Antenatal and delivery care are essential maternal health services (MHS) for survival and wellbeing. Nigeria has the highest global burden of maternal mortality with low utilization antenatal and delivery services. Though, early marriage is a strong predictor of early pregnancy and childbirth, but it is not clear if it is associated with low use of MHS. This study assessed early marriage as a determinant of poor MHS utilization in Nigeria.

This study used data from the 2018 Nigeria Demographic and Health Survey (NDHS) which is based on descriptive cross-sectional survey design. The data was limited to ever married women aged 15-24 years. Data was analyzed using SPSS version 20.

This study indicates lower likelihood of women who marry early to use antenatal care (OR=0.25, 95% CI=0.21-0.31), receive minimum 4 ANC (OR=0.22, 95% CI=0.18-0.26), receive iron supplementation (OR=0.38, 95% CI=0.33-0.45) and IPTp for malaria prevention (OR=0.57, 95%CI=0.50-0.66). Conversely, Early marriage was found to be associated with higher likelihood of facility delivery (OR=4.6, 95% CI=4.02-5.26) and lower likelihood of delivery by unskilled attendant (OR=0.31, 95% CI=0.26-0.31). These associations disappear in the adjusted model. Nevertheless, the nuanced analysis showed association in the adjusted odd ratio for use of antenatal care (AOR=0.44, 95% CI=0.20-0.99) and number of antenatal care visits (AOR=0.37, 95% CI=0.14-0.95) among women who married at less than fourteen years

Early marriage below age 14 years negatively affect utilization of MHS. There is the need to strengthen legislation against early marriage especially among girls below 14 years and address socioeconomic challenges that exacerbate vulnerability.

Keywords: Antenatal care, Child marriage, Delivery, Early marriage, Maternal health services, Nigeria