BY ABUJAH RACHEAL
Many Nigerian women, especially in rural areas, lack access to contraceptive services, leading to high fertility rates, economic strain and health risks. Mrs Haraya Bala, a 32-year-old mother of six living in Yangoji, a rural community along the Abuja-Lokoja Expressway, typifies the aforesaid.
Bala never planned to have a large family.
Aside her inability to access to contraceptives, she faced cultural opposition to family planning.
“Each pregnancy was unplanned, and every time, I feared for my life,” Baba said, reflecting on the challenges she faced in managing her reproductive health.
Her story is not unique; Nigeria has one of the highest maternal mortality rates globally—512 deaths per 100,000 live births— with unintended pregnancies playing a major role.
Despite efforts to expand reproductive health services, only 20 per cent of married women and 50 per cent of sexually active unmarried women use contraception.
The unmet need for family planning remains high at 21 per cent for married women and 3 per cent for unmarried women.
Nigeria is striving to meet its 27 per cent Contraceptive Prevalence Rate (CPR) target by 2030, but persistent barriers—economic constraints, cultural resistance and limited healthcare access—continue to slow progress.
The 2023–24 Nigeria Demographic and Health Survey (DHS): Modern contraceptive use is 15 per cent for married women and 38 per cent for unmarried women.
According to the 2023–24 Nigeria Demographic and Health Survey (DHS), modern contraceptive use is 15 per cent for married women and 38 per cent for unmarried women.
The South West has the highest modern contraceptive use at 43.9 per cent, while the North West (11 per cent) and North East (13.1 per cent) have the lowest rates.
The most common methods for married women are implants and injectables, while unmarried women predominantly use male condoms and withdrawal methods.
Nigeria’s high fertility rate of 5.3 children per woman continues to strain healthcare and economic resources.
High fertility increases the burden on maternal healthcare systems, contributing to overcrowded hospitals, overworked healthcare workers, and limited resources for essential services.
“Expanding family planning services is critical too; reducing maternal deaths by preventing unintended pregnancies and high-risk births, improving child health by ensuring adequate birth spacing, and fostering economic growth by allowing families to better allocate their financial resources,” experts say.
Locally, several policies have been adopted to improve family planning.
The policies include inter alia, the National Family Planning Blueprint (2020- 2024), which sets ambitious goals for expanding contraceptive access; integration of family planning services into primary healthcare centres to make them more accessible.
Another key policy is donor partnerships with organisations like UNFPA and USAID, which provide contraceptive supplies and technical support.
However, stakeholders say funding remains a major challenge.
Despite government pledges, budgetary allocations for family planning are inadequate and often rely on international donors.
A troubling development is the 97 per cent reduction in family planning funding, from N2.23 billion in 2024 to N66.39 million in 2025.
Stakeholders warn that this drastic cut jeopardises Nigeria’s reproductive health goals and could reverse gains made in maternal and child health.
Dr Ejike Oji, Chairman of the Association for the Advancement of Family Planning in Nigeria, sounded a note of caution. “Without proper funding, family planning programs will collapse, leading to more unintended pregnancies and maternal deaths,” he said.
For many women in the Federal Capital Territory (FCT), Nasarawa and Niger, the cost of contraception is a significant barrier.
For the sake of clarity, these are the prices of some contraceptives in private health facilities: Oral Contraceptive Pills (Combifem, Levofem): N700 – N2,300; Injectables: N3,000 – N7,500; implants: N10,000 – N40,000; condom — N500 – N5,000.
For low-income families, these costs are prohibitive.
Mrs Asabe Shaibu, a market vendor in the Gajiri community along the Abuja-Kaduna Expressway, spoke in dismay.
“I wanted to space my children, but I couldn’t afford family planning services,” she said.
A Guttmacher Institute study found that every N1, 000 invested in family planning saves N4, 000 in maternal healthcare costs.
Expanding access could prevent 1.5 million unintended pregnancies annually, saving the public health system an estimated N1.2 billion.
Religious and traditional beliefs shape family planning decisions; some religious leaders oppose contraception, while others support birth spacing to protect maternal and child health.
According to Imam Yusuf Bello, a cleric in Etsu Gudu, Niger, a village where women often give birth on the mountainside due to a lack of healthcare facilities, Islam supports child spacing if it ensures the well-being of the mother and child.
“The challenge is misinformation, which we must correct.”
Bello explained the importance of engaging religious leaders in advocacy efforts.
“In many Nigerian households, men make reproductive decisions, leaving women with little say in contraceptive choices.
“Addressing male involvement in family planning programs could significantly improve uptake,” he said.
Millions of Nigerian women live in rural or hard-to-reach areas, where family planning services are scarce.
A 2023 study found that over 60 per cent of rural women lack access to modern contraceptives due to shortage of trained health workers; limited healthcare facilities; poor road networks restrict movement.
Worthy of note, several initiatives are working to bridge these gaps. The Integrate Project – trains community pharmacists and health workers to provide contraceptives in underserved areas.
The Family Health and Empowerment Initiative (Niger State) – works with religious leaders to change cultural perceptions of family planning.
MSI Nigeria Reproductive Choices, a leading provider of sexual and reproductive health services across all 36 states and the FCT, provides mobile family planning services to remote communities across Nigeria including in the FCT.
Mr Emmanuel Ajah, Country Director, MSI Nigeria Reproductive Choices, said that in 2024, the organisation supported more than 3.5 million women and girls in accessing family planning (FP), with more than 2 million choosing Long-Acting Reversible Contraceptives (LARC).
Ajah said that about 64 per cent of the clients had no other access to FP services.
“MSI Nigeria, in collaboration with the government at all levels, currently meets about 35 per cent of Nigeria’s FP demand through public facilities, private partnerships, and its medical centres,” he said.
He said that the organisation employed more than 500 Community-Based Mobilisers and 65 Social and Behaviour Change Communication Officers to raise awareness in urban and rural areas.
Additionally, he said the organisation offered a toll-free contact centre (22252) for counselling, advice and referrals on reproductive health.
Mrs Godiya Auta, a 27-year-old mother of three in the Amba community, Nasarawa State, said she never considered contraception until a health worker explained her options.
“Now, I can space my pregnancies and focus on my family,” Auta said.
To accelerate progress, Dr Funmilola Ola-Olorun, Senior Lecturer at the University of Ibadan, stressed the need for annual two per cent growth in contraceptive prevalence.
Ola-Olorun stressed increased domestic funding to reduce reliance on donors and the need to expand access to rural areas through community-based healthcare workers.
“Family planning education integrated into the secondary school curriculum and greater engagement of traditional and religious leaders,” she said.
Prof. Oladapo Ladipo, the President Emeritus of the Association for Reproductive and Family Health (ARFH), proposed creative approaches to normalise family planning, including attaching condoms to bottles of beer to spark conversations about sexual health.
According to Mrs Maimuna Abdullahi, a Health Economist and Monitoring & Evaluation Specialist at the African Health Budget Network (AHBN), every woman deserves the right to decide if, when, and how many children to have.
Health experts hold that family planning is not just a women’s issue rather a national priority; investing in reproductive health will save lives, reduce maternal mortality and drive economic growth.
They say that in Nigeria’s quest to attain a healthier, more prosperous future, addressing family planning gaps must remain a top priority.
Recommended for you
Leave a Reply
Leave a Reply
