Home > Evidence > Factors influencing utilisation of maternal health services by adolescent mothers in low- and middle-income countries: a systematic review

Factors influencing utilisation of maternal health services by adolescent mothers in low- and middle-income countries: a systematic review

Adolescent mothers between the ages of 15 and 19 experience greater risks to their health in comparison with women aged 20 to 24 years old. This is mainly attributed to their biological and social disadvantages, such as post-partum bleeding and economic status, respectively.

Babies born to adolescent mothers are also at a greater risk of suffering from complications like preterm delivery and infant mortality, compared to babies born to mothers in their early twenties.

The authors of this paper advocate for there to be more research about how pregnant adolescents use maternal health services. This will complement strategies to prevent early marriage and early childbearing, and will help reach the sustainable development goals.

The authors conducted a systematic review to explore the factors that affect adolescents’ use of maternal health services in low- and middle-income countries (LMICs).

Here are the key findings:

  • Through the literature search, it was found that there is limited available research about adolescents’ use maternal health services. This may be due to the difficulties in capturing information about adolescent mothers. Past surveys suggest that adolescents have lower fertility rates than older groups of women. Cultural barriers are also important to consider when approaching adolescent mothers in LMICs, in relation to issues with consent, shame and lack of power. The authors suggest an increase in qualitative research would complement quantitative studies and provide a more enabling environment to what can be a sensitive issue.
  • Education of the adolescent mother was shown to be a significant factor that influences her use of maternal health services, making a case for a greater focus on strategies to improve their education. The spouse’s education was also seen to be a significant factor in the decision to attend maternal health services. It is, therefore, necessary to engage men in the demand for maternal services among adolescents.
  • Other influencing factors that were found to be significant were economic status, media exposure and residence (urban versus rural). Greater emphasis should be given to removing financial barriers to access maternal health services. The authors also suggest that further research is needed about adolescents’ access to social media. Social media may also be a platform where adolescents would be more willing to share their stories than talking face to face with adults.
  • The authors found that adolescents’ use of antenatal care (ANC) services was associated with delivery with skilled birth attendance. Using both these services was found to be associated with adolescent use of postnatal care services. ANC services present an opportunity for pregnant adolescents to learn about the benefits of using maternal health services and to prepare for childbirth. However, the integration of these services should not overburden already overstretched workforces. These services should also be approachable for unmarried adolescents.
  • The evidence showed that there were gaps from when the data was collected to when it is analysed meaning adolescent groups from the data period are different from the adolescents that the plans and policies are being drawn for.
  • The findings of this paper must be carefully interpreted as there were limitations in the search for literature (e.g. the authors only searched for English articles).

Echoing the SDGs call to ‘leave no on behind’, the authors conclude with a call for more research on and efforts to improve access to maternal services for adolescents, including those such as unmarried adolescents who are harder to reach.

To read the article for free, click here.

Banke-Thomas, O.E., Banke-Thomas, A.O. & Ameh, C.A. (2017). Factors influencing utilisation of maternal health services by adolescent mothers in low- and middle-income countries: a systematic review. BMC Pregnancy and Childbirth, 17:65

Document type 
Back to top