Adolescent pregnancy remains a significant public health issue in Nigeria, with high rates of unintended pregnancies and associated negative outcomes. A comparative study design was employed to assess adherence rates to health education programme interventions among adolescents in three major Nigerian cities. Adherence rates varied significantly, ranging from 45% to 60%, with urban areas showing higher adherence compared to rural settings. Health education programmes demonstrated varying levels of effectiveness across different geographical regions and must be tailored to specific contexts for optimal impact. Programmes should incorporate community engagement strategies, utilise digital platforms, and provide ongoing support to enhance long-term efficacy.