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Promoting gender equality through investments in sexual and reproductive health

Improved access to health services

Landkarte von Nigeria

As of: 01/2023

Nigeria’s healthcare sector is still underdeveloped compared to other emerging economies. Positive economic development and the fight against poverty depend on improvements in the social sectors, especially the health sector. Strong population growth poses a major challenge, as the majority of people are under 18 and therefore economically dependent on relatives. There can only be a demographic bonus after a significant decline in the birth rate, which could be utilised as a demographic dividend if state control and investment in health, education and employment are appropriate. At the same time, the demand for healthcare services has continued to rise in the wake of the COVID-19 pandemic. On behalf of the Federal Ministry for Economic Cooperation and Development (BMZ), KfW is carrying out a project to improve access to sexual and reproductive health and rights (SRHR) in Nigeria.

Project titleReproductive health and pandemic resilience
Commissioned byCommissioned by Federal Ministry for Economic Cooperation and Development (BMZ)
Country/RegionNigeria
Project partnersMarie Stopes International Organization Nigeria (MSION)

Current situation

Sexual and reproductive health and rights are significantly worse in Nigeria than in comparable African countries. Worldwide, 219 million women do not have access to contraceptives. Over 50 million of these women live in Nigeria. On average, a woman in Nigeria has 5.3 children. Mothers are about 70 times more likely to die at birth than in Germany. The high population growth rate of 2.5% is jeopardising Nigeria’s economic development, as around half of the population live on less than USD 1.9 per day – in other words, in bitter poverty. In the face of these problems, Nigeria aims to achieve demographic change while improving the health of mothers and children.

Arzt in einer Gesundheitsstation versorgt eine Patientin

Project approach

On behalf of the German Federal Government, KfW is improving access to services in sexual and reproductive health and rights (SRHR) in Nigeria. Access is currently restricted due to various factors: social norms require a sensitive approach to sexual education, causing a lack of knowledge about SRHRs for girls and women. In addition, healthcare facilities often do not have the capacity to provide women with sufficient counselling and treatment on SRHR. For example, there is a lack of contraceptives. Moreover, women and men often cannot afford contraceptives. The COVID-19 pandemic only reinforced these barriers to access further.

The project addresses these issues in four different ways. (1) New communication channels and cooperation with non-governmental organisations help to increase the acceptance of measures for family planning and the use of contraceptives. Care is taken to ensure that the measures are appropriate for the local conditions. (2) The Ministry of Health is seeing its competences strengthened with regard to SRHR. This includes collecting data and training health workers in the public sector. (3) Public health institutions provide improved access to and an expanded choice of SRHR services. In addition, mobile teams provide SRH services to women and girls in remote regions. Contraceptives are also sold via various distribution channels at affordable prices (social marketing). (4) To combat the increase in domestic violence in the wake of the COVID-19 pandemic, awareness-raising measures and dialogue formats address gender-based violence.

Overall, the project integrates a wide range of SRHR issues. These include family planning, abortion aftercare, cervical cancer screening, menstrual hygiene, and the prevention of sexual and gender-based violence or supporting those who have suffered such violence.

Impact

The project aims to improve the sexual and reproductive health of 1.5 million people, in particular women and marginalised groups. Indirectly, private providers of health services and health personnel from the government sector also benefit from the project: Health personnel receive further training, including awareness-raising measures on sexualised violence. The project also supports local civil society organisations such as the Muslim women’s network FOMWAN. This gives the project greater legitimacy. At the same time, support is provided to organisations that focus on women’s rights.

Overall, the project aims to improve the use of SRHR services and products. This also promotes self-determined family planning, which allows more individual decision-making about when and how many children a couple would like to have. This is a stepping stone out of poverty, and fosters gender equality among women. As a result, the proportion of people who know and use modern contraceptive methods is expected to increase. The same applies to the number of girls and young women who are educated about menstrual hygiene. Lastly, women who are victims of sexual violence should make greater use of initial consultations. This helps them to cope with trauma and creates discussion spaces on topics that were previously taboo.

The project contributes to the achievement of these following United Nations Sustainable Development Goals:

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