The Integrated Community Listening Survey, conducted by Nigeria Health Watch in March and April 2025, has revealed enduring barriers that continue to hinder access to sexual and reproductive health and rights (SRHR) services, particularly among young adults and rural communities.
Knowledge management lead at Nigeria Health Watch, Anwuli Nwankwo disclosed the findings on Thursday in Abuja at the National Policy Dialogue on Improving Adolescent Access to Sexual and Reproductive Health Services, themed “Improving Adolescent Access to Quality Sexual and Reproductive Health Services.”
The event was organised by the Nigeria Health Watch and its partners.
In her presentation, Nwankwo noted that the survey’s findings come despite the country’s longstanding commitments and programmatic investments in SRHR.
She explained that the survey assessed access to and barriers against SRHR services across six states – Lagos, Ebonyi, Cross River, Kano, Niger and Borno – representing all six geopolitical zones of Nigeria.
“The cross-sectional study, which drew data from 414 participants, aimed to uncover the realities behind the stagnation in reproductive health progress in Nigeria,” she said.
Presenting the findings, she pointed out that while 50 per cent of respondents reported having access to SRHR services, the other half did not, with young people aged 18 to 34 encountering the greatest challenges.
“Primary healthcare centres remain the first point of contact for most participants, yet many of these facilities are unable to provide comprehensive sexual and reproductive health services,” she stated.
The survey identified cultural beliefs and lack of awareness as the most common barriers. Other obstacles included distance to health facilities, cost of services, inadequate funding and limited human resources in the health sector.
“These barriers were more prominent among respondents aged 35 to 54 who had previously experienced difficulty accessing reproductive healthcare,” she said.
Although 81 per cent of respondents claimed they had not faced any barriers, the remaining 19 per cent overwhelmingly cited sociocultural and informational limitations.
Alarmingly, Nwankwo emphasised that younger respondents, those between 18 and 34, were disproportionately affected, suggesting that Nigeria’s youth continue to face systemic challenges in realising their reproductive rights.
She explained that the survey also linked these access barriers to serious consequences, including maternal and infant mortality, unintended pregnancies, and implementation gaps in existing SRHR policies.
“While primary health centres dominate as initial points of contact, their effectiveness is undermined by entrenched systemic and social limitations,” she said. “There is an urgent need for a more targeted and culturally sensitive approach.”
Nwankwo urged the government and development partners to prioritise investment in awareness campaigns, community engagement and health system strengthening.
She further recommended expanding SRHR education through culturally appropriate communication strategies and enhancing the capacity of primary health centres to deliver integrated reproductive services. She also called for leveraging mobile health technologies to reach underserved and remote populations.
Nwankwo underscored the need to address the economic burden preventing many Nigerians from accessing these vital services.
While the study provided critical insights, she acknowledged its limitations, including the absence of qualitative data and health provider perspectives.
“We identified a lack of awareness as a common barrier, but we couldn’t fully explore why. Is it due to weak public campaigns or are community gatekeepers restricting information flow?” she asked.
Science Nigeria reports that without a deeper understanding of these root causes, interventions risk being misdirected or ineffective.
Nonetheless, stakeholders said the findings offer a solid foundation for more data-driven, inclusive policymaking that can help bridge the SRHR access gap and strengthen Nigeria’s commitment to ensuring reproductive health as a fundamental human right.
Recall that the National Policy Dialogue also aims to confront the country’s alarmingly high adolescent fertility rate of 117 births per 1,000 girls aged 15–19. It will further address the low uptake of modern contraceptives among sexually active, unmarried adolescent girls, currently at just 7.8 per cent.
