Project – Role of Church-Organized Pre-Marital Health Screening in Reducing Marital Discord and Infertility among Couples

CHAPTER ONE

 Introduction

1.1 Background of the Study

Marriage is widely regarded as a foundational institution that contributes to emotional wellbeing, family stability, and social cohesion. For many couples, marriage marks the beginning of lifelong partnership, shared goals, and the potential for creating a family. However, contemporary marital life is not without challenges: conflicts, unmet expectations, health concerns, and issues related to fertility can negatively affect marital satisfaction and stability (Amato, 2000; Gottman & Levenson, 2000). In Nigeria — one of the most populous countries in Africa — health concerns such as genetic disorders, sexually transmitted infections (STIs), reproductive health issues, and undiagnosed chronic conditions remain significant problems among couples of reproductive age (Akinloye, 2012).

Churches, particularly Pentecostal congregations in urban centers like Lagos, play prominent roles in community life and family formation. In addition to spiritual guidance, many churches have begun organizing pre‑marital health screening programs aimed at preparing couples for marriage by identifying health risks that might lead to marital discord or infertility. These screenings commonly include tests for blood group compatibility, genotype (e.g., sickle cell status), HIV and other STIs, reproductive health assessments, and counseling based on results (WHO, 2019; Obiefuna et al., 2018). The premise is that early medical evaluation and intervention can reduce the personal, relational, and social burden associated with preventable health challenges, thereby promoting healthier and more resilient marriages.

Despite the increasing adoption of pre‑marital health screenings in some religious contexts, there is limited empirical research on how these programs influence marital outcomes, particularly in Pentecostal churches in Nigeria. This study, therefore, investigates the role of church‑organized pre‑marital health screening in reducing marital discord and infertility among couples in five selected Pentecostal churches in Lagos.

Marriage and family formation have significant biological, psychological, social, and spiritual dimensions. Beyond spiritual readiness, medical readiness — especially in contexts with high prevalence of reproductive health issues — is crucial to marital success. Health screenings prior to marriage can identify potential medical risk factors that may impact future marital life, such as incompatible blood groups (which may carry risks during pregnancy), genotypic incompatibilities (e.g., both partners being sickle cell trait carriers), undiagnosed sexually transmitted infections, and fertility‑related issues (Fagbamigbe et al., 2017; WHO, 2019).

Globally, health screening before marriage has been recognized as a preventive strategy in reducing the incidence of inherited disorders, STIs, and other medical conditions that can affect partnership outcomes and child health (Centers for Disease Control and Prevention, 2006; WHO, 2019). In Nigeria, premarital genotype and blood group screening have been recommended to raise awareness of sickle cell disease risk and reduce the birth of affected children (Olaniyan et al., 2016). Similarly, reproductive health screenings — including assessment of fertility potential and STI status — can help couples take early steps to prevent marital stress and long‑term health complications.

Pentecostal churches in Nigeria are increasingly integrating health components into their pre‑marital counseling programs. These screenings are often conducted in partnership with health professionals and may be coupled with spiritual counseling, lifestyle guidance, and referrals for follow‑up care. Scholars suggest that when health screenings are combined with counseling and education, couples tend to have greater health awareness, increased health‑seeking behavior, and improved communication about health issues (Adekunle, 2018; Eze et al., 2020).

However, despite these developments, there is a noticeable gap in academic knowledge about the effectiveness of church‑organized pre‑marital health screening programs in terms of actual outcomes such as reduction in marital conflict, enhanced mutual understanding of health issues, and prevention or early management of infertility. While some qualitative reports suggest positive impacts (e.g., increased communication and readiness for family planning), there is a lack of systematic, empirical research that quantifies or rigorously assesses these effects within Pentecostal contexts in Lagos.

The rapid urbanization of Lagos has also seen an increase in lifestyle‑related health issues, delayed childbearing, and reproductive health challenges among young adults. As such, understanding how church‑based health interventions influence marital dynamics and fertility outcomes is both socially relevant and timely.

