Youth Reproductive and Sexual Health in Nigeria Print

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Nearly one third  of Nigeria’s total population of 148.1 million is between the ages of 10 and 24.1,2 Nigerian adolescents’ sizeable share of the population makes them integral to the country’s social, political and economic development. Nigeria’s development is compromised by the sexual and reproductive health issues afflicting its youth. Lack of sexual health information and services make young people vulnerable to sexually transmitted infections (STIs) and unintended pregnancy. However, many organizations are working to improve adolescent reproductive and sexual health through advocacy and prevention programming.

Contraceptive use is low and youth underestimate risks of unprotected sex.

  • Twenty-seven percent of single, sexually active teen women report using some form of modern contraception. A little over half of young single, sexually active women between 20 and 24 use modern contraception.2
  • The rate of married teens and young women using contraception is much lower. Four percent of married teen women use modern contraceptives and fewer than 10 percent of married young women use them.2
  • The use of modern contraceptive methods among sexually active adolescent women has changed very little, from 4 percent in 1990 to 8 percent in 2003.  Similarly, unmet need for modern contraception remains high: Nearly one-third of sexually active women aged 15-24 had an unmet need for contraception in 2003.3
  • In a study on the perception of risk among college students in Osun State, Nigeria, 40 percent of the respondents reported engaging in unprotected sex in the month prior to being surveyed.4  Only 15 percent of the college students surveyed students perceived themselves to be at moderate-to-high risk of HIV infection. Health investigators categorized 77 percent of students surveyed as having a high risk of HIV infection and a mere 23 percent as having a low risk of contracting the virus.4

Young women are at risk of unintended pregnancy, often resulting in unsafe abortion.

  • Over 1.3 million unintended pregnancies occur annually in Nigeria. Well over half (760,000) of these pregnancies result in abortion.5
  • Fifty-four percent of young women in Nigeria give birth by age 20.6
  • The best maternal mortality estimate for Nigeria suggests that 54,000 women die each year due to pregnancy-related complications.6 The risk of injury and death from pregnancy-related complications is higher among teenaged mothers because they are more likely to experience an unsafe abortion and because they experience a higher risk of complications at birth due to underdeveloped bodies.
  • Abortion is illegal in Nigeria, except to save a woman’s life. As such, the majority of the abortions occurring in the country are unsafe.5 Experts believe that unsafe abortion accounts for up to 40 percent of maternal deaths in Nigeria.5
  • Even when young women are fortunate enough to survive an unsafe abortion, they often experience complications, including infection, hemorrhage, anemia and septic shock. There are also long-term consequences to unsafe abortion such as pelvic pain, pelvic inflammatory disease and infertility.5 
  • Fifty-five percent of Nigerian women who have abortions are under 25 years old.5

Youth are at risk of HIV and lack knowledge about STIs, including HIV.

  • Young  Nigerian women are almost three times as likely to be infected with HIV as young Nigerian men  - 2.3 percent of young women are HIV positive, compared to 0.8 percent of young men.7
  • Nigeria ranks third in terms of the actual number of people infected with HIV after India and South Africa.7
  • In a national health survey, 62 percent of young women indicated that they had no knowledge of STIs. Forty-three percent of young men said that had no knowledge of STIs.8
  • Though general knowledge about STIs is low, knowledge of AIDS is high.  Eighty-five percent of women and 95 percent of men between 15 and 24 indicated that they had heard  of AIDS.8
  • Nevertheless, thorough knowledge about HIV/AIDS is still low. In a Population Reference Bureau study, only 18 percent of young women and 21 percent of young men correctly identified two ways to avoid getting HIV/AIDS and rejected common myths about the illness.2

Attitudes towards traditional gender roles lead to unsafe sexual practices.

