Maureen Moneke and Christopher Bassey (Lead writers)
Sexual and reproductive health and rights (SRHR) is crucial in attaining several Sustainable Development Goals (SDGs), particularly those on good health and wellbeing, quality education, gender equality and reduced inequalities.
In Nigeria, this urgency is heightened by its youthful population, which makes up about 70% of the country’s population. However, access to modern contraceptives and youth-friendly SRHR services remains less despite the size of this demographic.
According to the 2023 Nigeria Demographic and Health Survey(NDHS), the modern contraceptive prevalence rate (mCPR) among married women is 14%, and 3.3% among adolescent girls aged 15–19. The unmet need for family planning is 15.8% among adolescents aged 15–19 (including married and sexually active unmarried), rising to 21% among women aged 20–24 and 22% among those aged 30–34.
At the recent Nigeria Health Watch policy dialogue themed “Closing Reproductive Health Impact Gaps: Strategic Approaches for Equity and Access”, stakeholders highlighted challenges and outlined strategies to strengthen equitable access to SRHR products and services across Nigeria’s healthcare system.
The economics of family planning
According to Vivianne Ihekweazu, Managing Director at Nigeria Health Watch, SRHR is not just a health issue, but an economic imperative. When girls and women can decide if, when, and how many children to have, the benefits extend far beyond individual families. Evidence supports this; for every additional US$1 invested in meeting the unmet need for modern contraception, reduces health care costs by US$3.
“Universal Health Coverage cannot be attained without universal SRHR access,” she said, noting that better maternal health, higher school completion rates, and a more resilient economy all depend on this integration.
The rapid growth in Nigeria’s population, without corresponding investment in SRHR and education, deepens poverty, restricts women’s ability to make informed decisions about their family size and places greater strain on national budgets. Young people continue to face multiple barriers, including limited knowledge of contraceptive services, social stigma, inadequate access to youth-friendly services, poor attitude among healthcare providers, and lack of confidentiality when seeking SRHR products and services.
Despite these challenges, Nigeria’s national family planning budget has been reduced by 97% from the ₦2.225 billion allocated in 2024 to ₦66.39 million in 2025. This funding shortfall exacerbates commodity stock-outs, restricts youth-friendly services, and threatens progress towards achieving the country’s FP2030 commitments.
It is essential to shift conversations around SRHR from seeing it as a cost to recognising it as a driver of economic resilience and national productivity. However, Dr Binyerem Ukaire, Director of the Department of Family Health at the Federal Ministry of Health and Social Welfare, highlighted the government’s efforts to bridge funding gaps and improve family planning outcomes in the country.
Social Welfare, giving her keynote address. Image credit: Nigeria Health Watch
She asserted that, “through the Presidential Initiative for Unlocking the Healthcare Value Chain, the Medipool is deploying 6 million U.S dollars for procurement of family planning products and ensuring good logistics supply management system for these commodities.”
Domestic innovation: examples worth scaling
Domestic financing for SRHR is critical to guarantee sustainable access to essential services. Thankfully, innovative financing models exist at Nigerian sub-national levels.
Kano State has made significant progress in improving access to family planning services by allocating a portion of the Kano State Health Trust Fund, which pools contributions from all 44 local governments and internally generated revenue. According to Pharmacist Aminu Bashir, Permanent Secretary of the Kano State Ministry of Health, the state has created its first-ever budget line for family planning, and established a tripartite funding partnership with the Gates Foundation and other partners.
Image credit: Nigeria Health Watch
Ogun State receives just $0.04 per capita in donor support, compared to Kano’s $1.07. However, Dr Tomi Coker, the Commissioner for Health, Ogun State emphasised the state’s commitment to financial independence, stating, “My strategy is to use what is existing to fund what is essential, and one thing that we tend to ignore, that is existing, is the Basic Health Care Provision Fund.”
Despite these and other similar initiatives, systemic barriers to accessing SRHR products and services persist. Dr. Taiwo, Country Director of The Challenge Initiative (TCI) Nigeria, noted that the existence of a budget line does not guarantee that funds will be approved, released, or effectively utilised. Across Nigeria, procurement delays and fragmented supply chains often result in stock-outs, affecting health facilities, and undermining both service quality and public trust. She highlighted that “we look at the logistics management information system and see that some states have 60–70% stock out of family planning commodities.”
Ogun’s self-reliant model does not overlook the value of external partnerships, but it demonstrates that with strong governance and effective public financial management systems, states can reduce reliance on donor funding and better safeguard essential health services from political or financial instability.
Image credit: Nigeria Health Watch
Improving access to youth-friendly services
Improving access to youth-friendly sexual and reproductive health (SRH) services requires layered, context-specific innovations. One example is the Machakos Youth Drop-in Centre in Kenya, which provides a judgement-free environment and youth friendly services tailored to the needs and realities of young people.
Similarly, Healthtracka is using discreet, self-testing kits called “Lemon kit” to help young women in Nigeria screen for STIs without stigma. In her words, Testimony Adeyemi, Marketing Lead at Healthtracka, stated “by partnering with the largest pharmacy chain, girls can access tests simply by asking for lemon — no questions asked.”
Expanding comprehensive sexuality education, both within and beyond school settings, is crucial to empower young people with accurate information about their sexual and reproductive health and rights.
In Africa, one in every five girls becomes pregnant before the age of 19, however research show that when young people have access to high-quality education, they are more likely to delay sexual activity and make safer and informed choices.
Mallam Ghali Dambazau, Assistant Director at the Ministry of Education, noted that the Ministry is working closely with the Ministry of Health to deliver comprehensive SRHR education. While trained teachers provide classroom instruction through the Family Life and HIV Education curriculum, health providers also visit schools to offer services, reinforce lessons, and support students with accurate information.
Despite Nigeria’s progressive policies and FP commitments like integrating family planning services into UHC and expanding youth-friendly services, reality tells a different story. Margret Bolaji, Youth Partnership Manager, FP2030, noted that“we need continuous provider training, supportive supervision and a mindset shift to treat adolescents professionally as clients.”
Digital tools are also vital in expanding access and ensuring confidentiality. By leveraging online platforms, it is possible to broaden reach, provide reliable information, and counter misinformation.
Dr. Fatima Bunza, Country Director of Tiko Nigeria, emphasised the importance of combining high-tech, low-tech, and no-tech solutions to reach diverse youth populations. For instance, physical Tiko cards distributed by trained community mobilisers provide access for girls without mobile phones, enabling them to enrol in and benefit from SRHR services.
Closing Nigeria’s SRHR impact gaps
With donor support declining and Nigeria’s population projected to nearly double by 2050, investing in SRHR has never been more critical. Failure to act risks deepening poverty, increasing maternal and child mortality, and preventing millions of young people from realising their reproductive rights.
However, by scaling proven approaches such as domestic financing models, inclusive multi-stakeholder partnerships, and youth-driven programme design, Nigeria can make significant progress and achieve its FP2030 commitments. This shift would move SRHR beyond donor dependency, positioning it as a powerful driver for economic growth and social development.
Spot on! We need to study our peculiarity as a nation and understand the strategy that will work in ensuring health is prioritized on all front.