Socio-Demographic Determinants of Premarital Screening Among Couples in Gusau Local Government Area

Abstract

Premarital screening is an important preventive health intervention for identifying genetic incompatibilities and infectious disease risks before marriage. This mixed-methods study assessed the socio-demographic determinants of premarital screening and compared post-marital health experiences among screened and unscreened couples in Gusau Local Government Area, Zamfara State, Nigeria. Quantitative data were obtained from 367 married couples selected through multistage sampling across four wards using a structured questionnaire, while qualitative data were collected through ten key informant interviews and five in-depth couple interviews. Quantitative data were analysed using descriptive statistics, chi-square tests, and an independent-samples t-test, while qualitative data underwent thematic analysis. Although 63.3% of respondents demonstrated high awareness of premarital screening (mean = 3.99/5), awareness did not correspond to similarly high screening practice. Sex was not significantly associated with awareness (χ² = 0.004, df = 1, p = 0.947). However, educational level (χ² = 31.065, df = 3, p < 0.001; Cramer’s V = 0.299) and religious beliefs (χ² = 21.313, df = 3, p < 0.001; Cramer’s V = 0.247) were significantly associated with screening practice. Screened couples reported substantially fewer post-marital health challenges than unscreened couples (17.6% vs. 56.6%; t = −11.726, df = 357, p < 0.001; Cohen’s d = 1.264). The findings indicate that although awareness is relatively high, socio-demographic factors influence screening uptake, while screening is associated with fewer reported post-marital health challenges. Strengthening community-based education, targeting individuals with limited formal education, engaging religious leaders, and supporting accessible screening services are recommended.