While her classmates were preparing for the West African Senior School Certificate Examination (WASSCE), 16-year-old Zuhara (not her real name) was forced to drop out of school in May 2025. She was pregnant.
In her remote village of Shere, located 13 kilometres from the nearest urban centre, access to healthcare is limited. Conversations about menstruation, sexuality and contraception are often shrouded in silence. Youth-friendly clinics are non-existent. There are no female doctors. There are no safe spaces for girls to ask questions.
“There was nowhere to go, no one to talk to. My pregnancy was unplanned – and entirely preventable,” Zuhara said, with quiet resolve.
Her story is echoed across communities in Nigeria, which has one of the highest adolescent fertility rates in the world – 117 births per 1,000 girls aged 15 to 19. Thousands of adolescents like Zuhara are caught in cycles of stigma, missed education and lost potential, simply for becoming pregnant in systems that failed them.
It was against this backdrop that a National Policy Dialogue was recently convened in Abuja to address adolescent access to sexual and reproductive health (SRH) services. Organised by Nigeria Health Watch and development partners, the dialogue underscored the urgent need for Nigeria to fund its adolescent reproductive health services more intentionally and sustainably.
With the 2030 Sustainable Development Goals deadline looming and external donor support dwindling, stakeholders at the event made one thing clear: If Nigeria does not start funding adolescent reproductive health from its own purse, the consequences will be devastating.
Recent research by Nigeria Health Watch, drawn from an Integrated Community Listening Survey in six states, revealed that half of all young respondents aged 18 to 34 struggled to access sexual and reproductive health and rights (SRHR) services.
“Despite decades of investments, we are still grappling with low awareness, long distances to health facilities, social stigma and weak service delivery,” said knowledge management lead, Anwuli Nwankwo at Nigeria Health Watch.
Nwankwo highlighted that misinformation and harmful cultural norms continue to act as major barriers for adolescent girls seeking information and care.
“Primary healthcare centres remain the first point of contact for many people, yet many are not equipped to deliver comprehensive SRHR services. In several states, there are no budget lines – so services don’t exist at all,” she added.
This disconnect has direct consequences. Girls like Zuhara pay the price with their futures, while health systems remain unable to respond adequately to growing needs.
Some states, however, are charting their own path.
Ogun State Commissioner for Health, Dr Tomi Coker disclosed that although the state received only $0.04 per capita in donor funding, it had remained committed to supporting adolescent reproductive health through homegrown resources.
She pointed to Ogun’s Maternal and Adolescent Maternal and Infant (MAMI) project as a state-funded success, with medicine procurement and supply chain management driven internally. A co-funding model, introduced by The Challenge Initiative (TCI), helped shift ownership gradually from donors to government, she said.
“We cannot continue to rely on handouts. This is about national sovereignty and long-term resilience,” Coker declared.
In Kano State, innovation has also helped close the gap. Permanent secretary in the Kano State Ministry of Health, Aminu Bashir revealed that the state created the Kano Health Trust Fund, pooling contributions from its 44 local governments and internally generated revenue.
“For the first time, Kano earmarked ₦500 million in its annual budget for family planning,” Bashir said.
The fund operates through a three-party arrangement involving the Kano government, the Bill & Melinda Gates Foundation and the Lafiya Project. This collaborative model has ensured continuity and scale for SRHR programmes in the state.
Yet experts argue that programmes targeting schools are just as important.
An assistant director of education working on adolescent health, Malam Talle Dambazau emphasised the importance of implementing the Family Life and HIV Education (FLHE) curriculum in Nigerian schools. “We need stronger collaboration between federal and state governments to ensure trained teachers deliver this curriculum and connect students with health and psychosocial services,” he said.
In 2023, the Federal Ministries of Health and Education jointly adopted a national framework for youth well-being. The framework promotes school-based interventions, digital learning and hygiene education, but implementation remains slow in many rural and underserved areas.
The Minister of Health and Social Welfare, Prof. Ali Pate made a compelling economic case for investment in adolescent health.
“Family planning is not just a health issue; it is a lever for economic growth, gender equity and national development,” Pate said. He reiterated the government’s commitment to expanding youth-friendly services, deploying mobile clinics, digitising data, and improving supply chains via the new Procurement and Value Chain Advisory Council.
However, implementation still varies widely from state to state.
For organisations like Tiko Nigeria, tech-enabled low-cost solutions remain vital. Tiko’s country director, Dr Fatima Bunza advocated for hybrid interventions, such as smartphone-based counselling and community eco-cards that link young people with services.
“Low-tech isn’t a fallback – it’s the core of our outreach model. It reaches girls others can’t,” she said.
Healthtracka, another private initiative, has launched “Lola AI” – a WhatsApp-based chatbot that delivers adolescent-focused SRHR content in simple language. “Lola speaks in a way that girls understand and trust,” said Testimony Adeyemi, the project’s marketing lead.
Personal stories also reminded attendees of the human cost of inaction.
Africa access lead at Organon, Mashishi Mokgadi recalled the story of Lucy, a 15-year-old girl who became pregnant due to lack of contraceptives, dropped out of school, and was married off.
“Lucy’s story is not just personal; it’s national. It touches every SDG, every sector. We can’t keep watering the flowers while the house burns,” Mokgadi said.
Organon, she added, is committed to preventing 120 million unintended pregnancies by 2030 and is already more than halfway toward that goal. She urged African governments to establish clear budget lines for SRHR, remove legal barriers, and treat health investments as drivers of development. Not costs.
The call for youth involvement was loud and clear.
Youth partnerships officer at FP2030, Margaret Bolaji emphasised youth-led accountability and spotlighted innovations like the “Lemon” STI self-testing kits for girls.
“Young people aren’t just beneficiaries, we are designers, leaders and watchdogs,” she said.
Peace Umanah of IYAFP Nigeria echoed this. “We need to stop being vague. Donors are moved by authentic voices. Speak from lived experience,” she urged.
At the end of the policy dialogue, one message rang loudest: If Nigeria wants to save its girls, protect their future, and meet its global development goals, it must begin by funding adolescent reproductive health robustly and sustainably.
Analysts believe that without this financial and political will, adolescent pregnancy will continue to rob Nigeria of its brightest minds, reinforce cycles of poverty and destabilise progress in education, gender equality and public health.
They argue that investing in adolescent SRHR is not just a human rights imperative. It’s a strategy for national development. It means girls like Zuhara won’t be forced out of school. It means Lucy’s story won’t be repeated. It means the house won’t burn. And the time to act is now.
