In northwest Nigeria, nearly one in three girls becomes a mother by age 19. These young girls, still navigating their own adolescence, face some of the highest risks during pregnancy and childbirth. Girls aged 15 to 19 are the least likely to access antenatal care (ANC), yet they are the most vulnerable to life-threatening complications such as eclampsia, systemic infections, and preterm or underweight births. To change this reality, PSI’s A360 program is working alongside state governments in Kano, Kaduna, Nasarawa, and Jigawa to make maternal, neonatal, and child health services truly responsive to adolescent needs.
At the heart of A360’s work is a deep belief that girls are more than just clients: they are individuals with hopes, dreams, and intersecting needs. Using a human-centered design approach, A360 co-creates solutions with girls, not just for them. These girl-led interventions are aspirational, community-based, and aligned with existing government structures. The Life, Family, and Health model is a platform that integrates stage-appropriate ANC education into group sessions while also supporting postpartum family planning and broader life skills development.
But changing health outcomes means changing social norms too. A360’s two-pronged strategy engages both girls and their husbands to foster shared decision-making and encourage care-seeking behaviors. Male Interpersonal Communication Agents lead husband-focused sessions that highlight the importance of ANC, respectful partnerships, and joint responsibility for maternal health.
For 18-year-old Zainab Abdullahi from Ringim in Jigawa State, Nigeria, this approach changed everything. Five months pregnant and newly married, Zainab only spoke to her husband about basic requests, such as asking for money for medical expenses. Like many in her community, he didn’t see ANC as a priority. But after several Life, Family, and Health sessions, Zainab began to see herself differently, not just as a girl going through pregnancy, but as a mother-in-the-making who deserved care and support.
One evening, after serving his favorite meal, fura da nono, a fermented milk-cereal, Zainab gently started a conversation. “I’ve been going to the health center,” she told him, “and I’ve learned how to take care of myself and our baby.”
She explained what she’d learned through A360, which included fetal development stages, signs of danger, and how ANC could protect her life and their child’s. She even handed him a brochure she received at her session and said, “You can come with me next time.”
To her surprise, he asked the next morning, “When’s the next session?” and joined her.
That moment marked a turning point, not just in Zainab’s pregnancy journey, but in their marriage. She gained the confidence to speak, and he learned how to listen. Together, they began navigating parenthood as partners.
Stories like Zainab’s echo across A360’s four intervention states. In 2024 alone, A360’s adolescent-responsive maternal, neonatal, and child health initiative led to measurable gains:
- Over 60,000 girls reached, with more than 10,000 pregnant girls attending pre-ANC sessions
- 99% conversion rate from pre-ANC to ANC registration
- 3,555 girls attended ANC in December alone
- More than 3,000 adolescent mothers adopted postpartum family planning methods (mainly long-acting reversible contraceptives)
- Over 27,000 husbands engaged, including 3,000+ who attended their wife’s fourth ANC visit
- 25% of ANC attendees were referred by their husbands
To promote financial readiness, A360 also introduced group savings sessions, helping girls prepare for safe deliveries and postnatal care, while building a foundation for longer-term economic security.
In 2025, A360 will expand this model to additional sites, with a deepened emphasis on state-led implementation. This includes capacity building, government-driven data systems, and robust knowledge sharing to ensure that what works for girls and is sustained by the systems that serve them. Because every girl, like Zainab, deserves to feel seen, supported, and safe as she brings new life into the world.