1.2 Statement of the Problem

In Nigeria, marital discord and infertility are significant concerns among couples of reproductive age. Several studies have identified health‑related factors — such as undiagnosed STIs, genetic incompatibilities, and reproductive system disorders — as contributors to marital stress, relationship breakdown, and infertility (Akinloye, 2012; Fagbamigbe et al., 2017). Even within religious communities that prioritize marital health, many couples enter marriage without comprehensive medical evaluation, and health challenges may emerge only after marriage has begun, contributing to conflict, blame, marital dissatisfaction, or delayed childbearing.

Church‑organized pre‑marital health screenings have the potential to identify health risks early, educate couples about health implications, and inform decision‑making about marriage and family planning. However, there is limited empirical evidence on whether such screenings translate into improved marital communication, reduced conflict associated with health issues, and decreased incidence or better management of infertility among couples. Without systematic research, church leaders and health policymakers cannot determine whether these programs are effective, need improvement, or require expansion.

This gap in evidence is particularly pronounced in Pentecostal churches in Lagos, where pre‑marital health initiatives are increasingly promoted but seldom evaluated. Therefore, this study seeks to examine the role of church‑organized pre‑marital health screening in reducing marital discord and infertility among couples in selected Pentecostal churches in Lagos.

1.3 Research Objectives

The main objective of this study is to examine the role of church‑organized pre‑marital health screening in reducing marital discord and infertility among couples in five selected Pentecostal churches in Lagos.

The specific objectives are:

1. To determine the level of awareness and participation in church‑organized pre‑marital health screening among engaged couples.
2. To examine the relationship between pre‑marital health screening outcomes and marital communication patterns.
3. To assess the relationship between pre‑marital health screening and incidences of marital discord related to health issues.
4. To explore the influence of pre‑marital health screening on fertility outcomes among couples.

1.4 Research Questions

1. What is the level of awareness and participation in church‑organized pre‑marital health screening among engaged couples in selected Pentecostal churches?
2. How do outcomes from pre‑marital health screening influence marital communication patterns among couples?
3. Is there a relationship between pre‑marital health screening and incidences of marital discord related to health issues?
4. What is the perceived influence of pre‑marital health screening on fertility outcomes among couples?

1.5 Research Hypothesis

H₀: There is no significant role of church‑organized pre‑marital health screening in reducing marital discord and infertility among couples in selected Pentecostal churches in Lagos.

1.6 Significance of the Study

This study is significant in several ways:

• Church Leadership: It will provide evidence to help Pentecostal church leaders refine or strengthen health screening components of premarital programs.
• Health Policy: Findings may inform partnerships between religious institutions and health agencies to support preventive health interventions for couples.
• Couples and Families: The study may increase awareness among couples about the importance of early medical evaluation in marital and reproductive planning.
• Academic Research: It contributes to the literature on preventive health in religious settings, marital wellbeing, and reproductive health in Nigeria.

1.7 Scope of the Study

This study focuses on couples attending five selected Pentecostal churches in Lagos State, Nigeria. It examines pre‑marital health screening awareness, participation, and outcomes in relation to marital communication, conflict, and fertility. The study does not extend to traditional, civil, or non‑church premarital health screening practices outside church contexts.

1.8 Definition of Terms

• Pre‑Marital Health Screening: Medical tests and evaluations conducted before marriage to determine health risks, including blood group, genotype, reproductive health status, and STI screening.
• Marital Discord: Persistent disagreement, conflict, or tension within a marital relationship.
• Infertility: The inability of a couple to conceive after one year of regular, unprotected intercourse.
• Pentecostal Church: A Christian denomination emphasizing personal spiritual experience, charismatic worship, and holistic wellbeing.
• Engaged Couples: Couples who are officially preparing for marriage and participating in pre‑marital programs.

Project – Role of Church-Organized Pre-Marital Health Screening in Reducing Marital Discord and Infertility among Couples