Determinants of marital decision despite sickle cell status awareness: a mixed method study

Abstract Introduction Sickle cell disease (SCD) is a significant public health concern in Nigeria. Despite widespread awareness campaigns advocating for premarital phenotype testing, many couples still make marital decisions that increase the risk of having children with SCD. This study aims to expl...

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Main Authors: Adeniyi Abraham Adesola, Joshua Simpa Lawal, David Mobolaji Akoki, Abigail Olawumi Oyedokun, Oluwatomisin Esther Agboola, Anuoluwapo Agnes Babawale, Biobele Jotham Brown
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-23066-8
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author Adeniyi Abraham Adesola
Joshua Simpa Lawal
David Mobolaji Akoki
Abigail Olawumi Oyedokun
Oluwatomisin Esther Agboola
Anuoluwapo Agnes Babawale
Biobele Jotham Brown
author_facet Adeniyi Abraham Adesola
Joshua Simpa Lawal
David Mobolaji Akoki
Abigail Olawumi Oyedokun
Oluwatomisin Esther Agboola
Anuoluwapo Agnes Babawale
Biobele Jotham Brown
author_sort Adeniyi Abraham Adesola
collection DOAJ
description Abstract Introduction Sickle cell disease (SCD) is a significant public health concern in Nigeria. Despite widespread awareness campaigns advocating for premarital phenotype testing, many couples still make marital decisions that increase the risk of having children with SCD. This study aims to explore the factors influencing marital decisions among parents of children with SCD, focusing on the relationship between phenotype awareness and marital choices. Method This mixed-method study was conducted among 209 parents of children with SCD receiving care at the paediatric haematology clinics of University College Hospital (UCH) and Oni Memorial Children Hospital (OMCH) in Ibadan, Nigeria. Quantitative data were collected through interviewer-administered structured questionnaires. Qualitative data were obtained through key informant interviews with stakeholders, including parents, healthcare providers, and SCD advocates. Qualitative data were thematically analysed and integrated with the quantitative findings. Result Findings revealed low premarital awareness of sickle cell phenotypes as only 14.5% of couples had mutual knowledge, while 36.7% were completely unaware. Key factors influencing phenotype combinations that carry risk of SCD birth included a willingness to "take the risk and hope for the best" (46.7%), limited understanding of the implications of SCD (33.3%), willingness to bear consequences (26.7%) and reliance on faith (20%). Higher educational levels correlated with improved awareness. Conclusion This study identifies significant gaps in premarital genetic awareness. Key gaps include a lack of knowledge about the implications of phenotype combinations and the tendency to prioritise cultural, emotional and religious factors over genetic risk considerations when making marital decisions. To bridge these gaps, improved public health education, accessible pre-marital genetic counselling and strategic engagement with religious and community leaders are essential to translating awareness into informed action.
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spelling doaj-art-8c5eef3adcc04b3a8ffde7675104d7392025-08-20T03:07:54ZengBMCBMC Public Health1471-24582025-05-012511810.1186/s12889-025-23066-8Determinants of marital decision despite sickle cell status awareness: a mixed method studyAdeniyi Abraham Adesola0Joshua Simpa Lawal1David Mobolaji Akoki2Abigail Olawumi Oyedokun3Oluwatomisin Esther Agboola4Anuoluwapo Agnes Babawale5Biobele Jotham Brown6Faculty of Clinical Sciences, College of Medicine, University of IbadanFaculty of Clinical Sciences, College of Medicine, University of IbadanFaculty of Clinical Sciences, College of Medicine, University of IbadanFaculty of Clinical Sciences, College of Medicine, University of IbadanFaculty of Clinical Sciences, College of Medicine, University of IbadanFaculty of Clinical Sciences, College of Medicine, University of IbadanDepartment of Paediatrics, College of Medicine, University of Ibadan/University College HospitalAbstract Introduction Sickle cell disease (SCD) is a significant public health concern in Nigeria. Despite widespread awareness campaigns advocating for premarital phenotype testing, many couples still make marital decisions that increase the risk of having children with SCD. This study aims to explore the factors influencing marital decisions among parents of children with SCD, focusing on the relationship between phenotype awareness and marital choices. Method This mixed-method study was conducted among 209 parents of children with SCD receiving care at the paediatric haematology clinics of University College Hospital (UCH) and Oni Memorial Children Hospital (OMCH) in Ibadan, Nigeria. Quantitative data were collected through interviewer-administered structured questionnaires. Qualitative data were obtained through key informant interviews with stakeholders, including parents, healthcare providers, and SCD advocates. Qualitative data were thematically analysed and integrated with the quantitative findings. Result Findings revealed low premarital awareness of sickle cell phenotypes as only 14.5% of couples had mutual knowledge, while 36.7% were completely unaware. Key factors influencing phenotype combinations that carry risk of SCD birth included a willingness to "take the risk and hope for the best" (46.7%), limited understanding of the implications of SCD (33.3%), willingness to bear consequences (26.7%) and reliance on faith (20%). Higher educational levels correlated with improved awareness. Conclusion This study identifies significant gaps in premarital genetic awareness. Key gaps include a lack of knowledge about the implications of phenotype combinations and the tendency to prioritise cultural, emotional and religious factors over genetic risk considerations when making marital decisions. To bridge these gaps, improved public health education, accessible pre-marital genetic counselling and strategic engagement with religious and community leaders are essential to translating awareness into informed action.https://doi.org/10.1186/s12889-025-23066-8Marital decisionSickle cell diseasePhenotype incompatiblePhenotype awarenessPremarital counselling
spellingShingle Adeniyi Abraham Adesola
Joshua Simpa Lawal
David Mobolaji Akoki
Abigail Olawumi Oyedokun
Oluwatomisin Esther Agboola
Anuoluwapo Agnes Babawale
Biobele Jotham Brown
Determinants of marital decision despite sickle cell status awareness: a mixed method study
BMC Public Health
Marital decision
Sickle cell disease
Phenotype incompatible
Phenotype awareness
Premarital counselling
title Determinants of marital decision despite sickle cell status awareness: a mixed method study
title_full Determinants of marital decision despite sickle cell status awareness: a mixed method study
title_fullStr Determinants of marital decision despite sickle cell status awareness: a mixed method study
title_full_unstemmed Determinants of marital decision despite sickle cell status awareness: a mixed method study
title_short Determinants of marital decision despite sickle cell status awareness: a mixed method study
title_sort determinants of marital decision despite sickle cell status awareness a mixed method study
topic Marital decision
Sickle cell disease
Phenotype incompatible
Phenotype awareness
Premarital counselling
url https://doi.org/10.1186/s12889-025-23066-8
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