Thought Leadership

Why Investing in Nigerians’ Reproductive Health Fuels Rights, Choice, and Progress

4 Mins read

Precious Ajayi and Sheriff Gbadamosi (Lead writers)

Nigeria is the most populous country in Africa and the sixth most populous country globally, with an estimated population of 236.7 million people. With an annual growth rate of 2.52%, the population is projected to double by 2050.

According to the 2025 United Nations Population Fund (UNFPA) report, 32% of respondents identified two children as the ideal family size. However, more than one in ten Nigerians report having more children than they desired. This gap between aspiration and reality reflects what UNFPA described as a “real fertility crisis”, not an issue of overpopulation or underpopulation, but the inability of individuals to achieve their reproductive goals.

This year’s World Population Day highlighted population dynamics and their implications for development, equality, and wellbeing. The theme “Empowering young people to create the families they want in a fair and hopeful world,” urged a shift in how fertility crises are understood, emphasising the need to focus on individual’s ability to exercise reproductive choice.

It was also a call to promote reproductive agency, which is more than just freedom from coercion or improved access to services; but the broader conditions that enable individuals to exercise their reproductive rights. These include gender equality, economic stability, quality healthcare, and confidence in a secure future.

Image credit: Nigeria Health Watch

Nigeria’s fertility crisis

The recent State of World Population report highlighted several concerning findings, noting that globally, nearly half of all pregnancies are unintended. 
In Nigeria, approximately, one in five pregnancies each year is unplanned, and more than half these end in abortion.

The consequences of unintended pregnancies are profound, placing financial strain on family, affecting overall health and well-being, and frequently causing school dropout among girls. They also significantly contribute to unsafe abortions and are a major driver of high maternal deaths
The real fertility crisis in Nigeria is rooted in significant barriers to reproductive agency, including:

  • Limited access to Sexual Reproductive and Health Rights (SRHR) services: In Nigeria, over 14 million women lack access to modern family planning methods due to inadequate supply, a limited range of contraceptive options, long distances to health facilities, and low confidence in available methods. The current uptake of modern contraceptives, the modern contraceptive prevalence rate (mCPR) among women aged 15–49 is only 14%, far below the global average of 44%. One-in-four women of reproductive age have an unmet need for family planning, meaning they wish to delay or avoid but are not using any method.
  • Socio-cultural norms: Strong pressure from family, community, and religious organisations often compel individuals to have more children than they desire. According to the UNFPA survey, 35% of Nigerian respondents cited social pressures as a reason for having, or expecting to have, more children than they desired. In some regions, a marketed preference for sons further drives continued childbearing.
  • Misinformation and lack of education: Persistent misconceptions about contraceptives, such as beliefs that they cause permanent infertility, continue to hinder uptake. Limited access to comprehensive sex education in schools and youth centres, and the absence of unbiased information outside these settings, contribute to poor reproductive health knowledge. The State of World Population reports that 38% of women who had abortions were unaware of family planning, while 17% feared side effects, and 6% lacked access or faced objections from their partners or family. Adolescent pregnancies are more prevalent in rural and less-educated communities, where lower education levels are strongly associated with increased maternal mortality risk.
  • Legal restrictions and gender-based violence: Abortion in Nigeria is legally allowed only when a pregnancy threatens a woman’s health resulting in many women seeking unsafe abortions. These unsafe procedures contribute to Nigeria’s high maternal mortality rate and severe health complications. Gender-based violence further limits reproductive autonomy, forced sexual relations within marriage are permitted under Nigerian criminal law, and child marriage remains common, especially in Northern Nigeria, where girls are often coerced into marriage as young as 12.
Image credit: Nigeria Health Watch

How Nigeria can do better

1. Increase Domestic Funding and Strengthen Political Commitment for SRHR:

Despite Nigeria’s stated commitments to sexual and reproductive health, including it FP2030 agenda, public funding for family planning and SRHR continues to fall short. The recent National SRHR Policy Dialogue in Abuja highlighted the gap between political rhetoric and sustained investment. With donor support declining, domestic resource mobilisation remains critical. Alarmingly, the proposed allocation for family planning in the 2025 national health budget has been cut to ₦66.39 million, a 97% reduction from the ₦2.225 billion allocated in 2024.

Without urgent reinvestment, Nigeria risks reversing decades of progress in family planning and SRHR. Increased funding must be accompanied by strong accountability mechanisms to ensure resources reach last-mile communities, where unmet needs remain highest.

2. Strengthen Comprehensive SRHR Services: 

Nigeria should ensure that, regardless of age, gender, location, or ability, has access to high-quality, affordable sexual and reproductive healthcare. This requires removing outdated restrictions, such as age limits or spousal consent requirements, and addressing provider bias to guarantee that choices are informed and voluntary. We must shore up our supply chains by investing in local contraceptive production and price regulation. Lessons can be drawn from Kenya and Rwanda, where drones now deliver commodities to remote communities. Nigeria should adopt international best practices such as the Minimum Initial Service Package for SRH in Emergencies, to protect lives are preserve and dignity even during crisis,

3. Prioritise Education and Information Dissemination:

Nigeria should introduce and sustain age-appropriate, rights-based, comprehensive sex education in schools. This includes non-stigmatising information on fertility awareness and reinforcing the importance of keeping girls in school. Combating widespread misinformation on sexual and reproductive health requires reliable digital resources and active community engagement. Innovative solutions like the Text4Life service, which enables individuals to confidentially report unplanned pregnancies and gender-based violence, can provide vital information and support.

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