In Nigeria and many other countries, it’s common for couples, and sometimes churches and mosques, to request health checks before marriage. Done well, premarital screening is an act of love: it helps couples make informed decisions about their health and future children. Done badly, it can lead to stigma, breakups based on misunderstandings, or pressure. As nurses, we’re often asked by friends and family what to test for and what results mean.
1. Haemoglobin genotype (sickle cell)
Sickle cell disease is inherited. Nigeria has the largest number of people with sickle cell disease in the world, and a large proportion of Nigerians carry the sickle cell trait (AS). If both partners carry the trait (e.g. AS and AS), each pregnancy has a 1 in 4 chance of a child with sickle cell disease (SS), a 1 in 2 chance of a child with the trait, and a 1 in 4 chance of AA.
| Couple | Chance of a child with SS in each pregnancy |
|---|---|
| AA + AA | 0% |
| AA + AS | 0% (50% chance of AS trait) |
| AS + AS | 25% |
| AS + SS | 50% |
| AA + SS | 0% (all children AS) |
Use an accredited laboratory with reliable methods (such as haemoglobin electrophoresis or HPLC), because errors in genotype results are reported and can have lifelong consequences. Couples who are both carriers have options: proceeding with awareness, prenatal diagnosis, IVF with genetic testing where available, adoption, or choosing not to marry. These are personal decisions; good genetic counselling helps.
2. HIV
Knowing your HIV status allows treatment and protects your partner. A person living with HIV who is on effective treatment with an undetectable viral load does not transmit HIV sexually, and can have HIV-negative children with proper care. Many couples with one HIV-positive partner (serodiscordant couples) live long, healthy married lives. See our HIV care guide.
3. Hepatitis B
Hepatitis B is common in Africa and Asia. If one partner has it, the other can be vaccinated and protected. Babies can be protected with the birth-dose vaccine and, when needed, treatment in pregnancy. See our hepatitis B guide.
4. Other useful checks
- Hepatitis C: curable with modern treatment.
- Syphilis and other STIs: treatable; important for pregnancy.
- Blood group and Rhesus factor: Rhesus-negative women need monitoring and anti-D in pregnancy where indicated.
- Blood pressure, blood sugar, weight.
- Rubella immunity for women planning pregnancy, and folic acid before conception.
- Mental health and family medical history: worth discussing honestly.
Handling results with love
- Test together and receive results with counselling where possible.
- Confidentiality: results belong to the individual. Health workers shouldn’t disclose them to families or religious leaders without consent.
- No blame: no one chooses their genotype or infections.
- Get accurate information before making big decisions.
- Fertility testing before marriage is not standard and can be stigmatising; fertility concerns are best discussed openly and medically if they arise.
More on love and relationships: Handling family pressure · Money and marriage · Sickle cell disease
Based on WHO information on sickle cell disease, HIV and hepatitis B. General health information; for personal results, speak to a qualified health professional or genetic counsellor.
*THE MINISTRY OF WISDOM WISDOM TO TAKE A BOLD STEP WHEN LIFE IS TOUGH*
_Topic: WISDOM TO MOVE FORWARD WHEN EVERYTHING IS SAYING “STAY”_
_2 Chronicles 20:17 says, Ye shall not need to fight in this battle: set yourselves, stand ye still, and see the salvation of the LORD._
_Deuteronomy 2:3 says, Ye have compassed this mountain long enough: turn you northward._
Hear me, child of God. There is a time to pray, there is a time to wait, but there is also a time to TAKE A BOLD STEP. Many destinies are stuck not because God did not speak, but because the man refused to move.
You are praying for open doors in business, but you have not taken the bold step to start. You are praying for promotion as a Director or for a job as a junior staff, but you have not taken the bold step to improve yourself. You are praying for that relationship, that family to be healed, but you are still waiting for perfect condition.
Listen, perfect condition will never come. Tough time will always be there. But wise men move even when it is tough.
*1. WISDOM KNOWS THAT A BOLD STEP IS NOT FOOLISHNESS, IT IS FAITH WITH WORKS.*
Many people confuse boldness with rashness. No! To resign without a plan is not boldness, it is foolishness. But to start that small business while you are still employed, that is wisdom. To learn that new skill while you are still a junior staff, that is wisdom. Faith says “God will do it.” Wisdom says “God will do it THROUGH the step I am taking.” _James 2:17 says, Even so faith, if it hath not works, is dead, being alone._ Your bold step is the leg that your faith will stand on.
