Experts in Nigeria’s health sector have identified unequal power structures, harmful cultural norms, poor funding, and systemic silence as major threats stalling progress in sexual and reproductive health and rights (SRHR) across the country.
At a panel session during the 2025 Insight Learning Forum (ILF) held Wednesday in Abuja, they called for urgent policy and cultural reforms to address longstanding gender inequities.
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They emphasised that the government must show commitment to tackling maternal deaths, teenage pregnancy, and gender-based violence.
Speaking during the session tagged “The Role of Digital Tools and Innovative Financing Models in Expanding Access to SRHR,” the Country Director at Plan International Nigeria, Charles Usie, argued that Nigeria’s SRHR crisis cannot be solved without a deliberate and provocative disruption of cultural and religious structures that have historically restricted women’s autonomy.
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Mr Usie noted that the conversation around SRHR must shift from framing it as a health issue alone to understanding it as a matter of power and control, particularly over women’s bodies, voices, and access to resources.
“We are talking about sexual and reproductive health and rights, but let’s be clear, we are dealing with an issue of unequal power. Women and girls do not have the same authority men enjoy. That’s why we have more condoms than sanitary pads because of who makes the decisions,” he said.
He emphasised that cultural and religious leaders often seen as untouchable must be challenged head-on.
“Triggering is too soft, we must provoke them. In 2025, women still need permission from husbands to access care. Even powerful women, directors, and professors are trapped in this system. What about poor women in rural communities? That’s the depth of the problem,” he added.
He said the most powerful tool for transforming healthcare is the budget.
“The most powerful tool in health is the budget. But how many women’s voices are reflected in our national budget? We spend billions and then gather in rooms like this asking how to help women. The answer is right there in the money.”
Nigeria’s SRHR crisis
Millions of Nigerian women lack access to modern contraception, maternal health services, and emergency care.
According to 2021 data, only 12 per cent of Nigerian women use modern contraceptives, while the unmet need for contraception stands at over 19 million.
Meanwhile, nearly 44 per cent of girls are married before the age of 18, exposing them to early pregnancies and heightened health risks.
Nigeria’s maternal mortality is among the highest in the world at over 1,000 deaths per 100,000 live births, nearly double the sub-Saharan African average.
Also, survivors of gender-based violence often have no place to turn and as of 2025, Nigeria has only 42 functioning GBV referral centers spread across just 22 of the country’s 36 states and the FCT.
SRHR services, where available, are often hindered by poor infrastructure, lack of trained personnel, financial exclusion, and deep-rooted cultural resistance.
Despite existing legal frameworks and health policies, enforcement remains weak, leaving many women in underserved and rural communities, unable to make decisions about their health or access essential services without male permission or interventions.
Collaborations with cultural leaders
Kemi Dasilva-Ibru, founder of the Women at Risk International Foundation (WARIF), highlighted the complexity of engaging traditional and religious leaders, many of whom reinforce harmful practices.
Ms Dasilva-Ibru acknowledged that while patriarchy cannot be ignored, cultural gatekeepers must be engaged strategically and not avoided.
“We must bring them in, educate them, show them that aligning with the rights of women is in their best interest. If I walk into a community accusing them of rape and child marriage, no one listens. But if I talk about the well-being of their daughters, the conversation changes,” she said.
She added that Nigeria lacks not just infrastructure, but also empathy and data-driven action.
“As a founder, where we run rape crisis centres, 78 per cent of survivors are under 18. The youngest I’ve treated was seven years old. And we only have 42 GBV centers in 22 states. That’s outrageous,” she said.
She also called for the integration of SRHR into national health policies and universal health coverage, not as a separate silo, but as part of the core system.
Patriarchy, power structures
In her comments, the Executive Director at HACEY, Rhoda Robinson, said that Nigeria’s gender inequality is not just systemic but generational, taught before girls even understand their place in the world.
Ms Robinson described it as ‘ingrained in our blood,’ reinforced through rigid social roles, unequal opportunity, and silence.
She noted that the power to make decisions is often denied to women from birth, leaving them dependent on families, husbands, or society to determine what is acceptable.
She said, “A lot of women are not allowed to make decisions. The family, the system, the society decides what she can or cannot do. Even educated women are still expected not to rise too high. We need to raise girls who see a future beyond motherhood and survival.”
She emphasised intersectionality, acknowledging that a woman’s experience varies widely depending on her age, location, wealth, education, and even disability status.
To change the narrative, she said, Nigeria must show girls a different future, one where they are more than wives, mothers, or economic dependents.
She also stressed the importance of bringing local leaders into the conversation, instead of trying to change things from the outside.
“The only vision many girls see for themselves is to grow up, be respectful, and become mothers. We must create spaces where they can imagine and see a different future for themselves.”
She called for more intentionality in leadership development starting far earlier than adulthood.
Also speaking, a Public Health lecturer at Babcock University, Jonathan Dangana, said the crisis begins with how boys are raised and how conversations about sex and consent are avoided in homes, schools, and religious settings.
Mr Dangana said a girl is told how to behave in her husband’s house before she even knows what a husband is, meanwhile, boys are taught nothing about responsibility.
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He called for age-appropriate, comprehensive sexual education starting from nursery school and continuing through to tertiary institutions.
“If we don’t start early, we’re building on ignorance. Right now, 6 out of 10 girls under ten have already been exposed to sex. But nobody talks about the men responsible for their existence” he said.
He also criticised the generational disconnect in policymaking.
“We are designing solutions for Gen Zs without involving them in conversations like this. They’ll only listen to us out of respect but we’re here speaking in language they don’t resonate with. We need to involve them directly in shaping solutions to address these crises,” he said.
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