A Systematic Review of Factors Affecting Uptake of Contraception amongst Adolescents in Nigeria

Abstract

Background: Adolescent contraceptive uptake remains a major public health concern in Nigeria, where high rates of unintended pregnancy contribute to adverse health, educational, and socioeconomic outcomes. Despite widespread awareness of contraceptive methods, utilization among adolescents remains low, suggesting the influence of multiple interacting factors. Objective: This study aimed to systematically review the factors affecting contraceptive uptake among adolescents in Nigeria. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines and registered with PROSPERO (CRD420261364491). Electronic databases including PubMed, Scopus, Web of Science, CINAHL, and Google Scholar were searched for studies published between 2000 and 2025. Eligible studies included observational and mixed-methods research focusing on adolescents aged 10–19 years in Nigeria. Data extraction and quality assessment were performed independently by two reviewers. Due to heterogeneity across studies, findings were synthesized narratively. Results: Fifteen studies met the inclusion criteria. Although awareness of contraceptive methods was consistently high, utilization remained low across studies. Key individual determinants included age, educational level, knowledge gaps, and fear of side effects. Interpersonal factors such as partner approval, parental communication, and peer influence significantly shaped contraceptive behaviour. Sociocultural and religious norms, stigma, and gender inequalities were identified as major barriers, particularly among unmarried adolescents. Socioeconomic disparities and rural residence further limited access to services. Health system challenges, including lack of adolescent-friendly services, provider bias, confidentiality concerns, and commodity stock-outs, also reduced utilization. Conversely, exposure to family planning information through mass media was consistently reported as a facilitator of contraceptive uptake. Conclusion: Contraceptive uptake among adolescents in Nigeria is influenced by interconnected factors operating at multiple levels. Addressing these challenges requires comprehensive, culturally sensitive interventions and strengthened adolescent-friendly health services to improve utilization and reproductive health outcomes.