Differential pattern of healthcare concerns and needs among adolescents across three developmental stages in south-west Nigeria

Background Adolescence is a critical developmental period marked by rapid biological, psychological, and social changes. Evidence on how healthcare needs vary across adolescent stages in low- and middle-income countries including Nigeria remains limited. This study examined patterns of health concerns, healthcare needs, and unmet needs among adolescents in south-western Nigeria and explored differences across early, middle, and late adolescence . Methods A community-based cross-sectional survey was conducted among 1,004 adolescents aged 10–19 years selected through multistage sampling in urban and rural communities of Osun State. Data were collected using a structured interviewer-administered questionnaire adapted from validated adolescent health assessment tools. Descriptive statistics, chi-square tests, and logistic regression analyses were used to assess associations between developmental stage and healthcare needs. Results Overall, 77.0% of adolescents reported at least one health concern, while 72.2% reported a healthcare need. Physical health conditions and concerns related to secondary sexual characteristics were the most frequently reported health concerns. Significant differences were observed across developmental stages. Compared with early adolescents, middle adolescents (adjusted OR = 6.09, 95% CI: 4.22–8.80) and late adolescents (adjusted OR = 8.16, 95% CI: 4.79–13.92) were significantly more likely to report healthcare needs. Adolescents in senior secondary schools have about three times higher odds of reporting met health care needs compared to those in junior secondary school (aOR = 3.378; 95% CI:1.89–6.25). Among adolescents with a health condition requiring care, 62.5% reported unmet healthcare needs. Early adolescents experienced the highest proportion of unmet need (73.2%), compared with middle (57.5%) and late adolescents (57.6%) (p < 0.001). Female early adolescents had the highest prevalence of unmet healthcare needs. Conclusion Health concerns, healthcare needs, and unmet healthcare needs are common among adolescents in south-west Nigeria and vary substantially across developmental stages. Early adolescents, particularly girls, experience the greatest burden of unmet healthcare needs. These findings highlight the need for life-stage-responsive adolescent health programmes and strengthened adolescent-friendly health services that address the distinct needs of early, middle, and late adolescence. Improving access to age-appropriate, equitable, and responsive healthcare may contribute to better adolescent health outcomes and support progress towards universal health coverage..