BARRIERS TO UTILIZING SKILLED BIRTH ATTENDANCE AMONG ADOLESCENT MOTHERS IN URBAN INFORMAL SETTLEMENTS IN NIGERIA: A LITERATURE REVIEW

Abstract

This literature review synthesizes evidence on barriers to skilled birth attendance (SBA) among adolescent mothers in urban informal settlements in Nigeria. The paper adopts the Three Delays Model as the theoretical framework. Drawing on studies published between 2012 and 2025, the review identifies critical socioeconomic, cultural, health system, and individual-level barriers that impede access to facility-based delivery services. Key findings reveal that only 18–34% of adolescent mothers in Nigeria utilize health facilities for delivery, with rates particularly low in Northern Nigeria and urban slum communities. Major barriers include poverty and the high cost of services, low educational attainment, long distances to health facilities, negative attitudes of healthcare workers, cultural beliefs favoring traditional birth attendants, stigma against pregnant adolescents, and lack of family support. The review highlights the urgent need for multi-sectoral interventions, including girl-child education, expansion of health insurance coverage, improvement in healthcare worker attitudes, community engagement, and targeted support for vulnerable adolescent populations in urban informal settlements. These findings have significant implications for achieving Nigeria's maternal mortality reduction targets and the Sustainable Development Goals.