Effectiveness of a contraceptive intervention among married adolescent girls in northern Nigeria

Increasing contraceptive uptake among adolescent girls in low- and middle-income countries requires improving demand for contraception, strengthening adolescents’ confidence and self-efficacy to use contraception, building strong partner and family support, and making health systems more adolescent responsive. This paper examines the effectiveness of an intervention employing these components to increase modern contraceptive use among married adolescent girls in northern Nigeria, where, nationally, contraceptive use among this sub-group is just 3.3%. The study employed a quasi-experimental repeated cross-sectional design with intervention and comparison arms, surveyed at two time points approximately two years apart. The primary outcome of interest was current contraceptive use and secondary outcomes included comprehensive contraceptive knowledge, preference-aligned contraceptive use, and contraceptive self-efficacy, among others. Owing to substantial differences observed in the groups between the two time points and across the groups, inverse probability of treatment weighs using a propensity score approach was used to balance the distribution of observed covariates. The analysis employed a difference-in-differences framework. The total analytical sample was 4,334 (intervention n=2184, comparison n=2160). Participants in the intervention group were 44.3 percentage points (pp) more likely to be using contraception, 11.3 pp more likely to have comprehensive contraceptive knowledge, 19.8 pp more likely to have preference-aligned contraceptive use, and 53.4 pp more likely to have contraceptive self-efficacy than the comparison group. These findings add to the evidence on what works for improving adolescent contraceptive use and demonstrate that uptake can be increased even among highly marginalized and vulnerable populations, such as married adolescents, in conservative settings such as northern Nigeria using approaches delivered through the public health system.Included in this portal is the underlying data from the research paper as well as the supplementary data.