By Benjamin Joseph
Nigeria Health Watch’s national policy dialogue, themed “Closing Reproductive Health Impact Gaps – Strategic Approaches for Equity and Access,” sought to confront long-standing barriers preventing adolescents and underserved populations from accessing quality reproductive health services across Nigeria.
Despite the existence of multiple national strategies, global commitments, and a robust policy framework on sexual and reproductive health and rights (SRHR), Nigeria continues to witness widening gaps in service delivery and access. Millions of adolescents, rural women, and vulnerable groups are still unable to obtain essential reproductive health services; ranging from contraceptive access and maternal care to STI treatment and youth-friendly health information.
According to the 2023–2024 Nigeria Demographic and Health Surveyof, modern contraceptive prevalence among women aged 15–49 stands at only 15.3%, while the overall contraceptive prevalence rate (CPR) is just 20.3%. The national unmet need for family planning remains worryingly high at 21%.
These national averages obscure deep regional inequalities with states like Ekiti recording a modern contraceptive prevalence rate of 42.8%, compared to just 10.6% in Kano. These figures not only point to systemic weaknesses but highlight the urgent need to accelerate progress in delivering rights-based, equitable, and accessible reproductive health care.
Against this backdrop, In line with efforts to address these long-standing barriers preventing adolescents and underserved populations from accessing quality reproductive health services across Nigeria. Nigeria Health Watch convened a one-day National policy dialogue in Abuja under the theme: Closing Reproductive Health Impact Gaps – Strategic Approaches for Equity and Access.
The event convened key stakeholders and provided a platform to examine the realities faced by adolescents and marginalized groups, while also exploring strategic, multi-sectoral approaches to closing Nigeria’s reproductive health impact gaps. They included policymakers, youth representatives, healthcare providers, civil society leaders and private sector.
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“The Future of Health Lies in Equity and Access”– Vivianne Ihekweazu
Delivering the opening keynote address on behalf of Prof. Muhammad Ali Pate, Coordinating Minister of Health and Social Welfare, Vivianne Ihekweazu, Managing Director of Nigeria Health Watch, reiterated emphasized commitment to improving access to affordable and rights-based sexual and reproductive health care; particularly through equitable family planning services.
“Family planning is far more than a health intervention; it is a driver of economic growth, education, gender equality, and social transformation. It empowers individuals, strengthens families, and builds resilient societies,” she stated.
She acknowledged the deep-seated inequities in access to reproductive health services, citing barriers shaped by economic, socio-cultural, religious, and geographic realities, as well as funding and human resource constraints. These persistent gaps, she warned, continue to undermine the health and economic potential of millions of Nigerians.
“Access in this context encompasses availability, affordability, acceptability, and appropriateness of SRH services and information. Together, equity and access form the foundation of sustainable development and social justice.” Ihenkwazu said.
Ihekweazu emphasized that Nigeria’s FP2030 commitments are aligned with its broader Universal Health Coverage and Sustainable Development Goals, and must now be translated into measurable progress. She stressed the need to drive digitalization and innovation to accelerate service delivery
“The Nigerian health sector plans to gradually digitalize services and open new frontiers to improve access to family planning by leveraging technology, platforms, and digital tools including through mobile clinics, self-care, and public-private partnerships to scale up delivery,” she stated.
“Family Planning is Far More Than a Health Intervention; It’s a Driver of Social Transformation” – Dr. Ukaire
While delivering the address at the national policy dialogue, Dr. Binyerem C. Ukaire, Director of Family Health at the Federal Ministry of Health and Social Welfare, emphasized that family planning is not merely a clinical intervention, but a strategic tool for advancing education, economic growth, and gender equity.
“Family planning is far more than a health intervention. It is a driver of economic growth, education, gender equality, and social transformation. It empowers individuals, strengthens families, and builds resilient societies. That is why our work here is critical, not just for health outcomes but for national prosperity,” she said.
Dr. Ukaire noted that Nigeria’s FP2030 commitments are grounded in a rights-based approach that ensures equity in access which is defined not only by availability, but by affordability, acceptability, and appropriateness. She noted that government reforms are now leveraging digital platforms, mobile clinics, and self-care models to expand reach and enhance service.
“Access means more than proximity. It means services that are affordable, appropriate, and acceptable. That is why we are gradually digitalizing family planning services, offering mobile clinics, self-care interventions, and remote information to improve reach, particularly for those in remote and underserved areas, ” she noted.
She added that under the HOPE Agenda of the current administration, the Federal Ministry of Health has prioritized investments in health infrastructure, workforce training, and contraceptive supply chains. Key initiatives include the Basic Health Care Provision Fund, the new MAMI and the NHIA’s reimbursement model for family planning services.
“Without functional places to offer services, we can’t talk about closing the reproductive health gap. We are revitalizing our PHC facilities, integrating services across platforms; maternal and child health, HIV/AIDS, and adolescent health, while addressing chronic issues like stockouts through a stronger supply chain, ” Dr. Ukarie explained.
Policy is Not Enough: Aggressive, Coordinated Action Needed for Reproductive Health Equity
The first panel at the national policy dialogue, explore the recurring theme the urgent need for sustainable financing models, subnational commitment, and systemic accountability to close reproductive health impact gaps. One of the panelists, Dr. Binyerem Ukaire, Director of Family Health at the Federal Ministry of Health, reinforced her keynote address, described the impact of foreign aid cuts and noted that the Federal Government has mobilized $200 million to sustain access to SRHR, including malaria, TB, HIV, and family planning services.
“We cannot afford a situation where women are denied their right to access family planning products. Through the Basic Health Care Provision Fund, integration at PHCs, and commitment from NPHCDA, we’re making progress. In 2025, $6 million has been committed directly to SRHR. And through the DLI2 mechanism, states that commit to funding family planning will receive federal matching funds to sustain the cycle,” she explained.
