ADOLESCENT SEXUALITY AND REPRODUCTIVE HEALTH IN NORTHERN NIGRIA: A CASE STUDY OF SHEKAL COMMUNITY, BAUCHI

Background The study was carried out in Shekal community in Bauchi. The approaches employed in the study included, Focus Group Discussions (FGDs) with 5 different target audiences providing qualitative input while questionnaires were administered to 7 categories of target audiences. Issues around disclosure, age of marriage, early marriage, marriage to older men, education and gender formed the basis of discussion in the FGDs, while the questionnaire provided opportunities for a fuller rendering of the situation of adolescent sexuality in parts of northern Nigeria

Study Location: Shekal is a community located in Bauchi, Bauchi Local Government Area. It is centrally located, with a target population of about15,000 and is situated about 4 kilometers from the Emir of Bauchi’s palace, around the central market area. It comprises of mainly Hausas, Gerawa and Fulanis.

Study Rationale: A desk review[1] (carried out by Action Health International) of published data revealed certain features of the reproductive health characteristics of married adolescents, namely; marriage to older husbands, low educational attainment, low social status, limited participation in decisions that affect their well being, limited access to health services, increased risk of maternal and infant mortality, increased vulnerability to STIs/HIV, low knowledge of contraception and large unmet need for contraception. A need to further study adolescent sexuality in Northern Nigeria became imperative to provide an in-depth understanding of the contextual situation, especially understanding the factors that support empowerment of young girls within marriages and how this interplays with their sexuality outcomes. A close study of women identified as ‘innovators’ who after an early marriage were able to further their education will facilitate unraveling these issues. It is hoped that the study findings will encourage the development of many more ‘innovators’ in North East and West of Nigeria. [1] Makinwa-Adebusoye P 2006: Hidden: A Profile of Married Adolescents in Northern Nigeria. Action Health Incorporated Publication

Study objectives To undertake a rapid situational assessment on married adolescents in the community in order to inform program plans. To study factors that influence the high occurrence and features of early marriage in order to influence programming in the community. Determine the profile of ‘Innovators” in the study location.

Modality Identification of Field Study Researchers. Contact with community. Site Inventory. Training of Field Assistants. Administration of Tools. Data Analysis.

Administration of Tools FGDs guides were developed for the following categories of people: i. Adolescent Married Males; ii. Adolescent Married Females; iii. Adolescent Unmarried Males; iv. Adolescent Unmarried Females; v. Adult Women (community leaders). Tools used for the quantitative study were administered to the following categories of people: i. Adolescent Married Males (men who married at <19 years); ii. Adolescent Married Females (aged < 19 years); iii. Adolescent Unmarried Males (aged <19 years); iv. Adolescent Unmarried females (<19 years); v. Adult Women (aged 24-49 years); vi. Innovators (women aged 24 –49 years); vii. women of similar age range of Innovators to provide basis for comparison; viii. male community leaders.

Overview of Research Findings Disclosure: It is a practice encouraged by Islam and there are Islamic injunctions regarding it. In the past illness, sickness and issues most investigated and disclosed were leprosy, epilepsy, madness, witchcraft, family business trade and taboos. The specific practice of disclosure of the status of HIV of a young bride or groom is not at all widespread, though some enlightened families insist on HIV test before marriage. However, it was clearly observed that the practice is not uniformly applied

Age at Sexual Debut and First birth: FGD findings showed that most persons interviewed were of the view that the ideal age of marriage for females are between 14 – 16 years and for males 20 -25 years. Sexual debut and first births were claimed by about 90% to be at about the same age, since no pre-marital sexual relation is allowed in Islam. The usual practice for first births is for the child to be born at the home of either the girl’s or the husband’s parents.

Age of Marriage: The general opinion of respondents during the FGDs was that the minimum age at which a girl should be married is 16 years. Some argued that a girl should marry as soon as she reaches puberty as instructed by Allah. 15% of Traditional/Religious leaders said that young girls should be married off at 12-15 years of age, a further 40% said that young girls should be married off at 15-17 years, 45% of respondents said that a girl should be married from 18 years of age. Interestingly all the traditional rulers insist that the practice of early marriage in Bauchi should continue.

Early Marriage and the attendant challenges: Respondents did not agree to the definition of early marriage as marriage to a girl before she reaches 18 years of age. They were of the opinion that yes, marriage to a girl younger than 16 years had specific challenges. Some of these include; inexperience in managing the home, early motherhood that could expose them to various reproductive health problems, discontinuing of education of the girl. In discussions with the male adolescents, they opined that these child brides can not effectively train their children since they are themselves ‘children’. 30% of the respondents said the reason for early marriage is to avoid pre-marital sex while 15% felt the girls were already mature.

