings show that the low levels of knowledge of obstetric danger signs, low perceptions of the importance of facility delivery, and the need to obtain husband’s permission before seeking care, are highly contextualised and reflect the socio-cultural and economic circumstances of married young women in northern Nigeria. Interventions must consider these cultural context, and include a strong male-involvement component.