  • Traditional Nigerian masculinity is defined by strength, a desire for sex and not allowing oneself “to be dominated by a woman.” This traditional model of masculinity encourages men, young and old, to dominate relationships with women.9
  • In male-dominated relationships, men may be less likely to accept a woman’s request to use a condom or her desire to abstain from sexual engagement entirely, thereby increasing sexual and reproductive health risks for both partners.9
  • A young woman’s difficulty in negotiating condom use is further exacerbated in cross-generational relationships, which are fairly common in parts of Nigeria.  The age gap limits a young woman’s autonomy and her ability to make decisions, including her ability to negotiate condom use or refuse to have sex with a husband who is known to be unfaithful for have an STI. 8,9,10
  • The influence of masculinity and perceived “machismo” has also limited the use of sexual and reproductive health services by young men.  Young men, often, believe that use of health services and other positive-seeking behaviors signifies a sign of weakness.9

Civil society organizations are implementing important advocacy and prevention initiatives.

  • Since democratic elections in 1999, Nigeria’s government has been more willing to address HIV/AIDS. The government is also credited with being more open than it had been, allowing civil society to take the lead in addressing sexual and reproductive health concerns.11
  • The Association for Reproductive and Family Health (ARFH) implements sexual and reproductive health and family planning services for people of Nigeria. ARFH focuses on adolescent development in order to enhance the sexual and reproductive health and rights of individuals and couples.12
  • International Center for Reproductive and Sexual Rights (INCRESE) advocates for the rights of marginalized young people, including sex workers, lesbian, gay, bisexual and transgender (LGBT) and people with disabilities at the local, regional and global levels.13
  • Education as a Vaccine Against AIDS (EVA) is an organization founded and managed by young people whom apply the principles of positive youth development to address the intersections of the AIDS epidemic and sexual and reproductive health issues in Nigeria and internationally.14
  • Nigeria’s Education as a Vaccine Against AIDS (EVA) and Advocates for Youth support a national youth advocacy leadership council, Youth Advocate Group (YAG), that works to: hold the government accountable for the full and responsible utilization of funds allocated for adolescent reproductive and sexual health; promote the meaningful participation of youth in decision-making regarding policies; and increase access to youth-friendly reproductive and sexual health information and services, including access to contraceptive commodities for young women.

Written by Melodi Sampson, Advocates for Youth;
Reviewed by Education as a Vaccine Against AIDS (EVA).

References

  1. Population Reference Bureau. 2008 World Population: Data Sheet. Washington, DC: Author, 2008.
  2. Population Reference Bureau. The World’s Youth 2006: Data Sheet. Washington, DC: Author, 2008.
  3. Sedgh G et al. Meeting Young Women’s Reproductive and Sexual Health Needs in Nigeria. New York:  Guttmacher Institute, 2009.
  4. Ijadunola K., et al. “College Students in Nigeria Underestimate their Risk of Contracting HIV/AIDS Infection.” The European Journal of Contraception and Reproductive Health Care 2007; 12(2): 131-137.
  5. Guttmacher Institute. “In Brief: Reducing Unsafe Abortion in Nigeria.” Washington, DC: Author, 2008.
  6. USAID.  Maternal Health in Nigeria.  Accessed from http://pdf.usaid.gov/pdf_docs/PNACR879.pdf on May 11, 2009.
  7. Joint United Nations Programme on HIV/AIDS (UNAIDS). “2008 Report on the Global AIDS Epidemic.” Geneva, CH: Author, 2008.
  8. National Population Commission. Nigeria Demographic and Health Survey 2003. Abuja, Nigeria: Author, 2004.
  9. Odimegwu C., et al. “Men’s Perceptions of Masculinities and Sexual Health Risks in Igboland, Nigeria.” International Journal of Men’s Health 2008; 7(1): 21-40.
  10. Population Council. “Child Marriage Briefing: Nigeria.” New York, NY: Author, 2004.
  11. USAID. “Nigeria Country Strategic Plan 2004-2009.”  Washington, DC: Author, 2009.
  12. Association for Reproductive and Family Health. “Background.” http://arfh-ng.org/background.htm (accessed March 16, 2009).
  13. International Center for Reproductive health and Sexual Rights.  “International Center for Reproductive and Sexual Rights” http://www.increse-increse.org ((accessed May 11, 2009)
  14. Education as a Vaccine Against AIDS (EVA).  “Education as a Vaccine Against AIDS”. http://www.gpinigeria.org/ (accessed May 11, 2009) http://www.evanigeria.org (accessed May 11, 2009)
 
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