Marriage to Older Men: Discussions with both the male and the female respondents revealed that girls marry older men out of choice, and not because they are unduly forced to by parents. The adolescent males opined that the girls do it out of greed or materialism, or to ensure financial security in the marriage. The adolescent females indicated that marriage to the older men is common because these men are more sensible, more stable, and would not behave irrationally which could lead to divorce. The study showed that 90% of the respondents were in support of girls’ marriages to older men

Education: While the female discussants (adults and adolescents) agreed that there is need to allow girls to pursue an educational career after marriage, the male discussants did not overwhelmingly favor the idea. According to some of them, education for girls is associated with a lot of responsibility, challenges, and in some cases ‘bad traits’. However, it was generally clear that both groups agreed that continuing education for girls is good as long as the resources are available, the girl is of good moral standing and she has the interest and ability to succeed. They believe an educated wife is a good asset and will help her family and her community.

Incentives that should be provided to keep girls in school up to JSS 3 Allow full Islamic dress in Schools. Economic Status should be elevated. Gender Separation in School. Making School Environment Gender Friendly. Parents should be empowered Financially. Scholarship for the girls. Improve Discipline in the System. Enlighten Parents and husbands.

Forced Marriage: Innovators all agreed that young girls should be allowed to choose their spouses. Interestingly, traditional/Religious leaders varied in their responses, 15% said it is alright to allow a young girl decide on her choice of spouse, while 85% disagreed. Some reasons given for the varied responses include; parents are responsible for making a choice, where the young girl is allowed to make a choice it will enable them live happily. 36% of parents made the choice for adolescent girls while 71.4% of males made their choice of spouse themselves.

Other Issues: Number of children to be born : Findings of all the FGDs showed a general disapproval of discussions regarding the issue of the desired number of children to be delivered to a family. Contraception: The female respondents during the FGDs had knowledge on different types of modern contraceptive methods available though they said they do not utilize these services much since their husbands who have to give permission and pay for these services often do not permit their wives to use contraceptives.

Uptake of Reproductive Health Services: 8% of women in the study location still give birth alone unattended, while 31% were attended to by Traditional Birth Attendants (TBAs). A majority of women were attended to during delivery by Nurses or doctors.

Profile of Innovators as Compared to that of the Control Group: Education Level of parents and husbands. Occupation of husbands and parents. Birth to a child that later died. Position as Wife. Age At First Intercourse. Decision-making. Knowledge and use of contraceptives. Desired number of children. Occupation of Innovators.

COMMUNITY FEED BACK/CONSULTATION Issues of empowering families to help educate their children, discipline and Islamic child upbringing and moral values in homes and communities. Ways to educate adolescents on sexuality and reproductive health, especially for adolescent females likely to marry early. More information regarding reproductive health services and how to access them. More information is also required on the prevailing child mortality rate in the community, various types of reproductive services accessible to the community etc. Implementation of the recommendations of the research will help tremendously in addressing the problems. Enlighten parents and husband on the need for their daughters and wives to utilize reproductive health services. Provide information on array of healthy food for pregnant women. Publicize reproductive health information through unconventional medium like in barbing saloons, at naming or wedding ceremonies etc.

CONCLUSIONS Early marriage is a feature of the way of life of the Muslim communities in the North East zone of Nigeria. Young girls who are often not educated beyond secondary school level, marry older husbands often chosen by their parents; this acts as a social security and ensures a means of survival of these people. Young boys are often considered too immature and not of good financial standing to maintain a marriage and do not readily marry their peers. Poverty plays a key and pivotal role in all the reasons deduced for early marriage, marriage to older men, and marriage into polygamous homes. The current practice of early marriage in the face of the HIV and AIDS pandemic is a cause for immediate concern. The high maternal and child morbidity and mortality rates in these regions are one of the highest in the world. A lot needs to be done to bring about an improvement in the standard of living of these people in order to improve their socio-economic status and consequently improve the life choices they make even when their decisions find a basis in religious teachings.

RECOMMENDATIONS It is recommended that a project that aims at building the skills of the community members on Income Generating Activities (IGAs) be implemented. This will address the underlying poverty proffered as a reason for early marriage of girls in the study sites. Identify Innovators in communities and make them advocates for girl child education, empowering them to support several adolescent girls in their communities to stay in school till tertiary levels Education of both young boys and girls up to tertiary school should be encouraged Knowing that early marriage/teenage pregnancy carries the risks of VVF, infant mortality etc, it is recommended that sensitization be carried out at the community level on the health implications of early marriage/teenage pregnancy.