Strengthening Awareness, Action on Sexual and Reproductive Health in Nigeria

Reproduction is an integral aspect of ensuring the continuity of human societies. As such, while human societies evolve, creating opportunities for open discussion and education on sexual and reproductive health and rights remains a crucial aspect of building resilient societies. To this end, Global Citizens Africa, through its project Move Afrika, organised the ‘Stride for Her Rights’ advocacy walk, bringing together partners like HACEY and Worthy to strengthen awareness of sexual and reproductive health and rights in Nigeria. Esther Oluku reports

A sea of like-minded young individuals converged at AP filling station, Lekki, poised for the “Stride for Her Rights” walk to Lekki-Ikoyi Link Bridge to raise public awareness and inspire policy action on Sexual and Reproductive Health and Rights (SRHR).

This event, organised by Global Citizens Africa in collaboration with HACEY Health Initiative and Worthy was a call to action on curating SRHR-friendly policies, raising awareness on increased funding for SRHR, and inspiring social change aimed at bettering SRHR of young Nigerians. 

According to the World Health Organisation, sexual and reproductive health refers to a broad range of services which “cover access to contraception, fertility and infertility care, maternal and perinatal health, prevention and treatment of sexually transmitted infections,z protection from sexual and gender-based violence, and education on safe and healthy relationships.”

Access to SRHR is an important aspect of human rights, making for emotional, social and mental well-being. Sexual and reproductive health is part of a broader dream subsumed within universal health coverage.

A 2023 report by the Nigeria Demographic Health Survey (NDHS) shows that 15 per cent of adolescent girls aged 15-19 have experienced pregnancy. Globally, studies have shown that comprehensive sex education (CSE) significantly reduces risky sexual behaviour among young people.

The implementation of CSE in Nigerian schools remains fragmented, often facing resistance from conservative groups who view it as a threat to cultural and religious values. 

Raising Awareness on SRHR

The Director of Global Citizens Africa, Ifeoma Chuks-Adizue, noted that to close existing information gaps and increase funding support for sexual and reproductive health services, more private sector players need to understand the importance of sexual and reproductive health to overall well-being.

“The objective of the walk is to drive awareness around sexual and reproductive health care and maternal care for women, and the need to have increased financing in these areas as well as in the areas of community health workers because we have key challenges in these areas.

“This, she said, would require the support of partners and government in funding and policies to drive positive change.

“We still have a lot of preventable deaths. We have community health workers who are not fully equipped and could do more with more government support. We trust that as we do this with our partners and the Lagos state government, we’ll come out with more positive results that we can celebrate as a nation over time.”

Adolescents and Youth-targeted Programmes

On her part, the Executive Director of HACEY Health Initiative, Ms Rhoda Robinson, emphasised the importance of equipping young people with the knowledge and agency to make informed choices. This, she believes, can be achieved through curating of adolescents and youth-targeted programmes.

According to Robinson, programmes which speak to the specific SRHR needs of young people will arm them with accurate, relevant and timely information to lead more successful lives.

“We cannot keep ignoring the fact that young people need this information. Nigeria has one of the highest youth populations with new HIV infections. We need to provide them with comprehensive sexuality education (CSE) in a way that is age-appropriate, culturally relevant, and medically accurate.

“This is the only way to reduce teenage pregnancies, unsafe abortions, and the spread of sexually transmitted infections. More youth-friendly and youth-targeted health services and products are designed to fit the unique needs of both women and young girls as well.

“We are looking at how we can ensure that young people continue having the platforms to demand these rights and healthcare needs as well,” she said.

Addressing Concerns in Rural Communities

Founder of Women at Risk International Foundation (WARIF), Dr Kemi da Silva Ibru, stressed the need for grassroots investment in SRHR services, seeing that over half of the country’s total population live in rural communities.

Ibru stated that situations such as shortages of health professionals and facilities still force many mothers to seek maternal care from traditional birth attendants, which could exacerbate survival risks if the birth attendants are not well-trained.

Thus, broadening interventions to include the provision of training for traditional birth attendants can save the lives of women in rural communities while giving rural women access to care.

“Rural communities where 54 per cent of Nigerians live face the greatest challenges. Many women still rely on traditional birth attendants due to the absence of functional primary healthcare centres.

“Empowering community health workers and traditional birth attendants with modern medical knowledge and equipment can save lives. In Nigeria, it’s 512 deaths per 100,000 live births. This is unacceptable.”

Raising Awareness of Contraceptives 

A 2020 WHO report found that globally, countries with liberal abortion laws tend to have lower abortion rates due to better access to contraception and reproductive health education. Nigeria, however, remains divided, with strong religious and cultural opposition to law reform. 

Robinson opined that increasing education on contraceptives and risks, as well as complications from unsafe abortions, would contribute significantly to improving women’s health and reducing maternal mortality. 

She stressed that access to contraceptive care will, in no small, prevent unwanted pregnancies.

“If we equip young people with the right information, we wouldn’t be having these conversations about unsafe abortion. More pregnancies would be planned and wanted. But in cases where abortion is necessary for medical reasons, it should be done safely, within the legal framework.”

Funding and Policy Implementation  

While advocacy is crucial, translating words into action requires government commitment both in policy and funding. Robinson insists that a holistic approach to SRHR would include developing policies backed by adequate funding to ensure implementation and improved health outcomes.

These would involve the multi-pronged partnership of private partners, non-governmental organisations and the government catering to funding needs and policy enforcement.

“We need to develop these policies and ensure that these policies speak to the problem. We are looking at it in terms of our partners. Private sector partners, media partners and development partners would be crucial on the one hand in rendering funding to support these initiatives and conducting research and development towards SRHR.

“The government has an active role not just in providing policies or ensuring that they have the right budgetary and human personnel allocation, but also in ensuring that they create a conducive platform and environment for partners to come together, and also for young people to seek the services out.”

Government’s Action on Maternal Health

The Special Adviser to the Lagos State Government on Health, Kemi Ogunyemi, acknowledged the existing gaps in SRHR while highlighting ongoing efforts to improve sexual and reproductive health in the state. 

Speaking on the state government’s action plan to curb incidences of maternal mortality, she said: “One of the biggest causes of maternal mortality is postpartum haemorrhage, and we are continuously training midwives, community health workers, and doctors on how to manage these emergencies.

“We have also increased funding for maternal health and expanded access to free healthcare through the Ilera Eko health insurance program for pregnant women in Lagos State.”

Societal and Media Role  

Cultural resistance remains a significant challenge in addressing SRHR issues as many young people lack the confidence to seek reproductive healthcare due to fear of stigmatisation.

Actress and social media influencer Ms Ada Afoluwake Ogunkeye, popularly known as Folu Storms, highlighted the role of people in society and social media channels in shaping narratives and bringing social change.

“Everyone is an influencer in their own right, whether in our homes, schools, churches, or mosques. This is a reminder that, in very small ways, we can support each other.

“If we don’t look after our healthcare systems, one day, you, me, or somebody that you love is going to be in a critical position, and we will then be wailing about a failed country. You and I are responsible for this country.

“So when we have problems, you and I, nine times out of 10, are part of the problem. So you and I have to be part of the solution.”

Prospects for the Future

Despite the challenges, sexual and reproductive health and rights challenges are garnering growing involvement of private organisations committed to ensuring improved reproductive and sexual health for the Nigerian public.

The ‘Stride for Her Rights’ walk represents one of many collaborations in the steps towards raising a healthier and empowered generation.