In Nigeria, very young adolescents face overlapping risks (early marriage, GBV, poor SRH knowledge, low HPV vaccination, and limited opportunities for girls) driven by social, economic, and institutional barriers. Understanding these determinants is crucial for targeted interventions. This study explored behaviours and norms shaping VYAs in Nigeria. We used a qualitative, multi-state design with social-ecological and norms frameworks plus Five Whys analysis to map behaviours and drivers. Our research in 12 states examined early marriage, gender-based violence, HPV vaccination, SRH gaps, and barriers to girls’ economic empowerment. We purposively sampled diverse stakeholders. About 35 participants per state participated in workshops using discussion guides, mapping, and dot voting to prioritize behaviours and drivers. We included participants from urban, rural, and conflict-affected settings. We used thematic analysis with deductive and inductive coding, guided by a codebook aligned to the Social Ecological Model and Social Norms Framework. We applied cross-case synthesis and triangulation to link behaviours with drivers and norms, and prioritized findings by prevalence, impact, feasibility, and intersectional vulnerabilities. Stakeholders indicated that behaviours, underlying drivers, and social norms strongly affect the well-being of very young adolescents in Nigeria. Harmful practices, such as early sexual initiation, transactional relationships, child, early and forced marriage, and limited use of health services, are widespread. Protective behaviours, including school participation and community engagement, are present but differ by location and population group. Key drivers include poverty, parental expectations, peer influence, gender norms, inadequate services, and media exposure. Norms that tie girls’ value to marriageability, discourage discussion of sexuality and abuse, and promote scepticism toward vaccination continue to increase risk. Intersectional vulnerabilities worsen these challenges. Stakeholders observed that girls in rural and conflict-affected areas face higher risks of child marriage, gender-based violence, and limited access to services. Urban and peri-urban girls are more exposed to sexualized media, economic instability, and transactional risks. Economic constraints, restrictive inheritance practices, and limited financial skills further limit girls’ economic opportunities. HPV vaccine uptake is hindered by misinformation, concerns about side effects or infertility, religious beliefs, and gender norms that shape decision-making. Stakeholders identified priority behaviours and drivers that can be addressed through multi-level interventions. Very young adolescents in Nigeria face interconnected risks stemming from social norms, economic constraints, and gaps in service delivery. Persistent harmful practices and structural inequities restrict protective behaviours and limit access to opportunities. Addressing these challenges requires targeted, multi-level interventions to change harmful norms, improve adolescent-friendly services, and increase protective and economic opportunities for girls.
Nwala et al. (Sat,) studied this question.