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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2025-05-01
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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. |
| format | Article |
| id | doaj-art-8c5eef3adcc04b3a8ffde7675104d739 |
| institution | DOAJ |
| issn | 1471-2458 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| 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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