At the subnational level, Pharmacist Aminu Bashir, from the Kano State Ministry of Health, highlighted creative financing strategies deployed in the state– a multi-pronged funding approach, including a N500 million allocation to family planning via its Health Trust Fund and a tripartite partnership with the Gates and Dangote Foundations. He also pointed the state’s integration of family planning into its Drug Revolving Fund.
“We cost commodities even if they are donor-funded. It helps facilities realize these aren’t free-for-all. We’ve also intensified high-level supervision, including by the Commissioner himself, to avoid leakages. The system now expects every missing product to be accounted for—this has improved service delivery and stock management tremendously,” he explained.
Dr. Ouwatomi Coker, Ogun State Commissioner for Health, in the same vein described how the state has successfully transitioned from donor dependency by leveraging basic healthcare funds, co-financing with UNFPA, and integrating family planning into its strategic budgeting in the state.
“We used to rely heavily on donor support, but today Ogun State is procuring its own family planning commodities, free at point-of-use. We’ve used BHCPF impress accounts at ward level and even small funds from our Drug Management Agency to plug gaps. Sustainability isn’t a buzzword—it’s now a reality for us,” Dr. Coker stated.
Panelists also acknowledged the central role of technology and youth engagement in closing
access gaps. Dr. Taiwo Johnson, Director of The Challenge Initiative (TCI), noted that despite the existence of budget lines, delays in fund approval and release still undermine progress. She emphasized the need for states to not only budget for FP services but also to institutionalize accountability mechanisms.
“Some states have the funds but haven’t released them. Others have had 70% stockout rates. That means a woman walks into a facility and finds nothing. We’re pushing for real-time data, co-created work plans, and supportive supervision. We don’t just train, we coach and mentor states into self-reliance,” she explained.
Addressing structural barriers from the education sector’s lens, Mal. Ghali Dambazau Talle, Assistant Director of Education for Health, Federal Ministry of Education, shared efforts to integrate sexual education through the Family Life and HIV Education (FLHE) curriculum. However, he cited challenges of decentralization, limited teacher training, and cultural sensitivities that restrict content delivery in many states.
“You can’t talk about condoms or HIV testing in most schools. There are structural, religious, and policy barriers that we must overcome. Teachers are trained, but without political and cultural alignment at the subnational level, implementation falters.” Mal. Talle explained.
Breaking the Silence: Private Sector and Youth Voices Driving SRHR Access
The second panel at the national policy dialogue explored how innovation, youth engagement, technology, and private sector collaboration can accelerate access to reproductive health services, particularly among adolescents and women. Speakers emphasized that family planning must be viewed as a strategic investment that requires empathy, systems integration, and inclusive financing models.
Mokgadi Mashishi, African Access Lead at Organon, stressed the need to approach sexual and reproductive health with a multi-sectoral lens that empowers women and ensures comprehensive, rights-based services. She also emphasized Organon’s global commitment to preventing over 120 million unintended pregnancies and tackling structural SRHR barriers.
“Family planning is not just a health sector issue—it’s every sector’s issue. Lack of access leads to early pregnancies, unsafe abortions, school dropout, poverty, and gender inequality. Every dollar invested in SRHR reduces future healthcare costs, boosts lifetime earnings, and frees up resources for schools and jobs. This is not just a moral imperative, it’s economic logic,” she stated.
Dr. Fatima Bunza, Country Director at Tiko Nigeria, highlighted the role of digital tools in linking underserved girls to youth-friendly services. She explained how Tiko’s technology enables girls to find safe information and locate nearby care options, while also helping implementers monitor service gaps.
“Technology helps eliminate shame and secrecy for girls seeking services. Many don’t even know where to get information, let alone who to ask. With Tiko, they can chat, be directed to safe locations, and access services with confidence. We also use the platform to track performance and reduce resource leakages,” Dr. Bunza explained.
In a similar vein, Peace Umanah, representing the International Youth Alliance for Family Planning (IYAFP), described how the organization partners with grassroots, youth-led initiatives across 40+ countries. She noted that stigma and provider bias continue to block youth access to contraception and SRHR information.
“Young people face affordability barriers, judgment from providers, and fear of exposure. Imagine going to a primary healthcare center and the nurse asks, ‘Does your mother know you’re here?’ That question alone pushes many away. We bridge funding gaps, amplify youth voices, and support local actors who know the terrain,” Umanah narrated.
Margaret Bolaji, Youth Partnership Manager FP2030 for North, West and Central Africa, emphasized Nigeria’s leadership in global family planning commitments. However, she warned that strong national policy is not translating into access on the ground for adolescent girls and young women.
“Yes, Nigeria has committed to FP2030. But when young people get to the clinic, they meet judgment, stockouts, and rejection. Some providers even say, ‘You don’t have a child yet? Wait until you do.’ This mindset must shift. We must move from policy to aggressive action, supervision, value clarification, and respectful, youth-centered care,” she stressed.
While wrapping up the panel discussion, bringing in a private sector innovation perspective, Testimony Adeyemi, Marketing Lead at Health Tracka, shared how the platform uses artificial intelligence (AI) to deliver confidential SRHR tools like Lola AI and youth-friendly STI testing kits in Nigeria.
“We built ‘Lemon’; an STI testing kit with no stigma attached. A girl walks into a pharmacy and asks for a Lemon, and she gets it. No judgment. With Lola AI, we’ve created a WhatsApp-based chatbot that gives young women verified, localized reproductive health information. We listen, we build with kindness, and we meet them where they are,” Adeyemi explained.