*2. WISDOM TAKES A BOLD STEP EVEN WHEN FEAR IS PRESENT.*
You will never be free from fear before you move. Fear will be there. Discouragement will be there. The market is tough, capital is small, people may laugh — fear will speak. But wisdom does not wait for fear to disappear, it moves with fear trembling under its feet. David was afraid of Goliath’s size, but he still ran towards him. _1 Samuel 17:48 says, And it came to pass, when the Philistine arose and came and drew nigh to meet David, that David hasted, and ran toward the army to meet the Philistine._ The day you run towards what you fear, fear will start running from you.
*3. WISDOM MEASURES THE STEP BEFORE IT TAKES IT.*
This is what makes your bold step different. A foolish man jumps into any business because others are doing it. A wise man sits down first. Ask yourself: If I take this step, what will it cost me? What will I lose if I fail? What will I gain if it works? Do I have a covering? Do I have counsel? Jesus said in _Luke 14:28, For which of you, intending to build a tower, sitteth not down first, and counteth the cost?_ Boldness without calculation becomes bondage. So sit down. Count. Plan. Then STAND UP AND MOVE.
*4. WISDOM TAKES THE SMALL BOLD STEP, NOT ALWAYS THE BIG ONE.*
You want to stay ahead of others, but you are waiting for one big break. No! Life moves by small bold steps taken consistently. That phone call you are afraid to make to that Director. That proposal you have not submitted. That apology you have not given in your family. That is the bold step that will open the big door. _Zechariah 4:10 says, For who hath despised the day of small things?_ That small email you send today can put you ahead of 100 people tomorrow. Don’t despise small boldness.
*5. WISDOM KNOWS WHEN IT IS TIME TO LEAVE THE OLD PLACE.*
Some of you are stuck in business, in career, in a relationship that is draining you, because you are sentimental about a place God has told you to leave. You have compassed that same mountain, same level, same complaint for 3 years. God is saying “You have stayed long enough here.” A bold step sometimes is to QUIT what is not working. Abraham had to leave his father’s house to become a nation. _Genesis 12:1 says, Get thee out of thy country… unto a land that I will shew thee._ It takes wisdom to know that staying is now more dangerous than moving.
*6. WISDOM DOES NOT WAIT FOR EVERYBODY TO AGREE BEFORE IT MOVES.*
If you wait for your family, your colleagues, your village people to all clap for your decision, you will never move. Bold people are often lonely at the point of decision. Joseph took a bold step to dream, his brothers did not agree. David took a bold step to face Goliath, his brothers mocked him. Move anyway. When the result comes, those who did not agree will come and celebrate. _Proverbs 21:5 says, The thoughts of the diligent tend only to plenteousness._ Be diligent in your mind, make up your mind, then move.
*7. WISDOM TAKES A BOLD STEP AND LEAVES THE RESULT TO GOD.*
This is the final secret to stay ahead when things are tough. After you have prayed, planned, counted the cost, taken the small step, LEAVE THE OUTCOME TO GOD. You are not God to know if it will fail or succeed. Your job is to step. God’s job is to establish. Some steps will bring profit, some will bring lessons, but none will leave you where you were. _Proverbs 16:9 says, A man’s heart deviseth his way: but the LORD directeth his steps._ When you take one step, God directs the next 10 steps.
*FINAL WORD FOR YOU:*
Stop waiting for the tough time to end before you move. Tough time will not end — but wise men learn to make progress INSIDE the tough time.
In your business, take that bold step to start again.
In your career, take that bold step to learn that course, write that exam.
In your family, take that bold step to forgive, to love again.
As a Director, take that bold step to reform that department.
As a junior staff, take that bold step to show excellence where others are complaining.
You will not remain behind. You will stay ahead.
*PRAYER FOR YOU:*
Father, in the name of Jesus, I pray for every heart that is discouraged, that is confused. In this tough season, give them light to see the next step. Give them courage to take a bold step. Remove the spirit of fear, of delay, of procrastination. Let their small step become a great testimony. Where others are stuck, let them move forward. Let them stay ahead by wisdom, in Jesus mighty name, Amen.
—
*THE MINISTRY OF WISDOM – WISDOM TO TAKE A BOLD STEP WHEN LIFE IS TOUGH*
_Topic: WISDOM TO MOVE FORWARD WHEN EVERYTHING IS SAYING “STAY”_
_2 Chronicles 20:17 says, Ye shall not need to fight in this battle: set yourselves, stand ye still, and see the salvation of the LORD._
_Deuteronomy 2:3 says, Ye have compassed this mountain long enough: turn you northward._
Hear me, child of God. There is a time to pray, there is a time to wait, but there is also a time to TAKE A BOLD STEP. Many destinies are stuck not because God did not speak, but because the man refused to move.
You are praying for open doors in business, but you have not taken the bold step to start. You are praying for promotion as a Director or for a job as a junior staff, but you have not taken the bold step to improve yourself. You are praying for that relationship, that family to be healed, but you are still waiting for perfect condition.
