Social Determinants of Adolescent Sexual and Reproductive Health Outcomes in North West Nigeria: Implications for Health Education

Adolescent sexual and reproductive health in Nigeria is shaped by complex social determinants including poverty, gender inequality, education access, and community norms. This study analysed the social determinants of adolescent sexual and reproductive health outcomes in North West Nigeria, with data from Sokoto, Kebbi, and Zamfara states. A cross-sectional analytical design was employed, with 380 adolescents aged 15 to 19 years recruited from schools and community youth groups across nine local government areas. Data were collected on household socioeconomic status, educational status, social support, access to health services, and key reproductive health outcomes. Structural equation modelling was used to test a conceptual model of social determinants and health outcomes. Results showed that educational access (standardised coefficient 0.48), maternal education (0.35), and exposure to reproductive health education (0.41) were the strongest determinants of positive sexual and reproductive health outcomes. Poverty and early marriage significantly predicted negative outcomes. The study concludes that health education interventions must be embedded within broader social protection frameworks to be effective in North West Nigeria. Recommendations include community-based health education addressing gender norms and supporting girls' school retention. Keywords: social determinants, adolescent sexual and reproductive health, North West Nigeria, health education, structural equation modelling