Listen, perfect condition will never come. Tough time will always be there. But wise men move even when it is tough.
*1. WISDOM KNOWS THAT A BOLD STEP IS NOT FOOLISHNESS, IT IS FAITH WITH WORKS.*
Many people confuse boldness with rashness. No! To resign without a plan is not boldness, it is foolishness. But to start that small business while you are still employed, that is wisdom. To learn that new skill while you are still a junior staff, that is wisdom. Faith says “God will do it.” Wisdom says “God will do it THROUGH the step I am taking.” _James 2:17 says, Even so faith, if it hath not works, is dead, being alone._ Your bold step is the leg that your faith will stand on.
*2. WISDOM TAKES A BOLD STEP EVEN WHEN FEAR IS PRESENT.*
You will never be free from fear before you move. Fear will be there. Discouragement will be there. The market is tough, capital is small, people may laugh — fear will speak. But wisdom does not wait for fear to disappear, it moves with fear trembling under its feet. David was afraid of Goliath’s size, but he still ran towards him. _1 Samuel 17:48 says, And it came to pass, when the Philistine arose and came and drew nigh to meet David, that David hasted, and ran toward the army to meet the Philistine._ The day you run towards what you fear, fear will start running from you.
*3. WISDOM MEASURES THE STEP BEFORE IT TAKES IT.*
This is what makes your bold step different. A foolish man jumps into any business because others are doing it. A wise man sits down first. Ask yourself: If I take this step, what will it cost me? What will I lose if I fail? What will I gain if it works? Do I have a covering? Do I have counsel? Jesus said in _Luke 14:28, For which of you, intending to build a tower, sitteth not down first, and counteth the cost?_ Boldness without calculation becomes bondage. So sit down. Count. Plan. Then STAND UP AND MOVE.
*4. WISDOM TAKES THE SMALL BOLD STEP, NOT ALWAYS THE BIG ONE.*
You want to stay ahead of others, but you are waiting for one big break. No! Life moves by small bold steps taken consistently. That phone call you are afraid to make to that Director. That proposal you have not submitted. That apology you have not given in your family. That is the bold step that will open the big door. _Zechariah 4:10 says, For who hath despised the day of small things?_ That small email you send today can put you ahead of 100 people tomorrow. Don’t despise small boldness.
*5. WISDOM KNOWS WHEN IT IS TIME TO LEAVE THE OLD PLACE.*
Some of you are stuck in business, in career, in a relationship that is draining you, because you are sentimental about a place God has told you to leave. You have compassed that same mountain, same level, same complaint for 3 years. God is saying “You have stayed long enough here.” A bold step sometimes is to QUIT what is not working. Abraham had to leave his father’s house to become a nation. _Genesis 12:1 says, Get thee out of thy country… unto a land that I will shew thee._ It takes wisdom to know that staying is now more dangerous than moving.
*6. WISDOM DOES NOT WAIT FOR EVERYBODY TO AGREE BEFORE IT MOVES.*
If you wait for your family, your colleagues, your village people to all clap for your decision, you will never move. Bold people are often lonely at the point of decision. Joseph took a bold step to dream, his brothers did not agree. David took a bold step to face Goliath, his brothers mocked him. Move anyway. When the result comes, those who did not agree will come and celebrate. _Proverbs 21:5 says, The thoughts of the diligent tend only to plenteousness._ Be diligent in your mind, make up your mind, then move.
*7. WISDOM TAKES A BOLD STEP AND LEAVES THE RESULT TO GOD.*
This is the final secret to stay ahead when things are tough. After you have prayed, planned, counted the cost, taken the small step, LEAVE THE OUTCOME TO GOD. You are not God to know if it will fail or succeed. Your job is to step. God’s job is to establish. Some steps will bring profit, some will bring lessons, but none will leave you where you were. _Proverbs 16:9 says, A man’s heart deviseth his way: but the LORD directeth his steps._ When you take one step, God directs the next 10 steps.
*FINAL WORD FOR YOU:*
Stop waiting for the tough time to end before you move. Tough time will not end — but wise men learn to make progress INSIDE the tough time.
In your business, take that bold step to start again.
In your career, take that bold step to learn that course, write that exam.
In your family, take that bold step to forgive, to love again.
As a Director, take that bold step to reform that department.
As a junior staff, take that bold step to show excellence where others are complaining.
You will not remain behind. You will stay ahead.
*PRAYER FOR YOU:*
Father, in the name of Jesus, I pray for every heart that is discouraged, that is confused. In this tough season, give them light to see the next step. Give them courage to take a bold step. Remove the spirit of fear, of delay, of procrastination. Let their small step become a great testimony. Where others are stuck, let them move forward. Let them stay ahead by wisdom, in Jesus mighty name, Amen.